S05172 Summary:

BILL NOS05172
 
SAME ASSAME AS A06450
 
SPONSORHANNON
 
COSPNSR
 
MLTSPNSR
 
Amd Pub Health L, generally
 
Enhances the authority of the department of health to supervise and regulate continuing care retirement communities.
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S05172 Actions:

BILL NOS05172
 
03/10/2017REFERRED TO HEALTH
01/03/2018REFERRED TO HEALTH
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S05172 Committee Votes:

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S05172 Floor Votes:

There are no votes for this bill in this legislative session.
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S05172 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          5172
 
                               2017-2018 Regular Sessions
 
                    IN SENATE
 
                                     March 10, 2017
                                       ___________
 
        Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health
 
        AN ACT to amend the public health law,  in  relation  to  promoting  the
          development,  expansion  and  efficient  operation  of continuing care
          retirement communities;  and  providing  for  the  repeal  of  certain
          provisions upon expiration thereof
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Paragraphs e and f of subdivision 2-b of  section  4601  of
     2  the  public health law, as amended by chapter 7 of the laws of 2015, are
     3  amended and a new paragraph g is added to read as follows:
     4    e. communities established under this article  and  offering  fee-for-
     5  service  continuing  care contracts must offer, along with such fee-for-
     6  service continuing care contracts,  life  care  and/or  continuing  care
     7  contracts as defined in subdivision eight-a of this section; [and]
     8    f. communities established under this article offering continuing care
     9  at  home  contracts must also offer continuing care retirement contracts
    10  and must maintain a continuing care retirement community  that  operates
    11  in support of the continuing care at home contracts[.]; and
    12    g.  for  purposes  of  this article, any reference to "continuing care
    13  retirement community" or "community" shall also apply to the term  "life
    14  plan community".
    15    § 2. Paragraph a of subdivision 8 of section 4651 of the public health
    16  law,  as  amended by chapter 545 of the laws of 2004, is amended to read
    17  as follows:
    18    a. "Fee-for-service continuing care retirement community" or "communi-
    19  ty" shall mean a facility or facilities  established  pursuant  to  this
    20  article  to provide a comprehensive, cohesive living arrangement for the
    21  elderly, oriented to the enhancement of the quality of life, pursuant to
    22  the terms of the fee-for-service continuing care contract on a  fee-for-
    23  service  schedule.  Such facility, at a minimum, shall provide access to
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10281-01-7

        S. 5172                             2
 
     1  on-site geriatric services,  including,  but  not  limited  to,  nursing
     2  facility  services,  services  provided  by an adult care facility, home
     3  health services, a meal plan, social  services  and  independent  living
     4  units.  For  purposes of this article, any reference to "fee-for-service
     5  continuing care retirement community" or "community" shall also apply to
     6  the term "life plan community".
     7    § 3. Section 4602 of the public health law, as added by chapter 689 of
     8  the laws of 1989, the section  heading  and  subdivisions  1  and  2  as
     9  amended  by  chapter  659  of the laws of 1997, the opening paragraph of
    10  subdivision 1 as amended by section 81 of part A of chapter  62  of  the
    11  laws of 2011, the opening paragraph of subdivision 2 as amended by chap-
    12  ter  549 of the laws of 2014, subdivision 3 as amended by chapter 155 of
    13  the laws of 2012, is amended to read as follows:
    14    § 4602. Continuing  care  retirement  community  council;  powers  and
    15  duties.    1. The continuing care retirement community council is hereby
    16  established, to consist of the following, or their designees: the attor-
    17  ney general; the commissioner; the director of the office for the aging;
    18  and eight public members appointed by the governor with the  advice  and
    19  consent  of  the  senate. Such public members shall be representative of
    20  the public, and have a demonstrated expertise or interest in  continuing
    21  care  retirement  communities;  provided  that no [more] less than [one]
    22  three such [member] members shall be a sponsor, owner, operator,  manag-
    23  er,  member of a board of directors, or shareholder of a continuing care
    24  retirement community. At least two public members shall be residents  of
    25  a  continuing  care  retirement  community.  At  least one of the public
    26  members shall be a representative of an organization  with  demonstrated
    27  experience  in representing the interests of senior citizens. The public
    28  members of the council shall have fixed terms of four years. The council
    29  shall be chaired by the commissioner or his or her designee.
    30    Members of such council shall serve  without  compensation  for  their
    31  services  as  members  of  the  council, except that each of them may be
    32  allowed the necessary and actual expenses which [he] they shall incur in
    33  the performance of [his] their duties under this article.
    34    2. The council shall meet as often  as  may  be  deemed  necessary  to
    35  fulfill  its  responsibilities.  The  council  shall  have the following
    36  powers and duties:
    37    a. to [approve or reject  applications  to  obtain  a  certificate  of
    38  authority  for  the  establishment  and  operation  of a continuing care
    39  retirement community.  In  reviewing  applications,  the  council  shall
    40  consider  the  extent to which the applications reflect various sponsor-
    41  ships, organizational structures, geographic dispersion, and the  public
    42  benefit.  In  determining  the  public  benefit of a community requiring
    43  construction of a total nursing facility component greater than or equal
    44  to ninety beds, the council shall obtain and consider the recommendation
    45  of the state hospital review and planning council  with  regard  to  the
    46  effect of the construction of the community's nursing facility beds upon
    47  existing facilities in the same geographic area] assist the commissioner
    48  on policy matters related to the establishment and operation of continu-
    49  ing care retirement communities;
    50    b.  to  [require  the  reporting  of such facts and information as the
    51  council may deem necessary to enforce the provisions of  this  article;]
    52  assist the commissioner in the development of the state's overall policy
    53  regarding  continuing  care retirement communities and cause studies and
    54  research to be conducted as it may deem advisable and necessary; and
    55    c. [to coordinate the oversight of operating communities and to assign
    56  review and regulatory responsibility  for  particular  aspects  of  such

        S. 5172                             3

     1  communities  to  the  appropriate  agencies, consistent with their legal
     2  authority, to assure consistent state supervision without duplication of
     3  inspection or regulatory review;
     4    d.]  to  make such recommendations to the governor and the legislature
     5  as may be necessary to encourage or further regulate the development  of
     6  continuing care retirement communities[;
     7    e. to establish and charge equitable and reasonable annual charges for
     8  operators,  not  to  exceed  fifty  dollars per approved living unit, to
     9  subsidize, in part, expenditures incurred in reviewing applications  for
    10  certificates of authority and in inspecting, regulating, supervising and
    11  auditing continuing care retirement communities;
    12    f.  to  review  reports  from the participating agencies regarding the
    13  operations and financial management of approved  communities,  including
    14  any  reports regarding the financial condition of any community that may
    15  be in need of close supervision and any reports of deficiencies  in  the
    16  provision of health or social services to residents of any community;
    17    g. to adopt rules and regulations and amendments thereto to effectuate
    18  the provisions of this article;
    19    h.  to  revoke,  suspend,  limit,  or annul a certificate of authority
    20  under conditions set forth in section forty-six hundred fifteen of  this
    21  article,  including when such action is taken at the specific request of
    22  any participating council agency. When action  has  been  taken  by  the
    23  commissioner  pursuant to subdivision seven of section forty-six hundred
    24  three of this article, the council shall  meet  as  soon  as  reasonably
    25  possible  to  approve  or  disapprove the action of the commissioner and
    26  shall take such further action as may be appropriate;
    27    i. to develop guidelines for applications for certificates of authori-
    28  ty;
    29    j. to make a final determination regarding an application for authori-
    30  zation to enter into priority reservation agreements where  the  commis-
    31  sioner has proposed to reject such application;
    32    k. to require the reporting of such facts and information as the coun-
    33  cil  may deem necessary to determine whether characteristics of residen-
    34  tial health care demonstration facilities such as comprehensive  systems
    35  of  residential and support services for the elderly may be successfully
    36  incorporated into existing or approved continuing care retirement commu-
    37  nities;
    38    l. to review and approve or reject  applications  by  continuing  care
    39  retirement community operators to use entrance fees to assist the opera-
    40  tor  in  financing the construction or purchase of a proposed continuing
    41  care retirement community in accordance with paragraph b of  subdivision
    42  six of section forty-six hundred ten of this article; and
    43    m.  to  review  and approve or reject any proposed financing by indus-
    44  trial development agencies of  continuing  care  retirement  communities
    45  pursuant  to  article eighteen-A of the general municipal law as author-
    46  ized by section forty-six hundred four-a of this article.
    47    3. The council shall establish guidelines under which the commissioner
    48  is authorized to approve or reject  any  proposed  refinancing,  if  the
    49  council  has  already approved an application pursuant to paragraph a of
    50  subdivision two of this section].
    51    § 4. Section 4603 of the public health law, as amended by chapter  659
    52  of  the  laws of 1997, subdivisions 10 and 11 as amended and subdivision
    53  12 as added by chapter 401 of the laws of 2003, is amended  to  read  as
    54  follows:
    55    §  4603. Commissioner; power and duties. The commissioner[, in consul-
    56  tation with the council,] shall have the following powers and duties:

        S. 5172                             4
 
     1    1. a. to receive applications from potential operators  of  continuing
     2  care  retirement  communities  and  to  distribute such applications for
     3  review to the participating agencies;
     4    [2.]  b. to collect and compile recommendations from the participating
     5  agencies and to present consolidated materials[,  including  recommenda-
     6  tions, to the council for its review and action];
     7    [3.]  c. to develop uniform forms for applications for certificates of
     8  authority, to review the status of such applications, and to  coordinate
     9  the  review  of  such  applications  in order to minimize duplication or
    10  delay;
    11    [4.] d. to  provide  information  to  entities  wishing  to  establish
    12  continuing  care  retirement  communities  and  to persons interested in
    13  becoming residents of such communities and to assist operators and resi-
    14  dents of such communities, to  the  extent  appropriate,  with  concerns
    15  relating to the operation of such facilities;
    16    [5.]  e.  to  [issue  certificates  of  authority  to those applicants
    17  approved by the council] approve or  reject  applications  to  obtain  a
    18  certificate  of  authority  for  the  establishment  and  operation of a
    19  continuing care retirement community.  In  reviewing  applications,  the
    20  commissioner shall consider the extent to which the applications reflect
    21  various  sponsorships,  organizational structures, geographic dispersion
    22  and the public benefit. In determining the public benefit of a community
    23  requiring construction of a total  nursing  facility  component  greater
    24  than or equal to ninety beds, the commissioner shall obtain and consider
    25  the recommendation of the public health and health planning council with
    26  regard  to  the  effect  of  the construction of the community's nursing
    27  facility beds upon existing facilities in the same geographic area;
    28    [6.] f. to coordinate the [interagency regulatory review of the appli-
    29  cations, development and operations of communities in order to  minimize
    30  duplication  or delay] oversight of operating communities and to consol-
    31  idate review and regulatory  responsibility,  including  inspections  of
    32  continuing  care  retirement  community facilities, to assure consistent
    33  state  supervision  without  duplication  of  inspection  or  regulatory
    34  review;
    35    [7.]  g.  if  the  immediate  health,  safety, or financial needs of a
    36  community's residents are in jeopardy, to suspend or limit a certificate
    37  of authority pursuant to subdivision two of  section  forty-six  hundred
    38  fifteen  of  this article. If the commissioner suspends a certificate of
    39  authority, he or she shall [immediately] notify the council;
    40    [8.] h. to [make recommendations concerning and  to  promulgate  rules
    41  and  regulations  and  amendments  thereto that have been adopted by the
    42  council to effectuate the provisions of this article]  adopt  rules  and
    43  regulations  and amendments thereto to effectuate the provisions of this
    44  article;
    45    [9.] i. to carry out  any  other  responsibilities  entrusted  to  the
    46  commissioner  pursuant to this chapter that may be necessary with regard
    47  to the health care activities of continuing care retirement communities;
    48    [10.] j. to make available to all prospective operators all  pertinent
    49  regulations regarding health and insurance necessary to comply with this
    50  article;
    51    [11.]  k.  to  approve  or  reject  applications for authorization, by
    52  prospective continuing care retirement  community  applicants,  entities
    53  that have filed an application for a certificate of authority and opera-
    54  tors,  to  enter  into cancelable priority reservation agreements and to
    55  collect refundable priority  reservation  fees  from  prospective  resi-
    56  dents[;  provided  that  in  any case where the commissioner proposes to

        S. 5172                             5

     1  reject such application, the council  shall  meet  within  a  reasonable
     2  period  of  time not to exceed ninety days to make a final determination
     3  regarding such application]; [and
     4    12.]  l. to approve or reject any proposed refinancing consistent with
     5  the guidelines established pursuant  to  subdivision  three  of  section
     6  forty-six hundred two of this article[.];
     7    m. to revoke, suspend, limit or annul a certificate of authority under
     8  conditions  set forth in section forty-six hundred fifteen of this arti-
     9  cle, including when such action is taken at the specific request of  any
    10  participating council agency;
    11    n. to require the reporting of such facts and information to determine
    12  whether characteristics of residential health care demonstration facili-
    13  ties  such  as comprehensive systems of residential and support services
    14  for the elderly  may  be  successfully  incorporated  into  existing  or
    15  approved continuing care retirement communities;
    16    o.  to  review  and  approve or reject applications by continuing care
    17  retirement community operators to use entrance fees to assist the opera-
    18  tor in financing the construction or purchase of a  proposed  continuing
    19  care  retirement community in accordance with paragraph b of subdivision
    20  six of section forty-six hundred ten of this article; and
    21    p. to review and approve or reject any proposed  financing  by  indus-
    22  trial  development  agencies  of  continuing care retirement communities
    23  pursuant to article eighteen-A of the general municipal law  as  author-
    24  ized by section forty-six hundred four-a of this article.
    25    2. Notwithstanding any provision of law to the contrary, this subdivi-
    26  sion shall apply to any application to obtain a certificate of authority
    27  for  the  establishment  and  operation  of a continuing care retirement
    28  community or fee-for-service continuing care  retirement  community  and
    29  any application for the certification or licensure of any component of a
    30  continuing  care retirement community or fee-for-service continuing care
    31  retirement community.
    32    a. For an application to obtain a certificate  of  authority  for  the
    33  establishment  and  operation  of a continuing care retirement community
    34  submitted to the commissioner  pursuant  to  this  article  and  article
    35  forty-six-A  of this chapter, within one hundred eighty calendar days of
    36  the department deeming the application complete, the commissioner  shall
    37  make a decision to approve or disapprove the application. If the commis-
    38  sioner  determines  to  disapprove  the  application,  the basis of such
    39  disapproval shall be provided in writing; however, disapproval shall not
    40  be based on the incompleteness of the application. If  the  commissioner
    41  fails to take action to approve or disapprove the application within one
    42  hundred eighty days of the application being deemed complete, the appli-
    43  cation shall be deemed approved.
    44    b. The commissioner, in consultation with the public health and health
    45  planning  council,  shall  develop  a streamlined application review and
    46  approval process to be available for use on or before January first, two
    47  thousand eighteen in relation to the approval of components of a contin-
    48  uing care retirement community, including, but not limited to,  a  resi-
    49  dential  health  care  facility, adult care facility and assisted living
    50  facility; provided, however, that no such streamlined application review
    51  and approval process shall limit or restrict the authority of the public
    52  health and planning council to issue final approval or  disapproval  for
    53  the  establishment,  construction or addition of residential health care
    54  facility beds.
    55    c. For an application that requires approval by the public health  and
    56  health  planning  council,  the  application shall be placed on the next

        S. 5172                             6

     1  council  agenda  following  the  commissioner  deeming  the  application
     2  complete.
     3    d. Where the commissioner requires the applicant to submit information
     4  to  satisfy a contingency imposed on the approval of an application, the
     5  commissioner shall have thirty calendar days to review  and  approve  or
     6  disapprove  the  submitted  information.  If the commissioner determines
     7  that the information is incomplete,  the  department  shall  notify  the
     8  applicant in writing and provide the applicant with ten calendar days to
     9  correct the deficiency or provide additional information. If the commis-
    10  sioner  determines  that  the submitted information does not satisfy the
    11  contingency, the basis for such disapproval shall be provided  in  writ-
    12  ing;  however,  disapproval  shall not be based on the incompleteness of
    13  the application. Within fifteen calendar days of  complete  satisfaction
    14  of  a  contingency,  the  commissioner shall transmit the final approval
    15  letter to the applicant.
    16    § 5. Subdivision 1 of section  4604  of  the  public  health  law,  as
    17  amended  by  chapter  659  of  the  laws  of 1997, is amended to read as
    18  follows:
    19    1. No person shall construct, expand, acquire, maintain, or operate  a
    20  continuing  care  retirement  community,  or enter into a contract as an
    21  operator, or solicit the execution of any contract for  continuing  care
    22  retirement  community services to be provided within the state or adver-
    23  tise itself or otherwise hold itself as a  "continuing  care  retirement
    24  community"  or  a "life plan community", without obtaining a certificate
    25  of authority pursuant to this article;  provided,  however,  nothing  in
    26  this subdivision shall prohibit a person, authorized pursuant to section
    27  forty-six  hundred  twenty-one  or  forty-six hundred twenty-two of this
    28  article, from entering into priority reservation agreements, soliciting,
    29  collecting or receiving priority reservation fees, or  constructing  and
    30  maintaining  sales  offices  and  model units with respect to a proposed
    31  continuing care retirement community.
    32    § 6. Subdivision 1 of section  4655  of  the  public  health  law,  as
    33  amended  by  chapter  545  of  the  laws  of 2004, is amended to read as
    34  follows:
    35    1. No person shall construct, expand, acquire, maintain, or operate  a
    36  fee-for-service  continuing  care  retirement community, or enter into a
    37  contract as an operator, or solicit the execution of  any  contract  for
    38  fee-for-service  continuing  care  retirement  community  services to be
    39  provided within the state or advertise itself or otherwise  hold  itself
    40  as  a  "fee-for-service continuing care retirement community" or a "life
    41  plan community", without obtaining a certificate of  authority  pursuant
    42  to  this  article;  provided, however, nothing in this subdivision shall
    43  prohibit a person, authorized  pursuant  to  section  forty-six  hundred
    44  seventy-four  or  forty-six  hundred  seventy-five of this article, from
    45  entering into priority reservation agreements, soliciting, collecting or
    46  receiving priority reservation fees,  or  constructing  and  maintaining
    47  sales offices and model units with respect to a proposed fee-for-service
    48  continuing   care  retirement  community.  Such  facility  shall  obtain
    49  approval to utilize residential health  care  facility  beds  authorized
    50  under subdivision five of section forty-six hundred four of this chapter
    51  and/or  shall meet such other conditions for acquisition of the residen-
    52  tial health care facility beds as the commissioner may determine.
    53    § 7. Subdivision 3 of section  4604  of  the  public  health  law,  as
    54  amended by chapter 7 of the laws of 2015, is amended to read as follows:
    55    3.  Nothing in this article shall be construed to enlarge, diminish or
    56  modify: a social services  district's  otherwise  valid  recovery  under

