(a)   All persons who intend to submit a feasibility study under subsection
(b) of this section shall file with the Department a statement of
intent to provide continuing care at least 30 days prior to submission
of a feasibility study for approval by the Department.
  (b)   A provider may not collect deposits for continuing care or begin
construction of a new facility without approval by the Department of a
feasibility study. The feasibility study shall be filed in a form
satisfactory to the Department and shall include at least the following
information:
    (1)   A statement of the purpose for the proposed construction or conversion;
    (2)   Documentation of the financial resources of the provider;
    (3)   A statement of the capital expenditures necessary to accomplish the
project and the plan for acquiring the necessary capital;
    (4)   A plan demonstrating the financial feasibility of the proposed project
that shall include future funding sources;
    (5)   A study that demonstrates the market for the project;
    (6)   An actuarial forecast reviewed by a qualified actuary;
    (7)   A statement of the planned fee structure, including any proposed
escalator or other automatic adjustment provision;
    (8)   A description of the facility that is proposed to be used or is being
used to furnish continuing care;
    (9)   A copy of the proposed escrow and deposit agreements; and
    (10)   The form and substance of any advertising campaign or proposed
advertisement for the facility that is available at the time of filing.
  (c)   The provider may collect deposits from prospective subscribers,
provided that a feasibility study has been approved by the Department
and that funds collected are maintained in an escrow account.
  (c-1)   (1)   Each deposit agreement shall comply with the requirements of this
subsection.
    (2)   If the deposit agreement is used for a deposit on a unit for which the
provider has not received written approval to withdraw deposits under
§ 11(c) of this subtitle, the deposit agreement shall:
      (i)   State that all deposits and entrance fees shall be held in escrow
until:
        1.   The issuance of an initial certificate of registration for the unit;
        2.   Construction is completed;
        3.   A certificate of occupancy, or its equivalent, has been issued by the
local jurisdiction; and
        4.   The provider has been issued appropriate licenses or certificates by
the Department of Health and Mental Hygiene, the Maryland Health Care
Commission, and the Department;
      (ii)   Describe the disposition of any interest earned on deposits and
entrance fees;
      (iii)   State the amount of any processing fee and whether it will be refunded
if the deposit agreement is canceled; and
      (iv)   Describe the disposition of the deposit if the deposit agreement is
canceled before the continuing care agreement is executed.
    (3)   If the deposit agreement is used for a deposit on a unit for which the
provider has received written approval to withdraw deposits under §
11(c) of this subtitle, the deposit agreement shall:
      (i)   State that the provider may use all deposits and entrance fees at any
time; or
      (ii)   Describe any applicable limitations on the use of deposits and entrance
fees.
  (d)   A feasibility study may be approved by the Department when it
determines that:
    (1)   The number of comprehensive or domiciliary beds in the facility, for
which licenses are required by the Department of Health and Mental
Hygiene, is not inconsistent with the State health plan;
    (2)   A reasonable financial plan has been developed for developing and
operating the project;
    (3)   A market for the facility appears to exist;
    (4)   The feasibility study was prepared by a recognized authority;
    (5)   The actuarial forecast supports the projections for the project;
    (6)   The escrow agreement and deposit agreement are approved by the
Department; and
    (7)   The approved escrow agreement is executed by the provider and the
financial institution.
  (e)   A provider may not enter into a continuing care agreement until the
issuance of a preliminary certificate of registration by the
Department. The application shall be filed in a form satisfactory to
the Department and shall contain at least the following information:
    (1)   The name and address of the facility and the name and address of any
affiliate, parent or subsidiary person;
    (2)   The organizational structure and management of the provider, including:
      (i)   If the provider is a corporation or limited liability company, the name
of the corporation or limited liability company, the state in which the
corporation is incorporated or the limited liability company is formed,
and the name of the chief executive officer;
      (ii)   If the provider is a partnership, the names of the general partners,
the state governing the formation of the partnership, and the name of
the primary individual responsible for managing the partnership;
      (iii)   If the provider is an unincorporated association, the names of the
members, the state governing the association's activities, and the
name of the primary individual responsible for managing the
association;
      (iv)   If the provider is a partnership having a corporation or limited
liability company as one or more of its general partners, the name of
the corporation or limited liability company, the state in which the
corporation is incorporated or the limited liability company is formed,
and the name of the chief executive officer;
      (v)   If the provider is a trust, the name of the trustee, the names of the
owners of beneficial interests in the trust, the state governing the
trust, and the name of the primary individual responsible for
overseeing the trust's activities;
      (vi)   The names and occupation of any of the officers, directors, trustees,
managing or general partners, and any other person with a 10% or
greater financial equity or beneficial interest in the provider and a
description of the person's financial interest in or occupation with
the provider;
      (vii)   The name and address of any professional service firm, association,
trust, partnership, company, or corporation in which a person
identified in item (vi) of this paragraph has a 10% or greater
financial interest and which is anticipated to provide goods, premises,
or services to the facility or provider of a value of $10,000 or more
within any fiscal year and a description of the goods, premises, or
services and their anticipated cost to the facility or provider;
however, disclosure of salary, wage, or benefit information of
employees of the provider is not required; and
      (viii)   A statement regarding whether the provider is qualified, or intends to
qualify, as a tax exempt organization under the Internal Revenue Code;
    (3)   A copy of the corporate charter, partnership agreement, articles of
association, membership agreement, trust agreement, or similar
instrument or agreement pertaining to the legal organization of the
provider;
    (4)   A certified financial statement of the provider for as many of the most
recent fiscal years, not exceeding 3 years, for which certified
financial statements are obtainable under generally accepted accounting
principles. If the provider's fiscal year ended more than 90 days
prior to the date of filing, there shall also be included an income
statement, which need not be certified, covering the period between the
date the fiscal year ended and a date not more than 90 days prior to
the date the application is filed;
    (5)   A statement as to any affiliation with a religious, charitable, or
other nonprofit organization; the extent of any affiliation, and the
extent, if any, to which the affiliate organization will be responsible
for the financial and contractual obligations of the provider;
    (6)   A copy of the agreement to be entered into between the provider and
subscriber for continuing care, and any priority admission agreements
between the provider and any health care provider to provide
health-related services;
    (7)   A statement of the most current fee structure, including escalator or
other automatic adjustment provisions;
    (8)   A statement of the role of any publicly funded benefit or insurance
program in the financing of care;
    (9)   The form and substance of any advertising campaign, advertisement, or
other promotional material for the facility that has not been
previously filed with the Department; and
    (10)   Other reasonable and pertinent data that the Department requires.
  (f)   If the provider plans to advertise before having a certificate of
registration issued under § 11 of this subtitle, the form and
substance of any advertisement or advertising campaign must be
submitted to the Department before the advertisement or advertising
campaign may be used.
  (g)   A preliminary certificate of registration shall be issued by the
Department if it determines that:
    (1)   The feasibility study has been approved;
    (2)   The continuing care agreement to be used between the provider and the
subscriber meets the requirements of §§ 13, 14, and 15 of this
subtitle;
    (3)   All of the financial and organizational materials required to be
submitted under subsection (e) of this section have been submitted to
the Department; and
    (4)   The form and substance of all advertising and other promotional
materials filed are not deceptive, misleading, or likely to mislead.
  (h)   If a preliminary certificate of registration is not obtained from the
Department within 6 months of the approval of a feasibility study, or
such longer time as is allowed by the Department for good cause shown,
the provider shall refund all deposits and cease in its attempts to
market continuing care under that application.
|