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This entry was published on 2015-04-10
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SECTION 4601
Definitions
Public Health (PBH) CHAPTER 45, ARTICLE 46
§ 4601. Definitions. As used in this article:

1. "Certificates" or "certificate of authority" shall mean an
authorization in writing, approved by the council and issued by the
commissioner, for an operator to operate a continuing care retirement
community and to enter into continuing care retirement contracts and
continuing care at home contracts pertaining to such community.

2. "Commissioner" shall mean the commissioner of health.

2-a. "Continuing care retirement contract" or "continuing care at home
contract" shall mean a single contract to provide a person the services
provided by a continuing care retirement community.

2-b. "Continuing care retirement community" or "community" shall mean
a facility or facilities established to provide a comprehensive,
cohesive living arrangement for the elderly, oriented to the enhancement
of the quality of life and which, pursuant to a contract, at a minimum:

a. for continuing care retirement contracts, provides independent
living units, and meal plan options. The independent living unit can be
made available either through a non-equity arrangement or through an
equity arrangement including, but not limited to a cooperative or
condominium. For purposes of this article, the purchase price of an
independent living unit in an equity arrangement, regardless of the form
of the purchase agreement, shall not be considered an entry fee for
purposes of calculating reserve liabilities, but shall be considered an
entry fee for escrow purposes;

b. provides a range of health care and social services, subject to
such terms as may be included within the contract, which shall include
adult care facility services of an on-site or affiliated adult care
facility, and at a minimum, sixty days of prepaid services of an on-site
or affiliated nursing facility for residents not receiving services
under a fee-for-service contract;

c. provides access to health services as defined in the contract,
prescription drugs, and rehabilitation services;

d. nothing in this article shall eliminate the obligation of a
continuing care retirement community to provide at least sixty days of
prepaid nursing facility services to all residents, with the exception
of residents receiving services under the terms of a fee-for-service
continuing care contract as defined in this section. The prepaid days
must include the first sixty days of nursing facility services, whether
or not consecutive, not covered by Title XVIII of the federal social
security act;

e. communities established under this article and offering
fee-for-service continuing care contracts must offer, along with such
fee-for-service continuing care contracts, life care and/or continuing
care contracts as defined in subdivision eight-a of this section; and

f. communities established under this article offering continuing care
at home contracts must also offer continuing care retirement contracts
and must maintain a continuing care retirement community that operates
in support of the continuing care at home contracts.

3. "Contracts" or "agreements" shall mean continuing care at home or
continuing care retirement contracts as defined in this article.

4. "Control", "controlling", "controlled by", and "under common
control with" shall mean the possession, directly, or indirectly, of the
power to direct or cause the direction of the management and policies of
a person, whether through the ownership of voting securities or voting
rights, by contract (except a commercial contract for goods or
non-management services) or otherwise; but no person shall be deemed to
control another person solely by reason of his being an officer or
director of such other person. Control shall be presumed to exist if any
person directly or indirectly owns, controls, or holds with the power to
vote ten percent or more of the voting securities or voting rights of
any other person or is a corporate member of the legal entity.

5. "Council" shall mean the continuing care retirement community
council, established pursuant to section forty-six hundred two of this
article.

6. "Entrance fee" shall mean an initial or deferred transfer to an
operator of a sum of money, made or promised to be made by a person or
persons entering into a continuing care retirement contract or
continuing care at home contract, for the purpose of ensuring services
pursuant to such a contract.

7. "Facility" shall mean any place in which an operator undertakes to
provide a resident with the services of a continuing care retirement
community, pursuant to a contract, whether such place is constructed,
owned, leased, rented, or otherwise contracted for by the operator.

8. "Life care contract" shall mean a single continuing care retirement
contract or a continuing care at home contract to provide a person, for
the duration of such person's life, the services provided by the
continuing care retirement community, which services shall include
unlimited services of the affiliated community's nursing facility or
affiliated nursing home. Such term also shall mean a single continuing
care retirement contract to provide a person, for the duration of such
person's life, the services provided by the continuing care retirement
community under an arrangement in which the costs of the residents'
unlimited nursing home or home care services are paid for in whole or in
part by a long term care insurance policy approved by the superintendent
in accordance with applicable regulations or by long term care insurance
or medical assistance payments in accordance with the partnership for
long term care program pursuant to the provisions of section three
hundred sixty-seven-f of the social services law, section three thousand
two hundred twenty-nine of the insurance law and section four thousand
six hundred twenty-three of this chapter.

8-a. "Fee-for-service continuing care contract" shall mean a single
continuing care retirement contract that provides long-term and other
services on a per diem, fee-for-service or monthly rate.

8-b. "Continuing care at home contract" shall mean a single contract
to provide a person with long term care services and supports based upon
the person's needs and coordinated by a case manager, which shall
include services provided to the person in his or her residence and
services of the community's nursing facility and adult care facility, or
affiliated facilities.

9. "Life care shall mean those services provided pursuant to a "life
care contract".

10. "Living unit" shall mean an apartment, room, cottage, or other
area within a community set aside for the exclusive use of one or more
residents, or in the case of a continuing care at home contract, the
contract holder's private residence.

11. "Monthly care fee" shall mean the monthly cost to a resident for
prepayment of any services, including rent, rendered pursuant to a
contract, exclusive of entrance fees or other prepayments, and any other
regular periodic charges to the resident, determined on a monthly basis,
pursuant to the provisions of a contract.

12. "Operator" shall mean a legal entity operating a continuing care
retirement community pursuant to a certificate of authority.

13. "Priority reservation agreement" shall mean a cancelable agreement
between a prospective continuing care retirement community applicant, an
applicant for a certificate of authority or an operator and a
prospective resident, 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, under which the
prospective resident will pay a refundable priority reservation fee. A
priority reservation agreement does not fall within the meaning of
contracts or agreements as defined in subdivision three of this section.

14. "Priority reservation fee" shall mean the refundable sum of money
paid by a prospective resident for deposit with the escrow agent for a
prospective continuing care retirement community applicant, an applicant
for a certificate of authority or an operator pursuant to a priority
reservation agreement.

15. "Resident" shall mean any person who, pursuant to a continuing
care retirement contract or continuing care at home contract, is
entitled to reside in and/or receive services from a continuing care
retirement community.

15-a. "ILU resident" shall mean a continuing care retirement contract
holder who resides in a living unit within the continuing care
retirement community.

15-b. "Home resident" shall mean a continuing care at home contract
holder who resides in a private residence off of the continuing care
retirement community campus.

16. "Residential health care demonstration facility" shall mean a
residential health care facility containing up to sixty beds, within the
defined geographical boundary of each health systems agency established
under the provisions of subdivision (c) of section twenty-nine hundred
four of this chapter, provided that such residential health care
facility is an integrated part of a comprehensive system of residential
and support services for the elderly, providing either directly or
through one or more affiliated entities, prior to the effective date of
this subdivision, on or adjacent to the site of the proposed residential
health care facility, independent living units, an adult care facility
as defined in section two of the social services law and a range of
health care and social services, which may include home health care,
counselling, case management and information and referral.

16-a. "Social services" shall mean those services which may include,
but not be limited to counseling, case management, and information and
referral.

17. "Superintendent" shall mean the superintendent of financial
services.