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DEPARTMENT OF HUMAN SERVICES AGING AND PEOPLE WITH DISABILITIES DIVISION OREGON ADMINISTRATIVE RULES CHAPTER 411 DIVISION 58 LONG TERM CARE REFERRAL SERVICES 411058000 Definitions (1) Applicant means
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How to fill out long term care referral

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How to fill out long term care referral

01
To fill out a long term care referral form, follow these points:
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Start by gathering all the necessary information about the patient, including their personal details, medical history, and any specific care requirements.
03
Contact the appropriate healthcare provider or agency to obtain the referral form.
04
Carefully read and understand the instructions provided on the form.
05
Fill in the patient's personal information, such as their name, contact details, and date of birth.
06
Provide details about the patient's medical condition and any relevant diagnoses.
07
Indicate the desired type of long term care service needed, such as home care, assisted living, or nursing facility.
08
Include any additional information or special requirements, such as dietary restrictions or mobility aids.
09
Review the completed referral form to ensure accuracy and completeness.
10
Submit the form to the designated healthcare provider or agency through the preferred submission method, whether it is online, mail, or in-person.
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Keep a copy of the referral form for your records.
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Remember to consult with healthcare professionals or caregivers for specific guidance related to the long term care referral process.

Who needs long term care referral?

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Long term care referral is required for individuals who require ongoing assistance with their daily living activities due to physical or cognitive impairments.
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Common individuals who may need a long term care referral include:
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- Elderly individuals who have difficulty performing activities of daily living independently.
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- Individuals with chronic illnesses or disabilities that limit their mobility or ability to care for themselves.
05
- Patients recovering from surgery or medical procedures who need extended recovery and assistance.
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- Individuals with progressive cognitive conditions, such as Alzheimer's disease or dementia, requiring specialized care and supervision.
07
- Those in need of palliative care or end-of-life support.
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It is best to consult with healthcare professionals or social workers to determine if a long term care referral is necessary for a specific individual.
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Long term care referral is the process of recommending or suggesting a specific care plan or facility for individuals who require ongoing medical or personal care assistance.
Healthcare professionals, social workers, or family members may be required to file a long term care referral for an individual in need of specialized care.
To fill out a long term care referral, one must gather information about the individual's medical history, current needs, and preferences, and submit the referral to the appropriate care facility or agency.
The purpose of long term care referral is to ensure that individuals in need of long-term care receive appropriate and specialized assistance to improve their quality of life.
Information such as the individual's medical history, current health status, care preferences, and any specific needs or requirements must be reported on a long term care referral.
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