AHCA's Updated July 2014 Edition of The Long Term Care Survey Manual Get the most widely used and easy-to-follow survey reference manual on the market today, with all the latest revised CMS guidance. This edition includes revised guidelines for 20 F-tags in Appendix PP that CMS released in mid-July 2014. This is the first major update since March 2013. PRODUCT NUMBER ITEM DESCRIPTION/TITLE LTC Survey (Binder) 6775N-0714 6775-0714 Dollars Spent $0 - $24.95 $25 - $49.95 $50 - $99.99 $100 - $149.99 $150 - $199.99 $200 - $249.99 $250 - $349.99 $350 - $449.99 $450 - $549.99 $550 - $1,000 $1,000.01 - $2,000.00 $2,000.01 - $3,000.00 QUANTITY UNIT PRICE $79.95 $59.95 LTC Survey (Softbound) Shipping cost $8.95 $12.95 $16.95 $20.95 $24.95 $28.95 $34.95 $42.95 $52.95 $69.95 $129.95 $199.95 Dollars Spent $3,000.01 - $4,000.00 $4,000.01 - $5,000.00 $5,000.01 - $6,000.00 SUBTOTAL Shipping cost $280.00 $360.00 $440.00 SHIPPING & HANDLING (SEE CHART) PRIORITY FEES DC (5.75%) ANDMD(6%) ADD SALES For orders above $6,000, please call our customer service team for a shipping quote: 800-321-0343 PRIORITY FEES (Add to standard rates) Next Day (early a.m.) $45.00 Next Day $25.00 2nd Day $15.00 TAX TOTAL SHIP TO: (If different from “Ordered By”) Name Organization ORDERED BY: (PLEASE PRINT CLEARLY. ITEMS IN BOLD ARE REQUIRED.) Address Name City Title Phone Organization Fax Address E-mail City State Zip State Zip We cannot ship to a P.O. Box. This address is a: Phone TOTAL COST ¡ Facility/Business ¡ Residence Fax E-mail (Necessary to receive order confirmation) Is your organization a member of AHCA? ¡ Yes ¡ No PAYMENT METHOD: (Please check one, sorry, no cash or COD’s) ¡ Check enclosed payable to “AHCA” (A $25.00 fee will be chared on all returned checks) ¡ Visa ¡ MasterCard ¡ American Express Acct #: Exp. Date: Name as it appears on card: Signature: You can place your order by phone or fax and charge your purchase with Visa, Mastercard, or American Express. AHCA awaits your call weekdays between 9:00 a.m. and 5:00 p.m. (EASTERN TIME). We suggest you list the items, product numbers, and quantities and have your credit card information handy for our staff when you call toll-free! FOR FASTER SERVICE: Call toll-free: 1-800-321-0343 Fax your order: 1-800-869-5605 Order Online: www.AHCApublications.org www.NCALpublications.org FOR MAIL ORDERS: Use our convenient order form and mail your order with payment to: AHCA/NCAL Fullfilment PO Box 1340 Hurlock,MD 21643 PUB14
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