senate Bill S2118

Amended

Relates to the ability of continuing care retirement communities to offer seniors additional service options

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 11 / Jan / 2013
    • REFERRED TO HEALTH
  • 05 / Feb / 2013
    • 1ST REPORT CAL.50
  • 11 / Feb / 2013
    • 2ND REPORT CAL.
  • 12 / Feb / 2013
    • ADVANCED TO THIRD READING
  • 04 / Mar / 2013
    • PASSED SENATE
  • 04 / Mar / 2013
    • DELIVERED TO ASSEMBLY
  • 04 / Mar / 2013
    • REFERRED TO HEALTH
  • 18 / Jun / 2013
    • RECALLED FROM ASSEMBLY
  • 18 / Jun / 2013
    • RETURNED TO SENATE
  • 18 / Jun / 2013
    • VOTE RECONSIDERED - RESTORED TO THIRD READING
  • 18 / Jun / 2013
    • AMENDED ON THIRD READING 2118A
  • 21 / Jun / 2013
    • COMMITTED TO RULES
  • 08 / Jan / 2014
    • REFERRED TO HEALTH
  • 27 / Feb / 2014
    • AMEND AND RECOMMIT TO HEALTH
  • 27 / Feb / 2014
    • PRINT NUMBER 2118B
  • 06 / May / 2014
    • 1ST REPORT CAL.557
  • 07 / May / 2014
    • 2ND REPORT CAL.
  • 12 / May / 2014
    • ADVANCED TO THIRD READING
  • 20 / May / 2014
    • SUBSTITUTED BY A4611B

Summary

Relates to the ability of continuing care retirement communities to offer seniors additional service options.

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Bill Details

Versions:
S2118
S2118A
S2118B
Legislative Cycle:
2013-2014
Law Section:
Public Health Law
Laws Affected:
Amd Pub Health L, generally
Versions Introduced in 2011-2012 Legislative Cycle:
S5224B

Sponsor Memo

BILL NUMBER:S2118

TITLE OF BILL: An act to amend the public health law, in relation to
ability of continuing care retirement communities to offer seniors
additional service options

PURPOSE OR GENERAL IDEA OF BILL: To allow continuing care communities
to offer life care and life care at home programs to seniors.

SUMMARY OF SPECIFIC PROVISIONS: Section 1 - amends subdivisions 2-a,
2-b, 3, 8, 9, 10 and 10-a of section 4601 of the Public Health Law to
add life care and life care programs as options to be offered as part
of a continuing care retirement contract.

Section 2 - amends the opening paragraph of subdivision 2 of section
4602 of the Public Health Law to delete the requirement that a life
care contract mandate at least four council meetings per year.

Section 3 - amends subdivision 1 of section 4603-a of the Public
Health Law to change the name of "life care community council" to
"continuing care retirement community council."

Section 4 - amends paragraphs d and e and clause (C) of subparagraph
(iv) of paragraph j of subdivision 2 of section 4604 of the Public
Health Law to change language to reflect continuing care retirement
contracts and that clause (C) relates to facilities licensed by the
Department of Health rather than the Department of Social Services.

Section 5 - amends paragraph b of subdivision 4 and subdivisions 5 and
8 of section 4604 of the Public Health Law to provide oversight by the
Commissioner of Health rather than the Commissioner of Social
Services, and add life care at home services and amend language to
refer to continuing care retirement contracts.

Section 6 - amends paragraph g of subdivision 2 of section 4604-a of
the Public Health Law to reflect the option of life care at home
services.

Section 7 amends paragraph d of subdivision 1 of section 4605 of the
Public Health Law to add continuing care retirement contracts.

Section 8 - amends the opening paragraph, paragraph d of subdivision
11 and subdivision 13 of section 4606 of the Public Health Law to
change language to "continuing care retirement contracts."

Section 9 - paragraphs e, f and g of subdivision 14 of section 4606 of
the Public Health Law are renumbered and a new paragraph e is added to
list the types of meal plans available.

