Closure or Voluntary Termination Process for Medicare-certified Home Health Agencies

Closure or Voluntary Termination Process for Medicare-certified Home Health Agencies

A Medicare-certified home care agency that closes will provide the following:

  • Written notice on agency letterhead. The written notice shall include:
    • Health Facility Identification Number (HFID)
    • CMS Certification Number (CCN)
    • Date the agency is voluntarily terminating Medicare Certification
    • Specify whether the agency will or will not remain licensed
    • Notice will be signed by Home Health Agency official

If deemed status, the Medicare-certified home health agency will notify the accrediting organization of the closure.

If deemed status, MDH cannot recommend the closure until after we have received a copy of the closure letter from the accrediting organization.
CMS-approved Accrediting Organizations (PDF)

Written notice should be emailed or mailed to:
Minnesota Department of Health
Health Regulation Division
Licensing and Certification Program
PO Box 64900
St. Paul, MN 55164-0900
Attn: Certification Specialist
Email address: Health.CM-Cert@state.mn.us

CMS 855A application and all supporting documentation should be submitted to the designated Medicare Administrative Contractor (MAC) for the closure.

MDH will forward documents to CMS of the closure when the written notice and the approval letter and CMS-855A from the MAC are received.

Updated Wednesday, August 30, 2017 at 08:59AM