SB 475: Continuing care contracts: cancellation: payments.
- Session Year: 2015-2016
- House: Senate
- Latest Version Date: 2015-09-10
Existing law requires a continuing care retirement facility, as defined, to possess a certificate of authority issued by the State Department of Social Services before it can enter into a continuing care contract, as defined. Existing law requires that a continuing care contract be in writing and contain specified information. Existing law provides that a continuing care contract may be canceled without cause by written notice from either party within 90 days of the residents initial occupancy.
Existing law requires a provider to pay, during the cancellation period, all refunds owed to a resident within 14 days after a resident makes possession of the living unit available to the provider. Existing law requires a provider to pay a lump-sum payment that is conditioned upon resale of a unit to a resident within 14 days after resale of the unit.
This bill would require a continuing care retirement facility to pay the full lump-sum payment that is conditioned upon resale of a unit to a resident within 14 days after resale of a unit. The bill would require a continuing care retirement facility, for contracts signed after January 1, 2016, to pay a resident or his or her estate a specified portion of the full lump-sum payment, notwithstanding a providers documented good-faith effort to resell the unit, if the unit remains vacant 120 days after the residents termination. The bill would require any payment balance not paid to a resident within 180 days to accrue simple interest, to be compounded annually, at a rate of 4% until the full lump-sum payment is made. The bill would require any payment balance not paid to a resident within 240 days to accrue simple interest, to be compounded annually, at a rate of 6% until the full lump-sum payment is made. The bill would require a facility to make the lump-sum payment to a residents estate if the resident is deceased. The bill would provide that the repayment by a provider of all or a portion of an entrance fee before the resale of a unit would not subject any other entrance fee to the refund reserve requirements, except as provided. The bill would provide that, until January 1, 2017, these provisions do not apply to specified projects that are in development prior to January 1, 2016, provided that the initial contract for the project is entered into on or before January 1, 2017.
The bill would authorize any resident whose contract calls for a lump-sum payment conditioned upon resale of a unit to file a complaint with the department if the unit has not been resold for more than 12 months after possession of the unit was made available to the provider. The bill would require the department, in response to the complaint, to perform an investigation, as specified, to determine whether the provider made a sufficient good-faith effort to resell or reoccupy the unit. The bill would authorize a resident or a provider to submit a written request to the department for a formal review of the determination. The bill would require the provider to repay the full lump-sum payment owed to the resident within 20 business days of the departments final determination that the provider did not make a sufficient good-faith effort to reoccupy or resell the unit.
The bill would make corresponding changes to require a continuing care contract to contain a statement that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. The bill would also require a continuing care contract that provides for a refund or repayment of a lump sum of all or part of the entrance fee to include a statement that the provider will make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit.
Existing law requires a continuing care retirement facility, as defined, to possess a certificate of authority issued by the State Department of Social Services before it can enter into a continuing care contract, as defined. Existing law requires that a continuing care contract be in writing and contain specified information. Existing law provides that a continuing care contract may be canceled without cause by written notice from either party within 90 days of the residents initial occupancy.
Existing law requires a provider to pay, during the cancellation period, all refunds owed to a resident within 14 days after a resident makes possession of the living unit available to the provider. Existing law requires a provider to pay a lump-sum payment that is conditioned upon resale of a unit to a resident within 14 days after resale of the unit.
This bill would require a continuing care retirement facility to pay the full lump-sum payment that is conditioned upon resale of a unit to a resident within 14 days after resale of a unit. The bill would require a continuing care retirement facility, for contracts signed after January 1, 2016, to pay a resident or his or her estate a specified portion of the full lump-sum payment, notwithstanding a providers documented good-faith effort to resell the unit, if the unit remains vacant 120 days after the residents termination. The bill would require any payment balance not paid to a resident within 180 days to accrue compound interest every 30 days simple interest, to be compounded annually, at a rate not lower than of 4% until the full lump-sum payment is made. The bill would require any payment balance not paid to a resident within 240 days to accrue compound interest every 30 days simple interest, to be compounded annually, at a rate not lower than of 6% until the full lump-sum payment is made. The bill would require a facility to make the lump-sum payment to a residents estate if the resident is deceased. The bill would provide that the repayment by a provider of all or a portion of an entrance fee before the resale of a unit would not subject any other entrance fee to the refund reserve requirements, except as provided. The bill would provide that, until January 1, 2017, these provisions do not apply to specified projects that are in development prior to January 1, 2016, provided that the initial contract for the project is entered into on or before January 1, 2017.
The bill would authorize any resident whose contract calls for a lump-sum payment conditioned upon resale of a unit to file a complaint with the department if the unit has not been resold for more than 12 months after possession of the unit was made available to the provider. The bill would require the department, in response to the complaint, to perform an investigation, as specified, to determine whether the provider made a sufficient good faith good-faith effort to resell or reoccupy the unit. The bill would authorize a resident or a provider to submit a written request to the department for a formal review of the determination. The bill would require the provider to repay the full lump-sum payment owed to the resident within 20 business days of the departments final determination that the provider did not make a sufficient good faith good-faith effort to reoccupy or resell the unit.
The bill would make corresponding changes to require a continuing care contract to contain a statement that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. The bill would also require a continuing care contract that provides for a refund or repayment of a lump sum of all or part of the entrance fee to include a statement that the provider will make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit.
Existing law requires a continuing care retirement facility, as defined, to possess a certificate of authority issued by the State Department of Social Services before it can enter into a continuing care contract, as defined. Existing law requires that a continuing care contract be in writing and contain specified information. Existing law provides that a continuing care contract may be canceled without cause by written notice from either party within 90 days of the residents initial occupancy.
Existing law requires a provider to pay, during the cancellation period, all refunds owed to a resident within 14 days after a resident makes possession of the living unit available to the provider. Existing law requires a provider to pay a lump-sum payment that is conditioned upon resale of a unit to a resident within 14 days after resale of the unit.
This bill would require a continuing care retirement facility to pay the full lump-sum payment that is conditioned upon resale of a unit to a resident within 14 days after resale of a unit. The bill would require a continuing care retirement facility, for contracts signed after January 1, 2016, to pay a resident or his or her estate a specified portion of the full lump-sum payment, notwithstanding a providers documented good-faith effort to resell the unit, if the unit remains vacant 120 days after the residents termination. The bill would require any payment balance not paid to a resident within 120 180 days to accrue compound interest every 30 days at a rate not lower than 4% until the full lump-sum payment is made. The bill would require any payment balance not paid to a resident within 180 240 days to accrue compound interest every 30 days at a rate not lower than 6% until the full lump-sum payment is made. The bill would require a facility to make the lump-sum payment to a residents estate if the resident is deceased. The bill would provide that the repayment by a provider of all or a portion of an entrance fee before the resale of a unit would not subject any other entrance fee to the refund reserve requirements, except as provided.
The bill would authorize any resident whose contract calls for a lump-sum payment conditioned upon resale of a unit to file a complaint with the department if the unit has not been resold for more than 12 months after possession of the unit was made available to the provider. The bill would require the department, in response to the complaint, to perform an investigation, as specified, to determine whether the provider made a sufficient good faith effort to resell or reoccupy the unit. The bill would authorize a resident or a provider to submit a written request to the department for a formal review of the determination. The bill would require the provider to repay the full lump-sum payment owed to the resident within 20 business days of the departments final determination that the provider did not make a sufficient good faith effort to reoccupy or resell the unit, and would require the provider to reimburse the department for reasonable costs associated with the investigation, as specified. unit.
The bill would make corresponding changes to require a continuing care contract to contain a statement that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. The bill would also require a continuing care contract that provides for a refund or repayment of a lump sum of all or part of the entrance fee to include a statement that the provider will make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit.
Existing law requires a continuing care retirement facility, as defined, to possess a certificate of authority issued by the State Department of Social Services before it can enter into a continuing care contract, as defined. Existing law requires that a continuing care contract be in writing and contain specified information. Existing law provides that a continuing care contract may be canceled without cause by written notice from either party within 90 days of the residents initial occupancy.
Existing law requires a provider to pay, during the cancellation period, all refunds owed to a resident within 14 days after a resident makes possession of the living unit available to the provider. Existing law requires a provider to pay a lump-sum payment that is conditioned upon resale of a unit to a resident within 14 days after resale of the unit.
This bill would require a continuing care retirement facility to pay the full lump-sum payment that is conditioned upon resale of a unit to a resident within 14 days after resale of a unit. The bill would require a continuing care retirement facility, for contracts signed after January 1, 2016, to pay a resident or his or her estate a specified portion of the full lump-sum payment, notwithstanding a providers documented good-faith effort to resell the unit, if the unit remains vacant 120 days after the residents termination. The bill would require any payment balance not paid to a resident within 120 days to accrue interest compound interest every 30 days at a rate not lower than 4% until the full lump-sum payment is made. The bill would require any payment balance not paid to a resident within 180 days to accrue interest compound interest every 30 days at a rate not lower than 6% until the full lump-sum payment is made. The bill would require a facility to make the lump-sum payment to a residents estate if the resident is deceased. The bill would provide that the repayment by a provider of all or a portion of an entrance fee before the resale of a unit would not subject any other entrance fee to the refund reserve requirements, except as provided.
The bill would authorize any resident whose contract calls for a lump-sum payment conditioned upon resale of a unit to file a complaint with the department if the unit has not been resold for more than 12 months after possession of the unit was made available to the provider. The bill would require the department, in response to the complaint, to perform an investigation, as specified, to determine whether the provider made a sufficient good faith effort to resell or reoccupy the unit. The bill would authorize a resident or a provider to submit a written request to the department for a formal review of the determination. The bill would require the provider to repay the full lump-sum payment owed to the resident within 20 business days of the departments final determination that the provider did not make a sufficient good faith effort to reoccupy or resell the unit, and would require the provider to reimburse the department for reasonable costs associated with the investigation, as specified.
The bill would authorize the department to determine if a provider has failed to make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon the resale of the unit upon receiving a complaint from the resident or the residents estate. The bill would require the provider to repay the full lump-sum payment owed to the resident or the residents estate within 14 days of the departments determination that the provider failed to make a good faith effort to reoccupy or resell the unit, and would require the provider to reimburse the department for the costs incurred by the department associated with its determination.
The bill would make corresponding changes to require a continuing care contract to contain a statement that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. The bill would also require a continuing care contract that provides for a refund or repayment of a lump sum of all or part of the entrance fee to include a statement that the provider will make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit.
Existing law requires a continuing care retirement facility, as defined, to possess a certificate of authority issued by the State Department of Social Services before it can enter into a continuing care contract, as defined. Existing law requires that a continuing care contract be in writing and contain specified information. Existing law states provides that a continuing care contract may be canceled without cause by written notice from either party within 90 days of the residents initial occupancy.
Existing law requires the a provider to pay, during the cancellation period, all refunds owed to a resident within 14 days after a resident makes possession of the living unit available to the provider. Existing law requires the a provider to pay a lump-sum payment that is conditioned upon resale of a unit to the a resident within 14 days after resale of the unit.
This bill would require the a continuing care retirement facility to pay the full lump-sum payment that is conditioned upon resale of a unit to the a resident within 14 days after resale of the a unit. The bill would require the a continuing care retirement facility, for contracts signed after January 1, 2016, to pay the a resident or his or her estate a specified portion of the full lump-sum payment, notwithstanding a providers documented good-faith effort to resell the unit, if the unit remains vacant 120 days after the residents termination. The bill would require any payment balance not paid to the a resident within 120 days to accrue interest at a rate not lower than the United States prime lending rate 4% until the full lump-sum payment is made. The bill would require any payment balance not paid to the a resident within 180 days to accrue interest at a rate not lower than 2% plus the United States prime lending rate 6% until the full lump-sum payment is made. The bill would require the a facility to make the lump-sum payment to the a residents estate if the resident is deceased. The bill would provide that the repayment by a provider of all or a portion of an entrance fee before the resale of a unit would not subject any other entrance fee to the refund reserve requirements, except as provided.
