STATE OF NEW YORK
        ________________________________________________________________________

                                          7742

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                      June 6, 2023
                                       ___________

        Introduced by M. of A. PAULIN -- read once and referred to the Committee
          on Health

        AN ACT to amend the public health law and the insurance law, in relation
          to  promoting  efficient  and  effective  oversight of continuing care
          retirement communities; and to repeal certain provisions of  such  law
          relating thereto

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Section 4602 of the public health law, as added by  chapter
     2  689 of the laws of 1989, the section heading and subdivisions 1 and 2 as
     3  amended  by  chapter  659  of the laws of 1997, the opening paragraph of
     4  subdivision 1 as amended by section 81 of part A of chapter  62  of  the
     5  laws of 2011, the opening paragraph of subdivision 2 as amended by chap-
     6  ter  549 of the laws of 2014, subdivision 3 as amended by chapter 155 of
     7  the laws of 2012, is amended to read as follows:
     8    § 4602. [Continuing care retirement community  council]  Commissioner;
     9  powers and duties.  [1. The continuing care retirement community council
    10  is  hereby established, to consist of the following, or their designees:
    11  the attorney general; the commissioner; the director of the  office  for
    12  the  aging;  and eight public members appointed by the governor with the
    13  advice and consent of the senate. Such public members shall be represen-
    14  tative of the public, and have a demonstrated expertise or  interest  in
    15  continuing  care  retirement communities; provided that no more than one
    16  such member shall be a sponsor, owner, operator, manager,  member  of  a
    17  board  of  directors,  or  shareholder  of  a continuing care retirement
    18  community. At least two public members shall be residents of a  continu-
    19  ing  care retirement community. At least one of the public members shall
    20  be a representative of an organization with demonstrated  experience  in
    21  representing the interests of senior citizens. The public members of the
    22  council  shall  have  fixed  terms  of  four years. The council shall be
    23  chaired by the commissioner or his or her designee.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11682-01-3

        A. 7742                             2

     1    Members of such council shall serve  without  compensation  for  their
     2  services  as  members  of  the  council, except that each of them may be
     3  allowed the necessary and actual expenses which he shall  incur  in  the
     4  performance of his duties under this article.
     5    2.  The  council  shall  meet  as  often as may be deemed necessary to
     6  fulfill its responsibilities.] The [council] commissioner shall have the
     7  following powers and duties:
     8    a. to receive applications from potential operators of continuing care
     9  retirement communities and to distribute such applications for review to
    10  the participating agencies;
    11    b. to develop uniform  forms  for  applications  for  certificates  of
    12  authority,  to review the status of such applications, and to coordinate
    13  the review of such applications in  order  to  minimize  duplication  or
    14  delay;
    15    c.  to provide information to entities wishing to establish continuing
    16  care retirement communities and to persons interested in becoming  resi-
    17  dents  of  such  communities,  to  the extent appropriate, with concerns
    18  relating to the operation of such facilities;
    19    d. to issue certificates of authority to approved applicants;
    20    e. to approve or  reject  applications  to  obtain  a  certificate  of
    21  authority  for  the  establishment  and  operation  of a continuing care
    22  retirement community. In reviewing applications, the  [council]  commis-
    23  sioner shall consider the extent to which the applications reflect vari-
    24  ous  sponsorships, organizational structures, geographic dispersion, and
    25  the public benefit. In determining the public  benefit  of  a  community
    26  requiring  construction  of  a  total nursing facility component greater
    27  than or equal to ninety beds, the [council]  commissioner  shall  obtain
    28  and  consider  the  recommendation of the [state hospital review] public
    29  health and health planning council with regard  to  the  effect  of  the
    30  construction  of  the  community's  nursing  facility beds upon existing
    31  facilities in the same geographic area;
    32    [b.] f. to require the reporting of such facts and information as  the
    33  [council]  commissioner  may deem necessary to enforce the provisions of
    34  this article;
    35    [c.] g. to coordinate the oversight of operating  communities  and  to
    36  assign  review  and  regulatory responsibility for particular aspects of
    37  such communities to the  appropriate  agencies,  consistent  with  their
    38  legal  authority,  to assure consistent state supervision without dupli-
    39  cation of inspection or regulatory review;
    40    [d.] h. to make such recommendations to the governor and the  legisla-
    41  ture  as  may be necessary to encourage or further regulate the develop-
    42  ment of continuing care retirement communities;
    43    [e.] i. to establish and charge equitable and reasonable annual charg-
    44  es for operators, not to exceed fifty dollars per approved living  unit,
    45  to  subsidize,  in part, expenditures incurred in reviewing applications
    46  for certificates of authority and in inspecting, regulating, supervising
    47  and auditing continuing care retirement communities;
    48    [f. to review reports from the participating  agencies  regarding  the
    49  operations  and  financial management of approved communities, including
    50  any reports regarding the financial condition of any community that  may
    51  be  in  need of close supervision and any reports of deficiencies in the
    52  provision of health or social services to residents of any community;
    53    g.] j. to adopt rules and regulations and amendments thereto to effec-
    54  tuate the provisions of this article;
    55    [h.] k. to revoke, suspend, limit, or annul a certificate of authority
    56  under conditions set forth in section forty-six hundred fifteen of  this

        A. 7742                             3

     1  article,  including when such action is taken at the specific request of
     2  any participating council agency. [When action has  been  taken  by  the
     3  commissioner  pursuant to subdivision seven of section forty-six hundred
     4  three  of  this  article,  the  council shall meet as soon as reasonably
     5  possible to approve or disapprove the action  of  the  commissioner  and
     6  shall take such further action as may be appropriate;
     7    i. to develop guidelines for applications for certificates of authori-
     8  ty;
     9    j.]  l.  to  carry  out  any  other  responsibilities entrusted to the
    10  commissioner pursuant to this chapter that may be necessary with  regard
    11  to the health care activities of continuing care retirement communities;
    12    m.  to make available to all prospective operators all pertinent regu-
    13  lations regarding health and insurance necessary  to  comply  with  this
    14  article;
    15    n. to [make a final determination regarding an application] approve or
    16  reject  applications  for  authorization  by prospective continuing care
    17  retirement community applicants, entities that have filed an application
    18  for a certificate of authority and operators, to enter into  cancellable
    19  priority  reservation agreements [where the commissioner has proposed to
    20  reject such application] and to collect refundable priority  reservation
    21  fees from prospective residents;
    22    [k.]  o. to require the reporting of such facts and information as the
    23  [council] commissioner may deem necessary to determine  whether  charac-
    24  teristics  of  residential  health care demonstration facilities such as
    25  comprehensive systems of residential and support services for the elder-
    26  ly may be successfully incorporated into existing or approved continuing
    27  care retirement communities;
    28    [l.] p. to review and approve or  reject  applications  by  continuing
    29  care  retirement  community operators to use entrance fees to assist the
    30  operator in financing the construction or purchase of a proposed contin-
    31  uing care retirement community in accordance with paragraph b of  subdi-
    32  vision six of section forty-six hundred ten of this article; and
    33    [m.]  q.  to  review  and  approve or reject any proposed financing by
    34  industrial development agencies of continuing care  retirement  communi-
    35  ties  pursuant  to  article  eighteen-A  of the general municipal law as
    36  authorized by section forty-six hundred four-a of this article.
    37    [3. The council shall establish guidelines under which the commission-
    38  er is authorized to approve or reject any proposed refinancing,  if  the
    39  council  has  already approved an application pursuant to paragraph a of
    40  subdivision two of this section.]
    41    § 2. Section 4603 of the public health  law  is  REPEALED  and  a  new
    42  section 4603 is added to read as follows:
    43    §  4603.  Continuing  care  retirement  community  council; powers and
    44  duties. 1. The continuing care retirement community  council  is  hereby
    45  established, to consist of the following, or their designees: the attor-
    46  ney general; the commissioner; the director of the office for the aging;
    47  and  eight  public members appointed by the governor with the advice and
    48  consent of the senate. Such public members shall  be  representative  of
    49  the  public, and have a demonstrated expertise or interest in continuing
    50  care retirement communities; provided that no more than one such  member
    51  shall  be  a  sponsor,  owner,  operator,  manager, member of a board of
    52  directors, or shareholder of a continuing care retirement community.  At
    53  least two public members shall be residents of a continuing care retire-
    54  ment  community. At least one of the public members shall be a represen-
    55  tative of an organization with demonstrated experience  in  representing
    56  the  interests  of  senior  citizens.  The public members of the council

