S T A T E   O F   N E W   Y O R K
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                                  3547

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            February 12, 2015
                               ___________

Introduced  by  Sen.  RANZENHOFER -- read twice and ordered printed, and
  when printed to be committed to the Committee on Rules

AN ACT to amend the public health law, in relation  to  the  ability  of
  continuing  care  retirement  communities  to offer seniors additional
  service options; and to repeal certain provisions of such law relating
  thereto

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Subdivision 1 of section 4601 of the public health law, as
amended by chapter 659 of the laws  of  1997,  is  amended  to  read  as
follows:
  1. "Certificates" or "certificate of authority" shall mean an authori-
zation in writing, approved by the council and issued by the commission-
er,  for  an  operator to operate a continuing care retirement community
and to enter into continuing care retirement  contracts  AND  CONTINUING
CARE AT HOME CONTRACTS pertaining to such community.
  S  2.  Subdivision  2-a  of  section 4601 of the public health law, as
amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
follows:
  2-a.  "Continuing care retirement [community] contract" OR "CONTINUING
CARE AT HOME CONTRACT" shall mean a single contract to provide a  person
the services provided by a continuing care retirement community.
  S  3.  Subdivision  2-b  of  section 4601 of the public health law, as
amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
follows:
  2-b.  "Continuing care retirement community" or "community" shall mean
a facility or facilities established to provide a  comprehensive,  cohe-
sive  living arrangement for the elderly, oriented to the enhancement of
the quality of life and which, pursuant to [the terms of the  continuing
care retirement community] A contract, at a minimum:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08853-01-5

              

S. 3547                             2

  a.  FOR  CONTINUING  CARE RETIREMENT CONTRACTS, provides[, or supports
through continuing care at home,] independent  living  units,  and  meal
plan  options.  The independent living unit can be made available either
through a  non-equity  arrangement  or  through  an  equity  arrangement
including, but not limited to a cooperative or condominium. For purposes
of  this article, the purchase price of an independent living unit in an
equity arrangement, regardless of the form of  the  purchase  agreement,
shall not be considered an entry fee for purposes of calculating reserve
liabilities, but shall be considered an entry fee for escrow purposes;
  b.  provides  a  range  of health care and social services, subject to
such terms as may be included within the contract, which  shall  include
adult  care  facility  services  of  an on-site or affiliated adult care
facility, and at a minimum, sixty days of prepaid services of an on-site
or affiliated nursing facility  for  residents  not  receiving  services
under a fee-for-service contract;
  c.  provides  access  to  health  services as defined in the contract,
prescription drugs, and rehabilitation services;
  d. nothing in this article shall eliminate the obligation of a contin-
uing care retirement community to provide at least sixty days of prepaid
nursing facility services to all residents, with the exception of  resi-
dents receiving services under the terms of a fee-for-service continuing
care  contract as defined in this section. The prepaid days must include
the first sixty days  of  nursing  facility  services,  whether  or  not
consecutive,  not  covered by Title XVIII of the federal social security
act; [and]
  e. communities established under this article  and  offering  fee-for-
service  continuing  care contracts must offer, along with such fee-for-
service continuing care contracts,  life  care  and/or  continuing  care
contracts as defined in subdivision eight-a of this section; AND
  F. COMMUNITIES ESTABLISHED UNDER THIS ARTICLE OFFERING CONTINUING CARE
AT  HOME  CONTRACTS MUST ALSO OFFER CONTINUING CARE RETIREMENT CONTRACTS
AND MUST MAINTAIN A CONTINUING CARE RETIREMENT COMMUNITY  THAT  OPERATES
IN SUPPORT OF THE CONTINUING CARE AT HOME CONTRACTS.
  S  4.  Subdivision  3  of  section  4601  of the public health law, as
amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
follows:
  3.  "Contracts"  or "agreements" shall mean continuing care at home or
continuing care retirement [community]  contracts  as  defined  in  this
article.
  S  4-a.  Subdivisions  7-a,  7-b and 7-c of section 4601 of the public
health law are REPEALED.
  S 5. Subdivision 6 of section  4601  of  the  public  health  law,  as
amended  by  chapter  659  of  the  laws  of 1997, is amended to read as
follows:
  6. "Entrance fee" shall mean an initial or  deferred  transfer  to  an
operator  of  a sum of money, made or promised to be made by a person or
persons entering into a continuing care retirement contract OR  CONTINU-
ING CARE AT HOME CONTRACT, for the purpose of ensuring services pursuant
to such a contract.
  S  6.  Subdivision  8  of  section  4601  of the public health law, as
amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
follows:
  8. "Life care contract" shall mean a single continuing care retirement
[community]  contract or a continuing care at home contract to provide a
person, for the duration of such person's life, the services provided by
the continuing care retirement community [or the continuing care at home

