.04 Application Procedure.

A. Before a person may apply for a license to operate a general hospice care program, the person shall obtain a certificate of need from the Maryland Health Resources Planning Commission under Health-General Article, Title 19, Annotated Code of Maryland.

B. The applicant shall submit an application for an initial license or renewal of a license on a written or electronic form provided by the Secretary.

C. The applicant shall provide the following information with the application as applicable:

(1) If the applicant is an individual and is sole owner of the hospice care program, the name and address of the applicant;

(2) If the applicant proposes to operate a facility providing inpatient hospice care services and someone other than the applicant owns the building or real property, or both, the name and address of the owner or owners;

(3) If the applicant is a partnership or limited partnership:

(a) The legal name of the partnership or limited partnership;

(b) Any trade name used by the partnership or limited partnership; and

(c) The name and address of each partner;

(4) If the applicant is a corporation:

(a) The name of the corporation;

(b) The date of incorporation;

(c) The state of incorporation;

(d) The name and address of each director;

(e) If the corporation is incorporated outside of the State, the name and address of the resident agent of the corporation;

(f) The name and address of each officer; and

(g) The name and address of any stockholder owning more than 5 percent of the stock of a corporate applicant;

(5) A statement that the applicant meets the requirements of Health-General Article, Title 19, Annotated Code of Maryland, and this chapter;

(6) The name of the individual who is to be the medical director of the hospice care program;

(7) The location and postal address of:

(a) The principal office of the proposed hospice care program;

(b) Any other office of the proposed hospice care program;

(c) Any facility providing inpatient hospice services to be operated by the hospice care program; and

(d) Any location where home-based hospice services are being provided in a residence owned or operated by the hospice; and

(8) A copy of the certificate of need determination from the Maryland Health Resources Planning Commission as required under §A of this regulation.

D. The Secretary:

(1) Shall deny or revoke a license if the applicant or licensee has been convicted of a felony involving Medicaid fraud or other activity involving a nursing home, or its residents; or

(2) May deny or revoke a license of the applicant or licensee who does not otherwise meet the requirements of this chapter.

E. A person aggrieved by the action of the Secretary under this regulation may appeal the Secretary's action by filing a request for a hearing in accordance with Regulation .28 of this chapter.