Change of Facility Name

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Presentation transcript:

Change of Facility Name Notification Within 10 Days

Objective To comply with the regulatory requirement regarding change of facility name from California Department of Public Health (CDPH)

Requirement A request for approval regarding change in facility name from California Department of Health (CDPH) should be obtained in accordance to California Code of Regulation.

Notifying CDPH Any changes made to a Skilled Nursing Facility license must be reported to Licensing and Certification (L&C) District Office (DO) in writing within 10 days of the change, pursuant to Sections 72211 and 73225 of Title 22 of the California Code of Regulation (CCR). The DO will assist on which forms submitted for the specific change to the license.

Notifying CDPH If a facility wishes to update any changes to its agency's name, address, phone number, or services provided, a written request should be made and forwarded to: San Bernardino District Office 464 West Fourth Street, Suite 529 San Bernardino, CA 92401 District Manager: Lena Resurreccion Phone: (909) 383-4777 Toll Free: (800) 344-2896 Fax: (909) 888-2315

Reference http://www.cdph.ca.gov/pubsforms/forms/Documents/SNF-ICF-AppRequestLtrChecklist.pdf