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32.02.01.00.htm 32.02.01.00. Title 32 MARYLAND DEPARTMENT OF AGING Subtitle 02 PROVIDER REGULATIONS Chapter 01 Certificate of Registration for Continuing Care Facilities and Providers Authority: Human Services Article, Title 10, Subtitle 4, Annotated Code of Maryland
32.02.01.01.htm 32.02.01.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Act" means Human Services Article, Title 10, Subtitle 4, Parts I―V and VII―IX, Annotated Code of Maryland.2) "Actuarial balance sheet" means a balance sheet that uses actuarial principles and practices to determine the value of certain items in the balance sheet based on actuarial techniques involving reasonable assumptions about contingencies, inflation
32.02.01.02.htm 32.02.01.02. 02 General Requirements to Offer Continuing Care.. A. A provider may not offer continuing care, enter into or renew an agreement for continuing care, begin construction for a new facility, or collect deposits for continuing care without having secured the necessary feasibility study approval or certificate of registration from the Department.B. Submissions.. 1) The submissions described in this section shall be filed with and approved by the Department.. 2) Statement of Intent. A
32.02.01.03.htm 32.02.01.03. 03 Preliminary Certificate of Registration.. A. Process to Obtain a Preliminary Certificate of Registration. A person shall file a:. 1) Statement of intent under Regulation .04 of this chapter;. 2) A feasibility study under Regulation .05 of this chapter; and. 3) An application under Regulation .06 of this chapter.. B. Forms and Fees for Feasibility Study and Application.. 1) A feasibility study and an application for a preliminary certificate of registration shall be sub
32.02.01.04.htm 32.02.01.04. 04 Statement of Intent to Apply for a Preliminary Certificate.. A. Statement of Intent. Any person that intends to offer continuing care agreements for new units or to file a feasibility study under Regulation .05 of this chapter shall file a statement of intent with the Department at least 30 days before submission of a feasibility study. If a feasibility study is not filed by the provider within 60 days after the statement of intent is filed, a new statement
32.02.01.05.htm 32.02.01.05. 05 Feasibility Study.. A. The feasibility study shall be prepared in a form satisfactory to the Department, by an authority recognized by the Department, and shall include at least the following information:1) A statement of the purpose for the proposed project or construction;. 2) A summary of the proposed project, which shall include the following information:. a) A description of the proposed project;. b) A statement regarding any affiliation of the provider with a religious,
32.02.01.06.htm 32.02.01.06. 06 Application for a Preliminary Certificate of Registration.. A. Application. An application for a preliminary certificate of registration shall include the information described in this regulation.B. The names and addresses of the following shall be included:. 1) The facility;. 2) The provider;. 3) Any affiliate, parent, or subsidiary person or business entity; and. 4) The chief executive officer of the provider, the facility, and each affiliate, parent, or subsidi
32.02.01.07.htm 32.02.01.07. 07 Department Action on Feasibility Study and Application for a Preliminary Certificate of Registration.A. The Department shall approve a feasibility study when it determines that:. 1) Either a certificate of need or an exemption from a certificate of need has been issued by MHCC for the number of comprehensive care beds proposed for the facility for which licenses are required by MDH;2) The number of licensed assisted living units proposed for the facility i
32.02.01.08.htm 32.02.01.08. 08 Advertising Before an Initial Certificate of Registration Has Been Issued.. A. If a provider that has submitted a feasibility study desires to advertise a continuing care community before an initial certificate of registration has been issued, the provider shall submit that advertising so it is received by the Department at least 3 working days before the advertising is to be aired, distributed, or otherwise used. The envelope or package in which the submission is deliver
32.02.01.09.htm 32.02.01.09. 09 Application for an Initial Certificate of Registration.. A. A provider shall file an application for an initial certificate of registration on a form provided by the Department.B. The application shall include verification that:. 1) All licenses and certificates required as of the date of the application from MDH, MHCC, and the Department for the new units have been issued;2) Agreements have been executed for at least 65 percent of the independent living units and at leas
32.02.01.10.htm 32.02.01.10. 10 Action of Department on Application for an Initial Certificate of Registration.. A. The Department shall issue an initial certificate of registration when it determines that all of the following conditions have been met:1) The provider has been issued a preliminary certificate of registration;. 2) The provider has received all licenses and certifications and letters of exemption required as of that date from MDH, MHCC, and the Department;3) The provider has submi
32.02.01.11.htm 32.02.01.11. 11 Request for Approval to Use Deposits.. A. After the issuance of an initial certificate of registration for any new units, the provider may submit to the Department a request for permission to use deposits.B. The request shall include verification that:. 1) Construction of the proposed project has been completed as evidenced by a certificate of substantial completion; and2) The provider has been issued:.
