FAQs Section 10: Reporting changes to my license information

10.1 How do I report a change of address?

You must notify the Agency at least 21 days in advance of the effective date of the change of address of record pursuant to Section 59A-35.040(2)(b), Florida Administrative Code.

Home Health Agency location:
The following items are necessary to process your request:

AHCA shall fine a home health agency $500 that fails to notify the agency within 21 days of the new location pursuant to 408.813 (3), F.S. and 59A-35.040(3), F.A.C.
A licensee is not authorized to operate in a new location until a license is obtained which specifies the new location. Failure to amend a license prior to a change of the address of record constitutes unlicensed activity.

Satellite Office location:
A request to add a satellite office must be received by the Agency 60 to 120 days in advance of the proposed effective date in accordance with 59A-35.040(2)(c), F.A.C.
The following items are necessary to process your request:

*Information on the branch approval process can be found at:http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Home_Care/HHA/medicare_medicaid.shtml

Drop-Off Site location:
The following item is necessary to process your request:

All requests for changes of address should be submitted to Agency for Health Care Administration, Home Care Unit, MS #34, 2727 Mahan Drive, Tallahassee, Florida, 32308

10.2 How do I add counties to my license?

Home health agencies may add counties that are located within their geographic service area. Effective July 14, 2010 per 59A-35 Florida Administrative Code adding a county will require the applicant to complete the AHCA Form 3110-1011 and a $25 fee to add counties. Read the Application Checklist Section D. to find out which sections of the application must be completed and submitted. In addition to the application the home health agency needs to submit a written plan to the Agency Home Care Unit office in Tallahassee which includes:

The Agency central office will review the home health agency’s previous survey findings and any administrative actions taken including fines, suspensions, revocations or injunctions. The Home Care Unit will make the decision and inform the home health agency. If approved, a new license will be issued containing the approved counties.

10.3 How do I report a change in the name of our agency?

Once all of the information is received the specialist for your area will print a new license certificate with the new name and mail it to you.

Please note that a name change is not the same as a change in the corporation or partnership or their owners. If you intend to have a new corporation or partnership or new owners take over the operation of your home health agency which may or may not result in a change of the employee identification number(EIN) this is considered a change of ownership and an application needs to be submitted for a change of ownership with the licensing fee. See question #10.4 below.

10.4 How do I do a change of ownership of a home health agency?

A change of ownership as defined in 2009 Chapter 408, Part II Florida Statutes is

All types of legal entities, including Limited Liability Companies are included in the change of ownership definition.

A change of ownership application needs to be completed and sent to the Home Care Unit 60 days prior to the change. An application for Change of Ownership AHCA Form 3110-1011 to incorporate changes to the law effective July 1, 2009. is required as well as the forms needed to comply with the reporting requirements in Chapter 408, Part II of the Florida Statutes which are posted at this website.

10.5 Who do I need to notify when I close my home health agency?

The home health agency needs to inform the Agency in writing not less than 30 days prior to the closing. Patients also need to be informed in writing of the closing. A copy of a notice of closure in the newspaper in the county(s) where the provider was located that advises patients of the discontinuance of the home health agency can be done in place of a written notice to each patient. The notice must appear at least once per week for four consecutive weeks.

The home health agency needs to provide copies of the clinical records to the patients or their legal guardian if requested. If continuing services are needed by patients, the home health agency needs to find another provider or contact a provider chosen by the patient. All clinical records must be forwarded to the new provider of services for the patient.

Once the home health agency closes, the license needs to be returned to the Agency. The home health agency remains responsible for retaining closed clinical records for six years for patients that received skilled services. Service provision plans for patients that received non-skilled services need to be retained for 3years.

10.6 How do I report a change to the service our home health agency provides directly?

If you are a Medicare or Medicaid certified home health agency, CMS will only accept changes in the direct services with the recertification survey report. You will need to have the change in direct service made to the CMS 1572 form with the surveyor as part of the recertification survey from either your accrediting organization or AHCA.

10.7 How do I obtain a replacement license certificate?

You need to complete sections 1, 2 and 15 of the home health application. Indicate on page two that you are requesting a replacement certificate. Send the applications sections along with a check for $25 and send to the Agency for Health Care Administration, Home Care Unit MS# 34 2727 Mahan Drive, Tallahassee, Fl 32308.

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