(A) Each of the following, in and of itself, constitutes full and adequate ground for deeming an applicant or licensee neither suitable nor responsible to establish or maintain a long-term care facility:

1. (1) The applicant or licensee has failed to demonstrate legal capacity, as demonstrated by such documents as articles of incorporation, to provide the services for which a license is sought.
2. (2) The applicant or licensee has acted in a manner resulting in jeopardy to the health, safety or welfare of residents of any health institution or facility.
3. (3) The applicant or licensee has prevented or attempted to impede the work of any duly authorized representative of the Department or the lawful enforcement of any provision of M.G.L. c. 111 or regulations promulgated thereunder.
4. (4) The applicant plans to assume or has assumed ownership of a long-term care facility in an effort to circumvent the effect and purpose of 105 CMR 153.000.
5. (5) The applicant or licensee does not have sufficient financial resources to provide services required by state and federal regulations and/or the financial management of one or more facilities for which an applicant or licensee was licensed has resulted in the filing of a petition for bankruptcy related to the financial solvency of the facility or has otherwise resulted in a lack of sufficient financial resources to provide services required by state and federal regulations.
6. (6) A facility operated by the applicant or licensee or a facility in which the applicant or licensee owns a 50% or greater interest or acts as a corporate officer or member of the board of directors has been the subject of proceedings that resulted in the suspension, denial or revocation of the license or renewal license of the facility or has been the subject of proceedings that resulted in the denial, cancellation or revocation of the medicaid certification of the facility.

7. (7) The applicant or licensee has maintained a substandard level of care, as measured by compliance with applicable licensing regulations in Massachusetts or elsewhere, with applicable federal conditions of participation in Medicare and Medicaid and other pertinent evidence, in any institution for which the applicant or licensee has been a licensee in Massachusetts or elsewhere.

   1. (a) The serious violation of applicable regulations shall constitute the maintenance of a substandard level of care.

   2. (b) For purposes of 105 CMR 153.012(A)(7), the following factors will be considered in determining whether a violation of applicable regulations is “serious”.

      1. 1. The extent of any violation including, but not limited to:

         1. i. the number of residents affected;
         2. ii. the length of time the violation persists; and
         3. iii. the frequency of the violation.

      2. 2. The actual or potential impact of any violation on residents of the facility. Violation of regulations in the following areas will be presumed to have an adverse impact upon residents:

         1. i. residents' rights;
         2. ii. nursing services; medication and diet;
         3. iii. resident comfort;
         4. iv. resident cleanliness and grooming;
         5. v. resident safety;
         6. vi. use of restraints;
         7. vii. sanitation;
         8. viii. linen supply;
         9. ix. resident abuse, mistreatment or neglect; or
         10. x. misappropriation of resident property.

(B) Factors that have a significant bearing on the suitability and responsibility of an applicant or licensee include, but are not limited to:

1. (1) The applicant or licensee has failed to demonstrate competence and experience in operating a long-term care facility.
2. (2) The applicant or licensee has failed to report patient or resident abuse, mistreatment or neglect to the Department as required under M.G.L. c. 111, § 72(G).
3. (3) The applicant or licensee has been convicted of, pleaded guilty to, or has, in a judicial proceeding, admitted facts sufficient for a finding that he or she is guilty of, any felony.
4. (4) The Attorney General has filed an action in any court concerning conditions in any health care facility for which the applicant or licensee was licensed, if that lawsuit resulted in an order or judgment against the applicant or licensee granting damages or any form of equitable relief, including an injunction.
5. (5) A facility owned or operated by the applicant or licensee has been the subject of proceedings that were ultimately resolved by settlement agreement but that were initiated to suspend, deny or revoke the license or renewal license or to deny, cancel or revoke the Medicaid certification of the facility.
6. (6) The applicant or licensee has obtained or attempted to obtain a license by fraud or misrepresentation or by submitting false information.
7. (7) The applicant or licensee has employed in a management or supervisory position a person whom a hearing officer has determined, pursuant to 105 CMR 153.018, to be unsuitable or not responsible to establish or maintain a long-term care facility.
8. (8) The applicant's or licensee's license or certificate of registration as a nursing home administrator has been suspended, revoked or denied.
9. (9) A facility owned or operated by the applicant or licensee has been the subject of proceedings that resulted in the suspension, denial or revocation of the license or renewal license of the facility or has been the subject of proceedings that resulted in the denial, cancellation or revocation of the medicaid certification of the facility.