Current through Register 1531, September 27, 2024
(1)
Requirements and
Limitations.
(a) No person or
legal entity shall advertise, operate, or maintain an Assisted Living Residence
until it has been certified by EOEA.
(b) Notwithstanding the requirement of 651
CMR 12.03(1), prior to the commencement of operations, an Applicant may
advertise an uncertified Assisted Living Residence only if it first initiates
the application process for Certification by notification to EOEA, and if it
clearly states in all advertising and marketing materials that it has not
completed the EOEA Certification process.
(c) An Applicant must have sufficient
property rights, as an owner or lessee, as the Secretary or his or her designee
finds necessary for the operation of an Assisted Living Residence.
(d) An Application for Certification shall
not be approved until the Applicant and premises meet the requirements of 651
CMR 12.03(2).
(2)
Application for Certification. Application shall be
made on forms and in the manner prescribed by EOEA. Every Application shall be
notarized and signed under the pains and penalties of perjury by the Applicant.
Except as set forth in 651 CMR 12.03(8), an Application shall be submitted to
EOEA at least 60 days prior to the date the Applicant plans to commence
operation of the Assisted Living Residence. EOEA shall charge a non-refundable
fee set by the Secretary of Administration and Finance pursuant to M.G.L. c. 7,
§ 3B for the filing of the Application for Certification of an Assisted
Living Residence. An Applicant shall file a separate Application for each
Assisted Living Residence for which Certification is sought. In support of the
Application for Certification each Applicant shall provide:
(a) The name and address of each officer,
director, and trustee; and the names and addresses of each owner, general
partner, limited partner, or shareholder with a 25% or greater interest in the
Assisted Living Residence;
(b)
Attestation, under the pains and penalties of perjury, 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 or health care facility;
(c) A list for each such individual of all
multi-family housing or health care facilities or providers in which she or he
has been or is an officer, director, trustee, or general partner;
(d) If the Applicant or any person named in
the Application as set forth in 651 CMR 12.03(2)(a) has or has had, within the
previous five years, an interest in one or more of the entities listed in 651
CMR 12.03(2)(d)1. through 3., evidence from the Massachusetts Department of
Public Health (DPH) that the entities have substantially met applicable
criteria for licensure or Certification and, if applicable, have corrected all
cited deficiencies without de-licensure or de-certification being imposed:
1. hospital, clinic, long term care facility,
mammography facility, institutions for unwed mothers, out of hospital dialysis
unit, hospice program, bacteriological laboratory, blood bank, or other entity
licensed by the DPH under M.G.L. c. 111;
2. medical provider licensed under other
applicable state statutes; including a facility, halfway house or treatment
program unit for alcoholism licensed under M.G.L. c. 111B, ambulance service
licensed under M.G.L. c. 111C, clinical laboratory licensed under M.G.L. c.
111D, and drug rehabilitation facility licensed under M.G.L. c. 111E;
or
3. home health agency in
Massachusetts certified under Title XVIII of the Social Security Act.
(e) A copy of the conversion
approval from the DPH, if an Applicant seeks to convert all or part of a
premises licensed as a Long Term Care Facility to an Assisted Living Residence
or if an Applicant seeks to add Assisted Living Residences to existing premises
licensed as a Long-term Care Facility;
(f) An operating plan which shall include the
following information:
1. The number of single
and double occupancy Units for which Certification is sought, the number of
single and double occupancy Units designated as Special Care Units, and the
number of Residents per Unit;
2.
