DSHS Form 16-197 Assisted Living Facility Policies and Procedures Attestation - Washington

What Is DSHS Form 16-197?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 16-197?
A: DSHS Form 16-197 is the Assisted Living Facility Policies and Procedures Attestation form used in Washington.

Q: What is the purpose of DSHS Form 16-197?
A: The purpose of DSHS Form 16-197 is to attest that the assisted living facility has established and implemented policies and procedures in accordance with Washington state regulations.

Q: Who needs to fill out DSHS Form 16-197?
A: Assisted living facilities in Washington need to fill out DSHS form 16-197.

Q: Is DSHS Form 16-197 required for all assisted living facilities in Washington?
A: Yes, DSHS Form 16-197 is required for all assisted living facilities in Washington.

Q: What information do I need to provide on DSHS Form 16-197?
A: You need to provide information about your assisted living facility's policies and procedures, including how they are communicated to staff and residents.

Q: When do I need to submit DSHS Form 16-197?
A: DSHS Form 16-197 needs to be submitted annually, within 30 days of the date of initial application or the provider's license renewal date.

Q: Can I submit DSHS Form 16-197 electronically?
A: Yes, you can submit DSHS Form 16-197 electronically through the DSHS Secure Access Washington (SAW) system.

Q: What happens if I don't submit DSHS Form 16-197?
A: Failure to submit DSHS Form 16-197 may result in an enforcement action, including fines or the suspension or revocation of the facility's license.

Q: Can I make changes to DSHS Form 16-197 after submitting it?
A: Yes, you can make changes to DSHS Form 16-197 after submitting it. However, any changes must be submitted within 30 days of the date the changes are implemented.