32.02.01.12.htm 32.02.01.12. 12 Action of the Department on Request for Approval to Use Deposits.. The Department shall issue a written approval to the provider permitting withdrawal of deposits from escrow for use by the provider when the Department determines that the provider has met the following requirements:A. Construction of the proposed project has been completed as evidenced by a certificate of substantial completion;B. A certificate of occupancy, or its equivalent, has been issued by the ap
32.02.01.13.htm 32.02.01.13. 13 Application for Renewal Certificate of Registration.. A. The provider shall file an application for a renewal certificate of registration within 120 days of the end of the provider's fiscal year on a form provided by the Department.B. A renewal certificate of registration shall be issued for 1 year, which is in effect from 6 months after the end of the provider's most recent fiscal year to 6 months after the close of the provider's current fiscal year.C. The application for a
32.02.01.14.htm 32.02.01.14. 14 Action of the Department on Application for Annual Renewal Certificate of Registration.. A. The Department shall approve an application for a renewal certificate of registration when it determines that:1) The required documents have been filed;. 2) Any revised agreements meet the applicable requirements of the Act and this chapter;. 3) The provider has not been found to be in financial difficulty;. 4) The necessary facilities for providing continuing care are in existence;.
32.02.01.15.htm 32.02.01.15. 15 Application for Renovation of Facility.. A. Statement of Intent. A provider that intends to undertake a renovation of its facility shall file a statement of intent with the Department at least 30 days before submitting a renovation approval request. If a renovation approval request is not filed by the provider within 60 days after the statement of intent is filed, a new statement of intent shall be filed with the Department at least 30 days before submission of
32.02.01.16.htm 32.02.01.16. 16 Action of the Department on Renovation Approval Request.. A. Approval Standards. The Department shall approve a renovation approval request when it determines that a reasonable financial plan, prepared by an authority recognized by the Department, has been submitted for the proposed renovation, and the plan demonstrates that:1) The anticipated sources of funds to finance the proposed renovation are equal to or greater than the anticipated uses of funds for the proposed ren
32.02.01.17.htm 32.02.01.17. 17 Application for Expansion of Facility.. A. Statement of Intent.. 1) A provider that intends to undertake an expansion of its facility shall file a statement of intent with the Department at least 30 days before submission of an expansion approval request.2) If the expansion approval request is not filed by the provider within 60 days after the statement of intent is filed, a new statement of intent shall be filed with the Department at least 30 days before submission of the f
32.02.01.18.htm 32.02.01.18. 18 Action of the Department on Expansion Approval Request.. A. The Department shall approve an expansion approval request and, if applicable, issue a revised certificate of registration that includes the additional units when it determines that:1) A market for the additional independent living and assisted living units appears to exist, based on reliable data; and2) A reasonable financial plan, prepared by an authority recognized by the Department, has been subm
32.02.01.19.htm 32.02.01.19. 19 Required Information Regarding Governance.. A. In General. At least annually, each provider shall conduct a meeting, open to all of the provider's subscribers, at which an authorized officer of the provider shall present a summary of the provider's operations, significant changes from the previous year, and goals and objectives for the next year. The provider shall make provisions to have an authorized officer receive and answer questions from subscribers at the meeting.
32.02.01.20.htm 32.02.01.20. 20 Operating Reserve Requirements.. A. Definitions.. 1) In this regulation, the following terms have the meanings indicated.. 2) Terms Defined.. a) "Binding agreement" means an unconditional, irrevocable letter of credit or line of credit agreement entered into by a provider and a financial institution.b) "Debt service fund" means one or more special loan funds, established under requirements imposed by a financial institution or under applicable financing documents, into wh
32.02.01.21.htm 32.02.01.21. 21 Disclosure Statement.. A. General. A provider shall furnish, without cost, a disclosure statement for each facility of the provider holding either a preliminary certificate of registration or a certificate of registration to all prospective subscribers and, upon request, annually to all subscribers. A disclosure statement shall be provided to a prospective subscriber before payment of any part of the entrance fee or, if earlier, the execution of a continuing care agree
32.02.01.22.htm 32.02.01.22. 22 Sale, Transfer, or Reorganization of Ownership or Control.. A. Sale or Transfer of Ownership or Control.. 1) Except as provided in §B of this regulation, a provider that holds an initial or renewal certificate of registration or a person with an ownership interest in or right to control that provider through governing body appointments or contractual or similar arrangements may not sell or otherwise transfer, directly or indirectly, more than 50 percent of the provider's owner
32.02.01.23.htm 32.02.01.23. 23 Sale, Transfer, or Other Disposition of Assets.. A. Definitions.. 1) In this regulation, the following terms have the meanings indicated.. 2) Terms Defined.. a) "Days cash on hand ratio" means the ratio created by the following calculation: [Unrestricted current cash and investments + Unrestricted noncurrent cash and investments] divided by [Total operating expenses― Depreciation and amortization) divided by 365]b) "Debt service coverage ratio" means the ratio c
32.02.01.24.htm 32.02.01.24. 24 Financial Review Committee.. A. The Financial Review Committee shall review providers' financial matters referred to it by the Department.B. The Secretary shall appoint seven members to the Committee from qualified applicants. The seven members shall consist of:1) Two persons knowledgeable in the field of continuing care;. 2) Two certified public accountants;. 3) One member of the financial community; and.
