Home Health Agency - Provisional

Contact Email

Phone

608-266-7297
Division of Quality Assurance/Bureau of Health Services
Licensing, Certification & CLIA Section
P.O. Box 2969
Madison, WI 53701-2969

Provisional license to operate a home health agency.

Type

Provisional

Description

License required to open and operate a home health agency, which provides part-time and intermittent skilled nursing and other therapeutic services on a visiting basis to persons in their homes.

Duration

90-Days. However, the agency may request to renew their provisional license for additional 90-day terms not to exceed one year from the original issuance date of the provisional license.

Fees

One-time application fee of $300.

Application Process

Contact the Division of Quality Assurance at 608-266-7297 or via email for application materials.

WI Statutes

Chapter 50.49, Licensing and Regulation of Home Health Agencies

WI Administrative Code

Chapter DHS 133, Home Health Agencies
Chapter DHS 12, Caregiver Background Checks

Federal Regulations

42 CFR 484 Code of Federal Regulations, Conditions of Participation, if the agency is certified for Medicare and/or Medicaid.

Last Revised: December 14, 2016