Form preview

VA Assisted Living Facility Disclosure Statement 2019-2026 free printable template

Get Form
Instructions for Completing the Assisted Living Facility Disclosure Statement Required by the Virginia Department of Social Services The Assisted Living Facility Disclosure Statement is required by
pdfFiller is not affiliated with any government organization

Get, Create, Make and Sign VA Assisted Living Facility Disclosure Statement

Edit
Edit your VA Assisted Living Facility Disclosure Statement form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your VA Assisted Living Facility Disclosure Statement form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing VA Assisted Living Facility Disclosure Statement online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use the services of a skilled PDF editor, follow these steps:
1
Check your account. In case you're new, it's time to start your free trial.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit VA Assisted Living Facility Disclosure Statement. Text may be added and replaced, new objects can be included, pages can be rearranged, watermarks and page numbers can be added, and so on. When you're done editing, click Done and then go to the Documents tab to combine, divide, lock, or unlock the file.
4
Get your file. Select the name of your file in the docs list and choose your preferred exporting method. You can download it as a PDF, save it in another format, send it by email, or transfer it to the cloud.
It's easier to work with documents with pdfFiller than you could have ever thought. Sign up for a free account to view.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

VA Assisted Living Facility Disclosure Statement Form Versions

Version
Form Popularity
Fillable & printabley

How to fill out VA Assisted Living Facility Disclosure Statement

Illustration

How to fill out VA Assisted Living Facility Disclosure Statement

01
Obtain the VA Assisted Living Facility Disclosure Statement form from the appropriate VA office or website.
02
Start by filling out the facility's name and address at the top of the form.
03
Provide the contact information for the facility, including phone number and email address.
04
Indicate the type of services offered by the facility in the designated section.
05
Include a detailed description of the types of assistance provided to residents.
06
State the payment options and fee structure for residents, including any additional charges.
07
List the facility's policies regarding resident rights and responsibilities.
08
Disclose any ownership interests and affiliations of the facility.
09
Have the managing authority review and sign the statement to verify accuracy.
10
Submit the completed Disclosure Statement to the appropriate VA authorities.

Who needs VA Assisted Living Facility Disclosure Statement?

01
The VA Assisted Living Facility Disclosure Statement is needed by assisted living facilities seeking to provide care to veterans.
02
Veterans and their families who are considering assisted living options should also review this statement to understand the services and care available.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.8
Satisfied
21 Votes

People Also Ask about

First, let us look at the average costs of assisted living communities., Assisted living in Virginia will cost an average of $4,850 per month (2021) which amounts to a yearly expense of $58,200. With that said, the cost of assisted living communities in Virginia is pricey than the national average of $4,300 per month.
File a Complaint Verbally or Request a Complaint Form Contact the Enforcement Division at 1-800-533-1560 or (804) 367-4691. If playback doesn't begin shortly, try restarting your device.
Licensed assisted living facility administrators are regulated and governed by the Board of Long-Term Care Administrators, which has specific educational and Administrator in Training requirements.
ASSISTED LIVING LICENSURE In Virginia, assisted living facilities are licensed by the Virginia Department of Social Services, and assisted living administrators are licensed by the Board of Long-Term Care Administrators within the Virginia Department of Health Professions.
File a Complaint Verbally or Request a Complaint Form Contact the Enforcement Division at 1-800-533-1560 or (804) 367-4691. If playback doesn't begin shortly, try restarting your device.
Nursing homes are regulated by the Virginia Department of Health (VDH).
The Department of Health and Mental Hygiene licenses three types of assisted living programs (ALPs) based on the level of care provided.
This setting is regulated through the Department for Aging and Rehabilitative Services, Adult Protective Services Division.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

pdfFiller makes it easy to finish and sign VA Assisted Living Facility Disclosure Statement online. It lets you make changes to original PDF content, highlight, black out, erase, and write text anywhere on a page, legally eSign your form, and more, all from one place. Create a free account and use the web to keep track of professional documents.
Use pdfFiller's Gmail add-on to upload, type, or draw a signature. Your VA Assisted Living Facility Disclosure Statement and other papers may be signed using pdfFiller. Register for a free account to preserve signed papers and signatures.
The pdfFiller mobile app makes it simple to design and fill out legal paperwork. Complete and sign VA Assisted Living Facility Disclosure Statement and other papers using the app. Visit pdfFiller's website to learn more about the PDF editor's features.
The VA Assisted Living Facility Disclosure Statement is a document that provides essential information about an assisted living facility's services, fees, and rights of residents. It aims to ensure transparency and help potential residents make informed decisions.
Any assisted living facility that participates in the Department of Veterans Affairs (VA) program must file a VA Assisted Living Facility Disclosure Statement. This includes facilities that receive funding or support through VA programs.
To fill out the VA Assisted Living Facility Disclosure Statement, facilities must provide accurate and complete information regarding their services, pricing, resident rights, and contact details. This typically involves following a structured format provided by the VA and ensuring all requested data is included.
The purpose of the VA Assisted Living Facility Disclosure Statement is to inform veterans and their families about the services offered at a facility, the costs associated with those services, and the rights of residents, thereby promoting informed choice and transparency.
The information that must be reported includes facility name, address, services provided, pricing, terms of service, staffing ratios, resident rights, and any fees or charges that may apply. It is essential that this information is presented clearly and accurately.
Fill out your VA Assisted Living Facility Disclosure Statement online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.