The following applications and forms are for use by nursing homes and those seeking an initial license.
These are the forms needed for making a change to the number of certified beds in a nursing facility.
Nursing homes are required to notify the Nursing Home Licensure and Certification Section within one working day following the occurrence of change in administrator or director of nursing. Please submit the completed Admin-DON Change form to [email protected].
Effective January 1, 2012, the Centers for Medicare and Medicaid Services has established a process for any entity to apply for funding to improve resident outcomes in certified nursing homes. Only civil money penalty (CMP) fund applications that meet the statutory intent of the regulations, Federal law and policy will be considered. Complete the application for consideration. Please direct any questions to [email protected]. You may submit a completed application to [email protected].