S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7742--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               June 6, 2023
                                ___________
 
 Introduced  by  M.  of  A.  PAULIN,  THIELE,  SEAWRIGHT -- read once and
   referred to the Committee on Health -- recommitted to the Committee on
   Health in accordance  with  Assembly  Rule  3,  sec.  2  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee

 AN ACT to amend the public health law and the insurance law, in relation
   to  promoting  efficient  and  effective  oversight of continuing care
   retirement communities; and to repeal certain provisions of  such  law
   relating thereto
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 4602 of the public health law, as added by  chapter
 689 of the laws of 1989, the section heading and subdivisions 1 and 2 as
 amended  by  chapter  659  of the laws of 1997, the opening paragraph of
 subdivision 1 as amended by section 81 of part A of chapter  62  of  the
 laws of 2011, the opening paragraph of subdivision 2 as amended by chap-
 ter  549 of the laws of 2014, subdivision 3 as amended by chapter 155 of
 the laws of 2012, is amended to read as follows:
   § 4602. [Continuing care retirement community  council]  COMMISSIONER;
 powers and duties.  [1. The continuing care retirement community council
 is  hereby established, to consist of the following, or their designees:
 the attorney general; the commissioner; the director of the  office  for
 the  aging;  and eight public members appointed by the governor with the
 advice and consent of the senate. Such public members shall be represen-
 tative of the public, and have a demonstrated expertise or  interest  in
 continuing  care  retirement communities; provided that no more than one
 such member shall be a sponsor, owner, operator, manager,  member  of  a
 board  of  directors,  or  shareholder  of  a continuing care retirement
 community. At least two public members shall be residents of a  continu-
 ing  care retirement community. At least one of the public members shall
 be a representative of an organization with demonstrated  experience  in

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11682-02-4
              

 A. 7742--A                          2

 representing the interests of senior citizens. The public members of the
 council  shall  have  fixed  terms  of  four years. The council shall be
 chaired by the commissioner or his or her designee.
   Members  of  such  council  shall serve without compensation for their
 services as members of the council, except that  each  of  them  may  be
 allowed  the  necessary  and actual expenses which he shall incur in the
 performance of his duties under this article.
   2. The council shall meet as often  as  may  be  deemed  necessary  to
 fulfill its responsibilities.] The [council] COMMISSIONER shall have the
 following powers and duties:
   a. TO RECEIVE APPLICATIONS FROM POTENTIAL OPERATORS OF CONTINUING CARE
 RETIREMENT COMMUNITIES AND TO DISTRIBUTE SUCH APPLICATIONS FOR REVIEW TO
 THE PARTICIPATING AGENCIES;
   B.  TO  DEVELOP  UNIFORM  FORMS  FOR  APPLICATIONS FOR CERTIFICATES OF
 AUTHORITY, TO REVIEW THE STATUS OF SUCH APPLICATIONS, AND TO  COORDINATE
 THE  REVIEW  OF  SUCH  APPLICATIONS  IN ORDER TO MINIMIZE DUPLICATION OR
 DELAY;
   C. TO PROVIDE INFORMATION TO ENTITIES WISHING TO ESTABLISH  CONTINUING
 CARE  RETIREMENT COMMUNITIES AND TO PERSONS INTERESTED IN BECOMING RESI-
 DENTS OF SUCH COMMUNITIES, TO  THE  EXTENT  APPROPRIATE,  WITH  CONCERNS
 RELATING TO THE OPERATION OF SUCH FACILITIES;
   D. TO ISSUE CERTIFICATES OF AUTHORITY TO APPROVED APPLICANTS;
   E.  to  approve  or  reject  applications  to  obtain a certificate of
 authority for the establishment  and  operation  of  a  continuing  care
 retirement  community.  In reviewing applications, the [council] COMMIS-
 SIONER shall consider the extent to which the applications reflect vari-
 ous sponsorships, organizational structures, geographic dispersion,  and
 the  public  benefit.  In  determining the public benefit of a community
 requiring construction of a total  nursing  facility  component  greater
 than  or  equal  to ninety beds, the [council] COMMISSIONER shall obtain
 and consider the recommendation of the [state  hospital  review]  PUBLIC
 HEALTH  and  HEALTH  planning  council  with regard to the effect of the
 construction of the community's  nursing  facility  beds  upon  existing
 facilities in the same geographic area;
   [b.]  F. to require the reporting of such facts and information as the
 [council] COMMISSIONER may deem necessary to enforce the  provisions  of
 this article;
   [c.]  G.  to  coordinate the oversight of operating communities and to
 assign review and regulatory responsibility for  particular  aspects  of
 such  communities  to  the  appropriate  agencies, consistent with their
 legal authority, to assure consistent state supervision  without  dupli-
 cation of inspection or regulatory review;
   [d.]  H. to make such recommendations to the governor and the legisla-
 ture as may be necessary to encourage or further regulate  the  develop-
 ment of continuing care retirement communities;
   [e.] I. to establish and charge equitable and reasonable annual charg-
 es  for operators, not to exceed fifty dollars per approved living unit,
 to subsidize, in part, expenditures incurred in  reviewing  applications
 for certificates of authority and in inspecting, regulating, supervising
 and auditing continuing care retirement communities;
   [f.  to  review  reports from the participating agencies regarding the
 operations and financial management of approved  communities,  including
 any  reports regarding the financial condition of any community that may
 be in need of close supervision and any reports of deficiencies  in  the
 provision of health or social services to residents of any community;
 A. 7742--A                          3

   g.] J. to adopt rules and regulations and amendments thereto to effec-
 tuate the provisions of this article;
   [h.] K. to revoke, suspend, limit, or annul a certificate of authority
 under  conditions set forth in section forty-six hundred fifteen of this
 article, including when such action is taken at the specific request  of
 any  participating  council  agency.  [When action has been taken by the
 commissioner pursuant to subdivision seven of section forty-six  hundred
 three  of  this  article,  the  council shall meet as soon as reasonably
 possible to approve or disapprove the action  of  the  commissioner  and
 shall take such further action as may be appropriate;
   i. to develop guidelines for applications for certificates of authori-
 ty;
   j.]  L.  TO  CARRY  OUT  ANY  OTHER  RESPONSIBILITIES ENTRUSTED TO THE
 COMMISSIONER PURSUANT TO THIS CHAPTER THAT MAY BE NECESSARY WITH  REGARD
 TO THE HEALTH CARE ACTIVITIES OF CONTINUING CARE RETIREMENT COMMUNITIES;
   M.  TO MAKE AVAILABLE TO ALL PROSPECTIVE OPERATORS ALL PERTINENT REGU-
 LATIONS REGARDING HEALTH AND INSURANCE NECESSARY  TO  COMPLY  WITH  THIS
 ARTICLE;
   N. to [make a final determination regarding an application] APPROVE OR
 REJECT  APPLICATIONS  for  authorization  BY PROSPECTIVE CONTINUING CARE
 RETIREMENT COMMUNITY APPLICANTS, ENTITIES THAT HAVE FILED AN APPLICATION
 FOR A CERTIFICATE OF AUTHORITY AND OPERATORS, to enter into  CANCELLABLE
 priority  reservation agreements [where the commissioner has proposed to
 reject such application] AND TO COLLECT REFUNDABLE PRIORITY  RESERVATION
 FEES FROM PROSPECTIVE RESIDENTS;
   [k.]  O. to require the reporting of such facts and information as the
 [council] COMMISSIONER may deem necessary to determine  whether  charac-
 teristics  of  residential  health care demonstration facilities such as
 comprehensive systems of residential and support services for the elder-
 ly may be successfully incorporated into existing or approved continuing
 care retirement communities;
   [l.] P. to review and approve or  reject  applications  by  continuing
 care  retirement  community operators to use entrance fees to assist the
 operator in financing the construction or purchase of a proposed contin-
 uing care retirement community in accordance with paragraph b of  subdi-
 vision six of section forty-six hundred ten of this article; and
   [m.]  Q.  to  review  and  approve or reject any proposed financing by
 industrial development agencies of continuing care  retirement  communi-
 ties  pursuant  to  article  eighteen-A  of the general municipal law as
 authorized by section forty-six hundred four-a of this article.
   [3. The council shall establish guidelines under which the commission-
 er is authorized to approve or reject any proposed refinancing,  if  the
 council  has  already approved an application pursuant to paragraph a of
 subdivision two of this section.]
   § 2. Section 4603 of the public health  law  is  REPEALED  and  a  new
 section 4603 is added to read as follows:
   §  4603.  CONTINUING  CARE  RETIREMENT  COMMUNITY  COUNCIL; POWERS AND
 DUTIES. 1. THE CONTINUING CARE RETIREMENT COMMUNITY  COUNCIL  IS  HEREBY
 ESTABLISHED, TO CONSIST OF THE FOLLOWING, OR THEIR DESIGNEES: THE ATTOR-
 NEY GENERAL; THE COMMISSIONER; THE DIRECTOR OF THE OFFICE FOR THE AGING;
 AND  EIGHT  PUBLIC MEMBERS APPOINTED BY THE GOVERNOR WITH THE ADVICE AND
 CONSENT OF THE SENATE. SUCH PUBLIC MEMBERS SHALL  BE  REPRESENTATIVE  OF
 THE  PUBLIC, AND HAVE A DEMONSTRATED EXPERTISE OR INTEREST IN CONTINUING
 CARE RETIREMENT COMMUNITIES; PROVIDED THAT NO MORE THAN ONE SUCH  MEMBER
 SHALL  BE  A  SPONSOR,  OWNER,  OPERATOR,  MANAGER, MEMBER OF A BOARD OF
 DIRECTORS, OR SHAREHOLDER OF A CONTINUING CARE RETIREMENT COMMUNITY.  AT
 A. 7742--A                          4
 
