Document 6554031

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