§ 7.3. Documentation to be submitted.
(a) The Department of Health will request that the following documentation of adherence to the standards be submitted to the Department of Health:
(1) A statement that the corporation meets the eight standards prescribed in § 7.2 (relating to minimum standards) for a facility to qualify as a primary health center as defined in the act.
(2) A copy of the certificate of incorporation and bylaws along with a list of members of the Board of Directors identified by home address and principal occupation.
(3) The name and address of the person designated by the Board of Directors to manage the operation of the center with a copy of the Board resolution designating such person to perform this function.
(4) A sample of the principal business forms and a brief description of the accounting system and business procedures used.
(5) A sample of a patient chart, demonstrating the form in which the medical records are kept.
(6) A description of referral procedures and an identification of principal referral resources.
(7) A description of method utilized to inform patients of contents of their medical records.
(8) A copy of Certificate of Safety for Public Occupancy and Safety of Elevators, if elevators are utilized, and Laboratory and Pharmacy Certificates, if such exist.
(9) A list of professional staff members with brief indications of professional qualifications, such as degrees.
(10) A brief description of the continuing education program in which the professional staff members participate and a brief description of other quality assurance measures utilized.
(b) The items listed in subsection (a) shall be submitted under cover of a notarized letter from the chairman of the governing body of the facility or his designee, certifying as to the completeness and accuracy of all statements and information submitted.
Cross References This section cited in 28 Pa. Code § 7.4 (relating to issuance of a certificate).
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