A04611 Summary:

BILL NOA04611B
 
SAME ASSAME AS S02118-B
 
SPONSORSchimminger
 
COSPNSRAbinanti, Paulin, Benedetto, Galef, Cook, Skoufis, Roberts, Hooper, Clark
 
MLTSPNSRBrennan, Jaffee, Magee, McDonald, Walter, Weisenberg
 
Amd Pub Health L, generally
 
Relates to the ability of continuing care retirement communities to offer seniors additional service options.
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A04611 Actions:

BILL NOA04611B
 
02/06/2013referred to health
06/17/2013amend and recommit to health
06/17/2013print number 4611a
01/08/2014referred to health
02/27/2014amend and recommit to health
02/27/2014print number 4611b
04/29/2014reported
05/01/2014advanced to third reading cal.601
05/05/2014passed assembly
05/05/2014delivered to senate
05/05/2014REFERRED TO HEALTH
05/20/2014SUBSTITUTED FOR S2118B
05/20/20143RD READING CAL.557
05/28/2014PASSED SENATE
05/28/2014RETURNED TO ASSEMBLY
12/17/2014delivered to governor
12/29/2014signed chap.549
12/29/2014approval memo.34
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A04611 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A4611B
 
SPONSOR: Schimminger
  TITLE OF BILL: An act to amend the public health law, in relation to ability of continuing care retirement communities to offer seniors addi- tional service options   PURPOSE OF THE BILL: To allow continuing care communities to offer life care and life care at home programs to seniors.   SUMMARY OF SPECIFIC PROVISIONS: Section 1 - Amends and adds a new subdivision to section 4601 of the Public Health Law to allow for continuing care at home as a continuing care retirement community contract option. Section 2 - Amends the opening paragraph of subdivision 2 of section 4602 of the Public Health Law to delete the requirement that a life care contract mandate at least four council meetings per year. Section 3 - Amends subdivision 1 of section 4603-a of the Public Health Law to change the name of "life care community council" to "continuing care retirement community council." Section 4 - Amends paragraphs d and c and clause (C) of subparagraph (iv) of paragraph j of subdivision 2 of section 4604 of the Public Health Law to change language to reflect continuing care retirement contracts and that clause (C) relates to facilities licensed by the Department of Health rather than the Department of Social Services. Section 5 - Amends paragraph b of subdivision 4 section 4604 of the Public Health Law to provide oversight by the Commissioner of Health rather than the Commissioner of Social Services. Section 6 - Amends paragraph g of subdivision 2 of section 4604-a of the Public Health Law to reflect the option of life care at home services. Section 7 - Amends subdivision 13 of section 4605 of the Public Health Law to change language to reflect the option of continuing care at home contracts. Section 8 - Paragraphs e, f and g of subdivision 14 of section 4606 of the Public Health Law are relettered paragraphs f, g and h and a new paragraph e is added to list the types of meal plans available. Section 9 - Amends section 4608 of the Public Health Law to include continuing care retirement community or continuing care at home contracts and limit certain provisions to life care and modified contracts only, and set forth certain requirements for life care at home contracts. Section 10 - Amends subdivision 1 of section 4612 of the Public Health Law to recognize that some residents under this section may be living at home. Section 11 - Amends subdivisions 1 and 2 of section 4614 of the Public Health Law to reflect that the Commissioner of Health shall have respon- sibility for oversight. Section 12 - Amends paragraph k of subdivision 1 of section 4615 of the Public Health Law to reflect responsibility of the Commissioner of Health. Section 13 - Section heading 4623 is amended to read as follows: Long term care insurance and continuing care retirement contracts. Section 14 - Provides that this act shall take effect immediately.   JUSTIFICATION: This bill would offer another option for seniors -- life care at home. Existing CCRC campus providers may establish a sepa- rate affiliated 501(c)3 corporation to offer various levels of home care services as chosen by the contract holder, based upon the needs of the seniors(s) in the home. This bill will expand the continuum of services from limited services at home, through increased services, and eventual residence, if needed, on a CCRC campus. At home services can include, as necessary, personal health coordination, emergency response system, health and wellness programs, home nurse visits, companion services, home inspections, transportation, meals, on-campus activities and cultural events. Services are coordinated by a case manager. The program allows planned continuity so seniors can know they will continue to receive services over the years with the same provider as their needs change and know they can remain at home as long as possible with such services as they may require.   PRIOR LEGISLATIVE HISTORY: 2011-2012: A.8405-A/S.5224-B.   FISCAL IMPLICATIONS: May reduce costs to state if seniors can remain at home and not spend down their assets and seek Medicaid assistance.   EFFECTIVE DATE: This act shall take effect on the one hundred and eightieth day after it shall have become law.
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A04611 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         4611--B
 
