Dear Assisted Living Facility Administrator:

Recently, Home and Community Services (HCS) received a finding from the State Auditor’s Office regarding compliance with 42 CFR 441.540(b)(9), which requires all person centered service plans to “be finalized and agreed to in writing by the individual and signed by all individuals and providers responsible for its implementation.”

The purpose of this letter is to advise you of this federal requirement and a change in ALTSA practice to meet these requirements. For residents whose payment source is Medicaid, the case manager will be requesting a signature from the assisted living provider on the resident’s completed CARE Service Summary. When requested by the case manager, please have an appropriate representative from the facility sign the service summary and promptly return the signed signature page to the case manager using a method that protects the client’s protected health information (e.g. secure email, fax, mail etc.).

Providers will need to determine who the appropriate facility representative will be to sign the service summary.

If you have any questions regarding this process, please contact Natalie Lehl, HCS Residential Program Manager at (360) 725-2370 or Natalie.lehl@dshs.wa.gov.

If you have any questions about anything listed on the CARE Services Summary, please contact the resident’s case manager.