AGING AND DISABILITY SERVICES ADMINISTRATION

September 22, 2004

ADSA: NH #2004-023
REVISED NURSING HOME APPLICATIONS

Dear Nursing Facility/Home Administrator:

As part of our continuing effort to improve customer service and streamline the nursing home license application process, Residential Care Services (RCS) has revised the nursing home license application and the application packet materials.

A number of changes to the nursing home application process will become effective October 1, 2004. The following changes will be implemented.

• The application packet has been revised to include more “user-friendly” instructions and terminology.
• Several concise and/or abbreviated applications have been developed for licensing activities, specifically, a change of ownership. These “mini” applications replace the more extensive application previously used for all initial licensing activities.
• A specific application was created to apply for a Medicaid contract (Medicaid certification).
• Attestation forms have been developed for use when management agreements and lease agreements are part of the licensee’s application.

Effective October 1, 2004, RCS will begin returning incomplete license applications to the applicant. By returning incomplete applications, the applicant will have timely and written detailed information about what is required for continued processing.

The current nursing home license application created in 1996 will not be used on or after October 1, 2004. Please discard all copies of the 1996 application and packet materials you may have on hand.

For your convenience, all of the revised nursing home license application materials will be placed on the ADSA website by October 1, 2004. You may access these materials by going online to http://www.aasa.dshs.wa.gov/professional/nh.htm and selecting the bullet that reads “Revised NH Applications”.

Sincerely,

Patricia K. Lashway, Director
Residential Care Services