Get Nj Cn-7 2021-2025

The NJ CN-7 form is essential for obtaining or amending a license for an acute care facility in New Jersey. This guide provides clear, step-by-step instructions to help you successfully complete the form online.

Follow the steps to fill out the NJ CN-7 form with ease.

1. Press the ‘Get Form’ button to access the NJ CN-7 form and open it in the online editor.
2. Begin by providing your contact information, including the official name of the facility and operating entity. This is important as it will appear on the final license.
3. In section I, specify the type of facility by checking the appropriate box. Include any relevant details about the services provided and the total change in bed capacity or services offered.
4. Complete section II for ambulatory care facilities, detailing the types of services and their corresponding capacities. Again, note any changes in service levels.
5. Proceed to section III, which outlines information about the operating entity. Indicate the type of ownership and provide information about the principals involved in the entity.
6. Respond to the questions regarding prior health care facility applications and legal matters. This ensures the department has a complete view of any relevant history.
7. List any affiliated health care facilities under section on affiliated entities, ensuring to include their addresses and Medicare Provider Numbers.
8. Finally, certify the application by providing your name, title, signature, and date, confirming that all provided information is accurate and complete.
9. After completing the form, save your changes. You can then download, print, or share the form for submission as required.

Complete the NJ CN-7 document online today to ensure your facility meets licensing requirements!