Section 10 - amends section 4608 of the Public Health Law to include
life care, modified of life care at home contracts and limit certain
provisions to life care and modified contracts only, and set forth
certain requirements for life care at home contracts.


Section 11 - amends subdivision 1 of section 4612 of the Public Health
Law to recognize that some residents under this section may be living
at home.

Section 12 - amends subdivisions 1 and 2 of section 4614 of the Public
Health Law to reflect that the Commissioner of Health shall have
responsibility for oversight.

Section 13 - amends paragraph k of subdivision 1 of section 4615 of
the Public Health Law to reflect responsibility of the Commissioner of
Health.

Section 14 - amends the section heading of section 4623 of the Public
Health Law.

Section 15 - provides that this act shall take effect on the one
hundred eightieth day after it shall have become law, provided that
the Department of Health is authorized to immediately take such steps
as may be necessary to ensure implementation of this act

JUSTIFICATION: This bill would offer another option for seniors --
life care at home. Existing CCRC campus providers may establish a
separate affiliated 501(c)3 corporation to offer various levels of
home care services as chosen by the contract holder, based upon the
needs of the seniors(s) in the home. This bill will expand the
continuum of services from limited services at home, through increased
services, and eventual residence, if needed, on a CCRC campus. At home
services can include, as necessary, personal health coordination,
emergency response system, health and wellness programs, home nurse
visits, companion services, home inspections, transportation, meals,
on-campus activities and cultural events. Services are coordinated by
a case manager. The program allows planned continuity so seniors can
know they will continue to receive services over the years with the
same provider as their needs change and know they can remain at home
as long as possible with such services as they may require.

PRIOR LEGISLATIVE HISTORY: 2012 - S.5224-B PASSED SENATE

FISCAL IMPLICATIONS: May reduce costs to state if seniors can remain
at home and not spend down their assets and seek Medicaid assistance

EFFECTIVE DATE: This act shall take effect on the one hundred and
eightieth day after it shall have become law.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2118

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 11, 2013
                               ___________

Introduced  by  Sens. RANZENHOFER, DeFRANCISCO, LIBOUS -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Health

AN ACT to amend the public health law, in relation to ability of contin-
  uing  care  retirement communities to offer seniors additional service
  options

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subdivisions 2-a, 2-b, 3, 8, 9, 10 and 10-a of section 4601
of the public health law, subdivision 2-a as added and subdivisions 3, 8
and  9 as amended by chapter 659 of the laws of 1997, subdivision 2-b as
amended by chapter 523 of the laws of 2011, subdivision 10 as  added  by
chapter  689 of the laws of 1989, and subdivision 10-a as added by chap-
ter 401 of the laws of 2003, are amended and three new subdivisions 7-a,
7-b and 7-c are added to read as follows:
  2-a.  "Continuing  care  retirement  contract"  shall  mean  a  single
contract  to provide a person the services provided by a continuing care
retirement community INCLUDING LIFE CARE OR LIFE CARE AT HOME.
  2-b. "Continuing care retirement community" or "community" shall  mean
a  facility  or facilities established to provide a comprehensive, cohe-
sive living arrangement for the elderly, oriented to the enhancement  of
the  quality  of life and which, pursuant to the terms of the continuing
care RETIREMENT contract OFFERED BY THE COMMUNITY, at a minimum:
  a. provides, OR SUPPORTS THROUGH LIFE CARE AT HOME, independent living
units, and [provides a] meal plan OPTIONS.  The independent living  unit
can be made available either through a non-equity arrangement or through
an  equity  arrangement  including,  but not limited to a cooperative or
condominium. For purposes of this article,  the  purchase  price  of  an
independent living unit in an equity arrangement, regardless of the form
of  the  purchase  agreement,  shall  not be considered an entry fee for

