Rule 15-16-1-3.3.20 - Evidence of Character and Related History As documentation for the Department, regarding the requirement for licensure, each applicant(s) for a license to operate a Pediatric Skilled Nursing Facility, whether for initial or renewal, shall submit together, with their application:
1. Two (2) personal character references and two (2) professional character references for the administrator, manager, or supervisor of the Pediatric Skilled Nursing Facility, except on renewal if previously provided to the Department; 2. The criminal record, if any, for himself and the manager, supervisor, director of nursing services of the Pediatric Skilled Nursing Facility, to include the court, date of conviction, the offense, penalties imposed by each conviction, regardless of adjudication; 3. Any injunctive or restrictive order or federal or state administrative order related to business activity or health care as a result of an action brought by a public agency or department; 4. A copy of current agreements entered into with third party providers; and 5. A copy of current agreements with each consultant employed by the center and documentation specifying frequency of consultative visits and required written, dated reports. 15 Miss. Code. R. § 16-1-3.3.20
Mississippi Code Annotated § 43-13-117