Contact Information

Complaint Hotline Toll Free Number 800-842-0078

KDADS Main Phone Number 785-296-4986

KDADS Main Toll Free Number 800-432-3535

Adult Care Homes Provider Information

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Nursing Facilities
- Licensure Information and Forms
  - Surveys, Reports, Regulations and Statutes
- Nursing Facility Advance KanCare Payment
  Advance Payment Process 2016: The Kansas Department of Health and Environment is experiencing delays in processing applications for Medicaid benefits. Until the delays are resolved, KDHE has agreed to issue advance payments to qualified Nursing Facilities (NFs) who submit advance payment requests for specific applicants who are waiting on an eligibility determination
- Client Assessment, Referral and Evaluation (CARE) Process and Procedures
- Nursing Facility Medicaid / MediKan Rate List
- CMS Technical User's Guide
  In July 2016, the Centers for Medicare & Medicaid Services (CMS) made several changes to the quality measure (QM) domain of the Five Star Nursing Home Quality Rating System. Download the current CMS Technical Users Guide - January 2017
- Minimum Data Set (MDS) Information
- Centers for Medicare and Medicaid Long Term Care Survey Process Forms
- Contact Information* - District Map
*Clicking on the image opens it in original size
Assisted Living, Residential Health Care Facilities, Home Plus, Boarding Care, Adult Day Care
- Licensure Information
  - Instructions
  - Applications
  - New Construction
  - Surveys, Reports, Regulations and Statutes
  - Fire Safety
  - Focus on Food Safety
- Home and Community Based Services Information
Guidelines
- Tuberculosis Guidelines
- Delegation of Nursing Tasks
Sunflower Connection
- Past Issues of The Sunflower Connection
Intermediate Care Facilities for Individuals with Intellectual Disabilities
- Licensure Information
  - Application
  - Forms
Fee Payment
Submission of many of the state licensure forms also requires submission of an accompanying fee. Fees must be paid by either check, money order or credit card payment authorization made payable to the Kansas Department for Aging and Disability Services (KDADS) for adult care homes (including assisted living/residential health care facilities, boarding care homes, home plus facilities and adult day care).

Beginning April 1, 2018, a 3.04 percent fee will be added to payments made by credit card. To make credit card payments to KDADS, use the Credit Card Application.

KDADS currently accepts:
- MasterCard
- VISA
Adult Care Home Forms and Manuals
- Facility Investigation Report
  - Facility Complaint Investigation Form (PDF)
  - Facility Complaint Investigation Form (Word)
- Witness Statement Form
  - ANE Witness Form (PDF)
  - ANE Witness Form (Word)
- Medicare Forms
- Medicaid Enrollment Forms
- License Renewal and Change Forms
  - State Licensure Renewal:
    The submission of the annual Licensure Renewal and license fees associated with the renewal is done on the Facility Home Page within an online Kansas Tracking of Adult Care Homes (KOTA) Web Application. An electronic notice is sent to the Administrator prior to the renewal due date. To access KOTA, click here or on the Web Applications link on the Home Page of this website.
    
    For any questions regarding access to this application, please contact the KDADS Computer Help Desk at 785-296-4987.
  - Change Forms:
    The submission of the below changes are done on the Facility Home Page within a On-Line Kansas Tracking of Adult Care Homes (KOTA) Web Application. To access KOTA, click here or on the Web Applications link on the Home Page of this website.
    For any questions regarding access to this application, please contact the KDADS Computer Help Desk at 785-296-4987.
    - Change of Administrator or Operator
    - Change of Facility Name / Address / Phone / E-Mail / Web page
    - Request to Share Administrator or Operator
    - Request to Change Use of a Required Room
    - Request for Change in Resident Capacity and/or Location
- Functional Capacity Screen Manual and Form
  - Resident Functional Capacity Screen
  - Functional Capacity Screen Manual
Request for Authorized Electronic Monitoring

Request for Authorized Electronic Monitoring