        A. 7742                             4

     1  shall have fixed terms of four years. The council shall  be  chaired  by
     2  the commissioner or his or her designee.
     3    Members  of  such  council  shall serve without compensation for their
     4  services as members of the council, except that  each  of  them  may  be
     5  allowed the necessary and actual expenses which he or she shall incur in
     6  the performance of his/her or their duties under this article.
     7    2.  The  council  shall  meet  as  often as may be deemed necessary to
     8  fulfill its responsibilities.  The  council  shall  have  the  following
     9  powers and duties:
    10    a.  to assist the commissioner on policy matters related to the estab-
    11  lishment and operation of continuing care retirement communities;
    12    b. to assist the commissioner in the development of the state's  over-
    13  all  policy  regarding  continuing care retirement communities and cause
    14  studies and research to be conducted as it may deem advisable and neces-
    15  sary; and
    16    c. to make such recommendations to the governor and the legislature as
    17  may be necessary to encourage or further  regulate  the  development  of
    18  continuing care retirement communities.
    19    §  3.  Subdivision  4  of  section  4604  of the public health law, as
    20  amended by chapter 659 of the laws of 1997, subparagraphs (i), (ii)  and
    21  (iii)  of  paragraph  a  as  further amended by section 104 of part A of
    22  chapter 62 of the laws of 2011, paragraphs b and d as amended by chapter
    23  549 of the laws of 2014, and paragraph c as amended by chapter 7 of  the
    24  laws of 2015, is amended to read as follows:
    25    4. No certificate of authority shall be issued unless the commissioner
    26  has approved an application meeting the requirements of this section and
    27  all other requirements established by law [has been approved by] includ-
    28  ing:
    29    a. [(i)] the [superintendent of financial services as to the] actuari-
    30  al  principles  involved, the financial feasibility of the facility, the
    31  form and content of the proposed contracts to be entered into with resi-
    32  dents and insurance contracts between an operator and an insurer requir-
    33  ing the insurer to assume, wholly or in part, the  cost  of  medical  or
    34  health  related services to be provided to a resident, provided that the
    35  review may be conducted by the commissioner  or  his  or  her  designee,
    36  including any necessary independent actuarial review;
    37    [(ii) the superintendent of financial services as to] b. the rates and
    38  rating  methodology, if any, to be used by the operator to determine any
    39  entrance fee, monthly care fee and/or any separate charges for the hous-
    40  ing component of the continuing care contract including but not  limited
    41  to  a cooperative or condominium fee charged to the resident as proposed
    42  in said operator's application for certificate of authority.  Subsequent
    43  increases in any entrance or monthly care fee in excess of  fees  calcu-
    44  lated pursuant to the approved rating methodology shall require approval
    45  of  the [superintendent] commissioner.  The term "rating methodology" as
    46  used herein shall incorporate a combination of variables  including  but
    47  not  limited  to  a pricing structure for comparable services, projected
    48  operating and health care costs and the applicable  inflationary  impact
    49  thereon,  projected  income  and  occupancy  rates and the refundability
    50  component of the continuing care retirement contract[.
    51    (iii) the superintendent of financial services as to];
    52    c. any monthly care fee charged to a resident which may  be  increased
    53  or  decreased  subject  to  approval by the [superintendent of financial
    54  services]  commissioner,  provided,  that  monthly  care  fees  may   be
    55  increased  or  decreased  without  specific  approval  as  long  as such
    56  increase or decrease does not exceed a relevant cost  index  or  indices

        A. 7742                             5

     1  which  reflect  all  components  of  continuing care including the costs
     2  associated with provision of health care as determined  and  promulgated
     3  at  least  annually  by  the [superintendent] commissioner or his or her
     4  designee,  including  any  necessary  independent  actuarial review, and
     5  provided further that the [superintendent] commissioner is  notified  of
     6  any such increase or decrease prior to its taking effect[.
     7    (iv) An];
     8    d.  the  requirement  that  an  individual resident's monthly care fee
     9  shall not be modified because of the increased need for services of that
    10  resident;
    11    [b. the commissioner as to those] e. aspects of the application relat-
    12  ing to adult care facility beds, if any;
    13    [c.] f. review by the public health and health planning council as  to
    14  the  establishment of a skilled nursing facility by the applicant and as
    15  to such other facilities and services as may require the  public  health
    16  and  health  planning  council's  approval of the application; provided,
    17  however, that the recommendations of the health  systems  agency  having
    18  geographical  jurisdiction of the area where the continuing care retire-
    19  ment community is located shall not be  required  with  respect  to  the
    20  establishment of an on-site or affiliated residential health care facil-
    21  ity  to serve residents as part of the continuing care retirement commu-
    22  nity, for up to the total number of  residential  health  care  facility
    23  beds  provided  for  in  subdivision five of this section in communities
    24  statewide;
    25    [d. the commissioner under section twenty-eight hundred  two  of  this
    26  chapter;]  provided, [however] further, that, the recommendations of the
    27  public health and health planning council and the health systems  agency
    28  having  geographical  jurisdiction of the area where the continuing care
    29  retirement community is located shall not be required  with  respect  to
    30  the  construction  of  an  on-site or affiliated residential health care
    31  facility to serve residents as part of the  continuing  care  retirement
    32  community, for up to the total number of residential health care facili-
    33  ty  beds provided for in subdivision five of this section in communities
    34  statewide; and
    35    [e. the] g. upon consultation with the attorney general, as  to  those
    36  aspects  of  the  application  relating to a cooperative, condominium or
    37  other equity arrangement for the independent living unit, if any.
    38    § 4. The opening paragraph of subdivision 6 of  section  4604  of  the
    39  public  health  law,  as  amended by chapter 659 of the laws of 1997, is
    40  amended to read as follows:
    41    If the [approvals] applicant has satisfied the  criteria  required  by
    42  subdivision  four  of  this  section [have been obtained], the [council]
    43  commissioner shall[, by majority vote,] either  approve  or  reject  the
    44  application  [within  sixty  days  of  the  date  on which the last such
    45  approval has been obtained]. In order to approve  the  application,  the
    46  [council] commissioner shall have determined that:
    47    §  5.  Subdivisions  7 and 9 of section 4604 of the public health law,
    48  subdivision 7 as amended by chapter 659 of the laws of 1997 and subdivi-
    49  sion 9 as added by chapter 689 of the laws of 1989, are amended to  read
    50  as follows:
    51    7.  Any  change  in  the  legal  entity  operating the continuing care
    52  retirement community, or in a controlling person of the community  shall
    53  require  approval  in  the  same  manner  as  an  original  application;
    54  provided,  however,  that  the  [council]  commissioner  may  waive  any
    55  requirement  to  provide information that is not relevant to such change

