MDS 3.0 Section Q - Local Contact Agency Referral And Discharge Planning Process

Local Contact Agency (LCA) Contact Information:

Submit Local Contact Agency Referrals to the Aging Services Division by fax to 701-328-8744 or email at carechoice@nd.gov.

Contact the Aging and Disability Resource LINK at 1-855-GO2-LINK (1-855-462-5465) Monday through Friday, 8 a.m. - 5 p.m. (Central Time) to learn about community living options.

Local Contact Agency Referral Process and Flow Sheets (424kb pdf)
Nursing Facility/Human Service Center Designation (243kb pdf)

Training

Local Contact Agency - Overview Training (May 2017) - Click the "Power button" on the image to begin the training.
MDS Section Q - General Overview Training (May 2017) - Click the "Power button" on the image to begin the training.

Forms

• Plan of Care for Discharge Potential (Print Version) (32kb Word Doc)
• Plan of Care for Discharge Potential (Word Version) (44kb Word Doc)
• Discharge Instructions (Word Version) (158kb Word Doc)
• SFN 584 - Local Contact Agency Referral Form (457kb PDF)
• SFN 585 - Local Contact Agency Transition Plan (967kb PDF)
  

Brochure

• Your Right to Get Information about Returning to the Community (CMS Section Q brochure) (1.54 MB pdf)