The bill would authorize the department to determine if a provider has failed to make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon the resale of the unit upon receiving a complaint from the resident or the residents estate. The bill would require the provider to repay the full lump-sum payment owed to the resident or the residents estate within 14 days of the departments determination that the provider failed to make a good faith effort to reoccupy or resell the unit, and would require the provider to reimburse the department for the costs incurred by the department associated with its determination.
The bill would make corresponding changes to require a continuing care contract to contain a statement that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. The bill would also require a continuing care contract that provides for a refund or repayment of a lump sum of all or part of the entrance fee to include a statement that the provider will make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit.
Existing law requires a continuing care retirement facility, as defined, to possess a certificate of authority issued by the State Department of Social Services before it can enter into a continuing care contract, as defined. Existing law requires that a continuing care contract be in writing and contain specified information. Existing law states a continuing care contract may be canceled without cause by written notice from either party within 90 days of the residents initial occupancy.
Existing law requires the provider to pay, during the cancellation period, all refunds owed to a resident within 14 days after a resident makes possession of the living unit available to the provider. Existing law requires the provider to pay a lump-sum payment that is conditioned upon resale of a unit to the resident within 14 days after resale of the unit.
This bill would require the continuing care retirement facility to pay the full lump-sum payment that is conditioned upon resale of a unit to the resident within 14 days after resale of the unit. The bill would require the continuing care retirement facility, for contracts signed after January 1, 2016, to pay the resident at least 20% or his or her estate a specified portion of the full lump-sum payment, notwithstanding a providers documented good-faith effort to resell the unit, if the unit remains vacant 120 days after the residents termination. The bill would require any payment balance not paid to the resident within 120 days to accrue interest at a rate not lower than the United States prime lending rate until the full lump-sum payment is made. The bill would require any payment balance not paid to the resident within 180 days to accrue interest at a rate not lower than 2% plus the United States prime lending rate until the full lump-sum payment is made. The bill would require the facility to make the lump-sum payment to the residents estate if the resident is deceased.
The bill would make corresponding changes to require a continuing care contract to contain a statement that a provider is prohibited from charging the resident or his or her descendants estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. The bill would also require a continuing care contract that provides for a refund or repayment of a lump sum of all or part of the entrance fee to include a statement that the provider will make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit.
Existing law requires a continuing care retirement facility, as defined, to possess a certificate of authority issued by the State Department of Social Services before it can enter into a continuing care contract, as defined. Existing law requires that a continuing care contract be in writing and contain specified information. Existing law states a continuing care contract may be canceled without cause by written notice from either party within 90 days of the residents initial occupancy.
Existing law requires the provider to pay, during the cancellation period, all refunds owed to a resident within 14 days after a resident makes possession of the living unit available to the provider. Existing law requires the provider to pay a lump-sum payment that is conditioned upon resale of a unit to the resident within 14 days after resale of the unit.
This bill would require the continuing care retirement facility to pay the full lump-sum payment that is conditioned upon resale of a unit to the resident within 14 days after resale of the unit. The bill would require the continuing care retirement facility, for contracts signed after January 1, 2016, to pay the resident at least 20% of the full lump-sum payment to the resident within 90 days after a formerly occupied unit has been vacated. payment, notwithstanding a providers documented good-faith effort to resell the unit, if the unit remains vacant 120 days after the residents termination. The bill would require any payment balance not paid to the resident within 90 120 days to accrue interest at a rate not lower than 2% plus the United States prime lending rate until the full lump-sum payment is made. The bill would require any payment balance not paid to the resident within 180 days to accrue interest at a rate not lower than 5% 2% plus the United States prime lending rate until the full lump-sum payment is made. The bill would require the facility to make the lump-sum payment to the residents estate if the resident is deceased.
The bill would make corresponding changes to require a continuing care contract to contain a statement that a provider is prohibited from charging the resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident. resident, unless the fee is part of an equity interest contract. The bill would also require a continuing care contract that provides for a refund or repayment of a lump sum of all or part of the entrance fee to include a statement that the provider will make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit.
Existing law requires a continuing care retirement facility, as defined, to possess a certificate of authority issued by the State Department of Social Services before it can enter into a continuing care contract, as defined. Existing law requires that a continuing care contract be in writing and contain specified information. Existing law states a continuing care contract may be canceled without cause by written notice from either party within 90 days of the residents initial occupancy.
Existing law requires the provider to pay, during the cancellation period, all refunds owed to a resident within 14 days after a resident makes possession of the living unit available to the provider. Existing law requires the provider to pay a lump-sum payment that is conditioned upon resale of a unit to the resident within 14 days after resale of the unit.
This bill would require the continuing care retirement facility to pay the full lump-sum payment that is conditioned upon resale of a unit to the resident within 14 days after resale of the unit, and in any event no later than 90 days after the resident has vacated the unit. unit. The bill would require the continuing care retirement facility, for contracts signed after January 1, 2016, to pay at least 20% of the full lump-sum payment to the resident within 90 days after a formerly occupied unit has been vacated. The bill would require any payments payment balance not paid to the resident within the 90-day period 90 days to accrue interest at a specified rate rate not lower than 2% plus the United States prime lending rate until the full lump-sum payment is made. The bill would require any payment balance not paid to the resident within 180 days to accrue interest at a rate not lower than 5% plus the United States prime lending rate until the full lump-sum payment is made. The bill would require the facility to make the lump-sum payment to the residents estate if the resident is deceased.
The bill would make corresponding changes to require a continuing care contract to contain a statement that a provider is prohibited from charging the resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident. The bill would also require a continuing care contract that provides for a refund or repayment of a lump sum of all or part of the entrance fee to include a statement that the provider will make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit.
Existing law requires a continuing care retirement facility, as defined, to possess a certificate of authority issued by the State Department of Social Services before it can enter into a continuing care contract, as defined. Existing law requires that a continuing care contract be in writing and contain specified information. Existing law states a continuing care contract may be canceled without cause by written notice from either party within 90 days of the residents initial occupancy.
Existing law requires the provider to pay, during the cancellation period, all refunds owed to a resident within 14 days after a resident makes possession of the living unit available to the provider. Existing law requires the provider to pay a lump-sum payment that is conditioned upon resale of a unit to the resident within 14 days after resale of the unit.
This bill would require the continuing care retirement facility to pay the full lump-sum payment that is conditioned upon resale of a unit to the resident within 14 days after resale of the unit, and in any event no later than 90 days after the resident has vacated the unit. The bill would require any payments not paid to the resident within the 90-day period to accrue interest at a specified rate until the full lump-sum payment is made. The bill would require the facility to make the lump-sum payment to the residents estate if the resident is deceased.
Unless the context otherwise requires, the definitions in this section govern the interpretation of this chapter.
(a)(1)Affiliate means any person, corporation, limited liability company, business trust, trust, partnership, unincorporated association, or other legal entity that directly or indirectly controls, is controlled by, or is under common control with, a provider or applicant.
(2)Affinity group means a grouping of entities sharing a common interest, philosophy, or connection (e.g., military officers, religion).
(3)Annual report means the report each provider is required to file annually with the department, as described in Section 1790.
(4)Applicant means any entity, or combination of entities, that submits and has pending an application to the department for a permit to accept deposits and a certificate of authority.
(5)Assisted living services includes, but is not limited to, assistance with personal activities of daily living, including dressing, feeding, toileting, bathing, grooming, mobility, and associated tasks, to help provide for and maintain physical and psychosocial comfort.
(6)Assisted living unit means the living area or unit within a continuing care retirement community that is specifically designed to provide ongoing assisted living services.
(7)Audited financial statement means financial statements prepared in accordance with generally accepted accounting principles, including the opinion of an independent certified public accountant, and notes to the financial statements considered customary or necessary to provide full disclosure and complete information regarding the providers financial statements, financial condition, and operation.
(b)(reserved)
(c)(1)Cancel means to destroy the force and effect of an agreement or continuing care contract.
(2)Cancellation period means the 90-day period, beginning when the resident physically moves into the continuing care retirement community, during which the resident may cancel the continuing care contract, as provided in Section 1788.2.
(3)Care means nursing, medical, or other health-related services, protection or supervision, assistance with the personal activities of daily living, or any combination of those services.
(4)Cash equivalent means certificates of deposit and United States treasury securities with a maturity of five years or less.
(5)Certificate or certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, authorizing a specified provider to enter into one or more continuing care contracts at a single specified continuing care retirement community.
(6)Condition means a restriction, specific action, or other requirement imposed by the department for the initial or continuing validity of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority. A condition may limit the circumstances under which the provider may enter into any new deposit agreement or contract, or may be imposed as a condition precedent to the issuance of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority.
(7)Consideration means some right, interest, profit, or benefit paid, transferred, promised, or provided by one party to another as an inducement to contract. Consideration includes some forbearance, detriment, loss, or responsibility, that is given, suffered, or undertaken by a party as an inducement to another party to contract.
(8)Continuing care contract means a contract that includes a continuing care promise made, in exchange for an entrance fee, the payment of periodic charges, or both types of payments. A continuing care contract may consist of one agreement or a series of agreements and other writings incorporated by reference.
(9)Continuing care promise means a promise, expressed or implied, by a provider to provide one or more elements of care to an elderly resident for the duration of his or her life or for a term in excess of one year. Any such promise or representation, whether part of a continuing care contract, other agreement, or series of agreements, or contained in any advertisement, brochure, or other material, either written or oral, is a continuing care promise.
(10)Continuing care retirement community means a facility located within the State of California where services promised in a continuing care contract are provided. A distinct phase of development approved by the department may be considered to be the continuing care retirement community when a project is being developed in successive distinct phases over a period of time. When the services are provided in residents own homes, the homes into which the provider takes those services are considered part of the continuing care retirement community.
(11)Control means directing or causing the direction of the financial management or the policies of another entity, including an operator of a continuing care retirement community, whether by means of the controlling entitys ownership interest, contract, or any other involvement. A parent entity or sole member of an entity controls a subsidiary entity provider for a continuing care retirement community if its officers, directors, or agents directly participate in the management of the subsidiary entity or in the initiation or approval of policies that affect the continuing care retirement communitys operations, including, but not limited to, approving budgets or the administrator for a continuing care retirement community.
(d)(1)Department means the State Department of Social Services.
(2)Deposit means any transfer of consideration, including a promise to transfer money or property, made by a depositor to any entity that promises or proposes to promise to provide continuing care, but is not authorized to enter into a continuing care contract with the potential depositor.
(3)Deposit agreement means any agreement made between any entity accepting a deposit and a depositor. Deposit agreements for deposits received by an applicant prior to the departments release of funds from the deposit escrow account shall be subject to the requirements described in Section 1780.4.
(4)Depository means a bank or institution that is a member of the Federal Deposit Insurance Corporation or a comparable deposit insurance program.
(5)Depositor means any prospective resident who pays a deposit. Where any portion of the consideration transferred to an applicant as a deposit or to a provider as consideration for a continuing care contract is transferred by a person other than the prospective resident or a resident, that third-party transferor shall have the same cancellation or refund rights as the prospective resident or resident for whose benefit the consideration was transferred.
(6)Director means the Director of Social Services.
(e)(1)Elderly means an individual who is 60 years of age or older.
(2)Entity means an individual, partnership, corporation, limited liability company, and any other form for doing business. Entity includes a person, sole proprietorship, estate, trust, association, and joint venture.
(3)Entrance fee means the sum of any initial, amortized, or deferred transfer of consideration made or promised to be made by, or on behalf of, a person entering into a continuing care contract for the purpose of ensuring care or related services pursuant to that continuing care contract or as full or partial payment for the promise to provide care for the term of the continuing care contract. Entrance fee includes the purchase price of a condominium, cooperative, or other interest sold in connection with a promise of continuing care. An initial, amortized, or deferred transfer of consideration that is greater in value than 12 times the monthly care fee shall be presumed to be an entrance fee.
(4)Equity means the value of real property in excess of the aggregate amount of all liabilities secured by the property.
(5)Equity interest means an interest held by a resident in a continuing care retirement community that consists of either an ownership interest in any part of the continuing care retirement community property or a transferable membership that entitles the holder to reside at the continuing care retirement community.
