S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         3547
                              2015-2016 Regular Sessions
                                   I N  S E N A T E
                                   February 12, 2015
                                      ___________
       Introduced  by  Sen.  RANZENHOFER -- read twice and ordered printed, and
         when printed to be committed to the Committee on Rules
       AN ACT to amend the public health law, in relation  to  the  ability  of
         continuing  care  retirement  communities  to offer seniors additional
         service options; 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:
    1    Section  1. Subdivision 1 of section 4601 of the public health law, as
    2  amended by chapter 659 of the laws  of  1997,  is  amended  to  read  as
    3  follows:
    4    1. "Certificates" or "certificate of authority" shall mean an authori-
    5  zation in writing, approved by the council and issued by the commission-
    6  er,  for  an  operator to operate a continuing care retirement community
    7  and to enter into continuing care retirement  contracts  AND  CONTINUING
    8  CARE AT HOME CONTRACTS pertaining to such community.
    9    S  2.  Subdivision  2-a  of  section 4601 of the public health law, as
   10  amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
   11  follows:
   12    2-a.  "Continuing care retirement [community] contract" OR "CONTINUING
   13  CARE AT HOME CONTRACT" shall mean a single contract to provide a  person
   14  the services provided by a continuing care retirement community.
   15    S  3.  Subdivision  2-b  of  section 4601 of the public health law, as
   16  amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
   17  follows:
   18    2-b.  "Continuing care retirement community" or "community" shall mean
   19  a facility or facilities established to provide a  comprehensive,  cohe-
   20  sive  living arrangement for the elderly, oriented to the enhancement of
   21  the quality of life and which, pursuant to [the terms of the  continuing
   22  care retirement community] A contract, at a minimum:
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD08853-01-5
       S. 3547                             2
    1    a.  FOR  CONTINUING  CARE RETIREMENT CONTRACTS, provides[, or supports
    2  through continuing care at home,] independent  living  units,  and  meal
    3  plan  options.  The independent living unit can be made available either
    4  through a  non-equity  arrangement  or  through  an  equity  arrangement
    5  including, but not limited to a cooperative or condominium. For purposes
    6  of  this article, the purchase price of an independent living unit in an
    7  equity arrangement, regardless of the form of  the  purchase  agreement,
    8  shall not be considered an entry fee for purposes of calculating reserve
    9  liabilities, but shall be considered an entry fee for escrow purposes;
   10    b.  provides  a  range  of health care and social services, subject to
   11  such terms as may be included within the contract, which  shall  include
   12  adult  care  facility  services  of  an on-site or affiliated adult care
   13  facility, and at a minimum, sixty days of prepaid services of an on-site
   14  or affiliated nursing facility  for  residents  not  receiving  services
   15  under a fee-for-service contract;
   16    c.  provides  access  to  health  services as defined in the contract,
   17  prescription drugs, and rehabilitation services;
   18    d. nothing in this article shall eliminate the obligation of a contin-
   19  uing care retirement community to provide at least sixty days of prepaid
   20  nursing facility services to all residents, with the exception of  resi-
   21  dents receiving services under the terms of a fee-for-service continuing
   22  care  contract as defined in this section. The prepaid days must include
   23  the first sixty days  of  nursing  facility  services,  whether  or  not
   24  consecutive,  not  covered by Title XVIII of the federal social security
   25  act; [and]
   26    e. communities established under this article  and  offering  fee-for-
   27  service  continuing  care contracts must offer, along with such fee-for-
   28  service continuing care contracts,  life  care  and/or  continuing  care
   29  contracts as defined in subdivision eight-a of this section; AND
   30    F. COMMUNITIES ESTABLISHED UNDER THIS ARTICLE OFFERING CONTINUING CARE
   31  AT  HOME  CONTRACTS MUST ALSO OFFER CONTINUING CARE RETIREMENT CONTRACTS
   32  AND MUST MAINTAIN A CONTINUING CARE RETIREMENT COMMUNITY  THAT  OPERATES
   33  IN SUPPORT OF THE CONTINUING CARE AT HOME CONTRACTS.
   34    S  4.  Subdivision  3  of  section  4601  of the public health law, as
   35  amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
   36  follows:
   37    3.  "Contracts"  or "agreements" shall mean continuing care at home or
   38  continuing care retirement [community]  contracts  as  defined  in  this
   39  article.
   40    S  4-a.  Subdivisions  7-a,  7-b and 7-c of section 4601 of the public
   41  health law are REPEALED.