                               2013-2014 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 6, 2013
                                       ___________
 
        Introduced  by M. of A. SCHIMMINGER, ABINANTI, PAULIN, BENEDETTO, GALEF,
          COOK, BOYLAND, SKOUFIS, ROBERTS, HOOPER -- Multi-Sponsored by -- M. of
          A. BRENNAN, JAFFEE, MAGEE,  McDONALD,  WEISENBERG  --  read  once  and
          referred  to  the  Committee  on  Health -- committee discharged, bill
          amended, ordered reprinted as amended and recommitted to said  commit-

          tee  --  recommitted  to  the  Committee  on Health in accordance with
          Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered
          reprinted as amended and recommitted to said committee
 
        AN ACT to amend the public health law, in relation to ability of contin-
          uing care retirement communities to offer seniors  additional  service
          options
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Subdivisions 2-a, 2-b, 3, 8, 10 and 10-a of section 4601 of
     2  the public health law, subdivision 2-a as added and subdivisions 3 and 8
     3  as amended by chapter 659 of  the  laws  of  1997,  subdivision  2-b  as
     4  amended  by  chapter 523 of the laws of 2011, subdivision 10 as added by
     5  chapter 689 of the laws of 1989, and subdivision 10-a as added by  chap-

     6  ter 401 of the laws of 2003, are amended and three new subdivisions 7-a,
     7  7-b and 7-c are added to read as follows:
     8    2-a.  "Continuing  care  retirement  community  contract" shall mean a
     9  single contract to provide a person the services provided by a  continu-
    10  ing care retirement community.
    11    2-b.  "Continuing care retirement community" or "community" shall mean
    12  a facility or facilities established to provide a  comprehensive,  cohe-
    13  sive  living arrangement for the elderly, oriented to the enhancement of
    14  the quality of life and which, pursuant to the terms of  the  continuing
    15  care retirement community contract, at a minimum:
    16    a.  provides, or supports through continuing care at home, independent
    17  living units, and [provides a]  meal  plan  options.    The  independent

    18  living  unit  can be made available either through a non-equity arrange-
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05244-09-4

        A. 4611--B                          2
 
     1  ment or through an equity arrangement including, but not  limited  to  a
     2  cooperative  or  condominium. For purposes of this article, the purchase
     3  price of an independent living unit in an equity arrangement, regardless
     4  of  the form of the purchase agreement, shall not be considered an entry
     5  fee for purposes  of  calculating  reserve  liabilities,  but  shall  be
     6  considered an entry fee for escrow purposes;
     7    b.  provides  a  range  of health care and social services, subject to

     8  such terms as may be included within the contract, which  shall  include
     9  adult  care  facility  services  of  an on-site or affiliated adult care
    10  facility, and at a minimum, sixty days of prepaid services of an on-site
    11  or affiliated nursing facility  for  residents  not  receiving  services
    12  under a fee-for-service contract;
    13    c.  provides  access  to  health  services as defined in the contract,
    14  prescription drugs, and rehabilitation services;
    15    d. nothing in this article shall eliminate the obligation of a contin-
    16  uing care retirement community to provide at least sixty days of prepaid
    17  nursing facility services to all residents, with the exception of  resi-
    18  dents receiving services under the terms of a fee-for-service continuing
    19  care  contract as defined in this section. The prepaid days must include
    20  the first sixty days  of  nursing  facility  services,  whether  or  not

