reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.14 - Action of the Department on Application for Annual Renewal Certificate of Registration

Current through Register Vol. 51, No. 14, July 12, 2024
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;
(5) The provider has received all required licenses and certificates from DHMH, MHCC, and the Department;
(6) The form and substance of all advertising and other promotional materials filed are not deceptive, misleading, or likely to mislead;
(7) If required under Regulation .13 of this chapter, an actuarial study, prepared or reviewed by a qualified actuary, has been submitted which meets the requirements of Regulation .13E of this chapter;
(8) The disclosure statement submitted complies with Regulation .21 of this chapter;
(9) The operating reserves comply with the requirements of Regulation .20 of this chapter; and
(10) All renewal fees and any late fees have been paid.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.15 - Application for Renovation of Facility

Current through Register Vol. 51, No. 14, July 12, 2024
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 a financial plan described in §B of this regulation. The statement of intent shall describe at a minimum the nature of the renovation.
B. Renovation Approval Request. A request for renovation approval shall:
(1) Be prepared in a form satisfactory to the Department; and
(2) Include at least the following information:
(a) A statement of the purpose and need for the renovation;
(b) A financial plan, prepared by an authority recognized by the Department, that:
(i) Meets the requirements of §C of this regulation, and
(ii) Demonstrates to the satisfaction of the Department that the renovation will not have an unreasonably adverse effect on the financial ability of the provider to furnish continuing care in accordance with the provider's agreements and the Act at each facility of the provider in the State; and
(c) Any further information the Department requires.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.16 - Action of the Department on Renovation Approval Request

Current through Register Vol. 51, No. 14, July 12, 2024
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 renovation; and
(2) The proposed renovation will not have an unreasonably adverse effect on the financial ability of the provider to furnish continuing care in accordance with the provider's agreements and the Act at each facility of the provider in the State.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.17 - Application for Expansion of Facility

Current through Register Vol. 51, No. 14, July 12, 2024
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 financial plan described in §B(3) of this regulation.
(3) A statement of intent shall describe at a minimum:
(a) The proposed expansion;
(b) The types of agreements proposed, such as extensive, modified, or fee-for-service, and whether entrance fees will be refundable or nonrefundable;
(c) The number of proposed additional units, if any, by unit type; and
(d) Any further information the Department requires.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.18 - Action of the Department on Expansion Approval Request

Current through Register Vol. 51, No. 14, July 12, 2024
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; and
(2) A reasonable financial plan, prepared by an authority recognized by the Department, has been submitted for the proposed expansion that demonstrates that the:
(a) Anticipated sources of funds to finance the proposed expansion are equal to or greater than the anticipated uses of funds for the proposed expansion, and
(b) Proposed expansion will not have an unreasonably adverse effect on the financial ability of the provider to furnish continuing care in accordance with the provider's agreements and the Act at each facility of the provider in the State.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.19 - Required Information Regarding Governance

Current through Register Vol. 51, No. 14, July 12, 2024
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.
B. Provider that has a Governing Body.
(1) A provider that has a governing body shall include at least one of the provider's subscribers as a full and regular member of the governing body.
(2) If a provider that has a governing body owns or operates more than three facilities in the State, there shall be at least one of the provider's subscribers as a full and regular member of the governing body for every three facilities in the State.
(3) Subscriber Member Selection Requirements.
(a) Subject to the provisions of §B(3)(b) of this regulation, a governing body member selected to meet the requirements of §B(1) and (2) of this regulation shall be a subscriber at a facility in the State and be selected according to the same general written standards and criteria used to select other members of the governing body.
(b) The governing body shall confer with the subscriber association at each facility of the provider before the subscriber officially joins the governing body.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.20 - Operating Reserve Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
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 which the provider is required to deposit moneys during the provider's fiscal year to pay the current portion of the principal due and the interest accruing in that year on the provider's debt.
(c) "Debt service reserve fund" means moneys required by a financial institution or under applicable financing documents to be deposited in a special loan fund, which are to be used to pay principal and interest payments due on the provider's debt if the provider is unable to pay when due the principal and interest from operating income or other sources.
(d) "Market value" means readily determinable fair value.
(e) Net Operating Expenses.
(i) "Net operating expenses" means a provider's total operating expenses at each facility of the provider, less depreciation, amortization, unusual and infrequent expenses, and changes in the obligation to provide future services.
(ii) "Net operating expenses" does not include interest expense if the provider has funded a debt service fund or other interest reserve under requirements imposed by a financial institution or under applicable financing documents, to the extent and in the amount the fund or reserve includes amounts to cover interest for the year in question.
(f) "Other interest reserve" means one or more special loan funds other than debt service funds or debt service reserve funds:
(i) Established under requirements imposed by a financial institution or under applicable financing documents; and
(ii) Into which the provider is required to deposit moneys during the provider's fiscal year to pay interest accruing in that year on the provider's debt.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.22 - Sale, Transfer, or Reorganization of Ownership or Control

