STATE OF NEW YORK
________________________________________________________________________
5485--A
2023-2024 Regular Sessions
IN ASSEMBLY
March 13, 2023
___________
Introduced by M. of A. PAULIN, BRONSON, STECK, L. ROSENTHAL, BENEDETTO,
DINOWITZ, HYNDMAN, LUPARDO, SAYEGH, DARLING, SEAWRIGHT, COLTON,
STIRPE, JACOBSON, EPSTEIN, WALKER, SIMON, JACKSON, FORREST, CRUZ,
CARROLL, HUNTER, MEEKS, WALLACE, McMAHON, LUNSFORD, CLARK, KELLES,
MITAYNES, ZINERMAN, REYES, GIBBS, GLICK, MAMDANI, McDONALD -- Multi-
Sponsored by -- M. of A. COOK, THIELE -- read once and referred to the
Committee on Health -- recommitted to the Committee on Health in
accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee
AN ACT to amend the social services law and the mental hygiene law, in
relation to violations of safety conditions in adult care facilities
The People of the State of New York, represented in Senate and Assem-
bly, do enact as follows:
1 Section 1. Paragraph (b) of subdivision 4 of section 460-d of the
2 social services law, as amended by chapter 733 of the laws of 1994, is
3 amended to read as follows:
4 (b) No operating certificate shall be revoked, suspended or limited
5 without a hearing held in accordance with procedures established by
6 department regulations, which procedures shall require that notice of
7 the time and place of the hearing, and notice of the charges, shall be
8 served in person or by certified mail addressed to the facility at least
9 thirty days prior to the date of the hearing. A written answer to the
10 charges may be filed with the department not less than ten business days
11 prior to the date of the hearing. An operating certificate may, never-
12 theless, be suspended or limited without a hearing for a period not in
13 excess of sixty days, upon written notice to the facility following a
14 finding by the department that the public health, or an individual's
15 health, safety or welfare, are in imminent danger; provided, however,
16 that if the department demonstrates reasonable efforts to commence a
17 hearing within such sixty-day period and to complete such hearing within
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02412-13-4
A. 5485--A 2
1 a reasonable period of time, the hearing officer may authorize the
2 department to extend the period of suspension or limitation for an
3 appropriate period of time, but in no event beyond an additional thirty
4 days.
5 § 2. Subdivision 7 of section 460-d of the social services law, as
6 added by chapter 669 of the laws of 1977, paragraph (a) as amended by
7 chapter 719 of the laws of 1989, paragraph (b) as amended by chapter 524
8 of the laws of 1984, subparagraph 2 of paragraph (b) as amended by chap-
9 ter 733 of the laws of 1994, is amended to read as follows:
10 7. (a) The department shall adopt regulations establishing civil
11 penalties of up to [one] two thousand dollars per violation, per day
12 and for repeat violations, under subparagraph two of paragraph (c) of
13 this subdivision for which a prior penalty was assessed, an amount up to
14 five thousand dollars per violation, per day to be assessed against all
15 adult care facilities [except facilities operated by a social services
16 district] for violations of (i) regulations of the department pertaining
17 to the care of residents in such facilities, (ii) paragraph (a) of
18 subdivision three of section four hundred sixty-one-a of this [chapter]
19 article, or (iii) an order issued pursuant to subdivision eight of this
20 section. The regulations shall specify the violations subject to penalty
21 and the amount of the penalty to be assessed in connection with each
22 such violation and shall specify that only civil penalties of up to
23 [one] two thousand dollars [per day] per violation, per day, shall be
24 assessed pursuant to this paragraph against an adult care facility found
25 responsible for an act of retaliation or reprisal against any resident,
26 employee, or other person for having filed a complaint with or having
27 provided information to any long term care [patient] ombudsman function-
28 ing in accordance with section [five hundred forty-four or five hundred
29 forty-five] two hundred eighteen of the [executive] elder law.
30 (b) [(1)] In addition to any other civil or criminal penalty provided
31 by law, the department shall have the power to assess civil penalties in
32 accordance with its regulations adopted pursuant to paragraph (a) of
33 this subdivision, after a hearing conducted in accordance with the
34 procedures established by regulations of the department. Such procedures
35 shall require that notice of the time and place of the hearing, together
36 with a statement of charges of violations, shall be served in person or
37 by certified mail addressed to the facility at least thirty days prior
38 to the date of the hearing. The statement of charges of violations shall
39 set forth the existence of the violations, the amount of penalty for
40 which it may become liable and the steps which must be taken to rectify
41 the violation and, where applicable, a statement that the department
42 contends that a penalty may be imposed under this paragraph regardless
43 of rectification. An answer to the charges of violations, in writing,
44 shall be filed with the department, not less than ten days prior to the
45 date of hearing. The answer shall notify the department of the facili-
46 ty's position with respect to each of the charges and shall include all
47 matters which if not disclosed in the answer would be likely to take the
48 department by surprise. The commissioner, or a member of [his] such
49 commissioner's staff who is designated and authorized by [him] such
50 commissioner to hold such hearing, may in [his] such commissioner's
51 discretion allow the facility to prove any matter not included in the
52 answer.
