Get State Of Tennessee Change Of Ownership Nursing Home Online Form 2012-2025
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How to fill out the State Of Tennessee Change Of Ownership Nursing Home Online Form online
Filling out the State Of Tennessee Change Of Ownership Nursing Home Online Form is an essential step for individuals or organizations looking to change ownership of a nursing home facility. This guide will provide you with clear, step-by-step instructions to help you navigate the form with ease.
Follow the steps to successfully complete the online form
- Click ‘Get Form’ button to obtain the form and open it in your browser.
- Enter the name and address of the nursing home facility, including city, state, county, and zip code. Ensure that all information provided is accurate.
- Provide contact details including telephone numbers, fax number, and email address where relevant.
- Indicate the total bed capacity of the facility and specify if the facility has secured units, Alzheimer's units, or ventilator units, along with their respective numbers of beds.
- Fill out the administrator information by providing their name and nursing home administrator license number. Additionally, answer whether the administrator has been convicted of any relevant crimes and provide details if applicable.
- List the legal entity type, such as Individual, Partnership, Corporation, etc., and select whether it is for-profit or non-profit. Provide names and addresses of all individual owners or partners.
- Answer questions regarding accreditation by federally recognized bodies and whether there is a parent company involved.
- Review any management contracts and the status of ownership regarding other health care facilities.
- Complete the verification section, ensuring that the application is signed and certified before a notary public.
- Once completed, save your changes. You may then download, print, or share the completed form as needed.
Ensure a smooth transition by completing your State Of Tennessee Change Of Ownership Nursing Home Online Form online today.
To anonymously report a nursing home, you can contact the Tennessee Department of Health's Complaint Intake Unit. They have a dedicated phone line and online resources to handle complaints. When reporting, provide as much detail as possible about the situation. Consider using the State Of Tennessee Change Of Ownership Nursing Home Online Form for related requests.
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