(6)Equity project means a continuing care retirement community where residents receive an equity interest in the continuing care retirement community property.
(7)Equity securities shall refer generally to large and midcapitalization corporate stocks that are publicly traded and readily liquidated for cash, and shall include shares in mutual funds that hold portfolios consisting predominantly of these stocks and other qualifying assets, as defined by Section 1792.2. Equity securities shall also include other similar securities that are specifically approved by the department.
(8)Escrow agent means a bank or institution, including, but not limited to, a title insurance company, approved by the department to hold and render accountings for deposits of cash or cash equivalents.
(f)Facility means any place or accommodation where a provider provides or will provide a resident with care or related services, whether or not the place or accommodation is constructed, owned, leased, rented, or otherwise contracted for by the provider.
(g)(reserved)
(h)(reserved)
(i)(1)Inactive certificate of authority means a certificate that has been terminated under Section 1793.8.
(2)Investment securities means any of the following:
(A)Direct obligations of the United States, including obligations issued or held in book-entry form on the books of the United States Department of the Treasury or obligations the timely payment of the principal of, and the interest on, which are fully guaranteed by the United States.
(B)Obligations, debentures, notes, or other evidences of indebtedness issued or guaranteed by any of the following:
(i)The Federal Home Loan Bank System.
(ii)The Export-Import Bank of the United States.
(iii)The Federal Financing Bank.
(iv)The Government National Mortgage Association.
(v)The Farmers Home Administration.
(vi)The Federal Home Loan Mortgage Corporation of the Federal Housing Administration.
(vii)Any agency, department, or other instrumentality of the United States if the obligations are rated in one of the two highest rating categories of each rating agency rating those obligations.
(C)Bonds of the State of California or of any county, city and county, or city in this state, if rated in one of the two highest rating categories of each rating agency rating those bonds.
(D)Commercial paper of finance companies and banking institutions rated in one of the two highest categories of each rating agency rating those instruments.
(E)Repurchase agreements fully secured by collateral security described in subparagraph (A) or (B), as evidenced by an opinion of counsel, if the collateral is held by the provider or a third party during the term of the repurchase agreement, pursuant to the terms of the agreement, subject to liens or claims of third parties, and has a market value, which is determined at least every 14 days, at least equal to the amount so invested.
(F)Long-term investment agreements, which have maturity dates in excess of one year, with financial institutions, including, but not limited to, banks and insurance companies or their affiliates, if the financial institutions paying ability for debt obligations or long-term claims or the paying ability of a related guarantor of the financial institution for these obligations or claims, is rated in one of the two highest rating categories of each rating agency rating those instruments, or if the short-term investment agreements are with the financial institution or the related guarantor of the financial institution, the long-term or short-term debt obligations, whichever is applicable, of which are rated in one of the two highest long-term or short-term rating categories, of each rating agency rating the bonds of the financial institution or the related guarantor, provided that if the rating falls below the two highest rating categories, the investment agreement shall allow the provider the option to replace the financial institution or the related guarantor of the financial institution or shall provide for the investment securities to be fully collateralized by investments described in subparagraph (A), and, provided further, if so collateralized, that the provider has a perfected first security lien on the collateral, as evidenced by an opinion of counsel and the collateral is held by the provider.
(G)Bankers acceptances or certificates of deposit of, or time deposits in, any savings and loan association that meets any of the following criteria:
(i)The debt obligations of the savings and loan association, or in the case of a principal bank, of the bank holding company, are rated in one of the two highest rating categories of each rating agency rating those instruments.
(ii)The certificates of deposit or time deposits are fully insured by the Federal Deposit Insurance Corporation.
(iii)The certificates of deposit or time deposits are secured at all times, in the manner and to the extent provided by law, by collateral security described in subparagraph (A) or (B) with a market value, valued at least quarterly, of no less than the original amount of moneys so invested.
(H)Taxable money market government portfolios restricted to obligations issued or guaranteed as to payment of principal and interest by the full faith and credit of the United States.
(I)Obligations the interest on which is excluded from gross income for federal income tax purposes and money market mutual funds whose portfolios are restricted to these obligations, if the obligations or mutual funds are rated in one of the two highest rating categories by each rating agency rating those obligations.
(J)Bonds that are not issued by the United States or any federal agency, but that are listed on a national exchange and that are rated at least A by Moodys Investors Service, or the equivalent rating by Standard and Poors Corporation or Fitch Investors Service.
(K)Bonds not listed on a national exchange that are traded on an over-the-counter basis, and that are rated at least Aa by Moodys Investors Service or AA by Standard and Poors Corporation or Fitch Investors Service.
(j)(reserved)
(k)(reserved)
(l)Life care contract means a continuing care contract that includes a promise, expressed or implied, by a provider to provide or pay for routine services at all levels of care, including acute care and the services of physicians and surgeons, to the extent not covered by other public or private insurance benefits, to a resident for the duration of his or her life. Care shall be provided under a life care contract in a continuing care retirement community having a comprehensive continuum of care, including a skilled nursing facility, under the ownership and supervision of the provider on or adjacent to the premises. A change shall not be made in the monthly fee based on level of care. A life care contract shall also include provisions to subsidize residents who become financially unable to pay their monthly care fees.
(m)(1)Monthly care fee means the fee charged to a resident in a continuing care contract on a monthly or other periodic basis for current accommodations and services, including care, board, or lodging. Periodic entrance fee payments or other prepayments shall not be monthly care fees.
(2)Monthly fee contract means a continuing care contract that requires residents to pay monthly care fees.
(n)Nonambulatory person means a person who is unable to leave a building unassisted under emergency conditions in the manner described by Section 13131.
(o)(reserved)
(p)(1)Per capita cost means a continuing care retirement communitys operating expenses, excluding depreciation, divided by the average number of residents.
(2)Periodic charges means fees paid by a resident on a periodic basis.
(3)Permanent closure means the voluntary or involuntary termination or forfeiture, as specified in subdivisions (a), (b), (g), (h), and (i) of Section 1793.7, of a providers certificate of authority or license, or another action that results in the permanent relocation of residents. Permanent closure does not apply in the case of a natural disaster or other event out of the providers control.
(4)Permit to accept deposits means a written authorization by the department permitting an applicant to enter into deposit agreements regarding a single specified continuing care retirement community.
(5)Prepaid contract means a continuing care contract in which the monthly care fee, if any, may not be adjusted to cover the actual cost of care and services.
(6)Preferred access means that residents who have previously occupied a residential living unit have a right over other persons to any assisted living or skilled nursing beds that are available at the community.
(7)Processing fee means a payment to cover administrative costs of processing the application of a depositor or prospective resident.
(8)Promise to provide one or more elements of care means any expressed or implied representation that one or more elements of care will be provided or will be available, such as by preferred access.
(9)Proposes means a representation that an applicant or provider will or intends to make a future promise to provide care, including a promise that is subject to a condition, such as the construction of a continuing care retirement community or the acquisition of a certificate of authority.
(10)Provider means an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. Provider also includes any entity that controls an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. The department shall determine whether an entity controls another entity for purposes of this article. No homeowners association, cooperative, or condominium association may be a provider.
(11)Provisional certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, under Section 1786. A provisional certificate of authority shall be limited to the specific continuing care retirement community and number of units identified in the applicants application.
(q)(reserved)
(r)(1)Refund reserve means the reserve a provider is required to maintain, as provided in Section 1792.6.
(2)(A)Refundable contract means a continuing care contract that includes a promise, expressed or implied, by the provider to pay an entrance fee refund or to repurchase the transferors unit, membership, stock, or other interest in the continuing care retirement community when the promise to refund some or all of the initial entrance fee extends beyond the residents sixth year of residency. Providers that enter into refundable contracts shall be subject to the refund reserve requirements of Section 1792.6.
(B)A continuing care contract that includes a promise to repay all or a portion of an entrance fee that is conditioned upon reoccupancy or resale of the unit previously occupied by the resident shall not be considered a refundable contract for purposes of the refund reserve requirements of Section 1792.6, provided that this conditional promise of repayment is not referred to by the applicant or provider as a refund. A provider may repay all or a portion of an entrance fee that is conditioned upon resale of the unit before the resale of the unit. The repayment of an entrance fee before the resale of the unit shall not cause any other entrance fee to be subject to the refund reserve requirements of Section 1792.6, provided that the provider does not promise, at the time of contracting or thereafter, to make this type of early repayment, represent that the provider intends to make this type of early repayment, or indicate that the provider has a practice of making this type of early repayment.
(3)Resale fee means a levy by the provider against the proceeds from the sale of a transferors equity interest.
(4)Reservation fee refers to consideration collected by an entity that has made a continuing care promise or is proposing to make this promise and has complied with Section 1771.4.
(5)Resident means a person who enters into a continuing care contract with a provider, or who is designated in a continuing care contract to be a person being provided or to be provided services, including care, board, or lodging.
(6)Residential care facility for the elderly means a housing arrangement as defined by Section 1569.2.
(7)Residential living unit means a living unit in a continuing care retirement community that is not used exclusively for assisted living services or nursing services.
(8)Residential temporary relocation means the relocation of one or more residents, except in the case of a natural disaster that is out of the providers control, from one or more residential living units, assisted living units, skilled nursing units, or a wing, floor, or entire continuing care retirement community building, due to a change of use or major repairs or renovations. A residential temporary relocation shall mean a relocation pursuant to this subdivision that lasts for a period of at least 9 months but that does not exceed 18 months without the written agreement of the resident.
(s)(reserved)
(t)(1)Termination means the ending of a continuing care contract as provided for in the terms of the continuing care contract.
(2)Transfer trauma means death, depression, or regressive behavior, that is caused by the abrupt and involuntary transfer of an elderly resident from one home to another and results from a loss of familiar physical environment, loss of well-known neighbors, attendants, nurses and medical personnel, the stress of an abrupt break in the small routines of daily life, or the loss of visits from friends and relatives who may be unable to reach the new facility.
(3)Transferor means a person who transfers, or promises to transfer, consideration in exchange for care and related services under a continuing care contract or proposed continuing care contract, for the benefit of another. A transferor shall have the same rights to cancel and obtain a refund as the depositor under the deposit agreement or the resident under a continuing care contract.
SEC. 2.Section 1788 of the Health and Safety Code is amended to read:1788.(a)A continuing care contract shall contain all of the following:
(1)The legal name and address of each provider.
(2)The name and address of the continuing care retirement community.
(3)The residents name and the identity of the unit the resident will occupy.
(4)If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferors name and address shall be specified.
(5)If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
(6)The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
(7)The duration of the continuing care contract.
(8)A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
(A)Regular observation of the residents health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
(B)Safe and healthful living accommodations, including housekeeping services and utilities.
(C)Maintenance of house rules for the protection of residents.
(D)A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
(E)Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
(F)Assisted living services.
(G)Assistance with taking medications.
(H)Central storing and distribution of medications.
(I)Arrangements to meet health needs, including arranging transportation.
(9)An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract. The schedule shall state that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(10)The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
(A)A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
(i)The resident is nonambulatory. The definition of nonambulatory, as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
(ii)The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
(iii)The residents condition or needs require the residents transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
(iv)The residents condition or needs require the residents transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
(B)Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
(i)Involve the resident and the residents responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the residents or responsible persons request, family members, or the residents physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the residents responsible person.
(ii)Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the residents responsible person, and upon the residents or responsible persons request, family members, and the residents health care professionals, to explain the reasons for transfer.
(iii)Notify the resident and the residents responsible person of the reasons for the transfer in writing.
(iv)Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
(v)The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the residents urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
(vi)The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the residents right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the departments Continuing Care Contracts Branch.
(vii)The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
(C)The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the residents responsible person, and upon the residents or responsible persons request, family members, the residents physician or other appropriate health care professional, and members of the providers interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the residents responsible person, or the provider.
(D)For disputed transfer decisions, the resident or the residents responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
(E)The decision of the departments Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
(F)Transfer of a second resident when a shared accommodation arrangement is terminated.
(11)Provisions describing any changes in the residents monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Unless the fee is part of an equity interest contract, a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident.