The location of Units and Special Care Units, common spaces, and egresses by
floor;
3. The fee structure for
lodging, meals and services;
4. The
type and extent of services to be offered, arrangements for providing such
services, including third party contracts, and linkages with hospital and
nursing facilities;
5. A Plan for
Self-administered Medication Management (SAMM) for Residents, including but not
limited to, assistance with as-necessary medication (PRN) when part of the
SAMM, and, if offered, Limited Medication Administration;
6. A means for Residents to communicate
urgent or emergency needs, and a plan to provide timely assistance to
them;
7. The number of staff to be
employed in the operation of the Assisted Living Residence and their minimum
qualifications and responsibilities;
8. A copy of the Residency Agreement that
will be used by the Assisted Living Residence. It must clearly describe the
rights and responsibilities of the Resident and Sponsor, and comply with all
requirements of M.G.L. c. 19D and
651 CMR 12.00;
9. A copy of all required current building,
fire safety, and locally approved state sanitary code certificates and
permits;
10. Procedures to notify a
Resident and his or her Legal or Resident Representative, as appropriate, that
the Assisted Living Residence is no longer an appropriate environment for the
Resident. Such notice shall describe the changes in the Resident's service
needs that justify such a finding, explain when those changes occurred, and
describe how the Resident's needs can no longer be satisfied;
11. A copy of all policies and procedures
related to the design and operation of a Special Care Residence or Residences
required under
651 CMR
12.04(4);
12. A copy of the quality improvement and
assurance program required under
651 CMR
12.04(10);
13. A copy of the disaster and emergency
preparedness plan required under
651 CMR
12.04(11);
14. A copy of the communicable disease
control plan required under
651 CMR
12.04(12);
15. A copy of the Controlled Substances
policies and procedures required by
651 CMR
12.04(14);
16. A statement citing the beginning and
ending dates of the Residence's fiscal year; and
17. Policies and procedures designed to
ensure a safe environment for all Residents.
(g) Applications for renewal Certification
must also include a statement that the data required by
651 CMR
12.04(13), information
documenting all substantial changes to the operating plan prior to the
effective date, and all other information required by EOEA, have been
submitted.
(3)
Review of Applications. The EOEA shall not review an
Application for Certification unless:
(a) The
Application includes all information required by EOEA;
(b) The Application includes all required
attachments and statements that are required for the Certification;
and
(c) The Applicant has paid all
required Application fees.
(4)
Evaluation of
Application. The EOEA shall not approve an Application for
Certification unless:
(a) The Secretary or his
or her designee has conducted a compliance review of the Assisted Living
Residence as set forth in
651 CMR
12.09 and has reasonably determined that the
premises meets the requirements of M.G.L. c. 19D and is in compliance with
651 CMR 12.00; and
(b) The Secretary or his or her designee has
conducted a review of the Applicant and has reasonably determined that the
Applicant meets the requirements of M.G.L. c. 19D and is in compliance with
651 CMR 12.00.
(c) EOEA may, in its discretion, deny
Certification to any Applicant who has directly or indirectly had an ownership
interest in an entity licensed under M.G.L. c. 111, or a medical provider
licensed under other applicable state statutes, or a home health agency
certified under Title XVIII of the Social Security Act, that:
1. has been the subject of a patient care
receivership action;
2. has ceased
to operate such an entity as a result of:
a. a
settlement agreement arising from a decertification action;
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;
3. has
been the subject of a substantiated case of patient abuse or neglect involving
material failure to provide adequate protection or services for a resident in
order to prevent such abuse or neglect; or
4. has over the course of its operation been
cited for repeated, serious or 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.
(5)
Deemed Certification Pending Approval by EOEA. A
Sponsor of an Assisted Living Residence which, on or before July 1, 1995 has
commenced construction or operation, or has received official action approval
for taxable or tax exempt financing by a governmental issuer, or has received a
site approval and market acceptance letter for a loan insured by the Federal
Housing Administration, shall, in order to commence or continue operations,
file an initial Application with EOEA for each such Assisted Living Residence
in accordance with 651 CMR 12.03(2) on a form provided by EOEA. For the
purposes of 651 CMR 12.03(5), "commencement of operations" means the Assisted
Living Residence is open and providing lodging, meals and services to Residents
under a Residency Agreement.
If the completed Application is date stamped by EOEA within 30
days after July 1, 1995 with full payment of the Application fee, the Applicant
shall be deemed to be certified to operate and maintain an Assisted Living
Residence from January 13, 1995 or from a date thereafter up to July 1, 1995.
The Assisted Living Residence shall be Certified until such time as EOEA issues
notice to the Applicant regarding the approval or denial of its
Application.
The Applicant and Assisted Living Residence shall be subject to
completion of all Application and review procedures and must comply with, and
shall be subject to, all requirements of St. 1994, c. 354 and 651 CMR 12.00 in
order to retain Certification.
(6)
Certification
Fee. Upon receiving notice of Certification, a Sponsor shall
forward within ten days to EOEA a Certification fee, set by the Secretary for
Administration and Finance pursuant to M.G.L. c. 7, § 3B based on the
number of Units certified on the date of its most recent Application. In the
event that the Applicant or Sponsor of an Assisted Living Residence alters the
Residence by the addition or removal of Units, a fee adjustment may be made by
EOEA. Failure to pay the fee within the ten day period shall result in a
finding of non-compliance by EOEA under
651
CMR 12.09. No fee for initial certification
or certification renewal shall be due from any Assisted Living Residence
created under the HUD Assisted Living Conversion Program.
