Information For:

Provider Site Home Page

Adult Care Home Information

** Elder Abuse Hotlines **

Survey & Certification Commission Contact Information

• Complaint Hotline Toll Free Number - 1-800-842-0078
• KDOA Main Phone Number - 785-296-4986
• KDOA Main Toll Free Number - 800-4325-3535
• KDOA Survey & Certification Regional Office Contact Information

Complaint Reports

• Facility Complaint Investigation Report Form (PDF)
• Facility Complaint Investigation Report Form (Word)
• ANE Witness Form (PDF)
• ANE Witness Form (Word)

Reporting Reasonable Suspicion of a Crime

Facilities or covered individuals needing to report a suspected crime against a resident when the hotline is closed may submit an e-mail to suspectedcrime@aging.ks.gov with the following information:

• Persons involved (resident victim, alleged perpetrator, witnesses, covered individuals with reason to suspect a crime has occurred)
• Date and time of the incident
• Description of the incident
• Injury, if any, to the resident
• Date and time report made to law enforcement
• Law Enforcement agency and case number

Complaint Program staff will respond to the e-mails during regular hotline hours.

Regulations / Informal Dispute Resolution

• State Statutes and Regulations Enforced by KDOA
• Delegation of Nursing Tasks to Medication Aides and Nurse Aides Position Statement
• Tuberculosis (TB) Guidelines for Adult Care Homes
• Resident Functional Capacity Screen Manual
• Resident Functional Capacity Screen Form

Adult Care Home Statistic Reporting

• Adult Care Home Statistics Report Forms and Web Application
• Adult Care Home Review Reports

State Adult Care Homes Licensure Forms

• Adult Care Home Licensure Information
• Related Forms for Health Care Providers
• Medicaid Provider - New Enrollment and Change of Ownership Forms

Newsletters / Publications

• Sunflower Connection Newsletters
• CARE Newsletters
• Helping the Kansas Adult Care Home Industry Provide Quality Care Brochure
• CMS Quality Indicator Survey Demonstration Project Brochure
Read about the Quality Indicator Survey (QIS) revised long-term care survey process. The QIS was designed as a staged process for use by surveyors to systematically and objectively review all regulatory areas and subsequently focus on selected areas for further review.
• Quality Indicator Survey (QIS) Surveyor Training Manual
This is the technical manual that will be used on the QIS Project.

Educational Information

• MDS Training Information and Registration Forms
• Audiovisual Library Catalog
• Audiovisual Request And Loan Agreement

Quality Practice Workgroup

In 2004 the KDOA Quality Practice Work Group was convened to address complex care issues in adult care homes. The group is comprised of KDOA staff as well as staff from adult care homes, associations and organizations. Best Practices Guidelines for Fall Management were developed.

• Best Practice Guidelines for Adult Care Homes - Fall Management

General Information for Medicaid Nursing Facility Providers

• Reimbursement for Nurse Aide Training and Competency Evaluation (NATCEP) Costs
• Reimbursement for Nurse Aide Training and Competency Evaluation or Competency Evaluation Program Cost

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