S. 3547                             3

corporation], which services shall include  unlimited  services  of  the
affiliated community's nursing facility or affiliated nursing home. Such
term  also  shall  mean  a single continuing care retirement [community]
contract  to  provide  a person, for the duration of such person's life,
the services provided by the continuing care retirement community  under
an  arrangement  in  which the costs of the residents' unlimited nursing
home or home care services are paid for in whole or in part  by  a  long
term  care insurance policy approved by the superintendent in accordance
with applicable regulations or by long term care  insurance  or  medical
assistance  payments  in  accordance  with the partnership for long term
care program pursuant to the provisions of section three hundred  sixty-
seven-f  of  the social services law, section three thousand two hundred
twenty-nine of the insurance law and section four thousand  six  hundred
twenty-three of this chapter.
  S  7. Section 4601 of the public health law is amended by adding a new
subdivision 8-b to read as follows:
  8-B. "CONTINUING CARE AT HOME CONTRACT" SHALL MEAN A  SINGLE  CONTRACT
TO PROVIDE A PERSON WITH LONG TERM CARE SERVICES AND SUPPORTS BASED UPON
THE  PERSON'S  NEEDS  AND  COORDINATED  BY  A  CASE MANAGER, WHICH SHALL
INCLUDE SERVICES PROVIDED TO THE PERSON IN  HIS  OR  HER  RESIDENCE  AND
SERVICES OF THE COMMUNITY'S NURSING FACILITY AND ADULT CARE FACILITY, OR
AFFILIATED FACILITIES.
  S  8.  Subdivision  15  of  section  4601 of the public health law, as
amended by chapter 659 of the laws of  1997,  is  amended  and  two  new
subdivisions 15-a and 15-b are added to read as follows:
  15.  "Resident"  shall  mean  any person who, pursuant to a CONTINUING
CARE RETIREMENT CONTRACT OR CONTINUING CARE AT HOME contract,  is  enti-
tled to reside in and/OR receive services from a continuing care retire-
ment community.
  15-A.  "ILU RESIDENT" SHALL MEAN A CONTINUING CARE RETIREMENT CONTRACT
HOLDER WHO RESIDES IN A LIVING UNIT WITHIN THE CONTINUING  CARE  RETIRE-
MENT COMMUNITY.
  15-B.  "HOME  RESIDENT"  SHALL MEAN A CONTINUING CARE AT HOME CONTRACT
HOLDER WHO RESIDES IN A PRIVATE RESIDENCE OFF  OF  THE  CONTINUING  CARE
RETIREMENT COMMUNITY CAMPUS.
  S 9. Paragraphs d and e of subdivision 2 of section 4604 of the public
health  law,  as amended by chapter 549 of the laws of 2014, are amended
to read as follows:
  d. a copy of the proposed forms of contracts to be entered  into  with
residents  [of  the  community or continuing care at home contract hold-
ers];
  e. complete details of any agreements with a licensed insurer, includ-
ing copies of proposed contracts, requiring the insurer to assume, whol-
ly or in part, the cost of medical or  health  related  services  to  be
provided  to  a  resident  [or continuing care at home contract holders]
pursuant to a continuing care retirement [community] CONTRACT or contin-
uing care at home contract;
  S 9-a. Subdivision 3 of section 4604 of  the  public  health  law,  as
amended  by  chapter  659  of  the  laws  of 1997, is amended to read as
follows:
  3. Nothing in this article shall be construed to enlarge, diminish  or
modify:  a  social  services  district's  otherwise valid recovery under
section three hundred sixty-nine of the social services law, nor medical
assistance eligibility under title eleven of article five of the  social
services law nor applicable provisions of the estates, powers and trusts
law.  Except  as  otherwise  provided in this article, the activities of

