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PLEASE COMPLETE THE APPLICATION ON A COMPUTER OR PRINT IN Facility Information Facility Legal Name: Facility Doing Business as:Facility Street Address: City: County: Zip Code:Phone Number: Email:
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Who needs assisted living waiver provider?

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What is ASSISTED LIVING WAIVER PROVIDER APPLICATION - California Form?

The ASSISTED LIVING WAIVER PROVIDER APPLICATION - California is a fillable form in MS Word extension needed to be submitted to the relevant address to provide specific info. It needs to be completed and signed, which may be done manually, or with the help of a particular software like PDFfiller. This tool helps to complete any PDF or Word document directly from your browser (no software requred), customize it depending on your needs and put a legally-binding electronic signature. Right after completion, user can easily send the ASSISTED LIVING WAIVER PROVIDER APPLICATION - California to the appropriate receiver, or multiple recipients via email or fax. The editable template is printable as well thanks to PDFfiller feature and options presented for printing out adjustment. In both electronic and in hard copy, your form should have a clean and professional look. It's also possible to save it as the template to use later, without creating a new blank form from scratch. Just amend the ready document.

ASSISTED LIVING WAIVER PROVIDER APPLICATION - California template instructions

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Assisted living waiver provider is a program that allows individuals to receive assisted living services in a community setting instead of a nursing home.
Assisted living waiver providers are required to be filed by assisted living facilities that participate in the waiver program.
Assisted living waiver provider can be filled out by submitting the necessary forms and documentation to the relevant state agency overseeing the program.
The purpose of the assisted living waiver provider is to provide a more cost-effective alternative to nursing home care for individuals who require assistance with daily activities.
Information such as the services provided, number of residents served, and any changes in program offerings must be reported on the assisted living waiver provider.
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