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KDHE Home - Health - Bureau of Health Facilities - LTC Semi-Annual Report

Long Term Care Semi-Annual Report Forms Information

This page contains copies of the Long Term Care Semi-Annual Report forms and instructions. This report gathers information on long term care facility residents and employees in accordance with KAR 28-39-163(d). There are three versions of this report: one for nursing facilties and nursing facilities for mental health; one for intermediate care facilties for the mentally retarded; and one for assisted living and residential health care facilties.

This page was last updated on: 12-30-03


The files listed below are in Adobe Acrobat (.pdf) format. Viewing these files through your internet browser requires the Adobe Acrobat Reader® plug-in. Please contact  Adobe Systems, Inc.®. for assistance with download, installation, or use of the plug-in.

Nursing Facilities and Nursing Facilities for Mental Health:

Intermediate Care Facilities for the Mentally Retarded:

Assisted Living and Residential Health Care Facilities: