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    esignatures-accepted / Minnesota Department of Human Services
    ... Ownership and Control Interest of an Entity (DHS-5259) Provider Entity Sale or Transfer Addendum (DHS-5550) ... Ownership and Control Interest of an Entity (DHS-5259) Provider Entity Sale or Transfer Addendum (DHS-5550) ...
    Description: This page lists all Provider Eligibility and Compliance (PEC) enrollment forms that accept electronic signatures
    Date: January 31, 2022
    mn.gov/dhs/partners-and-providers/news-initiatives-reports-workgroups/minnesota-
    1_Age&SexGroups_2010Census 2_RaceEthnicity_2000&2010Census 3_MedianHHincome 4_Poverty 5_Immigrants Note
    ... Median household income, Margin of Error $4618 $3687 $5259 $5428 $5255 $4431 $5726 $5154 $5903 $6138 Roseau ... 553 551 Winona Number in poverty 3948 5871 5259 6228 7393 7252 6893 6504 5416 5165 Wright ...
    Date: October 22, 2021
    mn.gov/dhs/assets/county-demographics_tcm1053-503687.xlsx
    Provider Screening Site Visits
    ... Ownership and Control Interest of an Entity ( DHS- 5259) ( PDF) Fitness Test • Fitness tests are conducted to ... when you submit the Disclosure of Ownership ( DHS- 5259) ( PDF) . • Owners are individuals with direct or indirect ...
    Description: SFS Provider Screening PowerPoint
    Date: June 13, 2024
    mn.gov/dhs/assets/sfs-provider-screening-presentation_tcm1053-627494.pdf
    Provider Screening Site Visits
    ... Ownership and Control Interest of an Entity ( DHS- 5259) ( PDF) Fitness Tests • Fitness tests are conducted to ... when you submit the Disclosure of Ownership ( DHS- 5259) ( PDF) . • Owners are individuals with direct or indirect ...
    Description: SFS Provider Screening PowerPoint
    Date: December 06, 2024
    mn.gov/dhs/assets/provider-screening-site-visits-presentation_tcm1053-642735.pdf
    FAQ for Home and Community-Based Services (HCBS) Revalidation / Minnesota Department of Human Services
    ... the Disclosure of Ownership and Control Interest (DHS-5259) . back to top
    Description: The following questions and answers provide further details about the Home and Community-Based Services (HCBS) revalidation process.
    Date: October 14, 2024
    mn.gov/dhs/partners-and-providers/policies-procedures/minnesota-health-care-prog
    PCA/CFSS Steps for Success workshop / Minnesota Department of Human Services
    ... Ownership and Control Interest of an Entity (DHS-5259) (PDF) during enrollment. If a QP is an ...
    Description: The Minnesota Department of Human Services (DHS) is in the process of transitioning from personal care assistance (PCA) to Community First Services and Supports (CFSS). During this transition time, Steps for Success training covers information from both programs. To learn more about CFSS, visit Community First Services and Supports.
    Date: July 15, 2024
    mn.gov/dhs/partners-and-providers/training-conferences/minnesota-health-care-pro
    Summary MA AC MnCare BH MFIP CCAP NorthStar GA MSA & HS
    ... 5183 533.04 33155798 21904775 11251023 0 2006 5259 533.02 33636290 12801706 20834585 0 2007 5239 ...
    Date: February 29, 2024
    mn.gov/dhs/assets/background_forecast_tables_0223v2_tcm1053-611355.xlsx
    CoverPage Introduction MainDisplay FeederData
    ... 63 61 65 - 84 043 MCLEOD 4942 5116 5259 5424 5573 5717 5879 65 - 84 044 MAHNOMEN ...
    Date: August 24, 2020
    mn.gov/dhs/assets/institutional-care-nf-2020_tcm1053-444520.xlsx
    Summary MA AC MnCare BH Fund GA MSA & HS
    ... 5183 533.04 33155798 21904775 11251023 0 2006 5259 533.02 33636290 12801706 20834585 0 2007 5239 ...
    Date: March 06, 2025
    mn.gov/dhs/assets/background_forecast_tablesDHS_0225_tcm1053-671721.xlsx
    Summary MA AC MnCare BHF GA MSA & HS
    ... 5183 533.04 33155798 21904775 11251023 0 2006 5259 533.02 33636290 12801706 20834585 0 2007 5239 ...
    Date: December 04, 2024
    mn.gov/dhs/assets/background_forecast_tablesDHS_1124v2_tcm1053-658393.xlsx

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