 LEAST TWO PUBLIC MEMBERS SHALL BE RESIDENTS OF A CONTINUING CARE RETIRE-
 MENT  COMMUNITY. AT LEAST ONE OF THE PUBLIC MEMBERS SHALL BE A REPRESEN-
 TATIVE OF AN ORGANIZATION WITH DEMONSTRATED EXPERIENCE  IN  REPRESENTING
 THE  INTERESTS  OF  SENIOR  CITIZENS.  THE PUBLIC MEMBERS OF THE COUNCIL
 SHALL HAVE FIXED TERMS OF FOUR YEARS. THE COUNCIL SHALL  BE  CHAIRED  BY
 THE COMMISSIONER OR THE DESIGNEE OF SUCH COMMISSIONER.
   MEMBERS  OF  SUCH  COUNCIL  SHALL SERVE WITHOUT COMPENSATION FOR THEIR
 SERVICES AS MEMBERS OF THE COUNCIL, EXCEPT THAT  EACH  OF  THEM  MAY  BE
 ALLOWED  THE NECESSARY AND ACTUAL EXPENSES WHICH SUCH MEMBER SHALL INCUR
 IN THE PERFORMANCE OF THEIR DUTIES UNDER THIS ARTICLE.
   2. THE COUNCIL SHALL MEET AS OFTEN  AS  MAY  BE  DEEMED  NECESSARY  TO
 FULFILL  ITS  RESPONSIBILITIES.  THE  COUNCIL  SHALL  HAVE THE FOLLOWING
 POWERS AND DUTIES:
   A. TO ASSIST THE COMMISSIONER ON POLICY MATTERS RELATED TO THE  ESTAB-
 LISHMENT AND OPERATION OF CONTINUING CARE RETIREMENT COMMUNITIES;
   B.  TO ASSIST THE COMMISSIONER IN THE DEVELOPMENT OF THE STATE'S OVER-
 ALL POLICY REGARDING CONTINUING CARE RETIREMENT  COMMUNITIES  AND  CAUSE
 STUDIES AND RESEARCH TO BE CONDUCTED AS IT MAY DEEM ADVISABLE AND NECES-
 SARY; AND
   C. TO MAKE SUCH RECOMMENDATIONS TO THE GOVERNOR AND THE LEGISLATURE AS
 MAY  BE  NECESSARY  TO  ENCOURAGE OR FURTHER REGULATE THE DEVELOPMENT OF
 CONTINUING CARE RETIREMENT COMMUNITIES.
   § 3. Subdivision 4 of section  4604  of  the  public  health  law,  as
 amended  by chapter 659 of the laws of 1997, subparagraphs (i), (ii) and
 (iii) of paragraph a as further amended by section  104  of  part  A  of
 chapter 62 of the laws of 2011, paragraphs b and d as amended by chapter
 549  of the laws of 2014, and paragraph c as amended by chapter 7 of the
 laws of 2015, is amended to read as follows:
   4. No certificate of authority shall be issued unless THE COMMISSIONER
 HAS APPROVED an application meeting the requirements of this section and
 all other requirements established by law [has been approved by] INCLUD-
 ING:
   a. [(i)] the [superintendent of financial services as to the] actuari-
 al principles involved, the financial feasibility of the  facility,  the
 form and content of the proposed contracts to be entered into with resi-
 dents and insurance contracts between an operator and an insurer requir-
 ing  the  insurer  to  assume, wholly or in part, the cost of medical or
 health related services to be provided to a resident, PROVIDED THAT  THE
 REVIEW  MAY  BE  CONDUCTED  BY  THE COMMISSIONER OR THE DESIGNEE OF SUCH
 COMMISSIONER, INCLUDING ANY NECESSARY INDEPENDENT ACTUARIAL REVIEW;
   [(ii) the superintendent of financial services as to] B. the rates and
 rating methodology, if any, to be used by the operator to determine  any
 entrance fee, monthly care fee and/or any separate charges for the hous-
 ing  component of the continuing care contract including but not limited
 to a cooperative or condominium fee charged to the resident as  proposed
 in said operator's application for certificate of authority.  Subsequent
 increases  in  any entrance or monthly care fee in excess of fees calcu-
 lated pursuant to the approved rating methodology shall require approval
 of the [superintendent] COMMISSIONER.  The term "rating methodology"  as
 used  herein  shall incorporate a combination of variables including but
 not limited to a pricing structure for  comparable  services,  projected
 operating  and  health care costs and the applicable inflationary impact
 thereon, projected income and  occupancy  rates  and  the  refundability
 component of the continuing care retirement contract[.
   (iii) the superintendent of financial services as to];
 A. 7742--A                          5