        S. 5172                             7
 
     1  section three hundred sixty-nine of the social services law, nor medical
     2  assistance  eligibility under title eleven of article five of the social
     3  services law nor applicable provisions of the estates, powers and trusts
     4  law.  Except  as  otherwise  provided in this article, the activities of
     5  continuing care retirement communities shall be subject to any other law
     6  governing such activities including but not limited to  article  twenty-
     7  eight  of  this chapter and article seven of the social services law and
     8  regulations  promulgated  thereunder;  provided,   however,   that   the
     9  provisions  of  paragraphs  (d)  and  (e) of subdivision four of section
    10  twenty-eight hundred one-a and section twenty-eight hundred two of  this
    11  chapter  shall  not apply, and provided that the provisions of paragraph
    12  (a) of subdivision one and the provisions of subdivision two of  section
    13  four  hundred  sixty-one-b  of  the  social services law with respect to
    14  public need and the  provisions  of  subdivision  one  of  section  four
    15  hundred  sixty-one-c of the social services law shall not apply to resi-
    16  dents who have been admitted in  accordance  with  a  contract  provided
    17  that, upon admission to the adult care facility, such residents shall be
    18  given  a notice which shall include, at a minimum, information regarding
    19  facility services,  resident  responsibilities,  supplemental  services,
    20  resident rights and protections and circumstances that warrant transfer,
    21  subject to the provisions of subdivision twenty-one of section forty-six
    22  hundred  eight  of  this  article. The number of residential health care
    23  facility beds available pursuant to subdivision five  of  this  section,
    24  without proof of public need therefor, shall be reduced by the number of
    25  residential  health  care  demonstration facility beds that are approved
    26  pursuant to this article.
    27    § 8. Subdivision 3 of section 4655 of the public health law, as  added
    28  by chapter 519 of the laws of 2004, is amended to read as follows:
    29    3.  Nothing in this article shall be construed to enlarge, diminish or
    30  modify: a social services  district's  otherwise  valid  recovery  under
    31  section three hundred sixty-nine of the social services law, nor medical
    32  assistance  eligibility under title eleven of article five of the social
    33  services law, nor applicable  provisions  of  the  estates,  powers  and
    34  trusts law. Except as otherwise provided in this article, the activities
    35  of  fee-for-service  continuing  care  retirement  communities  shall be
    36  subject to any other law governing such  activities  including  but  not
    37  limited to article twenty-eight of this chapter and article seven of the
    38  social  services  law  and regulations promulgated thereunder; provided,
    39  however, that the provisions of paragraphs (d) and  (e)  of  subdivision
    40  four  of  section  twenty-eight  hundred  one-a and section twenty-eight
    41  hundred two of this chapter shall  not  apply,  and  provided  that  the
    42  provisions  of  paragraph  (a)  of subdivision one and the provisions of
    43  subdivision two of  section  four  hundred  sixty-one-b  of  the  social
    44  services  law with respect to public need and the provisions of subdivi-
    45  sion one of section four hundred sixty-one-c of the social services  law
    46  shall not apply to residents who have been admitted in accordance with a
    47  fee-for-service  continuing  care contract provided that, upon admission
    48  to the adult care facility, such residents shall be given a notice which
    49  shall include, at a minimum, information  regarding  facility  services,
    50  resident  responsibilities,  supplemental  services, resident rights and
    51  protections and circumstances that  warrant  transfer,  subject  to  the
    52  provisions  of subdivision seventeen of section forty-six hundred fifty-
    53  nine of this article.  The number of residential  health  care  facility
    54  beds  available  pursuant  to  subdivision four of this section, without
    55  proof of public need therefor, shall be reduced by the number  of  resi-

        S. 5172                             8
 
     1  dential health care demonstration facility beds that are approved pursu-
     2  ant to this article.
     3    §  9.  Subdivision  4  of  section  4604  of the public health law, as
     4  amended by chapter 659 of the laws of 1997, subparagraphs (i), (ii)  and
     5  (iii)  of  paragraph  a  as  further amended by section 104 of part A of
     6  chapter 62 of the laws of 2011, paragraphs b and d as amended by chapter
     7  549 of the laws of 2014, paragraph c as amended by chapter 7 of the laws
     8  of 2015, is amended to read as follows:
     9    4. No certificate of authority shall be issued unless  an  application
    10  meeting  the  requirements  of  this  section and all other requirements
    11  established by law has been approved by the commissioner:
    12    a. [(i)] the [superintendent of financial services as to the actuarial
    13  principles involved, the financial feasibility of the facility, the form
    14  and content of the proposed contracts to be entered into with  residents
    15  and insurance contracts between an operator and an insurer requiring the
    16  insurer  to  assume,  wholly  or  in part, the cost of medical or health
    17  related services to be provided  to  a  resident]  actuarial  principles
    18  involved,  the  financial  feasibility  of the facility and the form and
    19  content of the proposed contracts to be  entered  into  with  residents,
    20  provided  that the review may be conducted by the commissioner or his or
    21  her designee, including any necessary independent actuarial review;
    22    [(ii) the superintendent of financial services as to] b. the rates and
    23  rating methodology, if any, to be used by the operator to determine  any
    24  entrance fee, monthly care fee and/or any separate charges for the hous-
    25  ing  component of the continuing care contract including but not limited
    26  to a cooperative or condominium fee charged to the resident as  proposed
    27  in said operator's application for certificate of authority.  Subsequent
    28  increases  in  any entrance or monthly care fee in excess of fees calcu-
    29  lated pursuant to the approved rating methodology shall require approval
    30  of the [superintendent] commissioner.  The term "rating methodology"  as
    31  used  herein  shall incorporate a combination of variables including but
    32  not limited to a pricing structure for  comparable  services,  projected
    33  operating  and  health care costs and the applicable inflationary impact
    34  thereon, projected income and  occupancy  rates  and  the  refundability
    35  component of the continuing care retirement contract[.
    36    (iii) the superintendent of financial services as to];
    37    c.  any  monthly care fee charged to a resident which may be increased
    38  or decreased subject to approval by  the  [superintendent  of  financial
    39  services]   commissioner,  provided,  that  monthly  care  fees  may  be
    40  increased or  decreased  without  specific  approval  as  long  as  such
    41  increase  or  decrease  does not exceed a relevant cost index or indices
    42  which reflect all components of  continuing  care  including  the  costs
    43  associated  with  provision of health care as determined and promulgated
    44  at least annually by the [superintendent] commissioner  or  his  or  her
    45  designee,  including  any  necessary  independent  actuarial review, and
    46  provided further that the [superintendent] commissioner is  notified  of
    47  any such increase or decrease prior to its taking effect[.
    48    (iv) An] d. the requirement that an individual resident's monthly care
    49  fee  shall not be modified because of the increased need for services of
    50  that resident;
    51    [b. the commissioner as to those] e. aspects of the application relat-
    52  ing to adult care facility beds, if any;
    53    [c.] f. following review by the  public  health  and  health  planning
    54  council  as  to  the  establishment of a skilled nursing facility by the
    55  applicant and as to such other facilities and services  as  may  require
    56  the public health and health planning council's approval of the applica-

        S. 5172                             9
 
     1  tion;  provided, however, that the recommendations of the health systems
     2  agency having geographical jurisdiction of the area where the continuing
     3  care retirement community is located shall not be required with  respect
     4  to the establishment of an on-site or affiliated residential health care
     5  facility  to  serve  residents as part of the continuing care retirement
     6  community, for up to the total number of residential health care facili-
     7  ty beds provided for in subdivision five of this section in  communities
     8  statewide;
     9    [d.  the  commissioner  under section twenty-eight hundred two of this
    10  chapter;] g. provided, however, that, the recommendations of the  public
    11  health  and health planning council and the health systems agency having
    12  geographical jurisdiction of the area where the continuing care  retire-
    13  ment  community  is  located  shall  not be required with respect to the
    14  construction of an on-site or affiliated residential health care facili-
    15  ty to serve residents as part of the continuing care retirement communi-
    16  ty, for up to the total number of residential health care facility  beds
    17  provided  for  in subdivision five of this section in communities state-
    18  wide; and
    19    [e. the] h. upon consultation with the attorney general, as  to  those
    20  aspects  of  the  application  relating to a cooperative, condominium or
    21  other equity arrangement for the independent living unit, if any.
    22    § 10. The opening paragraph of subdivision 6 of section  4604  of  the
    23  public  health  law,  as  amended by chapter 659 of the laws of 1997, is
    24  amended to read as follows:
    25    If the [approvals] applicant has satisfied the  criteria  required  by
    26  subdivision  four  of  this  section [have been obtained], the [council]
    27  commissioner shall[, by majority vote,] either  approve  or  reject  the
    28  application  [within  sixty  days  of  the  date  on which the last such
    29  approval has been obtained]. In order to approve  the  application,  the
    30  [council] commissioner shall have determined that:
    31    §  11.  Subdivisions 7 and 9 of section 4604 of the public health law,
    32  subdivision 7 as amended by chapter 659 of the laws of 1997 and subdivi-
    33  sion 9 as added by chapter 689 of the laws of 1989, are amended to  read
    34  as follows:
    35    7.  Any  change  in  the  legal  entity  operating the continuing care
    36  retirement community, or in a controlling person of the community  shall
    37  require  approval  in  the  same  manner  as  an  original  application;
    38  provided,  however,  that  the  [council]  commissioner  may  waive  any
    39  requirement  to  provide information that is not relevant to such change
    40  and provided, further, that the continued public need for the  community
    41  shall be presumed.
    42    9.  [If  the  council  approves the application, the] The commissioner
    43  shall issue the certificate of authority to the applicant upon  approval
    44  of the application.
    45    §  12.  Section 4604-a of the public health law, as amended by chapter
    46  659 of the laws of 1997, paragraph g of  subdivision  2  as  amended  by
    47  chapter 549 of the laws of 2014, is amended to read as follows:
    48    §  4604-a.  [Council]  Commissioner  approval  required for industrial
    49  development agency financing in connection with continuing care  retire-
    50  ment  communities.  1.  No person seeking financing in connection with a
    51  continuing care retirement community through an  industrial  development
    52  agency  shall undertake such financing without the prior approval of the
    53  [council] commissioner. Upon approving a proposed financing pursuant  to
    54  this  section,  the  [council] commissioner shall issue a certificate of
    55  authorization to the applicant.

