New DLC License Application/ Reapplication Forms

• By: Maureen Carland
• On: 04/29/2024 09:33:28
• In: Quality/Regulatory

The Division of Licensing and Certification  (“DLC”) has updated the application facilities need to complete and submit for both initial license as well as renewal of existing license.
 
There are now separate applications for Nursing home ONLY facilities and those facilities that are both SNF/NF and residential (aka “Multi-Level” facilities).   No longer will Multi-Levels complete the Nursing Home application.  
 
Also for the first time, all application materials—the completed application and the additional documents necessary—will be accepted by email, not hard copy.  The email address to which these documents must be sent is on the attached applications: DLRS.MedFacilities@Maine.gov .
 
Payment of licensing fees, however, must still be made via check or money order, and thus must still be made via mail or delivery to: DHHS/Div of Licensing & Certification, State House Station #11, Augusta, ME 04333-0011.
 
The new applications reflect the requirements of State Regulations (10-144 Ch 110); clarify some sections that needed clarifying; require email addresses for all persons named in the application; and require full contact information for management companies, if the facility is managed by an entity other than its owner.   

The new applications also require the submission, every renewal period, of copies of documents such as, but not limited to:

• leases, if the building(s) and/or land are leased rather than owned;
• surety bonds to protect residents' property;
• transfer agreements with hospitals;
• signed written agreements for qualified professional services; and
• the most recent water test if the facility is using a private water supply.   

 
Please be advised that all applications submitted to DLC after today's date must be one of these two new application forms, must include all required documents, and must be emailed. 
 
Additionally, only completed applications will be processed. Those that do not have a response for each question that is applicable to the submitting facility, or do not include the required documents,  will be returned to the facility for completion.   Please do not use abbreviations unless those are defined previously in the application.
 
Completed applications, all required additional documents, and payment must be received at least 20 days prior to the expiration of the facility's existing license.
 
Please also remember that no application can be processed until DLC has the required payment.   
 
If you have any questions, please email Lynn Hadyniak, JD, DLC Associate Director of Medical Facilities Unit,  at Lynn.Hadyniak@Maine.gov .
 
Staff Contact: mcarland@mehca.org