   C.  any  monthly care fee charged to a resident which may be increased
 or decreased subject to approval by  the  [superintendent  of  financial
 services]   COMMISSIONER,  provided,  that  monthly  care  fees  may  be
 increased or  decreased  without  specific  approval  as  long  as  such
 increase  or  decrease  does not exceed a relevant cost index or indices
 which reflect all components of  continuing  care  including  the  costs
 associated  with  provision of health care as determined and promulgated
 at least annually by the [superintendent] COMMISSIONER OR  THE  DESIGNEE
 OF  SUCH  COMMISSIONER,  INCLUDING  ANY  NECESSARY INDEPENDENT ACTUARIAL
 REVIEW, and provided further that the [superintendent]  COMMISSIONER  is
 notified of any such increase or decrease prior to its taking effect[.
   (iv) An];
   D.  THE  REQUIREMENT  THAT  AN  individual resident's monthly care fee
 shall not be modified because of the increased need for services of that
 resident;
   [b. the commissioner as to those] E. aspects of the application relat-
 ing to adult care facility beds, if any;
   [c.] F. REVIEW BY the public health and health planning council as  to
 the  establishment of a skilled nursing facility by the applicant and as
 to such other facilities and services as may require the  public  health
 and  health  planning  council's  approval of the application; provided,
 however, that the recommendations of the health  systems  agency  having
 geographical  jurisdiction of the area where the continuing care retire-
 ment community is located shall not be  required  with  respect  to  the
 establishment of an on-site or affiliated residential health care facil-
 ity  to serve residents as part of the continuing care retirement commu-
 nity, for up to the total number of  residential  health  care  facility
 beds  provided  for  in  subdivision five of this section in communities
 statewide;
   [d. the commissioner under section twenty-eight hundred  two  of  this
 chapter;]  provided, [however] FURTHER, that, the recommendations of the
 public health and health planning council and the health systems  agency
 having  geographical  jurisdiction of the area where the continuing care
 retirement community is located shall not be required  with  respect  to
 the  construction  of  an  on-site or affiliated residential health care
 facility to serve residents as part of the  continuing  care  retirement
 community, for up to the total number of residential health care facili-
 ty  beds provided for in subdivision five of this section in communities
 statewide; and
   [e. the] G. UPON CONSULTATION WITH THE attorney general, as  to  those
 aspects  of  the  application  relating to a cooperative, condominium or
 other equity arrangement for the independent living unit, if any.
   § 4. The opening paragraph of subdivision 6 of  section  4604  of  the
 public  health  law,  as  amended by chapter 659 of the laws of 1997, is
 amended to read as follows:
   If the [approvals] APPLICANT HAS SATISFIED THE  CRITERIA  required  by
 subdivision  four  of  this  section [have been obtained], the [council]
 COMMISSIONER shall[, by majority vote,] either  approve  or  reject  the
 application  [within  sixty  days  of  the  date  on which the last such
 approval has been obtained]. In order to approve  the  application,  the
 [council] COMMISSIONER shall have determined that:
   §  5.  Subdivisions  7 and 9 of section 4604 of the public health law,
 subdivision 7 as amended by chapter 659 of the laws of 1997 and subdivi-
 sion 9 as added by chapter 689 of the laws of 1989, are amended to  read
 as follows:
 A. 7742--A                          6
 
   7.  Any  change  in  the  legal  entity  operating the continuing care
 retirement community, or in a controlling person of the community  shall
 require  approval  in  the  same  manner  as  an  original  application;
 provided,  however,  that  the  [council]  COMMISSIONER  may  waive  any
 requirement  to  provide information that is not relevant to such change
 and provided, further, that the continued public need for the  community
 shall be presumed.
   9.  [If  the  council  approves the application, the] THE commissioner
 shall issue the certificate of authority to the applicant UPON  APPROVAL
 OF THE APPLICATION.
   §  6.  Section  4604-a of the public health law, as amended by chapter
 659 of the laws of 1997, paragraph g of  subdivision  2  as  amended  by
 chapter 549 of the laws of 2014, is amended to read as follows:
   §  4604-a.  [Council]  COMMISSIONER  approval  required for industrial
 development agency financing in connection with continuing care  retire-
 ment  communities.  1.  No person seeking financing in connection with a
 continuing care retirement community through an  industrial  development
 agency  shall undertake such financing without the prior approval of the
 [council] COMMISSIONER. Upon approving a proposed financing pursuant  to
 this  section,  the  [council] COMMISSIONER shall issue a certificate of
 authorization to the applicant.
   2. Prior to approving such financing, the [council] COMMISSIONER shall
 find that:
   a. The operator has  (i)  executed  contracts  for  at  least  seventy
 percent  of  all living units and has on deposit at least ten percent of
 the entrance fees or purchase price for such  units;  or  (ii)  executed
 contracts  for  at  least  sixty  percent of all living units and has on
 deposit at least twenty-five percent of the entrance  fees  or  purchase
 price for such units.
   b.  The  operator has demonstrated capability to comply fully with the
 requirements for a certificate of authority and has obtained  a  contin-
 gent certificate of authority pursuant to section forty-six hundred four
 of  this article and the operator has agreed to meet the requirements of
 article eighteen-A of the general municipal law.
   c. The applicant is a not-for-profit corporation as defined in section
 one hundred two of the not-for-profit corporation law that is (i) eligi-
 ble for tax-exempt financing under this section and (ii) is exempt  from
 taxation  pursuant  to section 501(c)(3) of the federal internal revenue
 code, and either has (i) an equity position in the community  equivalent
 to  no  less  than  fifteen  percent of the amount to be financed in the
 aggregate; or (ii) covenants (A) to meet a ratio of cash and investments
 to outstanding debt (reserve ratio) of no less than twenty-five  percent
 commencing at the end of the first quarter after twenty-four months from
 the  receipt  of a certificate of occupancy for the facility, and (B) to
 maintain that reserve ratio, as tested quarterly based upon the  facili-
 ty's interim financial statements and annually based upon audited finan-
 cial  statements,  until  debt reduction equal to twenty-five percent of
 total indebtedness is accomplished; and (c)  to  reduce  total  debt  by
 twenty-five  percent  of  the total indebtedness at the time the certif-
 icate of occupancy is received by no later than  five  years  after  the
 receipt of the certificate of occupancy.
   d.  The operator has submitted in connection with the proposed financ-
 ing a financial feasibility study, including a  financial  forecast  and
 market  study  prepared by an independent firm nationally recognized for
 continuing care retirement community feasibility studies,  demonstrating
 to  the  satisfaction of the [council] COMMISSIONER the financial sound-
 A. 7742--A                          7
 
 ness of the financing. In addition, the operator has submitted an analy-
 sis  of  economic  costs  and  benefits,  including  job  creation   and
 retention, the estimated value of tax exemptions provided, the project's
 impact  on local businesses and the availability and comparative cost of
 alternative financing sources. Such analysis shall  be  prepared  by  an
 independent entity.
   e.  The  operator  will  establish  and  maintain  a fully funded debt
 service reserve equal to the sum of maximum annual debt service  (inter-
 est  plus  annual  scheduled  principal  payments, not including balloon
 maturities, if any) on bonds authorized thereby having a maturity of ten
 years or less, plus the maximum annual debt service on bonds  authorized
 thereby  having a maturity of greater than ten years, provided, however,
 that in the case of tax-exempt bond issues, such  debt  service  reserve
 shall not exceed the maximum amount permitted by federal tax law.
   f. The operator will provide for such remedies or limitations of reme-
 dies  of  bondholders  as  may  be  required  by  or consistent with the
 provisions of this article and any regulations in existence at the  time
 of the issuance promulgated thereunder.
   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 such resident's or contract holder's assets are insufficient to pay
 for nursing facility services for a one year period.
   3. In addition, an operator which is subject to the provisions of this
 section shall:
   a.  provide  the [council or its designee] COMMISSIONER with notice of
 any monetary default or covenant default in connection with such financ-
 ing and shall further notify the [council or its designee]  COMMISSIONER
 of  any  withdrawal  from  the  debt service reserve fund established in
 connection with such financing;
   b. respond in writing to the operational recommendations of the [coun-
 cil or its designee] COMMISSIONER with respect to protecting the  inter-
 ests  of  continuing care retirement community residents in the event of
 any monetary default or covenant default provided for in connection with
 such financing;
   c. provide adequate security for the repayment of  the  bonds  issued,
 including  the  granting  of liens on real and personal property and the
 pledge of project revenues; the  maintenance  of  minimum  debt  service
 coverage  and other financial ratios as shall be required in regulations
 in existence at the time of issuance by the [council] COMMISSIONER;  and
 restrictions on other debt and expenditures; and
   d.  undertake  to  maintain the financial feasibility of the facility,
 including the retention of an independent consultant  to  recommend  and
 help implement remedial action.
   4.  The  [council]  COMMISSIONER  may  request, and shall receive, the
 technical assistance of any state agency or state  public  authority  in
 performing its functions under this article.
   § 7. Section 4605-a of the public health law, as added by chapter 7 of
 the laws of 2015, is amended to read as follows:
   § 4605-a. Certificate of authority; authority to offer continuing care
 at  home  contracts.    A continuing care retirement community may offer
 continuing care at home contracts upon approval by the [council] COMMIS-
 SIONER to amend the continuing care retirement  community's  certificate
 of authority. In order to qualify for an amendment to its certificate of
 A. 7742--A                          8
 
