6170 form - dhcs ca-2025

See details

3.9 out of 5

40 votes

The document is a Preadmission Screening and Resident Review (PASRR) Level I Screening Document required by the State of California's Department of Health Care Services. It mandates that all residents applying for admission to or residing in Medicaid-certified Nursing Facilities undergo screening for mental illness and intellectual disabilities, as per federal law. The document includes sections for resident identification, facility information, mental health assessments, and various screening questions to determine the need for further evaluation.

Here's how it works

01. Edit your pasrr online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send passr via email, link, or fax. You can also download it, export it or print it out.

The fastest way to redact 6170 form - dhcs ca online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Dochub is the greatest editor for modifying your paperwork online. Adhere to this straightforward guide to redact 6170 form - dhcs ca in PDF format online for free:

Register and log in. Register for a free account, set a strong password, and go through email verification to start managing your templates.
Add a document. Click on New Document and choose the file importing option: add 6170 form - dhcs ca from your device, the cloud, or a secure link.
Make changes to the sample. Utilize the upper and left-side panel tools to edit 6170 form - dhcs ca. Insert and customize text, pictures, and fillable fields, whiteout unneeded details, highlight the important ones, and comment on your updates.
Get your documentation accomplished. Send the form to other parties via email, generate a link for faster document sharing, export the sample to the cloud, or save it on your device in the current version or with Audit Trail added.

Explore all the advantages of our editor today!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Is DHCS the same as Medi-Cal?

DHCS is the single state agency responsible for financing and administering the states Medicaid program, Medi-Cal, which provides health care services to low-income persons and families who meet defined eligibility requirements. Medi-Cal is authorized and funded through a federal-state partnership.

What is Medicaid in California called?

0:22 1:59 First up we have the traditional Medicaid. This ones the original program it covers hospital visitsMoreFirst up we have the traditional Medicaid. This ones the original program it covers hospital visits doctor appointments. And even long-term Medical Care.

What is the full form of DHCS in California?

The California Department of Health Care Services (DHCS) is the backbone of Californias health care safety net, helping millions of Californians every day.

What is the name of the DHCS insurance in California?

Medi-Cal is Californias Medicaid program.

What are the four types of Medicaid?

The California Department of Health Care Services (DHCS) is a department within the California Health and Human Services Agency that finances and administers a number of individual health care service delivery programs, including Medi-Cal, which provides health care services to low-income people.

pasrr california

6170 form dhcs ca template Printable 6170 form dhcs ca 6170 form dhcs ca pdf 6170 form dhcs ca online 6170 form dhcs ca download Dhcs Medi-Cal application Medi-Cal forms DHCS CA gov Services

Is California DHCS Medicaid?

Medi-Cal is Californias Medicaid program. This is a public health insurance program that provides free or low cost medical services for children and adults with limited income and resources.