2013 New York Consolidated Laws
PBH - Public Health
Article 46 - (4600 - 4624) CONTINUING CARE RETIREMENT COMMUNITIES
4608 - Continuing care retirement contract.

 
    §  4608.  Continuing  care  retirement  contract.  A  continuing  care
  retirement 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:
    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;
    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 relating to a resident'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 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 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.  The  circumstances  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 community's nursing facility,  the  liability
  of  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 apportionment of the resident's monthly fee
  for the period of care required by the contract.  Nothing  herein  shall
  obligate  a  continuing  care retirement 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.  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. 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 available 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,  including  the  mandatory  refund provisions set forth in section
  forty-six hundred nine of this article;
    9. A statement of the advance notice to be provided the  resident,  of
  not  less  than sixty days, of any change in fees or charges or scope of
  care or services;
    10. A statement that no act, agreement, or statement of any  resident,
  or  of  an individual purchasing care for a resident under any agreement
  to furnish care to the resident, 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 the individual
  purchasing care for the resident;
    11. A description of the reinstatement policies if a  resident  leaves
  the facility or the contract is cancelled;
    12.  A  statement  that  internal  procedures  to resolve disputes and
  grievances have been established, and residents notified of them;
    13. 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;
    14. A statement that: a. the resident 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 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  shall  purchase
  the  coverage or equivalent coverage on behalf and at the expense of the
  resident  and  shall  have  the  authority  to  require  an  appropriate
  adjustment in payments by the resident to the community;
    c.  if  the  community  cannot purchase medicare coverage and medicare
  supplement coverage or the equivalent,  the  community  shall  have  the
  authority  to  require  an  adjustment  in  monthly fees, subject to the
  approval of the superintendent, to  fund  the  additional  risk  to  the
  facility; and
    d. if the resident fails to purchase or maintain medicare coverage and
  medicare  supplement  coverage  or the equivalent, and the community has
  not purchased such coverage, the community will be responsible  for  any
  expenses  which  would  have  been  covered  by  medicare  and  medicare
  supplement coverage. The community may add the amount of  such  expenses
  to the resident's monthly fees.
    15.  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 financial
  services; and

    16. A statement that property shall not be substituted as payment  for
  either the entrance fee or monthly fee.
    17.  A  statement  whether  the  continuing  care  retirement 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.