senate Bill S2118A

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

See Assembly Version of this Bill:
A4611A
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, S5224B

Sponsor Memo

BILL NUMBER:S2118A

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 OF THE 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 and adds a new subdivision to section 4601 of the
Public Health Law to allow for continuing care at home as continuing
care retirement community contract option.

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 of section 4604 of the
Public Health Law to provide oversight by the Commissioner of Health
rather than the Commissioner of Social Services.

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

Section 7 Amends subdivision 13 of section 4606 of the Public Health
Law to change language to reflect the option of continuing care at
home contracts.

Section 8 - 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 9 - Amends section 4608 of the Public Health Law to include
Continuing care retirement community or continuing 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 10 - 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 11 - Amends subdivisions land 2 of section 4614 of the Public
Health Law to reflect that the Commissioner of Health shall have
responsibility for oversight.

Section 12 - Amends paragraph k of subdivision 1 of section 4615 of
the Public Health Law to reflect responsibility of the Commissioner
of Health.

Section 14 - 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: 2011-2012:
A.8405-A/S.5224-B.

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--A
    Cal. No. 50

                       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 -- reported favorably from said committee, ordered to first and
  second report, ordered to a third reading, passed by Senate and deliv-
  ered  to  the Assembly, recalled, vote reconsidered, restored to third
  reading, amended and ordered reprinted, retaining  its  place  in  the
  order of third reading

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, 10 and 10-a of section 4601 of
the public health law, subdivision 2-a as added and subdivisions 3 and 8
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  COMMUNITY  contract"  shall  mean  a
single  contract to provide a person the services provided by a continu-
ing care retirement community.
  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 COMMUNITY contract, at a minimum:
  a. provides, OR SUPPORTS THROUGH CONTINUING 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  arrange-
ment  or  through  an equity arrangement including, but not limited to a

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05244-03-3

S. 2118--A                          2

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  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 CONTINUING CARE AT  HOME  OR
continuing  care retirement COMMUNITY contracts as defined in this arti-
cle.
  7-A. "CONTINUING CARE AT HOME CORPORATION" SHALL MEAN  AN  ESTABLISHED
SEPARATE  501  (C)  3 CORPORATION AFFILIATED WITH AN EXISTING CONTINUING
CARE RETIREMENT COMMUNITY 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.
  7-B. "CONTINUING CARE AT HOME CONTRACT" SHALL MEAN A  SINGLE  CONTRACT
TO PROVIDE A PERSON WITH LONG TERM CARE SERVICES AND SUPPORTS BASED UPON
AN  INDIVIDUAL'S  NEEDS  AND  COORDINATED BY A CASE MANAGER, WHICH SHALL
INCLUDE SERVICES PROVIDED TO THE INDIVIDUAL IN HIS OR HER RESIDENCE  AND
SERVICES  OF  THE AFFILIATED COMMUNITY'S NURSING FACILITY AND ADULT CARE
FACILITY, OR AFFILIATED FACILITIES.
  7-C. A. "CONTINUING CARE AT HOME" CORPORATIONS PROVIDING SERVICES IN A
NURSING HOME 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. "CONTINUING 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
COMMUNITY contract OR A CONTINUING CARE AT HOME CONTRACT  to  provide  a
person, for the duration of such person's life, the services provided by
the  continuing care retirement community OR THE CONTINUING CARE AT HOME
CORPORATION, which services shall  include  unlimited  services  of  [an
on-site or affiliated nursing facility] THE AFFILIATED COMMUNITY'S NURS-
ING  FACILITY  OR  AFFILIATED NURSING HOME.  Such term also shall mean a
single continuing  care  retirement  COMMUNITY  contract  to  provide  a
person, for the duration of such person's life, the services provided by

S. 2118--A                          3

the  continuing  care retirement 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.
  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 contracts to be entered  into  with
residents of the community OR CONTINUING CARE AT HOME CONTRACT HOLDERS;
  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 OR  CONTINUING  CARE  AT  HOME  CONTRACT  HOLDERS
pursuant to a continuing care retirement COMMUNITY OR CONTINUING CARE AT
HOME contract;
  (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--A                          4

imposed or damages assessed, or the  date,  nature  and  issuer  of  the
order;
  S 5. Paragraph b of subdivision 4 of section 4604 of the public health
law,  as  amended by chapter 659 of the laws of 1997, is 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;
  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 OR CONTINUING CARE AT HOME CONTRACT HOLDERS
have life care contracts, the operator has adequately  made  the  assur-
ances  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] SUCH RESIDENT'S OR CONTRACT HOLDER'S assets are insuffi-
cient to pay for nursing facility services for a one year period.
  S 7. Subdivision 13 of section 4606 of the public health law, as added
by chapter 659 of the laws of 1997, is amended to read as follows:
  13.  The  initial  disclosure  statement  and marketing materials of a
continuing care retirement community AND CONTINUING CARE AT HOME  CORPO-
RATION  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 market-
ing materials of a continuing care retirement  community  OR  CONTINUING
CARE  AT HOME CORPORATION which offers various types of contracts, which
may include life care contracts, must clearly  differentiate  among  the
various types of contracts which it may offer.
  S  8.  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 9. Section 4608 of the public health law, as added by chapter 689 of
the  laws of 1989, the section heading, the opening paragraph and subdi-
vision 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 COMMUNITY contract.  A continuing
care retirement COMMUNITY OR CONTINUING  CARE  AT  HOME  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
superintendent, 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 OR CONTINUING
CARE AT HOME CONTRACT HOLDER OR HOLDERS;
  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;

