Application for Determination of Eligibility for Long-Term Care Home Admission (Home and Community Care Support Services)

To be filled out by LTC home applicants as part of the process for determination of eligibility for admission to a LTC home. This completed form is for use by Home and Community Care Support Services (HCCSS) as the designated placement co-ordinators for long-term care homes, as per the Fixing Long-Term Care Act, 2021, s 47(1).

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Form Number 014-4767-69
Title Application for Determination of Eligibility for Long-Term Care Home Admission (Home and Community Care Support Services)
Description To be filled out by LTC home applicants as part of the process for determination of eligibility for admission to a LTC home. This completed form is for use by Home and Community Care Support Services (HCCSS) as the designated placement co-ordinators for long-term care homes, as per the Fixing Long-Term Care Act, 2021, s 47(1).