DSHS Form 10-573 Planned Action Notice - Pre-admission Screening and Resident Review (Pasrr) Determination - Washington

DSHS Form 10-573 Planned Action Notice - Pre-admission Screening and Resident Review (Pasrr) Determination - Washington

What Is DSHS Form 10-573?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 10-573?A: DSHS Form 10-573 is the Planned Action Notice form for Pre-admission Screening and Resident Review (PASRR) Determination in Washington.

Q: What is Pre-admission Screening and Resident Review (PASRR)?A: Pre-admission Screening and Resident Review (PASRR) is a process used to ensure that individuals with mental illness, intellectual disability, or developmental disabilities receive the appropriate level of care in a nursing facility.

Q: What is the purpose of DSHS Form 10-573?A: The purpose of DSHS Form 10-573 is to notify an individual or their representative of the determination made regarding their eligibility for nursing facility services based on the PASRR process.

Q: Who fills out DSHS Form 10-573?A: The form is typically filled out by the Washington State Department of Social and Health Services (DSHS) or their authorized representative.

Q: What information does DSHS Form 10-573 contain?A: DSHS Form 10-573 contains information about the individual's PASRR determination, including whether they are determined to have a mental illness, intellectual disability, or developmental disability that requires nursing facility services.

Q: What should an individual do after receiving DSHS Form 10-573?A: After receiving DSHS Form 10-573, the individual should review the determination made and contact the appropriate DSHS office if they disagree with the decision or have any questions.

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Form Details:

  • Released on November 1, 2018;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DSHS Form 10-573 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 10-573 Planned Action Notice - Pre-admission Screening and Resident Review (Pasrr) Determination - Washington

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