N.Y. Public Health Law § 4655*2: Certification procedures and requirements

* § 4655. Certification procedures and requirements. 1.

Notwithstanding any other provision of law, an assisted living operator

may apply to the department to obtain an enhanced assisted living

certificate pursuant to this section.

(a) Such application shall be on a form approved by the department.

(b) An assisted living operator may apply for such a certificate for

the entire facility or any number of beds at the facility.

(c) To obtain an enhanced assisted living certificate, the applicant

must submit a plan to the department setting forth how the additional

needs of residents will be safely and appropriately met at such

residence. Such plan shall include, but need not be limited to, a

written description of services, staffing levels, staff education and

training, work experience, and any environmental modifications that have

been made or will be made to protect the health, safety and welfare of

such persons in the residence.

(d) In addition to any other requirements of assisted living, an

operator of enhanced assisted living may hire care staff directly

pursuant to standards developed by the department or contract with a

home care services agency which has been approved to operate pursuant to

article thirty-six of this chapter.

(e) No assisted living residence shall be certified as enhanced

assisted living unless and until the applicant obtains the written

approval of the department.

2. No resident shall be permitted to continue to age in place under

the terms of an enhanced assisted living certificate unless the

operator, the resident's physician, and, if applicable, the resident's

licensed or certified home care agency, agree that the additional needs

of the resident can be safely and appropriately met at the residence. A

resident eligible for enhanced assisted living or his or her

representative shall submit to the residence a written report from a

physician, which report shall state that:

(a) the physician has physically examined the resident within the last

month; and

(b) the resident is not in need of twenty-four hour skilled nursing

care or medical care which would require placement in a hospital or

residential health care facility.

3. The residence must notify a resident that, while the residence will

make reasonable efforts to facilitate the resident's ability to age in

place pursuant to an individualized service plan, there may be a point

reached where the needs of the resident cannot be safely or

appropriately met at the residence, requiring the transfer of the

resident to a more appropriate facility in accordance with the

provisions of this article.

4. If a resident reaches the point where he or she is in need of

twenty-four hour skilled nursing care or medical care required to be

provided by facilities licensed pursuant to article twenty-eight of this

chapter or article nineteen, thirty-one or thirty-two of the mental

hygiene law, then the resident must be discharged from the residence and

the operator shall initiate proceedings for the termination of the

residency agreement of such resident in accordance with the provisions

of section four hundred sixty-one-h of the social services law.

Provided, however, a resident may remain at the residence if each of the

following conditions are met:

(a) a resident in need of twenty-four hour skilled nursing care or

medical care hires appropriate nursing, medical or hospice staff to care

for his or her increased needs;

(b) the resident's physician and home care services agency both

determine and document that, with the provision of such additional

nursing, medical or hospice care, the resident can be safely cared for

in the residence, and would not require placement in a hospital, nursing

home or other facility licensed under article twenty-eight of this

chapter or article nineteen, thirty-one or thirty-two of the mental

hygiene law;

(c) the operator agrees to retain the resident and to coordinate the

care provided by the operator and the additional nursing, medical or

hospice staff; and

(d) the resident is otherwise eligible to reside at the residence.

5. In addition to the requirements otherwise required for licensure as

assisted living, any residence that advertises or markets itself as

serving individuals with special needs, including, but not limited to,

individuals with dementia or cognitive impairments, must submit a

special needs plan to the department setting forth how the special needs

of such residents will be safely and appropriately met at such

residence. Such plan shall include, but need not be limited to, a

written description of specialized services, staffing levels, staff

education and training, work experience, professional affiliations or

special characteristics relevant to serving persons with special needs,

and any environmental modifications that have been made or will be made

to protect the health, safety and welfare of such persons in the

residence. In approving an application for special needs certification,

the department shall develop standards to ensure adequate staffing and

training in order to safely meet the needs of the resident. The

standards shall be based upon recommendations of the task force

established by section five of the chapter of the laws of two thousand

four which added this section. No residence shall market themselves as

providing specialized services unless and until the department has

approved such applicant for a special needs assisted living certificate.

6. An enhanced assisted living certificate shall not be required of an

adult care facility, or part thereof, which has obtained approval by the

department to operate an assisted living program pursuant to section

four hundred sixty-one-l of the social services law. Provided, however,

such exemption shall only apply to those beds at the facility which are

subject to the assisted living program.

* NB There are 2 § 4655's