 authority,  the continuing care retirement community shall submit to the
 commissioner the following:
   1.  a  business  plan  to  the  commissioner [and superintendent] that
 includes the following:
   (a) a description of the continuing care at home services that will be
 provided, the market that will be served by the continuing care at  home
 contracts,  and the fees to be charged to prospective continuing care at
 home contract holders;
   (b) a copy of the proposed continuing care at home contract; and
   (c) an actuarial study prepared by an independent actuary  in  accord-
 ance  with standards adopted by the American Academy of Actuaries demon-
 strating the impact that the continuing care at home contracts will have
 on the overall operations of the continuing  care  retirement  community
 and  further  demonstrating that the addition of continuing care at home
 contracts will not jeopardize the financial solvency of  the  continuing
 care retirement community.
   2.  a  market feasibility study demonstrating to the commissioner [and
 superintendent] sufficient consumer interest in continuing care at  home
 contracts and further demonstrating that the addition of continuing care
 at  home  contracts  will not have an adverse impact on the provision of
 services to continuing care retirement contract holders.
   3. materials that meet all requirements established by the  [New  York
 state] department [of financial services].
   4.  [A]  A copy of the notification sent to continuing care retirement
 contract holders describing the anticipated impact of  the  addition  of
 continuing care at home contracts on continuing care retirement communi-
 ty  resources  and  proof that such notification has been distributed to
 all continuing care retirement contract holders.
   § 8. Section 4605-b of the public health law, as added by chapter 7 of
 the laws of 2015, is amended to read as follows:
   § 4605-b. Certificate of authority; limitation on continuing  care  at
 home  contracts.    The  number  of  continuing  care  at home contracts
 approved on a certificate of authority shall be limited to:
   1. The number of approved living units on the continuing care  retire-
 ment  community's  premises  that are intended for ILU residents, except
 that the [council] COMMISSIONER may approve additional contracts upon  a
 submission  [to  the  commissioner]  by  an operator consistent with the
 provisions set forth in section forty-six hundred five-a of  this  arti-
 cle;
   2. The demonstrated number of continuing care at home contract holders
 that can be supported in the existing or approved future capacity of the
 adult  care  facility  and  skilled nursing facility consistent with the
 provisions set forth in section forty-six hundred five-a of  this  arti-
 cle; and
   3.  Conditions set forth by the [New York state] department [of finan-
 cial services], based upon the [superintendent]  COMMISSIONER'S  assess-
 ment of the following:
   (a) the overall financial impact on the community; and
   (b)  the  submitted  materials  set forth in section forty-six hundred
 five-a of this article.
   § 9. Section 4607 of the public health law, as added by chapter 689 of
 the laws of 1989, paragraph d of subdivision 2 as amended by chapter 659
 of the laws of 1997, is amended to read as follows:
   § 4607. Annual statement.  1. Within four months of close of the oper-
 ator's fiscal year, unless an extension of time to file has been  grant-
 ed,  the  operator  shall file an annual statement with the commissioner
 A. 7742--A                          9
 
 [and superintendent] showing the condition as of the  last  day  of  the
 preceding  calendar or fiscal year. If the commissioner [and superinten-
 dent do] DOES not receive the annual statement within four months of the
 end  of  the  operator's fiscal year or have not granted an extension of
 time to file, the [council] COMMISSIONER may charge a late fee.
   2. The annual statement shall be in such form as the [council] COMMIS-
 SIONER prescribes and shall contain at least the following:
   a. Any change in status with respect to the information required to be
 submitted pursuant to section forty-six hundred four of this article;
   b. Financial statements audited by  an  independent  certified  public
 accountant, which shall contain, for two or more periods if the communi-
 ty has been in existence that long, the following:
   (i) an accountant's opinion and, in accordance with generally accepted
 accounting principles:
   (A) a balance sheet,
   (B) a statement of income and expenses,
   (C) a statement of equity or fund balances,
   (D) a statement of changes in financial position,
   (ii)  notes to the financial statements considered customary or neces-
 sary to ensure full disclosure of the  financial  statements,  financial
 condition, and operation;
   c. A detailed listing of the assets maintained for the reserves;
   d.  A  copy  of  the  most  recent  actuarial review of the community,
 including such information as may be required  by  the  [superintendent]
 COMMISSIONER  including an opinion of a qualified consulting actuary, as
 to the current and projected soundness of the community, provided howev-
 er that a new actuarial review must be submitted triennially; and
   e. Such other reasonable financial and other information as the [coun-
 cil] COMMISSIONER may require with respect to the operator or the commu-
 nity, or its directors, controlling persons, trustees, members,  branch-
 es,  subsidiaries or affiliates to determine the financial status of the
 community and the management capabilities of the operator.
   3. Sixty days before commencement of each calendar or fiscal  year  or
 official opening date, whichever is applicable, each operator shall file
 with  the  commissioner [and superintendent] a computation of the annual
 long-term debt service and a projected annual revenue and expense summa-
 ry for the next ten years.
   § 10. Section 4658 of the public health law, as added by  chapter  519
 of the laws of 2004, is amended to read as follows:
   §  4658. Annual statement. 1. Within four months of close of an opera-
 tor's fiscal year, unless an extension of time to file has been granted,
 the operator shall file an annual statement with the commissioner  show-
 ing the condition as of the last day of the preceding calendar or fiscal
 year.  If  the commissioner does not receive the annual statement within
 four months of the end of the operator's fiscal year or has not  granted
 an extension of time to file, the council may charge a late fee.
   2. The annual statement shall be in such form as the [council] COMMIS-
 SIONER prescribes and shall contain at least the following:
   a. Any change in status with respect to the information required to be
 submitted  pursuant  to  section  forty-six  hundred fifty-seven of this
 article;
   b. Financial statements audited by  an  independent  certified  public
 accountant, which shall contain, for two or more periods if the communi-
 ty has been in existence that long, the following:
 A. 7742--A                         10
 
   (i)  notes  to the financial statements considered customary or neces-
 sary to ensure full disclosure of the  financial  statements,  financial
 condition, and operation; and
   (ii)  an  accountant's  opinion  and,  in  accordance  with  generally
 accepted accounting principles: (A) a balance sheet, (B) a statement  of
 income and expenses, (C) a statement of equity or fund balances, and (D)
 a statement of changes in financial position;
   c. A detailed listing of the assets maintained for the reserves; and
   d. Such other reasonable financial and other information as the [coun-
 cil] COMMISSIONER may require with respect to the operator or the commu-
 nity,  or its directors, controlling persons, trustees, members, branch-
 es, subsidiaries or affiliates to determine the financial status of  the
 community and the management capabilities of the operator.
   3.  Sixty  days before commencement of each calendar or fiscal year or
 official opening date, whichever is applicable, each operator shall file
 with the commissioner a computation of the annual long-term debt service
 and a projected annual revenue and expense  summary  for  the  next  ten
 years.
   §  11.  Subdivision  16  of  section 4608 of the public health law, as
 amended by chapter 7 of the laws of 2015, is amended to read as follows:
   16. 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  financial
 services] COMMISSIONER;
   §  12.  Subdivisions 1 and 2 of section 4614 of the public health law,
 as amended by chapter 7 of the laws of 2015,  are  amended  to  read  as
 follows:
   1.  The  commissioner, or designee[; and the superintendent, or desig-
 nee;] may at any time, and shall at least once every three years,  visit
 each  community  and examine the business of any applicant for a certif-
 icate of authority and any operator engaged in the execution of continu-
 ing care retirement contracts or continuing 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 superintendent] COMMISSIONER, 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 superinten-
 dent] COMMISSIONER 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,]
 COMMISSIONER  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[, or department of financial services] may, upon presentation
 of proper identification, have access to, and inspect, any records main-
 tained 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.
   § 13. Section 4615 of the public health law, as added by  chapter  689
 of  the laws of 1989, paragraph j of subdivision 1 as further amended by
 section 104 of part A of chapter 62 of the laws of 2011, paragraph k  of
 A. 7742--A                         11
 
