N.Y. Public Health Law § 4601: Definitions

§ 4601. Definitions. As used in this article:

1. "Certificates" or "certificate of authority" shall mean an

authorization in writing, approved by the council and issued by the

commissioner, for an operator to operate a continuing care retirement

community and to enter into continuing care retirement contracts and

continuing care at home contracts pertaining to such community.

2. "Commissioner" shall mean the commissioner of health.

2-a. "Continuing care retirement contract" or "continuing care at home

contract" shall mean a single contract to provide a person the services

provided by a continuing care retirement community.

2-b. "Continuing care retirement community" or "community" shall mean

a facility or facilities established to provide a comprehensive,

cohesive living arrangement for the elderly, oriented to the enhancement

of the quality of life and which, pursuant to a contract, at a minimum:

a. for continuing care retirement contracts, provides independent

living units, and meal plan options. The independent living unit can be

made available either through a non-equity arrangement or through an

equity arrangement including, but not limited to a cooperative or

condominium. For purposes of this article, the purchase price of an

independent living unit in an equity arrangement, regardless of the form

of the purchase agreement, shall not be considered an entry fee for

purposes of calculating reserve liabilities, but shall be considered an

entry fee for escrow purposes;

b. provides a range of health care and social services, subject to

such terms as may be included within the contract, which shall include

adult care facility services of an on-site or affiliated adult care

facility, and at a minimum, sixty days of prepaid services of an on-site

or affiliated nursing facility for residents not receiving services

under a fee-for-service contract;

c. provides access to health services as defined in the contract,

prescription drugs, and rehabilitation services;

d. nothing in this article shall eliminate the obligation of a

continuing care retirement community to provide at least sixty days of

prepaid nursing facility services to all residents, with the exception

of residents receiving services under the terms of a fee-for-service

continuing care contract as defined in this section. The prepaid days

must include the first sixty days of nursing facility services, whether

or not consecutive, not covered by Title XVIII of the federal social

security act;

e. communities established under this article and offering

fee-for-service continuing care contracts must offer, along with such

fee-for-service continuing care contracts, life care and/or continuing

care contracts as defined in subdivision eight-a of this section; and

f. communities established under this article offering continuing care

at home contracts must also offer continuing care retirement contracts

and must maintain a continuing care retirement community that operates

in support of the continuing care at home contracts.

3. "Contracts" or "agreements" shall mean continuing care at home or

continuing care retirement contracts as defined in this article.

4. "Control", "controlling", "controlled by", and "under common

control with" shall mean the possession, directly, or indirectly, of the

power to direct or cause the direction of the management and policies of

a person, whether through the ownership of voting securities or voting

rights, by contract (except a commercial contract for goods or

non-management services) or otherwise; but no person shall be deemed to

control another person solely by reason of his being an officer or

director of such other person. Control shall be presumed to exist if any

person directly or indirectly owns, controls, or holds with the power to

vote ten percent or more of the voting securities or voting rights of

any other person or is a corporate member of the legal entity.

5. "Council" shall mean the continuing care retirement community

council, established pursuant to section forty-six hundred two of this

article.

6. "Entrance fee" shall mean an initial or deferred transfer to an

operator of a sum of money, made or promised to be made by a person or

persons entering into a continuing care retirement contract or

continuing care at home contract, for the purpose of ensuring services

pursuant to such a contract.

7. "Facility" shall mean any place in which an operator undertakes to

provide a resident with the services of a continuing care retirement

community, pursuant to a contract, whether such place is constructed,

owned, leased, rented, or otherwise contracted for by the operator.

8. "Life care contract" shall mean a single continuing care retirement

contract or a continuing care at home contract to provide a person, for

the duration of such person's life, the services provided by the

continuing care retirement community, which services shall include

unlimited services of the affiliated community's nursing facility or

affiliated nursing home. Such term also shall mean a single continuing

care retirement contract to provide a person, for the duration of such

person's life, the services provided by the continuing care retirement

community under an arrangement in which the costs of the residents'

unlimited nursing home or home care services are paid for in whole or in

part by a long term care insurance policy approved by the superintendent

in accordance with applicable regulations or by long term care insurance

or medical assistance payments in accordance with the partnership for

long term care program pursuant to the provisions of section three

hundred sixty-seven-f of the social services law, section three thousand

two hundred twenty-nine of the insurance law and section four thousand

six hundred twenty-three of this chapter.

8-a. "Fee-for-service continuing care contract" shall mean a single

continuing care retirement contract that provides long-term and other

services on a per diem, fee-for-service or monthly rate.

8-b. "Continuing care at home contract" shall mean a single contract

to provide a person with long term care services and supports based upon

the person's needs and coordinated by a case manager, which shall

include services provided to the person in his or her residence and

services of the community's nursing facility and adult care facility, or

affiliated facilities.

9. "Life care shall mean those services provided pursuant to a "life

care contract".

10. "Living unit" shall mean an apartment, room, cottage, or other

area within a community set aside for the exclusive use of one or more

residents, or in the case of a continuing care at home contract, the

contract holder's private residence.

11. "Monthly care fee" shall mean the monthly cost to a resident for

prepayment of any services, including rent, rendered pursuant to a

contract, exclusive of entrance fees or other prepayments, and any other

regular periodic charges to the resident, determined on a monthly basis,

pursuant to the provisions of a contract.

12. "Operator" shall mean a legal entity operating a continuing care

retirement community pursuant to a certificate of authority.

13. "Priority reservation agreement" shall mean a cancelable agreement

between a prospective continuing care retirement community applicant, an

applicant for a certificate of authority or an operator and a

prospective resident, for the purpose of evaluating market demand for a

proposed continuing care retirement community and for the purpose of

guaranteeing to prospective residents an opportunity for priority

placement in a continuing care retirement community, under which the

prospective resident will pay a refundable priority reservation fee. A

priority reservation agreement does not fall within the meaning of

contracts or agreements as defined in subdivision three of this section.

14. "Priority reservation fee" shall mean the refundable sum of money

paid by a prospective resident for deposit with the escrow agent for a

prospective continuing care retirement community applicant, an applicant

for a certificate of authority or an operator pursuant to a priority

reservation agreement.

15. "Resident" shall mean any person who, pursuant to a continuing

care retirement contract or continuing care at home contract, is

entitled to reside in and/or receive services from a continuing care

retirement community.

15-a. "ILU resident" shall mean a continuing care retirement contract

holder who resides in a living unit within the continuing care

retirement community.

15-b. "Home resident" shall mean a continuing care at home contract

holder who resides in a private residence off of the continuing care

retirement community campus.

16. "Residential health care demonstration facility" shall mean a

residential health care facility containing up to sixty beds, within the

defined geographical boundary of each health systems agency established

under the provisions of subdivision (c) of section twenty-nine hundred

four of this chapter, provided that such residential health care

facility is an integrated part of a comprehensive system of residential

and support services for the elderly, providing either directly or

through one or more affiliated entities, prior to the effective date of

this subdivision, on or adjacent to the site of the proposed residential

health care facility, independent living units, an adult care facility

as defined in section two of the social services law and a range of

health care and social services, which may include home health care,

counselling, case management and information and referral.

16-a. "Social services" shall mean those services which may include,

but not be limited to counseling, case management, and information and

referral.

17. "Superintendent" shall mean the superintendent of financial

services.