Home Health Change of Address
According to the minimum licensing regulations, notification of changes such as name and address must be provided to the department in writing or by facsimile within 24 hours of the occurrence.
Relocation of an Agency. The department shall be notified in writing of any relocation of an agency. An agency may only relocate within its geographic service area in effect on August 15, 1995, or for an agency licensed after that date, a 50-mile radius of the location where the agency was originally licensed.
Branch: an office from which a home health agency provides services within a portion of the total geographic service area served by the parent agency. The branch office is part of the parent home health agency; is located within a 50-mile radius of the parent agency; and shares administration and supervision.
All providers having a change of address shall submit:
- A “Letter of Intent” describing the change that has occurred and the effective date of that change.
- A completed license application, (HSS Form)
- A fee (HSS Payment Procedure)
- If the parent moves, the fee is $600 plus $300 for each branch office.
- If a single branch office moves, the fee is $300.
- If more than one branch office move, the fee is $300 per branch.
The provider must submit notice of the change of address to the fiscal intermediary (FI) according to their process. Health Standards Section cannot complete the process until receipt of the 855A form from the FI.