Licensure and Medicare/Medicaid Certification
Licensure
State law requires hospitals, long term care facilities, clinics, hospice programs and out of hospital dialysis units to be deemed suitable and responsible by the Department of Public Health, Division of Health Care Quality and comply with licensure regulations in order to operate. Providers must be deemed suitable and licensed before they begin providing services.
An application for a determination of suitability and license to operate must also be filed when there is a transfer or change of ownership. Applicants must submit a completed “Notice of Intent to Acquire” (see below) at least 90 days in advance of the proposed date of transfer of ownership for nursing homes and hospitals, and at least 30 days in advance for all other provider types; and all programmatic documentation with 48 hours of the actual transfer. “Change of ownership” includes: transfer of a majority interest of the ownership; change in trustee or a majority of the trustees of a trust; transfer of a majority of any class of the stock of a for-profit corporation; changes in the corporate membership or trustees of a non-profit corporation such as the Department determines to constitute a shift in control of the program; or the initiation of foreclosure proceedings by a mortgagee in possession.
Licensure Laws
- Hospitals: MGL Chapter 111, section 51, MGL Chapter 111, section 51G, and 105 CMR 130.000;
- Long term care facilities (nursing homes and rest homes): MGL Chapter 111, section 71; and 105 CMR 150.000, 105 CMR 151.000, and 105 CMR 153.000;
- Clinics: MGL Chapter 111, section 51, and 105 CMR 140.000;
- Hospice: MGL Chapter 111, section 57D and 105 CMR 141.000;
- Out of hospital dialysis units: MGL Chapter 111, section 51A and 105 CMR 145.000.
Initial Licensure and Change of Ownership Applications
1. Applicants for licensure must satisfy applicable Determination of Need and Plan Review requirements before submitting their application for a determination of suitability.
2. Applicants for licensure must complete the “Initial Licensure Application: Notice of Intent to Acquire/ Application for Determination of Suitability” form and submit all required attachments in order for their application to be deemed substantially complete. The Department is unable to process incomplete applications for suitability:
All Applicants:
- Initial Licensure Application/Notice of Intent to Acquire (PDF) | RTF 1.92MB
- Table 1 – DPS Certificate or Local Occupancy Permit (PDF) | RTF
- Table 2 – Fee Schedule (PDF) | RTF
- CORI Form (PDF) | RTF 3.35MB
Selected applicants as may be required:
3. In addition, applicants must submit appropriate programmatic documentation specific to their provider type. You must contact a DHCQ Licensure Coordinator for specific forms, either by phone at 617-753-8000, or by email: Ray.Cryan@State.MA.US (nursing homes and rest homes); or Pearlina.Mills@State.MA.US (clinics and hospice).
Changes to Existing Licenses
Current licensees should contact the appropriate Licensure Coordinator for changes to an existing license: Ray Cryan (nursing homes and rest homes) by phone 617-753-8114, or by email at Ray.Cryan@State.MA.US; or Pearlina Mill (clinics and hospice) by phone at 617-753-8124, or by email at Pearlina.Mills@State.MA.US.
Currently licensed hospitals should contact David Brown, Licensure and Certification Coordinator, either by phone at 617-753-8115, or by email: David.Brown@DPH.State.MA.US for changes to an existing hospital license.
Complaints Regarding Licensed Facilities
If you wish to file a complaint against a licensed or certified provider, please contact the Complaint Unit at 617-753-8150 or go to: How To File a Complaint. For information on regulations prohibiting abuse, neglect and misappropriation see: 105 CMR 155.000.
Medicare and Medicaid Certification
Health care providers must be certified in order to participate in the Medicare and Medicaid programs.
Providers must be operational (already providing services), when they apply for Medicare (and, for long term care facilities, Medicaid) certification.
For additional information on the certification process, please contact David Brown, Licensure and Certification Coordinator, either by phone at 617-753-8115, or by email: David.Brown@DPH.State.MA.US.
This information is provided by the Division of Health Care Quality within the Department of Public Health.