(12)The providers continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
(13)The providers obligations, if any, to resume care upon the residents return after a transfer from the continuing care retirement community.
(14)The providers obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
(15)The conditions under which the resident must permanently release his or her living unit.
(16)If real or personal properties are transferred in lieu of cash, a statement specifying each items value at the time of transfer, and how the value was ascertained.
(A)An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
(B)When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
(C)The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
(17)The amount of the entrance fee.
(18)In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
(19)The amount of any processing fee.
(20)The amount of any monthly care fee.
(21)For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
(A)A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
(B)The regular rate of payment agreed upon (per day, week, or month).
(C)A provision specifying whether payment will be made in advance or after services have been provided.
(D)A provision specifying the provider will adjust monthly care fees for the residents support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
(E)A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
(F)A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
(G)A statement that the provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(22)All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
(A)For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
(i)Fees shall not be subject to change during the lifetime of the agreement.
(ii)Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
(iii)Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
(B)For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
(23)A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the residents monthly care fees or in the price or scope of any component of care or other services.
(24)A provision indicating whether the residents rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
(25)If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
(26)Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
(27)A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right.
(28)Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days written notice by the provider without cause, or that the provider waives this right.
(29)The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
(30)A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
(A)Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for just cause, good cause, or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes just cause, good cause, or otherwise activates the termination provision:
(i)Filing or lodging a formal complaint with the department or other appropriate authority.
(ii)Participation in an organization or affiliation of residents, or other similar lawful activity.
(B)The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents organization or association.
(C)Nothing in this paragraph diminishes the providers ability to terminate the continuing care contract for good and sufficient cause.
(31)A statement that at least 90 days written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
(32)A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
(33)The policy or terms for refunding or repaying a lump sum of any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund or repaying a lump sum of all or a part of the entrance fee shall also do all of the following:
(A)Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the residents unit.
(B)State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
(i)Amortize the specified amount at the same rate as the residents entrance fee.
(ii)Refund the unamortized balance to the resident at the same time the provider pays the residents entrance fee refund.
(C)State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
(D)State the provider shall make a good-faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. No later than July 1, 2016, a provider shall provide notice to all current residents with contracts applicable to this subparagraph regarding the statement required by this subparagraph as a clarification of the residents existing contract.
(E)For all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the provider shall state the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
(34)The following notice at the bottom of the signatory page:
NOTICE | (date) |
This is a continuing care contract as defined by paragraph (8) of subdivision (c), or subdivision (l) of Section 1771 of the California Health and Safety Code. This continuing care contract form has been approved by the State Department of Social Services as required by subdivision (b) of Section 1787 of the California Health and Safety Code. The basis for this approval was a determination that (provider name) has submitted a contract that complies with the minimum statutory requirements applicable to continuing care contracts. The department does not approve or disapprove any of the financial or health care coverage provisions in this contract. Approval by the department is NOT a guaranty of performance or an endorsement of any continuing care contract provisions. Prospective transferors and residents are strongly encouraged to carefully consider the benefits and risks of this continuing care contract and to seek financial and legal advice before signing.
(35)The provider may not attempt to absolve itself in the continuing care contract from liability for its negligence by any statement to that effect, and shall include the following statement in the contract: Nothing in this continuing care contract limits either the providers obligation to provide adequate care and supervision for the resident or any liability on the part of the provider which may result from the providers failure to provide this care and supervision.
(36)Provisions describing how the provider will proceed in the event of a closure, including an explanation of how the provider will comply with Sections 1793.80, 1793.81, 1793.82, and 1793.83.
(b)A life care contract shall also provide that:
(1)All levels of care, including acute care and physicians and surgeons services, will be provided to a resident.
(2)Care will be provided for the duration of the residents life unless the life care contract is canceled or terminated by the provider during the cancellation period or after the cancellation period for good cause.
(3)A comprehensive continuum of care will be provided to the resident, including skilled nursing, in a facility under the ownership and supervision of the provider on, or adjacent to, the continuing care retirement community premises.
(4)Monthly care fees will not be changed based on the residents level of care or service.
(5)A resident who becomes financially unable to pay his or her monthly care fees shall be subsidized provided the residents financial need does not arise from action by the resident to divest the resident of his or her assets.
(c)Continuing care contracts may include provisions that do any of the following:
(1)Subsidize a resident who becomes financially unable to pay for his or her monthly care fees at some future date. If a continuing care contract provides for subsidizing a resident, it may also provide for any of the following:
(A)The resident shall apply for any public assistance or other aid for which he or she is eligible and that the provider may apply for assistance on behalf of the resident.
(B)The providers decision shall be final and conclusive regarding any adjustments to be made or any action to be taken regarding any charitable consideration extended to any of its residents.
(C)The provider is entitled to payment for the actual costs of care out of any property acquired by the resident subsequent to any adjustment extended to the resident under this paragraph, or from any other property of the resident that the resident failed to disclose.
(D)The provider may pay the monthly premium of the residents health insurance coverage under Medicare to ensure that those payments will be made.
(E)The provider may receive an assignment from the resident of the right to apply for and to receive the benefits, for and on behalf of the resident.
(F)The provider is not responsible for the costs of furnishing the resident with any services, supplies, and medication, when reimbursement is reasonably available from any governmental agency, or any private insurance.
(G)Any refund due to the resident at the termination of the continuing care contract may be offset by any prior subsidy to the resident by the provider.
(2)Limit responsibility for costs associated with the treatment or medication of an ailment or illness existing prior to the date of admission. In these cases, the medical or surgical exceptions, as disclosed by the medical entrance examination, shall be listed in the continuing care contract or in a medical report attached to and made a part of the continuing care contract.
(3)Identify legal remedies that may be available to the provider if the resident makes any material misrepresentation or omission pertaining to the residents assets or health.
(4)Restrict transfer or assignments of the residents rights and privileges under a continuing care contract due to the personal nature of the continuing care contract.
(5)Protect the providers ability to waive a residents breach of the terms or provisions of the continuing care contract in specific instances without relinquishing its right to insist upon full compliance by the resident with all terms or provisions in the contract.
(6)Provide that the resident shall reimburse the provider for any uninsured loss or damage to the residents unit, beyond normal wear and tear, resulting from the residents carelessness or negligence.
(7)Provide that the resident agrees to observe the off-limit areas of the continuing care retirement community designated by the provider for safety reasons. The provider may not include any provision in a continuing care contract that absolves the provider from liability for its negligence.
(8)Provide for the subrogation to the provider of the residents rights in the case of injury to a resident caused by the acts or omissions of a third party, or for the assignment of the residents recovery or benefits in this case to the provider, to the extent of the value of the goods and services furnished by the provider to or on behalf of the resident as a result of the injury.
(9)Provide for a lien on any judgment, settlement, or recovery for any additional expense incurred by the provider in caring for the resident as a result of injury.
(10)Require the residents cooperation and assistance in the diligent prosecution of any claim or action against any third party.
(11)Provide for the appointment of a conservator or guardian by a court with jurisdiction in the event a resident becomes unable to handle his or her personal or financial affairs.
(12)Allow a provider, whose property is tax exempt, to charge the resident, on a pro rata basis, property taxes, or in-lieu taxes, that the provider is required to pay.
(13)Make any other provision approved by the department.
(d)A copy of the residents rights as described in Section 1771.7 shall be attached to every continuing care contract.
(e)A copy of the current audited financial statement of the provider shall be attached to every continuing care contract. For a provider whose current audited financial statement does not accurately reflect the financial ability of the provider to fulfill the continuing care contract obligations, the financial statement attached to the continuing care contract shall include all of the following:
(1)A disclosure that the reserve requirement has not yet been determined or met, and that entrance fees will not be held in escrow.
(2)A disclosure that the ability to provide the services promised in the continuing care contract will depend on successful compliance with the approved financial plan.
(3)A copy of the approved financial plan for meeting the reserve requirements.
(4)Any other supplemental statements or attachments necessary to accurately represent the providers financial ability to fulfill its continuing care contract obligations.
(f)A schedule of the average monthly care fees charged to residents for each type of residential living unit for each of the five years preceding execution of the continuing care contract shall be attached to every continuing care contract. The provider shall update this schedule annually at the end of each fiscal year. If the continuing care retirement community has not been in existence for five years, the information shall be provided for each of the years the continuing care retirement community has been in existence.
(g)If any continuing care contract provides for a health insurance policy for the benefit of the resident, the provider shall attach to the continuing care contract a binder complying with Sections 382 and 382.5 of the Insurance Code.
(h)The provider shall attach to every continuing care contract a completed form in duplicate, captioned Notice of Cancellation. The notice shall be easily detachable, and shall contain, in at least 10-point boldface type, the following statement:
NOTICE OF CANCELLATION | (date) |
Your first date of occupancy under this contract | |
is: _____________________________________________ | |
You may cancel this transaction, without any penalty within 90 calendar days from the above date.
If you cancel, any property transferred, any payments made by you under the contract, and any negotiable instrument executed by you will be returned within 14 calendar days after making possession of the living unit available to the provider. Any security interest arising out of the transaction will be canceled.
If you cancel, you are obligated to pay a reasonable processing fee to cover costs and to pay for the reasonable value of the services received by you from the provider up to the date you canceled or made available to the provider the possession of any living unit delivered to you under this contract, whichever is later.
If you cancel, you must return possession of any living unit delivered to you under this contract to the provider in substantially the same condition as when you took possession.
Possession of the living unit must be made available to the provider within 20 calendar days of your notice of cancellation. If you fail to make the possession of any living unit available to the provider, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any other written notice, or send a telegram
to | |
(Name of provider) | |
|---|---|
at | |
(Address of providers place of business) | |
not later than midnight of_____________(date). | |
I hereby cancel this | |
(Residentsor | |
(a)During the cancellation period, the provider shall pay all refunds owed to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider.
(b)After the cancellation period, any refunds due to a resident under a continuing care contract shall be paid within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later.
(c)In nonequity projects, if the continuing care contract is canceled by either party during the cancellation period or terminated by the provider after the cancellation period, the resident shall be refunded the difference between the total amount of entrance, monthly, and optional fees paid and the amount used for care of the resident.
(d)If a resident has paid additional amounts for upgrades, special features, or modifications to the living unit and the provider terminates the residents continuing care contract, the provider shall amortize those additional amounts at the same rate as the entrance fee and shall refund the unamortized balance to the resident.
(e)(1)A lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of the unit shall not be considered to be a refund and may not be characterized or advertised as a refund. The full lump-sum payment shall be paid to the resident within 14 calendar days after resale of the unit. For contracts signed after January 1, 2016, notwithstanding a providers documented good-faith effort to resell the unit, the resident is entitled to the repayment of a specified portion, pursuant to subparagraphs (A) and (B), of the full lump-sum payment if the unit remains vacant 120 days after the residents termination. This repayment shall not cause the contract in question to be deemed a refundable contract, as defined in paragraph (2) of subdivision (r) of Section 1771.
(A)When a continuing care contract is terminated by the death of a resident, at least 10 percent of the full lump-sum payment shall be paid to the residents estate within 120 days after the residents termination.
(B)When a continuing care contract is terminated for a reason not described in subparagraph (A), at least 20 percent of the full lump-sum payment shall be paid to the resident within 120 days after the residents termination.
(2)Any payment balance that has not been paid to the resident within 180 days shall accrue interest at a rate calculated pursuant to paragraph (3). Any payment balance that has not been paid to the resident within 240 days shall accrue interest at a rate calculated pursuant to paragraph (4). Interest shall continue to accrue until the date the full lump-sum payment is paid to the resident. This paragraph shall apply only to continuing care contracts entered into on or after January 1, 2016.
(3)Any payments that are not paid to the resident within the 180-day period pursuant to paragraph (2) shall accrue simple interest, to be compounded annually, at a rate of 4 percent.
(4)Any payments that are not paid to the resident within the 240-day period pursuant to paragraph (2) shall accrue simple interest, to be compounded annually, at a rate of 6 percent.
(f)After the death of a resident, a lump-sum payment that is conditioned upon resale of a unit shall be subject to subdivision (e) and the payment and interest, if any, shall be payable to the residents estate.