    21  consecutive,  not  covered by Title XVIII of the federal social security
    22  act; and
    23    e. communities established under this article  and  offering  fee-for-
    24  service  continuing  care contracts must offer, along with such fee-for-
    25  service continuing care contracts,  life  care  and/or  continuing  care
    26  contracts as defined in subdivision eight-a of this section.
    27    3.  "Contracts"  or "agreements" shall mean continuing care at home or
    28  continuing care retirement community contracts as defined in this  arti-
    29  cle.
    30    7-a. "Continuing care at home corporation" shall mean a not-for-profit
    31  corporation  affiliated  with  a  continuing  care  retirement community
    32  campus provider through which contract holders pay an entrance fee and a
    33  monthly fee, both of which would correspond  to  the  level  of  service

    34  chosen by the contract holder.
    35    7-b.  "Continuing  care at home contract" shall mean a single contract
    36  to provide a person with long term care services and supports based upon
    37  an individual's needs and coordinated by a  case  manager,  which  shall
    38  include  services provided to the individual in his or her residence and
    39  services of the affiliated community's nursing facility and  adult  care
    40  facility, or affiliated facilities.
    41    7-c. a. "Continuing care at home" corporations providing services in a
    42  nursing  home  as  defined  in  section twenty-eight hundred one of this
    43  chapter must be licensed under article twenty-eight and shall be subject
    44  to the provisions and standards of such article.

    45    b. "Continuing care at home" corporations providing home care services
    46  as defined in section thirty-six hundred two of  this  chapter  must  be
    47  licensed under article thirty-six and shall be subject to the provisions
    48  and standards of such article.
    49    8. "Life care contract" shall mean a single continuing care retirement
    50  community  contract  or  a continuing care at home contract to provide a
    51  person, for the duration of such person's life, the services provided by
    52  the continuing care retirement community or the continuing care at  home
    53  corporation,  which  services  shall  include  unlimited services of [an
    54  on-site or affiliated nursing facility] the affiliated community's nurs-

    55  ing facility or affiliated nursing home.  Such term also  shall  mean  a
    56  single  continuing  care  retirement  community  contract  to  provide a

        A. 4611--B                          3
 
     1  person, for the duration of such person's life, the services provided by
     2  the continuing care retirement community under an arrangement  in  which
     3  the costs of the residents' unlimited nursing home or home [health] care
     4  services  are paid for in whole or in part by a long term care insurance
     5  policy approved by the  superintendent  in  accordance  with  applicable
     6  regulations  or  by  long  term  care  insurance  or  medical assistance
     7  payments in accordance with the partnership for long term  care  program
     8  pursuant to the provisions of section three hundred sixty-seven-f of the

     9  social  services  law, section three thousand two hundred twenty-nine of
    10  the insurance law and section four thousand six hundred twenty-three  of
    11  this chapter.
    12    10.  "Living  unit"  shall  mean an apartment, room, cottage, or other
    13  area within a community set aside for the exclusive use of one  or  more
    14  residents,  or  in  the  case of a continuing care at home contract, the
    15  contract holder's private residence.
    16    [10-a. "Meal plan" shall mean an arrangement whereby the person enter-
    17  ing into the continuing care retirement contract  is  provided  with  no
    18  fewer  than five meals per month. Additional meals shall be available on
    19  a fee-for-service basis.]
    20    § 2. The opening paragraph of subdivision 2 of  section  4602  of  the
    21  public  health  law,  as  amended by chapter 659 of the laws of 1997, is

    22  amended to read as follows:
    23    The council shall meet as often as may be deemed necessary to  fulfill
    24  its  responsibilities[,  but in no event less than four times per year].
    25  The council shall have the following powers and duties:
    26    § 3. Subdivision 1 of section 4603-a of  the  public  health  law,  as
    27  added by chapter 393 of the laws of 1991, is amended to read as follows:
    28    1.  The commissioner, upon approval of the [life care] continuing care
    29  retirement community council and the public health council shall issue a
    30  certificate of incorporation of up  to  three  residential  health  care
    31  demonstration facilities. Notwithstanding any provision of article twen-
    32  ty-eight of this chapter or any other provisions of law to the contrary,
    33  the  public health council may approve without regard to the requirement

