Information for Providers
Introduction | Rules
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Division of Quality Assurance:
Links - Centers for Medicare and Medicaid Services (including S&C
letters), HIPAA, Civil
Rights, US Department of Labor, etc.
Licensee Change of Ownership:
If operation of the hospice is later transferred to
another owner, ownership group, or to a lessee, the licensee is required
to notify the Division of Quality Assurance at the time they are planning
a change-of-ownership transfer as the license
Documentation must be submitted to the Division of
Quality Assurance to officiate the change of owner.
If operation of the hospice is later transferred to another
owner, ownership group, or to a lessee, the Health Insurance Benefits
Agreement will be transferred.
You are required to notify the Division
of Quality Assurance at the time you are planning a
change-of-ownership transfer as your license is non-transferable.
Complete all applicable sections of application, including Section
B. which may be obtained from the Hospice Licensing Specialist
who can be reached at 608-266-2702
See Rules & Regulations
Wisconsin Statutes, Chapter 50.90
Code, HFS 131 - Hospice Rules
Please review and submit
Policies and Procedures Necessary to
meet HFS 131
A nonrefundable fee
of $300.00 must be included with your application as required under
HFS 131.14(1), except that:
The fee for a hospice that is a nonprofit corporation and
is served entirely by uncompensated volunteers or employs
persons in not more than 1.5 positions at 40 hours of employment
per week shall be $25; and
The fee for a hospice that is a nonprofit organization,
that is served entirely by uncompensated volunteers and
that charges no fees may be waived by the department upon
Your check should be made payable to the Division
of Quality Assurance.
Background Check Process - A background check is completed
on all signatories and interested parties having access to clients.
Select the appropriate section, "New
Applicant" or "Existing License Holder."
Complete and return HFS 64A and HFS 69A.
Review Chapters 1 and 2
in the "Caregiver Program Manual" concerning the fees
and process of employees' background checks.
The applications, fees, and forms should be sent to: Department
of Health Services, Hospice Licensing Specialist, Division of Quality
Assurance, Post Office Box 2969, Madison, WI 53701-2969.
Safety in Healthcare
Provider resources for Safety
Preparedness for Long Term Care and Assisted Living Facilities
The Centers for Disease Control and Prevention
Emergency Preparedness and Response website includes preparedness
resources for healthcare facilities. (exit DHS)
U.S. Department of Labor
States Department of Labor, Wage and Hour Division Fact Sheet website
provides information by topic of the Fair Labor Standards Act. (exit DHS)
Fact Sheet topics include: Health Care, Nursing Care Facilities, Nurses,
Recordkeeping, Home Health Care, Hours Worked, Overtime, and additional
Wisconsin's Flu Resource
Flu Resource website (exit DHS)
Wisconsin License, Permit and Registration Services
License, Permit and Registration Services - Category: Health/Medicine (exit DHS)
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Last Updated: August 25, 2014