        S. 5172                            10
 
     1    2. Prior to approving such financing, the [council] commissioner shall
     2  find that:
     3    a.  The  operator  has  (i)  executed  contracts  for at least seventy
     4  percent of all living units and has on deposit at least ten  percent  of
     5  the  entrance  fees  or  purchase price for such units; or (ii) executed
     6  contracts for at least sixty percent of all  living  units  and  has  on
     7  deposit  at  least  twenty-five percent of the entrance fees or purchase
     8  price for such units.
     9    b. The operator has demonstrated capability to comply fully  with  the
    10  requirements  for  a certificate of authority and has obtained a contin-
    11  gent certificate of authority pursuant to section forty-six hundred four
    12  of this article and the operator has agreed to meet the requirements  of
    13  article eighteen-A of the general municipal law.
    14    c. The applicant is a not-for-profit corporation as defined in section
    15  one hundred two of the not-for-profit corporation law that is (i) eligi-
    16  ble  for tax-exempt financing under this section and (ii) is exempt from
    17  taxation pursuant to section 501(c)(3) of the federal  internal  revenue
    18  code,  and either has (i) an equity position in the community equivalent
    19  to no less than fifteen percent of the amount  to  be  financed  in  the
    20  aggregate; or (ii) covenants (A) to meet a ratio of cash and investments
    21  to  outstanding debt (reserve ratio) of no less than twenty-five percent
    22  commencing at the end of the first quarter after twenty-four months from
    23  the receipt of a certificate of occupancy for the facility, and  (B)  to
    24  maintain  that reserve ratio, as tested quarterly based upon the facili-
    25  ty's interim financial statements and annually based upon audited finan-
    26  cial statements, until debt reduction equal to  twenty-five  percent  of
    27  total  indebtedness  is  accomplished;  and  (c) to reduce total debt by
    28  twenty-five percent of the total indebtedness at the  time  the  certif-
    29  icate  of  occupancy  is  received by no later than five years after the
    30  receipt of the certificate of occupancy.
    31    d. The operator has submitted in connection with the proposed  financ-
    32  ing  a  financial  feasibility study, including a financial forecast and
    33  market study prepared by an independent firm nationally  recognized  for
    34  continuing  care retirement community feasibility studies, demonstrating
    35  to the satisfaction of the [council] commissioner the  financial  sound-
    36  ness of the financing. In addition, the operator has submitted an analy-
    37  sis   of  economic  costs  and  benefits,  including  job  creation  and
    38  retention, the estimated value of tax exemptions provided, the project's
    39  impact on local businesses and the availability and comparative cost  of
    40  alternative  financing  sources.  Such  analysis shall be prepared by an
    41  independent entity.
    42    e. The operator will  establish  and  maintain  a  fully  funded  debt
    43  service  reserve equal to the sum of maximum annual debt service (inter-
    44  est plus annual scheduled  principal  payments,  not  including  balloon
    45  maturities, if any) on bonds authorized thereby having a maturity of ten
    46  years  or less, plus the maximum annual debt service on bonds authorized
    47  thereby having a maturity of greater than ten years, provided,  however,
    48  that  in  the  case of tax-exempt bond issues, such debt service reserve
    49  shall not exceed the maximum amount permitted by federal tax law.
    50    f. The operator will provide for such remedies or limitations of reme-
    51  dies of bondholders as  may  be  required  by  or  consistent  with  the
    52  provisions  of this article and any regulations in existence at the time
    53  of the issuance promulgated thereunder.
    54    g. Unless all residents or continuing care at  home  contract  holders
    55  have  life  care  contracts, the operator has adequately made the assur-
    56  ances required by subdivision two of section forty-six  hundred  twenty-

        S. 5172                            11

     1  four  of  this article and has agreed to fund the liability in the event
     2  that such resident's or contract holder's assets are insufficient to pay
     3  for nursing facility services for a one year period.
     4    3. In addition, an operator which is subject to the provisions of this
     5  section shall:
     6    a.  provide  the [council or its designee] commissioner with notice of
     7  any monetary default or covenant default in connection with such financ-
     8  ing and shall further notify the [council or its designee]  commissioner
     9  of  any  withdrawal  from  the  debt service reserve fund established in
    10  connection with such financing;
    11    b. respond in writing to the operational recommendations of the [coun-
    12  cil or its designee] commissioner with respect to protecting the  inter-
    13  ests  of  continuing care retirement community residents in the event of
    14  any monetary default or covenant default provided for in connection with
    15  such financing;
    16    c. provide adequate security for the repayment of  the  bonds  issued,
    17  including  the  granting  of liens on real and personal property and the
    18  pledge of project revenues; the  maintenance  of  minimum  debt  service
    19  coverage  and other financial ratios as shall be required in regulations
    20  in existence at the time of issuance by the [council] commissioner;  and
    21  restrictions on other debt and expenditures; and
    22    d.  undertake  to  maintain the financial feasibility of the facility,
    23  including the retention of an independent consultant  to  recommend  and
    24  help implement remedial action.
    25    4.  The  [council]  commissioner  may  request, and shall receive, the
    26  technical assistance of any state agency or state  public  authority  in
    27  performing its functions under this article.
    28    §  13.  Paragraphs  a  and  b  of subdivision 2 of section 4605 of the
    29  public health law, paragraph a as amended by chapter 659 of the laws  of
    30  1997  and paragraph b as amended by chapter 401 of the laws of 2003, are
    31  amended to read as follows:
    32    a. The commissioner[, in consultation with the council,] may authorize
    33  an operator of a community with an  on-site  or  affiliated  residential
    34  health  care  facility  to  provide[, for a limited period,] residential
    35  health care facility services to persons, who are not residents  of  the
    36  community,  provided,  however, that the operator shall not discriminate
    37  in the admission, retention or care of  any  such  person  because  such
    38  person  is or will be eligible for, or receives or will receive, medical
    39  assistance benefits pursuant to title eleven  of  article  five  of  the
    40  social  services  law.    For  communities in existence prior to January
    41  first, two thousand seventeen with an on-site or affiliated  residential
    42  health  care  facility,  each  community  is  authorized  to continue to
    43  provide residential health care facility services to persons who are not
    44  residents of the community at a percentage  deemed  permissible  by  the
    45  commissioner.  For  communities  approved  following  January first, two
    46  thousand seventeen with an on-site or affiliated residential health care
    47  facility, each community  shall  be  permitted  to  provide  residential
    48  health  care  facility  services to persons who are not residents of the
    49  community for a period of seven years, provided, however, that the oper-
    50  ator may seek an extension of this  authorization  at  the  end  of  the
    51  seven-year period upon written application to the commissioner.
    52    b.  [The]  Upon  written  notice to the commissioner, [in consultation
    53  with the council, may authorize] an operator  of  a  community  with  an
    54  on-site  or  affiliated  adult  care  facility  [to] may provide[, for a
    55  limited period,] adult care facility services to persons,  who  are  not
    56  residents  of  the community, provided, however, that the operator shall

        S. 5172                            12

     1  not discriminate in the admission, retention or care of any such  person
     2  because  such  person  is  or  will be eligible for, or receives or will
     3  receive, medical assistance benefits pursuant to title eleven of article
     4  five of the social services law or supplemental security income benefits
     5  pursuant  to  title  sixteen  of the federal social security act and any
     6  additional state payments made under title six of article  five  of  the
     7  social  services law. For persons who are not residents of the community
     8  at the time of admission to an adult care facility, the transfer of such
     9  resident to an on-site or affiliated residential  health  care  facility
    10  due  to  medical  necessity shall not constitute residential health care
    11  facility services to persons who are not residents of the community.
    12    § 14. Paragraphs a and b of subdivision  2  of  section  4656  of  the
    13  public  health  law,  as  added  by chapter 519 of the laws of 2004, are
    14  amended to read as follows:
    15    a. The commissioner[, in consultation with the council,] may authorize
    16  an operator of a community with an  on-site  or  affiliated  residential
    17  health  care  facility  to  provide[, for a limited period,] residential
    18  health care facility services to persons, who are not residents  of  the
    19  community,  provided,  however, that the operator shall not discriminate
    20  in the admission, retention or care of  any  such  person  because  such
    21  person  is or will be eligible for, or receives or will receive, medical
    22  assistance benefits pursuant to title eleven  of  article  five  of  the
    23  social  services  law.  For  communities  in  existence prior to January
    24  first, two thousand seventeen with an on-site or affiliated  residential
    25  health  care  facility,  each  community  is  authorized  to continue to
    26  provide residential health care facility services to persons who are not
    27  residents of the community at a percentage  deemed  permissible  by  the
    28  commissioner.  For  communities  approved  following  January first, two
    29  thousand seventeen with an on-site or affiliated residential health care
    30  facility, each community  shall  be  permitted  to  provide  residential
    31  health  care  facility  services to persons who are not residents of the
    32  community for a period of seven years, provided, however, that the oper-
    33  ator may seek an extension of this  authorization  at  the  end  of  the
    34  seven-year  period  upon  written  application to the commissioner.  For
    35  persons who are not residents of the community at the time of  admission
    36  to  an  adult care facility, the transfer of such resident to an on-site
    37  or affiliated residential health care facility due to medical  necessity
    38  shall  not  constitute  residential  health  care  facility  services to
    39  persons who are not residents of the community.
    40    b. [The] Upon written notice to  the  commissioner,  [in  consultation
    41  with  the  council,  may  authorize]  an operator of a community with an
    42  on-site or affiliated adult care  facility  [to]  may  provide[,  for  a
    43  limited  period,]  adult  care facility services to persons, who are not
    44  residents of the community, provided, however, that the  operator  shall
    45  not  discriminate in the admission, retention or care of any such person
    46  because such person is or will be eligible  for,  or  receives  or  will
    47  receive, medical assistance benefits pursuant to title eleven of article
    48  five of the social services law or supplemental security income benefits
    49  pursuant  to  title  sixteen  of the federal social security act and any
    50  additional state payments made under title six of article  five  of  the
    51  social  services law. For persons who are not residents of the community
    52  at the time of admission to an adult care facility, the transfer of such
    53  resident to an on-site or affiliated residential  health  care  facility
    54  due  to  medical  necessity shall not constitute residential health care
    55  facility services to persons who are not residents of the community.

