Office of Licensure and Certification

The Office of Licensure and Certification administers the state licensing programs for hospitals, outpatient surgical hospitals, nursing facilities, home care organizations and hospice programs.

The Office of Licensure and Certification (OLC) administers the state licensing programs for hospitals, outpatient surgical hospitals, nursing facilities, home care organizations and hospice programs. The OLC also administers the certification and registration programs for managed care health insurance plans, licensees, private review agents and the Certificate of Public Need (COPN) program. In addition to state programs, the OLC is the state survey agency for the federal reimbursement programs under the Centers for Medicare and Medicaid Services (CMS). The OLC conducts inspections and complaint surveys assuring compliance with federal regulations for 16 classifications of medical care providers and services receiving federal reimbursement from CMS.

During the past fiscal year, the OLC updated its Web site (www.vdh.virginia.gov/olc) providing easier access and additional information. The office also produced a CD to assist nursing facilities with evaluating resident care. Eighty-three new medical care facility projects totaling $700,038,198 were approved for Certificates of Public Need during the past fiscal year.

In 2006, the OLC completed and implemented rules and regulations governing licensure of home care and hospice organizations. The new regulations protect people served by home care and hospice providers whose services are rendered in a patient’s residence and are not subject to the same public scrutiny as are those of health care institutions.

Working in collaboration with a long-term care constituent group, OLC is focusing efforts on reducing the occurrence of pressure ulcers in nursing facility residents. While there has been a significant reduction in the rate of this debilitating condition, from 13 percent to 10.5 percent in 2006, Virginia remains above the national average of 10 percent. In addition, the OLC provides focused training via on-site and electronic training methods.

State and federal regulatory programs guard the health, safety and welfare of the public by establishing and enforcing standards to assure quality health care. Inspections are used to satisfy both state licensure requirements and federal certification requirements. The OLC also investigates consumer complaints regarding quality of health care services. In 2006, the OLC Center conducted 1,959 inspections. The COPN program seeks to assure the geographic dispersion and availability of medical facilities and proven medical technologies across Virginia, and promotes the development of and access to services by every person who needs them regardless of their ability to pay. In 2005, the program authorized 83 project certificates totaling $700,038,198 and denied 23 projects totaling $151,946,497.