32.02.01.25.htm 32.02.01.25. 25 Referrals to the Financial Review Committee.. A. The Department may refer to the Committee for its consideration:. 1) A provider's application for a renewal certificate after review by the Department; or. 2) A finding of possible financial difficulty, at any time.. B. Upon receipt of a referral from the Department, the Committee shall:. 1) Request from the Department any additional material which the Committee may require;. 2) Review the material to determine:.
32.02.01.26.htm 32.02.01.26. 26 Findings of Financial Difficulty.. A. Upon a final determination by the Department that a provider is in financial difficulty, the Department shall notify the provider, by certified mail, return receipt requested, of the determination, including whether the Department has determined that there is a significant risk of financial failure.B. The Department may:. 1) Consult with the Financial Review Committee to review the findings and possible corrective financial plans; and
32.02.01.27.htm 32.02.01.27. 27 Deposit Agreement and Processing Fee.. A. A deposit agreement used for a deposit on a unit for which the provider has not received written approval to withdraw deposits under Regulation .12 of this chapter shall:1) State that all deposits and entrance fees shall be held in escrow until:. a) The issuance of an initial certificate of registration for the unit,. b) Construction is completed,.
32.02.01.28.htm 32.02.01.28. 28 Continuing Care Agreement.. A. Each continuing care agreement shall, in a form acceptable to the Department:. 1) List the total consideration paid, or to be paid, by the subscriber for continuing care, including a schedule or inventory that sets forth in one place the value of all entrance fees, subscription fees, property transferred, surcharges, periodic fees, donations, and other fees;2) Describe in detail all items of service to be provided to the subscriber
32.02.01.29.htm 32.02.01.29. 29 Withdrawal of Application or Rescission of Agreement Before Occupancy Date.. A. Withdrawal of Application. A person seeking admission to a continuing care facility may withdraw an application at any time before execution of the continuing care agreement. A provider shall refund within not more than 60 days of the withdrawal all money paid, less any nonrefundable processing fee that was specified in the deposit agreement, to a prospective subscriber who withdraws an applica
32.02.01.30.htm 32.02.01.30. 30 Rescissions for Violation of the Act.. If the terms of an agreement are in violation of the terms of the Act and a subscriber is injured by the violation, the subscriber may rescind the agreement at any time. The subscriber is entitled to treble damages for extensive injuries arising from a violation.
32.02.01.31.htm 32.02.01.31. 31 Termination of the Agreement After the Occupancy Date.. A. Termination by a Subscriber. If the subscriber elects to terminate the agreement after the date of occupancy, refund of the entrance fee is governed by the terms of the agreement.B. Dismissal or Discharge by the Provider.. 1) An agreement may not permit dismissal or discharge of a subscriber from a facility, including by involuntary transfer to an accommodation outside the facility, before expiration of the agreement fo
32.02.01.32.htm 32.02.01.32. 32 Public Information.. A. The Department shall:. 1) Make the information required to be provided under this chapter available to all interested persons; and2) Publicize the availability of this information.. B. Information will be made available for review to all interested persons under COMAR 32.01.02..
32.02.01.33.htm 32.02.01.33. 32 Inspection by the Department.. A. The Department may:. 1) Inspect any facility offering continuing care;. 2) Examine the records of a provider or person that controls a provider; and. 3) Audit or observe any service rendered under a continuing care agreement.. B. A provider shall cooperate with the Department in all reasonable requests to inspect, examine, audit, or observe the provider, the facility, the services, and the records of the provider.C. If a continuing care f
32.02.01.34.htm 32.02.01.34. 34 Removal of Records and Accounts.. A. A provider may not remove from the State records or assets of the provider related to the operation of the facility or the provision of services under continuing care agreements without the written consent of the Department.B. A provider may request from the Department approval to remove records or assets from the State by submitting the verification that the Department requires to establish that removal of records or assets will:
32.02.01.35.htm 32.02.01.35. 35 Administrative Sanctions.. A. The Secretary may deny, suspend, or revoke a preliminary, initial, or renewal certificate of registration for cause. Cause for denial, suspension, or revocation includes, but is not limited to the following:1) Violations of the provisions of the Act;. 2) Violations of regulations in this chapter;. 3) Misrepresentations of fact to the Department or to subscribers;. 4) Submission of false financial information to the Department;.
32.02.01.36.htm 32.02.01.36. 36 Appeals.. A person aggrieved by a denial of a certificate of registration, by a revocation of a certificate of registration, or by any other action of the Department or Secretary under this chapter, may file a written appeal. An appeal of any action taken by the Department or Secretary under this chapter shall be conducted in accordance with the Maryland Administrative Procedure Act, State Government Article, Title 10, Subtitles 2 and 3, Annotated Code of
32.02.01.9999.htm 32.02.01.9999. Administrative History Effective date: December 26, 1980 (7:26 Md. R. 2423). Regulations .02B, .04A, .08, .10, and .14 amended effective March 28, 1983 (10:6 Md. R. 559). Regulations .04A, .05A, .06, and .09 amended effective December 31, 1984 (11:26 Md. R. 2280). Regulation .07 repealed and new Regulation .07 adopted effective December 31, 1984 (11:26 Md. R. 2280) ―Regulations .01―22 repealed and new Regulations .01―22 adopted effective June 2, 1986 (13:11 Md. R. 1274)
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