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The NC DMA Long Term Care FL2 Form is a comprehensive document used to collect and record essential information about recipients of long-term care services. It includes sections for recipient identification, current and requested levels of care, diagnosis details, personal care assistance needs, functional limitations, and special care factors. The form also requires physician signatures and provides instructions for submission.

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What is a FL2 form in North Carolina?

FL2 (A one-page form completed by the primary care physician that lists patient health conditions, medications, care needed, dietary restrictions, etc.)

What is FL 2 form?

Alternative Dispute Resolution Options (FL-2)

Who fills out the FL2 form?

Once the determination of level of care is made, the physician will complete a document called an FL2. This is a one-page medical form that lists the physicians recommended level of care as well as medical diagnoses, care needs, and medications.

Does Medicaid pay for memory care in North Carolina?

North Carolina Medicaid Programs for Memory Care North Carolina Medicaid pays for the cost of memory care indirectly through the Personal Care Services program.

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