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Out-of-State Licensee Reporting

Published on Apr 17, 2020

In response to Governor Northam’s Executive Orders 57, 51 and 42, hospitals, licensed nursing facilities, dialysis facilities, physicians’ offices, and other health care facilities in Virginia must notify DHP prior to, or within a reasonable time after employing or engaging an out-of-state healthcare practitioner to provide services for the health care facility or office in the Commonwealth. A health care facility includes assisted living facilities, congregate care settings, and any alternate care facility established in response to the COVID-19 emergency. 

Facilities must complete the out-of-state licensed provider form and supply the following information on each provider:

  • Name of the licensed provider
  • State of licensure
  • License type
  • License number

Please access the Out-of-State Licensee Reporting Form here.

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