        A. 7742                             6

     1  and provided, further, that the continued public need for the  community
     2  shall be presumed.
     3    9.  [If  the  council  approves the application, the] The commissioner
     4  shall issue the certificate of authority to the applicant upon  approval
     5  of the application.
     6    §  6.  Section  4604-a of the public health law, as amended by chapter
     7  659 of the laws of 1997, paragraph g of  subdivision  2  as  amended  by
     8  chapter 549 of the laws of 2014, is amended to read as follows:
     9    §  4604-a.  [Council]  Commissioner  approval  required for industrial
    10  development agency financing in connection with continuing care  retire-
    11  ment  communities.  1.  No person seeking financing in connection with a
    12  continuing care retirement community through an  industrial  development
    13  agency  shall undertake such financing without the prior approval of the
    14  [council] commissioner. Upon approving a proposed financing pursuant  to
    15  this  section,  the  [council] commissioner shall issue a certificate of
    16  authorization to the applicant.
    17    2. Prior to approving such financing, the [council] commissioner shall
    18  find that:
    19    a. The operator has  (i)  executed  contracts  for  at  least  seventy
    20  percent  of  all living units and has on deposit at least ten percent of
    21  the entrance fees or purchase price for such  units;  or  (ii)  executed
    22  contracts  for  at  least  sixty  percent of all living units and has on
    23  deposit at least twenty-five percent of the entrance  fees  or  purchase
    24  price for such units.
    25    b.  The  operator has demonstrated capability to comply fully with the
    26  requirements for a certificate of authority and has obtained  a  contin-
    27  gent certificate of authority pursuant to section forty-six hundred four
    28  of  this article and the operator has agreed to meet the requirements of
    29  article eighteen-A of the general municipal law.
    30    c. The applicant is a not-for-profit corporation as defined in section
    31  one hundred two of the not-for-profit corporation law that is (i) eligi-
    32  ble for tax-exempt financing under this section and (ii) is exempt  from
    33  taxation  pursuant  to section 501(c)(3) of the federal internal revenue
    34  code, and either has (i) an equity position in the community  equivalent
    35  to  no  less  than  fifteen  percent of the amount to be financed in the
    36  aggregate; or (ii) covenants (A) to meet a ratio of cash and investments
    37  to outstanding debt (reserve ratio) of no less than twenty-five  percent
    38  commencing at the end of the first quarter after twenty-four months from
    39  the  receipt  of a certificate of occupancy for the facility, and (B) to
    40  maintain that reserve ratio, as tested quarterly based upon the  facili-
    41  ty's interim financial statements and annually based upon audited finan-
    42  cial  statements,  until  debt reduction equal to twenty-five percent of
    43  total indebtedness is accomplished; and (c)  to  reduce  total  debt  by
    44  twenty-five  percent  of  the total indebtedness at the time the certif-
    45  icate of occupancy is received by no later than  five  years  after  the
    46  receipt of the certificate of occupancy.
    47    d.  The operator has submitted in connection with the proposed financ-
    48  ing a financial feasibility study, including a  financial  forecast  and
    49  market  study  prepared by an independent firm nationally recognized for
    50  continuing care retirement community feasibility studies,  demonstrating
    51  to  the  satisfaction of the [council] commissioner the financial sound-
    52  ness of the financing. In addition, the operator has submitted an analy-
    53  sis  of  economic  costs  and  benefits,  including  job  creation   and
    54  retention, the estimated value of tax exemptions provided, the project's
    55  impact  on local businesses and the availability and comparative cost of

        A. 7742                             7

     1  alternative financing sources. Such analysis shall  be  prepared  by  an
     2  independent entity.
     3    e.  The  operator  will  establish  and  maintain  a fully funded debt
     4  service reserve equal to the sum of maximum annual debt service  (inter-
     5  est  plus  annual  scheduled  principal  payments, not including balloon
     6  maturities, if any) on bonds authorized thereby having a maturity of ten
     7  years or less, plus the maximum annual debt service on bonds  authorized
     8  thereby  having a maturity of greater than ten years, provided, however,
     9  that in the case of tax-exempt bond issues, such  debt  service  reserve
    10  shall not exceed the maximum amount permitted by federal tax law.
    11    f. The operator will provide for such remedies or limitations of reme-
    12  dies  of  bondholders  as  may  be  required  by  or consistent with the
    13  provisions of this article and any regulations in existence at the  time
    14  of the issuance promulgated thereunder.
    15    g.  Unless  all  residents or continuing care at home contract holders
    16  have life care contracts, the operator has adequately  made  the  assur-
    17  ances  required  by subdivision two of section forty-six hundred twenty-
    18  four of this article and has agreed to fund the liability in  the  event
    19  that such resident's or contract holder's assets are insufficient to pay
    20  for nursing facility services for a one year period.
    21    3. In addition, an operator which is subject to the provisions of this
    22  section shall:
    23    a.  provide  the [council or its designee] commissioner with notice of
    24  any monetary default or covenant default in connection with such financ-
    25  ing and shall further notify the [council or its designee]  commissioner
    26  of  any  withdrawal  from  the  debt service reserve fund established in
    27  connection with such financing;
    28    b. respond in writing to the operational recommendations of the [coun-
    29  cil or its designee] commissioner with respect to protecting the  inter-
    30  ests  of  continuing care retirement community residents in the event of
    31  any monetary default or covenant default provided for in connection with
    32  such financing;
    33    c. provide adequate security for the repayment of  the  bonds  issued,
    34  including  the  granting  of liens on real and personal property and the
    35  pledge of project revenues; the  maintenance  of  minimum  debt  service
    36  coverage  and other financial ratios as shall be required in regulations
    37  in existence at the time of issuance by the [council] commissioner;  and
    38  restrictions on other debt and expenditures; and
    39    d.  undertake  to  maintain the financial feasibility of the facility,
    40  including the retention of an independent consultant  to  recommend  and
    41  help implement remedial action.
    42    4.  The  [council]  commissioner  may  request, and shall receive, the
    43  technical assistance of any state agency or state  public  authority  in
    44  performing its functions under this article.
    45    § 7. Section 4605-a of the public health law, as added by chapter 7 of
    46  the laws of 2015, is amended to read as follows:
    47    § 4605-a. Certificate of authority; authority to offer continuing care
    48  at  home  contracts.    A continuing care retirement community may offer
    49  continuing care at home contracts upon approval by the [council] commis-
    50  sioner to amend the continuing care retirement  community's  certificate
    51  of authority. In order to qualify for an amendment to its certificate of
    52  authority,  the continuing care retirement community shall submit to the
    53  commissioner the following:
    54    1. a business plan  to  the  commissioner  [and  superintendent]  that
    55  includes the following:

        A. 7742                             8

     1    (a) a description of the continuing care at home services that will be
     2  provided,  the market that will be served by the continuing care at home
     3  contracts, and the fees to be charged to prospective continuing care  at
     4  home contract holders;
     5    (b) a copy of the proposed continuing care at home contract; and
     6    (c)  an  actuarial study prepared by an independent actuary in accord-
     7  ance with standards adopted by the American Academy of Actuaries  demon-
     8  strating the impact that the continuing care at home contracts will have
     9  on  the  overall  operations of the continuing care retirement community
    10  and further demonstrating that the addition of continuing care  at  home
    11  contracts  will  not jeopardize the financial solvency of the continuing
    12  care retirement community.
    13    2. a market feasibility study demonstrating to the  commissioner  [and
    14  superintendent]  sufficient consumer interest in continuing care at home
    15  contracts and further demonstrating that the addition of continuing care
    16  at home contracts will not have an adverse impact on  the  provision  of
    17  services to continuing care retirement contract holders.
    18    3.  materials  that meet all requirements established by the [New York
    19  state] department [of financial services].
    20    4. [A] a copy of the notification sent to continuing  care  retirement
    21  contract  holders  describing  the anticipated impact of the addition of
    22  continuing care at home contracts on continuing care retirement communi-
    23  ty resources and proof that such notification has  been  distributed  to
    24  all continuing care retirement contract holders.
    25    § 8. Section 4605-b of the public health law, as added by chapter 7 of
    26  the laws of 2015, is amended to read as follows:
    27    §  4605-b.  Certificate of authority; limitation on continuing care at
    28  home contracts.   The  number  of  continuing  care  at  home  contracts
    29  approved on a certificate of authority shall be limited to:
    30    1.  The number of approved living units on the continuing care retire-
    31  ment community's premises that are intended for  ILU  residents,  except
    32  that  the [council] commissioner may approve additional contracts upon a
    33  submission [to the commissioner] by  an  operator  consistent  with  the
    34  provisions  set  forth in section forty-six hundred five-a of this arti-
    35  cle;
    36    2. The demonstrated number of continuing care at home contract holders
    37  that can be supported in the existing or approved future capacity of the
    38  adult care facility and skilled nursing  facility  consistent  with  the
    39  provisions  set  forth in section forty-six hundred five-a of this arti-
    40  cle; and
    41    3. Conditions set forth by the [New York state] department [of  finan-
    42  cial  services],  based upon the [superintendent] commissioner's assess-
    43  ment of the following:
    44    (a) the overall financial impact on the community; and
    45    (b) the submitted materials set forth  in  section  forty-six  hundred
    46  five-a of this article.
    47    § 9. Section 4607 of the public health law, as added by chapter 689 of
    48  the laws of 1989, paragraph d of subdivision 2 as amended by chapter 659
    49  of the laws of 1997, is amended to read as follows:
    50    § 4607. Annual statement.  1. Within four months of close of the oper-
    51  ator's  fiscal year, unless an extension of time to file has been grant-
    52  ed, the operator shall file an annual statement  with  the  commissioner
    53  [and  superintendent]  showing  the  condition as of the last day of the
    54  preceding calendar or fiscal year. If the commissioner [and  superinten-
    55  dent do] does not receive the annual statement within four months of the

