NS Medical Status Report for Long-Term Care Admission

Nova Scotia's Continuing Care program uses this report so the attending physician or nurse practitioner can tell a long-term care facility that a medically stable patient is medically suitable for admission. It complements the Care Coordinator's functional assessment. Facilities require it before admission, and it must be no more than 90 days old on the day the patient is admitted.

Who completes it

The patient's attending physician or nurse practitioner completes and signs the whole report, including whether they are the primary care provider and whether that provider will follow the patient after admission. The Care Coordinator completes the separate functional assessment.

Submitting and payment

How to submit it
Send the completed report, and any update, to the Continuing Care intake office for your area, or directly to the Care Coordinator when one is named on the form.

Good to know

  • List up to six active diagnoses, MRSA and VRE screening results, other infection control issues, and all medications, including non-prescription ones, with dose, frequency and route.
  • If the patient's condition changes significantly before admission, meaning a change that affects the care plan, update the report and send it to the Continuing Care intake office.
  • The form also asks for pneumococcal and influenza vaccine dates, allergies, INR frequency for anticoagulated patients, recent surgery and dressing changes, and code status if established.
  • Only patients ready to move now should apply. Patients join the wait list by assessment date, and hospital patients who refuse the first available bed are removed from it.

Get the official form

Download the current version from the source each time; forms change without notice.

Medical Status Report For Admission to a Long-Term Care Facility

Fill it with Vero

Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

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Frequently asked questions

How long is a Nova Scotia Medical Status Report valid?

It must not be older than 90 days when the patient is admitted to the long-term care facility, and facilities require it before admission. If the patient's condition changes significantly before admission, in a way that would affect the care plan, the attending physician or nurse practitioner must update it regardless of its age.

Can a nurse practitioner complete the Medical Status Report?

Yes. The form is to be completed by the patient's attending qualified medical practitioner or nurse practitioner, for patients who are medically stable. It also asks whether you are the patient's primary care provider and whether that provider will keep following the patient after the move to long-term care.

How does long-term care placement start in Nova Scotia?

The physician's office directs the patient to call Continuing Care. A Care Coordinator assesses the patient's needs and explores options such as Home Care first. Patients assessed as ready for long-term care are wait-listed by the date of their assessment, and the Medical Status Report gives the facility the medical side of the picture.