4766-2-15 Changes to be reported to the board.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-2-18 of the Administrative Code.]

(A) Each licensed MTO shall give written notification to the board within ten business days of any additions, deletions, or changes in:

(1) Executive officers or board members;

(2) Medical director, including:

(a) Contact information; and

(b) Medical license number;

(3) Ownership of a licensed MTO;

(4) Tax ID or EIN number;

(5) The name of the primary contact person(s), business or administrative office telephone number, email address, and if applicable, office fax number.

(B) Within ten days of the date a permitted ambulance or non-transport vehicle is permanently withdrawn from service, the licensed MTO shall return to the board a "Deletion of Vehicle" form and the decal from the right rear window.

(C) Within ten business days of the date a licensed MTO ceases to operate, it shall return to the board all vehicle decals and the certificate of licensure.

(D) Within ten business days of the date a licensed MTO ceases to operate a satellite base, it shall return to the board the certificate of licensure.

(E) A licensed MTO may apply at any time to be licensed at a higher level. The application shall be made on a "Change in Level of Service Medical Transportation Organization" form and include the one hundred dollar license fee. The MTO shall also ensure compliance with rules 4766-2-04 and 4766-2-08 of the Administrative Code. A change in level of service does not change the expiration date of the license.

(F) A MTO licensed at the intermediate or advanced life support level may apply at any time to be licensed at a lower level. The application shall be made on a "Change in Level of Service Medical Transportation Organization" form and include the one hundred dollar license fee. The MTO shall also ensure compliance with rules 4766-2-04 and 4766-2-08 of the Administrative Code. A change in level of service does not change the expiration date of the license.

(G) A licensed MTO may apply at any time for change of address of headquarters location. The application shall be made on the "Headquarters Change of Address" form and include the one hundred dollar license fee. The MTO shall also ensure compliance with rules 4766-2-04 and 4766-2-08 of the Administrative Code. A change in the headquarters address does not change the expiration date of the license.

Effective: 6/15/2017
Five Year Review (FYR) Dates: 01/13/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.07
Prior Effective Dates: 07/02/2009, 04/16/2012