Current through Register Vol. 51, No. 14, July 12, 2024
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 ownership of a facility or more than 50 percent of the ownership of, or right to control, a person that owns or controls a facility, unless the provider or person obtains the approval of the Department to the sale or other transfer in accordance with §§C-F of this regulation.
(2) Any series of sales or other transfers within a 12-month period shall be aggregated for purposes of this regulation.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.23 - Sale, Transfer, or Other Disposition of Assets

Current through Register Vol. 51, No. 14, July 12, 2024
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 created by the following calculation: [Total excess of revenues over expenses + Interest, depreciation and amortization expenses-Amortization of deferred revenue + Net proceeds from the collection of entrance fees] divided by [Maximum annual debt service or annual lease payments].
(c) "Future service obligation" means a financial obligation of a provider that equals any positive number resulting from the calculation to determine the amount by which the present value of the net costs of future services and the use of facilities to be provided to the current subscribers exceeds the balance of deferred revenue from entrance fees, which calculation is required to be performed annually by generally accepted accounting principles.
(d) "Liquid resources" means an asset that is easily converted to cash.
(e) "Maximum annual debt service" means the greatest amount required to pay the debt service requirements of any long-term indebtedness for any fiscal year, excluding any year in which the amount due is defined in the applicable financing documents as a balloon payment.
(f) "Operating ratio" means the ratio created by the following calculation: [Total operating expenses-Depreciation and amortization expenses] divided by [Total revenues-Amortization of deferred revenue].
(g) "Ordinary course of business" means transactions that occur on a routine basis without the involvement of the board of directors, or other governing body, such as paying employees and vendors, collecting fees, and selling and purchasing investments.
(h) "Transfer" means a sale, disposition, donation, lease, or other transaction that diminishes the ownership rights that the provider has in any assets.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.24 - Financial Review Committee

Current through Register Vol. 51, No. 14, July 12, 2024
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
(4) Two consumer members, preferably subscribers of continuing care facilities.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.25 - Referrals to the Financial Review Committee

Current through Register Vol. 51, No. 14, July 12, 2024
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.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.26 - Findings of Financial Difficulty

Current through Register Vol. 51, No. 14, July 12, 2024
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
(2) Assist the provider to develop an adequate corrective financial plan.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.27 - Deposit Agreement and Processing Fee

Current through Register Vol. 51, No. 14, July 12, 2024
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,
(c) A certificate of occupancy, or its equivalent, has been issued by the local jurisdiction, and
(d) The provider has been issued appropriate licenses or certificates by DHMH, MHCC, and the Department;
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.29 - Withdrawal of Application or Rescission of Agreement Before Occupancy Date

