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Long-Term Care (LTC) Change of Ownership (CHOW)

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The following documentation must be completed to support a long-term care (LTC) change of ownership (CHOW) request:

  1. A new Provider Enrollment and Management System (PEMS) enrollment application
  2. An organizational chart
  3. Tax filing documentation (i.e., an assumed name certificate, a franchise tax account, and a certificate of filing/incorporation) if applicable
  4. “Yes” answers to the following questions on the Ownership/Controlling Interest page in PEMS:
  • Have there been any changes of ownership or control within the past 5 years, as defined in Title 42 Code of Federal Regulations (CFR) §489.18?
  • Are you seeking enrollment due to change of ownership?
  1. A bill of sale or lease agreement
  2. A letter by the Centers for Medicare and Medicaid Services (CMS) that acknowledges the CHOW or a CMS tie-in notice for the acquisition or merger. The initial CMS acknowledgement letter that provides a recommendation of approval can be submitted, but the application will require additional approval by the Texas Health and Human Services Commission (HHSC) through a waiver process.

Note: This documentation is required only when enrolling with approved Medicare information. Medicare enrollment is not a prerequisite for LTC.