|Classification / Identification:|
| ||Form Number:||014-4767-69E-LHIN||Edition date: ||2017/05 |
| ||Title:||Application for Determination of Eligibility for Long-Term Care Home Admission (LHIN)|
| ||Ministry:||Health and Long-Term Care|| || |
| ||Branch/ABC:||Licensing and Policy|| || |
| ||Program:||Aging and Long-Term Care Unit|| || |
| ||Purpose of Form:||To be filled out by LTC home applicants as part of the process for determination of eligibility for admission to a LTC home. This form is for use effective the date when LHINs become designated as the placement co-ordinators for long-term care homes by the Ontario Ministry of Health and Long-Term Care.|| || |
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