        A. 7742                             9

     1  end  of  the  operator's fiscal year or have not granted an extension of
     2  time to file, the [council] commissioner may charge a late fee.
     3    2. The annual statement shall be in such form as the [council] commis-
     4  sioner prescribes and shall contain at least the following:
     5    a. Any change in status with respect to the information required to be
     6  submitted pursuant to section forty-six hundred four of this article;
     7    b.  Financial  statements  audited  by an independent certified public
     8  accountant, which shall contain, for two or more periods if the communi-
     9  ty has been in existence that long, the following:
    10    (i) an accountant's opinion and, in accordance with generally accepted
    11  accounting principles:
    12    (A) a balance sheet,
    13    (B) a statement of income and expenses,
    14    (C) a statement of equity or fund balances,
    15    (D) a statement of changes in financial position,
    16    (ii) notes to the financial statements considered customary or  neces-
    17  sary  to  ensure  full disclosure of the financial statements, financial
    18  condition, and operation;
    19    c. A detailed listing of the assets maintained for the reserves;
    20    d. A copy of the  most  recent  actuarial  review  of  the  community,
    21  including  such  information  as may be required by the [superintendent]
    22  commissioner including an opinion of a qualified consulting actuary,  as
    23  to the current and projected soundness of the community, provided howev-
    24  er that a new actuarial review must be submitted triennially; and
    25    e. Such other reasonable financial and other information as the [coun-
    26  cil] commissioner may require with respect to the operator or the commu-
    27  nity,  or its directors, controlling persons, trustees, members, branch-
    28  es, subsidiaries or affiliates to determine the financial status of  the
    29  community and the management capabilities of the operator.
    30    3.  Sixty  days before commencement of each calendar or fiscal year or
    31  official opening date, whichever is applicable, each operator shall file
    32  with the commissioner [and superintendent] a computation of  the  annual
    33  long-term debt service and a projected annual revenue and expense summa-
    34  ry for the next ten years.
    35    §  10.  Section 4658 of the public health law, as added by chapter 519
    36  of the laws of 2004, is amended to read as follows:
    37    § 4658. Annual statement. 1. Within four months of close of an  opera-
    38  tor's fiscal year, unless an extension of time to file has been granted,
    39  the  operator shall file an annual statement with the commissioner show-
    40  ing the condition as of the last day of the preceding calendar or fiscal
    41  year. If the commissioner does not receive the annual  statement  within
    42  four  months of the end of the operator's fiscal year or has not granted
    43  an extension of time to file, the council may charge a late fee.
    44    2. The annual statement shall be in such form as the [council] commis-
    45  sioner prescribes and shall contain at least the following:
    46    a. Any change in status with respect to the information required to be
    47  submitted pursuant to section  forty-six  hundred  fifty-seven  of  this
    48  article;
    49    b.  Financial  statements  audited  by an independent certified public
    50  accountant, which shall contain, for two or more periods if the communi-
    51  ty has been in existence that long, the following:
    52    (i) notes to the financial statements considered customary  or  neces-
    53  sary  to  ensure  full disclosure of the financial statements, financial
    54  condition, and operation; and
    55    (ii)  an  accountant's  opinion  and,  in  accordance  with  generally
    56  accepted  accounting principles: (A) a balance sheet, (B) a statement of

        A. 7742                            10

     1  income and expenses, (C) a statement of equity or fund balances, and (D)
     2  a statement of changes in financial position;
     3    c. A detailed listing of the assets maintained for the reserves; and
     4    d. Such other reasonable financial and other information as the [coun-
     5  cil] commissioner may require with respect to the operator or the commu-
     6  nity,  or its directors, controlling persons, trustees, members, branch-
     7  es, subsidiaries or affiliates to determine the financial status of  the
     8  community and the management capabilities of the operator.
     9    3.  Sixty  days before commencement of each calendar or fiscal year or
    10  official opening date, whichever is applicable, each operator shall file
    11  with the commissioner a computation of the annual long-term debt service
    12  and a projected annual revenue and expense  summary  for  the  next  ten
    13  years.
    14    §  11.  Subdivision  16  of  section 4608 of the public health law, as
    15  amended by chapter 7 of the laws of 2015, is amended to read as follows:
    16    16. A statement that any amendment to the contract and any  change  in
    17  fees  or  charges, other than those within the guidelines of an approved
    18  rating system, must be approved  by  the  [superintendent  of  financial
    19  services] commissioner;
    20    §  12.  Subdivisions 1 and 2 of section 4614 of the public health law,
    21  as amended by chapter 7 of the laws of 2015,  are  amended  to  read  as
    22  follows:
    23    1.  The  commissioner, or designee[; and the superintendent, or desig-
    24  nee;] may at any time, and shall at least once every three years,  visit
    25  each  community  and examine the business of any applicant for a certif-
    26  icate of authority and any operator engaged in the execution of continu-
    27  ing care retirement contracts or continuing care at  home  contracts  or
    28  engaged  in the performance of obligations under such contracts. Routine
    29  examinations may be conducted by  having  documents  designated  by  and
    30  submitted  to such [commissioners or superintendent] commissioner, which
    31  shall include financial documents and  records  conforming  to  commonly
    32  accepted  accounting  principles and practices. The final written report
    33  of each such examination conducted by such [commissioners or superinten-
    34  dent] commissioner shall be filed with the  commissioner  and,  when  so
    35  filed,  shall constitute a public record. A copy of each report shall be
    36  provided to members of the continuing care retirement community council.
    37  Any operator being examined shall, upon  request,  give  reasonable  and
    38  timely  access  to  all  of  its records. The representative or examiner
    39  designated  by  the  [commissioners  or  superintendent,  respectively,]
    40  commissioner  may,  at  any  time,  examine  the records and affairs and
    41  inspect the community's facilities, whether in connection with a  formal
    42  examination or not.
    43    2.  Any  duly  authorized  officer, employee, or agent of the [health]
    44  department[, or department of financial services] may, upon presentation
    45  of proper identification, have access to, and inspect, any records main-
    46  tained by the community relevant to the [respective] agency's regulatory
    47  authority, with or without advance notice, to secure compliance with, or
    48  to prevent a violation of, any provision of this article.
    49    § 13. Section 4615 of the public health law, as added by  chapter  689
    50  of  the laws of 1989, paragraph j of subdivision 1 as further amended by
    51  section 104 of part A of chapter 62 of the laws of 2011, paragraph k  of
    52  subdivision  1  as amended by chapter 7 of the laws of 2015 and subdivi-
    53  sion 3 as amended by chapter 659 of the laws of 1997, is amended to read
    54  as follows:

        A. 7742                            11

     1    § 4615. Revocation, suspension or annulment of certificate of authori-
     2  ty. 1. The [council] commissioner may revoke, suspend,  limit  or  annul
     3  the certificate of authority of an operator upon proof that:
     4    a.  The  operator  failed to continue to meet the requirements for the
     5  authority originally granted;
     6    b. The operator lacked one or  more  of  the  qualifications  for  the
     7  certificate of authority as specified by this article;
     8    c.  The  operator  made a material misstatement, misrepresentation, or
     9  committed fraud  in  obtaining  the  certificate  of  authority,  or  in
    10  attempting to obtain the same;
    11    d. The operator lacked fitness or was untrustworthy;
    12    e.  The  operator  engaged  in  fraudulent  or  dishonest practices of
    13  management in the conduct of business under the certificate of  authori-
    14  ty;
    15    f. The operator converted or withheld funds;
    16    g.  The operator failed to comply with, or violated, any proper order,
    17  rule or regulation of the council or  violated  any  provision  of  this
    18  article;
    19    h.  The unsound business practices of the operator renders its further
    20  transactions in this state hazardous or injurious to the public;
    21    i. The operator has refused to be examined or to produce its accounts,
    22  records, and files for  examination,  or  its  officers,  employees,  or
    23  controlling persons have refused to give information with respect to the
    24  affairs  of the community or to perform any other legal obligation as to
    25  such examination;
    26    j. The [superintendent of financial services] commissioner has made  a
    27  determination  that  the  operator  is  insolvent  within the meaning of
    28  section one thousand three hundred nine of the insurance law; or
    29    k. The commissioner has found violations of applicable statutes, rules
    30  or regulations which threaten to affect directly the health, safety,  or
    31  welfare of a resident.
    32    2. No certificate of authority shall be revoked, suspended, limited or
    33  annulled  without  a hearing, except that a certificate of authority may
    34  be temporarily suspended or limited prior to a hearing for a period  not
    35  in  excess of sixty days upon written notice to the operator following a
    36  finding by the commissioner that the public health or safety is in immi-
    37  nent danger or there exists any condition or practice  or  a  continuing
    38  pattern  of  conditions or practices that pose an imminent danger to the
    39  health or safety of any resident. Any delay in the hearing process occa-
    40  sioned by the operator shall toll the  running  of  said  suspension  or
    41  limitation and shall not abridge the full time provided in this subdivi-
    42  sion.
    43    3. Any state agency which seeks to revoke, suspend, limit or annul the
    44  certificate of authority or any other license or certificate required to
    45  be  obtained  by  an  operator of a continuing care retirement community
    46  pursuant to law, shall request the [council] commissioner to commence  a
    47  hearing pursuant to this section.
    48    4. The [council] commissioner shall fix a time and place for the hear-
    49  ing.  The  commissioner  shall cause to be served in person or mailed by
    50  registered or certified mail to the operator at least  ten  days  before
    51  the  date fixed for the hearing a copy of the charges, together with the
    52  notice of the time and place of the hearing.  The  operator  shall  file
    53  with  the  commissioner  not less than three days prior to the hearing a
    54  written answer to the charges. The agency which initiated the proceeding
    55  shall be responsible for providing evidence in support of the charges to

        A. 7742                            12

     1  the commissioner in order to prepare a statement of  charges  and  shall
     2  provide evidence in support of the charges at the hearing.
     3    5.  All  orders  hereunder  shall  be subject to review as provided in
     4  article seventy-eight of the civil practice law and  rules.  Application
     5  for  such  review must be made within sixty days after service in person
     6  or by registered or certified mail of a copy of the order upon the oper-
     7  ator.
     8    § 14. Section 4616 of the public health law, as added by  chapter  689
     9  of  the laws of 1989, the opening paragraph as amended by chapter 659 of
    10  the laws of 1997, is amended to read as follows:
    11    § 4616. Appointment of a caretaker. Upon a determination by the [coun-
    12  cil] commissioner  that  there  exists  operational  deficiencies  in  a
    13  continuing care retirement community that show:
    14    1. a condition or conditions in substantial violation of the standards
    15  for  health,  safety  or patient care established under federal or state
    16  law or regulations; or
    17    2. [or] that there exists in the facility a  pattern  or  practice  of
    18  habitual  violation  of  the standards of health, safety or patient care
    19  established under federal or state law  or  regulations,  the  [council]
    20  commissioner  shall  take  the  actions  prescribed by section forty-six
    21  hundred fifteen of this article, and, where the  [council]  commissioner
    22  deems it to be in the public interest, the [council may request that the
    23  commissioner, and upon request of the council the] commissioner shall[,]
    24  petition  a  court  of  competent jurisdiction to appoint a caretaker as
    25  defined in section twenty-eight hundred one of this chapter.  The  peti-
    26  tion, the proceedings, and the procedures for appointment of a caretaker
    27  shall  be governed by the provisions of section forty-six hundred seven-
    28  teen of this article, and the powers, duties and rights of  a  caretaker
    29  appointed pursuant to such section shall be the same as those authorized
    30  by subdivision four of such section.
    31    §  15.  Subdivisions  1,  2 and 8 of section 4617 of the public health
    32  law, subdivision 1 as amended by chapter 659 of the laws  of  1997,  and
    33  subdivisions  2  and  8 as added by chapter 689 of the laws of 1989, are
    34  amended to read as follows:
    35    1. The [council] commissioner may, [if it determines] upon a  determi-
    36  nation  that serious operational deficiencies exist or serious financial
    37  problems exist and such action is desirable,  enter  into  an  agreement
    38  with  the  operator  or owners of a continuing care retirement community
    39  with respect to the appointment of a receiver  to  take  charge  of  the
    40  community  under conditions as found acceptable by both parties. Receiv-
    41  ership commenced in accordance with the provisions of  this  subdivision
    42  shall  terminate  at  such  time  as may be provided in the receivership
    43  agreement, or at such time as either party notifies the other in writing
    44  that it wishes to terminate such receivership.
    45    2. [Upon request of the council, the] The commissioner shall,  at  the
    46  time  of revocation, suspension or temporary suspension of a certificate
    47  of authority, apply to the supreme court where the community is situated
    48  for an order directing the owner of the land and/or structure on  or  in
    49  which  the community is located, to show cause why a receiver should not
    50  be appointed to take charge of the community.  In those cases where  the
    51  certificate  of  authority  has  been  revoked, suspended or temporarily
    52  suspended, the supreme  court  shall  appoint  a  receiver  that,  where
    53  reasonably possible, is a legal entity that holds a valid certificate of
    54  authority.  Such  application  shall contain proof by affidavit that the
    55  facility has had its certificate of  authority  revoked,  suspended,  or
    56  temporarily  suspended. Such order to show cause shall be returnable not