 subdivision  1  as amended by chapter 7 of the laws of 2015 and subdivi-
 sion 3 as amended by chapter 659 of the laws of 1997, is amended to read
 as follows:
   § 4615. Revocation, suspension or annulment of certificate of authori-
 ty.  1.  The  [council] COMMISSIONER may revoke, suspend, limit or annul
 the certificate of authority of an operator upon proof that:
   a. The operator failed to continue to meet the  requirements  for  the
 authority originally granted;
   b.  The  operator  lacked  one  or  more of the qualifications for the
 certificate of authority as specified by this article;
   c. The operator made a material  misstatement,  misrepresentation,  or
 committed  fraud  in  obtaining  the  certificate  of  authority,  or in
 attempting to obtain the same;
   d. The operator lacked fitness or was untrustworthy;
   e. The operator  engaged  in  fraudulent  or  dishonest  practices  of
 management  in the conduct of business under the certificate of authori-
 ty;
   f. The operator converted or withheld funds;
   g. The operator failed to comply with, or violated, any proper  order,
 rule  or  regulation  of  the  council or violated any provision of this
 article;
   h. The unsound business practices of the operator renders its  further
 transactions in this state hazardous or injurious to the public;
   i. The operator has refused to be examined or to produce its accounts,
 records,  and  files  for  examination,  or  its officers, employees, or
 controlling persons have refused to give information with respect to the
 affairs of the community or to perform any other legal obligation as  to
 such examination;
   j.  The [superintendent of financial services] COMMISSIONER has made a
 determination that the operator  is  insolvent  within  the  meaning  of
 section one thousand three hundred nine of the insurance law; or
   k. The commissioner has found violations of applicable statutes, rules
 or  regulations which threaten to affect directly the health, safety, or
 welfare of a resident.
   2. No certificate of authority shall be revoked, suspended, limited or
 annulled without a hearing, except that a certificate of  authority  may
 be  temporarily suspended or limited prior to a hearing for a period not
 in excess of sixty days upon written notice to the operator following  a
 finding by the commissioner that the public health or safety is in immi-
 nent  danger  or  there exists any condition or practice or a continuing
 pattern of conditions or practices that pose an imminent danger  to  the
 health or safety of any resident. Any delay in the hearing process occa-
 sioned  by  the  operator  shall  toll the running of said suspension or
 limitation and shall not abridge the full time provided in this subdivi-
 sion.
   3. Any state agency which seeks to revoke, suspend, limit or annul the
 certificate of authority or any other license or certificate required to
 be obtained by an operator of a  continuing  care  retirement  community
 pursuant  to law, shall request the [council] COMMISSIONER to commence a
 hearing pursuant to this section.
   4. The [council] COMMISSIONER shall fix a time and place for the hear-
 ing. The commissioner shall cause to be served in person  or  mailed  by
 registered  or  certified  mail to the operator at least ten days before
 the date fixed for the hearing a copy of the charges, together with  the
 notice  of  the  time  and place of the hearing. The operator shall file
 with the commissioner not less than three days prior to  the  hearing  a
 A. 7742--A                         12
 
 written answer to the charges. The agency which initiated the proceeding
 shall be responsible for providing evidence in support of the charges to
 the  commissioner  in  order to prepare a statement of charges and shall
 provide evidence in support of the charges at the hearing.
   5.  All  orders  hereunder  shall  be subject to review as provided in
 article seventy-eight of the civil practice law and  rules.  Application
 for  such  review must be made within sixty days after service in person
 or by registered or certified mail of a copy of the order upon the oper-
 ator.
   § 14. Section 4616 of the public health law, as added by  chapter  689
 of  the laws of 1989, the opening paragraph as amended by chapter 659 of
 the laws of 1997, is amended to read as follows:
   § 4616. Appointment of a caretaker. Upon a determination by the [coun-
 cil] COMMISSIONER  that  there  exists  operational  deficiencies  in  a
 continuing care retirement community that show:
   1. a condition or conditions in substantial violation of the standards
 for  health,  safety  or patient care established under federal or state
 law or regulations; OR
   2. [or] that there exists in the facility a  pattern  or  practice  of
 habitual  violation  of  the standards of health, safety or patient care
 established under federal or state law  or  regulations,  the  [council]
 COMMISSIONER  shall  take  the  actions  prescribed by section forty-six
 hundred fifteen of this article, and, where the  [council]  COMMISSIONER
 deems it to be in the public interest, the [council may request that the
 commissioner, and upon request of the council the] commissioner shall[,]
 petition  a  court  of  competent jurisdiction to appoint a caretaker as
 defined in section twenty-eight hundred one of this chapter.  The  peti-
 tion, the proceedings, and the procedures for appointment of a caretaker
 shall  be governed by the provisions of section forty-six hundred seven-
 teen of this article, and the powers, duties and rights of  a  caretaker
 appointed pursuant to such section shall be the same as those authorized
 by subdivision four of such section.
   §  15.  Subdivisions  1,  2 and 8 of section 4617 of the public health
 law, subdivision 1 as amended by chapter 659 of the laws  of  1997,  and
 subdivisions  2  and  8 as added by chapter 689 of the laws of 1989, are
 amended to read as follows:
   1. The [council] COMMISSIONER may, [if it determines] UPON A  DETERMI-
 NATION  that serious operational deficiencies exist or serious financial
 problems exist and such action is desirable,  enter  into  an  agreement
 with  the  operator  or owners of a continuing care retirement community
 with respect to the appointment of a receiver  to  take  charge  of  the
 community  under conditions as found acceptable by both parties. Receiv-
 ership commenced in accordance with the provisions of  this  subdivision
 shall  terminate  at  such  time  as may be provided in the receivership
 agreement, or at such time as either party notifies the other in writing
 that it wishes to terminate such receivership.
   2. [Upon request of the council, the] THE commissioner shall,  at  the
 time  of revocation, suspension or temporary suspension of a certificate
 of authority, apply to the supreme court where the community is situated
 for an order directing the owner of the land and/or structure on  or  in
 which  the community is located, to show cause why a receiver should not
 be appointed to take charge of the community.  In those cases where  the
 certificate  of  authority  has  been  revoked, suspended or temporarily
 suspended, the supreme  court  shall  appoint  a  receiver  that,  where
 reasonably possible, is a legal entity that holds a valid certificate of
 authority.  Such  application  shall contain proof by affidavit that the
 A. 7742--A                         13