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05244-01-3

S. 2118                             2

purposes of calculating reserve liabilities, but shall be considered  an
entry fee for escrow purposes;
  b.  provides  a  range  of health care and social services, subject to
such terms as may be included within the contract, which  shall  include
adult  care  facility  services  of  an on-site or affiliated adult care
facility, and at a minimum, sixty days of prepaid services of an on-site
or affiliated nursing facility  for  residents  not  receiving  services
under a fee-for-service contract;
  c.  provides  access  to  health  services as defined in the contract,
prescription drugs, and rehabilitation services;
  d. nothing in this article shall eliminate the obligation of a contin-
uing care retirement community to provide at least sixty days of prepaid
nursing facility services to all residents, with the exception of  resi-
dents receiving services under the terms of a fee-for-service continuing
care  contract as defined in this section. The prepaid days must include
the first sixty days  of  nursing  facility  services,  whether  or  not
consecutive,  not  covered by Title XVIII of the federal social security
act; and
  e. communities established under this article  and  offering  fee-for-
service  continuing  care contracts must offer, along with such fee-for-
service continuing care contracts,  life  care  and/or  continuing  care
contracts as defined in subdivision eight-a of this section.
  3. "Contracts" or "agreements" shall mean LIFE CARE AT HOME OR contin-
uing care retirement contracts as defined in this article.
  7-A.  "LIFE CARE AT HOME" SHALL MEAN AN ESTABLISHED SEPARATE 501 (C) 3
CORPORATION AFFILIATED WITH THE EXISTING CCRC  CAMPUS  PROVIDER  THROUGH
WHICH  CONTRACT  HOLDERS  PAY AN ENTRANCE FEE AND A MONTHLY FEE, BOTH OF
WHICH WOULD CORRESPOND TO THE LEVEL OF SERVICE CHOSEN  BY  THE  CONTRACT
HOLDER.  A LIFE CARE AT HOME CONTRACT INCLUDES SERVICES COORDINATED BY A
CASE MANAGER BASED UPON INDIVIDUALS' NEEDS.  SERVICES  OFFERED  INCLUDE,
BUT ARE NOT LIMITED TO, PERSONAL HEALTH COORDINATION, EMERGENCY RESPONSE
SYSTEM,  HEALTH  AND  WELLNESS  PROGRAMS,  HOME  NURSE VISITS, COMPANION
SERVICES, HOME INSPECTIONS, TRANSPORTATION, MEALS, ON-CAMPUS  ACTIVITIES
AND  CULTURAL  EVENTS.  LIFE  CARE AT HOME SERVICES SHALL INCLUDE, BASED
UPON INDIVIDUAL CONTRACTS, SERVICES OF AN ON-SITE OR AFFILIATED  NURSING
FACILITY AND AN ON-SITE OR AFFILIATED ADULT CARE FACILITY.
  7-B.  "LIFE  CARE  AT  HOME  CONTRACT" SHALL MEAN A SINGLE CONTRACT TO
PROVIDE A PERSON, FOR THE DURATION OF SUCH PERSON'S LIFE, SUCH  SERVICES
SELECTED  BY  THE  INDIVIDUAL WHICH MAY INCLUDE SERVICES PROVIDED TO THE
INDIVIDUAL IN HIS OR HER RESIDENCE.
  7-C. A. "LIFE CARE AT HOME" CORPORATIONS PROVIDING  HOSPITAL  CARE  AS
DEFINED  IN  SECTION  TWENTY-EIGHT  HUNDRED  ONE OF THIS CHAPTER MUST BE
LICENSED  UNDER  ARTICLE  TWENTY-EIGHT  AND  SHALL  BE  SUBJECT  TO  THE
PROVISIONS AND STANDARDS OF SUCH ARTICLE.
  B.  "LIFE  CARE  AT HOME" CORPORATIONS PROVIDING HOME CARE SERVICES AS
DEFINED IN SECTION THIRTY-SIX  HUNDRED  TWO  OF  THIS  CHAPTER  MUST  BE
LICENSED UNDER ARTICLE THIRTY-SIX AND SHALL BE SUBJECT TO THE PROVISIONS
AND STANDARDS OF SUCH ARTICLE.
  8. "Life care contract" shall mean a single continuing care retirement
contract  to  provide  a person, for the duration of such person's life,
the services provided by the continuing care retirement community, which
services shall include unlimited services of an  on-site  or  affiliated
nursing  facility  AND  UNLIMITED  SERVICES  OF AN ON-SITE OR AFFILIATED
ADULT CARE FACILITY.  Such term also shall mean a single continuing care
retirement contract to provide  a  person,  for  the  duration  of  such
person's  life,  the services provided by the continuing care retirement

