The Approvalign® process is multi-phased and starts with identifying the states involved in a transaction and assigning a member of the Approvalign® team to each state and ends with the issuance of the licenses and/or licensure approvals needed to own and/or operate the facility or facilities involved in the deal.

The phases of the process involve, among other things, the following:

• Analyzing the implications of a transaction under the applicable licensure statutes and regulations on a state by state basis.

• Developing strategies where needed to minimize the need to obtain licensing approvals and/or to close the transaction pending receipt of required licensure approvals.

• Securing written confirmation where no licensure approvals are needed.

• Completing health care (i.e., assisted living, skilled nursing, and/or continuing care) licensure and ancillary license and permit (such as food permits, boiler permits, CLIA waivers, business licenses, salon permits, certificates of occupancy) application forms where licensure approvals are needed.

• Arranging for fire marshal and other inspections of the facilities where needed as part of securing the required licensure approvals.

• Preparing and filing foreign qualification and assumed business name filings and ensuring that, where required, they are consistent with the licensure applications being submitted.

• Working with the client to develop resident agreements and policies and procedures that comply with state law.

• Working closely with the client and the regulators to timely address and resolve any questions and/or concerns that may arise during the course of the licensure process.

• Reviewing/revising the legal documents involved in the transaction, including the purchase and sale agreement, loan documents, management agreement, and/or interim operating agreements, to accurately reflect the licensure process/requirements of each state.

• Providing needed licensure opinions.

• Submitting required documentation to secure Medicare and/or Medicaid tie in notices and/or new provider agreements.

The success of the Approvalign® process is built on relationships with the regulators, unwavering attention to detail, and in-depth knowledge of the long term care and senior housing industries. Our Approvalign® team members help to round out any senior housing transaction team with the knowledge and experience they bring to address the licensure aspects of a transaction.

The success of the Approvalign® process is also attributable to the use of a proprietary database, known as Approvatrack®, which allows us to streamline the process of preparing the required licensure and ancillary permit applications electronically rather than manually. Approvatrack® also provides a centralized place to monitor the status of in-process and pending licensure, ancillary permit applications, licensure legal opinions, and to maintain a master database of licensure information (see below).

In addition to the foregoing transaction-specific steps, on an ongoing basis, the members of the Approvalign® team update the information maintained in Approvatrack®. The information housed in the Approvatrack® database includes, but is not limited to, the following:

• Each state’s current health care and/or ancillary permit licensure rules and regulations.

• A complete set of application materials by state.

• Samples of the notices to residents and/or the regulators required for different types of transactions by state.

• Sample application cover letters.

• Sample “No CHOW” confirmation letters.

• Information on a state’s requirements and/or position on various licensure matters and, if relevant, how they have been addressed in prior transactions.

• Information that will help predict how a state will analyze a transaction from a change of ownership (CHOW)/No CHOW perspective.

• The names and contact information for the reviewers in each state.

• The names and contact information of local counsel available to provide assistance with a CHOW if and as needed.

• Notes on how a particular reviewer might prefer to see an issue handled.

• Each state’s ownership disclosure requirements which, among other things, can be key to the structuring of a transaction.

• The roadblocks and/or impediments encountered that can affect the structuring and/or timing of a transaction.

• Information on past transactions, including links to the applications filed, licenses received, and legal opinions given in the transaction.

The Lane Powell Approvalign® team works closely with the Lane Powell Health Care Transactions team to seamlessly meet the licensure and transactional needs of Lane Powell’s health care clients.