(g)Except as otherwise obligated by an equity interest contract, once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit.
(h)Nothing in this section shall be construed to limit or alter any legal remedies otherwise available to a resident or his or her estate.
(i)Until January 1, 2017, this section shall not apply to a project that is in development prior to January 1, 2016, including current repayable agreements, current deposit agreements that contemplate repayable entrance fees, and other projects that have received department approval to market units pursuant to Section 1771.4, or have received issuer, lender, or bond insurer approval to obtain bond financing, or other governmental approval based on a repayable entrance fee option, if the initial contract for the project is entered into on or before January 1, 2017.
SEC. 4.Section 1788.5 is added to the Health and Safety Code, to read:1788.5.(a)Any resident whose contract calls for a lump-sum payment conditioned upon resale of a unit may file a complaint with the department if the unit has not been resold for more than 12 months after possession of the unit was made available to the provider. A resident may file such a complaint regardless of whether or not the contract includes a provision expressly requiring a good-faith effort to resell the unit.
(b)(1)In response to the complaint, the department shall perform an investigation to determine whether the provider has made a sufficient good-faith effort to resell or reoccupy the unit. At the departments discretion, the investigation may include any of the following:
(A)Inspections of the unit and the continuing care retirement community.
(B)Interviews with the provider, staff, and employees.
(C)Opinions and analysis from consultants.
(D)Written submissions from the resident or provider.
(E)A hearing.
(2)The department shall consider whether the provider has adequately refurbished the unit for reletting, made necessary repairs, reasonably marketed the unit to potential residents, and shown the unit to prospective residents.
(c)Following the investigation, the department shall issue a written determination, which includes a statement of the basis for the determination.
(d)A resident, in the case of a determination of sufficient good faith, or a provider, in the case of a determination of lack of sufficient good faith, shall have the right to submit to the department a written request for a formal review of the determination within 20 business days after the department issues the written determination. The party requesting review shall provide all supporting documentation at that time. If no written request for review is made, the departments determination shall be considered final. If a written request for review is made, the review shall be conducted by the deputy director of the Community Care Licensing Division. If the department requires additional information from the resident or provider, it shall be requested within the first 30 business days after receiving the request for review. The resident or provider shall provide this additional information within 20 business days after it is requested by the department. If the deputy director determines that the previous determination was not made in accordance with applicable statutes or regulations of the department, the department shall withdraw its previous determination and issue a new determination. The resident and provider shall be notified in writing of the deputy directors decision within 40 business days from the time when all necessary information has been received by the department. The deputy directors decision is considered final and concludes the administrative appeal rights of the resident and provider.
(e)If the department determines that the provider has not made a sufficient good-faith effort to reoccupy or resell the unit, the provider shall repay the full lump-sum payment owed to the resident within 20 business days after the departments determination becomes final. The departments final determination and its factual findings, and any interim determination and factual findings, shall be inadmissible in court or any other proceeding, with the exception of any proceeding to enforce this subdivision.
Unless the context otherwise requires, the definitions in this section govern the interpretation of this chapter.
(a)(1)Affiliate means any person, corporation, limited liability company, business trust, trust, partnership, unincorporated association, or other legal entity that directly or indirectly controls, is controlled by, or is under common control with, a provider or applicant.
(2)Affinity group means a grouping of entities sharing a common interest, philosophy, or connection (e.g., military officers, religion).
(3)Annual report means the report each provider is required to file annually with the department, as described in Section 1790.
(4)Applicant means any entity, or combination of entities, that submits and has pending an application to the department for a permit to accept deposits and a certificate of authority.
(5)Assisted living services includes, but is not limited to, assistance with personal activities of daily living, including dressing, feeding, toileting, bathing, grooming, mobility, and associated tasks, to help provide for and maintain physical and psychosocial comfort.
(6)Assisted living unit means the living area or unit within a continuing care retirement community that is specifically designed to provide ongoing assisted living services.
(7)Audited financial statement means financial statements prepared in accordance with generally accepted accounting principles, including the opinion of an independent certified public accountant, and notes to the financial statements considered customary or necessary to provide full disclosure and complete information regarding the providers financial statements, financial condition, and operation.
(b)(reserved)
(c)(1)Cancel means to destroy the force and effect of an agreement or continuing care contract.
(2)Cancellation period means the 90-day period, beginning when the resident physically moves into the continuing care retirement community, during which the resident may cancel the continuing care contract, as provided in Section 1788.2.
(3)Care means nursing, medical, or other health-related services, protection or supervision, assistance with the personal activities of daily living, or any combination of those services.
(4)Cash equivalent means certificates of deposit and United States treasury securities with a maturity of five years or less.
(5)Certificate or certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, authorizing a specified provider to enter into one or more continuing care contracts at a single specified continuing care retirement community.
(6)Condition means a restriction, specific action, or other requirement imposed by the department for the initial or continuing validity of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority. A condition may limit the circumstances under which the provider may enter into any new deposit agreement or contract, or may be imposed as a condition precedent to the issuance of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority.
(7)Consideration means some right, interest, profit, or benefit paid, transferred, promised, or provided by one party to another as an inducement to contract. Consideration includes some forbearance, detriment, loss, or responsibility, that is given, suffered, or undertaken by a party as an inducement to another party to contract.
(8)Continuing care contract means a contract that includes a continuing care promise made, in exchange for an entrance fee, the payment of periodic charges, or both types of payments. A continuing care contract may consist of one agreement or a series of agreements and other writings incorporated by reference.
(9)Continuing care promise means a promise, expressed or implied, by a provider to provide one or more elements of care to an elderly resident for the duration of his or her life or for a term in excess of one year. Any such promise or representation, whether part of a continuing care contract, other agreement, or series of agreements, or contained in any advertisement, brochure, or other material, either written or oral, is a continuing care promise.
(10)Continuing care retirement community means a facility located within the State of California where services promised in a continuing care contract are provided. A distinct phase of development approved by the department may be considered to be the continuing care retirement community when a project is being developed in successive distinct phases over a period of time. When the services are provided in residents own homes, the homes into which the provider takes those services are considered part of the continuing care retirement community.
(11)Control means directing or causing the direction of the financial management or the policies of another entity, including an operator of a continuing care retirement community, whether by means of the controlling entitys ownership interest, contract, or any other involvement. A parent entity or sole member of an entity controls a subsidiary entity provider for a continuing care retirement community if its officers, directors, or agents directly participate in the management of the subsidiary entity or in the initiation or approval of policies that affect the continuing care retirement communitys operations, including, but not limited to, approving budgets or the administrator for a continuing care retirement community.
(d)(1)Department means the State Department of Social Services.
(2)Deposit means any transfer of consideration, including a promise to transfer money or property, made by a depositor to any entity that promises or proposes to promise to provide continuing care, but is not authorized to enter into a continuing care contract with the potential depositor.
(3)Deposit agreement means any agreement made between any entity accepting a deposit and a depositor. Deposit agreements for deposits received by an applicant prior to the departments release of funds from the deposit escrow account shall be subject to the requirements described in Section 1780.4.
(4)Depository means a bank or institution that is a member of the Federal Deposit Insurance Corporation or a comparable deposit insurance program.
(5)Depositor means any prospective resident who pays a deposit. Where any portion of the consideration transferred to an applicant as a deposit or to a provider as consideration for a continuing care contract is transferred by a person other than the prospective resident or a resident, that third-party transferor shall have the same cancellation or refund rights as the prospective resident or resident for whose benefit the consideration was transferred.
(6)Director means the Director of Social Services.
(e)(1)Elderly means an individual who is 60 years of age or older.
(2)Entity means an individual, partnership, corporation, limited liability company, and any other form for doing business. Entity includes a person, sole proprietorship, estate, trust, association, and joint venture.
(3)Entrance fee means the sum of any initial, amortized, or deferred transfer of consideration made or promised to be made by, or on behalf of, a person entering into a continuing care contract for the purpose of ensuring care or related services pursuant to that continuing care contract or as full or partial payment for the promise to provide care for the term of the continuing care contract. Entrance fee includes the purchase price of a condominium, cooperative, or other interest sold in connection with a promise of continuing care. An initial, amortized, or deferred transfer of consideration that is greater in value than 12 times the monthly care fee shall be presumed to be an entrance fee.
(4)Equity means the value of real property in excess of the aggregate amount of all liabilities secured by the property.
(5)Equity interest means an interest held by a resident in a continuing care retirement community that consists of either an ownership interest in any part of the continuing care retirement community property or a transferable membership that entitles the holder to reside at the continuing care retirement community.
(6)Equity project means a continuing care retirement community where residents receive an equity interest in the continuing care retirement community property.
(7)Equity securities shall refer generally to large and midcapitalization corporate stocks that are publicly traded and readily liquidated for cash, and shall include shares in mutual funds that hold portfolios consisting predominantly of these stocks and other qualifying assets, as defined by Section 1792.2. Equity securities shall also include other similar securities that are specifically approved by the department.
(8)Escrow agent means a bank or institution, including, but not limited to, a title insurance company, approved by the department to hold and render accountings for deposits of cash or cash equivalents.
(f)Facility means any place or accommodation where a provider provides or will provide a resident with care or related services, whether or not the place or accommodation is constructed, owned, leased, rented, or otherwise contracted for by the provider.
(g)(reserved)
(h)(reserved)
(i)(1)Inactive certificate of authority means a certificate that has been terminated under Section 1793.8.
(2)Investment securities means any of the following:
(A)Direct obligations of the United States, including obligations issued or held in book-entry form on the books of the United States Department of the Treasury or obligations the timely payment of the principal of, and the interest on, which are fully guaranteed by the United States.
(B)Obligations, debentures, notes, or other evidences of indebtedness issued or guaranteed by any of the following:
(i)The Federal Home Loan Bank System.
(ii)The Export-Import Bank of the United States.
(iii)The Federal Financing Bank.
(iv)The Government National Mortgage Association.
(v)The Farmers Home Administration.
(vi)The Federal Home Loan Mortgage Corporation of the Federal Housing Administration.
(vii)Any agency, department, or other instrumentality of the United States if the obligations are rated in one of the two highest rating categories of each rating agency rating those obligations.
(C)Bonds of the State of California or of any county, city and county, or city in this state, if rated in one of the two highest rating categories of each rating agency rating those bonds.
(D)Commercial paper of finance companies and banking institutions rated in one of the two highest categories of each rating agency rating those instruments.
(E)Repurchase agreements fully secured by collateral security described in subparagraph (A) or (B), as evidenced by an opinion of counsel, if the collateral is held by the provider or a third party during the term of the repurchase agreement, pursuant to the terms of the agreement, subject to liens or claims of third parties, and has a market value, which is determined at least every 14 days, at least equal to the amount so invested.
(F)Long-term investment agreements, which have maturity dates in excess of one year, with financial institutions, including, but not limited to, banks and insurance companies or their affiliates, if the financial institutions paying ability for debt obligations or long-term claims or the paying ability of a related guarantor of the financial institution for these obligations or claims, is rated in one of the two highest rating categories of each rating agency rating those instruments, or if the short-term investment agreements are with the financial institution or the related guarantor of the financial institution, the long-term or short-term debt obligations, whichever is applicable, of which are rated in one of the two highest long-term or short-term rating categories, of each rating agency rating the bonds of the financial institution or the related guarantor, provided that if the rating falls below the two highest rating categories, the investment agreement shall allow the provider the option to replace the financial institution or the related guarantor of the financial institution or shall provide for the investment securities to be fully collateralized by investments described in subparagraph (A), and, provided further, if so collateralized, that the provider has a perfected first security lien on the collateral, as evidenced by an opinion of counsel and the collateral is held by the provider.
(G)Bankers acceptances or certificates of deposit of, or time deposits in, any savings and loan association that meets any of the following criteria:
(i)The debt obligations of the savings and loan association, or in the case of a principal bank, of the bank holding company, are rated in one of the two highest rating categories of each rating agency rating those instruments.
(ii)The certificates of deposit or time deposits are fully insured by the Federal Deposit Insurance Corporation.
