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Application for Licensing and/or Certification of a General Acute Care Hospital

General acute care hospital means a hospital, licensed by the Department, having a duly constituted governing body with overall administrative and professional responsibility and an organized medical staff which provides 24- hour inpatient care, including the following basic services: medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, and dietary services. A general acute care hospital shall not include separate buildings which are used exclusively to house personnel or provide activities not related to hospital patients.

The following forms and documents are required for licensure and/or certification.

In addition to the forms below, you are required to submit additional documents for a change of ownership.  Also, please submit proof of General Acute Care Hospital (GACH) accreditation from the Joint Commission of the Accreditation of Healthcare Organizations (JCAHO), American Osteopathic Association (AOS), or the Det Norske Veritas Healthcare, Inc. (DNV), if applicable.  These documents must be submitted with your completed application.  The required information and instructions are listed on the checklist contained in the "General Acute Care Hospital Application Request Letter and Instructional Checklist" (pdf)Opens a new browser window letter.

To be licensed only:

To be licensed and certified with Medicaid/Medi-Cal/Medicare:

 

 
 
Last modified on: 4/23/2010 3:41 PM