Bureau of Health Facility Regulation
Home Care Unit
2727 Mahan Drive - Mail Stop #34
Tallahassee, FL 32308
(850) 412-4403 Phone
(850) 922-5374 Fax
5.1 How do I report an address change and what are the requirements? How do I report a name change and what are the requirements?
ANSWER: Florida Administrative code 59A-27.002(5), Change of Registration Information. Within 21 days prior to any change in registration information, a registered health care services pool shall advise the Agency of any change in business name; location; mailing address; or phone number. Complete and submit Section 1 of Healthcare Licensing Application, Health Care Services Pool along with proof of insurance coverage in the new name or address which shall be mailed to AHCA (2727 Mahan Drive – Mailstop 34, Tallahassee, Florida 32308) along with a check or money order in the amount of $25.00 made payable to AHCA. Any requests that results in the agency issuing a revised registration certificate other that an initial, renewal or change of ownership application, requires a fee of $25.00.
5.2 How do I report a personnel change and what are the requirements?
ANSWER: Only change is the managing employee and the financial officer must be reported. Send the information in a letter along with proof of level 2 background screening. These positions must be filled by someone who has successfully completed a level 2 background screening. If a new background screening check is necessary, visit the Agency’s background screening web page for information on the requirements for fingerprinting and the locations throughout the state when the scanning of fingerprints is done: http://ahca.myflorida.com/backgroundscreening click on “background screening”.
5.3 I am moving to another suite in this building, do I need to send a new application?
ANSWER: No, but you need to notify AHCA of the change of address. Send a letter to the AHCA Home Care Unit, 2727 Mahan Drive – Mail Stop 34, Tallahassee, FL 32308 to request an address change, giving your registration number, your old address, the new address, and new telephone number, fax number and email address if changed. A check or money order for $25 payable to AHCA is required. A revised registration certificate will be mailed to you with the new address.
5.4 The wrong person is listed in www.floridahealthfinder.gov as our managing employee, how do I get this corrected?
ANSWER: The information in www.floridahealthfinder.gov comes from your registration application. Send a letter to the AHCA Home Care Unit, 2727 Mahan Drive – Mail Stop 34, Tallahassee, FL 32308 and notify them of the person who should be listed as the managing employee. State law requires that the person be level 2 background screened (fingerprinted), unless he or she has already been screened and this is verified by AHCA.
5.5 What constitutes a Change of Ownership?
ANSWER: “Change of ownership” means:(a) An event which the license sells or otherwise transfers its ownership to a different individual or entity as evidence by a change in federal identification number or taxpayer identification number; or
A change solely in the Management Company or Board of Directors is not a change of ownership.
5.6 How do I file for a change of ownership?
ANSWER: The applicant must submit a change of ownership application at least 60 days prior to the proposed effective date of change of ownership. Include the following with the application:
Please note: The seller’s (transferors) registration must be active on the date the Agency issues the license to the buyer. The seller’s registration cannot be expired, denied or revoked.
5.7 If my Federal Employer Identification Number(EIN#) changes and not the ownership percentage(s) is this a change of ownership?