    34  of public need as set forth in subdivision three of section twenty-eight
    35  hundred one-a of this chapter, a certificate of incorporation or  appli-
    36  cation for establishment of such facilities.
    37    §  4.  Paragraphs d and e and clause (C) of subparagraph (iv) of para-
    38  graph j of subdivision 2 of section 4604 of the public health law, para-
    39  graph d as added by chapter 689 of the laws of 1989 and paragraph e  and
    40  clause (C) of subparagraph (iv) of paragraph j as amended by chapter 659
    41  of the laws of 1997, are amended to read as follows:
    42    d.  a  copy of the proposed forms of contracts to be entered into with
    43  residents of the community or continuing care at home contract holders;
    44    e. complete details of any agreements with a licensed insurer, includ-
    45  ing copies of proposed contracts, requiring the insurer to assume, whol-

    46  ly or in part, the cost of medical or  health  related  services  to  be
    47  provided  to  a  resident  or  continuing  care at home contract holders
    48  pursuant to a continuing care retirement community or continuing care at
    49  home contract;
    50    (C) is or was subject to a currently effective injunctive or  restric-
    51  tive order or federal or state administrative order relating to business
    52  activity  or  health  care  as a result of an action brought by a public
    53  agency or department, including, without limitation, actions affecting a
    54  license to operate a hospital as defined by section twenty-eight hundred
    55  one of this chapter, or a facility required to be licensed or  certified
    56  by  the  department  [of social services]. The statement shall set forth

        A. 4611--B                          4
 

     1  the court or agency, date of conviction or judgment, the penalty imposed
     2  or damages assessed, or the date, nature and issuer of the order;
     3    §  5.  Paragraphs  b,  c and d of subdivision 4 of section 4604 of the
     4  public health law, as amended and paragraph d as added by chapter 659 of
     5  the laws of 1997, are amended to read as follows:
     6    b. the commissioner [of social services] as to those  aspects  of  the
     7  application relating to adult care facility beds, if any;
     8    c.  the  public health and health planning council under section twen-
     9  ty-eight hundred one-a of this chapter as  to  the  establishment  of  a
    10  skilled  nursing  facility by the applicant and as to such other facili-
    11  ties and services as may require the public health and  health  planning
    12  council's  approval  of  the  application;  provided,  however, that the

    13  recommendations of the [state hospital review and planning  council  and
    14  the]  health systems agency having geographical jurisdiction of the area
    15  where the continuing care retirement community is located shall  not  be
    16  required  with  respect to the establishment of an on-site or affiliated
    17  residential health care facility to  serve  residents  as  part  of  the
    18  continuing  care  retirement  community,  for  up to the total number of
    19  residential health care facility beds provided for in  subdivision  five
    20  of this section in communities statewide;
    21    d.  the  commissioner  under  section twenty-eight hundred two of this
    22  chapter; provided, however, that,  the  recommendations  of  the  [state
    23  hospital  review  and] public health and health planning council and the

    24  health systems agency having geographical jurisdiction of the area where
    25  the continuing  care  retirement  community  is  located  shall  not  be
    26  required  with  respect  to the construction of an on-site or affiliated
    27  residential health care facility to  serve  residents  as  part  of  the
    28  continuing  care  retirement  community,  for  up to the total number of
    29  residential health care facility beds provided for in  subdivision  five
    30  of this section in communities statewide; and
    31    §  6.  Paragraph  g  of  subdivision 2 of section 4604-a of the public
    32  health law, as added by chapter 659 of the laws of 1997, is  amended  to
    33  read as follows:
    34    g.  Unless  all  residents or continuing care at home contract holders
    35  have life care contracts, the operator has adequately  made  the  assur-
    36  ances  required  by subdivision two of section forty-six hundred twenty-

    37  four of this article and has agreed to fund the liability in  the  event
    38  that [resident] such resident's or contract holder's assets are insuffi-
    39  cient to pay for nursing facility services for a one year period.
    40    § 7. Subdivision 13 of section 4606 of the public health law, as added
    41  by chapter 659 of the laws of 1997, is amended to read as follows:
    42    13.  The  initial  disclosure  statement  and marketing materials of a
    43  continuing care retirement community and continuing care at home  corpo-
    44  ration  must  clearly  include  a description of the services offered as
    45  part of its contract, including, but not limited to, any limitations  on
    46  nursing  facility services. The initial disclosure statement and market-
    47  ing materials of a continuing care retirement  community  or  continuing

