Staff reporting
Hospice notification.
Generate the written notice to Licensing for a resident on hospice — print it to submit, and a copy is emailed to the APCH team.
For staff use. Under Title 22 CCR § 87632(d)(2), the licensee must notify the Department in writing within five working days of the initiation of hospice care for a resident — or within five working days of admitting a resident already on hospice. The notice must include the resident's name, date of admission to the facility, and the hospice's name and address. This page builds that notice for you to print and submit to your Licensing Program Analyst, and emails a copy (PDF attached) to David & Colin for the file. It contains resident details, so only complete it on a trusted device.