Notify us as a licensee

As a licensee for a day hospital or private hospital in Queensland you are expected tell us about changes to:

• executive staff and management
• ownership
• accreditation
• issues which affect your suitability to operate a hospital.

How to use interactive PDF forms

The application forms are formatted as interactive PDFs. Please open the forms in Internet Explorer or Firefox. Find help online or contact us at Private_Health@health.qld.gov.au if you have trouble downloading or completing these forms or call (07) 3708 5325 for a plain PDF version of the form.

Executive staff

Tell us about the termination or appointment of:

• chief executive
• director
• day to day manager
• nurse in charge.

We will need to see the following information from you for appointment of a:

• day-to-day manager or nurse in charge of the hospital (however titled)
  • their curriculum vitae
  • contact details including email address and phone number
  • AHPRA registration number - nurse in charge only
  • appointment date.

• chief executive, director or office holder of a licensee company:
  • their full name and contact details including email address and phone number
  • position title
  • appointment date
  • a completed Statutory Declaration (DOCX 579 kB) form.

Ownership

Tell us about changes to the ownership - including changes to the major shareholders or parent company - by providing:

• a summary of changes, including names of owners to be added and/or deleted
• the effective date of changes.

Accreditation

Tell us if you change your accrediting agency by providing:

• evidence of appointment
• effective date of the change.

Issues which affect your suitability to operate a hospital

You must tell us if the authority holder (the entity holding a licence or approval) or individuals associated:

• is affected by bankruptcy
• is convicted of an indictable offence or an offence against a corresponding law
• has an authority suspended or cancelled
• dies.

Please refer to the Private Health Facilities Act 1999, Section 143a.

When to tell us about a change

You are required to provide us with written notice within 21 days of the change.

Fees

There is no fee associated with telling us about these changes.

How to notify us about the change

You can notify us of changes via email to Private_Health@health.qld.gov.au.

A notification form is available for this purpose. We recommend you use encryption or a secure file transfer to share information securely with us.

If you are unsure about your obligations at any time, contact the Private Health Regulation Unit on (07) 3708 5325 or email Private_Health@health.qld.gov.au.

Temporary changes to clinical services

If you are discontinuing or reducing the level of clinical services for which your facility is licenced for a short period of time, you can tell us by submitting a change to CSCF notification form.

You can use this form to let us know if your hospital is temporarily:

• discontinuing a health service
• proposing a health service to go on by-pass.

Download the Temporary CSCF Change Notification Form (DOCX 572 kB) and return the completed form to Private_Health@health.qld.gov.au.

Legislation

These notifications are required by the:

• Private Health Facilities Act 1999, Section 143a
• Private Health Facilities Regulation 2016, Section 5.