        A. 7742                            13

     1  less than five days after service is completed  and  shall  provide  for
     2  personal  service of a copy thereof and the papers on which it is based,
     3  on the owner or owners of the land and/or structures on or in which  the
     4  community  is  located.  If  any  such owner and manager cannot with due
     5  diligence be served personally within the county where the  property  is
     6  located  and  within  the  time fixed in such order, then service may be
     7  made on such person by posting a copy thereof  in  a  conspicuous  place
     8  within  the  community  in  question,  and  by sending a copy thereof by
     9  registered mail, return receipt requested, to such  owner  at  the  last
    10  address  registered by him with the department or in the absence of such
    11  registration to the address set forth in the  last  recorded  deed  with
    12  respect  to  the  facility.  Service  shall be deemed complete on filing
    13  proof of service thereof in the office of the county clerk, or the clerk
    14  of the city of New York, as the case may be.
    15    8. Any other provision of this article notwithstanding, the  [council]
    16  commissioner  may,  if  [it]  he  or she deems appropriate, grant to any
    17  community operating or scheduled to operate under a receivership author-
    18  ized by this section a certificate of authority, the duration  of  which
    19  shall be limited to the duration of the receivership.
    20    §  16.  Section 4668 of the public health law, as added by chapter 519
    21  of the laws of 2004, is amended to read as follows:
    22    § 4668. Revocation, suspension or annulment of certificate of authori-
    23  ty. 1. The [council] commissioner may revoke, suspend,  limit  or  annul
    24  the certificate of authority of an operator upon proof that:
    25    a.  The  operator  failed to continue to meet the requirements for the
    26  authority originally granted;
    27    b. The operator lacked one or  more  of  the  qualifications  for  the
    28  certificate of authority as specified by this article;
    29    c.  The  operator  made a material misstatement, misrepresentation, or
    30  committed fraud  in  obtaining  the  certificate  of  authority,  or  in
    31  attempting to obtain the same;
    32    d. The operator lacked fitness or was untrustworthy;
    33    e.  The  operator  engaged  in  fraudulent  or  dishonest practices of
    34  management in the conduct of business under the certificate of  authori-
    35  ty;
    36    f. The operator converted or withheld funds;
    37    g.  The operator failed to comply with, or violated, any proper order,
    38  rule or regulation of the council or  violated  any  provision  of  this
    39  article;
    40    h.  The unsound business practices of the operator renders its further
    41  transactions in this state hazardous or injurious to the public;
    42    i. The operator has refused to be examined or to produce its accounts,
    43  records and  files  for  examination,  or  its  officers,  employees  or
    44  controlling persons have refused to give information with respect to the
    45  affairs  of the community or to perform any other legal obligation as to
    46  such examination; or
    47    j. The commissioner has found violations of applicable statutes, rules
    48  or regulations which threaten to affect directly the health, safety,  or
    49  welfare  of  a  resident of a fee-for-service continuing care retirement
    50  community.
    51    2. No certificate of authority shall be revoked, suspended, limited or
    52  annulled without a hearing, except that a certificate of  authority  may
    53  be  temporarily suspended or limited prior to a hearing for a period not
    54  in excess of sixty days upon written notice to the operator following  a
    55  finding  by the commissioner that public health or safety is in imminent
    56  danger or there exists any condition or practice or a continuing pattern

        A. 7742                            14

     1  of conditions or practices that pose an imminent danger to the health or
     2  safety of any resident. Any delay in the hearing process  occasioned  by
     3  the operator shall toll the running of said suspension or limitation and
     4  shall not abridge the full time provided in this subdivision.
     5    3. Any state agency which seeks to revoke, suspend, limit or annul the
     6  certificate of authority or any other license or certificate required to
     7  be obtained by an operator of a community pursuant to law, shall request
     8  the  [council]  commissioner  to  commence  a  hearing  pursuant to this
     9  section.
    10    4. The [council] commissioner shall fix a time and place for the hear-
    11  ing. The commissioner shall cause to be served in person  or  mailed  by
    12  registered  or  certified  mail to the operator at least ten days before
    13  the date fixed for the hearing a copy of the charges, together with  the
    14  notice  of  the  time  and place of the hearing. The operator shall file
    15  with the commissioner not less than three days prior to  the  hearing  a
    16  written answer to the charges. The agency which initiated the proceeding
    17  shall be responsible for providing evidence in support of the charges to
    18  the  commissioner  in  order to prepare a statement of charges and shall
    19  provide evidence in support of the charges at the hearing.
    20    5. All orders pursuant to this section shall be subject to  review  as
    21  provided  in  article seventy-eight of the civil practice law and rules.
    22  Application for such review  shall  be  made  within  sixty  days  after
    23  service  in  person  or by registered or certified mail of a copy of the
    24  order upon the operator.
    25    § 17. Section 4669 of the public health law, as added by  chapter  519
    26  of the laws of 2004, is amended to read as follows:
    27    §  4669.  Appointment  of  a  caretaker.   Upon a determination by the
    28  [council] commissioner that there exists operational deficiencies  in  a
    29  fee-for-service continuing care retirement community that show:
    30    1.  there  exists  in  the  facility a pattern or practice of habitual
    31  violation of the standards of health, safety or patient care established
    32  under federal or state law or regulations,  the  [council]  commissioner
    33  shall  take  the  actions prescribed by section forty-six hundred sixty-
    34  eight of this article, and, where the [council] commissioner deems it to
    35  be in the public interest, the [council may  request  the  commissioner,
    36  and  upon  request  of the council the] commissioner shall[,] petition a
    37  court of competent jurisdiction to appoint a  caretaker  as  defined  in
    38  section  twenty-eight  hundred  one  of  this chapter. The petition, the
    39  proceedings, and the procedures for appointment of a caretaker shall  be
    40  governed  by the provisions of section forty-six hundred seventy of this
    41  article, and the power, duties  and  rights  of  a  caretaker  appointed
    42  pursuant to such section shall be the same as those authorized by subdi-
    43  vision four of such section; or
    44    2. a condition or conditions in substantial violation of the standards
    45  for  health,  safety  or patient care established under federal or state
    46  law or regulations.
    47    § 18. Subdivisions 1, 2 and 8 of section 4670  of  the  public  health
    48  law, as added by chapter 519 of the laws of 2004, are amended to read as
    49  follows:
    50    1.  The [council] commissioner may, [if it determines] upon a determi-
    51  nation that serious operational deficiencies exist or serious  financial
    52  problems  exist  and  such  action is desirable, enter into an agreement
    53  with the operator or owners of a fee-for-service continuing care retire-
    54  ment community with respect to the appointment of  a  receiver  to  take
    55  charge  of  the  community  under conditions as found acceptable by both
    56  parties.  Receivership commenced in accordance with  the  provisions  of

        A. 7742                            15

     1  this  subdivision shall terminate at such time as may be provided in the
     2  receivership agreement, or at such time as  either  party  notifies  the
     3  other in writing that it wishes to terminate such receivership.
     4    2.  [Upon  request of the council, the] The commissioner shall, at the
     5  time of revocation, suspension or temporary suspension of a  certificate
     6  of authority, apply to the supreme court where the community is situated
     7  for  an  order directing the owner of the land and/or structure on or in
     8  which the community is located, to show cause why a receiver should  not
     9  be  appointed  to take charge of the community. In those cases where the
    10  certificate of authority has  been  revoked,  suspended  or  temporarily
    11  suspended,  the  supreme  court  shall  appoint  a  receiver that, where
    12  reasonably possible, is a legal entity that holds a valid certificate of
    13  authority. Such application shall contain proof by  affidavit  that  the
    14  facility  has  had  its  certificate  of authority revoked, suspended or
    15  temporarily suspended. Such order to show cause shall be returnable  not
    16  less  than  five  days  after service is completed and shall provide for
    17  personal service of a copy thereof and the papers on which it is  based,
    18  on  the owner or owners of the land and/or structures on or in which the
    19  community is located. If any such owner  and  manager  cannot  with  due
    20  diligence  be  served personally within the county where the property is
    21  located and within the time fixed in such order,  then  service  may  be
    22  made  on  such  person  by posting a copy thereof in a conspicuous place
    23  within the community in question, and  by  sending  a  copy  thereof  by
    24  registered  mail,  return  receipt  requested, to such owner at the last
    25  address registered by him or her with the department or in  the  absence
    26  of  such registration to the address set forth in the last recorded deed
    27  with respect to the facility. Service shall be deemed complete on filing
    28  proof of service thereof in the office of the county clerk, or the clerk
    29  of the city of New York, as the case may be.
    30    8. Any other provision of this article notwithstanding, the  [council]
    31  commissioner  may,  if  [it]  he  or she deems appropriate, grant to any
    32  community operating or scheduled to operate under a receivership author-
    33  ized by this section a certificate of authority, the duration  of  which
    34  shall be limited to the duration of the receivership.
    35    §  19.  Paragraph  g  of  subdivision  4 of section 4621 of the public
    36  health law, as added by chapter 406 of the laws of 1991, is  amended  to
    37  read as follows:
    38    g.  If  the  funds  in  an  escrow account under this section, and any
    39  interest thereon, are not released to the applicant within such time  as
    40  provided by rules and regulations adopted by the [council] commissioner,
    41  then  such funds shall be returned by the escrow agent to the person who
    42  had made the payments or the person's legal representative.
    43    § 20. Subdivision 1 of section 4623  of  the  public  health  law,  as
    44  amended  by  chapter  659  of  the  laws  of 1997, is amended to read as
    45  follows:
    46    1. The [council] commissioner may approve an application for a certif-
    47  icate of authority and [the commissioner] may  issue  a  certificate  of
    48  authority  for  the  establishment  and  operation  of a continuing care
    49  retirement community under an arrangement which otherwise complies  with
    50  the requirements of this article except that the costs of nursing facil-
    51  ity or home health care services are paid for in whole or in part by (a)
    52  long  term  care  insurance  obtained and paid for by the resident or by
    53  medical assistance payments in accordance with the partnership for  long
    54  term care program pursuant to section three hundred sixty-seven-f of the
    55  social  services  law and section three thousand two hundred twenty-nine
    56  of the insurance law or (b) other group or  individual  long  term  care

