Connecticut Administrative Code › Title 19a - Public Health and Well-being › 495 - Licensure of Private Freestanding Mental Health Day Treatment Facilities, Intermediate Treatment Facilities and Psychiatric Outpatient Clinics for Adults › Short-term Hospitals, Special, Hospice and Hospice Inpatient Facilities › Section 19a-495-6b - Licensure procedures

Current through July 10, 2024
(a) No person,
				group of persons, association, organization, institution or agency, public or
				private shall establish, conduct or maintain a hospice inpatient facility
				without a license issued by the Commissioner of Public Health in accordance
				with this section except as provided in section
				19a-491
				of the Connecticut General Statutes. Such person or entity shall secure such
				license and any other required government authorization to provide hospice care
				services for terminally ill persons on a twenty-four-hour basis in all settings
				including, but not limited to, a private home, nursing home, residential care
				home or specialized residence that provides supportive services and shall
				present to the department satisfactory evidence that such person or entity has
				retained the services of qualified personnel necessary to provide services in
				such settings.
(b)
Application for initial or renewal licensure.
(1) Application for the initial granting or
				renewal of a license shall be made by the applicant to the department, in
				writing, on forms provided by the department.
(2) The application shall be signed by the
				owner of the hospice inpatient facility or by a person duly authorized to act
				on behalf of owner of the facility and shall include responses to all the
				information required on the forms provided by the department. The application
				shall be signed under oath, the signature notarized and the application form
				shall cite the provisions of section
				53a-157b
				of the Connecticut General Statutes.
(3) Application for the grant or renewal of a
				license to operate a hospice inpatient facility shall include the following
				information, if applicable:
(A) Statement of
				ownership and operation;
(B) Names
				and titles of professional and unlicensed direct care employees;
(C) Signed acknowledgement of duties for the
				administrator, medical director, and director of nurses upon initial
				application only;
(D) Patient
				capacity;
(E) Total number of
				employees, by category;
(F)
				Services provided;
(G) Evidence of
				financial capacity;
(H)
				Certificates of malpractice and public liability insurance; and
(I) Local Fire Marshal's biennial
				license;
(J) Affidavits as
				described in section
				19a-491a(a)
				of the Connecticut General Statutes;
(K) Reports from criminal history and patient
				abuse background searches pursuant to section
				19a-491c
				of the Connecticut General Statutes;
(L) The licensing or renewal fee an provided
				in the Connecticut General Statutes; and
(M) Such additional information as the
				Department may request.
(4) Any person who makes a material false
				statement in an application shall be subject to penalties in accordance with
				section
				19a-500
				of the Connecticut General Statutes.