The New York State Senate

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

                                  8193

                       2019-2020 Regular Sessions

                          I N  A S S E M B L Y

                              June 7, 2019
                               ___________

Introduced  by M. of A. SCHIMMINGER, GOTTFRIED -- read once and referred
  to the Committee on Health

AN ACT to amend the public health law, in relation  to  promoting  effi-
  cient  and  effective oversight of continuing care retirement communi-
  ties; 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
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.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD13175-02-9

A. 8193                             2

  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;
  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

A. 8193                             3

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
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 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

A. 8193                             4

ALLOWED THE NECESSARY AND ACTUAL EXPENSES WHICH HE OR SHE SHALL INCUR IN
THE PERFORMANCE OF HIS/HER OR 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  HIS  OR  HER  DESIGNEE,
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];
  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 HIS OR HER
DESIGNEE, INCLUDING ANY  NECESSARY  INDEPENDENT  ACTUARIAL  REVIEW,  and

A. 8193                             5

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:
  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.

A. 8193                             6

  §  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-
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

A. 8193                             7

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
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-

A. 8193                             8

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
[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;

A. 8193                             9

  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:
  (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-

A. 8193                            10

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. Subdivision 1 of section 4667 of the public health law, as added
by chapter 519 of the laws of 2004, is amended to read as follows:
  1. The commissioner[, or his or her designee,] may at  any  time,  and
shall  at least once every three years, visit each community and examine
the business of any applicant for a certificate  of  authority  and  any
operator  engaged  in  the  execution of fee-for-service continuing care
contracts or engaged  in  the  performance  of  obligations  under  such
contracts.  Routine  examinations  may  be conducted by having documents
designated by and submitted to the  commissioner,  which  shall  include
financial documents and records conforming to commonly accepted account-
ing  principles  and  practices.  The  final written report of each such
examination conducted by  the  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

A. 8193                            11

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 commissioner may, at any
time, examine the records and affairs and inspect the community's facil-
ities, whether in connection with a formal examination or not.
  §  14.  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
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

A. 8193                            12

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  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.
  § 15. 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.
  §  16.  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

A. 8193                            13

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 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] HE OR SHE  deems  appropriate,  grant  to  any
community operating or scheduled to operate under a receivership author-
ized  by  this section a certificate of authority, the duration of which
shall be limited to the duration of the receivership.
  § 17. 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

A. 8193                            14

  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
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.
  §  18.  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.

A. 8193                            15

  §  19.  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
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 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]  HE  OR SHE deems appropriate, grant to any
community operating or scheduled to operate under a receivership author-
ized by this section a certificate of authority, the duration  of  which
shall be limited to the duration of the receivership.
  §  20.  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.
  § 21. 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:

A. 8193                            16

  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
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.
  § 22. 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.
  §  23.  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.
  § 24. 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.
  § 25. 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.

A. 8193                            17

  § 26. 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:
  §  27.  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:
  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:
  § 28. 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.
  §  29.  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.
  §  30.  This  act  shall  take effect on the one hundred eightieth day
after it shall have become a law.  Effective immediately, the  addition,
amendment  and/or  repeal  of  any  rule or regulation necessary for the
implementation of this act on its effective date are  authorized  to  be
made and completed on or before such effective date.