1. A. Required Annual Reports and Statements. Each section 556 related institution shall submit annually to the Commission, within 90 days after the close of the related institution's annual accounting period (fiscal year), the following reports and statements as specified in Section III of Accounting and Reporting System for Related Institutions:

   1. (1) A balance sheet (Schedule D);
   2. (2) A statistical, cost finding and revenue analysis report (Schedules A, B, and G);
   3. (3) A profit and loss statement (Schedule C);
   4. (4) Statements of selected data related to owners and related organizations (Schedules E and F);
   5. (5) Certification (Schedule H);
   6. (6) A statement of its dealings and relationships with certain entities.

2. B. Report Formats.

   1. (1) The required report and statement formats to be used by section 556 related institutions when submitting the annual reports and statements required by §A, of this regulation, are those presented in the Commission's “Accounting and Reporting System for Related Institutions,” except for the statement required under §A(6), of this regulation.
   2. (2) Nonprofit related institutions shall file a verified statement pursuant to §A(6), of this regulation, setting forth the following information in substantially the following form: "We, the undersigned, the Chairman of the Board of Trustees and the Chief Administrative or Executive Officer of _________________ (name of related institution) hereby certify that to the best of our knowledge, information and belief, _____________________ has transacted business which had an (related institution actual or imputed value or worth or $10,000 or greater or which entailed contract prices, consideration or other advances by the related institution in the amount of $10,000 or greater during _______________________ with the following firms or businesses, of (fiscal year period) which the related institution's Board of Trustees are employees, partners, directors, officers or beneficial owners of 3 percent or more of the capital account or stock of the firm or business: Trustee Affiliated firm Nature of Amount in and type or title transaction dollars of affiliation __________________________________ (name and title of chairman) __________________________________ (name and title of chief executive or administrative officer) __________________________________ (name of related institution)
   3. (3) Proprietary related institutions shall file a verified statement pursuant to §A(6) setting forth the following information in substantially the following form: "We, the undersigned, the chief executive officer and the chief administrative or financial officer of ___________________________ (name of related institution) hereby certify that, to the best of our knowledge, information and belief, _______________________, has transacted business which had (name of related institution) an actual or imputed value or worth of $5,000 or greater which entailed contract prices, consideration or other advances by the related institution in the amount of $5,000 or greater during ____ (fiscal year period) with the following firms or organizations whose employees, partners, directors, officers or beneficial owners of 3 percent or more of the capital account or stock therein are also officers, directors, or beneficial owners of 10 percent or more of the capital account or stock of ______________________________________ (name of related institution) Related institution Affiliated firm Nature of Amount in owner, director or and type or title transaction dollars officer of affiliation ____________________________________ (name of chief executive officer) ____________________________________ (name and title of chief administrative or financial officer) ____________________________________ (name of related institution).

3. C. Failure to File Reports.

   1. (1) Any section 556 related institution which does not file any report or statement required herein is liable for a civil penalty of $100 per day for each day the filing of the report or statement is delayed unless an extension is granted as provided in §D of this regulation.
   2. (2) This penalty may not be considered a part of reasonable costs for purposes of rate setting by the Commission.

4. D. Requests for Extension of Time to File Required Reports or Statements.

   1. (1) Any section 556 related institution may file with the Commission written requests for reasonable extensions of time to file any or all of the required reports or statements.
   2. (2) The requests for extensions shall be supported by justification for the approval of the extension requests.
   3. (3) The Executive Director shall respond promptly in writing to the requesting related institution upon receipt of the requests by either approving or disapproving the requests.
   4. (4) If needed for evaluation of any request, the Executive Director will seek additional information from the requesting related institution.

