Frequently Asked Questions

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I want to open a center. How should I proceed?

You have already made the first step by contacting the Office of Health Facility Licensure and Certification (OHFLAC). Information will be provided to you. It is recommended that you submit a letter of intent; however, requesting information by telephone can also accomplish this goal. After you review the attached information, if you have not already obtained a copy of the regulations, this should be your next step. The regulations provide more specific detailed information. After you obtain the regulations, you should review them carefully and if necessary, make note of specific questions you may want answered or clarified. You may contact OHFLAC for clarification on any regulation. To request an application or obtain a copy of the regulations, contact the Assisted Living Program at (304) 558-0050. There is a minimal charge for copies of the regulations; however, you can also obtain a copy of the regulations by connecting to OHFLAC’s website @ www.wvdhhr.org/ohflac/rules.

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I have a tract of land that I am interested in building a center on? What should I do?

You must request a site inspection, by contacting OHFLAC and obtaining a site/building inspection form or connect to the website at www.wvdhhr.org/ohflac. This link will allow you to obtain a copy of the site inspection form which must be completed and submitted to OHFLAC prior to the state office completing the inspection. Once, the inspection is completed, a report will be generated which identifies any problems noted with the site. At least thirty (30) days should be allowed between submission of the site inspection form and the preferred inspection date.
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I have purchased an existing structure and would like to open a center? How should I proceed?

Prior to opening a medical adult day care center in an existing structure, whether it has been used for this type of program in the past or not, a building inspection must be completed by OHFLAC surveyors. The inspection will identify to the prospective applicant, the number of participants the center may be licensed for, as well as identify other environmental problems, such as Americans with Disabilities Act (ADA) requirements that have not been incorporated into the existing structure and which may be in violation of licensure standards. The building inspection form may be requested from OHFLAC or obtained by link to the website at www.wvdhhr.org/ohflac. The form must be completed and submitted prior to OHFLAC surveyors conducting the inspection. Once the inspection is completed, a report will be sent identifying what must be completed prior to opening the center.

Architectural drawings for additions and renovations to existing structures must be submitted to OHFLAC and the WV State Fire Marshal (SFMO) for approval, prior to beginning any reconstruction or making other changes in an existing structure.
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I have completed the site and/or building inspection and am interested in proceeding with my project. What should I do next?
A letter of intent or application should be submitted prior to beginning new construction or admitting participants to an existing structure. For existing centers, the application should be received in the office prior to changing ownership or purchasing. If a letter of intent is submitted, it should specify:
1. The proposed type of program (Medical Adult Day Care Center)
2. The planned number of participants to be served daily in the center
3. The types of services to be offered or provided
To provide a letter of intent, the following address should be used:

Office of Health Facility Licensure and Certification
Assisted Living Program
1 Davis Square, Suite 101
Charleston, WV 25301-1799

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I have submitted my letter of intent and want to proceed with building a new structure. What is the next step?

Architectural drawings and specifications (mechanical and electrical) are required for new construction in Medical Adult Day Care Centers. Plans must be submitted to OHFLAC, Assisted Living Program for approval, prior to the initiation of the construction phase. The drawings and specifications should be prepared, sealed and signed by an individual registered to practice architecture in the State of West Virginia. The plans will be reviewed and a letter sent to you after the review is completed.
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Do I need a sprinkler or fire alarm system? Who should I contact?

For existing centers or structures, the WV State Fire Marshal’s Office (SFMO) should be contacted prior to purchasing an existing structure. This will enable you to make appropriate decisions, prior to purchasing. They will be able to provide accurate information to you regarding their role. If you have already purchased a building, you must contact the SFMO for the inspection. They will determine what type and size of sprinkler and/or alarm is needed for your center.

For new construction, a copy of the architectural plans or plans drawn to scale (depending on the size of the center) should be submitted to the SFMO. The SFMO will identify the type and size of the sprinkler and/or alarm system which is necessary for your center. They will assist you with becoming more familiar with the state fire code requirements. Prior to occupancy in any new structure, final approval must be given by the SFMO, as well as OHFLAC. For additional information, you may contact the SFMO at (304) 558-2191 extension 214.
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Should I contact the WV Health Care Authority?

If it is anticipated that a capital expenditure of one million dollars or more is projected, you must call the WVHCA at (304) 558-7000, and ask to speak with the Certificate of Need (CON) Director. For all Medical Adult Day Care Centers a CON is required.
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Will I need to contact the local Health Department?

You should contact your local Health Department to discuss the need for a site inspection or to obtain information from the sanitarian regarding your dietary/food service area and sewage disposal system. For an existing structure, the sanitarian will determine if those systems in place in an existing structure will be appropriate for the proposed number of participants. For a new structure, the sanitarian will be able to provide you with the specific information related to the food/dietary service requirements as well as the type of sewage disposal system required, if a public sewage system is not available in your area. Before a license can be issued, you will be required to submit approval of your food service area and sewage disposal (if applicable) by the county sanitarian. An annual inspection will also be required for license renewal.
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My project is nearing completion; how will I know that the building will be approved?