   42    S 5. Subdivision 6 of section  4601  of  the  public  health  law,  as
   43  amended  by  chapter  659  of  the  laws  of 1997, is amended to read as
   44  follows:
   45    6. "Entrance fee" shall mean an initial or  deferred  transfer  to  an
   46  operator  of  a sum of money, made or promised to be made by a person or
   47  persons entering into a continuing care retirement contract OR  CONTINU-
   48  ING CARE AT HOME CONTRACT, for the purpose of ensuring services pursuant
   49  to such a contract.
   50    S  6.  Subdivision  8  of  section  4601  of the public health law, as
   51  amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
   52  follows:
   53    8. "Life care contract" shall mean a single continuing care retirement
   54  [community]  contract or a continuing care at home contract to provide a
   55  person, for the duration of such person's life, the services provided by
   56  the continuing care retirement community [or the continuing care at home
       S. 3547                             3
    1  corporation], which services shall include  unlimited  services  of  the
    2  affiliated community's nursing facility or affiliated nursing home. Such
    3  term  also  shall  mean  a single continuing care retirement [community]
    4  contract  to  provide  a person, for the duration of such person's life,
    5  the services provided by the continuing care retirement community  under
    6  an  arrangement  in  which the costs of the residents' unlimited nursing
    7  home or home care services are paid for in whole or in part  by  a  long
    8  term  care insurance policy approved by the superintendent in accordance
    9  with applicable regulations or by long term care  insurance  or  medical
   10  assistance  payments  in  accordance  with the partnership for long term
   11  care program pursuant to the provisions of section three hundred  sixty-
   12  seven-f  of  the social services law, section three thousand two hundred
   13  twenty-nine of the insurance law and section four thousand  six  hundred
   14  twenty-three of this chapter.
   15    S  7. Section 4601 of the public health law is amended by adding a new
   16  subdivision 8-b to read as follows:
   17    8-B. "CONTINUING CARE AT HOME CONTRACT" SHALL MEAN A  SINGLE  CONTRACT
   18  TO PROVIDE A PERSON WITH LONG TERM CARE SERVICES AND SUPPORTS BASED UPON
   19  THE  PERSON'S  NEEDS  AND  COORDINATED  BY  A  CASE MANAGER, WHICH SHALL
   20  INCLUDE SERVICES PROVIDED TO THE PERSON IN  HIS  OR  HER  RESIDENCE  AND
   21  SERVICES OF THE COMMUNITY'S NURSING FACILITY AND ADULT CARE FACILITY, OR
   22  AFFILIATED FACILITIES.
   23    S  8.  Subdivision  15  of  section  4601 of the public health law, as
   24  amended by chapter 659 of the laws of  1997,  is  amended  and  two  new
   25  subdivisions 15-a and 15-b are added to read as follows:
   26    15.  "Resident"  shall  mean  any person who, pursuant to a CONTINUING
   27  CARE RETIREMENT CONTRACT OR CONTINUING CARE AT HOME contract,  is  enti-
   28  tled to reside in and/OR receive services from a continuing care retire-
   29  ment community.
