Residential Treatment Facilities
Residential Treatment Facilities (RTF) are community-based residences for de-institutionalized
state mental hospital clients. Residents are limited to those age 18 or over.
These facilities were designed to provide long-term residential care with an
overlay or coordination of mental health services. A state license covers five
levels of care that range from having nurses on staff for 24 hours daily to
independent apartment residences that receive only weekly staff contact.
Facilities must meet licensing requirements by submission of a completed application,
required documentation, and completion of a satisfactory survey. The biennial license
fee is $176.00/bed. Substantial financial penalties may be imposed for submission
of late renewal applications.
Initial/Change of Licensed Operator and Renewal Requirements
To renew a current state license that is due to expire, you must print the licensure
application form below and submit the completed form(s) with the renewal fee prior to
the expiration date of the license. Renewal applications must be received by the
Agency at least 60 days prior to expiration of a license or a late fee will be assessed.
- Completed and signed License Application
Form (349K PDF).
- NOTE: A renewal application will not be accepted if the residential treatment facility license is expired. An initial license application must be filed if your license has expired.
- Health Care Licensing
Application
, Addendum
, Voluntary Board Member
Affidavit, and
Affidavit of Compliance with Background Screening Requirements.
- These forms are recommended for use beginning October 1, 2006, to comply with the reporting requirements pursuant to Chapter 408, Part II, Florida Statutes. Please provide this information in addition to the licensing application for the specific provider/facility type.
- Copy of JCAHO, CARF, COA, or NCQA accreditation letter, survey & any
follow up reports to or from the accrediting organization, if accredited.
- Program narrative: list of and description of services, resident population
served, and staffing pattern (hours, coverage per shift, number, and types
of staff, etc.)
- Table of organization showing all levels.
- Resume of facility manager.
- Current balance sheet for owner(s) verifying financial information for the
facility.
- Statement of operations projecting first six months income, expenses, taxes,
credits, etc. (Not required for renewal applications).
- Certificate of Insurance verifying commercial or general liability insurance
coverage (minimum coverage is $300,000 per incidence and $1 million in aggregate).
- Satisfactory fire safety inspection report completed in the last 365 days.
- Satisfactory Department of Health sanitation inspection report completed
in the last 365 days.
- Zoning approval letter for Levels I-A, I-B, and II (Not required for renewal applications).
- Copies of FBI and FDLE satisfactory background screening results for the
managing employee (usually the CEO) and CFO completed in the last 5 years
or a completed fingerprint card for the Agency for Health Care Administration
to complete the required screening.
- Check for the application fee ($176 per bed).
- If the Agency will be completing the required background screening,
include a check for 42.25 per person.
Capacity Change Requirements (if applying for such changes other than with
license renewal)
- Completed and signed License Application
Form (349K PDF).
- Program narrative, if changed from what was filed with the last mental health
application.
- Zoning approval letter or form for Levels I and II, if requesting a higher capacity.
- Submit a check for any additional beds requested ($176 per bed).
Change of Services Requirements
- Completed and signed License Application
Form (349K PDF).
- Revised program narrative: Listing the changes planned in the program and
services provided, resident population served, age groups admitted, and staffing.
- Revised staffing pattern, staff coverage, number of staff and types of staff,
etc.
- Zoning approval letter or form for Levels I and II.
Background Screening
Florida Department of Law Enforcement and FBI fingerprinting screening must be
completed by the managing employee (usually the chief executive officer) and the
chief financial officer and then repeated every five years unless there is a new
hire. Please go to the background screening section
of this web site for additional documentation that must be submitted with your
application.
Applications/Forms
Statute/Rule Authority
Updated March 18, 2008
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