(iii)The certificates of deposit or time deposits are secured at all times, in the manner and to the extent provided by law, by collateral security described in subparagraph (A) or (B) with a market value, valued at least quarterly, of no less than the original amount of moneys so invested.
(H)Taxable money market government portfolios restricted to obligations issued or guaranteed as to payment of principal and interest by the full faith and credit of the United States.
(I)Obligations the interest on which is excluded from gross income for federal income tax purposes and money market mutual funds whose portfolios are restricted to these obligations, if the obligations or mutual funds are rated in one of the two highest rating categories by each rating agency rating those obligations.
(J)Bonds that are not issued by the United States or any federal agency, but that are listed on a national exchange and that are rated at least A by Moodys Investors Service, or the equivalent rating by Standard and Poors Corporation or Fitch Investors Service.
(K)Bonds not listed on a national exchange that are traded on an over-the-counter basis, and that are rated at least Aa by Moodys Investors Service or AA by Standard and Poors Corporation or Fitch Investors Service.
(j)(reserved)
(k)(reserved)
(l)Life care contract means a continuing care contract that includes a promise, expressed or implied, by a provider to provide or pay for routine services at all levels of care, including acute care and the services of physicians and surgeons, to the extent not covered by other public or private insurance benefits, to a resident for the duration of his or her life. Care shall be provided under a life care contract in a continuing care retirement community having a comprehensive continuum of care, including a skilled nursing facility, under the ownership and supervision of the provider on or adjacent to the premises. A change shall not be made in the monthly fee based on level of care. A life care contract shall also include provisions to subsidize residents who become financially unable to pay their monthly care fees.
(m)(1)Monthly care fee means the fee charged to a resident in a continuing care contract on a monthly or other periodic basis for current accommodations and services, including care, board, or lodging. Periodic entrance fee payments or other prepayments shall not be monthly care fees.
(2)Monthly fee contract means a continuing care contract that requires residents to pay monthly care fees.
(n)Nonambulatory person means a person who is unable to leave a building unassisted under emergency conditions in the manner described by Section 13131.
(o)(reserved)
(p)(1)Per capita cost means a continuing care retirement communitys operating expenses, excluding depreciation, divided by the average number of residents.
(2)Periodic charges means fees paid by a resident on a periodic basis.
(3)Permanent closure means the voluntary or involuntary termination or forfeiture, as specified in subdivisions (a), (b), (g), (h), and (i) of Section 1793.7, of a providers certificate of authority or license, or another action that results in the permanent relocation of residents. Permanent closure does not apply in the case of a natural disaster or other event out of the providers control.
(4)Permit to accept deposits means a written authorization by the department permitting an applicant to enter into deposit agreements regarding a single specified continuing care retirement community.
(5)Prepaid contract means a continuing care contract in which the monthly care fee, if any, may not be adjusted to cover the actual cost of care and services.
(6)Preferred access means that residents who have previously occupied a residential living unit have a right over other persons to any assisted living or skilled nursing beds that are available at the community.
(7)Processing fee means a payment to cover administrative costs of processing the application of a depositor or prospective resident.
(8)Promise to provide one or more elements of care means any expressed or implied representation that one or more elements of care will be provided or will be available, such as by preferred access.
(9)Proposes means a representation that an applicant or provider will or intends to make a future promise to provide care, including a promise that is subject to a condition, such as the construction of a continuing care retirement community or the acquisition of a certificate of authority.
(10)Provider means an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. Provider also includes any entity that controls an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. The department shall determine whether an entity controls another entity for purposes of this article. No homeowners association, cooperative, or condominium association may be a provider.
(11)Provisional certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, under Section 1786. A provisional certificate of authority shall be limited to the specific continuing care retirement community and number of units identified in the applicants application.
(q)(reserved)
(r)(1)Refund reserve means the reserve a provider is required to maintain, as provided in Section 1792.6.
(2)(A)Refundable contract means a continuing care contract that includes a promise, expressed or implied, by the provider to pay an entrance fee refund or to repurchase the transferors unit, membership, stock, or other interest in the continuing care retirement community when the promise to refund some or all of the initial entrance fee extends beyond the residents sixth year of residency. Providers that enter into refundable contracts shall be subject to the refund reserve requirements of Section 1792.6.
(B)A continuing care contract that includes a promise to repay all or a portion of an entrance fee that is conditioned upon reoccupancy or resale of the unit previously occupied by the resident shall not be considered a refundable contract for purposes of the refund reserve requirements of Section 1792.6, provided that this conditional promise of repayment is not referred to by the applicant or provider as a refund. A provider may repay all or a portion of an entrance fee that is conditioned upon resale of the unit before the resale of the unit. The repayment of an entrance fee before the resale of the unit shall not cause any other entrance fee to be subject to the refund reserve requirements of Section 1792.6, provided that the provider does not promise, at the time of contracting or thereafter, to make this type of early repayment, represent that the provider intends to make this type of early repayment, or indicate that the provider has a practice of making this type of early repayment.
(3)Resale fee means a levy by the provider against the proceeds from the sale of a transferors equity interest.
(4)Reservation fee refers to consideration collected by an entity that has made a continuing care promise or is proposing to make this promise and has complied with Section 1771.4.
(5)Resident means a person who enters into a continuing care contract with a provider, or who is designated in a continuing care contract to be a person being provided or to be provided services, including care, board, or lodging.
(6)Residential care facility for the elderly means a housing arrangement as defined by Section 1569.2.
(7)Residential living unit means a living unit in a continuing care retirement community that is not used exclusively for assisted living services or nursing services.
(8)Residential temporary relocation means the relocation of one or more residents, except in the case of a natural disaster that is out of the providers control, from one or more residential living units, assisted living units, skilled nursing units, or a wing, floor, or entire continuing care retirement community building, due to a change of use or major repairs or renovations. A residential temporary relocation shall mean a relocation pursuant to this subdivision that lasts for a period of at least nine months but that does not exceed 18 months without the written agreement of the resident.
(s)(reserved)
(t)(1)Termination means the ending of a continuing care contract as provided for in the terms of the continuing care contract.
(2)Transfer trauma means death, depression, or regressive behavior, that is caused by the abrupt and involuntary transfer of an elderly resident from one home to another and results from a loss of familiar physical environment, loss of well-known neighbors, attendants, nurses and medical personnel, the stress of an abrupt break in the small routines of daily life, or the loss of visits from friends and relatives who may be unable to reach the new facility.
(3)Transferor means a person who transfers, or promises to transfer, consideration in exchange for care and related services under a continuing care contract or proposed continuing care contract, for the benefit of another. A transferor shall have the same rights to cancel and obtain a refund as the depositor under the deposit agreement or the resident under a continuing care contract.
SEC. 2.Section 1788 of the Health and Safety Code is amended to read:1788.(a)A continuing care contract shall contain all of the following:
(1)The legal name and address of each provider.
(2)The name and address of the continuing care retirement community.
(3)The residents name and the identity of the unit the resident will occupy.
(4)If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferors name and address shall be specified.
(5)If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
(6)The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
(7)The duration of the continuing care contract.
(8)A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
(A)Regular observation of the residents health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
(B)Safe and healthful living accommodations, including housekeeping services and utilities.
(C)Maintenance of house rules for the protection of residents.
(D)A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
(E)Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
(F)Assisted living services.
(G)Assistance with taking medications.
(H)Central storing and distribution of medications.
(I)Arrangements to meet health needs, including arranging transportation.
(9)An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract. The schedule shall state that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(10)The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
(A)A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
(i)The resident is nonambulatory. The definition of nonambulatory, as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
(ii)The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
(iii)The residents condition or needs require the residents transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
(iv)The residents condition or needs require the residents transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
(B)Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
(i)Involve the resident and the residents responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the residents or responsible persons request, family members, or the residents physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the residents responsible person.
(ii)Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the residents responsible person, and upon the residents or responsible persons request, family members, and the residents health care professionals, to explain the reasons for transfer.
(iii)Notify the resident and the residents responsible person of the reasons for the transfer in writing.
(iv)Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
(v)The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the residents urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
(vi)The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the residents right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the departments Continuing Care Contracts Branch.
(vii)The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
(C)The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the residents responsible person, and upon the residents or responsible persons request, family members, the residents physician or other appropriate health care professional, and members of the providers interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the residents responsible person, or the provider.
(D)For disputed transfer decisions, the resident or the residents responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
(E)The decision of the departments Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
(F)Transfer of a second resident when a shared accommodation arrangement is terminated.
(11)Provisions describing any changes in the residents monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Unless the fee is part of an equity interest contract, a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident.
(12)The providers continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
(13)The providers obligations, if any, to resume care upon the residents return after a transfer from the continuing care retirement community.
(14)The providers obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
(15)The conditions under which the resident must permanently release his or her living unit.
(16)If real or personal properties are transferred in lieu of cash, a statement specifying each items value at the time of transfer, and how the value was ascertained.
(A)An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
(B)When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
(C)The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
(17)The amount of the entrance fee.
(18)In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
(19)The amount of any processing fee.
(20)The amount of any monthly care fee.
(21)For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
(A)A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
(B)The regular rate of payment agreed upon (per day, week, or month).
(C)A provision specifying whether payment will be made in advance or after services have been provided.
(D)A provision specifying the provider will adjust monthly care fees for the residents support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
(E)A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
(F)A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
(G)A statement that the provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(22)All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
(A)For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
(i)Fees shall not be subject to change during the lifetime of the agreement.
(ii)Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
(iii)Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
(B)For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
(23)A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the residents monthly care fees or in the price or scope of any component of care or other services.
(24)A provision indicating whether the residents rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
(25)If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
(26)Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
(27)A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right.
(28)Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days written notice by the provider without cause, or that the provider waives this right.
(29)The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
(30)A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
(A)Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for just cause, good cause, or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes just cause, good cause, or otherwise activates the termination provision:
(i)Filing or lodging a formal complaint with the department or other appropriate authority.
(ii)Participation in an organization or affiliation of residents, or other similar lawful activity.
(B)The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents organization or association.
(C)Nothing in this paragraph diminishes the providers ability to terminate the continuing care contract for good and sufficient cause.
(31)A statement that at least 90 days written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
(32)A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
(33)The policy or terms for refunding or repaying a lump sum of any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund or repaying a lump sum of all or a part of the entrance fee shall also do all of the following:
(A)Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the residents unit.
(B)State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
(i)Amortize the specified amount at the same rate as the residents entrance fee.
(ii)Refund the unamortized balance to the resident at the same time the provider pays the residents entrance fee refund.
(C)State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
(D)State the provider shall make a good-faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. No later than July 1, 2016, a provider shall provide notice to all current residents with contracts applicable to this subparagraph regarding the statement required by this subparagraph as a clarification of the residents existing contract.
(E)For all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the provider shall state the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
(34)The following notice at the bottom of the signatory page:
NOTICE | (date) |
This is a continuing care contract as defined by paragraph (8) of subdivision (c), or subdivision (l) of Section 1771 of the California Health and Safety Code. This continuing care contract form has been approved by the State Department of Social Services as required by subdivision (b) of Section 1787 of the California Health and Safety Code. The basis for this approval was a determination that (provider name) has submitted a contract that complies with the minimum statutory requirements applicable to continuing care contracts. The department does not approve or disapprove any of the financial or health care coverage provisions in this contract. Approval by the department is NOT a guaranty of performance or an endorsement of any continuing care contract provisions. Prospective transferors and residents are strongly encouraged to carefully consider the benefits and risks of this continuing care contract and to seek financial and legal advice before signing.
(35)The provider may not attempt to absolve itself in the continuing care contract from liability for its negligence by any statement to that effect, and shall include the following statement in the contract: Nothing in this continuing care contract limits either the providers obligation to provide adequate care and supervision for the resident or any liability on the part of the provider which may result from the providers failure to provide this care and supervision.
(36)Provisions describing how the provider will proceed in the event of a closure, including an explanation of how the provider will comply with Sections 1793.80, 1793.81, 1793.82, and 1793.83.
(b)A life care contract shall also provide that:
(1)All levels of care, including acute care and physicians and surgeons services, will be provided to a resident.
(2)Care will be provided for the duration of the residents life unless the life care contract is canceled or terminated by the provider during the cancellation period or after the cancellation period for good cause.
