N.Y. Public Health Law § 4656*2: General requirements; applicability of laws to assisted living and enhanced assisted living

* § 4656. General requirements; applicability of laws to assisted

living and enhanced assisted living. 1. No entity shall establish,

operate, provide, conduct, or offer assisted living in this state, or

hold itself out as an entity which otherwise meets the definition of

assisted living or advertise itself as assisted living or by a similar

term, without obtaining the approval of the department to operate as an

adult care facility pursuant to title two of article seven of the social

services law, obtaining the approval of the department as required in

this article, and otherwise acting in accordance with this article.

Provided however that an entity may simultaneously apply for approval to

operate as an adult care facility and as an assisted living residence

pursuant to this article. This subdivision shall not apply to assisted

living programs approved by the department pursuant to section four

hundred sixty-one-l of the social services law.

2. An assisted living operator shall comply with all applicable

statutes, rules and regulations required for maintaining a valid

operating certificate issued pursuant to title two of article seven of

the social services law and shall obtain and maintain all other

licenses, permits, registrations, or other governmental approvals

required in addition to requirements under this article.

3. Approval for licensure or certification pursuant to this article

may be granted only to an applicant who satisfactorily demonstrates:

(a) that such applicant possesses a valid operating certificate to

operate as an adult home or enriched housing program pursuant to article

seven of the social services law. An applicant that does not currently

possess such operating certificate as an adult home or enriched housing

program may simultaneously apply and be approved for such certificate

and all other licenses and certifications authorized under this article;

(b) that such applicant which has an existing valid adult care

facility operating certificate, is in good standing with the department.

For purposes of this subdivision, good standing shall mean the applicant

has not (i) received any official written notice from the department of

a proposed revocation, suspension, denial or limitation on the operating

certificate of the facility or residence; (ii) within the previous three

years, been assessed a civil penalty after a hearing conducted pursuant

to subparagraph one of paragraph (b) of subdivision seven of section

four hundred sixty-d of the social services law for a violation that has

not been rectified; (iii) within the previous year, received any

official written notice from the department of a proposed assessment of

a civil penalty for a violation described in subparagraph two of

paragraph (b) of subdivision seven of section four hundred sixty-d of

the social services law; (iv) within the previous three years, been

issued an order pursuant to subdivision two, five, six, or eight of

section four hundred sixty-d of the social services law; (v) within the

previous three years, been placed on, and if placed on, removed from the

department's "do not refer list" pursuant to subdivision fifteen of

section four hundred sixty-d of the social services law. Provided

however that in the case of an applicant which otherwise meets the

requirements of this section, but is not in good standing as provided in

this paragraph, the department may approve said applicant if it

determines that the applicant is of good moral character and is

competent to operate the residence. Such character and competence review

shall be limited to applicants not in good standing pursuant to this

paragraph or an applicant subject to paragraph (f) of this subdivision.

As part of the review provided pursuant to this paragraph, the

department shall, on its webpage, solicit and consider public comment;

(c) that such applicant has adequate financial resources to provide

such assisted living as proposed;

(d) that the building, equipment, staff, standards of care and records

to be employed in the operation comply with applicable statutes and any

applicable local law;

(e) that any license or permit required by law for the operation of

such residence has been issued to such operator; and

(f) in the case of an applicant which does not have an existing valid

adult care facility operating certificate, such applicant shall

otherwise comply with the provisions for certification as prescribed by

article seven of the social services law.

4. The department shall develop an expedited review and approval

process for applications for up to nine additional beds to an existing

enhanced or special needs assisted living certificate qualified as being

in good standing under section forty-six hundred fifty-three of this

article.

5. The knowing operation of an assisted living or enhanced assisted

living residence without the prior written approval of the department

shall be a class A misdemeanor.

6. Every assisted living residence that is required to possess an

assisted living residence license shall be licensed on a biennial basis

and shall pay a biennial licensure fee. Such fee shall be five hundred

dollars per license, with an additional fee of fifty dollars per

resident whose annual income is above four hundred percent of the

federal poverty level. Such additional fee shall be based on the total

occupied beds at the time of application, up to a maximum biennial

licensure fee of five thousand dollars. Said fee shall be in addition to

the fee charged by the department for certification as an adult care

facility. Every assisted living residence that applies for an enhanced

assisted living certificate or a special needs assisted living

certificate shall pay an additional biennial fee, in addition to any

other fee required by this subdivision, in the amount of two thousand

dollars, provided that for any residence applying for both an enhanced

assisted living certificate and a special needs assisted living

certificate the amount of such fee shall be three thousand dollars.

7. (a) All assisted living residences, as defined in subdivision one

of section forty-six hundred fifty-one of this article, including those

licensed and certified as an assisted living residence, special needs

assisted living residence, or enhanced assisted living residence, shall:

(i) report annually on quality measures to be established by the

department, in consultation with industry and consumer representatives,

including the long-term care ombudsman or their representative, in the

form and format prescribed by the department, with the first report due

no later than April fifteenth, two thousand twenty-five; and

(ii) post information, including the starting monthly service rate,

range for starting rent, approved admission or residency agreement, and

a consumer-friendly summary of all service fees, through a reporting

system to be developed by the department, in consultation with industry

and consumer representatives, that takes into account differences in

licensure and certification, services, agreements and fee structures

across facilities. Such information shall be posted in a conspicuous

place on the facility's website and in a public space within the

facility and shall be made available to the public on forms developed by

the department. Beginning on January first, two thousand twenty-five,

this information shall also be reported to the department.

(b) The department shall develop a system to score the results of the

assisted living quality reporting obtained pursuant to paragraph (a) of

this subdivision, in consultation with industry and consumer

representatives. Facilities scoring in the top quartile shall be granted

the classification of advanced standing on their annual surveillance

schedules.

Facilities may remain on advanced standing classification provided

they meet the scoring requirements in assisted living quality reporting

and until such time when they do not meet such scoring requirements.

(c) Effective April thirtieth, two thousand twenty-five, the

department shall post on its website the results of the assisted living

quality reporting, collected pursuant to subparagraph (i) of paragraph

(a) of this subdivision.

(d) No later than December thirty-first, two thousand twenty-five, the

department shall report to the legislature on the development of a

quality scoring system for adult care facilities, including adult homes

and enriched housing providers. Such report shall examine the specific

quality measures recommended and a process for information collection.

8. (a) Assisted living residences, as defined in subdivision one of

section forty-six hundred fifty-one of this article, including those

licensed and certified as an assisted living residence, special needs

assisted living residence, or enhanced assisted living residence, may

seek accreditation by agencies determined by the commissioner.

(b) Such accreditation agencies shall report data and information, in

a manner and form as determined by the department, pertaining to those

assisted living residences accredited by such agencies, and those

assisted living residences which obtain but lose such accreditation.

9. The requirements of this article shall be in addition to those

required of an adult care facility. In the event of a conflict between

any provision of this article and a provision of article seven of the

social services law or a regulation adopted thereunder, the applicable

provision of this article or the applicable regulation shall supersede

article seven of the social services law or the applicable regulation

thereunder to the extent of such conflict.

10. The assisted living operator shall not use deceptive or coercive

marketing practices to encourage residents or potential residents to

sign or reauthorize the residency agreement required pursuant to section

four thousand six hundred fifty-eight of this article.

* NB There are 2 § 4656's