COMMON ERRORS IN COMPLETING 2As THAT CAUSE DELAYS IN PROCESSING CON APPLICATIONS January 25, 2011

Presented by: Office of Long Term Care Division of Assisted Living Bureau of Licensure and Certification Nursing Home Unit Guy Warner, Deputy Director of Division Paul Pflieger, Unit Director

NAMES Include maiden names in name change section If another name, such as a nickname or an Americanized version of a name is used, include an AKA with that name

LICENSES If no longer licensed, include reason why Nursing home administrators with late registration Include certificate of good standing for attorneys with the application

EMPLOYMENT Not indicating name of position, type of business, dates of employment Using initials for business names

FACILITIES/AGENCIES Incomplete listing of owned/operated facilities/agencies Must list all facilities/agencies that applicants had ownership interest in for last 10 years Facilities/agencies must list the name as it appears on the operating certificate List applications for ownership, don’t list ownership until transaction completed

OWNERSHIP VS EMPLOYMENT If a director and an owner, include information on both on separate lines in the section Differentiate between director/employee of the facility and a director of the ownership entity

BLANKS AS ANSWERS NEVER LEAVE BLANKS NEVER ACCEPTABLE If the question does not apply, use NA NEVER LEAVE BLANKS Answer every question with YES or NO or NA DO NOT LEAVE EMPTY CHECK BOXES

DISCREPENCIES WITHIN THE APPLICATION 2A facilities or business are different from listing on 2B-provide an explanation Differing name for facility in different parts of the application Differentiate between operational interest and real estate interest-especially on 2Bs

NON OR LATE REPONSES TO REQUESTS FOR ADDITONAL INFORMATION Respond within timeframe given If having difficulty getting information, ask for an extension Let the reviewer know the status of your response

OTHER/MISCELLANEOUS Information in application different than operating certificate If not purchasing all affiliated services/programs, list disposition

FOR ADDITIONAL INFORMATION Call 518-408-1624 Or by e-mail to: PHP02@health.state.ny.us