S. 2118                             3

community under an arrangement in which  the  costs  of  the  residents'
unlimited  nursing  home  or  home  health care services are paid for in
whole or in part by a long term care insurance policy  approved  by  the
superintendent in accordance with applicable regulations or by long term
care  insurance  or  medical  assistance payments in accordance with the
partnership for long term care program pursuant  to  the  provisions  of
section  three hundred sixty-seven-f of the social services law, section
three thousand two hundred twenty-nine of the insurance law and  section
four thousand six hundred twenty-three of this chapter.
  9. "Life care" shall mean those services provided pursuant to a ["life
care contract"] "CONTINUING CARE RETIREMENT CONTRACT".
  10.  "Living  unit"  shall  mean an apartment, room, cottage, or other
area within a community set aside for the exclusive use of one  or  more
residents, OR THE CONTRACT HOLDER'S PRIVATE RESIDENCE.
  10-a.  "Meal plan" shall mean an arrangement whereby the person enter-
ing into the continuing care retirement contract is  provided  with  [no
fewer  than five meals per month. Additional meals shall be available on
a fee-for-service basis] OPTIONS REGARDING THE INCLUSION OF MEALS WITHIN
THE CONTRACT.
  S 2. The opening paragraph of subdivision 2 of  section  4602  of  the
public  health  law,  as  amended by chapter 659 of the laws of 1997, is
amended to read as follows:
  The council shall meet as often as may be deemed necessary to  fulfill
its  responsibilities[,  but in no event less than four times per year].
The council shall have the following powers and duties:
  S 3. Subdivision 1 of section 4603-a of  the  public  health  law,  as
added by chapter 393 of the laws of 1991, is amended to read as follows:
  1.  The commissioner, upon approval of the [life care] CONTINUING CARE
RETIREMENT community council and the public health council shall issue a
certificate of incorporation of up  to  three  residential  health  care
demonstration facilities. Notwithstanding any provision of article twen-
ty-eight of this chapter or any other provisions of law to the contrary,
the  public health council may approve without regard to the requirement
of public need as set forth in subdivision three of section twenty-eight
hundred one-a of this chapter, a certificate of incorporation or  appli-
cation for establishment of such facilities.
  S  4.  Paragraphs d and e and clause (C) of subparagraph (iv) of para-
graph j of subdivision 2 of section 4604 of the public health law, para-
graph d as added by chapter 689 of the laws of 1989 and paragraph e  and
clause (C) of subparagraph (iv) of paragraph j as amended by chapter 659
of the laws of 1997, are amended to read as follows:
  d.  a  copy  of  the  proposed  forms  of  CONTINUING  CARE RETIREMENT
contracts to be entered into with residents of the community;
  e. complete details of any agreements with a licensed insurer, includ-
ing copies of proposed contracts, requiring the insurer to assume, whol-
ly or in part, the cost of medical or  health  related  services  to  be
provided  to  a  resident  pursuant  to  a  continuing  care  retirement
[contract] CONTRACTUAL AGREEMENT;
  (C) is or was subject to a currently effective injunctive or  restric-
tive order or federal or state administrative order relating to business
activity  or  health  care  as a result of an action brought by a public
agency or department, including, without limitation, actions affecting a
license to operate a hospital as defined by section twenty-eight hundred
one of this chapter, or a facility required to be licensed or  certified
by  the department of [social services] HEALTH.  The statement shall set
forth the court or agency, date of conviction or judgment,  the  penalty

