Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 2 - MINIMUM STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE FACILITIES › Subchapter 3 - Licensing › Rule 15-16-1-2.3.9 - Initial Licensure

Current through June 25, 2024
For initial licensure, an applicant shall be in
						compliance with all requirements, as outlined in these regulations, and must
						submit documents, included but not limited to, those outlined:
1. A completed/signed application, on forms
					 as designated by MSDH. All information submitted on the application forms, or
					 by request for additional information, shall be accurate and current at the
					 time of filing;
2. A
					 non-refundable application/processing fee of $1000.00;
3. A Licensing Fee of $500.00 for up to 25
					 beds; with an additional $20.00 per bed for each licensed bed thereafter;
4. Certificates/letters of
					 approval from the local zoning authority indicating that the location of the
					 PPEC center conforms to local zoning ordinances, if applicable;
5. Certificates/letters of approval from the
					 local/regional/state Fire Marshal that the PPEC center is in compliance with
					 all applicable fire safety standards;
6. Evidence that the PPEC center's water and
					 sewer systems have been approved by the Mississippi State Department of Health;
7. A licensed facility shall
					 obtain a Food Service Permit from the Mississippi State Department of Health
					 Office of Environmental Health.
8.
					 Certificate of Occupancy;
9.
					 Clinical Laboratory Improvement Amendments (CLIA) certificate or CLIA
					 certificate of waiver.
10. Proof
					 of general and Professional Liability Insurance in the amount of at least
					 $300,000.00 including Workman's Compensation Insurance;
11. Articles of Incorporation, Disclosure of
					 Ownership and Control Information;
12. Proof of financial viability/contingency
					 plan demonstrating evidence that the applicant processes assets sufficient to
					 establish and sustain all components of a PPEC center to meet the provisions as
					 outlined in these regulations while operating and/or during extraordinary
					 circumstances including but not limited to audited financial statements, an
					 established line of credit issued from a federally insured institution in the
					 amount of at least $100,000.00, a projected twelve (12) month statement of
					 operations and a projected first twelve months statement of cash flow. The
					 requesting PPEC center shall provide evidence of the referenced above review in
					 the form of a certified affidavit or statement resultant of a review from an
					 independent certified public accountant firm.
13. That the center is located within 20
					 miles or 30 minutes (whichever is greater) of an Emergency Department that has
					 capabilities to handle pediatric emergencies;
14. The name of the PPEC center's
					 administrator, the name and license number of the Medical Director and Director
					 of Nursing along with proof of available licensed and supportive personnel who
					 will have responsibility for any part of the care given to PPEC center's
					 clients; as well as proof of ancillary support services such as dietary,
					 housekeeping, maintenance and other personnel either directly or contractually
					 secured to support the PPEC center on a daily basis;
15. The names and titles of personnel who
					 have been affiliated, during the preceding five (5) years with any other PPEC
					 center through ownership or employment, and the listing of names and addresses
					 of the appropriate PPEC center for each. This information shall be provided for
					 the applicant: administrator, and all licensed nurses; and
16. Floor sketch or drawing of premises to be
					 licensed, letter of intent and functional plan.
Mississippi Code
						Annotated § 41-125-19