Effective Date: 
1/2018

Documents

 

Instructions

Updated: 1/2018

 

Purpose

Form 1016 is used by the Local Intellectual and Developmental Disability Authority (LIDDA) service coordinator to identify a nursing facility resident’s need for Pre-admission Screening and Resident Review (PASRR) intellectual and developmental disability specialized services.

Procedure

When to Prepare

The LIDDA service coordinator must complete Form 1016 at every service planning team meeting.

Form Retention

Form 1016 must be kept in the resident’s record until notified otherwise by HHSC Legal Services.

Having trouble viewing or downloading a form?

Get Help