PDF
Word
Form DHS-6189C-ENG Adult Companion Services or Individualized Home Supports Without Training Provider Assurance Statement - Minnesota Health Care Programs (Mhcp) - Minnesota
What Is Form DHS-6189C-ENG?
This is a legal form that was released by the Minnesota Department of Human Services - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DHS-6189C-ENG?
A: DHS-6189C-ENG is a form for Adult Companion Services or Individualized Home Supports Without Training Provider Assurance Statement.
Q: What are Adult Companion Services?
A: Adult Companion Services are non-medical care and supervision provided to adults with disabilities or seniors to promote independence and enhance quality of life.
Q: What are Individualized Home Supports Without Training?
A: Individualized Home Supports Without Training are non-medical assistance provided in a person's home to help with daily activities and tasks.
Q: Who needs to fill out this form?
A: Providers of Adult Companion Services or Individualized Home Supports Without Training in the Minnesota Health Care Programs (MHCP) need to fill out this form.
Q: What is the purpose of this form?
A: This form serves as an assurance statement for providers to demonstrate compliance with the requirements of the Minnesota Health Care Programs.
Form Details:
- Released on August 1, 2021;
- The latest edition provided by the Minnesota Department of Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DHS-6189C-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.
