Section 10-12 - Licensing (a) Licensing Procedure. (i) For an initial license to be issued, the State Survey Agency shall receive: (A) A completed application on the form supplied by the State Survey Agency, including the completed items identified on the Hospice Licensure Checklist supplied by the State Survey Agency. (B) Each completed application shall be accompanied by the required licensure fee identified in the Wyoming Department of Health Aging Division, Healthcare Licensing and Surveys Chapter 1, Rules for Health Care Facilities Licensure Fees. The check or money order shall be made payable to the Treasurer, State of Wyoming. (ii) For renewal of a full license for one (1) year beginning July 1, and unless suspended or revoked, expiring on June 30 of the following year, the State Survey Agency shall receive: (A) A completed application form submitted no later than the date indicated in the renewal notice posted on the State Survey Agency website at: http://www.health.wyo.gov/ohls; and (B) The licensure fee required in paragraph (a)(i)(B) of this section. (b) Requirements for Licensure. The State Survey Agency shall consider: (i) Initial re-licensure and complaint survey deficiencies cited by the State Survey Agency; (ii) Life Safety Code deficiencies cited by the State Survey Agency; (iii) Complaint investigations and resolutions; (iv) Compliance with all laws and standards relating to communicable and reportable diseases, as required by the Wyoming Department of Health, State Health Officer, and Public Health Division; and (v) The effectiveness of the quality management program to evaluate and improve patient care and services. (c) Transfer of License. (i) Transfer or assignment of a hospice license is prohibited. The hospice shall comply with licensure requirements in paragraph (d) of this section in the event of a change in the ownership of a hospice. (d) Change of Ownership. (i) A change in ownership of a hospice occurs when there is a change in the legal entity responsible for the operation of the hospice, whether by lease or by ownership. (ii) For a Medicare and/or Medicaid certified hospice, the change of ownership determination by the Centers for Medicare and Medicaid Services will also be used to determine the licensure change in ownership. (iii) The new owner shall submit no later than sixty (60) calendar days prior to the event the following items: (A) A change in ownership application for licensure with the appropriate fee, as required in paragraph (a)(i)(B) of this section. (B) The checklist items required for an initial applicant. (iv) Within twenty-four (24) hours of the event, the new owner shall submit a copy of the signed bill of sale or lease agreement that reflects the effective date of the sale or lease. (e) Other changes. A licensure application and appropriate fee, as required in paragraph (a)(i)(B) of this section, shall be required for any of the following changes to be processed: (i) Name change of hospice. (ii) The number of licensed beds increased or decreased. (iii) Change in the main hospice address or ancillary locations. (f) Provisional License. (i) A provisional license is a temporary license that may be issued in the following instances: (A) For a new licensed provider. (B) For a change in ownership, if deemed appropriate by the State Survey Agency. (C) Following a successful licensure construction inspection for space that has not previously been occupied by patients. During the aforementioned inspection, there can be no deficiencies cited that could potentially result in harm to the patients. (D) Following a successful licensure construction inspection for space that has undergone expansion and remodel to the extent that significant structural, mechanical, plumbing, or fire safety changes have been made to the space occupied by patients. (E) Whenever deficiencies are cited that are serious and have resulted in harm or potential harm to patients. (F) Whenever the facility fails to satisfactorily correct cited deficient practice. (G) Whenever the facility fails to comply with any requirement of this rule. (ii) The state Medicaid office will be notified by the State Survey Agency whenever a provisional license is issued or reissued. (iii) A provisional license will be issued with an expiration date to be determined by the State Survey Agency at the time of issuance. (iv) A provisional license may be reissued for additional extended time, if deemed appropriate by the State Survey Agency. (v) If the provisional license is issued in lieu of a regular license, the facility must return the regular license to the State Survey Agency by return mail or hand delivery within five (5) calendar days of receipt of the provisional license. The provisional license must be posted in a public place in the facility. (g) Conditions for denying, revoking, or suspending a license. Denial, revocation, or suspension of a license may occur for noncompliance with any provisions of this rule. (h) Suspension of Admissions. The State Survey Agency may suspend new admissions or readmissions to the hospice when conditions are such that patient needs cannot be met. Conditions in a hospice shall not jeopardize the patient's health or safety. (i) Monitoring. The State Survey Agency shall place a Wyoming Department of Health approved monitor, at the hospice's expense, when conditions are such that patients' needs are not being met by the hospice. The monitor shall insure that neither the health nor the safety of the patients is jeopardized. (j) Hearings. (i) Any hospice aggrieved by a decision of the State Survey Agency may request a hearing by submitting a written request to the State Survey Agency within ten (10) calendar days of receipt of the notice of adverse action. (ii) The State Survey Agency (or designee) shall provide an opportunity for a hearing, if requested, and shall present at the hearing the evidence supporting any preliminary licensure decision(s) and reason(s) to the parties concerned. (iii) In matters concerned with the spread of communicable disease that may require the utilization of quarantine or isolation, the Wyoming State Health Officer or designated representative shall provide an opportunity for a hearing as outlined in W.S. § 35-4-112. (iv) Hearings requested under the terms of this rule shall be held in accordance with Chapter 2 - Uniform Rules for Contested Case Practice and Procedure, adopted by the Office of Administrative Hearings. (k) Posting of License. (i) The current license issued by the State Survey Agency shall be displayed in a public area within the hospice. (l) Surveys for Licensure. (i) The State Survey Agency or its designated representative shall perform initial and periodic surveys for the renewal of licensure. (A) These surveys shall be based on the current Rule for Hospice Programs as promulgated by the Wyoming Department of Health. (B) The State Survey Agency shall provide, within ten (10) working days after the last day of survey, copies of its cited deficiencies to the hospice. (C) The hospice shall provide an acceptable plan of correction to the State Survey Agency for all cited deficiencies within ten (10) calendar days after receipt of the deficiencies. (ii) At the time of survey, all records, including patient medical records, pertaining to matters involved in the survey shall be made available to members of the survey team as requested. Surveys may be conducted as focused, off-site administrative reviews, in which case specific records or categories of records will be requested by the State Survey Agency for review. The results of all surveys, including complaint investigations and administrative reviews, will be shared with the hospice administrator and other pertinent staff. (m) Voluntary Closure. (i) If a hospice voluntarily ceases to operate, it shall notify the State Survey Agency in writing at least sixty (60) working days prior to closure. (ii) The first working day after closure, the hospice's license shall be hand carried or sent by certified mail to Healthcare Licensing and Surveys, 6101 Yellowstone Rd., Ste. 186C, Cheyenne, WY 82002. 048-10 Wyo. Code R. § 10-12