3122 DAL

TO:	Adult Care Facility and Assisted Living Members
FROM:	Diane Darbyshire, Senior Policy Analyst
DATE:	April 23, 2009
SUBJECT:	DOH Issues Additional DAL Regarding Completion of ALR Medical Evaluation
ROUTE TO:	Administrators, Program Directors

ABSTRACT: Nurses can also assist in completion of 3122 under certain circumstances.

The Department of Health (DOH) has issued a Dear Administrator letter (DAL) regarding the completion of the Assisted Living Residence (ALR) Medical Evaluation form (DOH 3122). The letter discusses the ability for a nurse working in conjunction with the administrator and/or case manager to assist in completing the form under certain circumstances outlined in a previous DAL issued on February 2, 2009.

Both DALs are posted on the ACFs page of the Health Provider Network (HPN), and are also provided at the bottom of this screen as attachments for your convenience.

If you have any questions regarding the contents of this memo, please contact Diane Darbyshire at ddarbyshire@nyahsa.org or 518-449-2707, ext. 162.

Attachments

N:\NYAHSA\Policy\ddarbyshire\ACF DALs\Memo DAL nurse can complete 3122 4 09.doc

3122 DAL February 09 3122 DAL: Read More

3122 DAL April 09 3122 DAL: Read More

3122 DAL PDF Version: Read More