2023 New York Laws › PBH - Public Health › Article 46 - Continuing Care Retirement Communities › 4608 - Contracts.

§ 4608. Contracts. A continuing care retirement 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:
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  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 contracts, 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 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 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.  For continuing care retirement 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, 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  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  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;
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 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. A statement that  internal  procedures  to  resolve  disputes  and
  grievances  have  been  established,  and residents and contract holders
  notified of them;
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;
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 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;
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 or contract holder 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 or contract holder's monthly fees.
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 financial
  services;
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
  nursing  facility  beds  between  a  continuing care retirement contract
  holder and a continuing care at home contract holder;
19. For continuing care retirement contracts, 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; 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
  facility or nursing home;
b.  a  statement  as  to  whether   and   under   what   circumstances
  transportation  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;
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.