   30    15-A.  "ILU RESIDENT" SHALL MEAN A CONTINUING CARE RETIREMENT CONTRACT
   31  HOLDER WHO RESIDES IN A LIVING UNIT WITHIN THE CONTINUING  CARE  RETIRE-
   32  MENT COMMUNITY.
   33    15-B.  "HOME  RESIDENT"  SHALL MEAN A CONTINUING CARE AT HOME CONTRACT
   34  HOLDER WHO RESIDES IN A PRIVATE RESIDENCE OFF  OF  THE  CONTINUING  CARE
   35  RETIREMENT COMMUNITY CAMPUS.
   36    S 9. Paragraphs d and e of subdivision 2 of section 4604 of the public
   37  health  law,  as amended by chapter 549 of the laws of 2014, are amended
   38  to read as follows:
   39    d. a copy of the proposed forms of contracts to be entered  into  with
   40  residents  [of  the  community or continuing care at home contract hold-
   41  ers];
   42    e. complete details of any agreements with a licensed insurer, includ-
   43  ing copies of proposed contracts, requiring the insurer to assume, whol-
   44  ly or in part, the cost of medical or  health  related  services  to  be
   45  provided  to  a  resident  [or continuing care at home contract holders]
   46  pursuant to a continuing care retirement [community] CONTRACT or contin-
   47  uing care at home contract;
   48    S 9-a. Subdivision 3 of section 4604 of  the  public  health  law,  as
   49  amended  by  chapter  659  of  the  laws  of 1997, is amended to read as
   50  follows:
   51    3. Nothing in this article shall be construed to enlarge, diminish  or
   52  modify:  a  social  services  district's  otherwise valid recovery under
   53  section three hundred sixty-nine of the social services law, nor medical
   54  assistance eligibility under title eleven of article five of the  social
   55  services law nor applicable provisions of the estates, powers and trusts
   56  law.  Except  as  otherwise  provided in this article, the activities of
       S. 3547                             4
    1  continuing care retirement communities shall be subject to any other law
    2  governing such activities including but not limited to  article  twenty-
    3  eight  of  this chapter and article seven of the social services law and
    4  regulations   promulgated   thereunder;   provided,  however,  that  the
    5  provisions of paragraphs (d) and (e)  of  subdivision  four  of  section
    6  twenty-eight  hundred one-a and section twenty-eight hundred two of this
    7  chapter shall not apply, and provided that the provisions  of  paragraph
    8  (a)  of subdivision one and the provisions of subdivision two of section
    9  four hundred sixty-one-b of the social  services  law  with  respect  to
   10  public  need  and  the  provisions  of  subdivision  one of section four
   11  hundred sixty-one-c of the social services law shall not apply to  resi-
   12  dents  who  have  been  admitted  in  accordance with a [continuing care
   13  retirement community] contract provided  that,  upon  admission  to  the
   14  adult  care facility, such residents shall be given a notice which shall
   15  include, at a minimum, information regarding facility services, resident
   16  responsibilities, supplemental services, resident rights and protections
   17  and circumstances that  warrant  transfer.  The  number  of  residential
   18  health care facility beds available pursuant to subdivision five of this
   19  section,  without proof of public need therefor, shall be reduced by the
   20  number of residential health care demonstration facility beds  that  are
   21  approved pursuant to this article.
   22    S  10.  Paragraph  c  of  subdivision  4 of section 4604 of the public
   23  health law, as amended by chapter 549 of the laws of 2014, is amended to
   24  read as follows:
   25    c. the public health and health planning council [under section  twen-
   26  ty-eight  hundred  one-a  of  this chapter] as to the establishment of a
   27  skilled nursing facility by the applicant and as to such  other  facili-
   28  ties  and  services as may require the public health and health planning
   29  council's approval of  the  application;  provided,  however,  that  the
   30  recommendations  of the health systems agency having geographical juris-
   31  diction of the area where the continuing care  retirement  community  is
   32  located  shall  not  be required with respect to the establishment of an
   33  on-site or affiliated residential health care facility  to  serve  resi-
   34  dents as part of the continuing care retirement community, for up to the
   35  total  number  of  residential health care facility beds provided for in
   36  subdivision five of this section in communities statewide;
   37    S 11. The public health law is amended by adding a new section  4605-a
   38  to read as follows:
   39    S 4605-A. CERTIFICATE OF AUTHORITY; AUTHORITY TO OFFER CONTINUING CARE
   40  AT  HOME  CONTRACTS.  A  CONTINUING  CARE RETIREMENT COMMUNITY MAY OFFER
   41  CONTINUING CARE AT HOME CONTRACTS UPON APPROVAL BY THE COUNCIL TO  AMEND
   42  THE CONTINUING CARE RETIREMENT COMMUNITY'S CERTIFICATE OF AUTHORITY.  IN
   43  ORDER  TO  QUALIFY FOR AN AMENDMENT TO ITS CERTIFICATE OF AUTHORITY, THE
   44  CONTINUING CARE RETIREMENT COMMUNITY SHALL SUBMIT  TO  THE  COMMISSIONER
   45  THE FOLLOWING:
   46    1.  A  BUSINESS  PLAN  TO  THE  COMMISSIONER  AND  SUPERINTENDENT THAT
   47  INCLUDES THE FOLLOWING:
   48    (A) A DESCRIPTION OF THE CONTINUING CARE AT HOME SERVICES THAT WILL BE
   49  PROVIDED, THE MARKET THAT WILL BE SERVED BY THE CONTINUING CARE AT  HOME
   50  CONTRACTS,  AND THE FEES TO BE CHARGED TO PROSPECTIVE CONTINUING CARE AT
   51  HOME CONTRACT HOLDERS;
   52    (B) A COPY OF THE PROPOSED CONTINUING CARE AT HOME CONTRACT; AND
   53    (C) AN ACTUARIAL STUDY PREPARED BY AN INDEPENDENT ACTUARY  IN  ACCORD-
   54  ANCE  WITH STANDARDS ADOPTED BY THE AMERICAN ACADEMY OF ACTUARIES DEMON-
   55  STRATING THE IMPACT THAT THE CONTINUING CARE AT HOME CONTRACTS WILL HAVE
   56  ON THE OVERALL OPERATIONS OF THE CONTINUING  CARE  RETIREMENT  COMMUNITY
       S. 3547                             5
    1  AND  FURTHER  DEMONSTRATING THAT THE ADDITION OF CONTINUING CARE AT HOME
    2  CONTRACTS WILL NOT JEOPARDIZE THE FINANCIAL SOLVENCY OF  THE  CONTINUING
    3  CARE RETIREMENT COMMUNITY.
    4    2.  A  MARKET  FEASIBILITY STUDY DEMONSTRATING TO THE COMMISSIONER AND
    5  SUPERINTENDENT SUFFICIENT CONSUMER INTEREST IN CONTINUING CARE  AT  HOME
    6  CONTRACTS AND FURTHER DEMONSTRATING THAT THE ADDITION OF CONTINUING CARE
    7  AT  HOME  CONTRACTS  WILL NOT HAVE AN ADVERSE IMPACT ON THE PROVISION OF
    8  SERVICES TO CONTINUING CARE RETIREMENT CONTRACT HOLDERS.
    9    3. MATERIALS THAT MEET ALL REQUIREMENTS ESTABLISHED BY  THE  NEW  YORK
   10  STATE DEPARTMENT OF FINANCIAL SERVICES.
   11    4.  A  COPY  OF  THE  NOTIFICATION  SENT TO CONTINUING CARE RETIREMENT
   12  CONTRACT HOLDERS DESCRIBING THE ANTICIPATED IMPACT OF  THE  ADDITION  OF
   13  CONTINUING CARE AT HOME CONTRACTS ON CONTINUING CARE RETIREMENT COMMUNI-
   14  TY  RESOURCES  AND  PROOF THAT SUCH NOTIFICATION HAS BEEN DISTRIBUTED TO
   15  ALL CONTINUING CARE RETIREMENT CONTRACT HOLDERS.
   16    S 12. The public health law is amended by adding a new section  4605-b
   17  to read as follows:
   18    S  4605-B.  CERTIFICATE OF AUTHORITY; LIMITATION ON CONTINUING CARE AT
   19  HOME CONTRACTS. THE NUMBER OF CONTINUING CARE AT HOME CONTRACTS APPROVED
   20  ON A CERTIFICATE OF AUTHORITY SHALL BE LIMITED TO:
   21    1. THE NUMBER OF APPROVED LIVING UNITS ON THE CONTINUING CARE  RETIRE-
   22  MENT  COMMUNITY'S  PREMISES  THAT ARE INTENDED FOR ILU RESIDENTS, EXCEPT
   23  THAT THE COUNCIL MAY APPROVE ADDITIONAL CONTRACTS UPON A  SUBMISSION  TO
   24  THE COMMISSIONER BY AN OPERATOR CONSISTENT WITH THE PROVISIONS SET FORTH
   25  IN SECTION FORTY-SIX HUNDRED FIVE-A OF THIS ARTICLE;
   26    2. THE DEMONSTRATED NUMBER OF CONTINUING CARE AT HOME CONTRACT HOLDERS
   27  THAT CAN BE SUPPORTED IN THE EXISTING OR APPROVED FUTURE CAPACITY OF THE
   28  ADULT  CARE  FACILITY  AND  SKILLED NURSING FACILITY CONSISTENT WITH THE
   29  PROVISIONS SET FORTH IN SECTION FORTY-SIX HUNDRED FIVE-A OF  THIS  ARTI-
   30  CLE; AND
   31    3.  CONDITIONS SET FORTH BY THE NEW YORK STATE DEPARTMENT OF FINANCIAL
   32  SERVICES, BASED UPON THE SUPERINTENDENT'S ASSESSMENT OF THE FOLLOWING:
   33    (A) THE OVERALL FINANCIAL IMPACT ON THE COMMUNITY; AND
   34    (B) THE SUBMITTED MATERIALS SET FORTH  IN  SECTION  FORTY-SIX  HUNDRED
   35  FIVE-A OF THIS ARTICLE.
   36    S  13.  Paragraph  a  of  subdivision 14 of section 4606 of the public
   37  health law, as added by chapter 659 of the laws of 1997, is  amended  to
   38  read as follows:
   39    a.  a  brief  description  of  the  community,  including its name and
   40  location and amenities and services, INCLUDING MEAL OPTIONS, available;
   41    S 13-a. Paragraph e of subdivision 14 of section 4606  of  the  public
   42  health  law  is  REPEALED, and subdivisions f, g and h, as relettered by
   43  chapter 549 of the laws of 2014, are relettered e, f and g.
   44    S 14. Subdivision 13 of section 4606 of  the  public  health  law,  as
   45  amended  by  chapter  549  of  the  laws  of 2014, is amended to read as
   46  follows:
   47    13. The initial disclosure statement  and  marketing  materials  of  a
   48  continuing care retirement community [and continuing care at home corpo-
   49  ration]  must  clearly  include a description of the services offered as
   50  part of its contract, including, but not limited to, any limitations  on
   51  nursing  facility services. The initial disclosure statement and market-
   52  ing materials of a continuing care retirement community  [or  continuing
   53  care at home corporation] which offers various types of contracts, which
   54  may  include  life  care contracts, must clearly differentiate among the
   55  various types of contracts which it may offer.
