AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S RECOMMENDATIONS REGARDING REAL PROPERTY CHANGE OF OWNERSHIP.

House of Representatives
HB5512 / File No. 520 1

General Assembly File No. 520
February Session, 2026 House Bill No. 5512

House of Representatives, April 8, 2026

The Committee on Public Health reported through REP.
MCCARTHY VAHEY of the 133rd Dist., Chairperson of the
Committee on the part of the House, that the bill ought to pass.

AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S
RECOMMENDATIONS REGARDING REAL PROPERTY CHANGE OF
OWNERSHIP.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. Subsection (c) of section 19a-493 of the 2026 supplement to 1
the general statutes is repealed and the following is substituted in lieu 2
thereof (Effective October 1, 2026): 3
(c) (1) (A) For the purposes of this subsection, (i) "a person related by 4
blood or marriage" means a parent, spouse, child, brother, sister, aunt, 5
uncle, niece or nephew, (ii) "business entity" means a corporation, 6
association, trust, estate, partnership, limited partnership, limited 7
liability partnership, limited liability company, sole proprietorship, joint 8
stock company, nonstock corporation or other legal entity, (iii) 9
"institution" has the same meaning as provided in section 19a -490, and 10
(iv) "organizational chart" means a graphical representation of an 11
organization, including, but not limited to, the relationships between 12
such organization's ownership interests. 13
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(B) For the purposes of this subsection, (i) a change in the legal form 14
of the licensee, including, but not limited to, changes from a corporation 15
to a limited liability company, a partnership to a limited liability 16
partnership, a sole proprietorship to a corporation and similar changes, 17
shall not be considered a change in ownership if the beneficial 18
ownership remains unchanged and the owner provides such 19
information regarding the change to the department as may be required 20
by the commissioner to properly identify the current status of 21
ownership and beneficial ownership of the facility or institution, (ii) a 22
public offering of the stock of any corporation that owns, conducts, 23
operates or maintains any facility or institution shall not be considered 24
a change in ownership or beneficial ownership of such facility or 25
institution if the licensee and the officers and directors of such 26
corporation remain unchanged, such public offering cannot result in an 27
individual or entity owning ten per cent or more of the stock of such 28
corporation, and the owner provides such information to the 29
department as may be required by the department in order to properly 30
identify the current status of ownership and beneficial ownership of the 31
facility or institution, and (iii) a change of ownership of, or to, a business 32
entity recognized as a nonprofit organization under Section 501(c)(3) of 33
the Internal Revenue Code of 1986, or any subsequent corresponding 34
internal revenue code of the United States, as amended from time to 35
time, that is licensed as a hospital pursuant to this chapter resulting in 36
the transfer of ownership which is exempt from review required under 37
subsection (a) of section 19a -486a shall not be considered a change in 38
ownership provided the owner provides such information regarding 39
the change to the department as may be required by the commissioner 40
to properly identify the current status of ownership. 41
(C) For the purposes of this subsection, "serious risk to the life, safety 42
or quality of care of patients or residents" includes, but is not limited to, 43
any deficiency in state licensure or federal certification requirements, 44
including the provisions of 42 CFR 488.400 et seq., resulting in: 45
(i) An action by a state or federal agency to ban, curtail or temporarily 46
suspend admissions to a facility or to suspend or revoke a facility's 47
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license; 48
(ii) A decertification, termination or exclusion from Medicaid or 49
Medicare participation, including denial of payment for new 50
admissions resulting solely due to the provider's failure to correct 51
deficiencies or noncompliance with regulatory requirements, imposed 52
by the Department of Public Health or by the Centers for Medicare and 53
Medicaid Services, as a result of noncompliance with Medicaid or 54
Medicare conditions of participation; 55
(iii) A citation of any deficiency that constitutes a pattern or 56
widespread scope of actual harm or immediate jeopardy, or any 57
deficiency causing widespread actual harm, as described in 42 CFR 488; 58
(iv) A determination that the provider is a "poor performer" as 59
defined by the Centers for Medicare and Medicaid Services on the basis 60
of a finding of substandard quality of care or immediate jeopardy, as 61
described in 42 CFR 488, on the current survey and on a survey during 62
one of the two preceding years. For the purposes of this subparagraph, 63
"substandard quality of care" means the failure to meet one or more 64
requirements of 42 CFR 483.13, 42 CFR 483.15 or 42 CFR 483.25, that 65
constitute either immediate jeopardy to resident health or safety, a 66
