FYI’s on Assisted Living Licensing & Change in Ownership (CHOW) Applications
In recent months, staff at WHCA/WiCAL have heard from several WiCAL members with concerns about license and CHOW applications for assisted living facilities.
Eric and Rick with WHCA/WiCAL continue to work with the Bureau of Assisted Living (BAL) when members are experiencing issues with their license or CHOW applications, particularly when there are significant delays, when deals risk falling apart, when the fate of the facility is on the line, and the current license is coming up on its expiration.
In addition to helping these individual cases through the process and working with officials from BAL on your behalf, we have put together these recommendations and FAQs based on our experiences working with the Bureau of Assisted Living on specific cases and our conversations with them throughout the licensure and CHOW Processes.
- How are applications reviewed by BAL?
- Applications are reviewed in the order they are received; BAL receives a high volume of applications.
- When a CHOW is being considered, applicants are encouraged to apply as soon as possible due to applications being reviewed in the order they are received.
- When is an application considered “received” and pending BAL review?
- An application is considered “received” by BAL on the date the applicant pays. That date determines the order in which your application will be reviewed.
- If an applicant starts the application process in the portal but does not complete the application and does not pay, it is not considered complete and is not considered ready for review.
- Can applications be expedited?
- At the time of application submittal, applicants should inform BAL and may also notify staff at WHCA/WiCAL if there is a verifiable risk that residents could be unnecessarily displaced by a certain date if a license is not issued. There is no guarantee that applications can be expedited, but providing BAL with important information about critical deadlines as early as possible helps BAL when reviewing application materials.
- What is the most frequent issue holding up CHOWs?
- The biggest thing that has recently caused CHOWs to be held up is non-compliance.
- Often, the applicant has everything set on the application side with all the documents submitted and approved, but there may be outstanding deficiencies that the current licensee needs to correct.
- All outstanding noncompliance, fees and forfeitures must be resolved by the current licensee before a CHOW may be approved.
- In addition, any pending complaints regarding a facility must be investigated and the subsequent deficiencies from the complaint investigation/survey must be corrected before the CHOW can go through.
- There can be delays that hold up a CHOW including the time it can take between the date a complaint is submitted, the complaint is investigated by BAL, the SOD is received by the facility, the opportunity for the current licensee to correct the deficiencies, and the time it takes for a verification visit (VV) to occur to clear the SOD.
- Once you receive an SOD, the facility is not eligible for a verification visit for 45 days. If you have corrected the deficiencies and are ready for your VV prior to the 45 days and the CHOW timeline is tight, a request for an expedited VV can be made through your regional BAL Director. The request is not a guarantee of the timing and the VV’s are still unannounced.
- When complaints happen during the midst of a CHOW, this can slow down the process, and while it is outside of the facility’s control, there are steps that can be taken to help mitigate this possibility.
- Whenever a sale or change in ownership occurs, there can be uncertainty amongst residents and their families, leading to heightened scrutiny and confusion, causing increased complaints against the provider.
- In order to help mitigate the likelihood of complaints during a CHOW process, ensuring that facilities have a robust grievance process in place, and to increasing communication with residents, families, and staff during the CHOW process will help avoid complaints coming through BAL.
- There can be delays that hold up a CHOW including the time it can take between the date a complaint is submitted, the complaint is investigated by BAL, the SOD is received by the facility, the opportunity for the current licensee to correct the deficiencies, and the time it takes for a verification visit (VV) to occur to clear the SOD.
- The biggest thing that has recently caused CHOWs to be held up is non-compliance.
Keep in mind that in addition to these FAQs and recommendations based on our work and communication with BAL on the licensure and CHOW processes for assisted living facilities, there is also a relatively new licensing portal for providers, that you will need to use to submit your CHOW application. On March 17th, the Bureau held a virtual Q&A session with a walk through on using the new portal. Once the recording Session is published you will find the link to view it by visiting the following webpages for each facility type below:
Adult Family Homes
Community Based Residential Facilities
Residential Care Apartment Complexes
Additionally, the Bureau is hoping that with full implementation and increased familiarity amongst both staff and providers, that the new portal will also help to increase communication and decrease the turnaround time for applications.
As always, if you are dealing with a frustrating or confusing licensure or CHOW process, please reach out to Eric Koch, Sr. Vice President of Government Relations and Regulatory Affairs or Rick Abrams, CEO so that we can help you work through the process and advocate with BAL on your behalf.