(7)
Renewal Certification
Procedures. EOEA shall renew for a term of two years the
Certification of a Sponsor of an Assisted Living Residence if EOEA determines
that the Sponsor and the Assisted Living Residence meet the requirements of St.
1994, c. 354 and 651 CMR 12.00.
If the Application for renewal of Certification is filed and
date-stamped at EOEA at least 30 days before the stated expiration date of the
Certification, the Certification shall not expire on such date. The Sponsor and
Assisted Living Residence shall be deemed to be certified unless EOEA notifies
the Sponsor that the Application for renewal has been denied.
The Application shall be filed on a form provided by EOEA,
include an Application fee as set by the Secretary for Administration and
Finance and follow the procedures set forth in 651 CMR 12.03.
For the purposes of those Assisted Living Residences deemed
certified under 651 CMR 12.03(5), the running of the biennial period for
renewal of Certification shall begin on the date of issuance of Certification
by EOEA.
(8)
Change of Ownership. Any person or entity who intends
to acquire a 25% or greater interest in an existing Assisted Living Residence
shall submit an Application for Certification to EOEA at least 30 days prior to
the transfer of the ownership interest. The application for Certification shall
also include a statement on a form developed by EOEA, signed and notarized by
the parties, regarding the anticipated transfer of ownership of the Residence.
If EOEA receives these documents at least 30 days prior to the closing date of
the change of ownership, the new Applicant shall be considered to be deemed
temporarily certified from and after the date of the change of ownership, until
such time as EOEA approves or denies the Applicant's application for
Certification; provided that after the transfer of ownership has been
completed, the new Applicant has within five days submitted a signed and
notarized statement that the transfer of ownership has been completed. The
previous Sponsor shall return its Assisted Living Certificate to EOEA within
five days after the transfer of ownership. The current Certification of the
Residence shall be deemed valid until the completion of a Certification process
for changes sought. In the event of a transfer of ownership interest of an
Assisted Living Residence, it is within the Secretary's discretion to conduct a
full or partial compliance review.
(9)
Non-transferability of
Certification.
(a) Each
Certification shall be valid only in the possession of the Residence and the
Sponsor to whom it is issued and shall not be subject to sale, assignment or
other transfer, voluntary or involuntary;
(b) No Certification shall be valid for any
building premises other than those for which the Certification was originally
issued;
(c) Every Assisted Living
Residence Certification must be displayed in a conspicuous place in the
Residence; and
(d) The
Certification of a Sponsor to operate an Assisted Living Residence shall be
returned by registered mail to EOEA immediately upon:
1. Revocation of or refusal to renew the
Certification;
2. Transfer of
ownership;
3. Change of name of the
Sponsor; or
4. Closure or other
termination of the Residence's operations.
(10)
Closure. In the
event a Sponsor of an Assisted Living Residence elects to permanently close or
sell the Residence for any reason, compliance with the following notification
procedures is required:
(a)
Resident Notice. A written notice must be received by
the Residents, their Legal Representatives, and their Resident Representatives
(if applicable), at least 120 days prior to the date on which the Sponsor
intends to close or sell the Residence and cease operations as an Assisted
Living Residence. At a minimum, such notice shall include:
1. The date on which the Sponsor intends to
close or sell the Residence and cease operations as an Assisted Living
Residence;
2. A description of the
actions the Sponsor will take to assist the Residents in securing comparable
housing and services, if necessary; and
3. A reference to the rights of the Residents
that may be exercised under the landlord/tenant laws established under M.G.L.
c. 186 or M.G.L. c. 239.
(b)
EOEA Notice. A
written notice must be received by EOEA at least 120 days prior to the date on
which the Sponsor intends to close or sell the Residence and cease operations
as an Assisted Living Residence. Such notice shall include a copy of the
Resident notice in accordance with 651 CMR 12.03(10)(a), proof of notification
of all affected Residents and their Legal Representatives and Resident
Representatives (as applicable), and the identification of all Residents
receiving additional services, including but not limited to, Group Adult Foster
Care.
(11)
Suspension of Certification. If EOEA suspends the
Certification of an Assisted Living Residence, the Sponsor shall display the
notice of suspension in a prominent place in the Residence, in place of the
Certification, so long as the suspension is in effect.