    48  care  at home corporation which offers various types of contracts, which
    49  may include life care contracts, must clearly  differentiate  among  the
    50  various types of contracts which it may offer.
    51    §  8.  Paragraphs  e, f and g of subdivision 14 of section 4606 of the
    52  public health law are relettered paragraphs f, g and h and a  new  para-
    53  graph e is added to read as follows:
    54    e. the types of meal plans available;
    55    § 9. Section 4608 of the public health law, as added by chapter 689 of
    56  the  laws of 1989, the section heading, the opening paragraph and subdi-

        A. 4611--B                          5
 
     1  vision 6 as amended and subdivision 17 as added by chapter  659  of  the
     2  laws  of  1997,  subdivision  2 as amended by chapter 120 of the laws of

     3  1993, subdivision 8 as amended by chapter 66 of the  laws  of  1994  and
     4  subdivision 15 as further amended by section 104 of part A of chapter 62
     5  of the laws of 2011, is amended to read as follows:
     6    §  4608.  Continuing care retirement community contract.  A continuing
     7  care retirement community or continuing  care  at  home  contract  shall
     8  contain  all  of  the following information in no less than twelve point
     9  type and in plain language, in addition to any other terms or matter  as
    10  may  be required by regulations adopted by the council and issued by the
    11  superintendent, except when specifically noted:
    12    1. The amount of all money transferred, including, but not limited to,
    13  donations, subscriptions, deposits, fees, and any other amounts paid  or
    14  payable  by,  or  on  behalf of, the resident or residents or continuing

    15  care at home contract holder or holders;
    16    2. A description of all services which are  to  be  furnished  by  the
    17  operator,  a description of any fees in addition to the entrance fee and
    18  periodic charges provided for in the contract, and the conditions  under
    19  which  the  fees  may  be  adjusted, provided that an operator shall not
    20  charge any non-refundable application fee to a prospective resident  who
    21  has  paid  a  non-refundable  priority reservation agreement application
    22  fee;
    23    3. The procedures of the community or continuing care at  home  corpo-
    24  ration  relating to a resident's or contract holder's failure to pay the
    25  required monthly fees;
    26    4. A statement of the figures and terms  concerning  the  entry  of  a
    27  spouse to the community and the consequences if the spouse does not meet
    28  the requirements for entry;

    29    5.  A statement of the terms and conditions under which a contract may
    30  be cancelled by the operator or by a resident or contract holder and the
    31  conditions under which all or any portion of the entrance  fee  will  be
    32  refunded  by the operator, including the mandatory refund provisions set
    33  forth in sections forty-six hundred nine and forty-six  hundred  ten  of
    34  this article;
    35    6.  a.  The  procedures  and  conditions under which a resident may be
    36  transferred from his or her living unit or home  including  a  statement
    37  that,  at  the  time of transfer, the resident will be given the reasons
    38  for the transfer; the process by which a transfer decision is made;  the
    39  persons  with  the  authority  to  make  the  decision  to  transfer;  a
    40  description of any change in charges to be  paid  by  the  resident  for

    41  services  not  covered by the contract fees as a result of the transfer;
    42  and a statement regarding the disposition of and the right to return  to
    43  the living unit in cases of temporary and permanent transfers.
    44    b.  [The]  For  continuing  care  retirement  community contracts, the
    45  circumstances under which a living unit may  be  considered  vacant  and
    46  eligible  for  transfer  or  resale to a new resident, either due to the
    47  permanent transfer of a resident to the  community's  nursing  or  other
    48  specialized facility or due to the permanent transfer of a resident to a
    49  hospital  or other facility outside of the community; provided, however,
    50  that nothing therein shall relieve a community from its  obligations  to
    51  provide or to insure provision of all contractually required care pursu-
    52  ant  to  the  terms  of a continuing care retirement contract.  Should a

    53  resident's chronic condition require placement  in  a  more  specialized
    54  chronic  care  facility  that  provides  services  beyond those provided
    55  through the community's nursing facility, the liability of the community
    56  pursuant to the terms of a continuing care retirement contract shall  be

        A. 4611--B                          6
 
     1  equal to the current per diem rate of the nursing facility minus the pro
     2  rata  apportionment of the resident's monthly fee for the period of care
     3  required by the contract.  Nothing herein shall  obligate  a  continuing
     4  care  retirement community which does not have a life care contract with
     5  a resident to provide or pay for a level of  nursing  facility  services
     6  nor  for  any  duration  beyond  what  is  specifically described in its
     7  continuing care retirement contract with  that  resident.  This  section