       S. 3547                             6
    1    S 15. Section 4608 of the public health law, as amended by chapter 549
    2  of the laws of 2014, is amended to read as follows:
    3    S  4608.  [Continuing care retirement community contract] CONTRACTS. A
    4  continuing care retirement [community] CONTRACT or  continuing  care  at
    5  home  contract shall contain all of the following information in no less
    6  than twelve point type and in plain language, in addition to  any  other
    7  terms or matter as may be required by regulations adopted by the council
    8  and issued by the superintendent[, except when specifically noted]:
    9    1. The amount of all money transferred, including, but not limited to,
   10  donations,  subscriptions, deposits, fees, and any other amounts paid or
   11  payable by, or on behalf of, the resident  or  residents  or  continuing
   12  care at home contract holder or holders;
   13    2.  A  description  of  all  services which are to be furnished by the
   14  operator, a description of any fees in addition to the entrance fee  and
   15  periodic  charges provided for in the contract, and the conditions under
   16  which the fees may be adjusted, provided  that  an  operator  shall  not
   17  charge  any non-refundable application fee to a prospective resident who
   18  has paid a non-refundable  priority  reservation  agreement  application
   19  fee;
   20    3.  The procedures of the community [or continuing care at home corpo-
   21  ration] relating to a resident's or contract holder's failure to pay the
   22  required monthly fees;
   23    4. A statement of the figures and terms  concerning  the  entry  of  a
   24  spouse to the community and the consequences if the spouse does not meet
   25  the requirements for entry;
   26    5.  A statement of the terms and conditions under which a contract may
   27  be cancelled by the operator or by a resident or contract holder and the
   28  conditions under which all or any portion of the entrance  fee  will  be
   29  refunded  by the operator, including the mandatory refund provisions set
   30  forth in sections forty-six hundred nine and forty-six  hundred  ten  of
   31  this article;
   32    6.  a.  The  procedures  and  conditions under which a resident may be
   33  transferred from his or her living unit or home  including  a  statement
   34  that,  at  the  time of transfer, the resident will be given the reasons
   35  for the transfer; the process by which a transfer decision is made;  the
   36  persons  with  the  authority  to  make  the  decision  to  transfer;  a
   37  description of any change in charges to be  paid  by  the  resident  for
   38  services  not  covered by the contract fees as a result of the transfer;
   39  and a statement regarding the disposition of and the right to return  to
   40  the living unit in cases of temporary and permanent transfers.
   41    b.  For  continuing care retirement [community] contracts, the circum-
   42  stances under which a living unit may be considered vacant and  eligible
   43  for  transfer  or  resale to a new resident, either due to the permanent
   44  transfer of a resident to the community's nursing or  other  specialized
   45  facility or due to the permanent transfer of a resident to a hospital or
   46  other facility outside of the community; provided, however, that nothing
   47  therein  shall relieve a community from its obligations to provide or to
   48  insure provision of all contractually  required  care  pursuant  to  the
   49  terms  of  a  continuing  care  retirement contract. Should a resident's
   50  chronic condition require placement in a more specialized  chronic  care
   51  facility that provides services beyond those provided through the commu-
   52  nity's  nursing facility, the liability of the community pursuant to the
   53  terms of a continuing care retirement contract shall  be  equal  to  the
   54  current  per diem rate of the nursing facility minus the pro rata appor-
   55  tionment of the resident's monthly fee for the period of  care  required
   56  by the contract. Nothing herein shall obligate a continuing care retire-
       S. 3547                             7
    1  ment  community which does not have a life care contract with a resident
    2  to provide or pay for a level of nursing facility services nor  for  any
    3  duration  beyond  what  is specifically described in its continuing care
    4  retirement  contract  with  that resident. This section shall not affect
    5  the operator's obligation under subdivision  two  of  section  forty-six
    6  hundred twenty-four of this article;
    7    7.  For  continuing care retirement [community] contracts, a statement
    8  that, if the resident dies prior to occupancy date or, through  illness,
    9  injury,  or  incapacity  is precluded from becoming a resident under the
   10  terms of the contract, the contract is automatically rescinded  and  the
   11  resident  or his or her legal representative shall receive a full refund
   12  of all moneys paid to the facility, except for those costs  specifically
   13  incurred by the facility at the request of the resident and set forth in
