Rule 15-16-1-4.6.3 - Application for LicenseApplications should include:
1. Name of Facility. Every RBIR shall be designated by a permanent and distinctive name which shall be used in applying for a license and shall not be changed without first notifying the licensing agency in writing and receiving written approval of the change from the licensing agency. Such notice shall specify the name to be discontinued as well as the new name proposed. Only the official name, as approved by the licensing agency and by which the facility is licensed shall be used in telephone listing, on stationery, in advertising, etc. Two or more facilities shall not be licensed under a similar name.2. Number of Beds. RBIR shall contain no more than 12 beds.3. A copy of the on-site inspection report with approval for occupancy by the Office of the State Fire Marshal.4. A copy of the health inspection report with approval of occupancy from the Mississippi State Department of Health.5. Verification of a criminal history records check which was processed through the MSDH FingerPro system.6. Proof of financial viability as evidenced by one of the following: a. Verification of sufficient assets equal to one hundred thousand dollars or the cost of three months of operation, whichever is less; orb. A letter of credit equal to one hundred thousand dollars or the cost of three months of operation, whichever is less.7. Proof of worker's compensation insurance.8. Disclosure of ownership and control information.9. A written statement that the facility will not at any time participate in the Medicaid program (Section 43-13-101 et.seq.) or admit or keep any patients in the facility who are participating in the Medicaid program.15 Miss. Code. R. 16-1-4.6.3
Miss. Code Ann. § 41-75-13