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

2. 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

3. 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

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

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

6. 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

7. 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

8. 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

9. 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

10. 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

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

12. FOR ADDITIONAL INFORMATION
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