Legislation
SECTION 4659
Fee-for-service continuing care contract
Public Health (PBH) CHAPTER 45, ARTICLE 46-A
* § 4659. Fee-for-service continuing care contract. A fee-for-service
continuing care contract shall contain all of the following information
in no less than twelve point type and in plain language, in addition to
any other terms or matter as may be required by regulations adopted by
the council and issued by the commissioner:
1. The amount of all money transferred, including, but not limited to,
donations, subscriptions, deposits, fees, and any other amounts paid or
payable by, or on behalf of, the resident or residents;
2. A description of all services which are to be furnished by the
operator, a description of any fees in addition to the entrance fee and
periodic charges provided for in the contract, and the conditions under
which the fees may be adjusted, provided that an operator shall not
charge any non-refundable application fee to a prospective resident who
has paid a non-refundable priority reservation agreement application
fee;
3. The procedures of the community relating to a resident's failure to
pay the required monthly fees;
4. A statement of the figures and terms concerning the entry of a
spouse to the community and the consequences if the spouse does not meet
the requirements for entry;
5. A statement of the terms and conditions under which a contract may
be canceled by the operator or by a resident and the conditions under
which all or any portion of the entrance fee will be refunded by the
operator, including the mandatory refund provisions set forth in
sections forty-six hundred sixty and forty-six hundred sixty-two of this
article;
6. The procedures and conditions under which a resident may be
transferred from his or her living unit including a statement that, at
the time of transfer, the resident will be given the reasons for the
transfer; the process by which a transfer decision is made; the persons
with the authority to make the decision to transfer; a description of
any change in charges to be paid by the resident for services not
covered by the contract fees as a result of the transfer; and a
statement regarding the disposition of and the right to return to the
living unit in cases of temporary and permanent transfers;
7. A statement that, if the resident dies prior to occupancy date or,
through illness, injury or incapacity is precluded from becoming a
resident under the terms of the contract, the contract is automatically
rescinded and the resident or his or her legal representative shall
receive a full refund of all moneys paid to the facility, except for
those costs specifically incurred by the facility at the request of the
resident and set forth in writing in a separate addendum, signed by the
parties to the contract;
8. A statement of the conditions under which all or any portion of the
entrance fee will be released to the operator before the living unit
becomes available for occupancy, and a statement of the conditions under
which all or any portion of that fee will be refunded in the event of
the death of the resident and/or spouse following occupancy of a living
unit, including the mandatory refund provisions set forth in section
forty-six hundred sixty of this article;
9. A statement of the advance notice to be provided the resident, of
not less than sixty days, of any change in fees or charges or scope of
care or services;
10. A statement that no act, agreement, or statement of any resident,
or of an individual purchasing care for a resident under any agreement
to furnish care to the resident, shall constitute a valid waiver of any
provision of this article or of any regulation enacted pursuant thereto
intended for the benefit or protection of the resident or the individual
purchasing care for the resident;
11. A description of the reinstatement policies if a resident leaves
the facility or the contract is canceled;
12. A statement that internal procedures to resolve disputes and
grievances have been established, and residents notified of them;
13. A statement of the grace period, if any, for the payment of
periodic fees without a penalty, and the extent of any penalty for the
late payment thereof;
14. A statement that any amendment to the contract and any change in
fees or charges, other than those within the guidelines of an approved
rating system, must be approved by the commissioner;
15. A statement that property shall not be substituted as payment for
either the entrance fee or monthly fee; and
16. A statement whether the fee-for-service continuing care contract
includes any ownership, beneficial or trust interest in the assets of
the operator, the assets of the facility, or both. Assets shall include,
but are not limited to, property, trusts, reserves, interest and other
assets.
* NB There are 2 § 4659's
continuing care contract shall contain all of the following information
in no less than twelve point type and in plain language, in addition to
any other terms or matter as may be required by regulations adopted by
the council and issued by the commissioner:
1. The amount of all money transferred, including, but not limited to,
donations, subscriptions, deposits, fees, and any other amounts paid or
payable by, or on behalf of, the resident or residents;
2. A description of all services which are to be furnished by the
operator, a description of any fees in addition to the entrance fee and
periodic charges provided for in the contract, and the conditions under
which the fees may be adjusted, provided that an operator shall not
charge any non-refundable application fee to a prospective resident who
has paid a non-refundable priority reservation agreement application
fee;
3. The procedures of the community relating to a resident's failure to
pay the required monthly fees;
4. A statement of the figures and terms concerning the entry of a
spouse to the community and the consequences if the spouse does not meet
the requirements for entry;
5. A statement of the terms and conditions under which a contract may
be canceled by the operator or by a resident and the conditions under
which all or any portion of the entrance fee will be refunded by the
operator, including the mandatory refund provisions set forth in
sections forty-six hundred sixty and forty-six hundred sixty-two of this
article;
6. The procedures and conditions under which a resident may be
transferred from his or her living unit including a statement that, at
the time of transfer, the resident will be given the reasons for the
transfer; the process by which a transfer decision is made; the persons
with the authority to make the decision to transfer; a description of
any change in charges to be paid by the resident for services not
covered by the contract fees as a result of the transfer; and a
statement regarding the disposition of and the right to return to the
living unit in cases of temporary and permanent transfers;
7. A statement that, if the resident dies prior to occupancy date or,
through illness, injury or incapacity is precluded from becoming a
resident under the terms of the contract, the contract is automatically
rescinded and the resident or his or her legal representative shall
receive a full refund of all moneys paid to the facility, except for
those costs specifically incurred by the facility at the request of the
resident and set forth in writing in a separate addendum, signed by the
parties to the contract;
8. A statement of the conditions under which all or any portion of the
entrance fee will be released to the operator before the living unit
becomes available for occupancy, and a statement of the conditions under
which all or any portion of that fee will be refunded in the event of
the death of the resident and/or spouse following occupancy of a living
unit, including the mandatory refund provisions set forth in section
forty-six hundred sixty of this article;
9. A statement of the advance notice to be provided the resident, of
not less than sixty days, of any change in fees or charges or scope of
care or services;
10. A statement that no act, agreement, or statement of any resident,
or of an individual purchasing care for a resident under any agreement
to furnish care to the resident, shall constitute a valid waiver of any
provision of this article or of any regulation enacted pursuant thereto
intended for the benefit or protection of the resident or the individual
purchasing care for the resident;
11. A description of the reinstatement policies if a resident leaves
the facility or the contract is canceled;
12. A statement that internal procedures to resolve disputes and
grievances have been established, and residents notified of them;
13. A statement of the grace period, if any, for the payment of
periodic fees without a penalty, and the extent of any penalty for the
late payment thereof;
14. A statement that any amendment to the contract and any change in
fees or charges, other than those within the guidelines of an approved
rating system, must be approved by the commissioner;
15. A statement that property shall not be substituted as payment for
either the entrance fee or monthly fee; and
16. A statement whether the fee-for-service continuing care contract
includes any ownership, beneficial or trust interest in the assets of
the operator, the assets of the facility, or both. Assets shall include,
but are not limited to, property, trusts, reserves, interest and other
assets.
* NB There are 2 § 4659's