                                 CODE OF VIRGINIA

DISCLOSURE STATEMENT (§ 38.2-4902)

A. The disclosure statement of each facility shall contain all of the following
information unless such information is contained in the continuing care contract
and a copy of that contract is attached to and made a part of the initial
disclosure statement:

   1. The name and business address of the provider and a statement of whether
   the provider is a partnership, foundation, association, corporation or other
   type of business or legal entity.

   2. Full information regarding ownership of the property on which the facility
   is or will be operated and of the buildings in which it is or will be
   operated.

   3. The names and business addresses of the officers, directors, trustees,
   managing or general partners, and any person having a ten percent or greater
   equity or beneficial interest in the provider, and a description of such
   person&#8217;s interest in or occupation with the provider.

   4. For (i) the provider, (ii) any person named in response to subdivision 3 of
   this subsection or (iii) the proposed management, if the facility will be
   managed on a day-to-day basis by a person other than an individual directly
   employed by the provider:
   				a. A description of any business experience in the operation or management
   of similar facilities.
   				b. The name and address of any professional service, firm, association,
   foundation, trust, partnership or corporation or any other business or legal
   entity in which such person has, or which has in such person, a 10 percent or
   greater interest and which it is presently intended will or may provide goods,
   leases or services to the provider of a value of $500 or more, within any
   year, including:

      1. A description of the goods, leases or services and the probable or
      anticipated cost thereof to the provider;

      2. The process by which the contract was awarded;

      3. Any additional offers that were received; and

      4. Any additional information requested by the Commission detailing how and
      why a contract was awarded.
      					c. A description of any matter in which such person:

      1. Has been convicted of a felony or pleaded nolo contendere to a criminal
      charge, or been held liable or enjoined in a civil action by final judgment,
      if the crime or civil action involved fraud, embezzlement, fraudulent
      conversion, misappropriation of property or moral turpitude; or

      2. Is subject to an injunctive or restrictive order of a court of record, or
      within the past five years had any state or federal license or permit
      suspended or revoked as a result of an action brought by a governmental
      agency or department, arising out of or relating to business activity or
      health care, including without limitation actions affecting a license to
      operate a foster care facility, nursing home, retirement home, home for the
      aged or facility registered under this chapter or similar laws in another
      state; or

      3. Is currently the subject of any state or federal prosecution, or
      administrative investigation involving allegations of fraud, embezzlement,
      fraudulent conversion, or misappropriation of property.

   5. A statement as to:
   				a. Whether the provider is or ever has been affiliated with a religious,
   charitable or other nonprofit organization, the nature of any such
   affiliation, and the extent to which the affiliate organization is or will be
   responsible for the financial and contractual obligations of the provider.
   				b. Any provision of the federal Internal Revenue Code under which the
   provider is exempt from the payment of income tax.

   6. The location and description of the real property of the facility, existing
   or proposed, and to the extent proposed, the estimated completion date or
   dates of improvements, whether or not construction has begun and the
   contingencies under which construction may be deferred.

   7. The services provided or proposed to be provided under continuing care
   contracts, including the extent to which medical care is furnished or is
   available pursuant to any arrangement. The disclosure statement shall clearly
   state which services are included in basic continuing care contracts and which
   services are made available by the provider at extra charge.

   8. A description of all fees required of residents, including any entrance fee
   and periodic charges. The description shall include (i) a description of all
   proposed uses of any funds or property required to be transferred to the
   provider or any other person prior to the resident&#8217;s occupancy of the
   facility and of any entrance fee, (ii) a description of provisions for the
   escrowing and return of any such funds, assets or entrance fee, the manner and
   any conditions of return and to whom earnings on escrowed funds are payable
   and (iii) a description of the manner by which the provider may adjust
   periodic charges or other recurring fees and any limitations on such
   adjustments. If the facility is already in operation, or if the provider
   operates one or more similar facilities within this Commonwealth, there shall
   be included tables showing the frequency and average dollar amount of each
   increase in periodic rates at each facility for the previous five years or
   such shorter period that the facility has been operated by the provider.

   9. Any provisions that have been made or will be made to provide reserve
   funding or security to enable the provider to fully perform its obligations
   under continuing care contracts, including the establishment of escrow
   accounts, trusts or reserve funds, together with the manner in which such
   funds will be invested and the names and experience of persons who will make
   the investment decisions. The disclosure statement shall clearly state whether
   or not reserve funds are maintained.

   10. Certified financial statements of the provider, including (i) a balance
   sheet as of the end of the two most recent fiscal years and (ii) income
   statements of the provider for the two most recent fiscal years or such
   shorter period that the provider has been in existence.

   11. A pro forma income statement for the current fiscal year.

   12. If operation of the facility has not yet commenced, a statement of the
   anticipated source and application of the funds used or to be used in the
   purchase or construction of the facility, including:
   				a. An estimate of the cost of purchasing or constructing and equipping the
   facility including such related costs as financing expense, legal expense,
   land costs, occupancy development costs and all other similar costs that the
   provider expects to incur or become obligated for prior to the commencement of
   operations.
   				b. A description of any mortgage loan or other long-term financing
   intended to be used for any purpose in the financing of the facility and of
   the anticipated terms and costs of such financing, including without
   limitation, all payments of the proceeds of such financing to the provider,
   management or any related person.
   				c. An estimate of the percentage of entrance fees that will be used or
   pledged for the construction or purchase of the facility, as security for
   long-term financing or for any other use in connection with the commencement
   of operation of the facility.
   				d. An estimate of the total entrance fees to be received from or on behalf
   of residents at or prior to commencement of operation of the facility.
   				e. An estimate of the funds, if any, which are anticipated to be necessary
   to fund start-up losses and provide reserve funds to assure full performance
   of the obligations of the provider under continuing care contracts.
   				f. A projection of estimated income from fees and charges other than
   entrance fees, showing individual rates presently anticipated to be charged
   and including a description of the assumptions used for calculating the
   estimated occupancy rate of the facility and the effect on the income of the
   facility of any government subsidies for health care services to be provided
   pursuant to the continuing care contracts.
   				g. A projection of estimated operating expenses of the facility, including
   (i) a description of the assumptions used in calculating any expenses and
   separate allowances for the replacement of equipment and furnishings and
   anticipated major structural repairs or additions and (ii) an estimate of the
   percentage of occupancy required for continued operation of the facility.
   				h. Identification of any assets pledged as collateral for any purpose.
   				i. An estimate of annual payments of principal and interest required by
   any mortgage loan or other long-term financing.

   13. A description of the provider&#8217;s criteria for admission of new
   residents.

   14. A description of the provider&#8217;s policies regarding access to the
   facility and its services for nonresidents.

   15. Any other material information concerning the facility or the provider
   that may be required by the Commission or included by the provider.

   16. The procedure by which a resident may file a complaint or disclose any
   concern.

B. The disclosure statement shall state on its cover that the filing of the
disclosure statement with the Commission does not constitute recommendation or
endorsement of the facility by the Commission.

C. A copy of the standard form or forms for continuing care contracts used by
the provider shall be attached as an exhibit to each disclosure statement.

D. If the Commission determines that the disclosure statement does not comply
with the provisions of this chapter, it shall have the right to take action
pursuant to &#xA7; 38.2-4931.

HISTORY: 1985, c. 554, § 38.1-957; 1986, cc. 562, 598; 1992, c. 139; 2012, cc.
208, 303.