5. E. Review of Denial of Request for Extension.

   1. (1) Any related institution denied an extension of time under §D may file a written petition with the Commission for a hearing to review the action of the Executive Director in refusing its request for extension.
   2. (2) A petition for a hearing to review the Executive Director's action shall be filed with the Commission within 15 days of the date on which the related institution aggrieved was notified in writing of the action with respect to the requested extension and shall state the grounds for the petition.
   3. (3) A hearing on the petition, at which the petitioner may be represented by counsel, shall be held within 30 days of the date on which the petition was filed, before a review subcommittee composed of three members of the Commission chosen by the Chairman for this purpose.
   4. (4) The review subcommittee shall consist of at least two persons who have no connection with the management or policy of any hospital or related institution.
   5. (5) Promptly after the hearing, the subcommittee shall report to the Commission, which shall make its decision within 45 days after the date of the submission of the petition to review.
   6. (6) The decision of a majority of the Commission, which shall be rendered in the form of a written decision filed in the Commission's office, shall be final, subject to the right of review in accordance with Health-General Article, §19-221, Annotated Code of Maryland.

6. F. Stay of Charges.

   1. (1) Unless the Commission reverses the action of the Executive Director, the filing of a petition pursuant to §E may stay the continued accrual of the charges levied under §C against a related institution which fails to meet the deadline for filing reports or statements required in these regulations.
   2. (2) In cases where the Commission affirms the action of the Executive Director, the penalties which accrued during the appeal may be suspended or reduced by the Commission.

Authority: Health-General Article, §§19-207, 19-215, and 19-303,Annotated Code of Maryland

Effective date: April 24, 1973

Regulation .01B, C, E, F, J, and K adopted effective September 19, 1974 (1:1 Md. R. 17)

Regulation .03 amended effective July 28, 1978 (5:15 Md. R. 1189)

Regulation .03A, C amended effective May 4, 1979 (6:9 Md. R. 728)

Regulation .03D amended effective October 29, 1975 (2:24 Md. R. 1481); May 11, 1977 (4:10 Md. R. 767)

Regulation .03D, E amended effective April 7, 1978 (5:7 Md. R. 522)

Regulation .03H amended effective August 18, 1976 (3:17 Md. R. 915); August 31, 1977 (4:18 Md. R. 1398); July 28, 1978 (5:15 Md. R. 1189); December 29, 1978 (5:26 Md. R. 1922); May 4, 1979 (6:9 Md. R. 728)

Regulation .03I adopted effective August 18, 1976 (3:17 Md. R. 915)

Regulation .03J adopted effective July 28, 1978 (5:15 Md. R. 1189); December 29, 1978 (5:26 Md. R. 1922); May 4, 1979 (6:9 Md. R. 728)

Regulations .04 and .05 effective April 29, 1973

Regulation .05G amended as an emergency provision effective December 23, 1976 (4:2 Md. R. 73)

Regulation .06 adopted effective September 19, 1974 (1:1 Md. R. 17)

Regulation .07 adopted effective April 7, 1978 (5:7 Md. R. 522)

Regulations .01—.03 amended effective October 3, 1980 (7:20 Md. R. 1879)

Regulation .01A amended effective December 14, 1987 (14:25 Md. R. 2660)

Regulation .02 amended effective December 14, 1987 (14:25 Md. R. 2660); May 29, 1989 (16:10 Md. R. 1109); April 5, 1999 (26:7 Md. R. 543)

Regulation .02A amended effective January 8, 1990 (16:26 Md. R. 2793); February 4, 1991 (18:2 Md. R. 149); January 6, 1992 (18:26 Md. R. 2830); August 30, 1993 (20:17 Md. R. 1346); January 2, 1995 (21:26 Md. R. 2188); May 6, 1996 (23:7 Md. R. 553); April 7, 1997 (24:7 Md. R. 553); May 4, 1998 (25:9 Md. R. 680); April 5, 1999 (26:7 Md. R. 543); March 6, 2000 (27:4 Md. R. 454); July 9, 2001 (28:13 Md. R. 1216); September 30, 2002 (29:19 Md. R. 1524); March 29, 2004 (31:6 Md. R. 509); August 1, 2005 (32:15 Md. R. 1321); April 10, 2006 (33:7 Md. R. 673); June 4, 2007 (34:11 Md. R. 971); May 18, 2009 (36:10 Md. R. 717); April 5, 2010 (37:7 Md. R. 571); June 27, 2011 (38:13 Md. R. 756); July 9, 2012 (39:13 Md. R. 785); April 14, 2014 (41:7 Md. R. 422); December 21, 2015 (42:25 Md. R. 1543); August 13, 2018 (45:16 Md. R. 775); March 9, 2020 (47:5 Md. R. 311); February 8, 2021 (48:3 Md. R. 94); December 11, 2023 (50:24 Md. R. 1042); November 25, 2024 (51:23 Md. R. 1036); April 14, 2025 (52:7 Md. R. 323)

