Connecticut State Department of Public Health

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Facilities Licensing and Investigations Section (FLIS) 

The Facilities Licensure Processing Unit is responsible for the Initial; Renewal; Change of Ownership; Change in Services; Changes in Beds

The following levels of care require a Connecticut license from the Department of Public Health. Please note that you do need to register with elicensure if you do not have a current account.  

ALSA (Assisted Living Service Agencies)
ASC (Ambulatory Surgical Centers)
CCNH (Chronic & Convalescent Nursing Homes)
CCRH (Chronic & Convalescent Nursing Home & Rest Homes with Nursing Supervision)
CDH (Chronic Disease Hospitals)
CH (Children’s Hospital)
GH (General Hospitals)
HEMO (Hemodialysis)
HHC (Home Health Care)
HHHA (Homemaker Home Health Aide Agency)
HSPC (Hospice)
INF (Infirmary Operated by an Educational Institution)
MAT (Maternity Hospital)
NHMG (Nursing Home Management Companies)
OPC (Outpatient Clinics Operated by Corporations or Municipalities)
PSY (Hospital for Mentally Ill Persons)
RCH (Residential Care Homes)
RHNS (Rest Home with Nursing Supervision)

Behavioral Health Levels of Care
POCA (Psychiatric Outpatient Clinic for Adults)
SA (Facilities for the Care or Treatment of Substance Abusive Persons)
MHDT (Mental Health Day Treatment)
MHRL (Mental Health Residential Living Centers)
MHCR (Mental Health Community Residence)

 

Questions pertaining to the applications should contact:

 CCNH; CCRH; RHNS; HHC; HHHC; GH; CD; PSY; HSPC; MAT  Colleen.Judge@ct.gov
 ALSA; ASC; HEMO; OPC  Nancy.Guzman@ct.gov
 NHMG; INF; FP & WCC & Key Personnel Changes  Christine.Jennings@ct.gov
 Change of Ownership Questions  Rose.C.McLellan@ct.gov
 POCA; SA; MHDT; MHRL & MHCR & RCH *Intermediate Care Facility for Individuals with Intellectually Disabled (ICF/IID) This level of care does not receive a State License.  Sandra.Bauer@ct.gov

 

Questions pertaining to the Regulations should contact:

INF; HHC; HHHC; & ALSA

Loan.Nguyen@ct.gov

ASC & Urgent Care & OPC/FP/WCC

Heidi.Caron@ct.gov

SA; POCA, MHDT; MHRL & MHCR

Alice.Martinez@ct.gov

RCH & Long Term Care

Karen.Gworek@ct.gov

Hospitals

Susan.Newton@ct.gov

HEMO

Cheryl.Davis@ct.gov

Long Term Care

Maria.LaRocca@ct.gov

Long Term Care

Cher.Michaud@ct.gov

Long Term Care

Connie.Green@ct.gov

Long Term Care

Norma.Schuberth@ct.gov

Building & Fire Safety

Anthony.M.Bruno@ct.gov

Main Line to DPH/FLIS

860-509-7400

 

The following forms are needed to complete online facility licensure applications

Ownership Form 1 (Partnership/LLC)

Sanitarian Report (School Infirmaries)

Ownership Form 2 (Trusts)

EXAMPLE of a Certificate of Insurance

Ownership Form 3 (Corporations; profit or non-profit)

Initial Home Health Care Agency Worksheet and Instructions

Local Fire Marshal’s Certificate

Initial Homemaker Home Health Aide Agency Worksheet & Instruction

Change in legal or d/b/a name form

Affidavits for Long Term Care Facilities

Increase/Decrease in Bed Form

 Attestation of Licensure Applicant

LTC Change of Ownership Checklist

Initial Outpatient Surgical Checklist

LTC Change of Ownership Instructions