S. 3547                             4

continuing care retirement communities shall be subject to any other law
governing such activities including but not limited to  article  twenty-
eight  of  this chapter and article seven of the social services law and
regulations   promulgated   thereunder;   provided,  however,  that  the
provisions of paragraphs (d) and (e)  of  subdivision  four  of  section
twenty-eight  hundred one-a and section twenty-eight hundred two of this
chapter shall not apply, and provided that the provisions  of  paragraph
(a)  of subdivision one and the provisions of subdivision two of section
four hundred sixty-one-b of the social  services  law  with  respect  to
public  need  and  the  provisions  of  subdivision  one of section four
hundred sixty-one-c of the social services law shall not apply to  resi-
dents  who  have  been  admitted  in  accordance with a [continuing care
retirement community] contract provided  that,  upon  admission  to  the
adult  care facility, such residents shall be given a notice which shall
include, at a minimum, information regarding facility services, resident
responsibilities, supplemental services, resident rights and protections
and circumstances that  warrant  transfer.  The  number  of  residential
health care facility beds available pursuant to subdivision five of this
section,  without proof of public need therefor, shall be reduced by the
number of residential health care demonstration facility beds  that  are
approved pursuant to this article.
  S  10.  Paragraph  c  of  subdivision  4 of section 4604 of the public
health law, as amended by chapter 549 of the laws of 2014, is amended to
read as follows:
  c. the public health and health planning council [under section  twen-
ty-eight  hundred  one-a  of  this chapter] as to the establishment of a
skilled nursing facility by the applicant and as to such  other  facili-
ties  and  services as may require the public health and health planning
council's approval of  the  application;  provided,  however,  that  the
recommendations  of the health systems agency having geographical juris-
diction of the area where the continuing care  retirement  community  is
located  shall  not  be required with respect to the establishment of an
on-site or affiliated residential health care facility  to  serve  resi-
dents as part of the continuing care retirement community, for up to the
total  number  of  residential health care facility beds provided for in
subdivision five of this section in communities statewide;
  S 11. The public health law is amended by adding a new section  4605-a
to read as follows:
  S 4605-A. CERTIFICATE OF AUTHORITY; AUTHORITY TO OFFER CONTINUING CARE
AT  HOME  CONTRACTS.  A  CONTINUING  CARE RETIREMENT COMMUNITY MAY OFFER
CONTINUING CARE AT HOME CONTRACTS UPON APPROVAL BY THE COUNCIL TO  AMEND
THE CONTINUING CARE RETIREMENT COMMUNITY'S CERTIFICATE OF AUTHORITY.  IN
ORDER  TO  QUALIFY FOR AN AMENDMENT TO ITS CERTIFICATE OF AUTHORITY, THE
CONTINUING CARE RETIREMENT COMMUNITY SHALL SUBMIT  TO  THE  COMMISSIONER
THE FOLLOWING:
  1.  A  BUSINESS  PLAN  TO  THE  COMMISSIONER  AND  SUPERINTENDENT THAT
INCLUDES THE FOLLOWING:
  (A) A DESCRIPTION OF THE CONTINUING CARE AT HOME SERVICES THAT WILL BE
PROVIDED, THE MARKET THAT WILL BE SERVED BY THE CONTINUING CARE AT  HOME
CONTRACTS,  AND THE FEES TO BE CHARGED TO PROSPECTIVE CONTINUING CARE AT
HOME CONTRACT HOLDERS;
  (B) A COPY OF THE PROPOSED CONTINUING CARE AT HOME CONTRACT; AND
  (C) AN ACTUARIAL STUDY PREPARED BY AN INDEPENDENT ACTUARY  IN  ACCORD-
ANCE  WITH STANDARDS ADOPTED BY THE AMERICAN ACADEMY OF ACTUARIES DEMON-
STRATING THE IMPACT THAT THE CONTINUING CARE AT HOME CONTRACTS WILL HAVE
ON THE OVERALL OPERATIONS OF THE CONTINUING  CARE  RETIREMENT  COMMUNITY

