Maryland Code § HG-19-120.2

Section HG-19-120.2
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(a) (1) In this section the following words have the meanings indicated.
(2) "Executive Director" means the Executive Director of the
Commission.
(3) "Nursing home" has the meaning stated in § 19-1401 of this title.
(4) "Request for acquisition" means a request for the Commission to
approve the acquisition of a nursing home.
(b) A person shall provide notice to the Commission at least 30 days before
the closing of a change of ownership of a nursing home that:
(1) Involves at least a 5% transfer in ownership interest; and
(2) Is not an acquisition that requires approval under subsection (c)
of this section.
(c) (1) This subsection does not apply to an acquisition that involves only
changes of ownership interests among existing owners of a nursing home.
(2) At least 60 days before the closing date of the acquisition of a
nursing home, a person shall:
(i) Submit to the Commission a request for acquisition; and
(ii) Provide notice to the residents, resident representatives,
and employees of the nursing home that:
1. The request for acquisition was submitted to the
Commission; and
2. There will be an opportunity to submit comments in
accordance with subsection (f) of this section.

(d) (1) The Executive Director shall review a completed request for
acquisition within 45 days after receiving the completed request from the applicant.
(2) The Executive Director, in consultation with the Secretary or the
Secretary's designee, may:
(i) Approve the acquisition;
(ii) Approve the acquisition with conditions;
(iii) Deny the acquisition; or
(iv) Refer the request for acquisition to the Commission for a
final decision.
(e) To approve a request submitted under subsection (c) of this section, the
Executive Director must find that the acquisition:
(1) Is consistent with the State Health Plan; and
(2) Subject to subsection (f) of this section, is in the public interest.
(f) In determining whether an acquisition of a nursing home is in the public
interest, the Executive Director shall:
(1) Solicit and accept comments from individuals who:
(i) Reside in the nursing home;
(ii) Have family members who reside in the nursing home; or
(iii) Are employees of the nursing home; and
(2) Consult with the Attorney General on whether the acquisition
raises public interest concerns.
(g) If the Executive Director refers a request for acquisition to the
Commission under subsection (d)(2)(iv) of this section, the Commission shall use the
criteria specified in subsections (e) and (f) of this section and regulations adopted by
the Commission to make a final decision within 60 days after receiving the completed
request from the applicant.
(h) If the Executive Director denies a request for acquisition or imposes a
condition on the approval of the acquisition, a person that is a party to the acquisition

may submit a written request for the Commission to review the decision in accordance
with regulations adopted by the Commission.
(i) (1) A decision of the Commission under subsection (g) or (h) of this
section shall be a final decision for the purpose of judicial review.
(2) A person that is a party to the acquisition may take a direct
judicial appeal within 30 days after the Commission makes the final decision.
(3) The Commission shall send each final decision to the Secretary,
the Secretary of Aging, the Office of Health Care Quality, the Office of the Attorney
General, and the State Long-Term Care Ombudsman.
(j) (1) On or before July 1 immediately following the acquisition of a
nursing home and each year for 3 years thereafter, the person that acquired the
nursing home shall submit a report to the Commission in accordance with regulations
adopted by the Commission.
(2) The Commission shall provide the report required under
paragraph (1) of this subsection to the Secretary, the Secretary of Aging, the Office of
Health Care Quality, the Office of the Attorney General, and the State Long-Term
Care Ombudsman.
(k) (1) The Commission shall adopt regulations through an update to the
State Health Plan for Facilities and Services to carry out the provisions of this
section.
(2) The regulations adopted under this subsection shall:
(i) Require the person that acquired ownership of a nursing
home to:
1. Reduce the number of resident rooms in the nursing
home that contain more than two beds in accordance with standards established by
the Commission; or
2. Receive a waiver from the requirement established
under item 1 of this item from the Executive Director in accordance with standards
established by the Commission;
(ii) 1. If necessary, allow the person that acquired
ownership of a nursing home to temporarily delicense beds for at least 3 years
immediately following the acquisition to reduce the number of resident rooms that
contain more than two beds; and

2. Authorize the Commission to extend the period the
beds are temporarily delicensed beyond 3 years for good cause shown, including
demonstrated progress toward eliminating multibedded rooms by expanding the
existing facility or transferring the beds to another facility within a merged asset
system in the same jurisdiction;
(iii) Establish standards for the evaluation of the quality of the
nursing homes currently or previously owned, whether in the State or outside the
State, by the person that submitted a request for acquisition; and
(iv) Subject to paragraph (3) of this subsection, establish
criteria for the Executive Director and the Commission to consider when making a
decision regarding a request for acquisition.
(3) The criteria established by the Commission under paragraph
(2)(iv) of this subsection shall require that the Commission take into consideration
whether any nursing home currently or previously owned, within or outside the State,
by the person submitting the request, for the period of 3 years immediately preceding
the submission of the request:
(i) Maintained a quality assessment and assurance committee
that met at least quarterly;
(ii) Was the subject of an enforcement action, a special focus
facility designation, or a deficiency involving serious or immediate threat, actual
harm, or immediate jeopardy to a resident; or
(iii) Was the subject of a lawsuit judgment, or an arbitration
finding, following a complaint filed by a resident, resident representative, or a
government agency.

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