MI DHHS DCH-3877 2019 free printable template

READMISSION SCREENING (PAS)/ANNUAL RESIDENT REVIEW (ARR)(Mental Illness/Intellectual Developmental Disability/Related Conditions Identification) Michigan Department of Health and Human Services Level

How to fill out MI DHHS DCH-3877

How to fill out MI DHHS DCH-3877

1. Obtain the MI DHHS DCH-3877 form from the Michigan Department of Health and Human Services website or your local office.
2. Fill out the personal information section, including your name, address, and contact details.
3. Indicate the purpose of the form by checking the appropriate box.
4. Provide details regarding the service or assistance you are requesting.
5. Include relevant information about any income and resources, if applicable.
6. Review the form for accuracy and completeness.
7. Sign and date the form at the designated area.
8. Submit the completed form to the appropriate MI DHHS office.

Who needs MI DHHS DCH-3877?

1. Individuals applying for medical assistance or health services from the Michigan Department of Health and Human Services.
2. Families seeking eligibility for certain assistance programs.
3. People needing special services that require documentation through the MI DHHS DCH-3877 form.

People Also Ask about

What is an OBRA screening Michigan?

OBRA Screening Anyone seeking admission to a nursing facility must be screened for indicators of an Intellectual/Developmental Disability or a mental illness, prior to admission. Residents already in a nursing facility must be screened annually and/or for significant changes in their condition.

What is an involuntary mental health commitment in Michigan?

Involuntary Hospitalization: In order for a person to be involuntarily hospitalized, they must meet the Michigan Mental Health Code definition of a "person requiring treatment." A person may be seriously mentally ill and still not fit that definition.

What is the Michigan mental health Code definition of developmental disability?

(25) "Developmental disability" means either of the following: (a) If applied to an individual older than 5 years of age, a severe, chronic condition that meets all of the following requirements: (i) Is attributable to a mental or physical impairment or a combination of mental and physical impairments.

What is mental health Code Section 403 Michigan?

Sec. 403. Individuals shall receive involuntary mental health treatment only pursuant to the provisions of this act.

What is the mental health code in Michigan?

The Mental Health Code requires a person-centered approach to the planning, selection, and delivery of the supports, services, and/or treatment you receive from the public mental health system (community mental health programs, their service providers and licensed psychiatric hospitals.

What do federal regulations mandate a preadmission screening and resident review Pasrr for?

Preadmission Screening and Resident Review (PASRR) is a federal requirement to help ensure that individuals are not inappropriately placed in nursing homes for long term care.

What is Michigan mental health Code Section 409?

409. (1) Each community mental health services program shall establish 1 or more preadmission screening units with 24-hour availability to provide assessment and screening services for individuals being considered for admission into hospitals or alternative treatment programs.

What is Mdhhs mental health code?

Mental Health Code Section 712 The Mental Health Code requires a person-centered approach to the planning, selection, and delivery of the supports, services, and/or treatment you receive from the public mental health system (community mental health programs, their service providers and licensed psychiatric hospitals.

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What is MI DHHS DCH-3877?

MI DHHS DCH-3877 is a form used by the Michigan Department of Health and Human Services to report specific information related to health care services.

Who is required to file MI DHHS DCH-3877?

Entities and individuals providing certain health care services under Michigan's Medicaid program are required to file MI DHHS DCH-3877.

How to fill out MI DHHS DCH-3877?

To fill out MI DHHS DCH-3877, follow the instructions provided with the form, ensuring all required fields are completed accurately and any necessary supporting documentation is included.

What is the purpose of MI DHHS DCH-3877?

The purpose of MI DHHS DCH-3877 is to collect data necessary for the administration and oversight of health care services under the Michigan Medicaid program.

What information must be reported on MI DHHS DCH-3877?

MI DHHS DCH-3877 requires reporting of information such as provider details, service information, patient demographics, and any relevant data related to the health care services provided.