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Get the free HCBS OWNERSHIP & STRUCTURE CHANGE REQUEST - mmac mo

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SECTION 1: PROVIDER INFORMATION COMPLETE ALL APPLICABLE FIELDS IN A LEGIBLE MANNER. Please complete ONE form per provider EIN. THIS IS A REQUIRED SECTION. LEGAL AGENCY NAME AS IT APPEARS WITH THE
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Individuals or organizations applying for Home and Community-Based Services (HCBS) that require ownership and structure documentation.
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Service providers or care facilities seeking certification or accreditation that includes HCBS ownership and structure evaluation.
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HCBS ownership amp structure refers to the ownership and organizational structure of a Home and Community Based Services provider.
All HCBS providers are required to file ownership and structure information.
HCBS providers must complete the required forms provided by the governing agency and submit accurate ownership and structure information.
The purpose of HCBS ownership and structure reporting is to ensure transparency and accountability within the HCBS provider network.
HCBS ownership and structure reports typically include information on owners, board members, organizational affiliations, and financial interests.
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