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Application%20Process%20for%20HHA%20Licensure Powered By Docstoc
					                               KDHE Initial Licensure Process for
                                HOME HEALTH AGENCIES

                            For Information and Process contact:
                                       Licensure Area
                        KDHE/Bureau of Child Care and Health Facilities
                                1000 SW Jackson, Suite 200
                                 Curtis State Office Building
                                  Topeka, KS 66612-1365
                                       (785) 296-1258
                                    FAX: (785) 291-3419

1. You must contact, by phone, or in writing, the Kansas Department of Health and
   Environment (KDHE) Licensure Staff of your intent to initiate the home health agency
   licensure process.

2. You are responsible for knowing and complying with all local and state regulations.

3. You must request an application packet from the Licensure staff person. This completed
   packet must be returned to the licensure staff at the address listed above. A complete packet
   must contain:

       A.      The application form;
       B.      The $100 application fee;
       C.      Form ACC300A (attestation statement for home health licensure);
       D.      All applicable materials listed on the attached “Home Health Agency Initial
               Licensure Required Application Materials” chart (ACC 300B).

   After the Licensure Staff has received and checked items A-C from the application packet
   listed above for completeness, our staff will confirm receipt of packet submission to the
   email address you have provided on the initial application.

4. The application information is forwarded to the Certification Coordinator for data entry.

5. All of the Item D submitted with the application packet will be forwarded to the Initial
   Application Reviewer for review.

6. The Reviewer will conduct the initial review in order of the submission. Per KSA 77-511, the
   Reviewer has 90 days from receipt of your information to review it for compliance with
   licensure requirements and notify the applicant of the review findings. If the Reviewer
   indentifies that revisions and/or additional information are needed, the “90 day” clock may
   restart with the receipt of each submission of information from the applicant.

7. The Reviewer will contact the applicant and provide initial review results and any missing
   required data will be requested. It is the applicant’s responsibility to contact the Reviewer if
   there are any questions.

8. Once all required information has been verified, the applicant will be contacted and the home
   health license will be issued.
                                                                                         Revised 04/11

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