 facility has had its certificate of  authority  revoked,  suspended,  or
 temporarily  suspended. Such order to show cause shall be returnable not
 less than five days after service is completed  and  shall  provide  for
 personal  service of a copy thereof and the papers on which it is based,
 on the owner or owners of the land and/or structures on or in which  the
 community  is  located.  If  any  such owner and manager cannot with due
 diligence be served personally within the county where the  property  is
 located  and  within  the  time fixed in such order, then service may be
 made on such person by posting a copy thereof  in  a  conspicuous  place
 within  the  community  in  question,  and  by sending a copy thereof by
 registered mail, return receipt requested, to such  owner  at  the  last
 address  registered  by  [him]  SUCH OWNER with the department or in the
 absence of such registration to  the  address  set  forth  in  the  last
 recorded  deed  with  respect  to  the facility. Service shall be deemed
 complete on filing proof of service thereof in the office of the  county
 clerk, or the clerk of the city of New York, as the case may be.
   8.  Any other provision of this article notwithstanding, the [council]
 COMMISSIONER may, if [it] SUCH COMMISSIONER deems appropriate, grant  to
 any  community  operating  or  scheduled to operate under a receivership
 authorized by this section a certificate of authority, the  duration  of
 which shall be limited to the duration of the receivership.
   §  16.  Section 4668 of the public health law, as added by chapter 519
 of the laws of 2004, is amended to read as follows:
   § 4668. Revocation, suspension or annulment of certificate of authori-
 ty. 1. The [council] COMMISSIONER may revoke, suspend,  limit  or  annul
 the certificate of authority of an operator upon proof that:
   a.  The  operator  failed to continue to meet the requirements for the
 authority originally granted;
   b. The operator lacked one or  more  of  the  qualifications  for  the
 certificate of authority as specified by this article;
   c.  The  operator  made a material misstatement, misrepresentation, or
 committed fraud  in  obtaining  the  certificate  of  authority,  or  in
 attempting to obtain the same;
   d. The operator lacked fitness or was untrustworthy;
   e.  The  operator  engaged  in  fraudulent  or  dishonest practices of
 management in the conduct of business under the certificate of  authori-
 ty;
   f. The operator converted or withheld funds;
   g.  The operator failed to comply with, or violated, any proper order,
 rule or regulation of the council or  violated  any  provision  of  this
 article;
   h.  The unsound business practices of the operator renders its further
 transactions in this state hazardous or injurious to the public;
   i. The operator has refused to be examined or to produce its accounts,
 records and  files  for  examination,  or  its  officers,  employees  or
 controlling persons have refused to give information with respect to the
 affairs  of the community or to perform any other legal obligation as to
 such examination; or
   j. The commissioner has found violations of applicable statutes, rules
 or regulations which threaten to affect directly the health, safety,  or
 welfare  of  a  resident of a fee-for-service continuing care retirement
 community.
   2. No certificate of authority shall be revoked, suspended, limited or
 annulled without a hearing, except that a certificate of  authority  may
 be  temporarily suspended or limited prior to a hearing for a period not
 in excess of sixty days upon written notice to the operator following  a
 A. 7742--A                         14
 
 finding  by the commissioner that public health or safety is in imminent
 danger or there exists any condition or practice or a continuing pattern
 of conditions or practices that pose an imminent danger to the health or
 safety  of  any resident. Any delay in the hearing process occasioned by
 the operator shall toll the running of said suspension or limitation and
 shall not abridge the full time provided in this subdivision.
   3. Any state agency which seeks to revoke, suspend, limit or annul the
 certificate of authority or any other license or certificate required to
 be obtained by an operator of a community pursuant to law, shall request
 the [council] COMMISSIONER  to  commence  a  hearing  pursuant  to  this
 section.
   4. The [council] COMMISSIONER shall fix a time and place for the hear-
 ing.  The  commissioner  shall cause to be served in person or mailed by
 registered or certified mail to the operator at least  ten  days  before
 the  date fixed for the hearing a copy of the charges, together with the
 notice of the time and place of the hearing.  The  operator  shall  file
 with  the  commissioner  not less than three days prior to the hearing a
 written answer to the charges. The agency which initiated the proceeding
 shall be responsible for providing evidence in support of the charges to
 the commissioner in order to prepare a statement of  charges  and  shall
 provide evidence in support of the charges at the hearing.
   5.  All  orders pursuant to this section shall be subject to review as
 provided in article seventy-eight of the civil practice law  and  rules.
 Application  for  such  review  shall  be  made  within sixty days after
 service in person or by registered or certified mail of a  copy  of  the
 order upon the operator.
   §  17.  Section 4669 of the public health law, as added by chapter 519
 of the laws of 2004, is amended to read as follows:
   § 4669. Appointment of a caretaker.    Upon  a  determination  by  the
 [council]  COMMISSIONER  that there exists operational deficiencies in a
 fee-for-service continuing care retirement community that show:
   1. there exists in the facility a  pattern  or  practice  of  habitual
 violation of the standards of health, safety or patient care established
 under  federal  or  state law or regulations, the [council] COMMISSIONER
 shall take the actions prescribed by section  forty-six  hundred  sixty-
 eight of this article, and, where the [council] COMMISSIONER deems it to
 be  in  the  public interest, the [council may request the commissioner,
 and upon request of the council the] commissioner  shall[,]  petition  a
 court  of  competent  jurisdiction  to appoint a caretaker as defined in
 section twenty-eight hundred one of  this  chapter.  The  petition,  the
 proceedings,  and the procedures for appointment of a caretaker shall be
 governed by the provisions of section forty-six hundred seventy of  this
 article,  and  the  power,  duties  and  rights of a caretaker appointed
 pursuant to such section shall be the same as those authorized by subdi-
 vision four of such section; or
   2. a condition or conditions in substantial violation of the standards
 for health, safety or patient care established under  federal  or  state
 law or regulations.
   §  18.  Subdivisions  1,  2 and 8 of section 4670 of the public health
 law, as added by chapter 519 of the laws of 2004, are amended to read as
 follows:
   1. The [council] COMMISSIONER may, [if it determines] UPON A  DETERMI-
 NATION  that serious operational deficiencies exist or serious financial
 problems exist and such action is desirable,  enter  into  an  agreement
 with the operator or owners of a fee-for-service continuing care retire-
 ment  community  with  respect  to the appointment of a receiver to take
 A. 7742--A                         15
 
 charge of the community under conditions as  found  acceptable  by  both
 parties.    Receivership  commenced in accordance with the provisions of
 this subdivision shall terminate at such time as may be provided in  the
 receivership  agreement,  or  at  such time as either party notifies the
 other in writing that it wishes to terminate such receivership.
   2. [Upon request of the council, the] THE commissioner shall,  at  the
 time  of revocation, suspension or temporary suspension of a certificate
 of authority, apply to the supreme court where the community is situated
 for an order directing the owner of the land and/or structure on  or  in
 which  the community is located, to show cause why a receiver should not
 be appointed to take charge of the community. In those cases  where  the
 certificate  of  authority  has  been  revoked, suspended or temporarily
 suspended, the supreme  court  shall  appoint  a  receiver  that,  where
 reasonably possible, is a legal entity that holds a valid certificate of
 authority.  Such  application  shall contain proof by affidavit that the
 facility has had its certificate  of  authority  revoked,  suspended  or
 temporarily  suspended. Such order to show cause shall be returnable not
 less than five days after service is completed  and  shall  provide  for
 personal  service of a copy thereof and the papers on which it is based,
 on the owner or owners of the land and/or structures on or in which  the
 community  is  located.  If  any  such owner and manager cannot with due
 diligence be served personally within the county where the  property  is
 located  and  within  the  time fixed in such order, then service may be
 made on such person by posting a copy thereof  in  a  conspicuous  place
 within  the  community  in  question,  and  by sending a copy thereof by
 registered mail, return receipt requested, to such  owner  at  the  last
 address  registered by [him or her] SUCH OWNER with the department or in
 the absence of such registration to the address set forth  in  the  last
 recorded  deed  with  respect  to  the facility. Service shall be deemed
 complete on filing proof of service thereof in the office of the  county
 clerk, or the clerk of the city of New York, as the case may be.
   8.  Any other provision of this article notwithstanding, the [council]
 COMMISSIONER may, if [it] SUCH COMMISSIONER deems appropriate, grant  to
 any  community  operating  or  scheduled to operate under a receivership
 authorized by this section a certificate of authority, the  duration  of
 which shall be limited to the duration of the receivership.
   §  19.  Paragraph  g  of  subdivision  4 of section 4621 of the public
 health law, as added by chapter 406 of the laws of 1991, is  amended  to
 read as follows:
   g.  If  the  funds  in  an  escrow account under this section, and any
 interest thereon, are not released to the applicant within such time  as
 provided by rules and regulations adopted by the [council] COMMISSIONER,
 then  such funds shall be returned by the escrow agent to the person who
 had made the payments or the person's legal representative.
   § 20. Subdivision 1 of section 4623  of  the  public  health  law,  as
 amended  by  chapter  659  of  the  laws  of 1997, is amended to read as
 follows:
   1. The [council] COMMISSIONER may approve an application for a certif-
 icate of authority and [the commissioner] may  issue  a  certificate  of
 authority  for  the  establishment  and  operation  of a continuing care
 retirement community under an arrangement which otherwise complies  with
 the requirements of this article except that the costs of nursing facil-
 ity or home health care services are paid for in whole or in part by (a)
 long  term  care  insurance  obtained and paid for by the resident or by
 medical assistance payments in accordance with the partnership for  long
 term care program pursuant to section three hundred sixty-seven-f of the
 A. 7742--A                         16
 
