State License Applications for

Health Facilities

Application for Licensure text

2019 Novel Coronavirus (COVID-19)

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Emergency Application for Bed Increases & Alternate Care Sites
Hospitals and Long Term Cares (LTC) who wish to temporarily increase bed number or provide care and services at an alternate care site must complete a Hospital/LTC Emergency Licensure Application. This process applies to both tribal and non-tribal facilities as an emergency action to maintain accurate numbers of increased beds and services provided at alternate care sites.
Temporary Bed Increases
Hospitals & LTCs can increase currently licensed bed capacity, add an on-campus location to their current license, or move an existing service to another location. Hospitals & LTCs must specify the type of space being added. Facilities are expected to follow the Center for Disease Control and Prevention (CDC) Alternate Care Sites Guidance.
Temporary Satellite Requests
Hospitals & LTCs can add inpatient beds and/or outpatient services at an off-campus location. Facilities are expected to follow the CDC Alternate Care Sites Guidance and in conjunction with Center for Medicare & Medicaid Services (CMS) provider specific regulations that are not waived.
License applications must be submitted to Matthew Thomas, Health Care Facilities Licensing & Certification at with the subject line “Emergency Application – [FACILITY NAME]”.  Please allow 1-3 business days for processing and review. Health Facilities Licensing and Certification will evaluate applications in the order received and will notify the facility of the application decision by email. If you need this material in an alternate format, please call 907-334-2664.

Published 4/6/2020

The document below provides links and other vital information for those who are interested in becoming Medicare & Medicaid participates.

License Fee Schedule

Provider Type Provisional Biannual Renewal
Hospital $2,000 + $85/bed $4,000 + $170/bed
Nursing Home $1,000 + $125/bed $2,000 + $250/bed
Ambulatory Surgical Center $650 $1,300
Free-Standing Birth Center $250 $500
Home Health Agency ≤ 5 FTEs: $1,000;
6-15 FTEs: $1,500;
16-50 FTEs: $2,000;
≥ 51 FTEs: $3,000;
+ $500 per branch/subunit
≤ 5 FTEs: $2,000;
6-15 FTEs: $3,000;
16-50 FTEs: $4,000;
≥ 51 FTEs: $6,000;
+ $1,000 per branch/subunit
Volunteer Hospice $100
+ $100 per each additional
+ $200 per each additional branch/subunit
Non-Volunteer Hospice   $250
+ $100 per each additional branch/subunit
+ $200 per each additional branch/subunit
Inpatient Hospice Facility  $250 + $75/bed
+ $100 per each additional branch/subunit
$500 + $150/bed
+ $200 per each additional branch/subunit
Frontier Extended Stay Clinic  $250 + $100/bed $500 + $200/bed

License Applications


Did You Know?

State licensed facilities who are accredited by a nationally recognized organization may be eligible to waive the biennial State licensing survey during the current/upcoming licensing period. To review related regulations for survey waivers, see 7 ACC 12.925 and AS 47.32.030(a)(9)(A-C).
To apply, complete theInspection Waiver Application, attach the required documents and email to:
If you have any questions, contact us at 907-334-2483.
State Licensure Modification Application
Modification Application
This application should be utilized when changing information or services on a previously approved licensure application.

Ambulatory Surgical Centers (ASC)
Free-Standing Birth Centers
Rural Health Clinics (RHC) / Frontier Extended Stay Clinics (FESC)
Home Health Agencies (HHA)
Hospice Agencies
Hospitals (This application applies to all hospitals including General Acute Care, Rural Primary Care, Critical Access, Long Term Acute Care, and Specialized Hospitals.)
Nursing Homes (LTC) (New facilities must complete the LTC Application AND the Initial LTC documents located below. Facilities that are renewing their bi-annual license are only required to complete the LTC Application.)
LTC Application

State License Fees - Please review the following memorandum from the Office of the Lieutenant Governor regarding the adoption of new licensing fees for health facilities in Alaska.  The effective date for the new licensing fees was June 29th, 2017.

Licensing Fees Memorandum