Current through Register Vol. 51, No. 14, July 12, 2024
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 application before signing a continuing care agreement.
B. Rescission of Agreement Before the Occupancy Date.
(1) If the subscriber rescinds the agreement before the date of occupancy, and the rescission either occurs within 90 days after entering into the agreement or because of a substantial change in the subscriber's physical, mental, or financial condition, the provider shall, within 30 days of rescission, refund all moneys paid by the subscriber except:
(a) Any processing fee previously specified as nonrefundable; and
(b) Special additional costs incurred by the provider due to modifications in the structure or furnishings of the unit specifically requested by the subscriber, but only if the:
(i) Costs do not exceed the costs of modification or the reasonable costs of restoration actually incurred by the provider, and
(ii) Modification was described in writing in a separate addendum to the agreement as required by Regulation .28A(23) of this chapter.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.30 - Rescissions for Violation of the Act

Current through Register Vol. 51, No. 14, July 12, 2024
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.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.31 - Termination of the Agreement After the Occupancy Date

Current through Register Vol. 51, No. 14, July 12, 2024
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 for any reason, unless the:
(a) Dismissal or discharge is for just cause; and
(b) Subscriber is given advance notice of at least 60 days.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.32 - Public Information

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Department shall:
(1) Make the information required to be provided under this chapter available to all interested persons; and
(2) Publicize the availability of this information.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.33 - Inspection by the Department

Current through Register Vol. 51, No. 14, July 12, 2024
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.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.34 - Removal of Records and Accounts

Current through Register Vol. 51, No. 14, July 12, 2024
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:
(1) Facilitate the operations of the provider and make the operations more economical; and
(2) Not diminish the service or protection given to the provider's subscribers.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.35 - Administrative Sanctions

Current through Register Vol. 51, No. 14, July 12, 2024
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;
(5) Failure to prepare or implement an adequate corrective financial plan when found to be in financial difficulty; or
(6) Agreement terms or provisions that:
(a) Violate the Act,
(b) Violate regulations in this chapter, or
(c) Are not approved by the Department.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.01 - Certificate of Registration for Continuing Care Facilities and Providers › Section 32.02.01.36 - Appeals

Current through Register Vol. 51, No. 14, July 12, 2024
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 Maryland, and COMAR 32.01.01.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.02 - General Requirements to Offer Continuing Care at Home

Current through Register Vol. 51, No. 14, July 12, 2024
A. A provider may not offer continuing care at home or collect deposits for continuing care at home without having secured the necessary feasibility study approval.
B. A provider may not provide continuing care at home without having secured an initial certificate of registration from the Department.
C. Submissions.
(1) The submissions described in this section shall be filed with and approved by the Department.
(2) Statement of Intent. An entity which intends to offer continuing care at home agreements shall file a statement of intent with the Department at least 30 days before submission of the feasibility study.
(3) Application for Approval of Feasibility Study. A provider shall obtain approval by the Department of a feasibility study before a provider may collect deposits for continuing care at home. Deposits collected for continuing care at home shall be maintained in an escrow account held in Maryland in a federally insured depository under an escrow agreement approved by the Department.
(4) Application for Preliminary Certificate. A preliminary certificate of registration is required before a provider may offer or enter into continuing care at home agreements.
(5) Application for Initial Certificate. An initial certificate of registration is required before a provider may provide services under a continuing care at home agreement.
(6) Application for Renewal of Certificate of Registration. A current certificate of registration or provisional renewal certificate of registration is required to continue to operate as a continuing care at home provider.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.03 - Preliminary Certificate of Registration

Current through Register Vol. 51, No. 14, July 12, 2024
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.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.04 - Statement of Intent to Apply for a Preliminary Certificate

Current through Register Vol. 51, No. 14, July 12, 2024
A. Statement of Intent. An entity that intends to offer continuing care at home agreements 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 of intent shall be filed with the Department at least 30 days before submission of a feasibility study.
B. Contents. A statement of intent shall contain, at a minimum, the following information:
(1) The name of the provider;
(2) Whether entrance fees will be refundable or nonrefundable;
(3) The types of agreements proposed to generate the required contract reserves;
(4) Whether the provider is proposed to be for-profit or nonprofit;
(5) The name of the management company, if any, that will manage the day-to-day operations;
(6) If applicable, the name of the:
(a) Person proposing to create or finance the provider,
(b) Marketing consultant,
(c) Provider's attorney, and
(d) Preparer of the feasibility study, along with the preparer's qualifications;
(7) A statement indicating whether any proposed comprehensive care beds will need a new certificate of need from MHCC;
(8) Whether the provider plans to build a facility; and
(9) Any further information the Department requires.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.06 - Application for a Preliminary Certificate of Registration