A pre-opening or building inspection must be requested as your project nears completion. You or your architect should request a pre-opening building inspection by contacting OHFLAC. The request should be done thirty (30) days prior to the preferred inspection date and your architect or builder will be required to submit specific documentation validating substantial completion of your project.
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I need to admit participants as quickly as possible; am I allowed to do this?

Once the building inspection process has been completed and the building is approved, you may admit participants with the approval from OHFLAC. This information will be provided to you once the building is approved. (You can admit up to five (5) participants, until the health inspection is completed.) You are responsible for notifying OHFLAC when you are ready for your initial health inspection.

If you have purchased an existing Medical Adult Day Care Center, and the center has a valid and unexpired license, you may continue to operate the center for up to ninety (90) days, if an approved application has been received by OHFLAC. However, you must be preparing your center for the Change of Ownership (CHOW) inspection, during that ninety (90) day period. If OHFLAC receives any complaints, prior to your receiving a license for the CHOW, an inspection can be conducted at any time. You should request the licensure inspection as soon as possible to avoid delay in obtaining your license. If any enforcement action has been implemented against the previous owners, this may limit your ability to operate under the previous owner’s license and may delay the licensing process, depending on the type and severity of the enforcement.
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I am completing the application and you have included a Criminal Investigation Background check card. What should I do with this and why is it required?

Criminal Record Check through the Central Abuse Registry

As part of the licensing process, a criminal record check must be conducted on all new licensees, owners or directors. A record request check card will be included with the application and should be returned when the application is submitted. The instructions for completing the card and providing the prints will be included. Please follow the instructions carefully and submit to OHFLAC with a $10.00 money order made payable to the Superintendent, West Virginia State Police. OHFLAC will forward this information to the WV State Police and the results will be provided to OHFLAC. The licensee/owner/director will be responsible for obtaining criminal record checks on all employees of the center.
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What type of participants can I admit to my center?

The Medical Adult Day Care Center must develop written policies that identify the population(s) you will serve and that describes the admission process. You may admit participants with limited and intermittent nursing care needs; however, if you plan to provide limited and intermittent nursing care in your center, you must meet the requirements as specified in the rule, prior to admitting a participant. Limited and Intermittent nursing care is defined as direct hands on nursing care of individuals who need no more than two (2) hours of nursing care per day for no longer than ninety (90) days in duration. Residents that require nursing care that exceeds ninety (90) days may continue at the center if you have requested a waiver of the ninety (90) day limitation. Examples of limited nursing care would be: B12 injections, routine doses of insulin, indwelling Foley catheters, wound care, etc. If in doubt as to what is considered limited and intermittent nursing care or extensive and ongoing nursing care, always contact OHFLAC. Requesting a waiver for the nursing care does not guarantee an approval of the waiver. The waiver may be denied if there are not adequate policies/procedures in place and appropriate licensed staff to meet the participant care needs.
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How many participants can I serve in my center at one time?

The number of participants you may serve at any one time will be determined by the size of your center. There is no limit on the maximum number. The center must also satisfy all state fire code requirements, sanitation requirements and local zoning and building requirements.
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I want my staff to administer medications to the participants. Is there any special training required?
There are two methods that can be utilized in a medical adult day care center for administering medications to residents.
1. The participant may administer their own medications
  
  If you utilize this method, there are specific regulatory requirements to comply with including certification by the physician that the resident is competent to self administer. Medications must be stored in such a way that other participants cannot access them. The center must develop a written policy that outlines how, specifically, medications are to be stored and handled in these instances.
2. Licensed nurses can administer medications
  
  You may employ or contract with an LPN or RN to give medications to the participants. Again, the center must develop a written policy that outlines how medications are to be stored and handled to ensure that only authorized persons have access to medications.
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I have completed all the application and building requirements, can I now admit participants?

Once the building has been inspected and approved, you may accept up to five (5) participants and notify OHFLAC. You may also request your initial health inspection at that time. Scheduling of the initial inspection will be coordinated as soon as possible, if you have demonstrated your readiness. For your initial inspection, you will be notified of the date of your inspection. To help you prepare for the inspection, you can request a list of the documents that surveyors will ask for during the entrance to your center. When the initial inspection is conducted, you should have all your documentation and all policies and procedures related to the operation of your center in place.

Once the survey is complete, and based on surveyor findings and/or citations, the decision to allow admission of additional residents to the center will be determined by OHFLAC. Requests to accept more than five participants to the center prior to the initial inspection will be determined on an individual basis. Factors which may influence this determination may be previous complaints received, number of staff and/or qualifications of staff, problems with pre-opening issues, etc. These requests must be directed to the Assisted Living Program Manager.

If you fail to be in substantial compliance with the medical adult day care licensure rule, you will not be issued a license until the citations are corrected.
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What are the costs or fees involved with getting copies of regulations and inspections?

Copies of Regulations (rules):

Medical Adult Day Care Centers $10.00
Initial Application Fee: $100.00
Renewal Licensure Fee: $100.00

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