Md. Code Regs. 32.02.01.13

Current through Register Vol. 51, No. 24, December 2, 2024

Section 32.02.01.13 - 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 fee for a renewal certificate of registration shall include the following information and attachments:

(1) Any changes or additions to the information submitted on the most recent application;

(2) An original certified financial statement for the preceding fiscal year prepared in accordance with generally accepted accounting principles, which include the principles expressed in the American Institute of Certified Public Accounts' "Audit and Accounting Guide for Health Care Organizations";

(3) All exhibits or attachments to the certified financial statements, including:

(a) A balance sheet,

(b) An income statement,

(c) A statement of cash flows,

(d) The related notes to the financial statements, and

(e) The opinion of an independent certified public accountant;

(4) An operating budget for the current fiscal year prepared in accordance with generally accepted accounting principles;

(5) A projection of the number of subscribers who will require nursing home care and an estimate of the life expectancy of future subscribers;

(6) A projected operating budget for the next succeeding fiscal year prepared in accordance with generally accepted accounting principals;

(7) An actuarial study which meets the requirements of §E of this regulation;

(8) A report specifying:

(a) The total current number of units,

(b) Whether each unit is occupied or unoccupied, and

(c) Changes in unit configurations proposed for the succeeding year;

(9) A copy of each current license and certificate required to be issued by DHMH or the Department;

(10) A copy of the provider's most recent certificate of need or exemption letter from MHCC;

(11) The form and substance of any advertising campaign or proposed advertisement and other promotional materials not previously filed with the Department;

(12) A renewal fee of $25 per unit;

(13) A cash flow projection for the current fiscal year and the next 2 fiscal years prepared in accordance with generally accepted accounting principles;

(14) A statement that provides the dates of the meetings held the previous year to comply with Regulation .19 of this chapter;

(15) A copy of the disclosure statement prepared in accordance with Regulation .21 of this chapter; and

(16) A statement that indicates compliance with the operating reserve requirement in Regulation .20 of this chapter.

D. Actuarial Study Exceptions.

(1) Until January 1, 1999, §E of this regulation does not apply to facilities which offer only domiciliary care or comprehensive care and do not offer independent living units.

(2) Section E of this regulation does not apply to a facility:

(a) Where the only health care provided to subscribers is either priority admission to an independent nursing facility or paid for on a fee-for-service basis;

(b) Where:

(i) The provider is in the process of decertifying as a provider; and

(ii) Fewer than five of the facility's subscribers have continuing care agreements that promise the provider will provide more than 90 days of nursing care on a basis other than fee-for-service; or

(c) Where:

(i) The comprehensive care facility is Medicaid certified;

(ii) The continuing care agreements presently offered new subscribers only provide nursing care on a fee-for-service basis, and

(iii) 5 percent or less of the facility's subscribers have continuing care agreements that promise the provider will provide nursing care on a basis other than fee-for-service.

E. Actuarial Study.

(1) Unless exempted by §D of this regulation, every 3 years after occupancy of the facility has begun, a provider shall submit to the Department with its renewal application an actuarial study, prepared or reviewed by a qualified actuary. The actuarial study shall include:

(a) An actuarial balance sheet for current subscribers;

(b) A cohort pricing analysis for a cohort of new subscribers; and

(c) Projected cash and investment balances for a period of 20 years.

(2) The actuarial study required by §E(1) of this regulation shall be performed in accordance with generally accepted actuarial principles and the standards of practice adopted by the Actuarial Standards Board of the American Academy of Actuaries. The actuarial study shall include or be accompanied by a statement of the opinion of a qualified actuary as to whether:

(a) The data and assumptions used are appropriate;

(b) The methods employed are consistent with sound actuarial principles and practices;

(c) Provision has been made for all actuarial liabilities and related statement items; and

(d) The provider is in satisfactory actuarial balance.

(3) The actuarial study shall include supporting detailed documentation, including a projection of future population flows and health care bed needs for 20 years using appropriate inflation factors, mortality, morbidity, withdrawal, and other demographic assumptions.

(4) The Department may request the information required in §E(1)-(3) of this regulation more frequently to assist in the determination of possible financial difficulty as provided in Regulation .26 of this chapter.

F. If the materials required in §C of this regulation are not received in the Department within 120 days after the end of the provider's fiscal year, the Department shall charge a late fee of $10 per unit in addition to the renewal fee per unit, unless a written request for an extension is submitted to and approved by the Department within the 120-day period.

G. Failure to file the annual renewal application or obtain an extension within 120 days after the end of a fiscal year is a violation of the Act and this chapter.

Md. Code Regs. 32.02.01.13

Regulations .13 adopted effective June 2, 1986 (13:11 Md. R. 1274)
Regulations .13 adopted effective July 27, 1998 (25:15 Md. R. 1192)
Regulation .13 amended effective October 6, 2008 (35:20 Md. R. 1777); March 22, 2010 (37:6 Md. R. 481)
Regulation .13C amended effective March 1, 2004 (31:4 Md. R. 318); March 4, 2013 (40:4 Md. R. 348)
Regulation .13D amended effective December 25, 2000 (27:25 Md. R. 2283); amended effective 43:17 Md. R. 959, eff. 8/29/2016