Application for a License

(A) Application for original or renewal licensure shall be made on forms prescribed by and available from the Department. Every application shall be signed under the pains and penalties of perjury by the applicant or a person authorized to act on behalf of the applicant. (B) The Department will accept an application for an inpatient hospice facility only if the applicant is a hospice program that has been licensed pursuant to 105 CMR 141.000 for more than two years. (C) The Department shall determine the number of licensed hospice inpatient facilities in accordance with M.G.L. c. 111, § 57D.