S. 2118--A                          5

  3. The procedures of the community OR CONTINUING CARE AT  HOME  CORPO-
RATION  relating to a resident's OR CONTRACT HOLDER'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 OR CONTRACT HOLDER 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 article;
  6. a. The procedures and conditions under  which  a  resident  may  be
transferred  from  his  or her living unit OR HOME 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 CONTINUING CARE RETIREMENT COMMUNITY 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  transfer  of  a  resident to the community's nursing or other
specialized facility 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 pursu-
ant 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 community'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 apportionment 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  CONTINUING  CARE  RETIREMENT  COMMUNITY 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 CONTINUING CARE AT HOME CONTRACTS THE CIRCUMSTANCES UNDER WHICH
THE  CONTRACT  HOLDER  MAY  MOVE  INTO A CAMPUS INDEPENDENT LIVING UNIT,
ADULT CARE FACILITY OR NURSING HOME;

S. 2118--A                          6

  9. [A] FOR CONTINUING CARE  RETIREMENT  COMMUNITY  CONTRACTS  ONLY,  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 resident
OR CONTRACT HOLDER, 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 CONTRACT HOLDER, or of an individual purchasing care  for  a
resident  OR  CONTRACT HOLDER under any agreement to furnish care to the
resident OR CONTRACT HOLDER, 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 CONTRACT HOLD-
ER or the individual  purchasing  care  for  the  resident  OR  CONTRACT
HOLDER;
  [11.  A]  12.  FOR  CONTINUING  CARE  RETIREMENT COMMUNITY CONTRACTS A
description of the reinstatement  policies  if  a  resident  leaves  the
facility or the contract is cancelled;
  [12.] 13. FOR CONTINUING CARE AT HOME CONTRACTS A DESCRIPTION OF POLI-
CIES IF THE CONTRACT IS CANCELLED.
  14.  A  statement  that  internal  procedures  to resolve disputes and
grievances have been established, and  residents  AND  CONTRACT  HOLDERS
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 OR CONTRACT HOLDER, AS
APPLICABLE shall, if eligible, enroll in medicare parts a and b  or  the
equivalent  and  shall continue to maintain 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 OR  CONTRACT  HOLDER  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  OR  CONTINUING  CARE  AT  HOME CORPORATION shall purchase the
coverage or equivalent coverage on behalf and  at  the  expense  of  the
resident  OR  CONTRACT HOLDER and shall have the authority to require an
appropriate adjustment in payments by the resident OR CONTRACT HOLDER to
the community OR CONTINUING CARE AT HOME CORPORATION;
  c. if the community OR CONTINUING  CARE  AT  HOME  CORPORATION  cannot
purchase  medicare  coverage  and  medicare  supplement  coverage or the
equivalent, the community shall have the authority to require an adjust-
ment in monthly fees, subject to the approval of the superintendent,  to
fund the additional risk to the facility OR CORPORATION; and
  d.  if  the  resident OR CONTRACT HOLDER fails to purchase or maintain
medicare coverage and medicare supplement coverage  or  the  equivalent,
and  the  community  OR  CONTINUING  CARE  AT  HOME  CORPORATION has not
purchased such coverage, the community OR CORPORATION will be  responsi-
ble for any expenses which would have been covered by medicare and medi-
care  supplement  coverage.    The  community OR CORPORATION may add the

S. 2118--A                          7

amount of such expenses to the resident's OR CONTRACT  HOLDER'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] FOR CONTINUING CARE RETIREMENT  COMMUNITY  CONTRACTS,  A
statement  whether  the  continuing  care  retirement COMMUNITY 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 10. 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 11. 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
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 COMMUNITY contracts OR CONTINU-
ING CARE AT HOME 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  super-
intendent,  which shall include financial documents and records conform-
ing 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  commissioner  and,  when  so
filed, shall constitute a public record.  A copy of each report shall be
provided to members of the continuing care retirement community council.
Any  operator  being  examined  shall, upon request, give reasonable and
timely access to all of its  records.  The  representative  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 OR BY THE
CONTINUING CARE AT HOME CORPORATION relevant to the respective  agency's
regulatory  authority, with or without advance notice, to secure compli-
ance with, or to prevent a violation of, any provision of this article.
  S 12. 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:

S. 2118--A                          8

  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 OR A CONTRACT HOLDER OF A CONTINU-
ING CARE AT HOME CONTRACT.
  S 13. 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  14.  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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