 social  services  law and section three thousand two hundred twenty-nine
 of the insurance law or (b) other group or  individual  long  term  care
 insurance  approved  by the superintendent and the council in connection
 with  the application. The council, in consultation with the superinten-
 dent, shall provide  for  adequate  disclosure  to  residents  of  their
 options,  rights  and  obligations  under such an arrangement, and shall
 establish standards for the remittance and collection  of  premiums  and
 monthly care fees.
   §  21.  The  opening paragraph of subdivision 14 and subdivision 15 of
 section 4657 of the public health law, as added by chapter  519  of  the
 laws of 2004, are amended to read as follows:
   In  accordance  with  regulations promulgated by the [council] COMMIS-
 SIONER, the operator shall prepare a standard information sheet for each
 approved fee-for-service continuing  care  retirement  community,  which
 must  be  approved  by  the department, distributed with the community's
 marketing materials and attached to  the  initial  disclosure  statement
 prepared in accordance with this section. The standard information sheet
 shall  be  prepared in plain language and in twelve point type and shall
 include, but shall not be limited to the following information:
   15. Any other information as may be required by regulations promulgat-
 ed by the [council] COMMISSIONER.
   § 22. The opening paragraph  and  paragraph  d  of  subdivision  2  of
 section  4658  of  the public health law, as added by chapter 519 of the
 laws of 2004, are amended to read as follows:
   The annual statement shall be in such form as  the  [council]  COMMIS-
 SIONER prescribes and shall contain at least the following:
   d. Such other reasonable financial and other information as the [coun-
 cil] COMMISSIONER may require with respect to the operator or the commu-
 nity,  or its directors, controlling persons, trustees, members, branch-
 es, subsidiaries or affiliates to determine the financial status of  the
 community and the management capabilities of the operator.
   § 23. Subdivision 2 of section 4651 of the public health law, as added
 by chapter 519 of the laws of 2004, is amended to read as follows:
   2. "Certificates" or "certificate of authority" shall mean an authori-
 zation  in  writing, approved [by the council] and issued by the commis-
 sioner, for an operator to operate  a  fee-for-service  continuing  care
 retirement  community  and to enter into fee-for-service continuing care
 contracts pertaining to such community.
   § 24. Section 4654 of the public health law, as amended by chapter 545
 of the laws of 2004, is amended to read as follows:
   § 4654. Authorization of fee-for-service  continuing  care  retirement
 communities.    The  commissioner[, upon approval of the continuing care
 retirement community council,] shall approve up to eight fee-for-service
 continuing care retirement  communities  to  encourage  affordable  care
 options for middle income seniors, up to two of which may be operated by
 a for-profit entity.
   §  25. The opening paragraph of section 4659 of the public health law,
 as added by chapter 519 of the laws of  2004,  is  amended  to  read  as
 follows:
   A  fee-for-service  continuing  care 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 commissioner:
   §  26.  The  opening paragraph of subdivision 5 of section 4655 of the
 public health law, as amended by chapter 545 of the  laws  of  2004,  is
 amended to read as follows:
 A. 7742--A                         17
 
   If  the  [approvals]  APPLICANT HAS SATISFIED THE CRITERIA required by
 subdivision four-a of this section have  been  obtained,  the  [council]
 COMMISSIONER  shall[,  by  majority  vote,] either approve or reject the
 application [within sixty days of  the  date  on  which  the  last  such
 approval  has  been  obtained]. In order to approve the application, the
 [council] COMMISSIONER shall have determined that:
   § 27. Subdivisions 6 and 8 of section 4655 of the public  health  law,
 as  added  by  chapter  519  of the laws of 2004, are amended to read as
 follows:
   6. Any change  in  the  legal  entity  operating  the  fee-for-service
 continuing  care retirement community, or in a controlling person of the
 community shall require approval in  the  same  manner  as  an  original
 application;  provided,  however,  that  the  [council] COMMISSIONER may
 waive any requirement to provide information that  is  not  relevant  to
 such  change  and  provided, further, that the continued public need for
 the community shall be presumed.
   8. [If the council approves the  application,  the]  THE  commissioner
 shall issue a certificate of authority to the applicant UPON APPROVAL OF
 THE APPLICATION.
   §  28.  Section 4611 of the public health law, as added by chapter 689
 of the laws of 1989, the opening paragraph of subdivision 1  as  further
 amended  by  section 104 of part A of chapter 62 of the laws of 2011, is
 amended to read as follows:
   § 4611. Reserves and supporting assets.  1. An operator shall maintain
 reserve liabilities and supporting assets  in  an  amount  and  for  the
 purposes  set  forth  in  a  regulation issued by the [superintendent of
 financial services] COMMISSIONER.  Liquid assets must be maintained  for
 the following reserve liabilities:
   a.  Principal  and interest payments and payments for taxes and insur-
 ance for up to twelve months;
   b. Total estimated operating costs for up to six months as set by  the
 [superintendent] COMMISSIONER;
   c. Repairs and replacements for up to twelve months; and
   d.  In  addition,  the amount of liquid assets must meet any cash flow
 requirements and conditions as set forth in a regulation.
   2. The assets in support of reserve liabilities of subdivision one  of
 this section shall meet quantitative and qualitative standards set forth
 in regulations issued by the [superintendent] COMMISSIONER.
   §  29. Section 1119 of the insurance law, as amended by chapter 659 of
 the laws of 1997, is amended to read as follows:
   § 1119. Limited exemption for continuing care retirement  communities.
 [(a)] An organization complying with the provisions of article forty-six
 of  the  public health law may operate without being licensed under this
 chapter and without being subject to any  provisions  of  this  chapter,
 except  to  the  extent  that  such  organization  must  comply with the
 provisions of this chapter by virtue of such article[, and  such  organ-
 ization  must  comply  with  rules and regulations of the superintendent
 relating to:
   (1) financial feasibility of the continuing care retirement community,
   (2) actuarial principles established relating to such communities,
   (3) approval of continuing care retirement contracts and the rates and
 rating system, if any, for such contracts.
   (b) The superintendent may promulgate regulations in effectuating  the
 purposes and the provisions of this chapter and article forty-six of the
 public  health  law,  which  may  include requirements applicable to the
 A. 7742--A                         18

