List of Limited Review CON Schedules
This application is for those projects subject to a limited review pursuant to 10 NYCRR 710.1(c)(5)-(7). The Limited Review Application consists of a cover sheet and twelve (12) schedules - though not all of the schedules will need to be completed for a given project. The responses given on the cover sheet will determine which schedules to complete.
Some computers may experience a delay as these schedules open when the link is selected by "left click". If this occurs, DOH recommends a "right click" while the cursor is on the link, of the mouse, followed by selection of the "Save Target/Link As..." option on the menu.
- LRA Instructions (DOC, 291KB)
- LRA Cover Sheet (DOC, 61KB)
- Schedule LRA 2 Total Project Cost (DOC, 95KB)
- Schedule LRA 3 Proposed Plan for Project Financing (DOC, 91KB)
- LRA Schedule 4 Environmental Assessment (DOCX, 33KB)
- Schedule LRA 5 Space and Construction Cost Distribution (DOC, 160KB)
- Schedule 6 Architectural and Engineering Submission Requirements (DOC, 48KB)
- Architect's or Engineer's Letter of Certification
- Schedule LRA 7 Proposed Operating Budget (DOCX, 43KB)
- Schedule LRA 8 Staffing (DOCX, 28KB)
- Schedule LRA 10 Impact of Limited Review Application on Operating Certificate(services specific to the site) (DOC, 150KB)
- Schedule LRA 11 Part-Time Clinic (DOC, 265KB)
- Schedule LRA 12 Assurances (DOC, 68KB)
Submit necessary schedules via the NYSE-CON
Limited Review Application Fees
Limited Review Applications for more than one type of project listed shall only submit a single fee, reflecting the higher of the applicable fees:
| Type of LAR | Normal Fee | "Safety Net" Fee |
|---|---|---|
| Minor Construction | $1,000 | $500 |
| Equipment | $1,000 | $500 |
| Service Delivery | $500 | $250 |
| Cardiac Services | $500 | $250 |
| Relocation of Extension Clinic | $1,000 | $500 |
| Part-Time Clinic | $500 | $250 |
