400.1
No Level II assisted living facility may be established, conducted, or maintained in Arkansas without first obtaining a long term care facility license as required by Ark. Code Ann. § 20-10-201, et seq., Act 1230 of 2001, and these licensing standards. All licenses issued hereunder, and the beds stated on the license, are non-transferable from one owner or proprietor to another, or from one site or
location to another. No Level II assisted living facility may operate with more beds than is stated in the license, and no Level II assisted living facility may accept more residents than the number of beds stated on the license. No license shall be issued without proof of a valid, current Permit of Approval issued by the Health Services Permit Commission or Health Services Permit Agency.
400.2
The grant of a license for a facility as a Level II assisted living facility shall also be a grant of licensure as a Level I assisted living facility. However, separate licenses shall be issued for each, and shall reflect the number of beds for each as indicated on the application. Specifically, the issuance of a Level II assisted living facility license shall be a grant of authority to the facility to operate with the stated bed capacity set out in the Assisted Living Facility II license for the housing or delivery of services to individuals who are medically eligible for nursing home level of care or who receive services through the Medicaid 1915 (c) H&CBS wavier for assisted living. The issuance of a Level I assisted living facility license shall be a grant of authority to the facility to operate with the stated bed capacity set out in the Assisted Living Facility I license for the housing or delivery of services to those individuals who are not medically eligible for
nursing home level of care or who do not receive services through the Medicaid 1915 (c) H&CBS Wavier for assisted living. The initial licenses together shall reflect the total number of beds as set forth in the Permit of Approval. Subsequent licenses issued to the same owner will state the number of beds for which the facility has been authorized by the Health Services Permit Commission
or the Health Services Permit Agency at the time of the issuance of the subsequent license, and which are designated for the respective Level I and Level II licenses. Licenses issued as a result of a change of ownership shall state the number of beds for which the facility was licensed on the date of sale of the facility or the date of the sale of ownership of the facility.
400.3
When a facility is licensed as a Level II assisted living facility, the facility shall maintain physically distinct parts or wings to house individuals that receive or are medically eligible for the nursing home level of care separate and apart from those individuals who do not receive, or are not medically eligible for the nursing home level of care. Common areas must meet all requirements for a Level II
facility. However, Level II units may house Level I-level of care residents under the following conditions:
a. Any and all individuals residing in a Level II unit shall be counted as a Level II resident for purposes of determining staff for the Level II unit; and,
b. No individual meeting the criteria for Level II level of care may reside or be housed in a Level I unit or Level I bed.
c. Common areas must meet all requirements for a Level II facility. Staffing within the Level II parts or wings of the facility must meet the
requirements for Level II assisted living facilities at all times, independent of the staffing requirements for the Level I parts or wings of the facility, and regardless whether the Level II parts or wings house individuals who do not receive, or are
not eligible for, nursing home level of care.
401 LICENSING INFORMATION
401.1 Licenses to operate a Level II assisted living facility are issued to be effective beginning July 1st and expiring on the following June 30th. Fees for new licensure applications will be prorated by dividing the total licensure fee by three hundred sixty five (365) and then multiplying the result by the total number of days from the date the application is approved through June 30, inclusive.
401.2 Licenses shall be issued only for the premises and persons specified in the application and shall not be transferable.
401.3 Licenses shall be posted in a conspicuous place on the licensed premises.
401.4 Separate licenses are required for Level II assisted living facilities maintained on separate premises, even though they are operated under the same management. When two or more buildings located on contiguous land house Assisted Living operations, the owner or operator may choose to license each operation in each building separately, or to have all operations in all buildings operate under a
single license. Multiple licenses for multiple operations housed in separate buildings on contiguous land will be considered and treated under these regulations as separate Assisted Living Facilities, and each licensed operation must conform to the requirements of these regulations independent of the other licensed operations housed in other buildings on contiguous land.
401.5 Every Level II assisted living facility owner shall designate a distinctive name for the facility, which shall be included on the application for a license. The name of the facility shall not be changed without prior written notification to and receipt by the owner of the assisted living facility of approval from the Office of Long Term Care.
402 INITIAL LICENSURE
402.1 Initial licensure requires that the applicant for licensure possess a current, valid Permit of Approval (P-o-A) issued by the Health Services Permit Commission (HSPC) or Health Services Permit Agency (HSPA). Initial licensure shall apply to:
a. Newly constructed facilities designed to operate as assisted living facilities;
b. Existing structures not already licensed as a Level II assisted living facility
on the effective date of these regulations. Permits of approval held by residential care facilities as of the effective date of
Act 1230 of 2001 or held by subsequent purchases of those facilities shall also be considered permits of approval for assisted living without further action. However, residential care facilities that choose to offer Level II assisted living
services are not exempt from assisted living licensure requirements except as specifically provided by Act 1230 of 2001.