        A. 7742                            16

     1  insurance  approved  by the superintendent and the council in connection
     2  with the application. The council, in consultation with the  superinten-
     3  dent,  shall  provide  for  adequate  disclosure  to  residents of their
     4  options,  rights  and  obligations  under such an arrangement, and shall
     5  establish standards for the remittance and collection  of  premiums  and
     6  monthly care fees.
     7    §  21.  The  opening paragraph of subdivision 14 and subdivision 15 of
     8  section 4657 of the public health law, as added by chapter  519  of  the
     9  laws of 2004, are amended to read as follows:
    10    In  accordance  with  regulations promulgated by the [council] commis-
    11  sioner, the operator shall prepare a standard information sheet for each
    12  approved fee-for-service continuing  care  retirement  community,  which
    13  must  be  approved  by  the department, distributed with the community's
    14  marketing materials and attached to  the  initial  disclosure  statement
    15  prepared in accordance with this section. The standard information sheet
    16  shall  be  prepared in plain language and in twelve point type and shall
    17  include, but shall not be limited to the following information:
    18    15. Any other information as may be required by regulations promulgat-
    19  ed by the [council] commissioner.
    20    § 22. The opening paragraph  and  paragraph  d  of  subdivision  2  of
    21  section  4658  of  the public health law, as added by chapter 519 of the
    22  laws of 2004, are amended to read as follows:
    23    The annual statement shall be in such form as  the  [council]  commis-
    24  sioner prescribes and shall contain at least the following:
    25    d. Such other reasonable financial and other information as the [coun-
    26  cil] commissioner may require with respect to the operator or the commu-
    27  nity,  or its directors, controlling persons, trustees, members, branch-
    28  es, subsidiaries or affiliates to determine the financial status of  the
    29  community and the management capabilities of the operator.
    30    § 23. Subdivision 2 of section 4651 of the public health law, as added
    31  by chapter 519 of the laws of 2004, is amended to read as follows:
    32    2. "Certificates" or "certificate of authority" shall mean an authori-
    33  zation  in  writing, approved [by the council] and issued by the commis-
    34  sioner, for an operator to operate  a  fee-for-service  continuing  care
    35  retirement  community  and to enter into fee-for-service continuing care
    36  contracts pertaining to such community.
    37    § 24. Section 4654 of the public health law, as amended by chapter 545
    38  of the laws of 2004, is amended to read as follows:
    39    § 4654. Authorization of fee-for-service  continuing  care  retirement
    40  communities.    The  commissioner[, upon approval of the continuing care
    41  retirement community council,] shall approve up to eight fee-for-service
    42  continuing care retirement  communities  to  encourage  affordable  care
    43  options for middle income seniors, up to two of which may be operated by
    44  a for-profit entity.
    45    §  25. The opening paragraph of section 4659 of the public health law,
    46  as added by chapter 519 of the laws of  2004,  is  amended  to  read  as
    47  follows:
    48    A  fee-for-service  continuing  care contract shall contain all of the
    49  following information in no less than twelve point  type  and  in  plain
    50  language, in addition to any other terms or matter as may be required by
    51  regulations [adopted by the council and] issued by the commissioner:
    52    §  26.  The  opening paragraph of subdivision 5 of section 4655 of the
    53  public health law, as amended by chapter 545 of the  laws  of  2004,  is
    54  amended to read as follows:
    55    If  the  [approvals]  applicant has satisfied the criteria required by
    56  subdivision four-a of this section have  been  obtained,  the  [council]

        A. 7742                            17

     1  commissioner  shall[,  by  majority  vote,] either approve or reject the
     2  application [within sixty days of  the  date  on  which  the  last  such
     3  approval  has  been  obtained]. In order to approve the application, the
     4  [council] commissioner shall have determined that:
     5    §  27.  Subdivisions 6 and 8 of section 4655 of the public health law,
     6  as added by chapter 519 of the laws of 2004,  are  amended  to  read  as
     7  follows:
     8    6.  Any  change  in  the  legal  entity  operating the fee-for-service
     9  continuing care retirement community, or in a controlling person of  the
    10  community  shall  require  approval  in  the  same manner as an original
    11  application; provided, however,  that  the  [council]  commissioner  may
    12  waive  any  requirement  to  provide information that is not relevant to
    13  such change and provided, further, that the continued  public  need  for
    14  the community shall be presumed.
    15    8.  [If  the  council  approves the application, the] The commissioner
    16  shall issue a certificate of authority to the applicant upon approval of
    17  the application.
    18    § 28. Section 4611 of the public health law, as added by  chapter  689
    19  of  the  laws of 1989, the opening paragraph of subdivision 1 as further
    20  amended by section 104 of part A of chapter 62 of the laws of  2011,  is
    21  amended to read as follows:
    22    § 4611. Reserves and supporting assets.  1. An operator shall maintain
    23  reserve  liabilities  and  supporting  assets  in  an amount and for the
    24  purposes set forth in a regulation  issued  by  the  [superintendent  of
    25  financial  services] commissioner.  Liquid assets must be maintained for
    26  the following reserve liabilities:
    27    a. Principal and interest payments and payments for taxes  and  insur-
    28  ance for up to twelve months;
    29    b.  Total estimated operating costs for up to six months as set by the
    30  [superintendent] commissioner;
    31    c. Repairs and replacements for up to twelve months; and
    32    d. In addition, the amount of liquid assets must meet  any  cash  flow
    33  requirements and conditions as set forth in a regulation.
    34    2.  The assets in support of reserve liabilities of subdivision one of
    35  this section shall meet quantitative and qualitative standards set forth
    36  in regulations issued by the [superintendent] commissioner.
    37    § 29. Section 1119 of the insurance law, as amended by chapter 659  of
    38  the laws of 1997, is amended to read as follows:
    39    §  1119. Limited exemption for continuing care retirement communities.
    40  [(a)] An organization complying with the provisions of article forty-six
    41  of the public health law may operate without being licensed  under  this
    42  chapter  and  without  being  subject to any provisions of this chapter,
    43  except to the  extent  that  such  organization  must  comply  with  the
    44  provisions  of  this chapter by virtue of such article[, and such organ-
    45  ization must comply with rules and  regulations  of  the  superintendent
    46  relating to:
    47    (1) financial feasibility of the continuing care retirement community,
    48    (2) actuarial principles established relating to such communities,
    49    (3) approval of continuing care retirement contracts and the rates and
    50  rating system, if any, for such contracts.
    51    (b)  The superintendent may promulgate regulations in effectuating the
    52  purposes and the provisions of this chapter and article forty-six of the
    53  public health law, which may  include  requirements  applicable  to  the
    54  contracts  between  a continuing care retirement community and its resi-
    55  dents.

