§ 4655*2 — Certification procedures and requirements

* § 4655. Certification procedures and requirements. 1.\nNotwithstanding any other provision of law, an assisted living operator\nmay apply to the department to obtain an enhanced assisted living\ncertificate pursuant to this section.\n (a) Such application shall be on a form approved by the department.\n (b) An assisted living operator may apply for such a certificate for\nthe entire facility or any number of beds at the facility.\n (c) To obtain an enhanced assisted living certificate, the applicant\nmust submit a plan to the department setting forth how the additional\nneeds of residents will be safely and appropriately met at such\nresidence. Such plan shall include, but need not be limited to, a\nwritten description of services, staffing levels, staff education and\ntraining, work experience, and any environmental modifications that have\nbeen made or will be made to protect the health, safety and welfare of\nsuch persons in the residence.\n (d) In addition to any other requirements of assisted living, an\noperator of enhanced assisted living may hire care staff directly\npursuant to standards developed by the department or contract with a\nhome care services agency which has been approved to operate pursuant to\narticle thirty-six of this chapter.\n (e) No assisted living residence shall be certified as enhanced\nassisted living unless and until the applicant obtains the written\napproval of the department.\n 2. No resident shall be permitted to continue to age in place under\nthe terms of an enhanced assisted living certificate unless the\noperator, the resident's physician, and, if applicable, the resident's\nlicensed or certified home care agency, agree that the additional needs\nof the resident can be safely and appropriately met at the residence. A\nresident eligible for enhanced assisted living or his or her\nrepresentative shall submit to the residence a written report from a\nphysician, which report shall state that:\n (a) the physician has physically examined the resident within the last\nmonth; and\n (b) the resident is not in need of twenty-four hour skilled nursing\ncare or medical care which would require placement in a hospital or\nresidential health care facility.\n 3. The residence must notify a resident that, while the residence will\nmake reasonable efforts to facilitate the resident's ability to age in\nplace pursuant to an individualized service plan, there may be a point\nreached where the needs of the resident cannot be safely or\nappropriately met at the residence, requiring the transfer of the\nresident to a more appropriate facility in accordance with the\nprovisions of this article.\n 4. If a resident reaches the point where he or she is in need of\ntwenty-four hour skilled nursing care or medical care required to be\nprovided by facilities licensed pursuant to article twenty-eight of this\nchapter or article nineteen, thirty-one or thirty-two of the mental\nhygiene law, then the resident must be discharged from the residence and\nthe operator shall initiate proceedings for the termination of the\nresidency agreement of such resident in accordance with the provisions\nof section four hundred sixty-one-h of the social services law.\nProvided, however, a resident may remain at the residence if each of the\nfollowing conditions are met:\n (a) a resident in need of twenty-four hour skilled nursing care or\nmedical care hires appropriate nursing, medical or hospice staff to care\nfor his or her increased needs;\n (b) the resident's physician and home care services agency both\ndetermine and document that, with the provision of such additional\nnursing, medical or hospice care, the resident can be safely cared for\nin the residence, and would not require placement in a hospital, nursing\nhome or other facility licensed under article twenty-eight of this\nchapter or article nineteen, thirty-one or thirty-two of the mental\nhygiene law;\n (c) the operator agrees to retain the resident and to coordinate the\ncare provided by the operator and the additional nursing, medical or\nhospice staff; and\n (d) the resident is otherwise eligible to reside at the residence.\n 5. In addition to the requirements otherwise required for licensure as\nassisted living, any residence that advertises or markets itself as\nserving individuals with special needs, including, but not limited to,\nindividuals with dementia or cognitive impairments, must submit a\nspecial needs plan to the department setting forth how the special needs\nof such residents will be safely and appropriately met at such\nresidence. Such plan shall include, but need not be limited to, a\nwritten description of specialized services, staffing levels, staff\neducation and training, work experience, professional affiliations or\nspecial characteristics relevant to serving persons with special needs,\nand any environmental modifications that have been made or will be made\nto protect the health, safety and welfare of such persons in the\nresidence. In approving an application for special needs certification,\nthe department shall develop standards to ensure adequate staffing and\ntraining in order to safely meet the needs of the resident. The\nstandards shall be based upon recommendations of the task force\nestablished by section five of the chapter of the laws of two thousand\nfour which added this section. No residence shall market themselves as\nproviding specialized services unless and until the department has\napproved such applicant for a special needs assisted living certificate.\n 6. An enhanced assisted living certificate shall not be required of an\nadult care facility, or part thereof, which has obtained approval by the\ndepartment to operate an assisted living program pursuant to section\nfour hundred sixty-one-l of the social services law. Provided, however,\nsuch exemption shall only apply to those beds at the facility which are\nsubject to the assisted living program.\n * NB There are 2 § 4655's\n