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FAQs Section 2: Initial Home Health Agency Application Process:
2.1 What forms do I complete to start a new home health agency?
All of the forms needed to complete the application for licensure are directly beneath Licensure Application and Forms on this web page and include:
- The application for license, AHCA form 3110-1011
- Financial Schedules AHCA form 3110-0009
- Affidavit of Compliance with Background Screening AHCA Form 3100-0008, if the Administrator or Financial Officer provides proof of compliance with level 2 screening requirements submitted within the previous 5 years to meet any provider or professional licensure requirements of the Department of Health, the Agency for Persons with Disabilities, Department of Elder Affairs, Department of Financial Services or the Department of Children and Family Services;
- Health Care Licensing Application Addendum AHCA Form 3110-1024
Applicants should complete the above forms as applicable. Additional documents required to be sent with the application includes the following as applicable
- Attestation of Compliance with Distance Requirements AHCA Form3110-1026 for Initial and Change of Ownership applicants signed by the owner and notarized that attests the proposed home health agency is 10 or more miles from another home health agency in the same county owned by common controlling interests;
- proof of application -- screen print from accrediting organization web site or letter for receipt of application for accreditation with either the Accreditation Commission Health Care (ACHC); Community Health Accreditation Program (CHAP), or the Joint Commission (JC);
- current liability and professional malpractice insurance, not a binder;
- report or letter from local government zoning office. (An Occupational License or Business Tax Receipt does NOT meet this requirement)
- proof of the applicant's legal right to occupy the property which may include copies of warranty deeds, lease or rental agreements, contracts for deeds, quitclaim deeds, or other such documentation;
- a current bank statement or line of credit in the agency name showing sufficient funds to cover pre-opening costs prior to beginning operations, funding for contingencies and the funds necessary to cover three months of average expenses to sustain the home health agency until it reaches a positive cash flow;
- a Business Plan signed by the applicant which details the home health agency’s methods to obtain patients and its plan to recruit and maintain staff;
- corporate paperwork including certificate of status, affidavit of fictitious name if applicable, articles of incorporation or company organizational papers if an LLC and by laws;
- proof of Employee Identification Number from the IRS;
- proof of Level 2 background screening compliance for the administrator and financial officer that is not over five years old
The application, other required information and the licensure fee of $1,705.
Agency for Health Care Administration
Home Care Unit
2727 Mahan Drive, Mail Stop #34
Tallahassee, Fl. 32308
The fee is non-refundable. It is very important for the applicant to be familiar with the laws and rules and what is required in the application for licensure.
If after reviewing the application forms and statutory and rule requirements on our website you have additional questions, please call (850) 412-4403. Staff will be happy to answer questions that clarify the requirements as they apply to your specific situation, but cannot walk you through the application. Filling out the application is part of your responsibility as an applicant. The Agency's role in this process is to evaluate your application and, if there are elements missing from your application once submitted, provide you with an omissions response that gives you another opportunity to complete the application successfully. If you need extensive assistance in filling out your application, we would advise you to retain an attorney or a government relations consultant to assist you.
2.2 How long does it take to get licensed?
It takes up to four months from the date the initial application is received by the Home Care Unit in Tallahassee to become licensed. The process includes the following steps:
- initial application is received
- Home Care Unit verifies that the proposed agency is not less than 10 miles from any other agencies in the same county owned by common controlling interests; if it is less than 10 miles the application and licensure fee is returned to the applicant
- Agency staff have 30 days in law to review the application and respond in writing to the applicant describing items needing correction or request additional information
- one omission letter is prepared and sent to the applicant
- applicant has 21 days from the receipt of the letter to make corrections and/or provide missing information back to the Agency
- staff review the response to the omission letter and determines if application is complete
- the Agency receives proof that the proposed applicant becomes fully accredited (not conditional or provisional) within 120 days of receipt of the application in the Home Care Unit by one of the three approved accrediting organizations including Accreditation Commission Health Care (ACHC), Community Health Accreditation Program (CHAP) and the Joint Commission ( JC).
- if the accreditation survey is passed, the applicant receives a license which expires two years from the date it is issued
- The licensed home health agency must maintain their accreditation status or the license will be revoked
The applicant cannot begin serving patients until the accreditation survey is passed and the Home Care Unit issues a license. An applicant cannot operate a home health agency until the license has been issued per state law.
2.3 What is the cost of the home health license?
The licensure fee, which needs to be included with the application, is $1,705 for a 2-year license. The licensure fee is non-refundable. Checks or money orders are accepted. Starter checks for new bank accounts are not accepted. At this time, it is not possible to pay on-line.
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