§ 4601 — Definitions

New York § 4601

• Jurisdiction: New York
• Law PBH: Public Health
• Art. 46: Continuing Care Retirement Communities

Text

§ 4601. Definitions. As used in this article:\n 1. "Certificates" or "certificate of authority" shall mean an\nauthorization in writing, approved by the council and issued by the\ncommissioner, for an operator to operate a continuing care retirement\ncommunity and to enter into continuing care retirement contracts and\ncontinuing care at home contracts pertaining to such community.\n 2. "Commissioner" shall mean the commissioner of health.\n 2-a. "Continuing care retirement contract" or "continuing care at home\ncontract" shall mean a single contract to provide a person the services\nprovided by a continuing care retirement community.\n 2-b. "Continuing care retirement community" or "community" shall mean\na facility or facilities established to provide a comprehensive,\ncohesive living arrangement for the elderly, oriented to the enhancement\nof the quality of life and which, pursuant to a contract, at a minimum:\n a. for continuing care retirement contracts, provides independent\nliving units, and meal plan options. The independent living unit can be\nmade available either through a non-equity arrangement or through an\nequity arrangement including, but not limited to a cooperative or\ncondominium. For purposes of this article, the purchase price of an\nindependent living unit in an equity arrangement, regardless of the form\nof the purchase agreement, shall not be considered an entry fee for\npurposes of calculating reserve liabilities, but shall be considered an\nentry fee for escrow purposes;\n b. provides a range of health care and social services, subject to\nsuch terms as may be included within the contract, which shall include\nadult care facility services of an on-site or affiliated adult care\nfacility, and at a minimum, sixty days of prepaid services of an on-site\nor affiliated nursing facility for residents not receiving services\nunder a fee-for-service contract;\n c. provides access to health services as defined in the contract,\nprescription drugs, and rehabilitation services;\n d. nothing in this article shall eliminate the obligation of a\ncontinuing care retirement community to provide at least sixty days of\nprepaid nursing facility services to all residents, with the exception\nof residents receiving services under the terms of a fee-for-service\ncontinuing care contract as defined in this section. The prepaid days\nmust include the first sixty days of nursing facility services, whether\nor not consecutive, not covered by Title XVIII of the federal social\nsecurity act;\n e. communities established under this article and offering\nfee-for-service continuing care contracts must offer, along with such\nfee-for-service continuing care contracts, life care and/or continuing\ncare contracts as defined in subdivision eight-a of this section; and\n f. communities established under this article offering continuing care\nat home contracts must also offer continuing care retirement contracts\nand must maintain a continuing care retirement community that operates\nin support of the continuing care at home contracts.\n 3. "Contracts" or "agreements" shall mean continuing care at home or\ncontinuing care retirement contracts as defined in this article.\n 4. "Control", "controlling", "controlled by", and "under common\ncontrol with" shall mean the possession, directly, or indirectly, of the\npower to direct or cause the direction of the management and policies of\na person, whether through the ownership of voting securities or voting\nrights, by contract (except a commercial contract for goods or\nnon-management services) or otherwise; but no person shall be deemed to\ncontrol another person solely by reason of his being an officer or\ndirector of such other person. Control shall be presumed to exist if any\nperson directly or indirectly owns, controls, or holds with the power to\nvote ten percent or more of the voting securities or voting rights of\nany other person or is a corporate member of the legal entity.\n 5. "Council" shall mean the continuing care retirement community\ncouncil, established pursuant to section forty-six hundred two of this\narticle.\n 6. "Entrance fee" shall mean an initial or deferred transfer to an\noperator of a sum of money, made or promised to be made by a person or\npersons entering into a continuing care retirement contract or\ncontinuing care at home contract, for the purpose of ensuring services\npursuant to such a contract.\n 7. "Facility" shall mean any place in which an operator undertakes to\nprovide a resident with the services of a continuing care retirement\ncommunity, pursuant to a contract, whether such place is constructed,\nowned, leased, rented, or otherwise contracted for by the operator.