Out-of-State Nursing Facility Placement Cover Page - Washington, D.C.

Out-of-State Nursing Facility Placement Cover Page - Washington, D.C.

Out-of-State Nursing Facility Placement Cover Page is a legal document that was released by the Washington DC Department of Health Care Finance - a government authority operating within Washington, D.C..

FAQ

Q: What is the Out-of-State Nursing Facility Placement Cover Page?A: The Out-of-State Nursing Facility Placement Cover Page is a document used in Washington, D.C. to request placement of a resident in an out-of-state nursing facility.

Q: Who uses the Out-of-State Nursing Facility Placement Cover Page?A: The Out-of-State Nursing Facility Placement Cover Page is used by individuals, healthcare providers, and agencies in Washington, D.C. who need to place a resident in an out-of-state nursing facility.

Q: What is the purpose of the Out-of-State Nursing Facility Placement Cover Page?A: The purpose of the Out-of-State Nursing Facility Placement Cover Page is to provide necessary information and documentation for the placement of a resident in an out-of-state nursing facility.

Q: What information is required on the Out-of-State Nursing Facility Placement Cover Page?A: The Out-of-State Nursing Facility Placement Cover Page requires information such as the resident's name, date of birth, current facility, medical condition, and the requested out-of-state nursing facility.

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Form Details:

  • Released on September 11, 2019;
  • The latest edition currently provided by the Washington DC Department of Health Care Finance;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Washington DC Department of Health Care Finance.

Download Out-of-State Nursing Facility Placement Cover Page - Washington, D.C.

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