pattern of or widespread actual harm that is not immediate jeopardy or 67
a widespread potential for more than minimal harm, but less than 68
immediate jeopardy, with no actual harm; or 69
(v) A determination that the facility has failed to correct, on a second 70
revisit, deficiencies that have been cited during a prior survey, and that 71
has resulted in a denial by the Centers for Medicare and Medicaid 72
Services of payment for new admissions or a requirement by the 73
department to curtail admission. 74
(2) Any change in the ownership or beneficial ownership of a facility 75
or institution owned by an individual or a business entity that owns, 76
conducts, operates or maintains such facility or institution, including a 77
change in ownership or beneficial ownership resulting in a transfer to a 78
person related by blood or marriage to an owner or a beneficial owner, 79
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shall be subject to prior approval of the department, provided such 80
approval shall be conditioned upon a showing by such facility or 81
institution to the commissioner that it has complied with all 82
requirements of this chapter, the regulations relating to licensure and all 83
applicable requirements of the regulations of Connecticut state agencies 84
and the change of ownership or beneficial ownership meets the 85
requirements of subdivision (5) of subsection (c) of this section. 86
(3) Not later than one hundred twenty days before the proposed date 87
of a change in ownership or beneficial ownership of a facility or 88
institution, the proposed new owner, or in the case of a change in 89
beneficial ownership, the current owner, of such facility or institution 90
shall submit an application for approval to the department. Such 91
application shall be in a form and manner prescribed by the 92
commissioner and shall include, but need not be limited to, the 93
following: 94
(A) A cover letter identifying the facility or institution subject to such 95
change by name, address, county and number and type of beds licensed 96
by the department; 97
(B) A description of the proposed transaction resulting in such 98
change, including the name of each current owner of the facility or 99
institution; 100
(C) The name of each (i) proposed new owner or beneficial owner of 101
the facility or institution, and (ii) owner, proposed owner or beneficial 102
owner of the real property where the facility or institution is located; 103
(D) The name of each owner of any nonpublicly traded parent 104
corporation of each proposed new owner and beneficial owner; 105
(E) If applicable, (i) the proposed new owner's organizational chart, 106
(ii) the proposed new owner's parent business entity's organizational 107
chart, (iii) the organizational chart of each wholly -owned subsidiary of 108
such proposed new owner, and (iv) the current owner's organizational 109
chart showing the changes in beneficial ownership; 110
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(F) A copy of the agreement of sale or other transfer of ownership 111
interests and, if applicable, a copy of any lease or management 112
agreements that will be in effect after the transaction; 113
(G) The name and address of any licensed health care facility owned, 114
operated or managed by each proposed new owner , [and] proposed 115
new beneficial owner, proposed new real property owner or proposed 116
new beneficial owner of the real property in the United States or any 117
territory of the United States during the five years preceding the date on 118
which such application is submitted, and information relating to any 119
such facility, including: 120
(i) Disclosure of any direct or indirect interests, including such 121
interests in intermediate entities and parent, management and property 122
companies and other related entities arising from such ownership, 123
operation or management; 124
(ii) Disclosure of whether each such facility or institution is the 125
subject of a pending complaint, investigation or licensure action by a 126
governmental authority; 127
(iii) Disclosure of whether each such facility or institution has been 128
subject to: 129
(I) Three or more civil penalties imposed through final order of the 130
commissioner in accordance with the provisions of sections 19a -524 to 131
19a-528, inclusive, or civil penalties imposed pursuant to the laws or 132
regulations of another state during the two -year period preceding the 133
date on which such application is submitted; 134
(II) Sanctions, other than civil penalties less than or equal to twenty 135
thousand dollars, imposed in any state through final adjudication under 136
the Medicare or Medicaid program pursuant to Title XVIII or XIX of the 137
federal Social Security Act, 42 USC 301, as amended from time to time; 138
(III) Termination or nonrenewal of a Medicare or Medicaid provider 139
agreement; 140
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(IV) Any state licensing or federal certification deficiency during the 141
five-year period prior to the submission of the application that 142
presented a serious risk to the life, safety or quality of care of the 143
facility's patients or residents; and 144
(V) Any violation of any state licensing or federal certification 145