     8  shall  not  affect  the  operator's  obligation under subdivision two of
     9  section forty-six hundred twenty-four of this article;
    10    7. [A] For continuing care retirement community contracts, a statement
    11  that, if the resident dies prior to occupancy date or, through  illness,
    12  injury,  or  incapacity  is precluded from becoming a resident under the
    13  terms of the contract, the contract is automatically rescinded  and  the
    14  resident  or his or her legal representative shall receive a full refund
    15  of all moneys paid to the facility, except for those costs  specifically
    16  incurred by the facility at the request of the resident and set forth in
    17  writing in a separate addendum, signed by the parties to the contract;
    18    8. [A]  For continuing care at home contracts, the circumstances under

    19  which  the  contract  holder  may  move into a campus independent living
    20  unit, adult care facility or nursing home;
    21    9.  For continuing care retirement community contracts, a statement of
    22  the conditions under which all or any portion of the entrance  fee  will
    23  be released to the operator before the living unit becomes available for
    24  occupancy,  and  a  statement  of  the conditions under which all or any
    25  portion of that fee will be refunded in the event of the  death  of  the
    26  resident  and/or  spouse following occupancy of a living unit, including
    27  the mandatory refund provisions set forth in section  forty-six  hundred
    28  nine of this article;
    29    [9.] 10. A statement of the advance notice to be provided the resident
    30  or  contract  holder, of not less than sixty days, of any change in fees

    31  or charges or scope of care or services;
    32    [10.] 11. A statement that no act,  agreement,  or  statement  of  any
    33  resident  or  contract holder, or of an individual purchasing care for a
    34  resident or contract holder under any agreement to furnish care  to  the
    35  resident  or  contract  holder,  shall  constitute a valid waiver of any
    36  provision of this article or of any regulation enacted pursuant  thereto
    37  intended for the benefit or protection of the resident or contract hold-
    38  er  or  the  individual  purchasing  care  for  the resident or contract
    39  holder;
    40    [11. A] 12. For continuing  care  retirement  community  contracts,  a
    41  description  of  the  reinstatement  policies  if  a resident leaves the
    42  facility or the contract is cancelled;

    43    [12.] 13. For continuing care at  home  contracts,  a  description  of
    44  policies if the contract is cancelled.
    45    14.  A  statement  that  internal  procedures  to resolve disputes and
    46  grievances have been established, and  residents  and  contract  holders
    47  notified of them;
    48    [13.]  15. A statement of the grace period, if any, for the payment of
    49  periodic fees without a penalty, and the extent of any penalty  for  the
    50  late payment thereof;
    51    [14.]  16.  A  statement  that: a. the resident or contract holder, as
    52  applicable shall, if eligible, enroll in medicare parts a and b  or  the
    53  equivalent  and  shall continue to maintain that coverage, together with
    54  medicare supplement coverage at least equivalent in  benefits  to  those

    55  established  by  the  superintendent  as  minimum  benefits for medicare
    56  supplement policies;

        A. 4611--B                          7
 
     1    b. if the resident or  contract  holder  fails  to  maintain  medicare
     2  coverage  and  a medicare supplement coverage, or is ineligible for such
     3  coverage and fails to purchase the  equivalent  of  such  coverage,  the
     4  community  or  continuing  care  at  home corporation shall purchase the
     5  coverage  or  equivalent  coverage  on  behalf and at the expense of the
     6  resident or contract holder and shall have the authority to  require  an
     7  appropriate adjustment in payments by the resident or contract holder to
     8  the community or continuing care at home corporation;
     9    c.  if  the  community  or  continuing care at home corporation cannot

    10  purchase medicare coverage  and  medicare  supplement  coverage  or  the
    11  equivalent, the community shall have the authority to require an adjust-
    12  ment  in monthly fees, subject to the approval of the superintendent, to
    13  fund the additional risk to the facility or corporation; and
    14    d. if the resident or contract holder fails to  purchase  or  maintain
    15  medicare  coverage  and  medicare supplement coverage or the equivalent,
    16  and the community  or  continuing  care  at  home  corporation  has  not
    17  purchased  such coverage, the community or corporation will be responsi-
    18  ble for any expenses which would have been covered by medicare and medi-
    19  care supplement coverage.   The community or  corporation  may  add  the
    20  amount  of  such expenses to the resident's or contract holder's monthly
    21  fees.