\n 8. "Life care contract" shall mean a single continuing care retirement\ncontract or a continuing care at home contract to provide a person, for\nthe duration of such person's life, the services provided by the\ncontinuing care retirement community, which services shall include\nunlimited services of the affiliated community's nursing facility or\naffiliated nursing home. Such term also shall mean a single continuing\ncare retirement contract to provide a person, for the duration of such\nperson's life, the services provided by the continuing care retirement\ncommunity under an arrangement in which the costs of the residents'\nunlimited nursing home or home care services are paid for in whole or in\npart by a long term care insurance policy approved by the superintendent\nin accordance with applicable regulations or by long term care insurance\nor medical assistance payments in accordance with the partnership for\nlong term care program pursuant to the provisions of section three\nhundred sixty-seven-f of the social services law, section three thousand\ntwo hundred twenty-nine of the insurance law and section four thousand\nsix hundred twenty-three of this chapter.\n 8-a. "Fee-for-service continuing care contract" shall mean a single\ncontinuing care retirement contract that provides long-term and other\nservices on a per diem, fee-for-service or monthly rate.\n 8-b. "Continuing care at home contract" shall mean a single contract\nto provide a person with long term care services and supports based upon\nthe person's needs and coordinated by a case manager, which shall\ninclude services provided to the person in his or her residence and\nservices of the community's nursing facility and adult care facility, or\naffiliated facilities.\n 9. "Life care shall mean those services provided pursuant to a "life\ncare contract".\n 10. "Living unit" shall mean an apartment, room, cottage, or other\narea within a community set aside for the exclusive use of one or more\nresidents, or in the case of a continuing care at home contract, the\ncontract holder's private residence.\n 11. "Monthly care fee" shall mean the monthly cost to a resident for\nprepayment of any services, including rent, rendered pursuant to a\ncontract, exclusive of entrance fees or other prepayments, and any other\nregular periodic charges to the resident, determined on a monthly basis,\npursuant to the provisions of a contract.\n 12. "Operator" shall mean a legal entity operating a continuing care\nretirement community pursuant to a certificate of authority.\n 13. "Priority reservation agreement" shall mean a cancelable agreement\nbetween a prospective continuing care retirement community applicant, an\napplicant for a certificate of authority or an operator and a\nprospective resident, for the purpose of evaluating market demand for a\nproposed continuing care retirement community and for the purpose of\nguaranteeing to prospective residents an opportunity for priority\nplacement in a continuing care retirement community, under which the\nprospective resident will pay a refundable priority reservation fee. A\npriority reservation agreement does not fall within the meaning of\ncontracts or agreements as defined in subdivision three of this section.\n 14. "Priority reservation fee" shall mean the refundable sum of money\npaid by a prospective resident for deposit with the escrow agent for a\nprospective continuing care retirement community applicant, an applicant\nfor a certificate of authority or an operator pursuant to a priority\nreservation agreement.\n 15. "Resident" shall mean any person who, pursuant to a continuing\ncare retirement contract or continuing care at home contract, is\nentitled to reside in and/or receive services from a continuing care\nretirement community.\n 15-a. "ILU resident" shall mean a continuing care retirement contract\nholder who resides in a living unit within the continuing care\nretirement community.\n 15-b. "Home resident" shall mean a continuing care at home contract\nholder who resides in a private residence off of the continuing care\nretirement community campus.\n 16. "Residential health care demonstration facility" shall mean a\nresidential health care facility containing up to sixty beds, within the\ndefined geographical boundary of each health systems agency established\nunder the provisions of subdivision (c) of section twenty-nine hundred\nfour of this chapter, provided that such residential health care\nfacility is an integrated part of a comprehensive system of residential\nand support services for the elderly, providing either directly or\nthrough one or more affiliated entities, prior to the effective date of\nthis subdivision, on or adjacent to the site of the proposed residential\nhealth care facility, independent living units, an adult care facility\nas defined in section two of the social services law and a range of\nhealth care and social services, which may include home health care,\ncounselling, case management and information and referral.\n 16-a. "Social services" shall mean those services which may include,\nbut not be limited to counseling, case management, and information and\nreferral.\n 17. "Superintendent" shall mean the superintendent of financial\nservices.\n