New York Laws
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.