State Licensure and/or Federal Medicare Certification
Hospice Agency Application Materials
If your application is in accordance with Pennsylvania state licensure rules and regulations, the Division will issue you a license. Please keep in mind the length of time for the licensure process depends upon the accuracy of information provided.
This step is for Inpatient Hospice Units:
Architectural construction plans for your proposed
facility must be submitted to the Division of Safety Inspection for
review and approval.
Mr. Charles Schlegel, Director
Division of Safety Inspection
2150 Herr St., 1st Floor
Harrisburg, PA 17103
Phone: 717-787-1911 or visit the building safety page.
Hospice Agency Application for Federal Medicare Certification
NOTE: State licensure as a hospice agency is a requirement for federal certification.
After review and acceptance of the application materials and notification from CMS of the approval of the CMS-855A, the department will conduct a survey before recommending the agency for Medicare certification.
Mail completed forms to:
Please note change of address
Pennsylvania Department of Health
555 Walnut St.
7th Floor, Suite 701
Harrisburg, PA 17101