Form H1278, Request for Patient Trust Fund Information

Instructions for Opening a Form

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Effective Date: 8/1992

Updated: 3/1993

Form H1278 is an optional form to gather information about a client's patient trust fund.

The eligibility specialist can use Form H1278 for applications and reviews.

Prepare one copy.

Send the form to the nursing facility.

Keep the form according to the retention requirements of the case record.

Self-explanatory.