Part 822-4 Level of Care Determination Admission Decision (TA-4 - oasas ny 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the Patient Name and Patient ID # at the top of the form. This information is essential for identifying the patient throughout the assessment process.
  3. Proceed to evaluate the Non-Crisis Level of Care Determination by answering each LOCADTR Criteria question. For each criterion, select 'yes' or 'no' based on the patient's condition.
  4. Follow through with subsequent questions regarding functional skills, health care needs, and social support systems. Each response will guide you to the appropriate level of care needed.
  5. Once all sections are completed, review your answers carefully. Ensure that any additional factors relevant to placement are noted in the comments section.
  6. Finally, have a clinical staff member sign and date the form at the bottom to validate the admission decision.

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