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PARRIS N. GLENDENING, Governor
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Ch. 150
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(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 the beneficial interests in the trust, the state governing the trust, and
the name of the primary individual responsible for overseeing the trust's activities;
and
(vi) A statement regarding whether the provider is qualified, or
intends to qualify, as a tax-exempt organization under the Internal Revenue Code;
(3) A statement regarding any affiliation of the provider with a religious,
charitable, or other nonprofit organization, and the extent to which the organization
is responsible for the financial and contractual obligations of the provider;
(4) A description of all basic fees, including entrance fees, fees for health
related services, and periodic fees, collected by the provider from subscribers, setting
forth the amount and frequency of the fee changes during each of the previous 5
years. If the facility has been in operation less than 5 years, then the description shall
be for each year that it has been in operation;
(5) A statement describing provisions that have been or will be made to
comply with the operating reserve requirements as described in § 11B of this subtitle,
and a general statement regarding the provider's investment policy related to the
required reserves, including how often the reserve fund investment is reviewed and
by whom;
(6) A copy of the most recent certified financial statement obtainable
under generally accepted accounting principles;
(7) A description of the long-term financing for the facility;
(8) If the facility has not reached 85% occupancy of independent living
units, a summary of the feasibility study;
(9) A cash flow forecast statement for the current and the next 2 fiscal
years;
(10) The names and occupations of the officers, directors, trustees,
managing or general partners, and any other persons with a 10% or greater equity or
beneficial interest in the provider, and a description of the financial interest in or
occupation with the provider;
(11) The name and address of any professional service firm, association,
trust, partnership, company, or corporation in which a person identified in item (10)
of this subsection 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, including a description of the goods, premises, or services
and their anticipated cost to the facility or provider. However, the disclosure of salary,
wage, or benefit information of employees of the provider is not required;
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- 1495 -
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