S. 2118                             4

imposed  or  damages  assessed,  or  the  date, nature and issuer of the
order;
  S  5. Paragraph b of subdivision 4 and subdivisions 5 and 8 of section
4604 of the public health law, paragraph b of subdivision 4  as  amended
by  chapter 659 of the laws of 1997, subdivision 5 as amended by chapter
700 of the laws of 2006 and subdivision 8 as added by chapter 689 of the
laws of 1989, are amended to read as follows:
  b. the commissioner [of social services] as to those  aspects  of  the
application relating to adult care facility beds, if any;
  5.  Up  to  two  thousand  residential  health  care facility beds, as
authorized herein, that may be approved as components of continuing care
retirement communities shall not be considered by the department and the
health systems agencies in the determination of public need for residen-
tial health care facility  services;  provided,  however,  that  if  the
community seeking to construct such beds does not provide A life care OR
LIFE CARE AT HOME CONTRACT to all residents, it must adequately make the
assurances  required  by  subdivision  two  of section forty-six hundred
twenty-four of this article.
  8. The operator  shall  designate  and  make  knowledgeable  personnel
available  to prospective residents to answer questions about any infor-
mation contained in the disclosure statement or contract. The disclosure
statement and the CONTINUING CARE RETIREMENT contract shall  each  state
on  the  cover  or  top of the first page in bold twelve point print the
following "This matter involves a substantial financial investment and a
legally binding contract. In evaluating the disclosure statement and the
contract prior to any commitment, it is  recommended  that  you  consult
with  an attorney and financial advisor of your choice, if you so elect,
who can review these documents with you."
  S 6. Paragraph g of subdivision 2 of  section  4604-a  of  the  public
health  law,  as added by chapter 659 of the laws of 1997, is amended to
read as follows:
  g. Unless all residents have EITHER life care OR  LIFE  CARE  AT  HOME
contracts,  the  operator has adequately made the assurances required by
subdivision two of section forty-six hundred twenty-four of this article
and has agreed to fund the liability in the event that  resident  assets
are  insufficient  to  pay  for nursing facility services for a one year
period.
  S 7. Paragraph d of subdivision 1 of section 4605 of the public health
law, as amended by chapter 659 of the laws of 1997, is amended  to  read
as follows:
  d.  to offer and execute CONTINUING CARE RETIREMENT contracts, includ-
ing the collection of entrance fees and  deposits  pursuant  to  section
forty-six hundred eight of this article.
  S 8. The opening paragraph, paragraph d of subdivision 11 and subdivi-
sion  13 of section 4606 of the public health law, the opening paragraph
as amended by chapter 120 of the laws of 1993, paragraph d  of  subdivi-
sion  11  as added by chapter 689 of the laws of 1989 and subdivision 13
as added by chapter 659 of the laws of 1997,  are  amended  to  read  as
follows:
  Prior  to  the  execution of a CONTINUING CARE RETIREMENT contract, or
before the transfer of any  money,  other  than  a  refundable  priority
reservation  fee or non-refundable priority reservation agreement appli-
cation fee, to an operator by or on behalf of  a  prospective  resident,
whichever  occurs  first,  the operator shall deliver to the person with
whom the contract is to be entered into or the person's legal  represen-
tative the most recent annual statement as required by section forty-six

