Hospice
Frequently Asked Questions Regarding Hospice Licensure
1. What are the requirements for licensure as a hospice provider?
Florida Statute requires all entities desiring to provide hospice services first obtain a certificate of need from the Agency for Health Care Administration (Agency). Complete information on the certificate of need process may be found at http://ahca.myflorida.com/ CON-FA. After a certificate of need is issued authorizing establishment of a hospice program, the prospective provider may review the “Summary of Initial Hospice Licensure Process” and download application forms on the Agency’s hospice Licensure Application and Related Forms webpage. Specific questions regarding initial licensure and survey may be answered by contacting the Long Term Care Services Unit at (850) 412-4303.
2. What are the requirements for reporting a change of street address for the principal office?
Following the instructions for a change during licensure period on the Health Care Licensing Application, Hospice, (AHCA Recommended Form 3110-4001, Revised August 2011), Application Checklist, complete and submit the required sections of the application along with the required $25 fee to the address above.
Application forms may be downloaded from the hospice webpage on the Licensure Application and Related Forms webpage.
Sections 400.602(3)(b), Florida Statutes and 59A-35.040(2)(a), Florida Administrative Code require notification 60 days prior to the change of address.
3. What are the requirements for reporting a name change?
Following the instructions for a change during licensure period on the Health Care Licensing Application, Hospice, (AHCA Recommended Form 3110-4001, Revised August 2011), Application Checklist, complete and submit the required sections of the application along with the required $25 fee to the address above.
Proof of filing with the Florida Department of State, Division of Corporations (such as the registration of a fictitious name or corporate name change) is required. Filing instructions may be obtained on the Division of Corporations web site, https://dos.fl.gov/sunbiz/.
Application forms may be downloaded from the hospice Licensure Application and Related Forms webpage.
Section 400.602(3)(b), Florida Statutes, requires notification 60 days prior to a name change.
4. What are the requirements for reporting personnel changes?
Changes of administrator must be reported 21 days in advance to avoid a fine for late notification. This change must be submitted on a change during licensure application form. Other key personnel changes, such as for the position of medical director and nursing supervisor, may be reported at the time of the next licensure renewal.
5. What are the requirements for background screening/criminal history checks of personnel?
Level 2 screening, which includes state and nationwide criminal arrest history checks, is required every five years for:
- Any person seeking employment who may provide personal care or services directly to clients, or have access to client’s living areas, personal property or client funds;
- Volunteers are considered employees of the hospice in accordance with state rule, 58A-2.002(6), F.A.C., and therefore must undergo Level 2 screening if they will provide personal care or services directly to clients or have access to client funds, personal property or living areas;
- Any contractor who provides personal care or services directly to clients;
- Administrators and Financial Officers; and
- A controlling interest (owner, officer, board member) if AHCA has reason to believe the person has been convicted of a disqualifying offense.
See the Background Screening page of this web site for information on how to get level 2 screening: http://ahca.myflorida.com/backgroundscreening.
If level 2 background screening was completed within the past five years to meet any provider or professional licensure requirement of the Agency, Department of Health, Agency for Persons with Disabilities, Department of Elder Affairs or Department of Children and Families, the results may be used to satisfy licensure requirements if:
- a copy of the letter or website screen print from the screening agencyshowing the individual had no disqualifying offenses is provided and
- the Affidavit of Compliance with Background Screening Requirements , AHCA Form 3100-0008 August 2010 (which attests to compliance with the provisions of chapter 435 and 408.809, F.S.) is completed, notarized and submitted. This form may be found at http://ahca.myflorida.com/backgroundscreening .
Note: If background screening was done by the Agency within the last five years, this should be indicated on an application or notification of personnel change. The results would be available in the Agency’s background screening database.
The hospice provider must check the screening results to see if all employees or contractors were cleared. If any have disqualifying offenses, they cannot work in any capacity unless they receive an exemption from disqualification. Administrators should notify any disqualified persons of the right to request an exemption from disqualification. Information on exemption requests may be obtained online at http://ahca.myflorida.com/backgroundscreening or by calling the Agency’s Background Screening Unit at (850) 412-4503.
6. What are the requirements for opening a satellite office?
Florida Administrative Code, 58A-2.002(14) defines a satellite office as “an office or other physical location serving as a contact point for patients, which is remote from the provider’s principal office, but is not separately licensed, and shares administration with the principal office.”
Following the instructions for a change during licensure period on the Health Care Licensing Application, Hospice, (AHCA Recommended Form 3110-4001, Revised August 2011), Application Checklist, complete and submit the required sections of the application along with the required $25 fee to the address above.
Application forms may be downloaded from the hospice webpage at http://ahca.myflorida.com/longtermcare.
Sections 58A-2.003(2) and 59A-35.040(2)(c), Florida Administrative Code require notification 60 days prior to the change of address of a satellite office. The satellite office address will be added to the hospice license effective as of the date of opening.
7. What are the requirements for opening a freestanding hospice inpatient facility?
Florida Statute requires all hospice providers desiring to open a freestanding hospice inpatient facility first obtain a certificate of need from the Agency for Health Care Administration (Agency). Complete information on the certificate of need process may be found at http://ahca.myflorida.com/CON-FA.