 contracts between a continuing care retirement community and  its  resi-
 dents.
   (c)  Such  organization  shall be subject to the provisions of article
 seventy-four of this chapter. Prior to commencing action  under  article
 seventy-four,  the superintendent shall consult with the continuing care
 retirement community council established pursuant to  section  forty-six
 hundred two of the public health law].
   §  30.  Subdivision  1  of  section  4621 of the public health law, as
 amended by chapter 659 of the laws  of  1997,  is  amended  to  read  as
 follows:
   1.  No person, partnership, corporation or other entity shall solicit,
 collect or receive any priority reservation fee or enter into any agree-
 ment relating to the  payment  of  any  priority  reservation  fee  with
 respect to any continuing care retirement community to be operated with-
 in  the  state  without first obtaining the written authorization of the
 commissioner. The commissioner shall not grant such authorization to  an
 entity  that  has not yet obtained a certificate of authority unless the
 requirements of this section and any  applicable  regulations  are  met.
 Upon obtaining the authorization of the commissioner under this section,
 a prospective continuing care retirement community applicant or an enti-
 ty  that  has  filed  an  application for a certificate of authority may
 enter into cancelable priority reservation agreements  with  prospective
 residents  and solicit, collect and receive refundable priority reserva-
 tion fees for direct deposit into an escrow account, prior to  obtaining
 a  certificate of authority, for the purpose of evaluating market demand
 for a proposed continuing care retirement community and for the  purpose
 of  guaranteeing  to  prospective  residents an opportunity for priority
 placement in a continuing care retirement community. A priority reserva-
 tion fee shall not exceed two thousand dollars UNLESS THE  COMMISSIONER,
 IN  THE  DISCRETION  OF  SUCH  COMMISSIONER, ESTABLISHES THAT A PRIORITY
 RESERVATION FEE MAY EXCEED TWO THOUSAND DOLLARS. A non-refundable prior-
 ity reservation agreement application fee shall not exceed  the  maximum
 amount [for such fee as set forth in regulations adopted by the council]
 ESTABLISHED BY THE COMMISSIONER, IN SUCH COMMISSIONER'S DISCRETION.
   §  31.  Subdivision  1  of  section  4622 of the public health law, as
 amended by chapter 659 of the laws  of  1997,  is  amended  to  read  as
 follows:
   1.  No person, partnership, corporation or other entity shall solicit,
 collect or receive any priority reservation fee or enter into any agree-
 ment relating to the  payment  of  any  priority  reservation  fee  with
 respect  to  any  continuing care retirement community operated or to be
 operated within the state without first obtaining the  written  authori-
 zation  of  the  commissioner.  The  commissioner  shall  not grant such
 authorization to an entity that has obtained a certificate of  authority
 unless  the  requirements of this section and any applicable regulations
 are met. Upon obtaining the authorization of the commissioner under this
 section, an operator may  enter  into  cancelable  priority  reservation
 agreements  with  prospective residents and solicit, collect and receive
 refundable priority reservation fees for direct deposit into  an  escrow
 account  for  the  purpose  of  guaranteeing to prospective residents an
 opportunity for priority placement in  the  continuing  care  retirement
 community  for which the operator has obtained a certificate of authori-
 ty. A priority reservation fee shall not  exceed  two  thousand  dollars
 UNLESS  THE COMMISSIONER, IN THE DISCRETION OF SUCH COMMISSIONER, ESTAB-
 LISHES THAT A PRIORITY RESERVATION FEE MAY EXCEED TWO THOUSAND  DOLLARS.
 A  non-refundable  priority  reservation agreement application fee shall
 A. 7742--A                         19
 
 not exceed the maximum amount [for such fee as set forth in  regulations
 adopted by the council] ESTABLISHED BY THE COMMISSIONER, IN SUCH COMMIS-
 SIONER'S DISCRETION.
   § 32. Subdivision 1 of section 4674 of the public health law, as added
 by chapter 519 of the laws of 2004, is amended to read as follows:
   1.  No person, partnership, corporation or other entity shall solicit,
 collect or receive any priority reservation fee or enter into any agree-
 ment relating to the  payment  of  any  priority  reservation  fee  with
 respect  to  any fee-for-service continuing care retirement community to
 be operated within the state without first obtaining the written author-
 ization of the commissioner.  The  commissioner  shall  not  grant  such
 authorization  to  an  entity that has not yet obtained a certificate of
 authority unless the requirements of this  section  and  any  applicable
 regulations are met. Upon obtaining the authorization of the commission-
 er  under  this  section, a prospective community applicant or an entity
 having filed an application for a certificate  of  authority  may  enter
 into  cancelable  priority reservation agreements with prospective resi-
 dents and solicit, collect and receive refundable  priority  reservation
 fees  for  direct  deposit  into an escrow account, prior to obtaining a
 certificate of authority, for the purpose of  evaluating  market  demand
 for  a proposed fee-for-service continuing care retirement community and
 for the purpose of guaranteeing to prospective residents an  opportunity
 for  priority  placement in a fee-for-service continuing care retirement
 community. A priority reservation fee  shall  not  exceed  two  thousand
 dollars UNLESS THE COMMISSIONER, IN THE DISCRETION OF SUCH COMMISSIONER,
 ESTABLISHES  THAT  A  PRIORITY  RESERVATION  FEE MAY EXCEED TWO THOUSAND
 DOLLARS.  A non-refundable priority  reservation  agreement  application
 fee  shall  not  exceed the maximum amount [for such fee as set forth in
 regulations adopted by the council] ESTABLISHED BY THE COMMISSIONER,  IN
 SUCH COMMISSIONER'S DISCRETION.
   § 33. Subdivision 1 of section 4675 of the public health law, as added
 by chapter 519 of the laws of 2004, is amended to read as follows:
   1.  No person, partnership, corporation or other entity shall solicit,
 collect or receive any priority reservation fee or enter into any agree-
 ment relating to the  payment  of  any  priority  reservation  fee  with
 respect  to  any  fee-for-service  continuing  care retirement community
 operated or to be operated within the state without first obtaining  the
 written  authorization  of  the commissioner. The commissioner shall not
 grant such authorization to an entity that has obtained a certificate of
 authority unless the requirements of this  section  and  any  applicable
 regulations are met. Upon obtaining the authorization of the commission-
 er  under  this  section, an operator may enter into cancelable priority
 reservation agreements with prospective residents and  solicit,  collect
 and receive refundable priority reservation fees for direct deposit into
 an  escrow  account for the purpose of guaranteeing to prospective resi-
 dents an opportunity  for  priority  placement  in  the  fee-for-service
 continuing care retirement community for which the operator has obtained
 a  certificate of authority. A priority reservation fee shall not exceed
 two thousand dollars UNLESS THE COMMISSIONER, IN THE DISCRETION OF  SUCH
 COMMISSIONER, ESTABLISHES THAT A PRIORITY RESERVATION FEE MAY EXCEED TWO
 THOUSAND  DOLLARS.    A  non-refundable  priority  reservation agreement
 application fee shall not exceed the maximum amount [for such fee as set
 forth in regulations adopted by the council] ESTABLISHED BY THE  COMMIS-
 SIONER, IN SUCH COMMISSIONER'S DISCRETION.
   §  34.  No later than December 1, 2024, the commissioner of health, in
 conjunction with the superintendent of financial services, shall  evalu-
 A. 7742--A                         20
 
 ate and make recommendations regarding the additional resources required
 by  the  department of health to implement this act to the governor, the
 division of the budget, the senate finance committee  and  the  assembly
 ways and means committee.
   §  35.  Notwithstanding  section  163  of  the  state finance law, the
 commissioner  of  health  may  enter  into  new  contracts,  or  in  the
 discretion  of  such  commissioner,  institute a contract addendum to an
 existing contract to secure actuarial and other services,  necessary  to
 implement this act.
   § 36. This act shall take effect immediately.