Jack Plagge, Manager
Hospital & Outpatient Services Unit
Bureau of Health Facility Regulation
2727 Mahan Drive, Mail Stop #31
Tallahassee, Florida 32308
Telephone: (850) 412-4549
Fax: (850) 922-4351
A birth center is a licensed facility that is not an ambulatory surgical center, hospital or located within a hospital where births are planned to occur (following a normal, uncomplicated, low-risk pregnancy) away from the mother’s usual place of residence.
Facilities must meet license requirements through the submission of a completed application, required documentation, and completion of satisfactory licensure and life safety surveys.
State of Florida Certificate of Exemptions previously required to perform clinical laboratory tests in the waived category are no longer issued. For more information, visit the Laboratory Licensure Unit web page for waived laboratories.
Effective September 1, 2010, application processing of clinical laboratory licenses (non-waived testing) under the same ownership/control as the birth center will be the responsibility of the Agency's Hospital & Outpatient Services Unit. Unless expiring sooner, clinical laboratory renewal applications will be due when the next birth center renewal application is due and all applications will be reviewed concurrently.
This includes new facilities and reactivation of an expired license. At least 60 days before the effective date, an applicant must submit a licensure application, fees and supporting documents. When all required information is received and acceptable, licensure and life safety surveys will be scheduled. A license will be issued when documentation of successful licensure and life safety surveys are complete and filed. Note: A valid license is required before services can be provided.
The licensure application, renewal fee and supporting documents must be submitted to the Agency 120 to 60 days prior to the expiration date. A late fee of $50 per day, up to 50% of the licensure fee or $500 (whichever is less) will be assessed for any application not received 60 days prior to expiration. A renewal application will not be accepted if the license is expired. An initial license application must be filed if the license has expired.
Chapter 408.803, Florida Statutes defines "Change of ownership" as: an event in which 51 percent or more of the ownership, shares, membership, or controlling interest of a licensee is in any manner transferred or otherwise assigned. This does not apply to a licensee that is publicly traded on a recognized stock exchange. Also, a change solely in the management company or board of directors is not a change of ownership.
The licensure application, fee and supporting documents (see application checklist) must be submitted at least 60 days prior to the change of ownership. Before the application can be approved, any outstanding fees owed the State (owed by either party) must be paid and a bill of sale or other closing document signed by the buyer and the seller and showing the effective date of the transfer must be received by the Agency.
A change of physical address requires submission of an AHCA Form 3130-3001. Other documents that may be required include AHCA Form 3100-0007 and documentation verifying the applicant’s right to occupy the premises at the new address (i.e. warranty or quit claim deed; lease or rental agreement.)
A licensee must inform the agency not less than 30 days prior to the discontinuance of operation and comply with the requirements listed in Chapter 408.810(4), Florida Statutes.
|AHCA Form 3130-3001||
Birth Center Health Care Licensing Application [327KB, DOC]
Birth Center Health Care Licensing Application [396KB, PDF]
|All application types||Standard birth center application required to apply for or modify a birth center license.|
|AHCA Form 3110-1024||
|Please provide this information to comply with the reporting requirements of Chapter 408, Part II, Florida Statutes. Use of the form is not required if the same information is provided by other means.|
|AHCA Form 3100-008||
|Use this form to document current level 2 background screening performed via another state agency. Screening results must be attached.|
|AHCA Form 3170-2004||
|Clinical laboratory licenses under the same ownership/control as the birth center must concurrently submit a clinical laboratory application.|
|Articles of Incorporation or similarly titled document as filed with the Florida Department State.|
|Proof of Right to Occupy Premises||Initial
Change of Address
|Any documentation verifying the applicant’s right to occupy the premises at the physical address of the birth center (i.e. warrant or quit claim deed; lease or rental agreement).|
|Compliance With Zoning Requirements||Initial
Change of Address
|Any documentation from a local government identifying the facility is in compliance with local zoning requirements.|
|Certificate of Occupancy||
Initial due to new construction.
Change of address due to new construction.
Specific documentation from a local government granting the right to occupy a facility.
|Contract between the owner and a management company for management of services.|
|Closing Document||CHOW||Bill of sale or similar document signed by the buyer and the seller indicating the date of transfer of ownership.|
|Statement of Outstanding Deficiencies||CHOW||Statement from the buyer assuring any uncorrected licensure survey deficiencies will be corrected timely.|
|Statement of Outstanding Payments||CHOW||Statement from the buyer identifying any outstanding balance owed AHCA, and indicating who will pay and when.|
Birth Center Consent Form [29KB, PDF]
|Facility Records||Form for each patient to sign consenting to deliver in a birth center.|
|Fee Type||Amount||Who Pays||Due|
|Initial, renewal or CHOW Application||
(Annual licensure inspection fee $250 and annual life safety inspection fee $250.)
For initial applications, fee is to be submitted with the application.For renewal applications, fee is to be submitted upon written notification from the Agency advising the survey has been scheduled and the fee is due.
|Late Application||$50 per day, up to 50% of the licensure fee or $500 (whichever is less)||All late applications||If an application is not received at least 60 days prior to the anticipated effective date. Payment can be made any time during the application process or upon issuance of a final order.|
Each licensed birth center must submit a completed annual report form to the Agency for Health Care Administration no later than July 30 each year.
Birth Center Annual Report Form [178KB, PDF]
This form provides the procedures for notification of options available to a mother who has experienced a spontaneous fetal demise of less than 20 weeks gestation. This form is to be used by hospitals and birth centers and is similar to a Department of Health form that would be used by health care practitioners. The form is required by section 383.33625, F.S., the Stephanie Saboor Grieving Parents Act, and section 59A-3.281, F.A.C.
Disposition of Fetal Remains Form - AHCA Form 3100-006 [54.6KB, PDF]
A level 2 background screen is required of the administrator responsible for the day to day operations of the facility and the chief financial officer. Please visit the Agency's background screening web page for additional information regarding vendors, fees, locations etc. Background screens must be repeated every 5 years.
Updated February 7, 2014