Maryland Department of Health
Office of Health Care Quality

Long Term Care Change of Ownership (CHOW)

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Long T​​erm Care Owner​ship 

​Office of Health Care Quality's Long Term Care Unit determines a nursing home's compliance with State licensure and federal certification standards. 

Per COMAR 10.07.02.04B(4), if the sale, transfer, assignment, or lease of a nursing home causes a change in the person or persons who control or operate the nursing home, the nursing home shall be considered a “new nursing home” and the licensee must conform to all regulations applicable at the time of transfer of operations.

​The transfer of any stock which results in a change of the person or persons who control the nursing home, or a 25 percent or greater change in any form of ownership interest, constitutes a sale.​


​CHOW Application Requirements

  • Required Forms
    1. ​39-460F CHOW Application and Instructions
    2. 39-461F Nursing Home Ownership
    3. 39-462F Ownership of Property
    4. 39-463F Disclosure Form
    5. 39-464F Director of Nursing Agreement 
    6. 39-465F Medical Director Agreement
    7. CMS 1561 – Health Insurance Benefits Form
    8. CMS 671 Application - Medicare and Medicaid​
  • ​​Local Permits, if required by the local jurisdiction​
    1. ​Kitchen permit
    2. Zoning permit
    3. Use and occupancy permit
    4. Fire inspection report
  • Required ​​Documents
    1. Documentation of MHCC determination
    2. Confirmation of online submission of the Assurance of Compliance to the Office for Civil Rights
    3. Agreement between the Director of Nursing and the nursing home
    4. Policies and procedures, COMAR 10.07.02.13 and COMAR 10.07.09.15
    5. Quality assurance plan, COMAR 10.07.02.64
    6. Resident agreement.  A sample resident agreement is on the OHCQ website
    7. Transfer agreement with a local hospital, COMAR 10.07.02.39
    8. Documentation required to continue operating an existing special care unit, if applicable 
    9. Evidence of Financial Ability to Operate
    10. Bill of sale documenting the date of the transaction
    11. Letter of Good Standing:  The applicant must obtain an official letter of good standing from the Maryland Department of Assessments and Taxation (SDAT) Business Express
    12. Workers’ Compensation:  Attach a copy of the declaration page from your Workers’ Compensation coverage  

Maryland Heatlh Care Commission​​

​The Maryland Health Care Commission​ is an independent regulatory agency whose mission is to plan for health system needs, promote informed decision-making, increase accountability, and improve access in a rapidly changing healthcare environment by providing timely and accurate information on availability, cost, and quality of services to policy makers, purchasers, providers and the public. To access the Consumer Guide to Long Term Care, please visit their website​. ​


Transmittals​​

  1. ​​​OHCQ
  2. Medicaid​​

Important Resources​

  1. ​Medicaid Supports Planning

  2. Maryland Labor Board

  3. Maryland Access Point

  4. Maryland Health Care Commission

  5. Civil Rights Compliance

  6. CMS Form 671

  7. Worker's Compensation

  8. Nurse Practice Act

  9. Maryland Board of Nursing

  10. MD Department of Transportation

  11. Medicaid Fraud Control Unit

  12. CMS State Operations Manual (SOM)

  13. Center for Medicare and Medicaid Services​

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Approved Long Term Care CHOWs

  1. List of Approved Long Term Care CHOWS​


Contact OHCQ

Contact the Long Term Care Team

File a Long Term Care Complaint

Phone (410) 402-8201 / (877) 402-8219 / TTY (800) 735-2258   

Fax (410) 402-8234

Dawn Zulauf, Program Manager ​​


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