WAC 246-335-145   Initial application.  An applicant for initial licensure must submit to the department:

     (1) A completed application on forms provided by the department;

     (2) Evidence of current professional liability insurance in the amount of one hundred thousand dollars per occurrence and public liability and property damage insurance in the amount of two hundred thousand dollars per occurrence as a minimum;

     (3) Disclosure statements and criminal history background checks obtained within three months of the application date for the administrator and director of clinical services in accordance with RCW 43.43.830 through 43.43.845;

     (4) The following information:

     (a) Name of managing personnel, officers, administrator, director of clinical services and partners or individuals owning ten percent or more of the applicant's assets;

     (b) A description of the organizational structure;

     (c) A description of the hospice care center service categories to be offered directly or under contract;

     (d) Documentation that no more than forty-nine percent of patient care days, in the aggregate on a biennial basis will be provided in a hospice care center, under RCW 70.127.280 (1)(d);

     (e) Name, address, and phone numbers of the center location(s) within the state;

     (f) A copy of their current business license;

     (5) Other information as required by the department; and

     (6) Fees specified in WAC 246-335-990.



[Statutory Authority: Chapter 70.127 RCW. 02-18-026, § 246-335-145, filed 8/23/02, effective 10/1/02.]