        A. 7742                            18

     1    (c) Such organization shall be subject to the  provisions  of  article
     2  seventy-four  of  this chapter. Prior to commencing action under article
     3  seventy-four, the superintendent shall consult with the continuing  care
     4  retirement  community  council established pursuant to section forty-six
     5  hundred two of the public health law].
     6    §  30.  Subdivision  1  of  section  4621 of the public health law, as
     7  amended by chapter 659 of the laws  of  1997,  is  amended  to  read  as
     8  follows:
     9    1.  No person, partnership, corporation or other entity shall solicit,
    10  collect or receive any priority reservation fee or enter into any agree-
    11  ment relating to the  payment  of  any  priority  reservation  fee  with
    12  respect to any continuing care retirement community to be operated with-
    13  in  the  state  without first obtaining the written authorization of the
    14  commissioner. The commissioner shall not grant such authorization to  an
    15  entity  that  has not yet obtained a certificate of authority unless the
    16  requirements of this section and any  applicable  regulations  are  met.
    17  Upon obtaining the authorization of the commissioner under this section,
    18  a prospective continuing care retirement community applicant or an enti-
    19  ty  that  has  filed  an  application for a certificate of authority may
    20  enter into cancelable priority reservation agreements  with  prospective
    21  residents  and solicit, collect and receive refundable priority reserva-
    22  tion fees for direct deposit into an escrow account, prior to  obtaining
    23  a  certificate of authority, for the purpose of evaluating market demand
    24  for a proposed continuing care retirement community and for the  purpose
    25  of  guaranteeing  to  prospective  residents an opportunity for priority
    26  placement in a continuing care retirement community. A priority reserva-
    27  tion fee shall not exceed two thousand dollars unless the  commissioner,
    28  in  his  or  her discretion, establishes that a priority reservation fee
    29  may exceed two thousand dollars. A non-refundable  priority  reservation
    30  agreement  application fee shall not exceed the maximum amount [for such
    31  fee as set forth in regulations adopted by the council]  established  by
    32  the commissioner, in his or her discretion.
    33    §  31.  Subdivision  1  of  section  4622 of the public health law, as
    34  amended by chapter 659 of the laws  of  1997,  is  amended  to  read  as
    35  follows:
    36    1.  No person, partnership, corporation or other entity shall solicit,
    37  collect or receive any priority reservation fee or enter into any agree-
    38  ment relating to the  payment  of  any  priority  reservation  fee  with
    39  respect  to  any  continuing care retirement community operated or to be
    40  operated within the state without first obtaining the  written  authori-
    41  zation  of  the  commissioner.  The  commissioner  shall  not grant such
    42  authorization to an entity that has obtained a certificate of  authority
    43  unless  the  requirements of this section and any applicable regulations
    44  are met. Upon obtaining the authorization of the commissioner under this
    45  section, an operator may  enter  into  cancelable  priority  reservation
    46  agreements  with  prospective residents and solicit, collect and receive
    47  refundable priority reservation fees for direct deposit into  an  escrow
    48  account  for  the  purpose  of  guaranteeing to prospective residents an
    49  opportunity for priority placement in  the  continuing  care  retirement
    50  community  for which the operator has obtained a certificate of authori-
    51  ty. A priority reservation fee shall not  exceed  two  thousand  dollars
    52  unless  the  commissioner,  in his or her discretion, establishes that a
    53  priority reservation fee may exceed two thousand dollars.  A non-refund-
    54  able priority reservation agreement application fee shall not exceed the
    55  maximum amount [for such fee as set forth in regulations adopted by  the
    56  council] established by the commissioner, in his or her discretion.

        A. 7742                            19

     1    § 32. Subdivision 1 of section 4674 of the public health law, as added
     2  by chapter 519 of the laws of 2004, is amended to read as follows:
     3    1.  No person, partnership, corporation or other entity shall solicit,
     4  collect or receive any priority reservation fee or enter into any agree-
     5  ment relating to the  payment  of  any  priority  reservation  fee  with
     6  respect  to  any fee-for-service continuing care retirement community to
     7  be operated within the state without first obtaining the written author-
     8  ization of the commissioner.  The  commissioner  shall  not  grant  such
     9  authorization  to  an  entity that has not yet obtained a certificate of
    10  authority unless the requirements of this  section  and  any  applicable
    11  regulations are met. Upon obtaining the authorization of the commission-
    12  er  under  this  section, a prospective community applicant or an entity
    13  having filed an application for a certificate  of  authority  may  enter
    14  into  cancelable  priority reservation agreements with prospective resi-
    15  dents and solicit, collect and receive refundable  priority  reservation
    16  fees  for  direct  deposit  into an escrow account, prior to obtaining a
    17  certificate of authority, for the purpose of  evaluating  market  demand
    18  for  a proposed fee-for-service continuing care retirement community and
    19  for the purpose of guaranteeing to prospective residents an  opportunity
    20  for  priority  placement in a fee-for-service continuing care retirement
    21  community. A priority reservation fee  shall  not  exceed  two  thousand
    22  dollars  unless  the commissioner, in his or her discretion, establishes
    23  that a priority reservation fee may exceed  two  thousand  dollars.    A
    24  non-refundable  priority reservation agreement application fee shall not
    25  exceed the maximum amount [for such fee  as  set  forth  in  regulations
    26  adopted  by  the council] established by the commissioner, in his or her
    27  discretion.
    28    § 33. Subdivision 1 of section 4675 of the public health law, as added
    29  by chapter 519 of the laws of 2004, is amended to read as follows:
    30    1. No person, partnership, corporation or other entity shall  solicit,
    31  collect or receive any priority reservation fee or enter into any agree-
    32  ment  relating  to  the  payment  of  any  priority reservation fee with
    33  respect to any  fee-for-service  continuing  care  retirement  community
    34  operated  or to be operated within the state without first obtaining the
    35  written authorization of the commissioner. The  commissioner  shall  not
    36  grant such authorization to an entity that has obtained a certificate of
    37  authority  unless  the  requirements  of this section and any applicable
    38  regulations are met. Upon obtaining the authorization of the commission-
    39  er under this section, an operator may enter  into  cancelable  priority
    40  reservation  agreements  with prospective residents and solicit, collect
    41  and receive refundable priority reservation fees for direct deposit into
    42  an escrow account for the purpose of guaranteeing to  prospective  resi-
    43  dents  an  opportunity  for  priority  placement  in the fee-for-service
    44  continuing care retirement community for which the operator has obtained
    45  a certificate of authority. A priority reservation fee shall not  exceed
    46  two  thousand dollars unless the commissioner, in his or her discretion,
    47  establishes that a priority reservation  fee  may  exceed  two  thousand
    48  dollars.    A  non-refundable priority reservation agreement application
    49  fee shall not exceed the maximum amount [for such fee as  set  forth  in
    50  regulations  adopted by the council] established by the commissioner, in
    51  his or her discretion.
    52    § 34. No later than November 1, 2023, the commissioner of  health,  in
    53  conjunction  with the superintendent of financial services, shall evalu-
    54  ate and make recommendations regarding the additional resources required
    55  by the department of health to implement this act to the  governor,  the

        A. 7742                            20

     1  division  of  the  budget, the senate finance committee and the assembly
     2  ways and means committee.
     3    §  35.  Notwithstanding  section  163  of  the  state finance law, the
     4  commissioner of health may enter into new contracts, or in  his  or  her
     5  discretion,  institute  a  contract  addendum to an existing contract to
     6  secure actuarial and other services, necessary to implement this act.
     7    § 36. This act shall take effect immediately; provided, however,  that
     8  sections  three,  nine, eleven, twelve, thirteen, twenty-eight and twen-
     9  ty-nine of this act shall take effect June 1,  2024.    Effective  imme-
    10  diately, the addition, amendment and/or repeal of any rule or regulation
    11  necessary  for  the implementation of this act on its effective date are
    12  authorized to be made and completed on or before such effective date.