S. 3547                             5

AND  FURTHER  DEMONSTRATING THAT THE ADDITION OF CONTINUING CARE AT HOME
CONTRACTS WILL NOT JEOPARDIZE THE FINANCIAL SOLVENCY OF  THE  CONTINUING
CARE RETIREMENT COMMUNITY.
  2.  A  MARKET  FEASIBILITY STUDY DEMONSTRATING TO THE COMMISSIONER AND
SUPERINTENDENT SUFFICIENT CONSUMER INTEREST IN CONTINUING CARE  AT  HOME
CONTRACTS AND FURTHER DEMONSTRATING THAT THE ADDITION OF CONTINUING CARE
AT  HOME  CONTRACTS  WILL NOT HAVE AN ADVERSE IMPACT ON THE PROVISION OF
SERVICES TO CONTINUING CARE RETIREMENT CONTRACT HOLDERS.
  3. MATERIALS THAT MEET ALL REQUIREMENTS ESTABLISHED BY  THE  NEW  YORK
STATE DEPARTMENT OF FINANCIAL SERVICES.
  4.  A  COPY  OF  THE  NOTIFICATION  SENT TO CONTINUING CARE RETIREMENT
CONTRACT HOLDERS DESCRIBING THE ANTICIPATED IMPACT OF  THE  ADDITION  OF
CONTINUING CARE AT HOME CONTRACTS ON CONTINUING CARE RETIREMENT COMMUNI-
TY  RESOURCES  AND  PROOF THAT SUCH NOTIFICATION HAS BEEN DISTRIBUTED TO
ALL CONTINUING CARE RETIREMENT CONTRACT HOLDERS.
  S 12. The public health law is amended by adding a new section  4605-b
to read as follows:
  S  4605-B.  CERTIFICATE OF AUTHORITY; LIMITATION ON CONTINUING CARE AT
HOME CONTRACTS. THE NUMBER OF CONTINUING CARE AT HOME CONTRACTS APPROVED
ON A CERTIFICATE OF AUTHORITY SHALL BE LIMITED TO:
  1. THE NUMBER OF APPROVED LIVING UNITS ON THE CONTINUING CARE  RETIRE-
MENT  COMMUNITY'S  PREMISES  THAT ARE INTENDED FOR ILU RESIDENTS, EXCEPT
THAT THE COUNCIL MAY APPROVE ADDITIONAL CONTRACTS UPON A  SUBMISSION  TO
THE COMMISSIONER BY AN OPERATOR CONSISTENT WITH THE PROVISIONS SET FORTH
IN SECTION FORTY-SIX HUNDRED FIVE-A OF THIS ARTICLE;
  2. THE DEMONSTRATED NUMBER OF CONTINUING CARE AT HOME CONTRACT HOLDERS
THAT CAN BE SUPPORTED IN THE EXISTING OR APPROVED FUTURE CAPACITY OF THE
ADULT  CARE  FACILITY  AND  SKILLED NURSING FACILITY CONSISTENT WITH THE
PROVISIONS SET FORTH IN SECTION FORTY-SIX HUNDRED FIVE-A OF  THIS  ARTI-
CLE; AND
  3.  CONDITIONS SET FORTH BY THE NEW YORK STATE DEPARTMENT OF FINANCIAL
SERVICES, BASED UPON THE SUPERINTENDENT'S ASSESSMENT OF THE FOLLOWING:
  (A) THE OVERALL FINANCIAL IMPACT ON THE COMMUNITY; AND
  (B) THE SUBMITTED MATERIALS SET FORTH  IN  SECTION  FORTY-SIX  HUNDRED
FIVE-A OF THIS ARTICLE.
  S  13.  Paragraph  a  of  subdivision 14 of section 4606 of the public
health law, as added by chapter 659 of the laws of 1997, is  amended  to
read as follows:
  a.  a  brief  description  of  the  community,  including its name and
location and amenities and services, INCLUDING MEAL OPTIONS, available;
  S 13-a. Paragraph e of subdivision 14 of section 4606  of  the  public
health  law  is  REPEALED, and subdivisions f, g and h, as relettered by
chapter 549 of the laws of 2014, are relettered e, f and g.
  S 14. Subdivision 13 of section 4606 of  the  public  health  law,  as
amended  by  chapter  549  of  the  laws  of 2014, is amended to read as
follows:
  13. The initial disclosure statement  and  marketing  materials  of  a
continuing care retirement community [and continuing care at home corpo-
ration]  must  clearly  include a description of the services offered as
part of its contract, including, but not limited to, any limitations  on
nursing  facility services. The initial disclosure statement and market-
ing materials of a continuing care retirement community  [or  continuing
care at home corporation] which offers various types of contracts, which
may  include  life  care contracts, must clearly differentiate among the
various types of contracts which it may offer.

