1. (a) A legal entity shall submit an application for licensure for a new facility to the Nursing Home Licensure and Certification Section of the Division of Health Service Regulation at least 30 days prior to a license being issued or patients admitted.

2. (b) The application shall contain the following:

   1. (1) legal identity of applicant (licensee) and mailing address;
   2. (2) name or names under which the facility is presented to the public;
   3. (3) location and mailing address of facility;
   4. (4) ownership disclosure;
   5. (5) bed complement;
   6. (6) magnitude and scope of services offered;
   7. (7) name and current license number of the administrator;
   8. (8) name and current license number of the director of nursing; and
   9. (9) name and current license number of the medical director.

History Note: Authority G.S. 131E‑104; 131E-102;
Eff. January 1, 1996;
Amended Eff. July 1, 2012;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. March 22, 2015.