(3)A comprehensive continuum of care will be provided to the resident, including skilled nursing, in a facility under the ownership and supervision of the provider on, or adjacent to, the continuing care retirement community premises.
(4)Monthly care fees will not be changed based on the residents level of care or service.
(5)A resident who becomes financially unable to pay his or her monthly care fees shall be subsidized provided the residents financial need does not arise from action by the resident to divest the resident of his or her assets.
(c)Continuing care contracts may include provisions that do any of the following:
(1)Subsidize a resident who becomes financially unable to pay for his or her monthly care fees at some future date. If a continuing care contract provides for subsidizing a resident, it may also provide for any of the following:
(A)The resident shall apply for any public assistance or other aid for which he or she is eligible and that the provider may apply for assistance on behalf of the resident.
(B)The providers decision shall be final and conclusive regarding any adjustments to be made or any action to be taken regarding any charitable consideration extended to any of its residents.
(C)The provider is entitled to payment for the actual costs of care out of any property acquired by the resident subsequent to any adjustment extended to the resident under this paragraph, or from any other property of the resident that the resident failed to disclose.
(D)The provider may pay the monthly premium of the residents health insurance coverage under Medicare to ensure that those payments will be made.
(E)The provider may receive an assignment from the resident of the right to apply for and to receive the benefits, for and on behalf of the resident.
(F)The provider is not responsible for the costs of furnishing the resident with any services, supplies, and medication, when reimbursement is reasonably available from any governmental agency, or any private insurance.
(G)Any refund due to the resident at the termination of the continuing care contract may be offset by any prior subsidy to the resident by the provider.
(2)Limit responsibility for costs associated with the treatment or medication of an ailment or illness existing prior to the date of admission. In these cases, the medical or surgical exceptions, as disclosed by the medical entrance examination, shall be listed in the continuing care contract or in a medical report attached to and made a part of the continuing care contract.
(3)Identify legal remedies that may be available to the provider if the resident makes any material misrepresentation or omission pertaining to the residents assets or health.
(4)Restrict transfer or assignments of the residents rights and privileges under a continuing care contract due to the personal nature of the continuing care contract.
(5)Protect the providers ability to waive a residents breach of the terms or provisions of the continuing care contract in specific instances without relinquishing its right to insist upon full compliance by the resident with all terms or provisions in the contract.
(6)Provide that the resident shall reimburse the provider for any uninsured loss or damage to the residents unit, beyond normal wear and tear, resulting from the residents carelessness or negligence.
(7)Provide that the resident agrees to observe the off-limit areas of the continuing care retirement community designated by the provider for safety reasons. The provider may not include any provision in a continuing care contract that absolves the provider from liability for its negligence.
(8)Provide for the subrogation to the provider of the residents rights in the case of injury to a resident caused by the acts or omissions of a third party, or for the assignment of the residents recovery or benefits in this case to the provider, to the extent of the value of the goods and services furnished by the provider to or on behalf of the resident as a result of the injury.
(9)Provide for a lien on any judgment, settlement, or recovery for any additional expense incurred by the provider in caring for the resident as a result of injury.
(10)Require the residents cooperation and assistance in the diligent prosecution of any claim or action against any third party.
(11)Provide for the appointment of a conservator or guardian by a court with jurisdiction in the event a resident becomes unable to handle his or her personal or financial affairs.
(12)Allow a provider, whose property is tax exempt, to charge the resident, on a pro rata basis, property taxes, or in-lieu taxes, that the provider is required to pay.
(13)Make any other provision approved by the department.
(d)A copy of the residents rights as described in Section 1771.7 shall be attached to every continuing care contract.
(e)A copy of the current audited financial statement of the provider shall be attached to every continuing care contract. For a provider whose current audited financial statement does not accurately reflect the financial ability of the provider to fulfill the continuing care contract obligations, the financial statement attached to the continuing care contract shall include all of the following:
(1)A disclosure that the reserve requirement has not yet been determined or met, and that entrance fees will not be held in escrow.
(2)A disclosure that the ability to provide the services promised in the continuing care contract will depend on successful compliance with the approved financial plan.
(3)A copy of the approved financial plan for meeting the reserve requirements.
(4)Any other supplemental statements or attachments necessary to accurately represent the providers financial ability to fulfill its continuing care contract obligations.
(f)A schedule of the average monthly care fees charged to residents for each type of residential living unit for each of the five years preceding execution of the continuing care contract shall be attached to every continuing care contract. The provider shall update this schedule annually at the end of each fiscal year. If the continuing care retirement community has not been in existence for five years, the information shall be provided for each of the years the continuing care retirement community has been in existence.
(g)If any continuing care contract provides for a health insurance policy for the benefit of the resident, the provider shall attach to the continuing care contract a binder complying with Sections 382 and 382.5 of the Insurance Code.
(h)The provider shall attach to every continuing care contract a completed form in duplicate, captioned Notice of Cancellation. The notice shall be easily detachable, and shall contain, in at least 10-point boldface type, the following statement:
NOTICE OF CANCELLATION | (date) |
Your first date of occupancy under this contract | |
is: _____________________________________________ | |
You may cancel this transaction, without any penalty within 90 calendar days from the above date.
If you cancel, any property transferred, any payments made by you under the contract, and any negotiable instrument executed by you will be returned within 14 calendar days after making possession of the living unit available to the provider. Any security interest arising out of the transaction will be canceled.
If you cancel, you are obligated to pay a reasonable processing fee to cover costs and to pay for the reasonable value of the services received by you from the provider up to the date you canceled or made available to the provider the possession of any living unit delivered to you under this contract, whichever is later.
If you cancel, you must return possession of any living unit delivered to you under this contract to the provider in substantially the same condition as when you took possession.
Possession of the living unit must be made available to the provider within 20 calendar days of your notice of cancellation. If you fail to make the possession of any living unit available to the provider, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any other written notice, or send a telegram
to | |
(Name of provider) | |
|---|---|
at | |
(Address of providers place of business) | |
not later than midnight of_____________(date). | |
I hereby cancel this | |
(Residentsor | |
(a)During the cancellation period, the provider shall pay all refunds owed to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider.
(b)After the cancellation period, any refunds due to a resident under a continuing care contract shall be paid within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later.
(c)In nonequity projects, if the continuing care contract is canceled by either party during the cancellation period or terminated by the provider after the cancellation period, the resident shall be refunded the difference between the total amount of entrance, monthly, and optional fees paid and the amount used for care of the resident.
(d)If a resident has paid additional amounts for upgrades, special features, or modifications to the living unit and the provider terminates the residents continuing care contract, the provider shall amortize those additional amounts at the same rate as the entrance fee and shall refund the unamortized balance to the resident.
(e)(1)A lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of the unit shall not be considered to be a refund and may not be characterized or advertised as a refund. The full lump-sum payment shall be paid to the resident within 14 calendar days after resale of the unit. For contracts signed after January 1, 2016, notwithstanding a providers documented good-faith effort to resell the unit, the resident is entitled to the repayment of a specified portion, pursuant to subparagraphs (A) and (B), of the full lump-sum payment if the unit remains vacant 120 days after the residents termination. This repayment shall not cause the contract in question to be deemed a refundable contract, as defined in paragraph (2) of subdivision (r) of Section 1771.
(A)When a continuing care contract is terminated by the death of a resident, at least 10 percent of the full lump-sum payment shall be paid to the residents estate within 120 days after the residents termination.
(B)When a continuing care contract is terminated for a reason not described in subparagraph (A), at least 20 percent of the full lump-sum payment shall be paid to the resident within 120 days after the residents termination.
(2)Any payment balance that has not been paid to the resident within 180 days shall accrue interest at a rate calculated pursuant to paragraph (3). Any payment balance that has not been paid to the resident within 240 days shall accrue interest at a rate calculated pursuant to paragraph (4). Interest shall continue to accrue until the date the full lump-sum payment is paid to the resident. This paragraph shall apply only to continuing care contracts entered into on or after January 1, 2016.
(3)Any payments that are not paid to the resident within the 180-day period pursuant to paragraph (2) shall accrue compound interest every 30 days simple interest, to be compounded annually, at a rate not lower than of 4 percent.
(4)Any payments that are not paid to the resident within the 240-day period pursuant to paragraph (2) shall accrue compound interest every 30 days simple interest, to be compounded annually, at a rate not lower than of 6 percent.
(f)After the death of a resident, a lump-sum payment that is conditioned upon resale of a unit shall be subject to subdivision (e) and the payment and interest, if any, shall be payable to the residents estate.
(g)Except as otherwise obligated by an equity interest contract, once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit.
(h)Nothing in this section shall be construed to limit or alter any legal remedies otherwise available to a resident or his or her estate.
(i)Until January 1, 2017, this section shall not apply to a project that is in development prior to January 1, 2016, including current repayable agreements, current deposit agreements that contemplate repayable entrance fees, and other projects that have received department approval to market units pursuant to Section 1771.4, or have received issuer, lender, or bond insurer approval to obtain bond financing, or other governmental approval based on a repayable entrance fee option, if the initial contract for the project is entered into on or before January 1, 2017.
SEC. 4.Section 1788.5 is added to the Health and Safety Code, to read:1788.5.(a)Any resident whose contract calls for a lump-sum payment conditioned upon resale of a unit may file a complaint with the department if the unit has not been resold for more than twelve months after possession of the unit was made available to the provider. A resident may file such a complaint regardless of whether or not the contract includes a provision expressly requiring a good faith effort to resell the unit.
(b)(1)In response to the complaint, the department shall perform an investigation to determine whether the provider has made a sufficient good faith effort to resell or reoccupy the unit. At the departments discretion, the investigation may include any of the following:
(A)Inspections of the unit and the continuing care retirement community.
(B)Interviews with the provider, staff, and employees.
(C)Opinions and analysis from consultants.
(D)Written submissions from the resident or provider.
(E)A hearing.
(2)The department shall consider whether the provider has adequately refurbished the unit for reletting, made necessary repairs, reasonably marketed the unit to potential residents, and shown the unit to prospective residents.
(c)Following the investigation, the department shall issue a written determination, which includes a statement of the basis for the determination.
(d)A resident, in the case of a determination of sufficient good faith, or a provider, in the case of a determination of lack of sufficient good faith, shall have the right to submit to the department a written request for a formal review of the determination within 20 business days after the department issues the written determination. The party requesting review shall provide all supporting documentation at that time. If no written request for review is made, the departments determination shall be considered final. If a written request for review is made, the review shall be conducted by the deputy director of the Community Care Licensing Division. If the department requires additional information from the resident or provider, it shall be requested within the first 30 business days after receiving the request for review. The resident or provider shall provide this additional information within 20 business days after it is requested by the department. If the deputy director determines that the previous determination was not made in accordance with applicable statutes or regulations of the department, the department shall withdraw its previous determination and issue a new determination. The resident and provider shall be notified in writing of the deputy directors decision within 40 business days from the time when all necessary information has been received by the department. The deputy directors decision is considered final and concludes the administrative appeal rights of the resident and provider.
(e)If the department determines that the provider has not made a sufficient good faith effort to reoccupy or resell the unit, the provider shall repay the full lump-sum payment owed to the resident within 20 business days after the departments determination becomes final. The departments final determination and its factual findings, and any interim determination and factual findings, shall be inadmissible in court or any other proceeding, with the exception of any proceeding to enforce this subdivision.
Unless the context otherwise requires, the definitions in this section govern the interpretation of this chapter.
(a)(1)Affiliate means any person, corporation, limited liability company, business trust, trust, partnership, unincorporated association, or other legal entity that directly or indirectly controls, is controlled by, or is under common control with, a provider or applicant.
(2)Affinity group means a grouping of entities sharing a common interest, philosophy, or connection (e.g., military officers, religion).
(3)Annual report means the report each provider is required to file annually with the department, as described in Section 1790.
(4)Applicant means any entity, or combination of entities, that submits and has pending an application to the department for a permit to accept deposits and a certificate of authority.
