Current through Register Vol. 56, No. 18, September 16, 2024
(a) Except as
set forth in
13:45B-13.4, each health care
service firm shall register with the Division by submitting the following, on
forms provided by the Director:
1. A
registration form, which shall include the following information:
i. The name of the health care service firm
and any fictitious or trade name used in its operation and the names of health
care companies related through joint ownership, boards of directors, officers
or principals;
ii. Each primary
location including street and street number of the building(s) and place(s)
where its business is to be conducted and the addresses of all health care
companies related through joint ownership, boards of directors, officers or
principals;
iii. The name and
residence address of each officer, director, and principal;
iv. The name, residence and business street
address, and business telephone number of each person with an ownership
interest of 10 percent or more in the agency and the percentage of ownership
held; and
v. The name, residence
and business street address and business telephone number of each person who is
a managing agent of the agency; or, if the managing agent is a corporation,
association or other company, its name, street address and telephone number and
the names and addresses of its officers and directors;
2. A certification of each officer, director,
principal or owner setting forth whether he or she has ever been convicted of a
crime as set forth in
34:8-44;
3. A bond of $ 10,000 to secure compliance
with the Act. The Director may waive the bond requirement for any corporation
or entity having a net worth of $ 100,000 or more. In order to obtain a waiver,
the health care service firm shall provide a copy of a certified financial
report prepared by a certified public accountant or licensed accountant
establishing a net worth of $ 100,000 or greater; and
4. A list of any licenses held in another
state by the health care service firm, or by any officer, director, owner or
principal of the health care service firm, to provide health care services in
another state, a description of any actions taken by another state on those
licenses, including violations of health or labor laws, and a description of
any violations of Federal law by the health care service firm or any principal
of the health care service firm.
(b) A health care service firm shall provide
the information set forth in (a)1iv and v above prior to any change in
ownership or management.
(c) If any
information required to be included on the application changes, the health care
service firm shall provide that information to the Section, in writing, within
30 calendar days of the change.
(d)
In the event an officer, director, principal or owner is convicted of a crime
subsequent to filing the affidavit required by (a) above, the health care
service firm shall obtain a new affidavit from that individual and shall file
the affidavit with the Section within 30 days of the conviction.
