The Adult Long Term Care Functional Screen instructions are available both by individual module and as a complete document.
View/print complete set of LTC FS Instructions:
Wisconsin Long Term Care Functional Screen Instructions (PDF, 942 KB) Revised 10/8/2015, unmarked copy, 144 pages
Marked copy (PDF, 753 KB) of the LTC FS Instructions with recent changes highlighted so that screeners are able to note new areas.
View/print by module:
- Module 1: Overview of the LTC FS
- Module 2: LTC FS Target Groups
- Module 3: LTC FS Basic Information (Screen Information, Demographics)
- Module 4: ADLs and IADLs
- Module 5: Diagnoses
- Module 6: Health-Related Services (HRS) Table
- Module 7: Communication and Cognition
- Module 8: Behavioral Health
- Module 9: Risk
- Module 10: Completion of the Screen and Notes