        S. 5172                            13
 
     1    § 15. Section 4605-a of the public health law, as added by  chapter  7
     2  of the laws of 2015, is amended to read as follows:
     3    § 4605-a. Certificate of authority; authority to offer continuing care
     4  at  home  contracts.    A continuing care retirement community may offer
     5  continuing care at home contracts upon approval by the [council] commis-
     6  sioner to amend the continuing care retirement  community's  certificate
     7  of authority. In order to qualify for an amendment to its certificate of
     8  authority,  the continuing care retirement community shall submit to the
     9  commissioner the following:
    10    1. a business plan  to  the  commissioner  [and  superintendent]  that
    11  includes the following:
    12    (a) a description of the continuing care at home services that will be
    13  provided,  the market that will be served by the continuing care at home
    14  contracts, and the fees to be charged to prospective continuing care  at
    15  home contract holders;
    16    (b) a copy of the proposed continuing care at home contract; and
    17    (c)  an  actuarial study prepared by an independent actuary in accord-
    18  ance with standards adopted by the American Academy of Actuaries  demon-
    19  strating the impact that the continuing care at home contracts will have
    20  on  the  overall  operations of the continuing care retirement community
    21  and further demonstrating that the addition of continuing care  at  home
    22  contracts  will  not jeopardize the financial solvency of the continuing
    23  care retirement community.
    24    2. a market feasibility study demonstrating to the  commissioner  [and
    25  superintendent]  sufficient consumer interest in continuing care at home
    26  contracts and further demonstrating that the addition of continuing care
    27  at home contracts will not have an adverse impact on  the  provision  of
    28  services to continuing care retirement contract holders.
    29    3.  materials  that meet all requirements established by the [New York
    30  state] department [of financial services].
    31    4. [A] a copy of the notification sent to continuing  care  retirement
    32  contract  holders  describing  the anticipated impact of the addition of
    33  continuing care at home contracts on continuing care retirement communi-
    34  ty resources and proof that such notification has  been  distributed  to
    35  all continuing care retirement contract holders.
    36    §  16.  Section 4605-b of the public health law, as added by chapter 7
    37  of the laws of 2015, is amended to read as follows:
    38    § 4605-b. Certificate of authority; limitation on continuing  care  at
    39  home  contracts.    The  number  of  continuing  care  at home contracts
    40  approved on a certificate of authority shall be limited to:
    41    1. The number of approved living units on the continuing care  retire-
    42  ment  community's  premises  that are intended for ILU residents, except
    43  that the [council] commissioner may approve additional contracts upon  a
    44  submission  [to  the  commissioner]  by  an operator consistent with the
    45  provisions set forth in section forty-six hundred five-a of  this  arti-
    46  cle;
    47    2. The demonstrated number of continuing care at home contract holders
    48  that can be supported in the existing or approved future capacity of the
    49  adult  care  facility  and  skilled nursing facility consistent with the
    50  provisions set forth in section forty-six hundred five-a of  this  arti-
    51  cle; and
    52    3.  Conditions set forth by the [New York state] department [of finan-
    53  cial services], based upon the [superintendent]  commissioner's  assess-
    54  ment of the following:
    55    (a) the overall financial impact on the community; and

        S. 5172                            14
 
     1    (b)  the  submitted  materials  set forth in section forty-six hundred
     2  five-a of this article.
     3    §  17.  Section 4607 of the public health law, as added by chapter 689
     4  of the laws of 1989, paragraph d of subdivision 2 as amended by  chapter
     5  659 of the laws of 1997, is amended to read as follows:
     6    § 4607. Annual statement.  1. Within four months of close of the oper-
     7  ator's  fiscal year, unless an extension of time to file has been grant-
     8  ed, the operator shall file an annual statement  with  the  commissioner
     9  [and  superintendent]  showing  the  condition as of the last day of the
    10  preceding calendar or fiscal year. If the commissioner [and  superinten-
    11  dent do] does not receive the annual statement within four months of the
    12  end  of  the  operator's fiscal year or have not granted an extension of
    13  time to file, the [council] commissioner may charge a late fee.
    14    2. The annual statement shall be in such form as the [council] commis-
    15  sioner prescribes and shall contain at least the following:
    16    a. Any change in status with respect to the information required to be
    17  submitted pursuant to section forty-six hundred four of this article;
    18    b. Financial statements audited by  an  independent  certified  public
    19  accountant, which shall contain, for two or more periods if the communi-
    20  ty has been in existence that long, the following:
    21    (i) an accountant's opinion and, in accordance with generally accepted
    22  accounting principles:
    23    (A) a balance sheet,
    24    (B) a statement of income and expenses,
    25    (C) a statement of equity or fund balances,
    26    (D) a statement of changes in financial position,
    27    (ii)  notes to the financial statements considered customary or neces-
    28  sary to ensure full disclosure of the  financial  statements,  financial
    29  condition, and operation;
    30    c. A detailed listing of the assets maintained for the reserves;
    31    d.  A  copy  of  the  most  recent  actuarial review of the community,
    32  including such information as may be required  by  the  [superintendent]
    33  commissioner  including an opinion of a qualified consulting actuary, as
    34  to the current and projected soundness of the community, provided howev-
    35  er that a new actuarial review must be submitted triennially; and
    36    e. Such other reasonable financial and other information as the [coun-
    37  cil] commissioner may require with respect to the operator or the commu-
    38  nity, or its directors, controlling persons, trustees, members,  branch-
    39  es,  subsidiaries or affiliates to determine the financial status of the
    40  community and the management capabilities of the operator.
    41    3. Sixty days before commencement of each calendar or fiscal  year  or
    42  official opening date, whichever is applicable, each operator shall file
    43  with  the  commissioner [and superintendent] a computation of the annual
    44  long-term debt service and a projected annual revenue and expense summa-
    45  ry for the next ten years.
    46    § 18. Section 4658 of the public health law, as added by  chapter  519
    47  of the laws of 2004, is amended to read as follows:
    48    §  4658. Annual statement. 1. Within four months of close of an opera-
    49  tor's fiscal year, unless an extension of time to file has been granted,
    50  the operator shall file an annual statement with the commissioner  show-
    51  ing the condition as of the last day of the preceding calendar or fiscal
    52  year.  If  the commissioner does not receive the annual statement within
    53  four months of the end of the operator's fiscal year or has not  granted
    54  an extension of time to file, the council may charge a late fee.
    55    2. The annual statement shall be in such form as the [council] commis-
    56  sioner prescribes and shall contain at least the following:

        S. 5172                            15
 
     1    a. Any change in status with respect to the information required to be
     2  submitted  pursuant  to  section  forty-six  hundred fifty-seven of this
     3  article;
     4    b.  Financial  statements  audited  by an independent certified public
     5  accountant, which shall contain, for two or more periods if the communi-
     6  ty has been in existence that long, the following:
     7    (i) notes to the financial statements considered customary  or  neces-
     8  sary  to  ensure  full disclosure of the financial statements, financial
     9  condition, and operation; and
    10    (ii)  an  accountant's  opinion  and,  in  accordance  with  generally
    11  accepted  accounting principles: (A) a balance sheet, (B) a statement of
    12  income and expenses, (C) a statement of equity or fund balances, and (D)
    13  a statement of changes in financial position;
    14    c. A detailed listing of the assets maintained for the reserves; and
    15    d. Such other reasonable financial and other information as the [coun-
    16  cil] commissioner may require with respect to the operator or the commu-
    17  nity, or its directors, controlling persons, trustees, members,  branch-
    18  es,  subsidiaries or affiliates to determine the financial status of the
    19  community and the management capabilities of the operator.
    20    3. Sixty days before commencement of each calendar or fiscal  year  or
    21  official opening date, whichever is applicable, each operator shall file
    22  with the commissioner a computation of the annual long-term debt service
    23  and  a  projected  annual  revenue  and expense summary for the next ten
    24  years.
    25    § 19. Paragraphs a and c of subdivision 15  of  section  4608  of  the
    26  public  health  law,  as  amended  by chapter 7 of the laws of 2015, are
    27  amended to read as follows:
    28    a. the resident or contract holder, as applicable shall, if  eligible,
    29  enroll in medicare parts a and b or the equivalent and shall continue to
    30  maintain  that  coverage,  together with medicare supplement coverage at
    31  least equivalent in benefits to those established by the  superintendent
    32  as minimum benefits for medicare supplement policies; provided, however,
    33  that  such  medicare  supplement  coverage  shall  cover any coinsurance
    34  amounts due and payable for the twenty-first day through  the  hundredth
    35  day  of  any  medicare  part  a benefit period for post-hospital skilled
    36  nursing facility care;
    37    c. if the community cannot purchase  medicare  coverage  and  medicare
    38  supplement  coverage  or  the  equivalent,  the community shall have the
    39  authority to require an adjustment  in  monthly  fees,  subject  to  the
    40  approval  of  the  [superintendent] commissioner, to fund the additional
    41  risk to the facility; and
    42    § 20. Subdivision 16 of section 4608 of  the  public  health  law,  as
    43  amended by chapter 7 of the laws of 2015, is amended to read as follows:
    44    16.  A  statement that any amendment to the contract and any change in
    45  fees or charges, other than those within the guidelines of  an  approved
    46  rating  system,  must  be  approved  by the [superintendent of financial
    47  services] commissioner;
    48    § 21. Section 4608 of the public health law is amended by adding a new
    49  subdivision 21 to read as follows:
    50    21. A statement that, except as otherwise required  by  law,  rule  or
    51  regulation,  a continuing care retirement contract or continuing care at
    52  home contract shall take precedence over  any  conflicting  requirements
    53  for separate admissions agreements for covered levels of care including,
    54  but  not  limited to, a nursing home admissions agreement, an adult care
    55  facility admission agreement or an assisted living residency agreement.

