Non-Medical Supportive Care Services
The Bureau of Facilities and Licensing requests that the Home Health Agency (HHA) Annual Report and Attestation Form be completed, signed, and returned to the licensing agency 30 days prior to the renewal expiration date of the agency’s license. Use the links provided to download the required documentation.
K.S.A. 65-5104 requires a HHA to file its annual report and pay the annual fee within 30 days of the licensure renewal expiration date to avoid automatic licensure cancellation.
Ensure the following annual renewal application elements are submitted:
Email the completed Annual Report with supporting documentation to the application inbox. Checks or money orders for the non-refundable renewal fee, based on the total unique patient count, may be mailed to the address below. Make checks or money orders payable to: Kansas Department of Health and Environment. Include the agency’s State ID on all communications and payments.
Kansas Department of Health and Environment
C/O Bureau of Facilities and Licensing
1000 SW Jackson Street, Suite 330
Topeka, KS 66612-1365
Main phone: 785-296-0127
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