402.2 The initial licensure application shall be accompanied by one set of building
plans.
403 COMPLIANCE
An initial license will not be issued until the Department verifies that the facility is in compliance with the licensing standards set forth in these regulations. An initial license will be effective on the date specified by the Office of Long Term Care once the Office of Long Term Care determines the facility to be in compliance with these licensing standards and applicable laws and regulations. The license will expire on June 30th following the issuance of the license.
404 APPLICATION, EXPIRATION AND RENEWAL OF LICENSE
404.1 Applicants for licensure or renewal of Level II assisted living facility licensure shall obtain the necessary forms for initial or renewal licensure or to request relic ensure of the facility after a change of ownership (see Section 404.7 and
Section 405) from the Office of Long Term Care. The issuance of an application form shall not be construed to be a guarantee that the completed application will be acceptable, or that the Department will issue a license.
404.2 The facility shall not admit any residents until a license to operate a Level II assisted living facility has been issued, except as provided in Section 404.10(e) of these regulations for purposes of inspection and initial licensure.
404.3 Applicants for initial licensure, renewal, or re-licensure after a change in ownership shall pay in advance a license fee of $10.00 per bed to the Department. Such fee shall be refunded to the applicant in the event a license is not issued. An application fee of $250.00 shall also accompany every application which shall be non-refundable.
404.4 Annual renewal is required for all Level II assisted living facility licenses. Licenses are effective beginning July 1 and shall expire on June 30th of the following year. In the event that a facility’s license is not renewed by June 30, the
license for the facility will be void.
404.5 Applications for annual license renewal shall be delivered or, if mailed, postmarked to the Office of Long Term Care no later than June 1st before the June 30th expiration of the license. Any license fee received by the Department
after June 1 is subject to a ten percent (10%) penalty.
404.6 The operator of the facility shall sign applications and must successfully complete a criminal background check pursuant to Ark. Code Ann. 20-33-201, et seq., and in accordance with the Rules and Regulations for Conducting Criminal Record Checks for Employees of Long Term Care Facilities.
404.7 When a change in ownership of controlling interest in the facility is sold by person or persons named in the license to any other person or persons, the new owner shall, at least 30 days prior to completion of the sale, submit a new application and license fee, request to be inspected and meet the applicable standards and regulations, including but not limited to, life safety codes, at the time of inspection. The seller, in writing, shall report such change in ownership to the Office of Long Term Care at least thirty (30) days before the change is to be implemented. With the exception of civil money penalties imposed for violations or deficiencies that occurred prior to the sale of ownership or control, when a license is granted pursuant to a change of ownership, the buyer shall be responsible for implementation or performance of any remedy listed in Section 1004.2 imposed against the facility for violations or deficiencies that occurred
prior to the sale of ownership or control. The seller shall remain liable for all civil money penalties assessed against the facility that are imposed for violations or deficiencies occurring prior to the sale of ownership or operational control. The Department shall consider and may deny a license based upon any criteria provided for at Ark. Code Ann. § 20-10-224(f)(1), et seq. Failure to comply with
the provisions of this section will result in the denial of licensure to the new owner.
404.8 The applicant/licensee must furnish the following information:
a. The identity of each person having (directly or indirectly) an ownership interest of five percent (5%) or more in the facility;
b. The complete name and address of the assisted living facility for which license is requested and such additional information as the Department may require including, but not limited to, affirmative evidence of ability to comply with standards, rules and regulations as are lawfully prescribed hereunder;
c. In case such facility is organized as a corporation, the identity of each officer and director of the corporation, together with a certificate of good standing from the Arkansas Secretary of State;
d. In case such facility is organized as a partnership, the identity of each partner and a copy of the partnership agreement;
e. A statement from an authorized representative of the facility acknowledging that the facility is responsible for any funds that are
handled for the residents by the facility or its staff, including personal allowance funds, together with an acknowledgement that the failure to make restitution within ten (10) working days for lost or stolen funds will result in the non-renewal of licensure, or other sanctions;
f. A copy of any required contract agreement for the provision of services meeting specifications in Section 503 of these regulations;
g. A copy of the floor plan of the assisted living facility. If the assisted living facility will be a part of another facility under a different license, the distinct part of the facility that will be assisted living shall be identified.