The issuance of a certificate of need authorizing establishment of a hospice inpatient facility does not resolve licensure requirements. The Centers for Medicare and Medicaid Services, as part of the Medicare certification process, and state regulations require a survey (including life safety code compliance) prior to the addition of the inpatient facility address to the license and admission of patients.
In order to apply to add a freestanding inpatient facility to an existing hospice license, follow the instructions for a change during licensure period as listed on the Health Care Licensing Application, Hospice, (AHCA Recommended Form 3110-4001, Revised August 2011), Application Checklist. Complete and submit the appropriate sections of the application along with the required $25 fee to the address above.
Include the name of the hospice staff person responsible for scheduling the survey along with contact information and a copy of the Certificate of Need.
Application forms may be downloaded from the hospice webpage at http://ahca.myflorida.com/longtermcare.
Section 59A-35.040(2)(a), Florida Administrative Code requires notification 60 days in advance of the requested effective date. After receipt of the application, the Home Care Unit will request Agency field office staff tentatively schedule a survey. Field office staff will schedule the appointment as time and resources permit based on current workload and priorities. The building must have a certificate of occupancy signed by local authorized zoning, building and electrical officials prior to the survey.
Upon receipt of a survey report indicating all requirements have been met, the hospice license will be updated to include the new freestanding inpatient facility.
Beds may be added to an existing hospice inpatient facility without state approval through the certificate of need process, however notification of the intended bed increase must still be made to the Agency’s Certificate of Need Unit. In order to apply to increase the number of beds in an existing inpatient facility, submit the appropriate sections of the Health Care Licensing Application, Hospice as noted above and the required $25 fee. Section 59A-35.040(2)(c), Florida Administrative Code requires notification 60 days in advance of the requested effective date. The effective date of a bed addition is the date the agency receives the application and fee along with:
- a copy of the notification memo from the Agency’s Certificate of Need Unit;
- a copy of the certificate of occupancy signed by local authorized zoning, building and electrical officials and
- an attestation from the hospice provider assuring that the additional beds meet applicable life safety codes. The AHCA Recommended Form, Attestation of Compliance with Applicable Life Safety Codes for Additions to Existing Hospice Inpatient Facilities/Residential Units, is available on the Agency’s hospice webpage at http://ahca.myflorida.com/longtermcare .
Note: Hospice providers do not have to obtain Agency approval prior to contracting with a licensed health care facility for inpatient hospice care. Federal regulations require inpatient care be provided in a participating Medicare or Medicaid facility, i.e. a skilled nursing facility or hospital. The contracted facility address will not be listed on the hospice license. Contracts are reviewed and patient care sampled as part of the hospice survey; the physical plant requirements are surveyed as part of the skilled nursing facility or hospital.
8. What are the requirements for opening a hospice residential unit?
Florida Statute, 400.601(5) defines “hospice residential unit” as “a homelike living facility, other than a facility licensed under other parts of this chapter, under chapter 395, or under chapter 429, that is operated by a hospice for the benefit of its patients and is considered by a patient who lives there to be his or her primary residence.”
State approval through the certificate of need process is not required to open a hospice residential unit.
In order to apply to add a residential unit to an existing hospice license, follow the instructions for a change during licensure period as listed on the Health Care Licensing Application, Hospice, (AHCA Recommended Form 3110-4001, Revised August 2011), Application Checklist. Complete and submit the appropriate sections of the application along with the required $25 fee to the address above.
Include the name of the hospice staff person responsible for scheduling the survey along with contact information.
Application forms may be downloaded from the hospice webpage at http://ahca.myflorida.com/longtermcare.
Section 59A-35.040(2)(c), Florida Administrative Code requires notification 60 days in advance of the requested effective date. After receipt of the application, the Home Care Unit will request Agency field office staff tentatively schedule a survey. Field office staff will schedule the appointment as time and resources permit based on current workload and priorities. The building must have a certificate of occupancy signed by local authorized zoning, building and electrical officials prior to the survey.
Upon receipt of a survey report indicating all requirements have been met, the hospice license will be updated to include the new residential unit.
Beds may be added to an existing hospice residential unit by submitting the appropriate sections of the Health Care Licensing Application, Hospice as noted above and the required $25 fee. Section 59A-35.040(2)(c), Florida Administrative Code requires notification 60 days in advance of the requested effective date. The effective date of a bed addition is the date the agency receives the application and fee along with:
- a copy of the certificate of occupancy signed by local authorized zoning, building and electrical officials and
- an attestation from the hospice provider assuring that the additional beds meet applicable life safety codes. The AHCA Recommended Form, Attestation of Compliance with Applicable Life Safety Codes for Additions to Existing Hospice Inpatient Facilities/Residential Units, is available on the Agency’s hospice webpage at http://ahca.myflorida.com/longtermcare .
Note: While a hospice may provide care to existing residents of an assisted living facility, it may not contract with an assisted living facility for use of beds to provide residential hospice care. If the hospice intends to ‘lease‘ assisted living facility beds strictly for hospice patients, the assisted living facility must de-license the beds and the hospice must apply to license them as a residential unit.
Hospice inpatient care and services may not be provided in a hospice residential unit.
