DOH Issues DAL and New Affidavit Form That May Be Requested in Certain Situations

The Department of Health (DOH) has issued a new Dear Administrator Letter (DAL), DAL 22-31, releasing a new Affidavit form, DOH-5773. The Affidavit may be used in certain circumstances for a proposed Operator to demonstrate that they meet the experience requirements in statute and regulation. If, as submitted, the proposed Operator fails to clearly demonstrate compliance with the applicable law and regulation within the Adult Care Facility (ACF) Common Application, the Department will request clarification via the Affidavit regarding both the listed current and proposed Controlling Persons. The Affidavit is not required with all applications, and the Affidavit is not a replacement for any required documentation.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828