16 Del. Admin. Code § 3325-4.0

Current through Register Vol. 28, No. 5, November 1, 2024

Section 3325-4.0 - Requirements for the Submission of Financial Documents Upon Application for Renewal of a License

4.1 With the exception of Family Care Homes, which are addressed in Section 13.0 of these regulations, all annual applications for renewal of a license shall be submitted at least thirty (30) calendar days prior to the expiration date of the license. The application must include a transmittal letter containing:

4.1.1 The type of ownership for the facility as well as senior, subordinate and affiliated organizations, i.e. proprietorship, partnership, corporation, Subchapter S Corporation or Limited Liability Company and;

4.1.2 The place of incorporation/registration, including names and addresses for all persons/entities with a 5% or greater ownership;

4.1.3 Year-end financial statement(s) - balance sheet, income statement, and statement of cash flows for the facility (mostrecent year at year-end). If the year-end statement that is provided is three (3) or more months old when it is received by the Department a supplemental statement through the most recent month must be submitted. If the supplemental statement(s) is not prepared by independent accountants, it is to be attested to by the treasurer and a second officer;

4.1.4 Evidence of a surety bond in an amount equal to or greater than the sum of the previous four (4) months of all expenses as indicated on the most recent year-end profit and loss statement.

4.1.5 A copy of the Memorandum of Understanding executed by and between the principal and chief financial officer of the facility and the DHSS Cabinet Secretary, or their designee, agreeing and acknowledging any and all expenditures from this account will be at the call of and with the express written consent of DHSS for the emergency maintenance of the health, housing and welfare of the residents.

4.1.6 A list of officers with addresses;

4.1.7 Organization charts with names and titles (personnel - facility and controlling organization);

4.1.8 Organization chart (corporate structure), delineating senior, subordinate and affiliated organizations, lines of authority/ownership, and domicile;

4.1.9 Facility address (domicile), all aliases and E.I.N. (employer identification number);

4.1.10 Information on the ownership of the real estate on which the facility is located including: name of the organization, address (domicile), E.I.N and principals with 5% or greater ownership;

4.1.11 Name, address (domicile, and E.I.N. of the management entity involved in the operation of the facility, if any;

4.1.12 All items submitted separately must bear the signed certification statement: "I certify, under penalty of perjury, the attached statement is true, complete and correct";

4.1.13 Information on the controlling organization to include:

4.1.13.1 The most recent year-end financial statements for the controlling organization;

4.1.13.2 The most recent year-end personal financial statements of the proprietors or partners if the Controlling Organization is a proprietorship or partnership; and

4.1.13.3 The most recent year-end personal financial statement for guarantors of a corporate transaction if the Controlling Organization is a proprietorship or partnership.

4.2 Any material adverse change to the facility's financial position must be reported to the Department by the facility in writing within five (5) business days of its occurrence or discovery.

16 Del. Admin. Code § 3325-4.0

23 DE Reg. 45( 7/1/2019) (final)