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Long Term Care

This page is used by Acute Care and Long Term Care facilities to obtain forms, protocols, and other documentation that support their work with the County of San Diego clients needing referral or continued stay authorization in Long Term Care Facilities funded by the County of San Diego.

County LTC Admission and Concurrent Review Criteria

Applications

Facility Credentialing Application Instructions (doc)
2016-08-26

Forms

SF-LTC_Documentation_Needed_for_Referral_For_County_Funded_SNF.pdf
County Funded SNF 2016-08-15
SF-LTC_Mini-Cog_Exam.doc
All 2016-08-15
SF-LTC_Referral_Process_for_County_Funded_SNF.pdf
County Funded SNF 2016-08-15
SF-LTC_Referral_Screening_Form_Tips.pdf
2016-08-26
SF-LTC_Verification_of_Admission_and_Request_for_Initial_Authorization_to_SNF.pdf
2016-08-26
Case_Manager_Recommendation_for_Initial_Referral_to_LTC.doc
All 2017-12-22
SNFs_Contracted_with_Optum.docx
County Funded SNF 2018-09-05
Admin Day Request Form for LTC (doc)
ALL 2019-08-23
Bed Hold Request (doc)
2019-08-19
Bed Hold Return (doc)
2019-08-16
Case Management Concurrent Recommendation Long-Term Care County Funded SNF (pdf)
2016-08-15
Concurrent Review Guide for County Funded SNF (doc)
County Funded SNF 2017-08-24
Discharge Notification (doc)
ALL 2019-08-26
Documentation Needed for State Hospital Referral (pdf)
State Hospital 2017-12-22
Documentation for Concurrent Review (doc)
ALL 2019-08-26
Documentation needed for IMD (doc)
2019-08-06
Documentation needed for SNF or NBU Patch (doc)
SNF Patch 2019-06-26
LTC Levels of Care Summary (doc)
Updated 08/15/2019 2019-08-15
LTC Referral Screening Form (doc)
ALL 2019-08-26
Representative Payee Form (doc)
2019-08-19
Transfer Notification Form (doc)
All 2018-03-07
Verification of Admit to LTC Facility (doc)
ALL 2019-08-23

Manuals

Skilled_Nursing_Facilities_Handbook_-_3rd Edition.pdf
2016-08-26