   14  writing in a separate addendum, signed by the parties to the contract;
   15    [8.  For  continuing  care  at home contracts, the circumstances under
   16  which the contract holder may move  into  a  campus  independent  living
   17  unit, adult care facility or nursing home;]
   18    8.  FOR  CONTINUING  CARE  AT HOME CONTRACTS, A STATEMENT THAT, IF THE
   19  RESIDENT DIES PRIOR TO THE EFFECTIVE START DATE OF SERVICES OR,  THROUGH
   20  ILLNESS, INJURY, OR INCAPACITY IS PRECLUDED FROM MEETING THE ELIGIBILITY
   21  TERMS  OF  THE CONTRACT, THE CONTRACT IS AUTOMATICALLY RESCINDED AND THE
   22  RESIDENT OR HIS OR HER LEGAL REPRESENTATIVE SHALL RECEIVE A FULL  REFUND
   23  OF  ALL MONEYS PAID TO THE FACILITY, EXCEPT FOR THOSE COSTS SPECIFICALLY
   24  INCURRED BY THE FACILITY AT THE REQUEST OF THE RESIDENT AND SET FORTH IN
   25  WRITING IN A SEPARATE ADDENDUM, SIGNED BY THE PARTIES TO THE CONTRACT;
   26    9. For continuing care retirement [community] contracts,  a  statement
   27  of  the  conditions  under  which all or any portion of the entrance fee
   28  will be released to the operator before the living unit  becomes  avail-
   29  able for occupancy, and a statement of the conditions under which all or
   30  any  portion  of  that fee will be refunded in the event of the death of
   31  the resident and/or spouse following occupancy of a living unit, includ-
   32  ing the mandatory refund  provisions  set  forth  in  section  forty-six
   33  hundred nine of this article;
   34    10.  A  statement of the advance notice to be provided the resident or
   35  contract holder, of not less than sixty days, of any change in  fees  or
   36  charges or scope of care or services;
   37    11.  A  statement that no act, agreement, or statement of any resident
   38  or contract holder, or of an individual purchasing care for  a  resident
   39  or  contract  holder under any agreement to furnish care to the resident
   40  or contract holder, shall constitute a valid waiver of any provision  of
   41  this  article or of any regulation enacted pursuant thereto intended for
   42  the benefit or protection of the resident  or  contract  holder  or  the
   43  individual purchasing care for the resident or contract holder;
   44    12.   For   continuing   care   retirement  [community]  contracts,  a
   45  description of the reinstatement  policies  if  a  resident  leaves  the
   46  facility  or  the contract is cancelled; AND FOR CONTINUING CARE AT HOME
   47  CONTRACTS, A DESCRIPTION OF POLICIES  IF  THE  HOME  RESIDENT  RELOCATES
   48  THEIR PRIVATE RESIDENCE OR THE CONTRACT IS CANCELLED.
   49    13.  [For continuing care at home contracts, a description of policies
   50  if the contract is cancelled.
   51    14.] A statement that internal  procedures  to  resolve  disputes  and
   52  grievances  have  been  established,  and residents and contract holders
   53  notified of them;
   54    [15] 14.  A statement of the grace period, if any, for the payment  of
   55  periodic  fees  without a penalty, and the extent of any penalty for the
   56  late payment thereof;
       S. 3547                             8
    1    [16] 15. A statement that: a. the  resident  or  contract  holder,  as
    2  applicable  shall,  if eligible, enroll in medicare parts a and b or the
    3  equivalent and shall continue to maintain that coverage,  together  with
    4  medicare  supplement  coverage  at least equivalent in benefits to those
    5  established  by  the  superintendent  as  minimum  benefits for medicare
    6  supplement policies;
    7    b. if the resident or  contract  holder  fails  to  maintain  medicare
    8  coverage  and  a medicare supplement coverage, or is ineligible for such
    9  coverage and fails to purchase the  equivalent  of  such  coverage,  the
   10  community  [or  continuing  care at home corporation] shall purchase the
   11  coverage or equivalent coverage on behalf and  at  the  expense  of  the
   12  resident  or  contract holder and shall have the authority to require an
   13  appropriate adjustment in payments by the resident or contract holder to
   14  the community [or continuing care at home corporation];
   15    c. if the community [or continuing care at  home  corporation]  cannot
   16  purchase  medicare  coverage  and  medicare  supplement  coverage or the
   17  equivalent, the community shall have the authority to require an adjust-
   18  ment in monthly fees, subject to the approval of the superintendent,  to
   19  fund the additional risk to the facility [or corporation]; and
   20    d.  if  the  resident or contract holder fails to purchase or maintain
   21  medicare coverage and medicare supplement coverage  or  the  equivalent,
   22  and  the  community  [or  continuing  care  at home corporation] has not
   23  purchased such coverage, the community [or corporation] will be  respon-
   24  sible  for  any  expenses  which would have been covered by medicare and
   25  medicare supplement coverage. The community [or corporation] may add the
   26  amount of such expenses to the resident's or contract  holder's  monthly
   27  fees.
