Tenn. Comp. R. & Regs. 0720-12-.01 - STANDARD APPLICATION
(1) Application
for a certificate of need shall be made on form(s) provided by the Agency. The
applicant must provide all information requested in the application forms. The
information which may be required in the application form(s) includes, but is
not necessarily limited to, the following:
(a)
Facility identification, including legal interests and status, operator and
owners;
(b) Detailed project
description;
(c) Detailed project
cost data;
(d) Project operating
costs and revenues, patient charges, and occupancy rate;
(e) Information on whether the proposed
project will provide health care that meets appropriate quality
standards;
(f) Information on the
project's relationship to public needs and the existing health service system;
and
(g) A copy of any signed
agreement between the applicant and TennCare managed care organizations; if a
signed agreement has not been executed prior to the Agency's consideration of
the application, the applicant shall provide a list of any such organizations
with whom the applicant is negotiating, or a statement that the applicant does
not intend to contract with any TennCare managed care
organization(s).
(2) The
accuracy of the information provided must be attested to by the responsible
party or his agent in a notarized statement. Providing false, incorrect,
misleading, or fraudulent information is grounds for revocation of the
certificate of need.
Notes
Authority: T.C.A. ยงยง 4-5-201, et seq., 4-5-202, 68-11-1605, 68-11-1607, and 68-11-1619; 2016 Tenn. Pub. Acts Ch. 1043; and 2021 Tenn. Pub. Acts Ch. 557.
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