Regulation .03 amended effective July 1, 1985 (12:13 Md. R. 1279); December 10, 2001 (28:24 Md. R. 2128); October 5, 2009 (36:20 Md. R. 1529)

Regulation .03 amended as an emergency provision effective January 1, 2014 (41:2 Md. R. 89); amended permanently effective April 14, 2014 (41:7 Md. R. 422)

Regulation .03 amended effective August 4, 2014 (41:15 Md. R. 890)

Regulation .03D, E amended effective November 30, 2009 (36:24 Md. R. 1858)

Regulation .03F repealed effective January 1, 1983 (9:16 Md. R. 1605)

Regulation .03H amended effective January 1, 1984 (10:15 Md. R. 1351); October 10, 1994 (21:20 Md. R. 1732); February 12, 2007 (34:3 Md. R. 299)

Regulation .03H, L amended effective August 3, 1981 (8:15 Md. R. 1308); November 19, 1984 (11:23 Md. R. 1992); July 1, 1985 (12:13 Md. R. 1279); March 10, 1986 (13:5 Md. R. 545)

Regulation .03H, L amended as an emergency provision effective May 25, 1986 (13:12 Md. R. 1372); emergency status expired September 16, 1986

Regulation .03H, L amended effective November 3, 1986 (13:22 Md. R. 2399); December 15, 1986 (13:25 Md. R. 2660); December 28, 1987 (14:26 Md. R. 2747); September 4, 1989 (16:17 Md. R. 1886); April 27, 1992 (19:8 Md. R. 805)

Regulation .03I repealed effective February 13, 2006 (33:3 Md. R. 241)

Regulation .03K amended as an emergency provision effective April 1, 2003 (30:8 Md. R. 538); amended permanently effective July 7, 2003 (30:13 Md. R. 854)

Regulation .03K amended effective June 6, 2005 (32:11 Md. R. 983)

Regulation .03L amended effective February 13, 2006 (33:3 Md. R. 241)

Regulation .03L-1, L-2 adopted effective March 8, 1999 (26:5 Md. R. 391)

Regulation .03L-1 amended effective November 15, 2010 (37:23 Md. R. 1610)

Regulation .03L-3 adopted effective June 9, 2003 (30:11 Md. R. 735)

Regulation .03L-5 adopted effective January 13, 2011 (38:1 Md. R. 11)

Regulation .03M amended effective November 11, 2024 (51:22 Md. R. 963)

Regulation .03N amended as an emergency provision effective September 2, 1991 (18:19 Md. R. 2095); emergency status expired February 3, 1992

Regulation .03N amended effective January 6, 1992 (18:26 Md. R. 2830); March 8, 1999 (26:5 Md. R. 391); March 4, 2013 (40:4 Md. R. 346)

Regulation .06D amended effective March 4, 2013 (40:4 Md. R. 346)

Regulation .06I adopted effective June 30, 1986 (13:13 Md. R. 1492)

Regulation .06I amended effective August 13, 2007 (34:16 Md. R. 1432)

Regulation .08 adopted effective January 6, 1992 (18:26 Md. R. 2830)

Regulation .08A, B amended effective September 14, 2015 (42:18 Md. R. 1174)