1. (a) The terms defined in G.S. 90-405 shall have the same meaning in this Rule.
2. (b) "Applicant" means a health care provider that submits an application to the Director of the Division of Health Service Regulation requesting an exemption from G.S. 90-406.

3. (c) The application shall include the following information:

   1. (1) the name, mailing address, email address, and telephone number of the applicant;
   2. (2) a list of the designated health care services provided or to be provided by the applicant;
   3. (3) the name, mailing address, email address, and telephone number of the manager of the entity to which the applicant wants to make referrals;
   4. (4) a list of the owners of the entity to which the applicant wants to make referrals;
   5. (5) a list of the types of designated health care services provided or to be provided by the entity to which the applicant wants to make referrals;
   6. (6) evidence that there is a need for the proposed designated health care services in the county where the entity is or will be located;
   7. (7) evidence that alternative financing is not available from other sources to develop the entity to which the applicant wants to make referrals; and
   8. (8) a statement affirming that all health care providers located in the county where the entity is or will be located shall be offered access to the entity.

4. (d) Applications shall be:

   1. (1) mailed to the Office of the Director, Division of Health Service Regulation, Department of Health and Human Services, 2701 Mail Service Center, Raleigh, NC 27699-2701; or
   2. (2) delivered in person to the Office of the Director, Division of Health Service Regulation, Department of Health and Human Services, 1915 Health Services Way, Raleigh, North Carolina 27607.

History Note: Authority G.S. 90-408;
Eff. April 1, 1995;
Readopted Eff. November 1, 2019;
Amended Eff. November 1, 2025.