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Indiana State Department of Health

ISDH Home > Health Care Quality & Regulatory > Acute Care/Hospitals > Home Health Agency (HHA) Licensing and Certification Program Home Health Agency (HHA) Licensing and Certification Program

Program Overview

Welcome to the homepage for the Indiana State Department of Health Home Health Agency Licensing and Certification Program. The Indiana State Department of Health licenses agencies that provide: 

  • nursing services;
  • physical therapy;
  • occupational therapy;
  • speech therapy;
  • medical social worker;
  • home health aide;
  • other therapeutic services

to the patient at the patient's temporary or permanent residence.  The Indiana State Department of Health inspects state licensed home health agencies for quality of care to citizens of Indiana and to ensure compliance with state law and rules.  The Indiana State Department of Health also monitors agencies, on behalf of the Centers for Medicare and Medicaid Services, for quality of care for all citizens in need of those services and to ensure compliance with federal regulations.

Contact the Program

Indiana State Department of Health
Division of Acute Care
2 North Meridian Street, 4A
Indianapolis, IN 46204
(317) 233-7474 (Acute Care Receptionist)
(317) 233-1325 (ISDH Main Switchboard)
Map

Program Manager
Kelly Hemmelgarn
khemmelgarn@isdh.in.gov
(317) 233-7541
(317) 233-7472  [Administrative Assistant]

Report a Complaint or Incident to the ISDH

Report a complaint regarding a health care facility
Individuals can call or email to make complaints about care provided at any licensed or certified Indiana health care providers or suppliers.

Report an incident regarding a health care facility
The Incident Report Form is for health care facilities to notify the Indiana State Department of Health of a reportable incident pursuant to the ISDH Reportable Unusual Occurrence Policy.  The Incident Report Form is also for health care facility staff (nursing homes, intermediate care facilities, and hospice agencies) to report a reasonable suspicion of a crime against a resident pursuant to Federal regulations.  This form is not to be used to file a complaint.

Consumer Information

Centers for Medicare and Medicaid Services

Your Medicare Rights and Responsibilities

Advance Directives Resource Center

Out of Hospital Do Not Resuscitate Declaration and Order

Consumer Reports

Home Health Agency Reports

Home Health Compare (Medicare)

2005 Patient Profile of Home Health Agencies

2004 Patient Profile of Home Health Agencies

2003 Patient Profile of Home Health Agencies

Agency Changes

Select a topic below for instructions on how to submit the change to the department.  Please notify the department of changes as they occur at the agency.

Branch Information

Select a topic below for information related to Branch questions.

Applications: Applying for Initial Licensure or Change of Ownership

Review all applicable information PRIOR to submission of application to the Department.

Initial Application

To apply for an initial license to operate a home health agency complete the “APPLICATION FOR LICENSE TO OPERATE A HOME HEALTH AGENCY” (SF 4008) and submit with $250.00 licensure fee and other required information to the Indiana State Department of Health.

Forms to be completed and returned with the application:

FOR STATE LICENSE AND STATE LICENSE SEEKING MEDICAID:

FOR MEDICARE:

Medicare Forms:

Change of Ownership Application

To apply for a Change of Ownership for an existing agency complete the “Application for License to Operate a Home Health Agency” (State Form 4008) and submit with the $250.00 licensure fee, applicable purchase agreement, and other required information to the Indiana State Department of Health.

For CHOW involving a Medicare CCN please complete the following forms:

Medicare Forms:

Laws / Rules

General Information

Licensure Renewals

To renew the agency’s license to operate a home health agency complete the renewal application and submit with the $250.00 licensure fee to the Indiana State Department of Health.  In accordance with 410 IAC 17-11-3 an application for renewal of license shall be filed with the department at least sixty (60) days prior, but not sooner than ninety (90) days before, the expiration date of the current license.

If there are changes that occurred at your agency make sure all changes are made on the renewal application.  Include all applicable information with the application.  The application must be approved and licensure fee received PRIOR to issuance of license.

Submit the $250.00 licensure renewal fee with your renewal application (SF 48851).  Make sure check or money order payable to the Indiana State Department of Health.  Submit application and $250.00 renewal fee to:

Indiana State Department of Health
Attention: Cashier, 2nd Floor
P.O. Box 7236
Indianapolis, IN 46207

Survey Reporting System (SRS)

Directories

Directory of Home Health Agencies Located in City/County

Directory of Home Health Agencies Serving County

Employment Opportunities

Learn more about Employment Opportunities with the Indiana State Department of Health

Forms

Application for License to Operate a Home Health Agency (State Form 4008) Submit all documentation requested on application.

Branch Questionnaire for a Home Health Agency

Fiscal Intermediaries Information and Forms

Home Health Aide Registry Application

Renewal Application for License to Operate a Home Health Agency

Laws and Regulations

Federal Laws and Regulations

42 CFR 484

Appendix B  State Operations Manual

Code of Federal Regulations (CFR) Homepage

State Laws and Rules

Home Health Agency Statute

Home Health Agency Rules

Indiana Law and Rules Homepage

Indiana Register

Links

Professional Organizations

Indiana Association for Home and Hospice Care

Accreditation Organizations

Accreditation Commission for Health Care, Inc. (ACHC)

American Osteopathic Association

Community Health Accreditation Program (CHAP)

Joint Commission on Accreditation of Hospital Organizations

State Government

Indiana Public Access Counselor

Indiana Secretary of State

Office of Medicaid Policy and Planning (FSSA)

Federal Government

Agency for Healthcare Research and Quality (AHRQ)

Americans with Disabilities Act (ADA)

Centers for Disease Control and Prevention (CDC)

Centers for Medicare and Medicaid Services (CMS)
 
Health Care Excel (HCE)

National Government Services

National Patient Safety Foundation

Office of Civil Rights

U.S. Small Business Administration

Newsletters

March 2005

March 2004

March 2003

March 2002

Program Information and Policies

Registry changes effective January 14, 2008
Information on the registry for home health aides, certified nurse aides, and qualified medication aides.