(210 ILCS 55/5)
(from Ch. 111 1/2, par. 2805)
(a) Each application for a home health agency
provisional license as provided in Section 4 shall contain
the following information: (1) name, address and location of
the agency; (2) organization and governing structure of agency;
(3) number and qualification of staff; (4) sources of financing
of services and agency; (5) service area; (6) patient load; (7)
agency utilization; (8) service charges; (9) affiliation
agreements with other health care providers;
and (10) such other information as the Department may require.
(b) Applications for licenses to be effective on and after
March 1, 1978, shall be in accordance with departmental regulations.
(Source: P.A. 80-804.)