Get Con Progress Report/six-month Extension Request - Mississippi ... - Msdh Ms

The CON Progress Report/Six-Month Extension Request is a crucial document for tracking the progress of health-related projects in Mississippi. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to fill out the CON Progress Report/Six-Month Extension Request.

1. Click ‘Get Form’ button to obtain the CON Progress Report/Six-Month Extension Request form and open it in your editor.
2. Select the type of report you are submitting by checking the appropriate box: Six-Month Progress Report, Six-Month Extension Request, or Final Report.
3. Fill in the CON Review number and CON number in the provided fields.
4. Enter the facility name and project title in the specified spaces.
5. Indicate the effective date and the expiration date of the current extension period.
6. Complete the section for the CON holder's information, including name, address, and contact person details.
7. Document capital expenditures by stating the amount authorized and the amount made to date.
8. Provide a description of any significant changes regarding business or corporate leadership since the original approval.
9. Detail any agreements that are either in place or being planned, and attach any updated partnership agreements or corporation documents if necessary.
10. Document activities accomplished during the pre-construction phase, including land acquisition, site preparation, and architectural plans.
11. If construction has commenced, provide dates for the contract bids, awards, and the estimated percentage of completed work.
12. Include details regarding equipment, like purchase agreements and delivery schedules. Mention any changes in funding sources as well.
13. If applicable, provide documentation of activities related to acquiring capital equipment and changes in operations or personnel.
14. Complete the certification section by signing and dating it, ensuring accuracy and truthfulness in your statements.
15. After you have completed all required fields and attached necessary documentation, save the form, and you can download or print it for submission.

Complete your CON Progress Report/Six-Month Extension Request online to ensure timely and accurate submissions.