Hospice Agency
Change of Location Application Packet
A State license is required to operate as a Hospice Agency in California. A Hospice means "a specialized form of interdisciplinary health care that is designed to provide palliative care, alleviate the physical, emotional, social, and spiritual discomforts of an individual who is experiencing the last phases of life due to the existence of a terminal disease, and provide supportive care to the primary caregiver and the family of the hospice patient," pursuant to Health and Safety Code section 1746(d).
Attention Hospice Applicants! Please review [AFL 21-53 ] This AFL notifies hospices of the chaptering of SB 664 (Chapter 494, Statutes of 2021) that establishes a moratorium on hospice licensure, prohibiting the California Department of Public Health (CDPH) from issuing a new hospice license on or after January 1, 2022, and until 365 days from the date the California State Auditor (CSA) publishes a report on hospice licensure. Applications for licensure of a multiple location of an existing hospice, a change of geographical service area, or a change of location outside of a hospice's approved geographical service area will be subject to the moratorium.
Application After January 1, 2022
Applications for a Change of Location that also includes a Change in Geographical Service Area will be assessed based on the need for hospice services in the applicant's proposed geographical service area based on concentration of all existing hospice services in that area.
This does not apply to Change of Location applications that do not include a Change in Geographical Service Area.
To report a Change of Location, you must complete the required application packet.
How to Apply
An applicant must submit a completed application packet to the Centralized Applications Branch (CAB). The application packet contains the required forms in one location. The provider checklist identifies the required forms and supporting documents needed to apply for licensing and certification. The provider instructions are a resource to guide you through the process. The Sample Application Packet is a visual aid that displays a sample of the completed forms contained in the application packet.
Please refer to the following links to get started:
Application Packet Forms
Applicants must complete and submit the following forms in the application packet:
Where to Submit Applications
Submit completed application packets to the CAB at the address listed below. Do not send any completed application packets, forms, or supporting documents to the local CDPH, District Office.
California Department of Public Health
Licensing and Certification Program
Centralized Applications Branch
P.O. Box 997377, MS 3207
Sacramento, CA 95899-7377