S. 3547                             6

  S 15. Section 4608 of the public health law, as amended by chapter 549
of the laws of 2014, is amended to read as follows:
  S  4608.  [Continuing care retirement community contract] CONTRACTS. A
continuing care retirement [community] CONTRACT or  continuing  care  at
home  contract shall contain all of the following information in no less
than twelve point type and in plain language, in addition to  any  other
terms or matter as may be required by regulations adopted by the council
and issued by the superintendent[, except when specifically noted]:
  1. The amount of all money transferred, including, but not limited to,
donations,  subscriptions, deposits, fees, and any other amounts paid or
payable by, or on behalf of, the resident  or  residents  or  continuing
care at home contract holder or holders;
  2.  A  description  of  all  services which are to be furnished by the
operator, a description of any fees in addition to the entrance fee  and
periodic  charges provided for in the contract, and the conditions under
which the fees may be adjusted, provided  that  an  operator  shall  not
charge  any non-refundable application fee to a prospective resident who
has paid a non-refundable  priority  reservation  agreement  application
fee;
  3.  The procedures of the community [or continuing care at home corpo-
ration] relating to a resident's or contract holder's failure to pay the
required monthly fees;
  4. A statement of the figures and terms  concerning  the  entry  of  a
spouse to the community and the consequences if the spouse does not meet
the requirements for entry;
  5.  A statement of the terms and conditions under which a contract may
be cancelled by the operator or by a resident or contract holder and the
conditions under which all or any portion of the entrance  fee  will  be
refunded  by the operator, including the mandatory refund provisions set
forth in sections forty-six hundred nine and forty-six  hundred  ten  of
this article;
  6.  a.  The  procedures  and  conditions under which a resident may be
transferred from his or her living unit or home  including  a  statement
that,  at  the  time of transfer, the resident will be given the reasons
for the transfer; the process by which a transfer decision is made;  the
persons  with  the  authority  to  make  the  decision  to  transfer;  a
description of any change in charges to be  paid  by  the  resident  for
services  not  covered by the contract fees as a result of the transfer;
and a statement regarding the disposition of and the right to return  to
the living unit in cases of temporary and permanent transfers.
  b.  For  continuing care retirement [community] contracts, the circum-
stances under which a living unit may be considered vacant and  eligible
for  transfer  or  resale to a new resident, either due to the permanent
transfer of a resident to the community's nursing or  other  specialized
facility or due to the permanent transfer of a resident to a hospital or
other facility outside of the community; provided, however, that nothing
therein  shall relieve a community from its obligations to provide or to
insure provision of all contractually  required  care  pursuant  to  the
terms  of  a  continuing  care  retirement contract. Should a resident's
chronic condition require placement in a more specialized  chronic  care
facility that provides services beyond those provided through the commu-
nity's  nursing facility, the liability of the community pursuant to the
terms of a continuing care retirement contract shall  be  equal  to  the
current  per diem rate of the nursing facility minus the pro rata appor-
tionment of the resident's monthly fee for the period of  care  required
by the contract. Nothing herein shall obligate a continuing care retire-

