North Carolina Administrative Code
Title 10A - HEALTH AND HUMAN SERVICES
Chapter 14 - Director, Division of Health Service Regulation
Subchapter E - LICENSURE OF SUITABLE FACILITIES FOR THE PERFOMANCE OF SURGICAL ABORTIONS
Section .0100 - LICENSURE PROCEDURE
Section 14E .0109 - RENEWAL

Universal Citation: 10A NC Admin Code 14E .0109

Current through Register Vol. 39, No. 6, September 16, 2024

(a) Each license, shall be renewed at the beginning of each calendar year.

(b) The renewal 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.

(14) The number of abortion procedures performed since initial licensure or the most recent licensure renewal, whichever is later; and

(15) The number of patients that were transferred to a hospital since initial licensure or the most recent licensure renewal, whichever is later.

(c) Upon the filing of a renewal application, the clinic must pay a non-refundable renewal fee as defined in G.S. 131E-153.2.

(d) An application for renewal of licensure must be filed with the Division at least 30 days prior to the date of expiration. Renewal application forms shall be furnished by the Division.

(e) Failure to file a renewal application shall result in expiration of the license to operate.

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