Section 4: Application for certification; renewal; operating plan
[ Text of section effective until December 5, 2024. For text effective December 5, 2024, see below.]
Section 4. The department shall issue for a term of two years, and shall renew for like terms, a certification, subject to revocation by it for cause, to any person whom it reasonably determines to meet the regulatory requirements promulgated by the department in accordance with this chapter. Such certification shall not be transferable or assignable and shall be issued only to the person and for the premises named in the application. The certificate shall be posted in a conspicuous place on the approved premises.
Upon applying for initial certification or certification renewal, an applicant shall pay the department a fee based on the number of units at the assisted living residence. Said fee for initial application and renewal shall be established by the secretary of administration pursuant to the provisions of section three B of chapter seven of the General Laws; provided, however, that a minimum fee shall be established notwithstanding the number of units at the residence; and provided further, that said fees are sufficient to support the entire cost of the department's administration of this chapter. Monies collected from said fee may be appropriated for the purpose of supporting said administration.
Notwithstanding the previous paragraph, no fees, including minimum fees, for initial certification or certification renewal shall be due from any provider for assisted living units created under the HUD Assisted Living Conversion Program.
If an application for renewal is filed at least thirty days before the stated expiration date of the certification, such certification shall not expire on such date but the assisted living residence shall be deemed to be certified until such time as the department may notify the sponsor that the application for renewal has been denied.
Each applicant for initial certification shall file with the department an operating plan which includes the following information:
1. the number of units for which certification is sought and the number of residents per unit;
2. the location of resident units, common spaces and egresses by floor;
3. the base fee to be charged for each such unit;
4. the services to be offered and arrangements for providing such services, including linkages with hospital and nursing facilities if any;
5. the number of staff to be employed in the operation of said residence;
6. such other information as the department may reasonably require or the applicant may choose to provide as affirmative evidence of ability to comply with the regulations and provisions of this chapter.
Applicants and sponsors shall file all material changes to said operating plans prior to their effective date and as may otherwise be required by the department. A sponsor shall file annually on a date established by and on a form prescribed by the department a statement and a professional opinion prepared by a certified public account or comparable reviewer indicating whether the assisted living residence is in sound fiscal condition and is maintaining sufficient cash flow and reserves to meet the requirements of the service plans established for its residents.
Each applicant for initial certification and each sponsor applying for renewal of certification shall disclose the name and address of each officer, director, and trustee, and the names and addresses of limited partners or shareholders with more than twenty-five percent interest in the assisted living residence. The applicant or the sponsor shall furnish assurances that none of such individuals has ever been found in violation of any local, state or federal statute, regulation, ordinance, or other law by reason of that individual's relationship to an assisted living residence; and the applicant shall list, for each such individual, all multifamily housing or health care facilities or providers in the commonwealth or in other states in which she or he has been or is an officer, director, trustee, or general partner.
With respect to those persons who then have or have had within the previous five years before the date of such application an interest in an entity licensed under chapter one hundred and eleven of the General Laws, or a medical provider licensed under other applicable state statutes, or a home health agency certified under Title XVIII of the Social Security Act, as amended, the applicant shall furnish evidence from the department of public health that such facility or agency has substantially met applicable criteria for licensure or certification and, if applicable, has corrected all cited deficiencies without delicensure or decertification being imposed. The department may in its discretion deny certification to any applicant hereunder who has directly or indirectly had an ownership interest in an entity licensed under chapter one hundred and eleven, or a medical provider licensed under other applicable state statutes, or a home health agency certified under Title XVIII of the Social Security Act, as amended, that (i) has been the subject of a patient care receivership action, (ii) has ceased to operate such an entity as a result of (a) a settlement agreement arising from a decertification action or (b) a settlement agreement in lieu of a patient care receivership, or (c) a delicensure action or involuntary termination of participation in either the medical assistance program or the medicare program, or (iii) has been the subject of a substantiated case of patient abuse or neglect involving material failure to provide adequate protection or services for the resident in order to prevent such abuse or neglect, or (iv) has over the course of its operation been cited for repeated, serious and willful violations of rules and regulations governing the operation of said health care facility that indicate a disregard for resident safety and an inability to responsibly operate an assisted living residence.
Chapter 19D: Section 4. Application for certification; renewal; fee; operating plan; basic health services
[ Text of section as amended by 2024, 197, Sec. 6 effective December 5, 2024. For text effective until December 5, 2024, see above.]