S. 3547                             7

ment  community which does not have a life care contract with a resident
to provide or pay for a level of nursing facility services nor  for  any
duration  beyond  what  is specifically described in its continuing care
retirement  contract  with  that resident. This section shall not affect
the operator's obligation under subdivision  two  of  section  forty-six
hundred twenty-four of this article;
  7.  For  continuing care retirement [community] contracts, a statement
that, if the resident dies prior to occupancy date or, through  illness,
injury,  or  incapacity  is precluded from becoming a resident under the
terms of the contract, the contract is automatically rescinded  and  the
resident  or his or her legal representative shall receive a full refund
of all moneys paid to the facility, except for those costs  specifically
incurred by the facility at the request of the resident and set forth in
writing in a separate addendum, signed by the parties to the contract;
  [8.  For  continuing  care  at home contracts, the circumstances under
which the contract holder may move  into  a  campus  independent  living
unit, adult care facility or nursing home;]
  8.  FOR  CONTINUING  CARE  AT HOME CONTRACTS, A STATEMENT THAT, IF THE
RESIDENT DIES PRIOR TO THE EFFECTIVE START DATE OF SERVICES OR,  THROUGH
ILLNESS, INJURY, OR INCAPACITY IS PRECLUDED FROM MEETING THE ELIGIBILITY
TERMS  OF  THE CONTRACT, THE CONTRACT IS AUTOMATICALLY RESCINDED AND THE
RESIDENT OR HIS OR HER LEGAL REPRESENTATIVE SHALL RECEIVE A FULL  REFUND
OF  ALL MONEYS PAID TO THE FACILITY, EXCEPT FOR THOSE COSTS SPECIFICALLY
INCURRED BY THE FACILITY AT THE REQUEST OF THE RESIDENT AND SET FORTH IN
WRITING IN A SEPARATE ADDENDUM, SIGNED BY THE PARTIES TO THE CONTRACT;
  9. For continuing care retirement [community] contracts,  a  statement
of  the  conditions  under  which all or any portion of the entrance fee
will be released to the operator before the living unit  becomes  avail-
able for occupancy, and a statement of the conditions under which all or
any  portion  of  that fee will be refunded in the event of the death of
the resident and/or spouse following occupancy of a living unit, includ-
ing the mandatory refund  provisions  set  forth  in  section  forty-six
hundred nine of this article;
  10.  A  statement of the advance notice to be provided the resident or
contract holder, of not less than sixty days, of any change in  fees  or
charges or scope of care or services;
  11.  A  statement that no act, agreement, or statement of any resident
or contract holder, or of an individual purchasing care for  a  resident
or  contract  holder under any agreement to furnish care to the resident
or contract holder, shall constitute a valid waiver of any provision  of
this  article or of any regulation enacted pursuant thereto intended for
the benefit or protection of the resident  or  contract  holder  or  the
individual purchasing care for the resident or contract holder;
  12.   For   continuing   care   retirement  [community]  contracts,  a
description of the reinstatement  policies  if  a  resident  leaves  the
facility  or  the contract is cancelled; AND FOR CONTINUING CARE AT HOME
CONTRACTS, A DESCRIPTION OF POLICIES  IF  THE  HOME  RESIDENT  RELOCATES
THEIR PRIVATE RESIDENCE OR THE CONTRACT IS CANCELLED.
  13.  [For continuing care at home contracts, a description of policies
if the contract is cancelled.
  14.] A statement that internal  procedures  to  resolve  disputes  and
grievances  have  been  established,  and residents and contract holders
notified of them;
  [15] 14.  A statement of the grace period, if any, for the payment  of
periodic  fees  without a penalty, and the extent of any penalty for the
late payment thereof;