S. 2118                             5

hundred seven of this article, and an initial disclosure statement which
contains the following:
  d.  an  estimate of any funds which are anticipated to be necessary to
fund start-up losses and to assure full performance of  the  obligations
of  the  operator  pursuant  to  [life  care]  CONTINUING CARE contracts
including, but not limited to, any reserves required pursuant to section
forty-six hundred eleven of this article;
  13. The initial disclosure statement  and  marketing  materials  of  a
continuing  care retirement community must clearly include a description
of the services offered as part of  its  contract,  including,  but  not
limited  to,  any  limitations on nursing facility services. The initial
disclosure statement  and  marketing  materials  of  a  continuing  care
retirement  community which offers various types of contracts, which may
include life care, MODIFIED AND LIFE CARE AT HOME contracts, must clear-
ly differentiate among the various  types  of  contracts  which  it  may
offer.
  S  9.  Paragraphs  e, f and g of subdivision 14 of section 4606 of the
public health law are relettered paragraphs f, g and h and a  new  para-
graph e is added to read as follows:
  E. THE TYPES OF MEAL PLANS AVAILABLE;
  S  10.  Section 4608 of the public health law, as added by chapter 689
of the laws of 1989, the section  heading,  the  opening  paragraph  and
subdivision  6  as amended and subdivision 17 as added by chapter 659 of
the laws of 1997, subdivision 2 as amended by chapter 120 of the laws of
1993, subdivision 8 as amended by chapter 66 of the  laws  of  1994  and
subdivision 15 as further amended by section 104 of part A of chapter 62
of the laws of 2011, is amended to read as follows:
  S 4608. Continuing care retirement contract.  A LIFE CARE, MODIFIED OR
LIFE  CARE AT HOME continuing care retirement contract shall contain all
of the following information in no less than twelve point  type  and  in
plain  language,  in  addition  to  any  other terms or matter as may be
required by regulations adopted by the council and issued by the  super-
intendent, EXCEPT WHEN SPECIFICALLY NOTED:
  1. The amount of all money transferred, including, but not limited to,
donations,  subscriptions, deposits, fees, and any other amounts paid or
payable by, or on behalf of, the resident or residents;
  2. A description of all services which are  to  be  furnished  by  the
operator,  a description of any fees in addition to the entrance fee and
periodic charges provided for in the contract, and the conditions  under
which  the  fees  may  be  adjusted, provided that an operator shall not
charge any non-refundable application fee to a prospective resident  who
has  paid  a  non-refundable  priority reservation agreement application
fee;
  3. The procedures of the community relating to a resident's failure to
pay the required monthly fees;
  4. A statement of the figures and terms  concerning  the  entry  of  a
spouse to the community and the consequences if the spouse does not meet
the requirements for entry;
  5.  A statement of the terms and conditions under which a contract may
be cancelled by the operator or by a resident and the  conditions  under
which  all  or  any  portion of the entrance fee will be refunded by the
operator,  including  the  mandatory  refund  provisions  set  forth  in
sections  forty-six hundred nine and forty-six hundred ten of this arti-
cle;
  6. a. [The] FOR LIFE CARE AND MODIFIED CONTRACTS ONLY  THE  procedures
and conditions under which a resident may be transferred from his or her