standard in connection with an inappropriate discharge or denial of 146
admission; and 147
(H) Disclosure of whether each proposed new owner has ever been 148
convicted or pleaded guilty to a charge of fraud, patient or resident 149
abuse or neglect or a crime of violence or moral turpitude. 150
(4) After receiving an application for change in ownership, the 151
commissioner may schedule an inspection of such facility or institution 152
to determine if the facility or institution has complied with the 153
requirements of this chapter and the regulations of Connecticut state 154
agencies relating to licensure of such facility or institution. 155
(5) When evaluating an application for a change in ownership, the 156
commissioner shall consider whether each proposed new owner , [and] 157
beneficial owner and real property owner demonstrates character and 158
competence, quality of care and whether an acceptable history of past 159
and current compliance with state licensure requirements, applicable 160
federal requirements and state regulatory requirements exists for each 161
licensed health care facility owned, operated or managed by each 162
proposed new owner , [and] beneficial owner and real property owner 163
in the United States or any territory of the United States during the five 164
years preceding the date on which such application is submitted. The 165
commissioner may deny an application for change in ownership if such 166
qualities are not demonstrated, as evidenced by: 167
(A) Any such licensed health care facility being subject to any adverse 168
action described in subparagraph (G)(iii) of subdivision (3) of this 169
subsection; 170
(B) Any such licensed health care facility exhibiting continuing 171
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violations or a pattern of violations of state licensure standards or 172
federal certification standards; or 173
(C) An applicant's criminal conviction of, or guilty plea to, any of the 174
crimes described in subparagraph (H) of subdivision (3) of this 175
subsection. 176
(6) Notwithstanding the provisions of subdivision (5) of this 177
subsection, the commissioner may stay the determination of an 178
application if the commissioner determines that there is a pending 179
investigation of actions of the applicant at any facility operated or 180
managed by the applicant that, if substantiated, would constitute a 181
threat to the life, safety or quality of care of the patients or residents until 182
such time as there is a final determination of the allegations underlying 183
the investigation. 184
(7) If the commissioner denies an application for change in 185
ownership, a person related by blood or marriage to the applicant may 186
not apply to acquire ownership interest in the facility or institution. 187
(8) In the event of a change in ownership or beneficial ownership 188
resulting in a transfer to a person related by blood or marriage to an 189
owner or beneficial owner, the commissioner may waive the submission 190
of information required pursuant to the provisions of subparagraph (G) 191
of subdivision (3) of this subsection. In the event of a change in 192
ownership or beneficial ownership of five per cent or less of the 193
ownership of a business entity that is a licensed institution, the 194
commissioner may waive the submission of some or all of the 195
information required pursuant to the provisions of subdivision (3) of 196
this subsection or the determination required pursuant to subdivision 197
(5) of this subsection. The commissioner shall develop an application 198
process through which a person may request a waiver described in this 199
subdivision and criteria to be used by the commissioner when 200
evaluating such a request. The commissioner shall consult with 201
representatives of the long -term care industry when developing such 202
application process and criteria. 203
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(9) The provisions of this subsection shall not apply in the event of a 204
change of ownership or beneficial ownership of ten per cent or less of 205
the ownership of a licensed outpatient surgical facility, as defined in 206
section 19a-493b, resulting in a transfer to a physician licensed under 207
chapter 370 if such facility provides information, in a form and manner 208
prescribed by the commissioner, to update such facility's licensing 209
information. 210
(10) The commissioner may waive the submission of information 211
related to the real property owner required pursuant to subdivision (3) 212
of this subsection or the determination required pursuant to subdivision 213
(5) of this subsection if the proposed new owner demonstrates that the 214
proposed real property owner will have no involvement in the 215
management or operation of the nursing home. In making the 216
determination as to whether to grant such waiver, the commissioner 217
may consider the terms of the lease between the proposed new owner 218
and the proposed real property owner, the proposed real property 219
owner's lack of history with the ownership or management of a nursing 220
home and any other information the commissioner deems relevant. 221
This act shall take effect as follows and shall amend the following
sections:

Section 1 October 1, 2026 19a-493(c)

PH Joint Favorable

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The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of
the General Assembly, solely for purposes of information, summarization and explanation and do not
represent the intent of the General Assembly or either chamber thereof for any purpose. In general,
fiscal impacts are based upon a variety of informational sources, including the analyst’s professional
knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final
products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note

State Impact: None
Municipal Impact: None
Explanation
The bill makes procedural changes to the Department of Public
Health's approval process to change a licensed institution's ownership,
resulting in no fiscal impact.

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OLR Bill Analysis
HB 5512

AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S
RECOMMENDATIONS REGARDING REAL PROPERTY CHANGE
OF OWNERSHIP.

SUMMARY
This bill requires applicants for the Department of Public Health’s
(DPH) approval to change a licensed institution’s ownership to give
DPH the name of the real property’s owner, proposed owner, or
beneficial owner and certain information about that owner’s regulatory
compliance history and related matters, for DPH to consider in its
review.
The bill allows DPH to waive these requirements for nursing homes
if the property owner will not be involved in the home’s management
or operation. It also extends to these requirements DPH’s existing
authority, under narrow conditions, to waive required disclosures or
related determinations for any type of health care institution.
EFFECTIVE DATE: October 1, 2026
REAL PROPERTY OWNERS IN HEALTH CARE OWNERSHIP
CHANGES
Required Disclosures
Existing law generally subjects transfers of ownership or beneficial
ownership of DPH -licensed health care institutions (such as hospitals,
nursing homes, and behavioral health facilities) to prior approval by the
department. Certain types of transactions are exempt, such as a change
in a licensee’s legal form of ownership that does not change the
beneficial ownership.
Under the bill, in its application, the facility’s proposed new owner
(or current owner, for changes in beneficial ownership) must identify
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the owner, proposed owner, or beneficial owner of the real property
where the institution is located.
Existing law requires the application to also include (1) the name and
address of any U.S. -based (including territories) licensed health care
facility that each of the proposed new owners or beneficial owners
owned, operated, or managed during the prior five years and (2) several
related disclosures. The bill extends these requirements to include
facilities owned, operated, or managed by the real property’s proposed
new owner or beneficial owner.
The required disclosures include (1) any interest arising from the
person’s ownership, operation, or management of these facilities and (2)
whether each facility is currently subject to a government complaint,
investigation, or licensure action. The disclosures also must include
whether each facility has been subject to various disciplinary sanctions,
such as:
1. three or more civil penalties imposed through DPH final orders
or civil penalties in other states during the prior two years;
2. termination or nonrenewal of a Medicare or Medicaid provider
agreement; and
3. any state licensure or federal certification deficiency, during the
prior five years, that presented a serious risk to the life, safety, or
quality of care of the facility’s patients or residents (the law sets
out several examples of these serious risks, s uch as deficiencies
that led to a state or federal agency suspending or revoking the
facility’s license).
Grounds to Deny an Application
Existing law requires the DPH commissioner, when evaluating an
ownership change application, to consider whether each of the facility’s
proposed new owners and beneficial owners demonstrates character
and competence and quality of care. She must also consider whether the
U.S.-based licensed facilities they owned, operated, or managed have an
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acceptable history of compliance in the past five years with (1) state
licensure and regulatory requirements and (2) federal requirements.
The bill extends these requirements to the real property owner and
the facilities they owned, operated, or managed. In doing so, it allows
the commissioner to deny an application if the real property owner
owned, operated, or managed a facility that (1) was subject to any
adverse action required to be listed in the application or (2) had
continuing violations of state licensure or federal certification standards
or a pattern of these violations.
Permissible Waivers
Nursing Homes. The bill allows DPH to waive these requirements
for nursing homes if the property owner will not be involved in the
home’s management or operation. In deciding whether to grant the
waiver, DPH may consider the terms of the lease between the parties,
the p roperty owner’s lack of history in owning or managing nursing
homes, and anything else the commissioner deems relevant.
All Institution Types. The bill extends to its requirements the
existing authority for DPH to waive the submission of information or
the department’s required determinations.
Under these provisions, for certain transfers involving relatives, the
commissioner may waive the requirement to submit information on
other health care facilities they owned or operated during the past five
years. For changes of 5% or less of a licensed institution’s ownership or
beneficial ownership, she may waive the (1) submission of some or all
of the informa tion required or (2) determination as to the owner’s
character, competence, and history of regulatory compliance.
COMMITTEE ACTION
Public Health Committee
Joint Favorable
Yea 31 Nay 1 (03/23/2026)