Please contact DHHS, Division of Public Health for an initial licensure packet. See contact information.
Any person or entity intending to establish, operate or maintain an Intermediate Care Facility for Persons with Developmental Disabilities must first obtain a license from DHHS Division of Public Health.
1. The applicant must submit a completed application with required documents and appropriate fees.
2. The Division will review the application and required documents for completeness. Notification will be provided if additional information is needed to complete the application. A completed application is when the Division has received a complete and accurate application form, all the necessary supporting documentation and the required fee.
3. The Division will conduct an onsite inspection within 30 working days of receipt of a completed application to determine compliance. The inspection may be at a later date when requested by the applicant. The inspection date and time will be coordinated with the applicant. The facility must be furnished, have completed written policies and procedures to address the licensure requirements and be ready for operation prior to the initial inspection. The inspection and issuance of a license must be prior to client use and occupancy.
4. The Division will make a decision on issuance of a license after completion of the onsite inspection.
The signature(s) must be that of the owner(s) of the facility.
1. If the applicant is an individual or partnership, the application must be signed by the single owner or the partners.
2. If the applicant is a limited liability company, the application must be signed by two of its members. (Can be one member if there is only one member.)
3. If the applicant is a corporation, the application must be signed by two of the corporation’s officers. Only the corporate officers (President, Vice President, Treasurer, and Secretary) can sign the licensure application. A corporation’s Board member/Board officer cannot sign as a corporate officer. Also the Administrator cannot sign the application unless he or she is one of the owners mentioned.
4. If the applicant is a governmental unit, the application must be signed by the head of the governmental unit having jurisdiction over the facility to be licensed.
As a corporation you should put the name that is registered with the Secretary of State's office. This will be the same if you are a limited liability company.
The schematic plan is a diagram of the facility which describes the number and location of treatment areas, bedrooms (with measurements), kitchen/dining recreation/leisure/visitation areas, bathrooms, entrances, exits and other points of safety. This document will be placed in your public file. This does not mean architect plans. This can be hand drawn as long as it is legible.
At least 30 days prior to the expiration of your license, the Division will send you a renewal application and a letter identifying additional information needed. The application contains information that is currently in our records. You will review and update the information as needed. Submit the required documents and fee. The application must have the required signatures for the ownership type.
The Division will send you notification that we have not received a completed application by the license expiration date. The notification will state that the Division will not take action for 30 days following the expiration date and if you submit a completed application within the 30 days your license will be renewed. If you fail to submit a completed application, your license will be placed on lapsed status. During the lapsed status, the facility may not operate until the license is reinstated.
The license expires every year on March 31st. To continue to operate you must renew your license by the expiration date.
A License is issued only for the premise in the application and is not transferrable or assignable. A change in location terminates the license. The facility must submit an initial licensure application and the required documents. Keep in mind that services cannot be provided at the new location until a new license has been obtained.
A license is issued only for the persons/entity named in the application and is not transferrable or assignable. A change of ownership terminates the license. The facility must submit an initial licensure application and the required documents to obtain a new license in order to continue to operate.
Notify the DHHS Division of Public Health in writing of the change within 5 days.
Send your request to the Division in writing at least 30 days prior to the proposed effective date of the change along with the facility name, address, license number, and signature approved to sign such requests. Specify the number of beds you wish to increase/decrease and the bedroom for this change. There may be other documentation that you will be asked to submit, but the office will notify you of that information when they receive and review your request.
Send notification to the Division in writing prior to any new construction affecting care and treatment areas of the facility. Please refer to the Licensure Unit website for facility construction.
Please refer to the Licensure Unit’s website for facility construction.
Please keep in mind you must have Division approval prior to the start of any new construction projects for licensed healthcare facilities.
The occupancy certificate must be issued by the State Fire Marshal's office or delegated authority. You may contact the State Fire Marshal’s office or the delegated authority in your area. A list of delegated authorities is at http://www.sfm.nebraska.gov/programs-services/delauth.html
You may also contact the Division and we can make a referral to the State Fire Marshal’s office of your need for an inspection.
The Division will accept occupancy certificates dated up to 18 months prior to the expiration date of the license.