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Reporting changes to AHCA

8.1 How do I report a change in the administrator or alternate administrator?

Send the application sections 1, 7 and 11 to the Home Care Unit indicating the name of the new personnel and what their position (administrator, alternate administrator) will be in your agency.  If the new individual is an administrator or a chief financial officer and they have not had a level 2 background screening, please go to the link below to find out how to obtain a level 2 screening and the required costs. Background Screening information

8.2 How do I report a change in 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.

Nurse Registry Location:

The following items are necessary to process your request:

A nurse registry cannot move their agency to another geographic service area unless they submit an initial application for the new location. Initial licenses are issued for a specific geographic service area and cannot be moved to another area.

AHCA shall fine a Nurse Registry $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.

8.3 How do I report a change in the name of the registry?

Complete sections of the Nurse Registry AHCA Form 7004 (See Section D Change During Licensure Period on the Checklist) and send it along with a $25 processing fee for your name change and new certificate.  A copy of the affidavit of a fictitious name is required if a nurse registry chooses to operate under a name other than the name of the partnership or corporation.  An individually owned nurse registry must submit a copy of the document from the Divisions of Corporations that shows the name has been officially changed as well as submit amended articles of incorporation showing the name change.

8.4 How do I do a change of ownership of a nurse registry?

A change of ownership as defined in Chapter 408, Part II, Florida Statutes is “An event in which the licensee sells or otherwise transfers its ownership to a different individual or entity as evidenced by a change in federal employer identification number or taxpayer identification number; or an event in which 51 percent or more of the ownership, shares, membership, or controlling interest of a licensee is in any manner transferred or otherwise assigned.”  This does not apply to a licensee that is publicly traded on a recognized stock exchange. The definition of “licensee” now includes all legal entities.

A change of ownership application must be completed and sent to the Home Care Unit 60 days prior to the change in ownership. Nurse registries use the AHCA Form 3110-7004 recommended including the financial schedules AHCA Form 3110-7004A and the other application forms listed at the web site. In addition the new owner needs to supply the following:

See Section 12 for more questions and answers on Change of Ownership

8.5 What must I do to notify AHCA & others when I discontinue the operation of my nurse registry?

The registry must inform the Home Care Unit 30 days prior to the discontinuance of the agency and include the date the registry will no longer be in operation. The license certificate must be sent to the Home Care Unit. The registry must also inform patients or their legal representatives in writing of the closure date and provide options for obtaining or forwarding copies of records as per the wishes of the patient. A copy of the notice in a newspaper can also suffice for written notification to patients.