S. 2118                             6

living  unit  including  a  statement that, at the time of transfer, the
resident will be given the reasons for  the  transfer;  the  process  by
which  a  transfer  decision  is made; the persons with the authority to
make the decision to transfer; a description of any change in charges to
be paid by the resident for services not covered by the contract fees as
a  result  of the transfer; and a statement regarding the disposition of
and the right to return to the living unit in  cases  of  temporary  and
permanent transfers.
  b.  [The]  FOR LIFE CARE AND MODIFIED CONTRACTS ONLY THE circumstances
under which a living unit may be  considered  vacant  and  eligible  for
transfer or resale to a new resident, either due to the permanent trans-
fer of a resident to the community's nursing or other specialized facil-
ity  or  due  to  the  permanent transfer of a resident to a hospital or
other facility outside of the community; provided, however, that nothing
therein shall relieve a community from its obligations to provide or  to
insure  provision  of  all  contractually  required care pursuant to the
terms of a continuing care retirement contract.    Should  a  resident's
chronic  condition  require placement in a more specialized chronic care
facility that provides services beyond those provided through the commu-
nity's nursing facility, the liability of THE community pursuant to  the
terms  of  a  continuing  care retirement contract shall be equal to the
current per diem rate of the nursing facility minus the pro rata  appor-
tionment  of  the resident's monthly fee for the period of care required
by the contract.   Nothing  herein  shall  obligate  a  continuing  care
retirement  community  which  does  not have a life care contract with a
resident to provide or pay for a level of nursing facility services  nor
for any duration beyond what is specifically described in its continuing
care  retirement  contract  with  that  resident. This section shall not
affect the  operator's  obligation  under  subdivision  two  of  section
forty-six hundred twenty-four of this article;
  7.  [A] FOR LIFE CARE AND MODIFIED CONTRACTS ONLY A statement that, if
the resident dies prior to occupancy date or, through  illness,  injury,
or  incapacity  is precluded from becoming a resident under the terms of
the contract, the contract is automatically rescinded and  the  resident
or  his  or  her legal representative shall receive a full refund of all
moneys paid  to  the  facility,  except  for  those  costs  specifically
incurred by the facility at the request of the resident and set forth in
writing in a separate addendum, signed by the parties to the contract;
  8.  FOR  LIFE CARE AT HOME CONTRACTS THE CIRCUMSTANCES UNDER WHICH THE
CONTRACT HOLDER MAY MOVE INTO A CAMPUS INDEPENDENT LIVING UNIT;
  9. A statement of the conditions under which all or any portion of the
entrance fee will be released to the operator  before  the  living  unit
becomes available for occupancy, and a statement of the conditions under
which  all  or  any portion of that fee will be refunded in the event of
the death of the resident and/or spouse following occupancy of a  living
unit,  including  the  mandatory  refund provisions set forth in section
forty-six hundred nine of this article;
  [9.] 10. A statement of the advance notice to be  provided  the  resi-
dent,  of  not less than sixty days, of any change in fees or charges or
scope of care or services;
  [10.] 11. A statement that no act,  agreement,  or  statement  of  any
resident,  or  of an individual purchasing care for a resident under any
agreement to furnish care to the  resident,  shall  constitute  a  valid
waiver  of  any  provision  of this article or of any regulation enacted
pursuant thereto intended for the benefit or protection of the  resident
or the individual purchasing care for the resident;

