Current through Register Vol. 46, No. 39, September 25, 2024
(a)
Definitions.
For purposes of this section, the following terms shall
have the following meanings:
(1) The
term
equity means:
(i) any
right or claim to assets;
(ii) any
interest in property or in a business, subject to claims of
creditors;
(iii) the difference
between assets and liabilities;
(iv) net worth.
(2) The term asset means any
owned physical object or any right having economic value to its owner or any
item or source of wealth expressed, for accounting purposes, in terms of its
cost, depreciated cost determined in accordance with the applicable provisions
of Part 86 of this Title, or fair market value at date of donation.
(3) The term
withdrawal
shall include, but not be limited to, the following examples:
(i) any transfer of a facility's cash or
other assets directly or indirectly to or for the benefit of its
operator;
(ii) expenditures of the
facility's assets or equity for personal items not recognized as reimbursable
under the state's medical assistance program;
(iii) any liability incurred within any
period of time required for financial reporting in accordance with Part 86 of
this Title by a facility or its operator by reason of a mortgage, lease,
borrowing or other transaction relating to such a facility that exceeds, in the
aggregate, $50,000;
(iv) any
non-arm's length or related party loans made by the facility or its operator,
including loans to any individual, corporation, partnership, or other
organization related to the facility within the meaning of "related
organization", as that term is defined in section
451.229 of this Title;
(v) payment to the operator or owner of a
salary in excess of the maximum amount allowed for reimbursement purposes by
the Department of Health.
(b)
(1) No
medical facility operated for profit, or operator of such facility, may
withdraw said facility's equity or assets, without the prior approval of the
commissioner, if such a withdrawal would create or increase a negative net
worth position for the facility or occur when the facility is in a negative net
worth position.
(2) A withdrawal
shall be considered to have taken place if it has occurred during any period of
time required for financial reporting in accordance with Part 86 of this
Title.
(3) Negative net worth shall
be calculated without regard to any surplus created by revaluation of assets,
or to receivables resulting from non-arm's length or related party
loans.
(4) When calculating net
worth under this section, only the equity or assets of the facility shall be
considered, and not any other property owned by the facility's operator, nor
any other business entities related to the facility. Appeals and audits made
pursuant to Part 86 of this Title and Title 18 (Social Services) NYCRR,
respectively, shall not be considered for purposes of calculating net worth
unless finally determined.
(5) In
any administrative hearing brought pursuant to section
2808
(5) of the Public Health Law, this section
and Part 51 of this Title it shall be prima facie evidence of a withdrawal of
equity or assets in violation of section
2808
(5) of the Public Health Law and this section
if, at the close of the period of time required for financial reporting in
accordance with Part 86 of this Title, a facility is in a negative equity or
net worth position and the operator has withdrawn equity or assets from the
facility during the period of time covered by the financial report.
(c)
(1) An application for approval shall be
submitted on forms provided by the Department of Health at least 60 days prior
to the proposed withdrawal and shall specify the necessity, purpose, and impact
on patient care of the withdrawal and the details concerning such withdrawal
including, but not limited to, the principal amount, interest rate, repayment
terms, conditions of default, remedies upon default and obligee of any
transaction to be consummated in a proposed withdrawal, unless such items are
inapplicable. The application shall contain a current interim balance sheet and
a description of the facility's cash position, including as cash such cash
equivalents as certificates of deposit and treasury bills. Requests shall be
made by certified or registered mail. Nothing herein shall be construed to
prohibit the commissioner from considering applications submitted less than 60
days prior to the proposed withdrawal in an emergency situation that directly
affects the health, safety or welfare of patients.
(2) The commissioner or his designee shall
approve or disapprove a request for withdrawal of equity or assets within 60
days of the date of receipt of such a request. Any request not approved or
disapproved within 60 days shall be considered approved.
(3) In reviewing an application for
withdrawal, the commissioner shall consider:
(i) the necessity for the
withdrawal;
(ii) whether such
withdrawal would impair the facility's ability to render quality
care;
(iii) any expense which such
withdrawal would generate; and
(iv)
the financial condition of the facility in general.
(d) If an analysis of a facility's
financial reports indicates the violation of the provisions of this section,
the commissioner may review all documents which may indicate a withdrawal of
equity has occurred and the facility shall produce all data necessary for the
completion of such review.
(e) In
addition to any other remedy or penalty available, and after the operator has
been granted the opportunity for an administrative hearing, the commissioner
may require replacement of the withdrawn equity or assets and may impose a
penalty for violation of this regulation in an amount not to exceed ten percent
of any amount withdrawn without prior approval.