Current through Register Vol. 51, No. 14, July 12, 2024
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 provider;
(2) Any affiliate, parent, or subsidiary person or business entity; and
(3) The chief executive officer of the provider, and each affiliate, parent, or subsidiary person or business entity.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.08 - Advertising Before an Initial Certificate of Registration Has Been Issued

Current through Register Vol. 51, No. 14, July 12, 2024
If a provider that has submitted a feasibility study desires to advertise a continuing care at home project 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 delivered shall indicate in prominent type that the contents are proposed advertising materials for a project that does not have an initial certificate of registration.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.09 - Application for an Initial Certificate of Registration

Current through Register Vol. 51, No. 14, July 12, 2024
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 DHMH and MHCC have been issued;
(2) Agreements have been executed for at least the greater of either:
(a) 10 percent of the number of subscribers needed for the provider to reach its break-even point, or
(b) 30 subscribers;
(3) At least 10 percent of the total entrance fee has been collected for each agreement counted towards the requirement of §B(2) of this regulation;
(4) The provider has received a written commitment for any planned long-term financing; and
(5) Arrangements have been made to obtain the personnel and services necessary to provide continuing care at home.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.10 - Action of Department on Application for an Initial Certificate of Registration

Current through Register Vol. 51, No. 14, July 12, 2024
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 required as of that date from DHMH and MHCC;
(3) The provider has submitted documentation which demonstrates to the satisfaction of the Department that:
(a) Agreements have been executed for at least the greater of either:
(i) 10 percent of the number of subscribers needed for the provider to reach its break-even point, or
(ii) 30 subscribers; and
(b) At least 10 percent of the total entrance fee has been paid as a deposit for each of the executed agreements;
(4) The provider has submitted documentation that demonstrates to the satisfaction of the Department that there is a commitment for any planned long-term financing;
(5) The provider has submitted documentation that demonstrates to the satisfaction of the Department that arrangements for the personnel and services necessary to provide continuing care at home have been made; and
(6) The form and substance of all advertising and other promotional materials filed are not deceptive, misleading, or likely to mislead.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.12 - Action of the Department on Application for Renewal Certificate of Registration

Current through Register Vol. 51, No. 14, July 12, 2024
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) The proposed and existing agreements meet the requirements of the Act and this chapter;
(3) The provider has not been found to be in financial difficulty;
(4) The provider has the necessary resources for providing continuing care at home;
(5) The provider has received all required licenses and certificates from DHMH and MHCC;
(6) The form and substance of all advertising and other promotional materials filed are not deceptive, misleading, or likely to mislead;
(7) If required under Regulation .11D of this chapter, an actuarial study, prepared or reviewed by a qualified actuary, has been submitted which:
(a) Includes an actuarial balance sheet;
(b) Demonstrates that the resources available for current and replacement subscribers, including the actuarial present value of periodic fees expected to be paid in the future by present subscribers, are equal to the actuarial present value of the expected costs of performing all remaining obligations to the subscribers under the subscribers' agreements, with appropriate provision for surplus;
(c) Projects positive cash balances for a 20-year period;
(d) Includes a statement of the opinion of a qualified actuary as to whether:
(i) The data and assumptions used are appropriate and reasonable,
(ii) The methods employed are consistent with sound actuarial principles and practices, and
(iii) Provision has been made for all actuarial liabilities and related statement items;
(e) Includes supporting detailed documentation for the actuarial balance sheet including a projection of future population flows and service needs covered by the provider's agreements, which projection shall use appropriate inflation factors, mortality, morbidity, withdrawal, and other demographic assumptions; and
(f) Includes a cash flow projection for the next 20 years;
(8) The disclosure statement submitted complies with Regulation .15 of this chapter;
(9) The operating reserves comply with the requirements of Regulation .14 of this chapter; and
(10) All renewal fees and any late fees have been paid.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.13 - Required Information Regarding Governance

