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Department of Health Services
Division of Long Term Care
Residential Provider Reassessment
The Centers for Medicare and Medicaid Services (CMS) requires states to evaluate current Home and CommunityBased
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What is see residential provider self?
See residential provider self is a form used by residential providers to report their information to the appropriate authorities.
Who is required to file see residential provider self?
All residential providers are required to file see residential provider self.
How to fill out see residential provider self?
See residential provider self can be filled out online or submitted through mail, following the instructions provided on the form.
What is the purpose of see residential provider self?
The purpose of see residential provider self is to ensure that residential providers are compliant with regulations and to provide accurate information to the authorities.
What information must be reported on see residential provider self?
Residential providers must report their contact information, services provided, and any relevant certifications or licenses.
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