Moving or Opening Another Site: What to File and When

A behavioral health license is usually tied to an address, so moving a program or opening a second location is a licensing event, often with a notice deadline before the move. Medicare, Medicaid and, for opioid treatment programs, SAMHSA and DEA each need their own filings. Here are the state rules we have verified and the federal clocks that run alongside them.

Most state behavioral health licenses are issued for a place as well as an operator. Arizona's license is valid only for the premises occupied when it was issued (A.R.S. 36-407(C)); North Carolina's is premises-specific (G.S. 122C-23); Pennsylvania issues licenses per location and per activity (28 Pa. Code 709.11(b)). So a move across town, a second office, or even a reconfiguration that changes the licensed space can require a filing before anything happens. Moving first and telling the state later is how programs end up operating an unlicensed site.

Before a move, how much notice do states require?

From the state rules we have verified:

Florida: 30 days' notice to DCF before relocating a site (Fla. Stat. 397.407(6)).
Illinois: 30 days' written notice, and relocating without it draws a $1,000 fee (77 Ill. Adm. Code 2060.265).
Virginia: a modification application 30 days in advance for a change in services, locations or capacity, and approval before it starts (12VAC35-105-60).
Kentucky: a program may not move until an application with an $80 processing fee is filed (908 KAR 1:370).
Missouri: changes in program location, services or administration need DMH approval in advance (9 CSR 30-3.032).
Nevada: operating from a new location needs a recertification application (NAC 458.133).
Oregon: a certificate does not transfer to another service delivery location without Division approval (OAR 309-008-0300).
Pennsylvania: a change of location is reported on DDAP forms within 90 days, or the license expires automatically (28 Pa. Code 709.14).
North Dakota: a change of address requires notice; a change of level of care requires a new license application (N.D. Admin. Code 75-09.1-01-02).
New Jersey: relocation is a license modification with a $250 fee (N.J.A.C. 10:161B-2.1).

Where the rule speaks of notice rather than approval, expect the state to inspect the new space anyway. Plan the move so the new site is ready for an inspector before the old one closes.

Is a second site a new license or an addition?

It depends on the state's structure. Florida issues one license per site, listing each licensed service component, so a second location is effectively a second license. Other states add sites to an existing license for a fee: Texas charges $125 for each outpatient or residential site at a separate address (26 Tex. Admin. Code 564.408), Kentucky $80 per outpatient extension site (908 KAR 1:370), Nevada $50 per geographic location certified with an endorsement (NAC 458.138), and Washington $1,150 per branch agency (WAC 246-341-0365). Adding a service at an existing site has its own rules: Florida requires approval before adding a component, New Jersey charges nothing to add beds or services, and Washington charges $450 to add certifications. See licensing outpatient, IOP and PHP programs.

Do federal filings follow a move?

Medicare. Providers and suppliers report a change, addition or deletion of a practice location within 30 days (42 CFR 424.516(e)(1)). For a community mental health center, the new space also has to meet the conditions of participation.
Medicaid. States screen applications "for a new practice location" the same way they screen initial applications, by risk level, which can mean a site visit (42 CFR 455.450). Each state's Medicaid agency sets its own process for updating a location.
Accreditors. CARF's certificate lists the programs accredited, and its survey application asks for the locations where services are provided. Tell your accreditor before the move, and in states such as Ohio, where certification depends on accreditation, report any change in accreditation status to the state within ten days (Ohio Rev. Code 5119.36(D)).

What changes for an opioid treatment program?

Every approval moves together. SAMHSA requires OTPs to submit, through the OTP Extranet, and receive approval for the relocation of a primary dispensing unit or a medication unit and for adding a new medication unit. The SMA-162 for a relocation includes a detailed, labeled floor diagram of the building and a written description showing the facilities are adequate for dispensing and for individual and group counseling. Only the program sponsor may sign and submit it.

DEA registration is address-specific too. A registrant applies to modify its registration to change its address, by written request to DEA's Registration Unit or online, signed as 21 CFR 1301.13(j) requires (21 CFR 1301.51(a)). The state OTP license and the State Opioid Treatment Authority's approval follow the state's own rules. Two state limits stand out: Pennsylvania's rule, as published, bars narcotic treatment medication units (28 Pa. Code 715.25), and Indiana requires an OTP and any one additional addiction treatment facility it uses to be in the same county, which must remain the county where the OTP was located on July 1, 2008 (440 IAC 10-3-1). See adding a medication unit and the OTP approval hub.

Which items belong in the move plan?

Each state rule's notice or approval deadline, counted back from the move date.
The new floor plan and space description, measured against the state rule for each service.
Updated policies that name the new address, emergency procedures and posting locations, including the Part 2 Patient Notice (42 CFR 2.22(c)(2)).
Medicare and Medicaid location updates, with their 30-day and state-specific clocks.
Accreditor notice, and for an OTP, the SMA-162 and DEA modification before dispensing at the new address.
A plan for the old site's records under your confidentiality and retention policies.

How do we help?

Our Ownership Change or Relocation service is $795, flat: the state relocation filing, the notice calendar, and the Medicare, Medicaid, accreditor and OTP notices that go with it. An Additional Site or Service Component is $595, and an OTP Medication Unit is $1,495. Your officers sign; for the SMA-162 the program sponsor signs and submits from the sponsor's own account; you pay every state and federal fee directly. A move into a building the program has never been inspected in is a good time for a mock survey.

Common questions

Can we move our clinic and tell the state afterward?

Often not. Florida and Illinois require 30 days' notice before relocating, Virginia requires a modification application 30 days ahead and approval, and Kentucky requires the application before the move. Check your state's rule first.

Does a second office need its own license?

In some states, yes. Florida issues a license per site. Others add sites to the existing license for a fee, such as Texas at $125 per separate site and Washington at $1,150 per branch.

How fast must Medicare be told about a new location?

Within 30 days of a change, addition or deletion of a practice location, under 42 CFR 424.516(e).

What does an OTP need to relocate?

SAMHSA approval through an SMA-162 with a labeled floor diagram and facility description, signed by the program sponsor; a DEA registration change of address; and the state OTP approvals.