New Jersey will become the first state to require the use of a standardized form when a nursing home resident is transferred to a hospital, or when a resident is moved to a long-term care facility from the hospital.

The form, called the Universal Transfer Form, is one page and includes information such as the individual’s vital signs, diagnosis, medications, allergies and respiratory needs, the publication NJToday.net reported. The requirement takes effect on October 30.

Home health and nursing home groups, local hospital associations and other healthcare stakeholders worked together for over three years to develop and test the form.

“A Universal Transfer Form has been a goal of New Jersey’s healthcare system for many years,” Paul Langevin, president of the Health Care Association of New Jersey, told NJToday. “Anyone who moves within the healthcare system will have a synopsis of their prognosis, critical care needs and treatment plan.”