S. 2118                             7

  [11.  A] 12. FOR LIFE CARE AND MODIFIED CONTRACTS A description of the
reinstatement policies if a resident leaves the facility or the contract
is cancelled;
  [12.] 13. FOR LIFE CARE AT HOME CONTRACTS A DESCRIPTION OF POLICIES IF
THE CONTRACT IS CANCELLED.
  14.  A  statement  that  internal  procedures  to resolve disputes and
grievances have been established, and residents notified of them;
  [13.] 15. A statement of the grace period, if any, for the payment  of
periodic  fees  without a penalty, and the extent of any penalty for the
late payment thereof;
  [14.] 16. A statement that: a. the resident shall, if eligible, enroll
in medicare parts a and b or the equivalent and shall continue to  main-
tain  that coverage, together with medicare supplement coverage at least
equivalent in benefits to those established  by  the  superintendent  as
minimum benefits for medicare supplement policies;
  b.  if the resident fails to maintain medicare coverage and a medicare
supplement coverage, or is ineligible for such  coverage  and  fails  to
purchase  the  equivalent of such coverage, the community shall purchase
the coverage or equivalent coverage on behalf and at the expense of  the
resident  and shall have the authority to require an appropriate adjust-
ment in payments by the resident to the community;
  c. if the community cannot purchase  medicare  coverage  and  medicare
supplement  coverage  or  the  equivalent,  the community shall have the
authority to require an adjustment  in  monthly  fees,  subject  to  the
approval  of  the  superintendent,  to  fund  the additional risk to the
facility; and
  d. if the resident fails to purchase or maintain medicare coverage and
medicare supplement coverage or the equivalent, and  the  community  has
not  purchased  such coverage, the community will be responsible for any
expenses which would have been covered by medicare and medicare  supple-
ment coverage.  The community may add the amount of such expenses to the
resident's monthly fees.
  [15.]  17.  A  statement  that  any  amendment to the contract and any
change in fees or charges, other than those within the guidelines of  an
approved rating system, must be approved by the superintendent of finan-
cial services; and
  [16.]  18.  A  statement  that  property  shall  not be substituted as
payment for either the entrance fee or monthly fee.
  [17.] 19. A statement whether the continuing care retirement  contract
includes  any  ownership,  beneficial or trust interest in the assets of
the operator, the assets of the facility, or both. Assets shall include,
but are not limited to, property, trusts, reserves, interest  and  other
assets.
  S 11. Subdivision 1 of section 4612 of the public health law, as added
by chapter 689 of the laws of 1989, is amended to read as follows:
  1.  Residents [living] in a community authorized by this article shall
have the right of self-organization, the right to be represented by  one
or  more  individuals  of their own choosing, and the right to engage in
concerted activities for the purpose of keeping informed of  the  opera-
tion of the community in which they live.
  S  12.  Subdivisions 1 and 2 of section 4614 of the public health law,
as amended by chapter 659 of the laws  of  1997  and  subdivision  2  as
further  amended  by  section 104 of part A of chapter 62 of the laws of
2011, are amended to read as follows:
  1. The commissioner, or designee; AND the superintendent, or designee;
[and, with regard to communities for  which  the  department  of  social

S. 2118                             8

services  has  regulatory  responsibility,  the  commissioner  of social
services, or designee,] may at any time, and shall at least  once  every
three years, visit each community and examine the business of any appli-
cant  for  a  certificate  of  authority and any operator engaged in the
execution of continuing care retirement  contracts  or  engaged  in  the
performance  of  obligations under such contracts.  Routine examinations
may be conducted by having documents designated by and submitted to such
commissioners or superintendent, which shall include financial documents
and records conforming to commonly accepted  accounting  principles  and
practices.  The  final written report of each such examination conducted
by such commissioners or superintendent shall be filed with the  commis-
sioner  and, when so filed, shall constitute a public record.  A copy of
each report shall be provided to members of the continuing care  retire-
ment community council. Any operator being examined shall, upon request,
give  reasonable  and timely access to all of its records. The represen-
tative or examiner designated by the  commissioners  or  superintendent,
respectively,  may,  at  any  time,  examine the records and affairs and
inspect the community's facilities, whether in connection with a  formal
examination or not.
  2.  Any  duly  authorized  officer,  employee,  or agent of the health
department, [social services department,]  or  department  of  financial
services  may,  upon  presentation of proper identification, have access
to, and inspect, any records maintained by the community relevant to the
respective  agency's  regulatory  authority,  with  or  without  advance
notice,  to  secure  compliance  with, or to prevent a violation of, any
provision of this article.
  S 13. Paragraph k of subdivision 1  of  section  4615  of  the  public
health law, as amended by chapter 659 of the laws of 1997, is amended to
read as follows:
  k. The commissioner [or the commissioner of social services] has found
violations  of  applicable statutes, rules or regulations which threaten
to affect directly the health, safety, or welfare of  a  resident  of  a
continuing care retirement community.
  S 14. The section heading of section 4623 of the public health law, as
amended  by  chapter  659  of  the  laws  of 1997, is amended to read as
follows:
  Long  term  care  insurance  [for]  AND  continuing  care   retirement
contracts.
  S  15.  This  act  shall  take effect on the one hundred eightieth day
after it shall have become a  law;  provided,  however,  that  effective
immediately the department of health is authorized to take such steps in
advance of such effective date, including the addition, amendment and/or
repeal of any rule or regulation as may be necessary to ensure the time-
ly implementation of this act on such effective date.

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