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  • Idph Assisted Living App Form

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LIVING/SHARED HOUSING INITIAL LICENSE APPLICATION / / # of Ind Units/Res: / Total # of Units to be Licensed: Initial License #: Issue / Expiration dates: / Please address ALL questions and TYPE or PRINT your answers. If an item DOES NOT apply to your establishment, enter N/A. This form ( and all required attachments) must be completed, signed by the licensee, and sent to the address listed on page eight of this form. THE ENTIRE APPLICATION/LICENSURE PROCESS CANNOT BE LONGER THAN SIX (6).

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Please utilize the Complaint Form below to file the complaint. Please note if this complaint is concerning a care issue in a nursing home you need to call the Complaint Section for Nursing Homes under the Division of Health Service Regulation 919-855-4500.

Who Is Eligible? Age 65 or older or have a physical disability. Monthly income must be equal to or greater than the Supplemental Security Income (SSI) rate of $750 for single residents or $1,125 for married residents (as of 2018) Eligible for nursing home care but choose to receive care in an AL environment.

The Illinois Department of Public Health regulates assisted living establishments and shared housing establishments through one set of rules; assisted living requires single-occupancy private apartment units and shared housing does not.

If you wish to file a complaint about an Illinois nursing home, call the Department's toll-free hotline at 1-800-252-4343.

If you wish to file a complaint about an Illinois nursing home, call the Department's toll-free hotline at 1-800-252-4343.

You may file your complaint in one of three different ways: Online. File an informal complaint online. By Phone. You can reach us between 8:30 AM and 5:00 PM, Monday through Friday by calling 1-800-524-0795, 1-217-782-2024 outside the State of Illinois, or TTY at 1-800-858-9277. ... By Mail.

Administrator Requirements The state of Illinois accepts an Associate of Science in Assisted Living Administration or Bachelor of Science in Health Science with certification in Assisted Living Administration. Administrators must pass a test and obtain a state license.

The Illinois Department of Public Health regulates assisted living establishments and shared housing establishments through one set of rules; assisted living requires single-occupancy private apartment units and shared housing does not.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232