    22    [15.] 17. A statement that any  amendment  to  the  contract  and  any
    23  change  in fees or charges, other than those within the guidelines of an
    24  approved rating system, must be approved by the superintendent of finan-
    25  cial services; and
    26    [16.] 18. A statement  that  property  shall  not  be  substituted  as
    27  payment for either the entrance fee or monthly fee.
    28    [17.]  19.  [A]  For continuing care retirement community contracts, a
    29  statement whether the  continuing  care  retirement  community  contract
    30  includes  any  ownership,  beneficial or trust interest in the assets of
    31  the operator, the assets of the facility, or both. Assets shall include,
    32  but are not limited to, property, trusts, reserves, interest  and  other
    33  assets.

    34    § 10. Subdivision 1 of section 4612 of the public health law, as added
    35  by chapter 689 of the laws of 1989, is amended to read as follows:
    36    1.  Residents [living] in a community authorized by this article shall
    37  have the right of self-organization, the right to be represented by  one
    38  or  more  individuals  of their own choosing, and the right to engage in
    39  concerted activities for the purpose of keeping informed of  the  opera-
    40  tion of the community in which they live.
    41    §  11.  Subdivisions 1 and 2 of section 4614 of the public health law,
    42  as amended by chapter 659 of the laws  of  1997  and  subdivision  2  as
    43  further  amended  by  section 104 of part A of chapter 62 of the laws of
    44  2011, are amended to read as follows:
    45    1. The commissioner, or designee; and the superintendent, or designee;

    46  [and, with regard to communities for  which  the  department  of  social
    47  services  has  regulatory  responsibility,  the  commissioner  of social
    48  services, or designee,] may at any time, and shall at least  once  every
    49  three years, visit each community and examine the business of any appli-
    50  cant  for  a  certificate  of  authority and any operator engaged in the
    51  execution of continuing care retirement community contracts or  continu-
    52  ing  care at home contracts or engaged in the performance of obligations
    53  under such contracts.  Routine examinations may be conducted  by  having
    54  documents  designated  by  and submitted to such commissioners or super-
    55  intendent, which shall include financial documents and records  conform-
    56  ing  to commonly accepted accounting principles and practices. The final

        A. 4611--B                          8
 
     1  written report of each such examination conducted by such  commissioners
     2  or  superintendent  shall  be  filed  with the commissioner and, when so
     3  filed, shall constitute a public record.  A copy of each report shall be
     4  provided to members of the continuing care retirement community council.
     5  Any  operator  being  examined  shall, upon request, give reasonable and
     6  timely access to all of its  records.  The  representative  or  examiner
     7  designated by the commissioners or superintendent, respectively, may, at
     8  any  time,  examine  the records and affairs and inspect the community's
     9  facilities, whether in connection with a formal examination or not.
    10    2. Any duly authorized officer,  employee,  or  agent  of  the  health
    11  department,  [social  services  department,]  or department of financial

    12  services may, upon presentation of proper  identification,  have  access
    13  to,  and  inspect,  any  records  maintained  by the community or by the
    14  continuing care at home corporation relevant to the respective  agency's
    15  regulatory  authority, with or without advance notice, to secure compli-
    16  ance with, or to prevent a violation of, any provision of this article.
    17    § 12. Paragraph k of subdivision 1  of  section  4615  of  the  public
    18  health law, as amended by chapter 659 of the laws of 1997, is amended to
    19  read as follows:
    20    k. The commissioner [or the commissioner of social services] has found
    21  violations  of  applicable statutes, rules or regulations which threaten
    22  to affect directly the health, safety, or welfare of  a  resident  of  a
    23  continuing  care retirement community or a contract holder of a continu-

    24  ing care at home contract.
    25    § 13. The section heading of section 4623 of the public health law, as
    26  amended by chapter 659 of the laws  of  1997,  is  amended  to  read  as
    27  follows:
    28    Long   term  care  insurance  [for]  and  continuing  care  retirement
    29  contracts.
    30    § 14. This act shall take effect immediately.
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