A Vdss Model Form Alf is an approach to developing a Variable Data Set Structure (VDSS) for data sets that are of varying granularity and complexity. By providing analysts with the ability to organize and access specific fields, this method creates a straightforward way of determining how information should be processed or retrieved from datasets throughout their lifecycle. This structure allows for the efficient management of all relevant datasets, avoiding redundant sources, as well as simplifying analysis processes. In this blog post, we will go in-depth into what makes up a VDSS Model Form Alf and how it can provide valuable insights for any data set analysis project.
| Question | Answer |
|---|---|
| Form Name | Vdss Model Form Alf |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | relocation, VAC, UAI, NOTIFICATION |
VDSS MODEL FORM - ALF
DISCHARGE NOTIFICATION AND STATEMENT
(SEE 22 VAC
RESIDENT'S NAME: _____________________________________________________________________
|
|
Method of |
1. |
Date of discharge notification to resident: ________________ |
notification: _______________ |
2.a. |
Date of discharge notification to legal representative, if any:_______________________________ |
|
|
Name of |
Method of |
|
legal representative: ________________________________ |
notification: _______________ |
2.b. |
Date of discharge notification to designated contact person, if any: __________________________ |
|
|
Name of |
Method of |
|
designated contact person:___________________________ |
notification: ________________ |
3.Reason(s) for the discharge: __________________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
4.Actions taken by the facility to assist the resident in the discharge and relocation process:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
5.Date of the discharge: ______________________________
Destination (name and address): _______________________________________________________
__________________________________________________________________________________
6.If emergency discharge, name(s) of person(s) notified, relationship(s) to the resident, and date(s) of
notification: _______________________________________________________________________
__________________________________________________________________________________
7.If the UAI was completed by a public human services agency assessor and the resident is discharged or dies, name of assessor, agency, and date assessor notified: _______________________________
__________________________________________________________________________________
8.Date discharge statement provided (or mailed, option if emergency) to resident, legal representative and designated contact person: _________________________
Signed by: ___________________________________________ Date: __________________________
(Licensee or Administrator)
___________________________________________
(Name of Facility)