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Procedure for LHCSA Administrative Licensure Amendments (DAL DHCBS 22-02)

New Yorksub_regulatoryNYSDOH Division of Home and Community Based Services· effective 2022-02-15

What this rule requires your agency to do

  • 1Adding a site requires submitting the new address, effective date, counties, executed lease, floor plan, and Certificate of Occupancy.(Procedure for LHCSA Administrative Licensure Amendments (DAL DHCBS 22-02))
  • 2To amend a license, an LHCSA must submit a written request on agency letterhead signed by the administrator, by email to the appropriate regional office and to LHCSA@health.ny.gov, with the completed checklist and all required documents.(Procedure for LHCSA Administrative Licensure Amendments (DAL DHCBS 22-02))
  • 3When closing a site or surrendering a license, the agency must submit a Closure Plan or statement addressing maintenance, storage, safekeeping, and disposition of patient clinical records.(Procedure for LHCSA Administrative Licensure Amendments (DAL DHCBS 22-02))

Applies to: cross-cutting

Sets the procedure and required documents for LHCSAs to request administrative licensure amendments (adding/deleting services or counties, sites, address, name changes, closures).

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.