LCO 1 of 4 General Assembly Substitute Bill No. 1332 January Session, 2025 AN ACT CONCERNING NURSING HOME FINANCIAL ACCOUNTABILITY AND NURSING HOME OWNERSHIP BY PRIVATE EQUITY COMPANIES AND REAL ESTATE INVESTMENT TRUSTS. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. (NEW) (Effective from passage) (a) As used in this section: 1 (1) "Indirect ownership interest" means an ownership interest in (A) 2 an entity that has an ownership interest in a nursing home, or (B) an 3 indirect owner of a nursing home; 4 (2) "Nursing home" has the same meaning as provided in section 19a-5 490 of the general statutes; 6 (3) "Operational control" means to: (A) Influence or direct the actions 7 or policies of any part of a nursing home; or (B) choose, appoint or 8 terminate a member of the board, manager, managing member, senior 9 employee, consultant or other individual or entity that participates in 10 the operational oversight of a nursing home; 11 (4) "Ownership interest" means possession of equity in capital, stock, 12 profits or ownership of real estate on which a nursing home operates; 13 (5) "Private equity company" means a publicly traded or nonpublicly 14 traded entity that collects capital investments from individuals or 15 entities; and 16 Substitute Bill No. 1332 LCO 2 of 4 (6) "Real estate investment trust" has the same meaning as provided 17 in 26 USC 856. 18 (b) On and after October 1, 2025, a private equity company or real 19 estate investment trust shall not acquire or increase (1) any direct or 20 indirect ownership interest in a nursing home, or (2) any operational or 21 financial control over a nursing home. 22 Sec. 2. Subsection (a) of section 19a-491a of the general statutes is 23 repealed and the following is substituted in lieu thereof (Effective October 24 1, 2025): 25 (a) A person seeking a license to establish, conduct, operate or 26 maintain a nursing home shall provide the Department of Public Health 27 with the following information: 28 (1) (A) The name and business address of the owner and a statement 29 of whether the owner is an individual, partnership, corporation or other 30 legal entity; (B) the names of the officers, directors, trustees, or 31 managing and general partners of the owner, the names of persons 32 having a five per cent or greater ownership interest in the owner, and a 33 description of each such person's occupation with the owner; (C) if the 34 owner is a corporation which is incorporated in another state, a 35 certificate of good standing from the secretary of state of the state of 36 incorporation; and (D) if a private equity company or real estate 37 investment trust owns any portion of the business, evidence of 38 compliance with section 1 of this act and any information regarding 39 such company or trust required to be disclosed (i) on federal Form CMS-40 855a, and (ii) in accordance with 42 CFR 424.516 or 42 CFR 455.104, as 41 amended from time to time; 42 (2) A description of the relevant business experience of the owner and 43 of the administrator of the nursing home and evidence that the 44 administrator has a license issued pursuant to section 19a-514; 45 (3) Affidavits signed by the owner, any of the persons described in 46 subdivision (1) of this subsection, the administrator, assistant 47 Substitute Bill No. 1332 LCO 3 of 4 administrator, the medical director, the director of nursing and assistant 48 director of nursing disclosing any matter in which such person has been 49 convicted of a felony, as defined in section 53a-25, or has pleaded nolo 50 contendere to a felony charge, or has been held liable or enjoined in a 51 civil action by final judgment, if the felony or civil action involved fraud, 52 embezzlement, fraudulent conversion or misappropriation of property; 53 or is subject to an injunction or restrictive or remedial order of a court of 54 record at the time of application, within the past five years has had any 55 state or federal license or permit suspended or revoked as a result of an 56 action brought by a governmental agency or department, arising out of 57 or relating to health care business activity, including, but not limited to, 58 actions affecting the operation of a nursing home, retirement home, 59 residential care home or any facility subject to sections 17b-520 to 17b-60 535, inclusive, or a similar statute in another state or country; 61 (4) (A) A statement as to whether or not the owner is, or is affiliated 62 with, a religious, charitable or other nonprofit organization; (B) the 63 extent of the affiliation, if any; (C) the extent to which the affiliate 64 organization will be responsible for the financial obligations of the 65 owner; and (D) the provision of the Internal Revenue Code of 1986, or 66 any subsequent corresponding internal revenue code of the United 67 States, as from time to time amended, if any, under which the owner or 68 affiliate is exempt from the payment of income tax; 69 (5) The location and a description of other health care facilities of the 70 owner, existing or proposed, and, if proposed, the estimated completion 71 date or dates and whether or not construction has begun; 72 (6) Audited and certified financial statements of the owner, including 73 (A) a balance sheet as of the end of the most recent fiscal year, and (B) 74 income statements for the most recent fiscal year of the owner or such 75 shorter period of time as the owner shall have been in existence; and 76 (7) If the operation of the nursing home has not yet commenced, a 77 statement of the anticipated source and application of the funds used or 78 to be used in the purchase or construction of the home, including: 79 Substitute Bill No. 1332 LCO 4 of 4 (A) An estimate of such costs as financing expense, legal expense, 80 land costs, marketing costs and other similar costs which the owner 81 expects to incur or become obligated for prior to the commencement of 82 operations; and 83 (B) A description of any mortgage loan or any other financing 84 intended to be used for the financing of the nursing home, including the 85 anticipated terms and costs of such financing. 86 This act shall take effect as follows and shall amend the following sections: Section 1 from passage New section Sec. 2 October 1, 2025 19a-491a(a) Statement of Legislative Commissioners: Section 1(b) was redrafted for clarity, and, in Section 2(a), "evidence of compliance with section 1 of this act" was moved from Subdiv. (6) to Subdiv. (1)(D) for internal consistency. AGE Joint Favorable Subst. -LCO