53 (c) (1) Where the facility satisfactorily demonstrates that it either
54 had rectified the violations within thirty days of receiving written
55 notification of the results of the inspection pursuant to section four
56 hundred sixty-one-a of this [chapter] article, or had submitted within
A. 5485--A 3
1 thirty days an acceptable plan for rectification and was rectifying the
2 violations in accordance with the steps and within the additional peri-
3 ods of time as accepted by the department in such plan, no penalty shall
4 be imposed, except as provided in subparagraph two of this paragraph.
5 (2) Rectification shall not preclude the assessment of a penalty if
6 the department establishes at a hearing that a particular violation,
7 although corrected[, endangered or resulted in harm to any resident as
8 the result of]:
9 (i) endangered any resident. Endangerment is defined as:
10 (A) the total or substantial failure of the facility's fire detection
11 or prevention systems, or emergency evacuation procedures prescribed by
12 department safety standard regulations;
13 [(ii)] (B) the retention of any resident who has been evaluated by the
14 resident's physician as being medically or mentally unsuited for care in
15 the facility or as requiring placement in a hospital or residential
16 health care facility and for whom the operator is not making persistent
17 efforts to secure appropriate placement;
18 [(iii)] (C) the failure in systemic practices and procedures which
19 shall be defined as widespread or chronic, and material, noncompliance
20 with statutory or regulatory requirements, including but not limited to
21 the rights of residents under section four hundred sixty-one-d of this
22 article;
23 [(iv)] (D) the failure of the operator to take actions as required by
24 department regulations in the event of a resident's illness or accident;
25 [(v)] (E) the failure of the operator to provide at all times super-
26 vision of residents by numbers of staff at least equivalent to the night
27 staffing requirement set forth in department regulations; or
28 [(vi)] (F) [unreasonable] threats of retaliation or taking reprisals,
29 including but not limited to [unreasonable] threats of eviction or
30 hospitalization, against any resident, employee or other person who
31 makes a complaint concerning the operation of an adult care facility,
32 participates in the investigation of a complaint or is the subject of an
33 action identified in a complaint[.
34 The department shall specify in its regulations those regulations to
35 which this subparagraph two shall apply.
36 (3) In assessing penalties pursuant to this paragraph, the department
37 shall consider promptness of rectification, delay occasioned by the
38 department, and the specific circumstances of the violations as mitigat-
39 ing factors.
40 (c)]; or
41 (ii) resulted in harm to any resident, including but not limited to:
42 (A) physical harm;
43 (B) loss or denial of access to money or other personal property,
44 including but not limited to a violation of section one hundred thirty-
45 one-o of this chapter; or
46 (C) being subjected to (I) conduct by an operator, administrator, case
47 manager, or other employee in a supervisory position that violates the
48 rights of a resident under section four hundred sixty-one-d of this
49 article, or (II) an egregious failure by an operator, administrator,
50 case manager, or other employee in a supervisory position to ensure the
51 rights of a resident under section four hundred sixty-one-d of this
52 article.
53 (d) In assessing penalties pursuant to this paragraph, the department
54 shall consider promptness of rectification, delay occasioned by the
55 department, and the specific circumstances of the violations as mitigat-
56 ing factors.
A. 5485--A 4
1 (e) Upon the request of the department, the attorney general may
2 commence an action in any court of competent jurisdiction against any
3 facility subject to the provisions of this section, and against any
4 person or corporation operating such facility, for the recovery of any
5 penalty assessed by the department in accordance with the provisions of
6 this subdivision.
7 [(d)] (f) Any such penalty assessed by the department may be released
8 or compromised by the department, subject to and consistent with para-
9 graph (c) of this subdivision, before the matter has been referred to
10 the attorney general, and where such matter has been referred to the
11 attorney general, any such penalty may be released or compromised and
12 any action commenced to recover the same may be settled and discontinued
13 by the attorney general, after considering paragraph (c) of this subdi-
14 vision and with the consent of the department.
