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Frequently Asked Questions for SB 135 Hospice Facility Licensure

What is the effective date of this new legislation?

January 1, 2013

How does a currently licensed CLHF (B), SNF or Special Hospital, that is operated by a hospice, submit an application to change the category of licensure to Hospice Facility?

A currently licensed CLHF (B), SNF or Special Hospital, must undergo the same application process as any other initial hospice facility license applicant. For your convenience, L&C has created a letter and checklist to assist you in preparing a hospice facility application package. This checklist can be found on our  Hospice Facility Initial Application Packet webpage.

Once the application package and the licensing fee have been received by your local District Office (DO), the DO will review the application package for completion. Once the completed application has been approved by the DO and required surveys are performed, the DO will issue the license accordingly. 

What is the deadline for submitting this application, after the Department publishes guidance to providers and the district offices?

Effective January 1, 2013, California Department of Public Health (CDPH) Licensing & Certification (L&C) will be accepting applications for Hospice facility licensure. 

What is the process for a licensed hospice provider to obtain licensure for a new Hospice Facility?

Please refer to the answer to question 2. 

Does a provider need to become a licensed hospice before they apply for the hospice facility license, or can the applications be made concurrently?

Anyone interested in obtaining hospice facility licensure that is not currently a Licensed and Certified hospice service provider, would need to apply for a hospice provider license and certification prior to applying for a hospice facility license. 
If an applicant applies concurrently for the provider and facility license, they would first need to be approved as a licensed and certified hospice provider prior to receiving a hospice facility license approval. 

Please note: If the applicant submits both an application for a hospice provider license and a hospice facility license concurrently, and is denied hospice provider licensure, the application for a hospice facility license will also be denied and the application fees will not be refunded. 

How will the application process for a free-standing hospice facility differ from a hospice facility that is physically-located within another health facility?

The application process is the same for a freestanding hospice facility and a hospice facility that is physically-located within another health facility with the exception of the building requirements. A freestanding hospice facility must meet applicable building standards and requirements relating to the physical environment of the facility as specified in Section 418 of Title 42 of the CFR. These standards will be enforced by the local building department. A hospice facility that is located within the physical plant of another licensed health facility that is under the jurisdiction of the Office of Statewide Health Planning and Development (OSHPD) must meet the building standards for the category of health facility within which the hospice facility will be located. These standards will be enforced by OSHPD.

Are there circumstances under which a separately-licensed hospice facility could be located within a community care facility?

No. A hospice facility may be located within the physical plant of another licensed health facility (e.g. SNF or general acute care hospital). A community care facility is not defined as a health facility pursuant to Health & Safety Code (HSC) Section 1250.

Must a facility owned and operated by a hospice provider, where general inpatient care is provided, apply to become a hospice facility?  

Yes. A hospice provider that intends to provide inpatient hospice care in the hospice provider’s own facility must submit an application and fee for licensure as a hospice facility (HSC 1339.41 (b)).

If a hospice provider-owned facility does not intend to provide general inpatient care, can they remain licensed as a CLHF (B), or other category of licensure?

Yes, but they must refrain from using the word “hospice” in the facility name. Only a licensed hospice facility can use “hospice” in their name.  See the answer to question 10. 

Can any licensed facility continue to use the word, “hospice” in the name of their facility, if they are not licensed as a Hospice Facility?

No. Any unlicensed private or public organization must refrain from:
  1. Representing itself to be a hospice facility by its name or advertisement, soliciting, or any other presentments to the public, or in the context of services within the scope of the provisions of this bill imply that it is licensed to provide those services or to make any reference to employee bonding in relation to those services;

  2. Using the words “hospice facility,” “hospice home,” “hospice-facility,” or any combination of those terms, within its name; or,

  3. Using words to imply that it is licensed as a hospice facility to provide those services. 

What is the survey cycle for hospice facilities under state licensing law, and under the federal certification process? 

State law requires health facilities to be inspected no less than once every two years and as often as necessary to ensure the quality of care being provided (HSC 1279). Centers for Medicare & Medicaid Services (CMS) states recertification surveys are done an average of every 6 years. 

Can a home health agency (HHA) that provides hospice services apply to operate a hospice facility?

No. In order to be eligible to apply for a hospice facility license, the HHA must first obtain a license as a hospice provider. 

What is the fee structure for hospice facilities, and how frequently is the fee paid to the department?

The Licensing & Certification fees for hospice facilities in the first year (FY13-14) will be the same fees as CLHFs. Thereafter, the licensure fee for hospice facilities shall be established based on the costs associated with performing licensing activities for the specific facility category pursuant to HSC 1266. The licensure fees are collected annually and are based on the number of beds on the license. Fees amounts are updated annually on the CDPH website and can be accessed on the Health Care Facility Licensing Fees webpage.

Can a CLHF(B) that has already paid its licensing fee, and converts to a hospice facility, have the licensing fee pro-rated for the remainder of the CLHF-B fee due date?

No. Licensing & Certification does not have the authority to pro-rate fees. In addition, in order for a CLHF to obtain a hospice facility license, they must file a new licensing application which requires submittal of a new licensure fee. 

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