   28    [17] 16. A statement that any amendment to the contract and any change
   29  in  fees  or  charges,  other  than  those  within  the guidelines of an
   30  approved rating system, must be approved by the superintendent of finan-
   31  cial services; [and]
   32    [18] 17. A statement that property shall not be substituted as payment
   33  for either the entrance fee or monthly fee[.];
   34    18. A STATEMENT DESCRIBING THE METHOD  BY  WHICH  THE  COMMUNITY  WILL
   35  DETERMINE  PRIORITY FOR ACCESS TO AVAILABLE ADULT CARE FACILITY OR NURS-
   36  ING FACILITY BEDS BETWEEN A CONTINUING CARE RETIREMENT  CONTRACT  HOLDER
   37  AND A CONTINUING CARE AT HOME CONTRACT HOLDER;
   38    19.  For continuing care retirement [community] contracts, a statement
   39  whether the continuing care retirement [community] contract includes any
   40  ownership, beneficial or trust interest in the assets of  the  operator,
   41  the  assets  of the facility, or both. Assets shall include, but are not
   42  limited to, property, trusts, reserves, interest  and  other  assets[.];
   43  AND
   44    20. CONTINUING CARE AT HOME CONTRACTS SHALL INCLUDE THE FOLLOWING:
   45    A.  A  STATEMENT  DESCRIBING  THE CIRCUMSTANCES UNDER WHICH A CONTRACT
   46  HOLDER MAY MOVE INTO A CAMPUS INDEPENDENT LIVING UNIT, ADULT CARE FACIL-
   47  ITY OR NURSING HOME;
   48    B. A STATEMENT AS TO WHETHER AND UNDER WHAT CIRCUMSTANCES  TRANSPORTA-
   49  TION WILL BE PROVIDED TO CONTINUING CARE AT HOME CONTRACT HOLDERS;
   50    C. A STATEMENT DESCRIBING THE MECHANISM FOR MONITORING CONTINUING CARE
   51  AT HOME CONTRACT HOLDERS;
   52    D.  A  STATEMENT  DESCRIBING  THE  METHOD  BY WHICH THE COMMUNITY WILL
   53  DETERMINE PRIORITY FOR ACCESS TO AVAILABLE  ILUS  BETWEEN  A  CONTINUING
   54  CARE  AT  HOME  CONTRACT  HOLDER WHO WISHES TO CONVERT THE CONTRACT TO A
   55  CONTINUING CARE RETIREMENT CONTRACT AND  A  CONTINUING  CARE  RETIREMENT
   56  CONTRACT HOLDER;
       S. 3547                             9
    1    E.  A  STATEMENT  DESCRIBING ANY APPLICABLE GEOGRAPHICAL LIMITS OF THE
    2  CONTINUING CARE AT HOME SERVICES, AND THE POLICY THAT WILL  BE  FOLLOWED
    3  IN THE EVENT THAT A CONTINUING CARE AT HOME CONTRACT HOLDER RELOCATES TO
    4  A  DIFFERENT  RESIDENCE  OUTSIDE  THE GEOGRAPHICAL LIMITS COVERED BY THE
    5  CONTINUING CARE AT HOME CONTRACT; AND
    6    F.  A  STATEMENT DESCRIBING ANY APPLICABLE POLICY THAT WOULD ENTITLE A
    7  CONTINUING CARE AT HOME CONTRACT HOLDER TO SELECT ADULT CARE FACILITY OR
    8  SKILLED NURSING FACILITY PLACEMENT IN A FACILITY THAT IS NOT PART OF THE
    9  CONTINUING CARE RETIREMENT COMMUNITY.
   10    S 16. The public health law is amended by adding a new section  4608-a
   11  to read as follows:
   12    S  4608-A.  CONTINUING  CARE  AT  HOME  REQUIREMENTS.  CONTINUING CARE
   13  RETIREMENT COMMUNITIES OFFERING CONTINUING CARE AT HOME CONTRACTS SHALL:
   14    1. ENSURE THAT ALL CONTINUING CARE RETIREMENT COMMUNITY  EMPLOYEES  OR
   15  CONTRACTORS PROVIDING SERVICES TO CONTINUING CARE AT HOME CONTRACT HOLD-
   16  ERS  ARE DULY LICENSED OR CERTIFIED PURSUANT TO LAW, WHICH SHALL INCLUDE
   17  BUT NOT BE LIMITED TO ANY LICENSURE REQUIREMENTS FOR  THE  PROVISION  OF
   18  HOME CARE SERVICES SET FORTH IN ARTICLE THIRTY-SIX OF THIS CHAPTER;
   19    2.  INCLUDE  ALL  OPERATING  EXPENSES  FOR  CONTINUING  CARE  AT  HOME
   20  CONTRACTS IN THE CALCULATION OF RESERVE  REQUIREMENTS  REQUIRED  BY  THE
   21  DEPARTMENT OF FINANCIAL SERVICES; AND
   22    3.  INCLUDE  ALL  OPERATING  ACTIVITIES  FOR  CONTINUING  CARE AT HOME
   23  CONTRACTS IN THE TOTAL OPERATION OF THE COMMUNITY WHEN SUBMITTING FINAN-
   24  CIAL REPORTS AS REQUIRED BY THE DEPARTMENT AND THE DEPARTMENT OF  FINAN-
   25  CIAL SERVICES.
   26    S  17.  Subdivision  1  of  section  4612 of the public health law, as
   27  amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
   28  follows:
   29    1.  [Residents  in  a community authorized by this article] CONTINUING
   30  CARE RETIREMENT CONTRACT HOLDERS shall have the right of  self-organiza-
