Appendix G, Section II.(B)(1) or the criteria in 105 CMR 120.198: Appendix G, Section

II.(B)(2): (1) For applicants or licensees that issue bonds, a current rating for its most recent uninsured, uncollateralized, and unencumbered bond issuance of AAA, AA, or A (including adjustments of + or - ) as issued by Standard and Poor's (S&P) or Aaa, Aa, or A (including adjustments of 1, 2, or 3) as issued by Moody's. (2) For applicants or licensees that do not issue bonds, all the following tests must be met: (a) (Total Revenues less total expenditures) divided by total revenues must be equal to or greater than 0.04. (b) Long term debt divided by net fixed assets must be less than or equal to 0.67. (c) (Current assets and depreciation fund) divided by current liabilities must be greater than or equal to 2.55. (d) Operating revenues must be at least 100 times the total current decommissioning cost estimate (or the current amount required if certification is used) for all decommissioning activities for which the hospital is responsible as a self-guaranteeing license. (C) In addition, to pass the financial test, a licensee must meet the following requirements: (for institutions using 105 CMR 120.198: Appendix G: Section II, (A)(2) method of qualifying; for a self-guarantee 105 CMR 120.198: Appendix G: Sections II(C)(1) and II(C)(2) will apply. (1) The licensee's independent certified public accountant must have compared the data used by the licensee in the financial test, which is required to be derived from the independently audited year end financial statements, based on United States generally accepted accounting practices, for the latest fiscal year, with the amounts in such financial statement. In connection with that procedure, the licensee shall inform the Agency within 90 days of any matters coming to the attention of the auditor that cause the auditor to believe that the data specified in the financial test should be adjusted and that the licensee no longer passes the test. 105 CMR: DEPARTMENT OF PUBLIC HEALTH (2) After the initial financial test, the licensee must repeat passage of the test within 90 days after the close of each succeeding fiscal year. (3) If the licensee no longer meets the requirements of 105 CMR 120.198: Appendix G: Section I, the licensee must send notice to the Agency of its intent to establish alternative financial assurance as specified in Agency regulations. The notice must be sent by certified mail, return receipt requested, within 90 days after the end of the fiscal year for which the year end financial data show that the licensee no longer meets the financial test requirements. The licensee must provide alternate financial assurance within 120 days after the end of such fiscal year. III. Self-guarantee. The terms of a self-guarantee which an applicant or licensee furnishes must provide that: (A) The guarantee shall remain in force unless the licensee sends notice of cancellation by certified mail, and/or return receipt requested, to the Agency. Cancellation may not occur unless an alternative financial assurance mechanism is in place. (B) The licensee shall provide alternative financial assurance as specified in 105 CMR 120.125(C) within 90 days following receipt by the Agency of a notice of cancellation of the guarantee. (C) The guarantee and financial test provisions must remain in effect until the Agency has terminated the license or until another financial assurance method acceptable to the Agency has been put in effect by the licensee. (D) The applicant or licensee must provide to the Agency a written guarantee (a written commitment by a corporate officer or officer of the institution) which states that the licensee will fund and carry out the required decommissioning activities or, upon issuance of an order by the Agency, the licensee will set up and fund a trust in the amount of the current cost estimates for decommissioning. (E) If, at any time, the licensee's most recent bond issuance ceases to be rated in any category of "A" or above by either Standard and Poor’s or Moody’s, the licensee shall provide notice in writing of such fact to the Agency within 20 days after publication of the change by the rating service. (F) If, at any time, the licensee's most recent bond issuance ceases to be rated in any category of "A" or above by either Standard and Poor’s or Moody’s, the licensee will provide notice in writing of such fact to the Agency within 20 days after publication of the change by the rating service. If the licensee's most recent bond issuance ceases to be rated in any category of A or above by both Standard and Poor’s and Moody’s, the licensee no longer meets the requirements of 105 CMR 120 199: Appendix E, Section II.(A).