Hospice Services

 
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Facilities
 
 
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What would you like to do?

What you need to know

A hospice must be primarily engaged in providing care and services to terminally ill patients including bereavement counseling. Hospice services may be provided on an outpatient basis to the patient in the patient's place of residence. Hospice services may also be provided by an inpatient hospice facility. Hospice services must include the following:

  • Nursing services, physician services, and drugs and biologicals routinely available on a 24-hour basis
  • All other covered services available on a 24-hour basis to the extent necessary to meet the needs of individuals for care that is reasonably necessary for the palliation and management of terminal illness and related conditions
  • Services provided in a manner consistent with accepted standards of practice. A hospice must accept a patient only when it reasonably expects that it can adequately meet the patient's medical, therapeutic, and social needs in the patient's permanent or temporary place of residence
  • Each patient receiving services from the hospice is entitled to receive the full range of services; and
  • Each hospice that has multiple locations must provide at each location the same full range of services required by these regulations.

Applications, Requirements & Fees

Initial Licensure Requirements – read Title 175 NAC 16-003.01

  • Stage 1: Submit to the Department a complete application. For inpatient hospice facilities which meet the “new construction" definition at 16-002, see additional paperwork requirements on the Department's Facility Construction webpage.
  • Stage 2: Pass an onsite inspection as required at 175 NAC 16-005 and for inpatient hospice facilities submit a Completion Certificate form completed by a Nebraska-licensed architect or engineer which documents compliance by the inpatient hospice facility with 175 NAC 16-007.
      
    Please see the Inspections section of this page for initial inspection information.

Renewal Licensure Requirements – read Title 175 NAC 16-003.02

  • Stage 1: Department mails to licensee a notice of expiration and renewal application.
  • Stage 2: Licensee returns to the Department the renewal application with correct owner signatures, owner titles, dates, renewal fee, and additional items as required at 175 NAC 16-003.02A.
  • Stage 3: Department mails to licensee an updated license card after a complete renewal application is received.

Fees – The licensee must pay fees for licensure and services as set forth at 175 NAC 16-004.10

Forms – The following form may be completed online but must be printed, signed, and mailed to our office. We require an original signature on all applications.

Initial License Application

Renewal Licensure Application: please call (402) 471-4967 

Change Notification

Notifications:

An applicant or licensee must notify the Department in writing, by mail, electronic mail, or facsimile as required at: 175 NAC 16-004.07

Additional General Requirements:

Change of premises (for inpatient hospice facilities) or ownership (for all hospices) – The sale, whether of stock, title, or assets, lease, or discontinuance of operations terminates the license. The licensee must notify the Department in writing 10 days before a hospice is sold, leased, discontinued, or moved to a new location. A license is issued only for the premises and persons named in the application and is not transferable or assignable.

Forms:

The following form may be completed online but must be printed, signed, and mailed to our office.

Change or Correction Request Form  

Inspections

The Department inspects hospice services prior to and following licensure to determine compliance with 175 NAC 16-006 – Standards of Operations, Care and Treatment and for inpatient hospice facilities with 16-007 – Physical Plant Standards. The hospice service may not operate without an active license issued by the Department. Inspection requirements are at 175 NAC 16-005.

Initial Licensure Inspections:

An onsite inspection is scheduled with the applicant after the Department has received a complete initial license application and a written notification from the applicant with the date the applicant will be ready for the inspection. Unless the applicant requests a later date, the Department has 30 working days to conduct this initial onsite inspection after a complete application is received by the Department.

Prior to submitting an initial license application or requesting the initial onsite licensure inspection, the applicant should be ready to operate, but not operating. The hospice Administrator and back-up Administrator must be prepared to demonstrate during the Department's onsite inspection how the hospice will comply with the requirements at 175 NAC 16-006 and for inpatient hospice facilities at 16-007. Compliance is demonstrated through the use of hospice-specific organizational charts, job descriptions, policies, procedures, forms, and similar items along with a physical inspection of the hospice for inpatient hospice facilities prior to the applicant being issued a license by the Department.

Compliance Inspections:

Following initial licensure, the Department may conduct unannounced onsite inspections at any time the Department deems necessary to determine compliance with 175 NAC 16-006 and for inpatient hospice facilities with 16-007.

Inspection Results: See 175 NAC 16-005 

Medicare/Medicaid Certification

To request a hospice Medicare-certification initial enrollment paperwork packet, please call (402) 471-4967.

For Medicaid certification information see Nebraska State Medicaid webpage.


 

Office of Outpatient & In-home Care Services
Department of Health & Human Services/Division of Public Health/Licensure Unit
Phone Number
(402) 471-4967
 
Fax Number
(402) 742-2308
Mailing & Physical Addresses

DHHS Licensure Unit

Attn: Hospice Services Licensing
PO Box 94986

Lincoln NE 68509-4986


 

Nebraska State Office Building

301 Centennial Mall South
14th & M Streets, 1st Floor

Lincoln NE 68508

Hours: Monday - Friday 8:00 a.m. - 5:00 p.m. Closed federal holidays.