S. 3547                             8

  [16] 15. A statement that: a. the  resident  or  contract  holder,  as
applicable  shall,  if eligible, enroll in medicare parts a and b or the
equivalent and shall continue to maintain that coverage,  together  with
medicare  supplement  coverage  at least equivalent in benefits to those
established  by  the  superintendent  as  minimum  benefits for medicare
supplement policies;
  b. if the resident or  contract  holder  fails  to  maintain  medicare
coverage  and  a medicare supplement coverage, or is ineligible for such
coverage and fails to purchase the  equivalent  of  such  coverage,  the
community  [or  continuing  care at home corporation] shall purchase the
coverage or equivalent coverage on behalf and  at  the  expense  of  the
resident  or  contract holder and shall have the authority to require an
appropriate adjustment in payments by the resident or contract holder to
the community [or continuing care at home corporation];
  c. if the community [or continuing care at  home  corporation]  cannot
purchase  medicare  coverage  and  medicare  supplement  coverage or the
equivalent, the community shall have the authority to require an adjust-
ment in monthly fees, subject to the approval of the superintendent,  to
fund the additional risk to the facility [or corporation]; and
  d.  if  the  resident or contract holder fails to purchase or maintain
medicare coverage and medicare supplement coverage  or  the  equivalent,
and  the  community  [or  continuing  care  at home corporation] has not
purchased such coverage, the community [or corporation] will be  respon-
sible  for  any  expenses  which would have been covered by medicare and
medicare supplement coverage. The community [or corporation] may add the
amount of such expenses to the resident's or contract  holder's  monthly
fees.
  [17] 16. A statement that any amendment to the contract and any change
in  fees  or  charges,  other  than  those  within  the guidelines of an
approved rating system, must be approved by the superintendent of finan-
cial services; [and]
  [18] 17. A statement that property shall not be substituted as payment
for either the entrance fee or monthly fee[.];
  18. A STATEMENT DESCRIBING THE METHOD  BY  WHICH  THE  COMMUNITY  WILL
DETERMINE  PRIORITY FOR ACCESS TO AVAILABLE ADULT CARE FACILITY OR NURS-
ING FACILITY BEDS BETWEEN A CONTINUING CARE RETIREMENT  CONTRACT  HOLDER
AND A CONTINUING CARE AT HOME CONTRACT HOLDER;
  19.  For continuing care retirement [community] contracts, a statement
whether the continuing care retirement [community] contract includes any
ownership, beneficial or trust interest in the assets of  the  operator,
the  assets  of the facility, or both. Assets shall include, but are not
limited to, property, trusts, reserves, interest  and  other  assets[.];
AND
  20. CONTINUING CARE AT HOME CONTRACTS SHALL INCLUDE THE FOLLOWING:
  A.  A  STATEMENT  DESCRIBING  THE CIRCUMSTANCES UNDER WHICH A CONTRACT
HOLDER MAY MOVE INTO A CAMPUS INDEPENDENT LIVING UNIT, ADULT CARE FACIL-
ITY OR NURSING HOME;
  B. A STATEMENT AS TO WHETHER AND UNDER WHAT CIRCUMSTANCES  TRANSPORTA-
TION WILL BE PROVIDED TO CONTINUING CARE AT HOME CONTRACT HOLDERS;
  C. A STATEMENT DESCRIBING THE MECHANISM FOR MONITORING CONTINUING CARE
AT HOME CONTRACT HOLDERS;
  D.  A  STATEMENT  DESCRIBING  THE  METHOD  BY WHICH THE COMMUNITY WILL
DETERMINE PRIORITY FOR ACCESS TO AVAILABLE  ILUS  BETWEEN  A  CONTINUING
CARE  AT  HOME  CONTRACT  HOLDER WHO WISHES TO CONVERT THE CONTRACT TO A
CONTINUING CARE RETIREMENT CONTRACT AND  A  CONTINUING  CARE  RETIREMENT
CONTRACT HOLDER;