        S. 5172                            16
 
     1    §  22. Section 4659 of the public health law, as added by chapter  519
     2  of  the  laws of 2004, is amended by adding a new subdivision 17 to read
     3  as follows:
     4    17.  A statement that a fee-for-service continuing care contract shall
     5  take precedence over any conflicting requirements  for  separate  admis-
     6  sions  agreements for covered levels of care, including, but not limited
     7  to, a nursing home admissions agreement, an adult care  facility  admis-
     8  sion agreement, or an assisted living residency agreement.
     9    § 23. Subdivision 4 of section 4609 of the public health law, as added
    10  by  chapter  689 of the laws of 1989, is amended and a new subdivision 5
    11  is added to read as follows:
    12    4. Any refund made pursuant to this section must be paid no later than
    13  thirty days after the formerly occupied unit has been resold, but in  no
    14  event  later  than [one year] two years after the formerly occupied unit
    15  has been vacated.
    16    5. Nothing in this section shall preclude a resident  from  making  an
    17  immediate  irrevocable gift or a bequest to the community of all or part
    18  of the entrance  fee  which  would  otherwise  be  refunded  under  this
    19  section.
    20    § 24. Subdivision 4 of section 4660 of the public health law, as added
    21  by  chapter  519 of the laws of 2004, is amended and a new subdivision 5
    22  is added to read as follows:
    23    4. Any refund made pursuant to this section shall  be  paid  no  later
    24  than  thirty  days after the formerly occupied unit has been resold, but
    25  in no event later than [one year] two years after the formerly  occupied
    26  unit  has  been  vacated; provided, further, that a resident transfer to
    27  another level of care in the community shall not be considered  a  with-
    28  drawal  of  such  resident for purposes of requiring a refund under this
    29  section.
    30    5. Nothing in this section shall preclude a resident  from  making  an
    31  immediate  irrevocable gift or a bequest to the community of all or part
    32  of the entrance  fee  which  would  otherwise  be  refunded  under  this
    33  section.
    34    § 25. Subparagraph (v) of paragraph b of subdivision 6 of section 4610
    35  of the public health law, as amended by chapter 659 of the laws of 1997,
    36  is amended to read as follows:
    37    (v) the total amount of escrowed entrance fees or deposits that may be
    38  approved  for  release  under  this paragraph shall not exceed [fifteen]
    39  eighty-five percent of [the total costs of acquiring,  constructing  and
    40  equipping the proposed community] entrance fees or deposits collected;
    41    §  26.  Paragraph  e  of subdivision 1-a of section 4663 of the public
    42  health law, as added by chapter 545 of the laws of 2004, is  amended  to
    43  read as follows:
    44    e.  the total amount of escrowed entrance fees or deposits that may be
    45  approved for release under this subdivision shall not  exceed  [fifteen]
    46  eighty-five  percent  of [the total costs of acquiring, constructing and
    47  equipping the proposed community] entrance fees or deposits collected;
    48    § 27. Subdivisions 1 and 2 of section 4614 of the public  health  law,
    49  as  amended  by  chapter  7  of the laws of 2015, are amended to read as
    50  follows:
    51    1. The commissioner, or designee[; and the superintendent,  or  desig-
    52  nee;]  may at any time, and shall at least once every three years, visit
    53  each community and examine the business of any applicant for  a  certif-
    54  icate of authority and any operator engaged in the execution of continu-
    55  ing  care  retirement  contracts or continuing care at home contracts or
    56  engaged in the performance of obligations under such contracts.  Routine

        S. 5172                            17
 
     1  examinations  may  be  conducted  by  having documents designated by and
     2  submitted to such [commissioners or superintendent] commissioner,  which
     3  shall  include  financial  documents  and records conforming to commonly
     4  accepted  accounting  principles and practices. The final written report
     5  of each such examination conducted by such [commissioners or superinten-
     6  dent] commissioner shall be filed with the  commissioner  and,  when  so
     7  filed,  shall constitute a public record. A copy of each report shall be
     8  provided to members of the continuing care retirement community council.
     9  Any operator being examined shall, upon  request,  give  reasonable  and
    10  timely  access  to  all  of  its records. The representative or examiner
    11  designated  by  the  [commissioners  or  superintendent,  respectively,]
    12  commissioner  may,  at  any  time,  examine  the records and affairs and
    13  inspect the community's facilities, whether in connection with a  formal
    14  examination or not.
    15    2.  Any  duly  authorized  officer, employee, or agent of the [health]
    16  department[, or department of financial services] may, upon presentation
    17  of proper identification, have access to, and inspect, any records main-
    18  tained by the community relevant to the [respective] agency's regulatory
    19  authority, with or without advance notice, to secure compliance with, or
    20  to prevent a violation of, any provision of this article.
    21    § 28. Section 4615 of the public health law, as added by  chapter  689
    22  of  the laws of 1989, paragraph j of subdivision 1 as further amended by
    23  section 104 of part A of chapter 62 of the laws of 2011, paragraph k  of
    24  subdivision  1  as amended by chapter 7 of the laws of 2015 and subdivi-
    25  sion 3 as amended by chapter 659 of the laws of 1997, is amended to read
    26  as follows:
    27    § 4615. Revocation, suspension or annulment of certificate of authori-
    28  ty.  1. The [council] commissioner may revoke, suspend, limit  or  annul
    29  the certificate of authority of an operator upon proof that:
    30    a.  The  operator  failed to continue to meet the requirements for the
    31  authority originally granted;
    32    b. The operator lacked one or  more  of  the  qualifications  for  the
    33  certificate of authority as specified by this article;
    34    c.  The  operator  made a material misstatement, misrepresentation, or
    35  committed fraud  in  obtaining  the  certificate  of  authority,  or  in
    36  attempting to obtain the same;
    37    d. The operator lacked fitness or was untrustworthy;
    38    e.  The  operator  engaged  in  fraudulent  or  dishonest practices of
    39  management in the conduct of business under the certificate of  authori-
    40  ty;
    41    f. The operator converted or withheld funds;
    42    g.  The operator failed to comply with, or violated, any proper order,
    43  rule or regulation of the council or  violated  any  provision  of  this
    44  article;
    45    h.  The unsound business practices of the operator renders its further
    46  transactions in this state hazardous or injurious to the public;
    47    i. The operator has refused to be examined or to produce its accounts,
    48  records, and files for  examination,  or  its  officers,  employees,  or
    49  controlling persons have refused to give information with respect to the
    50  affairs  of the community or to perform any other legal obligation as to
    51  such examination;
    52    j. The [superintendent of financial services] commissioner has made  a
    53  determination  that  the  operator  is  insolvent  within the meaning of
    54  section one thousand three hundred nine of the insurance law; or

        S. 5172                            18
 
     1    k. The commissioner has found violations of applicable statutes, rules
     2  or regulations which threaten to affect directly the health, safety,  or
     3  welfare of a resident.
     4    1-a.  The  commissioner  shall not revoke, suspend, limit or annul the
     5  certificate of authority of an operator pursuant to subdivision  one  of
     6  this  section without first consulting with, and receiving a recommenda-
     7  tion from, the public health and health planning council.
     8    2. No certificate of authority shall be revoked, suspended, limited or
     9  annulled without a hearing, except that a certificate of  authority  may
    10  be  temporarily suspended or limited prior to a hearing for a period not
    11  in excess of sixty days upon written notice to the operator following  a
    12  finding by the commissioner that the public health or safety is in immi-
    13  nent  danger  or  there exists any condition or practice or a continuing
    14  pattern of conditions or practices that pose an imminent danger  to  the
    15  health or safety of any resident. Any delay in the hearing process occa-
    16  sioned  by  the  operator  shall  toll the running of said suspension or
    17  limitation and shall not abridge the full time provided in this subdivi-
    18  sion.
    19    3. Any state agency which seeks to revoke, suspend, limit or annul the
    20  certificate of authority or any other license or certificate required to
    21  be obtained by an operator of a  continuing  care  retirement  community
    22  pursuant  to law, shall request the [council] commissioner to commence a
    23  hearing pursuant to this section.
    24    4. The [council] commissioner shall fix a time and place for the hear-
    25  ing. The commissioner shall cause to be served in person  or  mailed  by
    26  registered  or  certified  mail to the operator at least ten days before
    27  the date fixed for the hearing a copy of the charges, together with  the
    28  notice  of  the  time  and place of the hearing. The operator shall file
    29  with the commissioner not less than three days prior to  the  hearing  a
    30  written answer to the charges. The agency which initiated the proceeding
    31  shall be responsible for providing evidence in support of the charges to
    32  the  commissioner  in  order to prepare a statement of charges and shall
    33  provide evidence in support of the charges at the hearing.
    34    5. All orders hereunder shall be subject  to  review  as  provided  in
    35  article  seventy-eight  of the civil practice law and rules. Application
    36  for such review must be made within sixty days after service  in  person
    37  or by registered or certified mail of a copy of the order upon the oper-
    38  ator.
    39    §  29.  Section 4616 of the public health law, as added by chapter 689
    40  of the laws of 1989, the opening paragraph as amended by chapter 659  of
    41  the laws of 1997, is amended to read as follows:
    42    § 4616. Appointment of a caretaker. Upon a determination by the [coun-
    43  cil]  commissioner  that  there  exists  operational  deficiencies  in a
    44  continuing care retirement community that show:
    45    1. a condition or conditions in substantial violation of the standards
    46  for health, safety or patient care established under  federal  or  state
    47  law or regulations; or
    48    2.  [or]  that  there  exists in the facility a pattern or practice of
    49  habitual violation of the standards of health, safety  or  patient  care
    50  established  under  federal  or  state law or regulations, the [council]
    51  commissioner shall take the  actions  prescribed  by  section  forty-six
    52  hundred  fifteen  of this article, and, where the [council] commissioner
    53  deems it to be in the public interest, the [council may request that the
    54  commissioner, and upon request of the council the] commissioner shall[,]
    55  petition a court of competent jurisdiction to  appoint  a  caretaker  as
    56  defined  in  section twenty-eight hundred one of this chapter. The peti-

