Pennsylvania Code › Title 31 - INSURANCE › Part VIII - Miscellaneous Provisions › Chapter 151 - CONTINUING CARE PROVIDERS › Section 151.4 - Statement in support of application

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Each applicant shall file a statement in
				support of an application for a certificate of authority, which shall contain
				the following information and appendices:
(1)
Occupancy status.
A description of whether the facility is
				ready for occupancy. If the facility is already occupied and in operation,
				indicate the date the facility commenced business. If the facility is under
				construction, indicate the estimated construction completion date.
(2)
Financing of facility.
A
				statement detailing existing or proposed mortgages, liens, security interests
				or loan commitments on the real property of the facility. Provide the name and
				address of mortgagees or other lenders and a copy of mortgages, liens, security
				interests or loan commitment documents. If other long term financing
				arrangements have been arranged or are contemplated, such as tax-free
				debentures, a complete description of the arrangement shall be provided and all
				pertinent contracts and documents shall be attached. If the facility is subject
				to a lease agreement, provide the name and address of interested parties and a
				copy of a lease.
(3)
Fiscal
				year.
A specification of the applicant's fiscal year.
(4)
Tax exempt status.
If
				the applicant claims tax exempt status under the Internal Revenue Code of 1954
				(26 U.S.C.A. §§
											1-9602) provide a ruling or other
				document evidencing qualification for tax exempt status. If the applicant
				claims it is not subject to the capital stock tax or corporate net income tax
				imposed by the Tax Reform Code of 1971 (72 P. S. §§
											7101-10004) provide the appropriate
				documentation demonstrating qualification for the exemption.
(5)
Feasibility study.
If
				operation of a facility has not yet commenced, provide a feasibility study
				prepared to secure financing for the proposed facility. If a feasibility study
				was not required to obtain financing, a study is not required to be produced
				under this subsection. The study should include:
(i) A description of the proposed facility
				including location, size, anticipated completion date and proposed construction
				program.
(ii) An identification and
				evaluation of the potential market, including a demographic and economic
				profile of the population in the facility's market area.
(iii) An identification of other existing or
				proposed facilities in the potential market area, including, if available, the
				occupancy rate for existing facilities for the last 3 years.
(iv) An estimate of net receipts from
				entrance fees, other than those included in the statement of source and
				application of funds, less estimated entrance fee refunds and a description of
				the actuarial bases and methods of calculation for the projection of entrance
				fee receipts.
(v) The name and
				address of the person who prepared the feasibility study and the experience of
				the person in preparing similar studies or otherwise consulting in the field of
				continuing care or related health care fields.
(6)
Financial analysis.
A
				financial analysis prepared for the purpose of determining that the facility
				has-or if the facility is proposed, will have-sufficient revenue and funds,
				including reserves. The analysis shall include a cash flow projection, a review
				of the adequacy of current pricing structures, and an examination of the
				long-term relationship between the facility's assets and liabilities. The
				analysis shall be prepared by either a qualified actuary or a certified public
				accountant.
(7)
Affiliates.
An organizational chart describing the relationship between the
				applicant and its affiliates, indicating the state of domicile of the entity
				and the primary business of each.
(8)
Previous licenses.
A
				statement indicating whether the applicant has ever applied for a certificate
				of authority for a facility in this Commonwealth or sought licensure in another
				jurisdiction. Indicate the status of the application-issued, refused, or
				pending. If a previous license was issued, provide the name and address of the
				facility licensed, the name of the issuing authority, the date of issuance, and
				the date of and reason for termination.
(9)
Organizational filings.
The documents described in this paragraph pertaining to the applicant shall be
				attached to the statement:
(i) If the
				applicant is a corporation, a copy of the charter shall be attached.
(ii) If the applicant is a partnership or
				other unincorporated association, a copy of the partnership agreement, articles
				of association or other membership agreement shall be attached.
(iii) If the applicant is a trust, a copy of
				the trust agreement or instrument shall be attached.
(iv) If the applicant uses a trade name which
				is required to be registered under
				54 Pa.C.S. §§
												301-332 (relating to Fictitious Names Act), a
				copy of the fictitious name registration shall be attached.
(10)
Entrance fees.
The
				relevant documents described in this paragraph shall be attached to the
				statement.
(i) If the applicant proposes to
				use an entrance fee escrow account, provide the name and address of the escrow
				agent and a copy of the escrow agreement.
(ii) If the applicant proposes to provide a
				letter of credit in lieu of using an entrance fee escrow account, identify the
				name and address of the financial institution providing the letter of credit,
				and provide a copy of the letter of credit executed in favor of the
				Commissioner.
(A) The letter of credit shall
				stipulate that the beneficiary need only draw a sight draft and present it to
				obtain the funds, and that no other document need be presented.
(B) The letter of credit shall indicate that
				it is not subject to conditions or qualifications outside the letter of
				credit.
(C) The letter of credit
				shall contain a clause which prevents the expiration of the letter of credit
				without notice-minimum 30 days-from the issuer to the Commissioner.
(iii) If the applicant proposes to
				deposit negotiable securities in lieu of using an entrance fee escrow account,
				acceptable negotiable securities executed in favor of the Commissioner shall be
				deposited at the time an application for a certificate of authority is
				made.
(iv) If the applicant
				proposes to post a bond issued by a surety company authorized to do business in
				this Commonwealth in lieu of using an entrance fee escrow account, provide the
				name and address of the surety company and a copy of the surety bond.
(11)
Biographical
				affidavits.
Biographical affidavits shall be filed by the following
				persons:
(i) For applicants, the managers or
				proposed managers shall file. If the manager is a corporation, provide
				biographical affidavits for the board of directors and all officers. If the
				manager is a partnership, provide biographical affidavits for the managing or
				general partners.
(ii) For
				corporate applicants, the corporation's board of directors and officers shall
				file.
(iii) For partnership
				applicants, managing or general partners shall file.
(iv) For unincorporated association
				applicants, officers and directors shall file.
(v) For trust applicants, administrators or
				trustees shall file.