404.9 A Level II assisted living facility may apply for and be granted a license to operate as a Level I-only facility. The facility shall, prior to the issuance of the license, provide a written plan to the Office of Long Term Care setting forth:
a. The means by which alternative placement for individuals who receive, or meet the medical eligibility for, nursing home level of care, will be made; and
b. The date of transfer to alternative placement for each resident that receives, or meets the medical eligibility for, nursing home level of care. The Office of Long Term Care shall evaluate all written plans, and will grant the license as a Level I-only facility only upon determination, in the sole discretion of the Office, that the proposed plan meets the best interest of residents. The facility
shall comply with all requirements of Section 602 regarding transfer of residents. A facility desiring to change its licensure status to a Level I from a Level II shall meet all requirements for, and shall make application without additional fee in
accordance with, new licensure applications.
404.10 Procedure for Licensure. The procedure for obtaining an Assisted Living License shall be:
a. The individual or entity seeking licensure shall request or obtain all forms for licensure from the Office of Long Term Care.
b. The individual or applicant shall fully complete all forms for licensure and submit same to the Office of Long Term Care, along with all licensure and application fees. As applicable and required by law or regulation, the individual or entity seeking licensure shall submit drawings or plans for the facility to the Office of Long Term Care at the time of application.
c. For a new facility, at the time of application submission to the Office of Long Term Care the applicant shall, in writing, request a life-safety code survey from the Office of Long Term Care.
d. For a new facility, the Office of Long Term Care will conduct an unannounced life-safety code survey to determine compliance with
applicable building code requirements.
e. For a new facility, upon being informed that the facility meets all requirements for all applicable building codes the facility may admit
residents.
f. For a new facility, upon admission of residents the facility shall, in writing, request an initial survey.
g. For a new facility, the Office of Long Term Care will conduct an unannounced initial survey to determine compliance with applicable law
and these regulations.
h. For a new facility, upon successful completion of the initial survey the facility shall be granted a license to operate as an Assisted Living Facility.
i. The Office of Long Term Care may elect, for any renewal application, to perform a survey prior to issuance of the license, and issuance of the license is contingent upon the facility being found in compliance with all program requirements.
405 CHANGE IN OWNERSHIP
405.1 Transactions constituting a change in ownership include, but are not limited to, the following:
a. Sale or donation of the facility’s legal title;
b. Lease of any portion of facility’s real or personal property;
c. A sole proprietor becomes a member of a partnership or corporation, succeeding him as the new operator;
d. A partnership dissolves;
e. One partnership is replaced by another through the removal, addition or substitution of a partner;
f. The corporate owner merges with, or is purchased by, another corporation or legal entity;
g. A not-for-profit corporation becomes a general corporation, or a for-profit corporation becomes not-for-profit.
405.2 Transactions that do not constitute a change of ownership include, but are not limited to, the following:
a. Changes in the membership of a corporate board of directors or board of trustees, or;
b. Changes in the membership of a not-for-profit corporation.
406 PROVISIONAL LICENSURE
Subject to the requirements below, a provisional license shall be issued to the Applicant and new operator of the long-term care facility when the Office of Long Term Care has received the Application for Licensure to Conduct a Long Term Care Facility. A
provisional license shall be effective from the date the Office of Long-Term Care provides notice to the Applicant and new operator, until the date the long-term care license is issued. With the exception of Medicaid or Medicare provider status, a
provisional license confers upon the holder all the rights and duties of licensure.
Prior to the issuance of a provisional license:
1. The purchaser and the seller of the long-term care facility shall provide the Office of Long Term Care with written notice of the change of ownership at least thirty (30) days prior to the effective date of the sale.
2. The Applicant and new operator of the long-term care facility shall provide the Office of Long Term Care with the application for licensure, including all applicable fees.
3. The Applicant and new operator of the long-term care facility shall provide the Office of Long Term Care with evidence of transfer of operational control signed by all applicable parties.
A provisional license holder may operate the facility under a new name, whether fictitious or otherwise. For purposes of this section, the term new name means a name that is different than the name under which the facility was operated by the prior owner,
and the term “operate” means that the provisional license holder may hold the facility out to the public using the new name. Examples include, but are not limited to, signage, letterhead, brochures or advertising (regardless of media) that bears the new name.
In the event that the provisional license holder operates the facility under a new name, the facility shall utilize the prior name in all communications with the Office of Long Term Care until such time as the license is issued. Such communications include, but are not
limited to, incident reports, notices, Plans of Correction, and MDS submissions. Upon the issuance of the license, the facility shall utilize the new name in all communications with the Office of Long Term Care.