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DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance F02111 (05/2017) STATE OF WISCONSIN Wis. Stat. Chapter 50-Page 0 of 8 ASSISTED LIVING Fits AND QUALIFIED APPLICATION For CommunityBased
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What is ASSISTED LIVING FIT AND QUALIFED APPLICATION Form?

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Assisted living fit and is a form of housing for elderly or disabled individuals who may need assistance with daily activities.
Assisted living facilities or caregivers responsible for the residents are required to file assisted living fit and.
Assisted living fit and can be filled out online or submitted in paper form with all required information and documentation.
The purpose of assisted living fit and is to ensure that the residents in assisted living facilities are receiving adequate care and support.
Information such as resident demographics, medical history, care plan, and any incidents or concerns must be reported on assisted living fit and.
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