15 § 3. Paragraphs (a) and (b) of subdivision 9 of section 460-d of the
16 social services law, paragraph (a) as amended by chapter 558 of the laws
17 of 1999 and paragraph (b) as added by chapter 848 of the laws of 1992,
18 are amended to read as follows:
19 (a) The department shall have authority to impose a civil penalty [not
20 exceeding one thousand dollars per day] consistent with section twelve
21 of the public health law against, and to issue an order requiring the
22 closing of, after notice and opportunity to be heard, any facility which
23 does not possess a valid operating certificate issued by the department
24 and is an adult care facility subject to the provisions of this article
25 and the regulations of the department. A hearing shall be conducted in
26 accordance with procedures established by department regulations which
27 procedures shall require that notice of the determination that the
28 facility is an adult care facility and the reasons for such determi-
29 nation and notice of the time and place of the hearing be served in
30 person on the operator, owner or prime lessor, if any, or by certified
31 mail, return receipt requested, addressed to such person and received at
32 least twenty days prior to the date of the hearing. If such operator,
33 owner or prime lessor, if any, is not known to the department, then
34 service may be made by posting a copy thereof in a conspicuous place
35 within the facility or by sending a copy thereof by certified mail,
36 return receipt requested, addressed to the facility. A written answer to
37 the notice of violation may be filed with the department not less than
38 five days prior to the date of the hearing. Demonstration by the facil-
39 ity that it possessed an operating certificate issued pursuant to this
40 article, article twenty-eight of the public health law or article
41 sixteen, [twenty-three,] thirty-one or thirty-two of the mental hygiene
42 law at the time the hearing was commenced shall constitute a complete
43 defense to any charges made pursuant to this subdivision.
44 (b) [The penalty authorized by this section shall begin to run thirty
45 days after the department provides the operator, in writing, with a
46 summary of the inspection of the facility by which the department deter-
47 mined that he or she is operating an uncertified adult care facility.]
48 The submission of an application by the operator for an operating
49 certificate for the facility shall not act as a bar to the imposition of
50 a penalty against the operator of an unlicensed adult care facility.
51 § 4. Paragraph (c) of subdivision 9 of section 460-d of the social
52 services law is amended by adding a new subparagraph (iv) to read as
53 follows:
54 (iv) If the department of health determines, based on a complaint or
55 other facts known to the department, that there is reason to believe
56 that an individual or entity is operating an adult home, enriched hous-
A. 5485--A 5
1 ing program, or residence for adults which does not possess a valid
2 operating certificate issued by the department, and that one or more
3 conditions or activities at such facility constitute or are likely to
4 give rise to an immediate danger to the health of the residents, and
5 awaiting a court order pursuant to subparagraph (iii) of this paragraph
6 would be seriously detrimental to the health of such residents, the
7 department of health may, notwithstanding an objection by the operator,
8 administrator or other person in charge, inspect the entire premises,
9 which shall include access to all dwellings on the said property which
10 house tenants/occupants as well as access to such tenants/occupants, for
11 the purpose of ascertaining whether such danger exists or is likely to
12 arise on an immediate basis. The department of health may request the
13 assistance of local law enforcement for purposes of carrying out such
14 inspection and may take any appropriate action if it determines that
15 such danger exists or is likely to arise, including issuing a written
16 notice directing the operator, administrator or other person in charge
17 of such facility to cease or correct the condition or activity at issue.
18 As promptly as possible thereafter, within a period not to exceed
19 fifteen days, the commissioner shall provide the operator an opportunity
20 to be heard and to present any proof that such condition or activity
21 does not constitute a danger to the health of the residents of such
22 facility. The attorney general, upon request of the department of
23 health, shall be authorized to apply to the supreme court in the county
24 in which the facility is located for an order for any appropriate addi-
25 tional relief.
26 § 5. Subdivision 11 of section 460-d of the social services law, as
27 amended by section 154 of subpart B of part C of chapter 62 of the laws
28 of 2011, is amended to read as follows:
29 11. On or before issuance by the department to an adult care facility
30 operator of official written notice of: the proposed revocation, suspen-
31 sion or denial of the operator's operating certificate; the limitation
32 of the operating certificate with respect to new admissions; the issu-
33 ance of a department order or commissioner's order; the seeking of equi-
34 table relief pursuant to this section; the [proposed] assessment of
35 civil penalties for violations of the provisions of [subparagraph two
36 of] paragraph [(b)] (c) of subdivision seven of this section or place-
37 ment on the "do not refer list" pursuant to subdivision fifteen of this
38 section, written notice also shall be given to the appropriate office of
39 the department of mental hygiene, department of corrections and communi-
40 ty supervision and local social services districts, and provided further
41 that the department of health shall notify hospitals, residential health
42 care facilities and adult care facilities in the locality in which such
43 facility is located that such notice has been issued. Upon resolution of
44 such enforcement action the department shall within ten days notify the
45 appropriate office of the department of mental hygiene, department of
46 corrections and community supervision, local social services districts
47 [and], hospitals, residential health care facilities and adult care
48 facilities.