        S. 5172                            19
 
     1  tion, the proceedings, and the procedures for appointment of a caretaker
     2  shall be governed by the provisions of section forty-six hundred  seven-
     3  teen  of  this article, and the powers, duties and rights of a caretaker
     4  appointed pursuant to such section shall be the same as those authorized
     5  by subdivision four of such section.
     6    §  30.  Subdivisions  1,  2 and 8 of section 4617 of the public health
     7  law, subdivision 1 as amended by chapter 659 of the laws  of  1997,  and
     8  subdivisions  2  and  8 as added by chapter 689 of the laws of 1989, are
     9  amended to read as follows:
    10    1. The [council] commissioner may, [if it determines] upon a  determi-
    11  nation  that serious operational deficiencies exist or serious financial
    12  problems exist and such action is desirable,  enter  into  an  agreement
    13  with  the  operator  or owners of a continuing care retirement community
    14  with respect to the appointment of a receiver  to  take  charge  of  the
    15  community  under conditions as found acceptable by both parties. Receiv-
    16  ership commenced in accordance with the provisions of  this  subdivision
    17  shall  terminate  at  such  time  as may be provided in the receivership
    18  agreement, or at such time as either party notifies the other in writing
    19  that it wishes to terminate such receivership.
    20    2. [Upon request of the council, the] The commissioner shall,  at  the
    21  time  of revocation, suspension or temporary suspension of a certificate
    22  of authority, apply to the supreme court where the community is situated
    23  for an order directing the owner of the land and/or structure on  or  in
    24  which  the community is located, to show cause why a receiver should not
    25  be appointed to take charge of the community.  In those cases where  the
    26  certificate  of  authority  has  been  revoked, suspended or temporarily
    27  suspended, the supreme  court  shall  appoint  a  receiver  that,  where
    28  reasonably possible, is a legal entity that holds a valid certificate of
    29  authority.  Such  application  shall contain proof by affidavit that the
    30  facility has had its certificate of  authority  revoked,  suspended,  or
    31  temporarily  suspended. Such order to show cause shall be returnable not
    32  less than five days after service is completed  and  shall  provide  for
    33  personal  service of a copy thereof and the papers on which it is based,
    34  on the owner or owners of the land and/or structures on or in which  the
    35  community  is  located.  If  any  such owner and manager cannot with due
    36  diligence be served personally within the county where the  property  is
    37  located  and  within  the  time fixed in such order, then service may be
    38  made on such person by posting a copy thereof  in  a  conspicuous  place
    39  within  the  community  in  question,  and  by sending a copy thereof by
    40  registered mail, return receipt requested, to such  owner  at  the  last
    41  address  registered by him with the department or in the absence of such
    42  registration to the address set forth in the  last  recorded  deed  with
    43  respect  to  the  facility.  Service  shall be deemed complete on filing
    44  proof of service thereof in the office of the county clerk, or the clerk
    45  of the city of New York, as the case may be.
    46    8. Any other provision of this article notwithstanding, the  [council]
    47  commissioner  may, if it deems appropriate, grant to any community oper-
    48  ating or scheduled to operate under a receivership  authorized  by  this
    49  section  a  certificate  of  authority,  the  duration of which shall be
    50  limited to the duration of the receivership.
    51    § 31. Section 4668 of the public health law, as added by  chapter  519
    52  of the laws of 2004, is amended to read as follows:
    53    § 4668. Revocation, suspension or annulment of certificate of authori-
    54  ty.  1.  The  [council] commissioner may revoke, suspend, limit or annul
    55  the certificate of authority of an operator upon proof that:

        S. 5172                            20
 
     1    a. The operator failed to continue to meet the  requirements  for  the
     2  authority originally granted;
     3    b.  The  operator  lacked  one  or  more of the qualifications for the
     4  certificate of authority as specified by this article;
     5    c. The operator made a material  misstatement,  misrepresentation,  or
     6  committed  fraud  in  obtaining  the  certificate  of  authority,  or in
     7  attempting to obtain the same;
     8    d. The operator lacked fitness or was untrustworthy;
     9    e. The operator  engaged  in  fraudulent  or  dishonest  practices  of
    10  management  in the conduct of business under the certificate of authori-
    11  ty;
    12    f. The operator converted or withheld funds;
    13    g. The operator failed to comply with, or violated, any proper  order,
    14  rule  or  regulation  of  the  council or violated any provision of this
    15  article;
    16    h. The unsound business practices of the operator renders its  further
    17  transactions in this state hazardous or injurious to the public;
    18    i. The operator has refused to be examined or to produce its accounts,
    19  records  and  files  for  examination,  or  its  officers,  employees or
    20  controlling persons have refused to give information with respect to the
    21  affairs of the community or to perform any other legal obligation as  to
    22  such examination; or
    23    j. The commissioner has found violations of applicable statutes, rules
    24  or  regulations which threaten to affect directly the health, safety, or
    25  welfare of a resident of a fee-for-service  continuing  care  retirement
    26  community.
    27    1-a.  The  commissioner  shall not revoke, suspend, limit or annul the
    28  certificate of authority of an operator pursuant to subdivision  one  of
    29  this  section without first consulting with, and receiving a recommenda-
    30  tion from, the public health and health planning council.
    31    2. No certificate of authority shall be revoked, suspended, limited or
    32  annulled without a hearing, except that a certificate of  authority  may
    33  be  temporarily suspended or limited prior to a hearing for a period not
    34  in excess of sixty days upon written notice to the operator following  a
    35  finding  by the commissioner that public health or safety is in imminent
    36  danger or there exists any condition or practice or a continuing pattern
    37  of conditions or practices that pose an imminent danger to the health or
    38  safety of any resident. Any delay in the hearing process  occasioned  by
    39  the operator shall toll the running of said suspension or limitation and
    40  shall not abridge the full time provided in this subdivision.
    41    3. Any state agency which seeks to revoke, suspend, limit or annul the
    42  certificate of authority or any other license or certificate required to
    43  be obtained by an operator of a community pursuant to law, shall request
    44  the  [council]  commissioner  to  commence  a  hearing  pursuant to this
    45  section.
    46    4. The [council] commissioner shall fix a time and place for the hear-
    47  ing. The commissioner shall cause to be served in person  or  mailed  by
    48  registered  or  certified  mail to the operator at least ten days before
    49  the date fixed for the hearing a copy of the charges, together with  the
    50  notice  of  the  time  and place of the hearing. The operator shall file
    51  with the commissioner not less than three days prior to  the  hearing  a
    52  written answer to the charges. The agency which initiated the proceeding
    53  shall be responsible for providing evidence in support of the charges to
    54  the  commissioner  in  order to prepare a statement of charges and shall
    55  provide evidence in support of the charges at the hearing.

        S. 5172                            21
 
     1    5. All orders pursuant to this section shall be subject to  review  as
     2  provided  in  article seventy-eight of the civil practice law and rules.
     3  Application for such review  shall  be  made  within  sixty  days  after
     4  service  in  person  or by registered or certified mail of a copy of the
     5  order upon the operator.
     6    §  32.  Section 4669 of the public health law, as added by chapter 519
     7  of the laws of 2004, is amended to read as follows:
     8    § 4669. Appointment of a caretaker.    Upon  a  determination  by  the
     9  [council]  commissioner  that there exists operational deficiencies in a
    10  fee-for-service continuing care retirement community that show:
    11    1. there exists in the facility a  pattern  or  practice  of  habitual
    12  violation of the standards of health, safety or patient care established
    13  under  federal  or  state law or regulations, the [council] commissioner
    14  shall take the actions prescribed by section  forty-six  hundred  sixty-
    15  eight of this article, and, where the [council] commissioner deems it to
    16  be  in  the  public interest, the [council may request the commissioner,
    17  and upon request of the council the] commissioner  shall[,]  petition  a
    18  court  of  competent  jurisdiction  to appoint a caretaker as defined in
    19  section twenty-eight hundred one of  this  chapter.  The  petition,  the
    20  proceedings,  and the procedures for appointment of a caretaker shall be
    21  governed by the provisions of section forty-six hundred seventy of  this
    22  article,  and  the  power,  duties  and  rights of a caretaker appointed
    23  pursuant to such section shall be the same as those authorized by subdi-
    24  vision four of such section; or
    25    2. a condition or conditions in substantial violation of the standards
    26  for health, safety or patient care established under  federal  or  state
    27  law or regulations.
    28    §  33.  Subdivisions  1,  2 and 8 of section 4670 of the public health
    29  law, as added by chapter 519 of the laws of 2004, are amended to read as
    30  follows:
    31    1. The [council] commissioner may, [if it determines] upon a  determi-
    32  nation  that serious operational deficiencies exist or serious financial
    33  problems exist and such action is desirable,  enter  into  an  agreement
    34  with the operator or owners of a fee-for-service continuing care retire-
    35  ment  community  with  respect  to the appointment of a receiver to take
    36  charge of the community under conditions as  found  acceptable  by  both
    37  parties.    Receivership  commenced in accordance with the provisions of
    38  this subdivision shall terminate at such time as may be provided in  the
    39  receivership  agreement,  or  at  such time as either party notifies the
    40  other in writing that it wishes to terminate such receivership.
    41    2. [Upon request of the council, the] The commissioner shall,  at  the
    42  time  of revocation, suspension or temporary suspension of a certificate
    43  of authority, apply to the supreme court where the community is situated
    44  for an order directing the owner of the land and/or structure on  or  in
    45  which  the community is located, to show cause why a receiver should not
    46  be appointed to take charge of the community. In those cases  where  the
    47  certificate  of  authority  has  been  revoked, suspended or temporarily
    48  suspended, the supreme  court  shall  appoint  a  receiver  that,  where
    49  reasonably possible, is a legal entity that holds a valid certificate of
    50  authority.  Such  application  shall contain proof by affidavit that the
    51  facility has had its certificate  of  authority  revoked,  suspended  or
    52  temporarily  suspended. Such order to show cause shall be returnable not
    53  less than five days after service is completed  and  shall  provide  for
    54  personal  service of a copy thereof and the papers on which it is based,
    55  on the owner or owners of the land and/or structures on or in which  the
    56  community  is  located.  If  any  such owner and manager cannot with due

