Section 23-93-207 - ApplicationThe application for a license shall contain the following documents and information:
(1)(A) An appointment of an Arkansas resident to serve as the registered agent for the provider shall be filed with the State Insurance Department. Thereafter, the registered agent shall be authorized to receive service of any lawful process in any proceeding arising under this subchapter against the provider or his or her agents.(B) On and after January 1, 2003, all licensed life care providers shall file with the Insurance Commissioner a designation of an Arkansas resident as an agent for service of legal process, and the commissioner shall maintain a listing in conformity with § 23-63-301 et seq.;(2) The states or other jurisdictions, including the federal government, in which an application for certification or similar documents for the subject facility have been or will be filed and any order, judgment, or decree entered in connection therewith by the regulatory authorities in each of the jurisdictions or by any court or administrative body thereof;(3) The names and business addresses of the officers, directors, trustees, managing or general partners, and any person having a ten percent (10%) or greater equity or beneficial interest in the provider and a description of that person's interest in or occupation with the provider;(4)(A) Copies of: (i) The articles of incorporation, with all amendments thereto, if the provider is a corporation;(ii) All instruments by which the trust is created or declared, if the provider is a trust; and(iii) The articles of partnership or association and all other organization papers, if the provider is organized under another form.(B) In the event the provider is not the legal title holder to the property upon which the facility is or is to be constructed, the documents listed in subdivision (4)(A) of this section shall be submitted for both the provider and the legal title holder;(5)(A) A legal description by metes and bounds or other acceptable means of the lands to be certified and the relationship of such lands to existing streets, roads, and other improvements, together with a map showing the proposed or actual facility and the dimensions of the living units as available, except for living units that are completed and available for inspection.(B) The map shall be drawn to scale, signed, and sealed by a professional engineer as defined in § 17-30-101 or a professional surveyor as defined in § 17-48-101;(6) Copies of the deed or other instrument establishing title of the provider and a title search, title report, or title certificate, or a binder or policy issued by a licensed title insurance company;(7) A statement concerning any litigation, orders, judgments, or decrees which might affect the offering;(8) A statement that the life care agreements will be offered to the public and entered into without regard to marital status, sex, race, creed, or national origin or, if not, any legally permissible restrictions on purchase that will apply;(9) A statement of the present conditions of physical access to the facility and the existence of any material adverse conditions that affect the facility that are known, should be known, or are readily ascertainable;(10) Copies of all contracts and agreements which the resident may be required to execute;(11) In the event there is or will be a blanket encumbrance affecting the facility or a portion thereof, a copy of the document creating it and a statement of the consequences upon a resident of a failure of the person bound to fulfill the obligations under which the instrument and the manner in which the interest of the resident is to be protected in the event of such an eventuality;(12) One (1) copy of the proposed disclosure statement required under § 23-93-106;(13) A current financial statement of the provider and any related predecessor, parent, or subsidiary company, including, but not limited to, a current profit and loss statement and balance sheet audited by an independent public accountant;(14) A statement concerning any adjudication of bankruptcy during the last five (5) years against the provider, its predecessor, parent, or subsidiary company, and any principal owning more than ten percent (10%) of the interests in the facility at the time of the filing of the application for certification. This requirement shall not extend to limited partners or those whose interests are solely those of investors;(15) Copies of all easements and restrictions, whether of record or not;(16) A statement as to the status of compliance with all the requirements of all laws, ordinances, and regulations of governmental agencies having jurisdiction over the construction, permitting, and licensing of the facility, together with copies of all necessary federal, state, county, and municipal approvals;(17) A statement that neither the provider nor any of its officers or principals have ever been convicted of a crime in this state or a foreign jurisdiction and that the provider has never been subject to any permanent injunction or final administrative order restraining a false or misleading promotional plan involving continuing care facility disposition or, if so, copies of all pleadings and orders in regard thereto;(18) A projected annual budget for the facility for the next five (5) years or such lesser time as the department allows;(19) Copies of market studies, if any, prepared on behalf of the provider concerning the feasibility of the project;(20) An affidavit signed by the provider that the contents of the application are true and accurate and made in good faith; and(21) Such other additional information as the department may require in individual cases after review of an application for certification to assure full and fair disclosure.Acts 1993, No. 787, § 6; 2001, No. 1604, § 118; 2005, No. 1178, § 16; 2011, No. 897, § 18; 2011, No. 898, § 8.