S. 3547                             9

  E.  A  STATEMENT  DESCRIBING ANY APPLICABLE GEOGRAPHICAL LIMITS OF THE
CONTINUING CARE AT HOME SERVICES, AND THE POLICY THAT WILL  BE  FOLLOWED
IN THE EVENT THAT A CONTINUING CARE AT HOME CONTRACT HOLDER RELOCATES TO
A  DIFFERENT  RESIDENCE  OUTSIDE  THE GEOGRAPHICAL LIMITS COVERED BY THE
CONTINUING CARE AT HOME CONTRACT; AND
  F.  A  STATEMENT DESCRIBING ANY APPLICABLE POLICY THAT WOULD ENTITLE A
CONTINUING CARE AT HOME CONTRACT HOLDER TO SELECT ADULT CARE FACILITY OR
SKILLED NURSING FACILITY PLACEMENT IN A FACILITY THAT IS NOT PART OF THE
CONTINUING CARE RETIREMENT COMMUNITY.
  S 16. The public health law is amended by adding a new section  4608-a
to read as follows:
  S  4608-A.  CONTINUING  CARE  AT  HOME  REQUIREMENTS.  CONTINUING CARE
RETIREMENT COMMUNITIES OFFERING CONTINUING CARE AT HOME CONTRACTS SHALL:
  1. ENSURE THAT ALL CONTINUING CARE RETIREMENT COMMUNITY  EMPLOYEES  OR
CONTRACTORS PROVIDING SERVICES TO CONTINUING CARE AT HOME CONTRACT HOLD-
ERS  ARE DULY LICENSED OR CERTIFIED PURSUANT TO LAW, WHICH SHALL INCLUDE
BUT NOT BE LIMITED TO ANY LICENSURE REQUIREMENTS FOR  THE  PROVISION  OF
HOME CARE SERVICES SET FORTH IN ARTICLE THIRTY-SIX OF THIS CHAPTER;
  2.  INCLUDE  ALL  OPERATING  EXPENSES  FOR  CONTINUING  CARE  AT  HOME
CONTRACTS IN THE CALCULATION OF RESERVE  REQUIREMENTS  REQUIRED  BY  THE
DEPARTMENT OF FINANCIAL SERVICES; AND
  3.  INCLUDE  ALL  OPERATING  ACTIVITIES  FOR  CONTINUING  CARE AT HOME
CONTRACTS IN THE TOTAL OPERATION OF THE COMMUNITY WHEN SUBMITTING FINAN-
CIAL REPORTS AS REQUIRED BY THE DEPARTMENT AND THE DEPARTMENT OF  FINAN-
CIAL SERVICES.
  S  17.  Subdivision  1  of  section  4612 of the public health law, as
amended by chapter 549 of the laws  of  2014,  is  amended  to  read  as
follows:
  1.  [Residents  in  a community authorized by this article] CONTINUING
CARE RETIREMENT CONTRACT HOLDERS shall have the right of  self-organiza-
tion,  the  right  to be represented by one or more individuals of their
own choosing, and the right to engage in concerted  activities  for  the
purpose  of  keeping informed of the operation of the community in which
they live.
  S 18. Subdivisions 1 and 2 section 4614 of the public health  law,  as
amended  by  chapter  549  of  the  laws of 2014, are amended to read as
follows:
  1. The commissioner, or designee; and the superintendent, or designee;
may at any time, and shall at least once every three years,  visit  each
community and examine the business of any applicant for a certificate of
authority  and  any operator engaged in the execution of continuing care
retirement [community] contracts or continuing care at home contracts or
engaged in the performance of obligations under such contracts.  Routine
examinations  may  be  conducted  by  having documents designated by and
submitted to such commissioners or superintendent, which  shall  include
financial documents and records conforming to commonly accepted account-
ing  principles  and  practices.  The  final written report of each such
examination conducted by such commissioners or superintendent  shall  be
filed  with  the  commissioner  and,  when  so filed, shall constitute a
public record. A copy of each report shall be provided to members of the
continuing care retirement community council. Any operator  being  exam-
ined  shall,  upon  request, give reasonable and timely access to all of
its records. The representative or examiner designated  by  the  commis-
sioners  or  superintendent, respectively, may, at any time, examine the
records and affairs and inspect the community's facilities,  whether  in
connection with a formal examination or not.

S. 3547                            10

  2.  Any  duly  authorized  officer,  employee,  or agent of the health
department, or department of financial services may,  upon  presentation
of proper identification, have access to, and inspect, any records main-
tained  by the community [or by the continuing care at home corporation]
relevant  to the respective agency's regulatory authority, with or with-
out advance notice, to secure compliance with, or to prevent a violation
of, any provision of this article.
  S 19. Paragraph k of subdivision 1  of  section  4615  of  the  public
health law, as amended by chapter 549 of the laws of 2014, is amended to
read as follows:
  k. The commissioner has found violations of applicable statutes, rules
or  regulations which threaten to affect directly the health, safety, or
welfare of a resident [of a continuing care retirement  community  or  a
contract holder of a continuing care at home contract].
  S  20.  The  section  heading and subdivision 2 of section 4623 of the
public health law, the section heading as amended by chapter 549 of  the
laws  of 2014 and subdivision 2 as amended by chapter 659 of the laws of
1997, are amended to read as follows:
  Long term care insurance and continuing care retirement  contracts  OR
CONTINUING CARE AT HOME CONTRACTS.
  2.  With regard to nursing facility or home health care services which
are part of the continuing care retirement contract OR  CONTINUING  CARE
AT  HOME  CONTRACT,  any  elimination or waiting periods and any deduct-
ibles, copayments, or other amounts not paid for by such long term  care
insurance  or medical assistance payments shall be the responsibility of
the continuing care retirement community.   The resident  shall  not  be
liable to pay any such amounts.
  S  21. This act shall take effect April 1, 2015 and shall be deemed to
have been in full force and effect on and after the  effective  date  of
chapter 549 of the laws of 2014.