49 § 6. Subdivision 12 of section 460-d of the social services law, as
50 amended by section 42 of part B of chapter 58 of the laws of 2004, is
51 amended to read as follows:
52 12. [Social] Hospitals, residential health care facilities, adult care
53 facilities, social services districts and other local government enti-
54 ties established pursuant to this chapter shall be prohibited from
55 making referrals for admissions to adult care facilities that have
56 received official written notice regarding: the proposed revocation,
A. 5485--A 6
1 suspension or denial of the operator's operating certificate; the limi-
2 tation of the operating certificate with respect to new admissions; the
3 issuance of department order or commissioner's orders; the seeking of
4 equitable relief pursuant to this section[; the proposed assessment of
5 civil penalties for violations of the provisions of subparagraph two of
6 paragraph (b) of subdivision seven of this section]; or the facility's
7 placement on the "do not refer list" pursuant to subdivision fifteen of
8 this section.
9 § 7. Section 460-d of the social services law is amended by adding a
10 new subdivision 18 to read as follows:
11 18. When the department of health issues official written notice to an
12 operator of a proposed action specified in subdivision eleven of this
13 section, and the department determines that there is a condition which
14 constitutes an imminent danger to the health, safety or welfare of any
15 resident, the department may prohibit that operator from admitting any
16 new resident to the facility until the department determines that there
17 is no longer an imminent danger to the health, safety or welfare of any
18 resident.
19 § 8. Section 461-c of the social services law is amended by adding a
20 new subdivision 10 to read as follows:
21 10. The operator of an adult home or an enriched housing program shall
22 provide to prospective residents who inquire about admission, and shall
23 post on its website, a copy of the facility's approved
24 admission/residency agreement.
25 § 9. The closing paragraph of subdivision 3 of section 461-d of the
26 social services law, as added by chapter 601 of the laws of 1981, is
27 amended to read as follows:
28 Waiver of any provision [contained within] of this subdivision by a
29 resident of an adult care facility or by the resident's legal represen-
30 tative or resident representative, with respect to a resident of an
31 adult home, residence for adults or enriched housing program, shall be
32 void.
33 § 10. Section 461-e of the social services law is amended by adding a
34 new subdivision 3-a to read as follows:
35 3-a. Every adult home and enriched housing program shall:
36 (a) Post in a prominent position in the facility so as to be accessi-
37 ble to all residents and to the general public:
38 (i) a summary of any report of inspection based on a complaint issued
39 by the department of health to the facility within the previous year
40 which resulted in the payment of a fine or penalty by the facility; and
41 (ii) notice of residents' right to review reports under paragraph (b)
42 of this subdivision.
43 (b) Provide to any resident and each applicant for admission an oppor-
44 tunity to review any report of inspection based on a complaint issued by
45 the department of health to the facility within the previous year.
46 (c) Provide to the resident council a summary of any report of
47 inspection based on a complaint issued by the department of health with-
48 in fourteen days of receipt by the facility.
49 § 11. Paragraphs (b) and (c) of subdivision 2 of section 461-a of the
50 social services law, paragraph (b) as amended by chapter 601 of the laws
51 of 1981 and paragraph (c) as amended by chapter 769 of the laws of 2021,
52 are amended to read as follows:
53 (b) [The department or a social services district, where appropriate,
54 shall each year conduct a minimum of one full inspection of each adult
55 care facility. Such inspection] An inspection of an adult care facility
56 under this section shall include, but shall not be limited to, examina-
A. 5485--A 7
1 tion of the medical, dietary and social services records of the facility
2 as well as the minimum standards of construction, life safety standards,
3 quality and adequacy of care, rights of residents, payments and all
4 other areas of operation. The purpose of any inspection shall be to
5 determine compliance with requirements of applicable provisions of law
6 and regulations of the department.
