Health Clinics
Applications/Licensure Requirements
Any person intending to establish, operate, or maintain a health clinic must first
obtain a license from the Department. A facility must not hold itself out as a health
clinic or as providing health care services unless licensed under the Health Care Facility
Licensure Act. An applicant for an initial or renewal license must demonstrate that the
health clinic meets the care, treatment, and operational and physical plant standards
contained in  175 Nebraska Administrative Code (NAC) 7 Sections 006 and 007.
A license is issued only for the premises and persons named in the application and is
not transferable or assignable.
Initial Licensure
The first stage consists of the applicant’s submission of affirmative evidence of
the ability to comply with the operational and physical plant standards contained in 175 NAC 7 Sections 006 and 007. The application is not complete until
the Department receives documents specified in 175 NAC 7 Section 003.01B.
The second stage consists of the Department’s review of the completed application
together with an inspection of the health clinic. The Department determines whether or not
the applicant for an initial license meets the standards contained in 175 NAC 7 and the Health Care Facility Licensure Act.
An applicant must:
- Submit a written application to the Department which includes
the information reviewed in 175 NAC 7 Section 003.01B.
- Pass an on-site inspection as specified in 175 NAC 7 Section 005.01-005.02E
Upon receipt of a completed application, contact will be made to schedule an initial
inspection date. A health clinic cannot operate until the inspection has been
completed and the Department determines a license can be issued.
All health clinic licenses expire each year on the last day of February.
All application materials must be submitted to:
Department of Health and Human Services
Division of Public Health
Licensure Unit
Acute Care Facilities
P O Box 94986
Lincoln, NE 68509-4986
Renewal Licensure
All Health Clinic licenses expire each year on the last day of February.
Renewal process: Notice of renewal is sent to the licensee’s preferred
mailing address not later than 30 days prior to the license expiration date. This notice
includes an application form with the current facility information. To renew a license the
following must be submitted:
- The application form with updated facility information as applicable and as required by 175 Nebraska Administrative Code (NAC) 7 Section 003.02A
- Required licensure fee specified in 175 NAC 7 Section 004.09.
- List of names and addresses of all persons in control of the facility. The list must
include all individual owners, partners, limited liability company members, parent
companies and members of boards of directors owning or managing the operations and any
other persons with financial interests or investments in the facility. In the case of
publicly held corporations, the individual owners listed must include any stockholders who
own 5% or more of the company’s stock
- If applicable, a list of satellite clinics with addresses, that share administration and
operate within the total geographic area. Please indicate total geographic area by
county.
- All Ambulatory Surgical Centers must also pay with their renewal licensure fee an
additional fee under the Outpatient Surgical Procedures Data Act. Neb. Rev. Stat §
81-6,111 to 81-6,119
- Current Certificate of Occupancy issued by the Nebraska State Fire Marshal or delegated authority for each clinic and
satellite site that is dated within the 18 months prior to the license expiration date.
Final Notice: If a renewal application is not postmarked or received by March
1, the health clinic will be sent a final notice.
If a renewal is not received by April 1, the license will be placed in lapsed status.
During lapsed status the facility may not operate until the license has been
reinstated.
Refusal to renew: The Department can refuse to renew a license. ( 175 NAC 7 Section 008.)
Forms
Initial License Application |
