How Administrators, DPCS's, Medical Directors and Designees Can Resign in California
Unlike most businesses, home health and hospice agencies have strict protocols around hiring and firing certain kinds of staff members because they must be reported and approved by the California Department of Public Health (CDPH). Reportable positions include:
Home Health Agency Reportable Staff
Administrator
Administrator Designee
Director of Patient Care Services (DPCS)
Hospice Agency Reportable Staff
Medical Director
Administrator
Administrator Designee
Director of Patient Care Services (DPCS)
Director of Patient Care Services (DPCS) Designee
Reporting Rules
Reportable positions must be in place prior to sending the enrollment application to CDPH. CDPH reviews all applications and determines if the staff members listed as employed by the home health or hospice agency fit the State-based criteria. If the staff qualify, they are approved for the position.
According to State law, these mandatory positions cannot remain vacant for more than 30 days while the company is active. This means home health and hospice agencies have a total of 30 days between the date of the staff member’s last day at work and the hire date of the replacement. CDPH also allows a 10 business day reporting period. This allows agencies approximately 2 weeks to gather the required data and documents to submit the Change of Staff application. All together, home health and hospice agencies have about 1.5 months from the termination or resignation date to submit a new staff member for consideration.
Operational Considerations
In the case of a vacancy, Designees are required to take over the position until it is filled. Often, this is when Designees are promoted to the top spot, as they are familiar with the company operations, staff, ownership and culture. However this is not always the case.
Replacements to reportable positions should be notified that they are in a probationary role until approved by CDPH.
Application Processing
CDPH application processing is long, complicated and tedious. Analysts and the California Department of Public Health (CDPH) Centralized Applications Branch (CAB) process hundreds, if not thousands of enrollment and change applications for all healthcare industries, not just home health and hospice. The massive workload can create an equally massive backlog, with applications being processed for months.
Application processing timeframes change drastically based on CDPH backlog, completion level of initial submission, the agency’s ability to quickly reply to requested information, the speed with which agencies pay their application fees, and even time of the year. Further, applications can be denied for a number of reasons, such as failure to submit the application fee payment on time, failure to submit requested information, or documents that do not fit the required criteria and unqualified staff. The agency’s only recourse is to resubmit the application and restart the process. This, of course, can make the new staff approval process take years instead of months. One of the drawbacks of this system is people who are listed in CDPH as working in a home health or hospice agency, are not disassociated from the agency until a new staff member has been approved.
How Reportable Staff Can Properly Resign from an Agency
Here are the best practices for resigning from a home health or hospice agency if you are in a reportable staff position.
Notify agency ownership as far in advance as possible. While the standard notification time frame is 2 weeks in most companies, we suggest giving agencies at least a 30-60 day notice. This allows the agency to find a qualified replacement, according to the regulatory requirements for home health or hospice, respectively. Not providing enough notice, puts the company in jeopardy as they scramble to find someone to meet minimum basic requirements, instead of someone who is truly the best person for the job.
Notify the agency in writing. Make sure your resignation is on paper, with a clear effective date. The letter doesn’t need fancy terminology, or even a reason, as California is an at will employment State. Anyone can be fired or resign for any reason, outside of discriminatory practices.
Notify CDPH via mail or email on the effective date. While this step is not mandatory, we recommend it. This way, if anything happens in the agency that can create a liability, staff will have proof of resignation within CDPH. We do feel it’s best to inform CDPH on or right after the effective date, to avoid situations where staff may change their mind and stay on in the agency, or extends their employment as the agency looks for a replacement. These situations happen often, especially if the agency has a hard time finding a replacement in the allotted time frame. Notifying at the actual resignation effective date ensures the situation is uncomplicated and that the agency has enough time to find a suitable candidate to take over.
Resignation Letter Wording
We have created sample wording that can be used in your resignation to both agencies and CDPH.
Letter to Agency Notifying of Your Resignation
This letter needs to have:
Current date
Notice of resignation
What position or positions you are resigning from
Effective date of resignation
Your name and contact information
Agency name and contact information
Your signature
This can be delivered in person, via mail or email.
Example wording:
1/1/2000
Attn: Example Home Health Agency, Inc.
123 State St. Anytown, CA 91111
This letter is to notify you of my resignation from the Administrator and Director of Patient Care Services positions of Example Home Health Agency, Inc., effective 1/31/2000.
Thank you,
Bob Smith, RN
Phone: 888-888-8888 / Email: bobsmith@email.com
Letter to CDPH Notifying of Your Resignation
This letter needs to have:
Current date
Notice of resignation
What position or positions you are resigning from
Effective date of resignation
Your name and contact information
Agency name and contact information
Your signature
This can be delivered via mail or email.
Example wording:
1/1/2000
Attn: Example Hospice Agency, Inc.
123 State St. Anytown, CA 91111
This letter is to notify you of my resignation from the Medical Director position of Example Hospice Agency, Inc., effective 1/31/2000.
Thank you,
Bob Smith, MD
Phone: 888-888-8888 / Email: bobsmith@email.com
CDPH Contact Information
Notification letters can be sent to the California Department of Public Health (CDPH) by mail or email. Here’s the contact information for the Centralized Applications Branch (CAB):
Centralized Applications Branch Email
Centralized Applications Branch Mail:
California Department of Public Health
Licensing and Certification Program
Centralized Applications Branch
P.O. Box 997377, MS 3207
Sacramento, CA 95899-7377
How Smart Business Solutions Can Help
Smart Business Solutions, Inc. helps agencies gather info, complete, submit and request manage various application types, both to CDPH and NGS, the Medicare intermediary for California. We also provide current application processing time frames and any CDPH/NGS process changes on our social media pages.