Current through Register Vol. 51, No. 14, July 12, 2024
A. In General.
(1) 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:
(a) The provider's operations;
(b) Significant changes from the previous year's operations; and
(c) The provider's goals and objectives for the next year.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.14 - Reserve Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
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 which the provider is required to deposit moneys during the provider's fiscal year to pay the current portion of the principal due and the interest accruing in that year on the provider's debt.
(c) "Debt service reserve fund" means moneys required by a financial institution or under applicable financing documents to be deposited in a special loan fund, which are to be used to pay principal and interest payments due on the provider's debt if the provider is unable to pay when due the principal and interest from operating income or other sources.
(d) "Market value" means readily determinable fair value.
(e) Net Operating Expenses.
(i) "Net operating expenses" means a provider's total operating expenses related to furnishing continuing care at home, less depreciation, amortization, unusual and infrequent expenses, and changes in the obligation to provide future services.
(ii) "Net operating expenses" does not include interest expense if the provider has funded a debt service fund or other interest reserve under requirements imposed by a financial institution or under applicable financing documents, to the extent and in the amount the fund or reserve includes amounts to cover interest for the year in question.
(f) "Other interest reserve" means one or more special loan funds other than debt service funds or debt service reserve funds:
(i) Established under requirements imposed by a financial institution or under applicable financing documents; and
(ii) Into which the provider is required to deposit moneys during the provider's fiscal year to pay interest accruing in that year on the provider's debt.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.16 - Sale, Transfer, or Reorganization of Ownership or Control

Current through Register Vol. 51, No. 14, July 12, 2024
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 ownership of, or right to control, the provider or a person that owns or controls a provider, unless the provider or person obtains the approval of the Department to the sale or other transfer in accordance with §§C-F of this regulation.
(2) Any series of sales or other transfers within a 12-month period shall be aggregated for purposes of this regulation.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.17 - Sale, Transfer, or Other Disposition of Assets

Current through Register Vol. 51, No. 14, July 12, 2024
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] / [(Total operating expenses - depreciation and amortization) / 365].
(b) "Debt service coverage ratio" means the ratio created by the following calculation: [Total excess of revenues over expenses + Interest, lease, depreciation, and amortization expenses / Amortization of deferred revenue + Net proceeds from the collection of entrance fees] / [Maximum annual debt service or annual lease payments].
(c) "Future service obligation" means a financial obligation of a provider that equals any positive number resulting from the calculation to determine the amount by which the present value of the net costs of future services to be provided to the current subscribers exceeds the balance of deferred revenue from entrance fees, which calculation is required to be performed annually by generally accepted accounting principles.
(d) "Liquid resources" means an asset that is easily converted to cash.
(e) "Maximum annual debt service" means the greatest amount required to pay the debt service requirements of any long-term indebtedness for any fiscal year, excluding any year in which the amount due is defined in the applicable financing documents as a balloon payment.
(f) "Operating ratio" means the ratio created by the following calculation: [Total operating expenses - Depreciation and amortization expenses] / [Total revenues - amortization of deferred revenue].
(g) "Ordinary course of business" means transactions that occur on a routine basis without the involvement of the board of directors, or other governing body, such as paying employees and vendors, collecting fees, and selling and purchasing investments.
(h) "Transfer" means a sale, disposition, donation, lease, or other transaction that diminishes the ownership rights that the provider has in any assets.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.18 - Financial Review Committee

Current through Register Vol. 51, No. 14, July 12, 2024
The Financial Review Committee authorized by Human Services Article, §§
									10-464 -10-469, Annotated Code of Maryland, shall review providers' financial matters referred to it by the Department in accordance with the provisions of COMAR 32.02.01.24.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.19 - Referrals to the Financial Review Committee

