{"ref":"DC-HSP-GOV-02","title":"Organizational Structure, Service Area and Multiple Locations","category":"Governance","summary":"Requires a written organizational chart that traces every line of authority to the location that holds the Medicare certification number, defines the Agency’s service area, and sets the steps before the Agency opens another location or starts or stops a service, including the CMS hospice enrollment moratorium and the District’s Certificate of Need law.","inShort":["Our organizational chart shows who is in charge of what. You see it at orientation.","Every location follows the same policies and is supervised from the main office.","No new location serves Medicare patients until Medicare approves it.","We serve patients in our service area. Tell your supervisor if a patient plans to move or travel."],"primaryCitation":"42 CFR §418.100(f)","citations":["D.C. Code §44-406(a), (c)","D.C. Code §44-411(c)-(d)","22-B DCMR §4005.18"],"federalCitations":["42 CFR §418.100(e)-(f)","42 CFR §418.116(a)","42 CFR §418.3","42 CFR §418.56(a)(2)","42 CFR §418.64","42 CFR §420.206","42 CFR §424.516(e)","91 FR 27946 (May 15, 2026)"],"surveyorAsks":["Show me your organizational chart. How do lines of authority at each location trace back to the location issued the certification number?","Do you operate any multiple locations? When did Medicare approve each one?"],"forms":[{"ref":"DC-HSP-GOV-02-A","title":"Organizational Structure and Location Review Record"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.100(f))","5. The Written Organizational Structure","5.1 When the chart is updated","5.2 Who sees it","6. Service Area","7. Opening an Additional Location","8. Supervision of Multiple Locations","9. Disclosure of Ownership and Control","10. Starting or Stopping a Service","11. Responsibilities","12. Records and Compliance Monitoring","13. References","14. Related Policies and Forms","15. Approval","16. Revision History"],"version":"1.0","sample":false,"pack":"dc-hospice","state":"Washington, DC","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}