§ 23-2-4-4 — Initial disclosure statement; contents

The initial disclosure statement shall contain the
following information:
(1) The name and business address of the provider.
(2) If the provider is a partnership, corporation, limited liability
company, or association, the names and duties of its officers,
directors, trustees, partners, members, or managers.
(3) The name and business address of any person having a five
percent (5%) or greater ownership interest in the provider or
manager of the continuing care retirement community.
(4) A description of the business experience of the provider and
its officers, directors, trustees, partners, or managers.
(5) A statement as to whether the provider or any of its officers,
directors, trustees, partners, or managers, within ten (10) years
prior to the date of the initial disclosure statement:
(A) was convicted of a crime;
(B) was a party to any civil action for fraud, embezzlement,
fraudulent conversion, or misappropriation of property that
resulted in a judgment against the provider or individual;
(C) had a prior discharge in bankruptcy or was found insolvent
in any court action; or
(D) had any state or federal licenses or permits suspended or
revoked in connection with any health care or continuing care
activities, or related business activities.
(6) The identity of any other continuing care retirement
community currently or previously operated by the provider or
manager of the continuing care retirement community.
(7) The location and description of other properties, both existing
and proposed, of the provider in which the provider owns a
twenty-five percent (25%) ownership interest, and on which
continuing care retirement communities are or are intended to be
located.
(8) A statement as to whether the provider is, or is affiliated with,
a religious, charitable, or other nonprofit association, and the
extent to which the affiliate organization is responsible for the
financial and contractual obligations of the provider.
(9) A description of all services to be provided by the provider
under its continuing care agreements with contracting parties, and
a description of all fees for those services, including conditions
under which the fees may be adjusted.
(10) A description of the terms and conditions under which the
continuing care agreement can be cancelled, or fees refunded.
(11) Financial statements of the provider prepared in accordance
with generally accepted accounting principles applied on a
consistent basis and certified by an independent certified or
public accountant, including a balance sheet as of the end of the
provider's last fiscal year and income statements for the last three
(3) fiscal years, or such shorter period of time as the provider has
been in operation.
(12) If the operation of the continuing care retirement community
has not begun, a statement of the anticipated source and
application of funds to be used in the purchase or construction of
the continuing care retirement community, and an estimate of the
funds, if any, which are anticipated to be necessary to pay for
start-up losses.
(13) A copy of the forms of agreement for continuing care used by
the provider.
(14) Any other information that the commissioner may require by
rule or order.
As added by Acts 1982, P.L.145, SEC.1. Amended by
P.L.8-1993, SEC.313; P.L.153-2009, SEC.6.