7 (c) (i) An inspection report shall be made of each inspection which
8 shall clearly identify and indicate in detail each area of operation,
9 including, but not limited to, the premises, equipment, personnel, resi-
10 dent care and services, and whether [each] any such area of operation or
11 any of its component parts is [or is] not in compliance with the regu-
12 lations of the department and all other applicable requirements. It also
13 shall identify those areas of operation or any of its component parts
14 found not in compliance as a result of failure in systemic practices and
15 procedures. The operator shall be notified of the results of the
16 inspection in a manner to be determined by regulations of the depart-
17 ment[. Such notification shall contain directions as may be appropriate
18 as to the manner and time in which compliance with applicable require-
19 ments of law or regulations of the department shall be effected] and
20 shall submit a written plan of correction to the department within thir-
21 ty calendar days from the date the inspection report is received. The
22 department shall notify the operator of the acceptability of the plan of
23 correction within thirty calendar days of the department's receipt of
24 such plan.
25 (ii) The department shall also require the operator of an adult home,
26 enriched housing program or residence for adults to develop, [biannual-
27 ly] annually update and implement plans for quality assurance activities
28 for each area of operation. Quality assurance activities include but
29 are not limited to, development and maintenance of performance standards
30 including infection control, measurement of adherence to such standards
31 and to applicable state and local laws and regulations, identification
32 of performance failures, design, and implementation of corrective
33 action. Each plan must also include the creation of a quality improve-
34 ment committee that is charged with meeting periodically, at least once
35 every six months, to review summary findings from monitoring implementa-
36 tion of the facility's plan, evaluating the effectiveness of corrective
37 action policies, and identifying trends and improvement activities.
38 While reviewing facility performance, the committee shall not examine
39 personally identifiable resident incidents. Such committee shall include
40 the administrator or operator of the facility, the resident council
41 president or other resident representative, and representatives from
42 frontline employees from each area of operation.
43 § 12. Subparagraphs (I) and (II) of paragraph 2 of subdivision (i) of
44 section 29.15 of the mental hygiene law, as amended by chapter 168 of
45 the laws of 2010, are amended to read as follows:
46 (I) A patient about to be discharged or conditionally released from a
47 department facility licensed or operated by the office for people with
48 developmental disabilities or from an inpatient facility operated or
49 licensed by the office of [alcoholism and substance abuse] addiction
50 services and supports or the office of mental health to an adult home,
51 enriched housing program or residence for adults, as defined in section
52 two of the social services law, shall be referred only to such home or
53 residence that is consistent with that patient's needs and that operates
54 pursuant to section four hundred sixty of the social services law,
55 provided further that: (A) for a department facility licensed or oper-
56 ated by the office for people with developmental disabilities or for an
A. 5485--A 8
1 inpatient facility operated by the office of [alcoholism and substance
2 abuse] addiction services and supports or the office of mental health,
3 the facility director retains authority to determine whether the home,
4 program or residence is consistent with that patient's needs and (B)
5 such referral shall be made to the patient's home county whenever possi-
6 ble or appropriate.
7 (II) No patient about to be discharged or conditionally released from
8 a department facility licensed or operated by the office for people with
9 developmental disabilities or from an inpatient facility operated or
10 licensed by the office of [alcoholism and substance abuse] addiction
11 services and supports or the office of mental health shall be referred
12 to any adult home, enriched housing program or residence for adults, as
13 defined in section two of the social services law, which has received an
14 official written notice from the department of health of: (A) the
15 proposed revocation, suspension or denial of its operating certificate;
16 (B) the limitation of its operating certificate with respect to new
17 admissions; (C) the issuance of a department of health order or commis-
18 sioner of health's order or the seeking of equitable relief pursuant to
19 section four hundred sixty-d of the social services law; (D) the
20 proposed assessment of civil penalties for violations of the provisions
21 of [subparagraph two of] paragraph [(b)] (c) of subdivision seven of
22 section four hundred sixty-d of the social services law; or placement on
23 the "do not refer list" pursuant to subdivision fifteen of section four
24 hundred sixty-d of the social services law. Referrals may resume when
25 such enforcement actions are resolved.
26 § 13. The commissioner of health shall develop a plan for posting all
27 the plans of correction and statements of deficiencies for all forms of
28 adult care facilities. Such plan shall include an analysis of the fiscal
29 impact and the time required to post such information. Such plan shall
30 be sent to the chairs of the senate and assembly health committees as
31 well as the director of the budget within one hundred days from the
32 effective date of this act.
33 § 14. Severability clause. If any provision of this act, or any appli-
34 cation of any provision of this act, is held to be invalid, or to
35 violate or be inconsistent with any federal law or regulation, that
36 shall not affect the validity or effectiveness of any other provision of
37 this act, which can be given effect without that provision or applica-
38 tion; and to that end, the provisions and applications of this act are
39 severable.
40 § 15. This act shall take effect on the thirtieth day after it shall
41 have become a law.