Current through Register Vol. 51, No. 14, July 12, 2024
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.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.20 - Findings of Financial Difficulty

Current through Register Vol. 51, No. 14, July 12, 2024
A. Upon final determination by the Department that a provider is in financial difficulty, the Department shall notify the provider of the determination by certified mail, return receipt requested.
B. The Department may:
(1) Consult with the Financial Review Committee to review the findings and possible corrective financial plans; and
(2) Assist the provider to develop an adequate corrective financial plan.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.21 - Deposit Agreement and Processing Fee

Current through Register Vol. 51, No. 14, July 12, 2024
A. A deposit agreement used before the provider has received an initial certificate of registration shall:
(1) State that all deposits and entrance fees shall be held in escrow until the:
(a) Issuance of an initial certificate of registration, and
(b) Provider has been issued appropriate licenses or certificates by DHMH and MHCC;
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.23 - Withdrawal of Application or Rescission of Agreement

Current through Register Vol. 51, No. 14, July 12, 2024
A. Withdrawal of Application. A person seeking admission to a continuing care at home program may withdraw an application at any time before execution of the continuing care at home agreement. A provider shall refund all money paid, less any nonrefundable processing fee that was specified in the deposit agreement, to a prospective subscriber who withdraws an application before signing a continuing care at home agreement.
B. Rescission of Agreement before Services Commence.
(1) If a subscriber rescinds an agreement by giving written notice of the rescission to the provider before the provider begins to provide continuing care at home services to the subscriber, and the rescission either occurs within 90 days after entering into the agreement or because of a substantial change in the subscriber's physical, mental, or financial condition, the provider shall, within 30 days of rescission, refund all moneys paid by the subscriber except any processing fee previously specified as nonrefundable.
(2) If a subscriber rescinds an agreement by giving written notice of the rescission to the provider before the provider begins to provide continuing care at home services to the subscriber, but more than 90 days after entering into the agreement, for any reason other than a substantial change in the subscriber's physical, mental, or financial condition, the provider shall refund the same amount specified in §B(1) of this regulation, except that the provider may require that the subscriber forfeit part of the refund. The forfeiture amount may not exceed 25 percent of any deposit paid by the subscriber.
(3) If a subscriber rescinds an agreement by giving written notice of the rescission to the provider before the provider begins to provide continuing care at home services to the subscriber, because of a substantial change in the subscriber's physical, mental, or financial condition, the provider shall refund the same amount specified in §B(1) of this regulation.
(4) If a subscriber dies before the date the provider begins to provide continuing care at home services to the subscriber, the agreement is automatically canceled, and the provider shall refund to the subscriber's legal representative the same amount specified in §B(1) of this regulation, except that the cancellation is not automatic and is at the option of the surviving subscriber if the agreement is in the name of two subscribers.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.24 - Rescissions for Violation of the Act

Current through Register Vol. 51, No. 14, July 12, 2024
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 of the Act.
Code of Maryland Regulations › Title 32 - MARYLAND DEPARTMENT OF AGING › Subtitle 02 - PROVIDER REGULATIONS › Chapter 32.02.02 - Certificate of Registration for Continuing Care at Home Providers › Section 32.02.02.25 - Termination of the Agreement after Services Commence

Current through Register Vol. 51, No. 14, July 12, 2024
A. Termination by a Subscriber. If a subscriber elects to terminate the agreement after the provider begins to provide continuing care at home services, any refund of the entrance fee is governed by the terms of the agreement.
B. Termination, Dismissal, or Discharge by the Provider.
(1) An agreement may not permit termination of the agreement or dismissal or discharge of a subscriber from the continuing care at home program, including by involuntary transfer to a health care or mental health facility, before expiration of the agreement for any reason, unless the:
(a) Dismissal or discharge is for just cause; and
(b) Subscriber is given advance notice of at least 60 days.