Hospice Agency
Change of Certification Application Packet ā
A State license is required to operate as a Hospice Agency in California.āÆA Hospice means āa specialized form of interdisciplinary health care that is designed to provide palliative care, alleviate the physical, emotional, social, and spiritual discomforts of an individual who is experiencing the last phases of life due to the existence of a terminal disease, and provide supportive care to the primary caregiver and the family of the hospice patient,ā pursuant to Health and Safety Code section 1746(d).
To apply for Medi-Cal and/or Medicare certificationā to a licensed health facility, you must complete the required application packet.ā
An applicant must submit a completed application packet to the Centralized Applications Branch (CAB). The provider instructions are a resource to guide you through the process. The provider checklist identifies the required forms and supporting documents needed to apply for certification.
Submit completed application packets to the CAB at the address listed below. Do not send any completed application packets, forms, or supporting documents to the local CDPH, District Office.