        S. 5172                            22
 
     1  diligence be served personally within the county where the  property  is
     2  located  and  within  the  time fixed in such order, then service may be
     3  made on such person by posting a copy thereof  in  a  conspicuous  place
     4  within  the  community  in  question,  and  by sending a copy thereof by
     5  registered mail, return receipt requested, to such  owner  at  the  last
     6  address  registered  by him or her with the department or in the absence
     7  of such registration to the address set forth in the last recorded  deed
     8  with respect to the facility. Service shall be deemed complete on filing
     9  proof of service thereof in the office of the county clerk, or the clerk
    10  of the city of New York, as the case may be.
    11    8.  Any other provision of this article notwithstanding, the [council]
    12  commissioner may, if it deems appropriate, grant to any community  oper-
    13  ating  or  scheduled  to operate under a receivership authorized by this
    14  section a certificate of authority,  the  duration  of  which  shall  be
    15  limited to the duration of the receivership.
    16    §  34.  Paragraph  g  of  subdivision  4 of section 4621 of the public
    17  health law, as added by chapter 406 of the laws of 1991, is  amended  to
    18  read as follows:
    19    g.  If  the  funds  in  an  escrow account under this section, and any
    20  interest thereon, are not released to the applicant within such time  as
    21  provided by rules and regulations adopted by the [council] commissioner,
    22  then  such funds shall be returned by the escrow agent to the person who
    23  had made the payments or the person's legal representative.
    24    § 35. Subdivision 1 of section 4623  of  the  public  health  law,  as
    25  amended  by  chapter  659  of  the  laws  of 1997, is amended to read as
    26  follows:
    27    1. The [council] commissioner may approve an application for a certif-
    28  icate of authority and [the commissioner] may  issue  a  certificate  of
    29  authority  for  the  establishment  and  operation  of a continuing care
    30  retirement community under an arrangement which otherwise complies  with
    31  the requirements of this article except that the costs of nursing facil-
    32  ity or home health care services are paid for in whole or in part by (a)
    33  long  term  care  insurance  obtained and paid for by the resident or by
    34  medical assistance payments in accordance with the partnership for  long
    35  term care program pursuant to section three hundred sixty-seven-f of the
    36  social  services  law and section three thousand two hundred twenty-nine
    37  of the insurance law or (b) other group or  individual  long  term  care
    38  insurance  approved  by the superintendent and the council in connection
    39  with the application. The council, in consultation with the  superinten-
    40  dent,  shall  provide  for  adequate  disclosure  to  residents of their
    41  options, rights and obligations under such  an  arrangement,  and  shall
    42  establish  standards  for  the remittance and collection of premiums and
    43  monthly care fees.
    44    § 36. The opening paragraph of subdivision 14 and  subdivision  15  of
    45  section  4657  of  the public health law, as added by chapter 519 of the
    46  laws of 2004, are amended to read as follows:
    47    In accordance with regulations promulgated by  the  [council]  commis-
    48  sioner, the operator shall prepare a standard information sheet for each
    49  approved  fee-for-service  continuing  care  retirement community, which
    50  must be approved by the department,  distributed  with  the  community's
    51  marketing  materials  and  attached  to the initial disclosure statement
    52  prepared in accordance with this section. The standard information sheet
    53  shall be prepared in plain language and in twelve point type  and  shall
    54  include, but shall not be limited to the following information:
    55    15. Any other information as may be required by regulations promulgat-
    56  ed by the [council] commissioner.

        S. 5172                            23

     1    §  37.  The  opening  paragraph  and  paragraph  d of subdivision 2 of
     2  section 4658 of the public health law, as added by chapter  519  of  the
     3  laws of 2004, are amended to read as follows:
     4    The  annual  statement  shall be in such form as the [council] commis-
     5  sioner prescribes and shall contain at least the following:
     6    d. Such other reasonable financial and other information as the [coun-
     7  cil] commissioner may require with respect to the operator or the commu-
     8  nity, or its directors, controlling persons, trustees, members,  branch-
     9  es,  subsidiaries or affiliates to determine the financial status of the
    10  community and the management capabilities of the operator.
    11    § 38. Subdivision 2 of section 4651 of the public health law, as added
    12  by chapter 519 of the laws of 2004, is amended to read as follows:
    13    2. "Certificates" or "certificate of authority" shall mean an authori-
    14  zation in writing, approved [by the council] and issued by  the  commis-
    15  sioner,  for  an  operator  to operate a fee-for-service continuing care
    16  retirement community and to enter into fee-for-service  continuing  care
    17  contracts pertaining to such community.
    18    § 39. Section 4654 of the public health law, as amended by chapter 545
    19  of the laws of 2004, is amended to read as follows:
    20    §  4654.  Authorization  of fee-for-service continuing care retirement
    21  communities.  The commissioner[, upon approval of  the  continuing  care
    22  retirement community council,] shall approve up to eight fee-for-service
    23  continuing  care  retirement  communities  to  encourage affordable care
    24  options for middle income seniors, up to two of which may be operated by
    25  a for-profit entity.
    26    § 40. The opening paragraph of section 4659 of the public health  law,
    27  as  added  by  chapter  519  of  the laws of 2004, is amended to read as
    28  follows:
    29    A fee-for-service continuing care contract shall contain  all  of  the
    30  following  information  in  no  less than twelve point type and in plain
    31  language, in addition to any other terms or matter as may be required by
    32  regulations [adopted by the council and] issued by the commissioner:
    33    § 41. The opening paragraph of subdivision 5 of section  4655  of  the
    34  public  health  law,  as  amended by chapter 545 of the laws of 2004, is
    35  amended to read as follows:
    36    If the [approvals] applicant has satisfied the  criteria  required  by
    37  subdivision  four-a  of  this  section have been obtained, the [council]
    38  commissioner shall[, by majority vote,] either  approve  or  reject  the
    39  application  [within  sixty  days  of  the  date  on which the last such
    40  approval has been obtained]. In order to approve  the  application,  the
    41  [council] commissioner shall have determined that:
    42    §  42.  Subdivisions 6 and 8 of section 4655 of the public health law,
    43  as added by chapter 519 of the laws of 2004,  are  amended  to  read  as
    44  follows:
    45    6.  Any  change  in  the  legal  entity  operating the fee-for-service
    46  continuing care retirement community, or in a controlling person of  the
    47  community  shall  require  approval  in  the  same manner as an original
    48  application; provided, however,  that  the  [council]  commissioner  may
    49  waive  any  requirement  to  provide information that is not relevant to
    50  such change and provided, further, that the continued  public  need  for
    51  the community shall be presumed.
    52    8.  [If  the  council  approves the application, the] The commissioner
    53  shall issue a certificate of authority to the applicant upon approval of
    54  the application.
    55    § 43. Section 4611 of the public health law, as added by  chapter  689
    56  of  the  laws of 1989, the opening paragraph of subdivision 1 as further

        S. 5172                            24
 
     1  amended by section 104 of part A of chapter 62 of the laws of  2011,  is
     2  amended to read as follows:
     3    § 4611. Reserves and supporting assets.  1. An operator shall maintain
     4  reserve  liabilities  and  supporting  assets  in  an amount and for the
     5  purposes set forth in a regulation  issued  by  the  [superintendent  of
     6  financial  services] commissioner.  Liquid assets must be maintained for
     7  the following reserve liabilities:
     8    a. Principal and interest payments and payments for taxes  and  insur-
     9  ance for up to twelve months;
    10    b.  Total estimated operating costs for up to six months as set by the
    11  [superintendent] commissioner;
    12    c. Repairs and replacements for up to twelve months; and
    13    d. In addition, the amount of liquid assets must meet  any  cash  flow
    14  requirements and conditions as set forth in a regulation.
    15    2.  The assets in support of reserve liabilities of subdivision one of
    16  this section shall meet quantitative and qualitative standards set forth
    17  in regulations issued by the [superintendent] commissioner.
    18    § 44. The public health law is amended by adding a new section 4625 to
    19  read as follows:
    20    § 4625. Continuing care retirement community workgroup. 1. Within  six
    21  months  of  the  effective  date of this section, the commissioner shall
    22  convene a continuing care retirement  community  workgroup  (hereinafter
    23  referred  to  in  this  section as the "workgroup"). The workgroup shall
    24  consist of, at a minimum, the  commissioner  or  his  or  her  designee;
    25  representatives  of  health care provider organizations; representatives
    26  of continuing care retirement communities, and representatives who  have
    27  expertise in the continuing care retirement community industry.
    28    2.  Workgroup members shall receive no compensation for their services
    29  as members of the workgroup, but shall  be  reimbursed  for  actual  and
    30  necessary expenses incurred in the performance of their duties.
    31    3. The workgroup shall:
    32    a.  review  existing continuing care retirement community and fee-for-
    33  service continuing care retirement community models  in  the  state  and
    34  nationally;
    35    b.  develop  recommendations  on  creating  cost-effective options for
    36  financing the  development  of  additional  continuing  care  retirement
    37  communities  and fee-for-service continuing care retirement communities;
    38  and
    39    c. submit a report by January first,  two  thousand  nineteen  to  the
    40  commissioner,  the  council,  the temporary president of the senate, the
    41  speaker of the assembly, the chair of the senate health  committee,  and
    42  the  chair  of  the assembly health committee containing recommendations
    43  for cost-effective options to encourage the growth  of  continuing  care
    44  retirement communities in the state of New York.
    45    4. All state departments, commissions, agencies and public authorities
    46  shall  provide the workgroup with any reasonably requested assistance or
    47  advice in a timely manner.
    48    § 45. This act shall take effect on  the  one  hundred  eightieth  day
    49  after  it  shall have become a law, provided, however, that section 4625
    50  of the public health law, as added by section forty-four  of  this  act,
    51  shall  expire  and  be  deemed  repealed  December  31,  2020; provided,
    52  further, that effective  immediately,  the  addition,  amendment  and/or
    53  repeal  of  any  rule  or regulation necessary for the implementation of
    54  this act on its effective date are authorized and directed  to  be  made
    55  and completed on or before such effective date.
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