   31  tion,  the  right  to be represented by one or more individuals of their
   32  own choosing, and the right to engage in concerted  activities  for  the
   33  purpose  of  keeping informed of the operation of the community in which
   34  they live.
   35    S 18. Subdivisions 1 and 2 section 4614 of the public health  law,  as
   36  amended  by  chapter  549  of  the  laws of 2014, are amended to read as
   37  follows:
   38    1. The commissioner, or designee; and the superintendent, or designee;
   39  may at any time, and shall at least once every three years,  visit  each
   40  community and examine the business of any applicant for a certificate of
   41  authority  and  any operator engaged in the execution of continuing care
   42  retirement [community] contracts or continuing care at home contracts or
   43  engaged in the performance of obligations under such contracts.  Routine
   44  examinations  may  be  conducted  by  having documents designated by and
   45  submitted to such commissioners or superintendent, which  shall  include
   46  financial documents and records conforming to commonly accepted account-
   47  ing  principles  and  practices.  The  final written report of each such
   48  examination conducted by such commissioners or superintendent  shall  be
   49  filed  with  the  commissioner  and,  when  so filed, shall constitute a
   50  public record. A copy of each report shall be provided to members of the
   51  continuing care retirement community council. Any operator  being  exam-
   52  ined  shall,  upon  request, give reasonable and timely access to all of
   53  its records. The representative or examiner designated  by  the  commis-
   54  sioners  or  superintendent, respectively, may, at any time, examine the
   55  records and affairs and inspect the community's facilities,  whether  in
   56  connection with a formal examination or not.
       S. 3547                            10
    1    2.  Any  duly  authorized  officer,  employee,  or agent of the health
    2  department, or department of financial services may,  upon  presentation
    3  of proper identification, have access to, and inspect, any records main-
    4  tained  by the community [or by the continuing care at home corporation]
    5  relevant  to the respective agency's regulatory authority, with or with-
    6  out advance notice, to secure compliance with, or to prevent a violation
    7  of, any provision of this article.
    8    S 19. Paragraph k of subdivision 1  of  section  4615  of  the  public
    9  health law, as amended by chapter 549 of the laws of 2014, is amended to
   10  read as follows:
   11    k. The commissioner has found violations of applicable statutes, rules
   12  or  regulations which threaten to affect directly the health, safety, or
   13  welfare of a resident [of a continuing care retirement  community  or  a
   14  contract holder of a continuing care at home contract].
   15    S  20.  The  section  heading and subdivision 2 of section 4623 of the
   16  public health law, the section heading as amended by chapter 549 of  the
   17  laws  of 2014 and subdivision 2 as amended by chapter 659 of the laws of
   18  1997, are amended to read as follows:
   19    Long term care insurance and continuing care retirement  contracts  OR
   20  CONTINUING CARE AT HOME CONTRACTS.
   21    2.  With regard to nursing facility or home health care services which
   22  are part of the continuing care retirement contract OR  CONTINUING  CARE
   23  AT  HOME  CONTRACT,  any  elimination or waiting periods and any deduct-
   24  ibles, copayments, or other amounts not paid for by such long term  care
   25  insurance  or medical assistance payments shall be the responsibility of
   26  the continuing care retirement community.   The resident  shall  not  be
   27  liable to pay any such amounts.
   28    S  21. This act shall take effect April 1, 2015 and shall be deemed to
   29  have been in full force and effect on and after the  effective  date  of
   30  chapter 549 of the laws of 2014.