10A N.C. Admin. Code 14E.0106

Current through Register Vol. 39, No. 8, October 15, 2024

Section 14E .0106 - APPLICATION

(a) Prior to the admission of patients, an applicant for a new clinic shall submit an application for licensure and receive approval from the Division.

(b) Application forms may be obtained by contacting the Division at 2712 Mail Service Center Raleigh, NC 27699-2712.

(c) The application form shall set forth:

(1) Legal identity of the applicant;

(2) The name or names under which the facility or services are advertised or presented to the public;

(3) The facility's mailing address;

(4) The facility's physical address;

(5) The ownership of the facility, including a description of the legal character of the operating ownership;

(6) The owner of the premises from which services are offered including the name and address of the owner of the premises if different from the owner of the facility;

(7) If the facility is operated under a management contract, the name and address of the building's management company;

(8) A description of the arrangements that have been made for the disposal of pathological waste, products of conception, and sharps, and the name and address of the provider of such services if not performed by the facility;

(9) The name, specialty, board certifications, and medical license number of the Medical Director;

(10) The name, specialty, board certifications, and medical license number of each member of the medical staff;

(11) The name, nursing certificate number, and renewal number of the Director of Nursing;

(12) The name, nursing certificate number, and renewal number of each nursing staff member; and

(13) The name of the consulting pathologist, the name of the consulting pathologist's laboratory, and the address of the laboratory.

(d) After construction requirements in 10A NCAC 13S .0200 have been met and the application for licensure has been received and approved, the Division shall conduct an on-site, licensure survey.

10A N.C. Admin. Code 14E .0106

Authority G.S. 14-45.1(a);
Eff. February 1, 1976;
Readopted Eff. December 19, 1977;
Amended Eff. July 1, 1994;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 24, 2019.

Authority G.S. 131E-153.2;
Eff. February 1, 1976;
Readopted Eff. December 19, 1977;
Amended Eff. July 1, 1994.
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 24, 2019;
Codifier determined that agency's findings of need did not meet criteria for emergency rule on June 22, 2023

Emergency Amended by North Carolina Register Volume 38, Issue 03, August 1, 2023 effective 6/30/2023 (EMERGENCY).

Repealed Eff. July 1, 2023 pursuant to G.S. 150B-21.7;

Temporary Amendment by North Carolina Register Volume 38, Issue 14, January 16, 2024 effective 12/22/2023 exp. 10/12/2024.

Adopted by North Carolina Register Volume 39, Issue 07, October 1, 2024 effective 9/1/2024.