Section 4. (a) The department shall issue a certification for a term of 2 years, and shall renew for like terms, to any applicant whom the department determines meets the regulatory requirements promulgated by the department in accordance with this chapter; provided, however, that a certification shall be subject to corrective action, modification, suspension or revocation for cause, as determined by the department. Such certification shall: (i) not be transferable or assignable; (ii) be issued only to the person and for the premises named in the application; (iii) indicate whether the residence has been approved to provide basic health services; and (iv) indicate the certification's expiration date. The department shall issue a certificate, which shall be posted by the residence in a conspicuous place on the approved premises and on the residence's website.
(b) Upon applying for initial certification or renewal, an applicant shall pay the department a fee based on the number of units at the assisted living residence, established by the secretary of administration and finance pursuant to the provisions of section 3B of chapter 7; provided, however, that a minimum fee shall be established notwithstanding the number of units at the residence. No fees for initial certification or renewal shall be due from any provider for assisted living units created under the United States Department of Housing and Urban Development Assisted Living Conversion Program.
(c) If an application for renewal of a certification is filed not less than 30 days before the expiration date, such certification shall not expire until the department notifies the sponsor that the application for renewal has been denied.
(d) Applicants for initial certification shall file with the department an operating plan that includes: (i) the number of units; (ii) the number of residents allowed per unit; (iii) the location of resident units, common spaces and egresses by floor; (iv) the base fee to be charged for each such unit; (v) the services to be offered, including basic health services, if applicable, and arrangements for providing such services, including linkages with hospitals and nursing facilities, if any; (vi) the number of staff to be employed; and (vii) other information the department deems necessary.
(e) Residences may seek certification by the department to provide basic health services; provided, however, that such residences shall offer all such basic health services defined in section 1; and provided further, that residences offering basic health services shall not restrict resident choice in the delivery of said services by third party providers. The residence shall submit a revised operating plan to the department in the event of a change in the scope of basic health services offered to residents. A residence seeking to provide basic health services shall include in its operating plan: (i) a proposed administrative and operational structure to ensure the safe and effective use of basic health services and meet the needs of its residents; and (ii) a compliance plan to meet the requirements established under this chapter and promulgated regulations, which shall include, but not be limited to: (A) staff qualifications and training; and (B) effective policies and procedures to ensure the availability of adequate supplies necessary for basic health services and the safe administration and secure storage of medications.
(f) Applicants and sponsors shall file material changes to the assisted living residence's operating plan prior to the change's effective date and as may otherwise be required by the department. A sponsor shall file annually on a date established by and on a form prescribed by the department, a statement and a professional opinion prepared by a certified public accountant or comparable reviewer indicating whether the assisted living residence is in sound fiscal condition and is maintaining sufficient cash flow and reserves to meet the requirements of the service plans established for its residents.
(g) Applicants for initial certification or renewal shall disclose the name and address of each officer, director, trustee and limited partner or shareholder with not less than 5 per cent interest in the assisted living residence and shall provide to the department documentation of the history of each such individual or entity, including, but not limited to: (i) all multifamily housing, assisted living residences or health care facilities in which the individual or entity has been an officer, director, trustee or partner and, if applicable, evidence from the relevant regulatory authority that said applicant has met criteria for licensure or certification; (ii) documentation of any enforcement action against the applicant and, if applicable, evidence that the applicant has corrected all cited deficiencies without revocation of licensure or certification; and (iii) any other evidence, as determined by the department.
(h) The department may deny certification to an applicant who had an ownership interest in an entity licensed under chapter 111, a licensed medical provider or a home health agency certified under Title XVIII of the Social Security Act, as amended, that: (i) has been subject to a patient care receivership action; (ii) has ceased to operate such an entity as a result of: (A) suspension or revocation of license or certification; (B) receivership; or (C) a settlement agreement arising from suspension or revocation of a license or certification; (iii) has a settlement agreement in lieu of or as a result of subclause (B) of clause (ii); (iv) has been the subject of a substantiated case of patient abuse or neglect involving material failure to provide adequate protection or services for the resident in order to prevent such abuse or neglect; or (v) has over the course of its operation been cited for repeated, serious and willful violations of rules and regulations governing the operation of said entity that indicate a disregard for resident safety and an inability to responsibly operate an assisted living residence.