(5)Assisted living services includes, but is not limited to, assistance with personal activities of daily living, including dressing, feeding, toileting, bathing, grooming, mobility, and associated tasks, to help provide for and maintain physical and psychosocial comfort.
(6)Assisted living unit means the living area or unit within a continuing care retirement community that is specifically designed to provide ongoing assisted living services.
(7)Audited financial statement means financial statements prepared in accordance with generally accepted accounting principles principles, including the opinion of an independent certified public accountant, and notes to the financial statements considered customary or necessary to provide full disclosure and complete information regarding the providers financial statements, financial condition, and operation.
(b)(reserved)
(c)(1)Cancel means to destroy the force and effect of an agreement or continuing care contract.
(2)Cancellation period means the 90-day period, beginning when the resident physically moves into the continuing care retirement community, during which the resident may cancel the continuing care contract, as provided in Section 1788.2.
(3)Care means nursing, medical, or other health-related services, protection or supervision, assistance with the personal activities of daily living, or any combination of those services.
(4)Cash equivalent means certificates of deposit and United States treasury securities with a maturity of five years or less.
(5)Certificate or certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, authorizing a specified provider to enter into one or more continuing care contracts at a single specified continuing care retirement community.
(6)Condition means a restriction, specific action, or other requirement imposed by the department for the initial or continuing validity of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority. A condition may limit the circumstances under which the provider may enter into any new deposit agreement or contract, or may be imposed as a condition precedent to the issuance of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority.
(7)Consideration means some right, interest, profit, or benefit paid, transferred, promised, or provided by one party to another as an inducement to contract. Consideration includes some forbearance, detriment, loss, or responsibility, that is given, suffered, or undertaken by a party as an inducement to another party to contract.
(8)Continuing care contract means a contract that includes a continuing care promise made, in exchange for an entrance fee, the payment of periodic charges, or both types of payments. A continuing care contract may consist of one agreement or a series of agreements and other writings incorporated by reference.
(9)Continuing care promise means a promise, expressed or implied, by a provider to provide one or more elements of care to an elderly resident for the duration of his or her life or for a term in excess of one year. Any such promise or representation, whether part of a continuing care contract, other agreement, or series of agreements, or contained in any advertisement, brochure, or other material, either written or oral, is a continuing care promise.
(10)Continuing care retirement community means a facility located within the State of California where services promised in a continuing care contract are provided. A distinct phase of development approved by the department may be considered to be the continuing care retirement community when a project is being developed in successive distinct phases over a period of time. When the services are provided in residents own homes, the homes into which the provider takes those services are considered part of the continuing care retirement community.
(11)Control means directing or causing the direction of the financial management or the policies of another entity, including an operator of a continuing care retirement community, whether by means of the controlling entitys ownership interest, contract, or any other involvement. A parent entity or sole member of an entity controls a subsidiary entity provider for a continuing care retirement community if its officers, directors, or agents directly participate in the management of the subsidiary entity or in the initiation or approval of policies that affect the continuing care retirement communitys operations, including, but not limited to, approving budgets or the administrator for a continuing care retirement community.
(d)(1)Department means the State Department of Social Services.
(2)Deposit means any transfer of consideration, including a promise to transfer money or property, made by a depositor to any entity that promises or proposes to promise to provide continuing care, but is not authorized to enter into a continuing care contract with the potential depositor.
(3)Deposit agreement means any agreement made between any entity accepting a deposit and a depositor. Deposit agreements for deposits received by an applicant prior to the departments release of funds from the deposit escrow account shall be subject to the requirements described in Section 1780.4.
(4)Depository means a bank or institution that is a member of the Federal Deposit Insurance Corporation or a comparable deposit insurance program.
(5)Depositor means any prospective resident who pays a deposit. Where any portion of the consideration transferred to an applicant as a deposit or to a provider as consideration for a continuing care contract is transferred by a person other than the prospective resident or a resident, that third-party transferor shall have the same cancellation or refund rights as the prospective resident or resident for whose benefit the consideration was transferred.
(6)Director means the Director of Social Services.
(e)(1)Elderly means an individual who is 60 years of age or older.
(2)Entity means an individual, partnership, corporation, limited liability company, and any other form for doing business. Entity includes a person, sole proprietorship, estate, trust, association, and joint venture.
(3)Entrance fee means the sum of any initial, amortized, or deferred transfer of consideration made or promised to be made by, or on behalf of, a person entering into a continuing care contract for the purpose of ensuring care or related services pursuant to that continuing care contract or as full or partial payment for the promise to provide care for the term of the continuing care contract. Entrance fee includes the purchase price of a condominium, cooperative, or other interest sold in connection with a promise of continuing care. An initial, amortized, or deferred transfer of consideration that is greater in value than 12 times the monthly care fee shall be presumed to be an entrance fee.
(4)Equity means the value of real property in excess of the aggregate amount of all liabilities secured by the property.
(5)Equity interest means an interest held by a resident in a continuing care retirement community that consists of either an ownership interest in any part of the continuing care retirement community property or a transferable membership that entitles the holder to reside at the continuing care retirement community.
(6)Equity project means a continuing care retirement community where residents receive an equity interest in the continuing care retirement community property.
(7)Equity securities shall refer generally to large and midcapitalization corporate stocks that are publicly traded and readily liquidated for cash, and shall include shares in mutual funds that hold portfolios consisting predominantly of these stocks and other qualifying assets, as defined by Section 1792.2. Equity securities shall also include other similar securities that are specifically approved by the department.
(8)Escrow agent means a bank or institution, including, but not limited to, a title insurance company, approved by the department to hold and render accountings for deposits of cash or cash equivalents.
(f)Facility means any place or accommodation where a provider provides or will provide a resident with care or related services, whether or not the place or accommodation is constructed, owned, leased, rented, or otherwise contracted for by the provider.
(g)(reserved)
(h)(reserved)
(i)(1)Inactive certificate of authority means a certificate that has been terminated under Section 1793.8.
(2)Investment securities means any of the following:
(A)Direct obligations of the United States, including obligations issued or held in book-entry form on the books of the United States Department of the Treasury or obligations the timely payment of the principal of, and the interest on, which are fully guaranteed by the United States.
(B)Obligations, debentures, notes, or other evidences of indebtedness issued or guaranteed by any of the following:
(i)The Federal Home Loan Bank System.
(ii)The Export-Import Bank of the United States.
(iii)The Federal Financing Bank.
(iv)The Government National Mortgage Association.
(v)The Farmers Home Administration.
(vi)The Federal Home Loan Mortgage Corporation of the Federal Housing Administration.
(vii)Any agency, department, or other instrumentality of the United States if the obligations are rated in one of the two highest rating categories of each rating agency rating those obligations.
(C)Bonds of the State of California or of any county, city and county, or city in this state, if rated in one of the two highest rating categories of each rating agency rating those bonds.
(D)Commercial paper of finance companies and banking institutions rated in one of the two highest categories of each rating agency rating those instruments.
(E)Repurchase agreements fully secured by collateral security described in subparagraph (A) or (B), as evidenced by an opinion of counsel, if the collateral is held by the provider or a third party during the term of the repurchase agreement, pursuant to the terms of the agreement, subject to liens or claims of third parties, and has a market value, which is determined at least every 14 days, at least equal to the amount so invested.
(F)Long-term investment agreements, which have maturity dates in excess of one year, with financial institutions, including, but not limited to, banks and insurance companies or their affiliates, if the financial institutions paying ability for debt obligations or long-term claims or the paying ability of a related guarantor of the financial institution for these obligations or claims, is rated in one of the two highest rating categories of each rating agency rating those instruments, or if the short-term investment agreements are with the financial institution or the related guarantor of the financial institution, the long-term or short-term debt obligations, whichever is applicable, of which are rated in one of the two highest long-term or short-term rating categories, of each rating agency rating the bonds of the financial institution or the related guarantor, provided that if the rating falls below the two highest rating categories, the investment agreement shall allow the provider the option to replace the financial institution or the related guarantor of the financial institution or shall provide for the investment securities to be fully collateralized by investments described in subparagraph (A), and, provided further, if so collateralized, that the provider has a perfected first security lien on the collateral, as evidenced by an opinion of counsel and the collateral is held by the provider.
(G)Bankers acceptances or certificates of deposit of, or time deposits in, any savings and loan association that meets any of the following criteria:
(i)The debt obligations of the savings and loan association, or in the case of a principal bank, of the bank holding company, are rated in one of the two highest rating categories of each rating agency rating those instruments.
(ii)The certificates of deposit or time deposits are fully insured by the Federal Deposit Insurance Corporation.
(iii)The certificates of deposit or time deposits are secured at all times, in the manner and to the extent provided by law, by collateral security described in subparagraph (A) or (B) with a market value, valued at least quarterly, of no less than the original amount of moneys so invested.
(H)Taxable money market government portfolios restricted to obligations issued or guaranteed as to payment of principal and interest by the full faith and credit of the United States.
(I)Obligations the interest on which is excluded from gross income for federal income tax purposes and money market mutual funds whose portfolios are restricted to these obligations, if the obligations or mutual funds are rated in one of the two highest rating categories by each rating agency rating those obligations.
(J)Bonds that are not issued by the United States or any federal agency, but that are listed on a national exchange and that are rated at least A by Moodys Investors Service, or the equivalent rating by Standard and Poors Corporation or Fitch Investors Service.
(K)Bonds not listed on a national exchange that are traded on an over-the-counter basis, and that are rated at least Aa by Moodys Investors Service or AA by Standard and Poors Corporation or Fitch Investors Service.
(j)(reserved)
(k)(reserved)
(l)Life care contract means a continuing care contract that includes a promise, expressed or implied, by a provider to provide or pay for routine services at all levels of care, including acute care and the services of physicians and surgeons, to the extent not covered by other public or private insurance benefits, to a resident for the duration of his or her life. Care shall be provided under a life care contract in a continuing care retirement community having a comprehensive continuum of care, including a skilled nursing facility, under the ownership and supervision of the provider on or adjacent to the premises. No change may A change shall not be made in the monthly fee based on level of care. A life care contract shall also include provisions to subsidize residents who become financially unable to pay their monthly care fees.
(m)(1)Monthly care fee means the fee charged to a resident in a continuing care contract on a monthly or other periodic basis for current accommodations and services services, including care, board, or lodging. Periodic entrance fee payments or other prepayments shall not be monthly care fees.
(2)Monthly fee contract means a continuing care contract that requires residents to pay monthly care fees.
(n)Nonambulatory person means a person who is unable to leave a building unassisted under emergency conditions in the manner described by Section 13131.
(o)(reserved)
(p)(1)Per capita cost means a continuing care retirement communitys operating expenses, excluding depreciation, divided by the average number of residents.
(2)Periodic charges means fees paid by a resident on a periodic basis.
(3)Permanent closure means the voluntary or involuntary termination or forfeiture, as specified in subdivisions (a), (b), (g), (h), and (i) of Section 1793.7, of a providers certificate of authority or license, or another action that results in the permanent relocation of residents. Permanent closure does not apply in the case of a natural disaster or other event out of the providers control.
(4)Permit to accept deposits means a written authorization by the department permitting an applicant to enter into deposit agreements regarding a single specified continuing care retirement community.
(5)Prepaid contract means a continuing care contract in which the monthly care fee, if any, may not be adjusted to cover the actual cost of care and services.
(6)Preferred access means that residents who have previously occupied a residential living unit have a right over other persons to any assisted living or skilled nursing beds that are available at the community.
(7)Processing fee means a payment to cover administrative costs of processing the application of a depositor or prospective resident.
(8)Promise to provide one or more elements of care means any expressed or implied representation that one or more elements of care will be provided or will be available, such as by preferred access.
(9)Proposes means a representation that an applicant or provider will or intends to make a future promise to provide care, including a promise that is subject to a condition, such as the construction of a continuing care retirement community or the acquisition of a certificate of authority.
(10)Provider means an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. Provider also includes any entity that controls an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. The department shall determine whether an entity controls another entity for purposes of this article. No homeowners association, cooperative, or condominium association may be a provider.
(11)Provisional certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, under Section 1786. A provisional certificate of authority shall be limited to the specific continuing care retirement community and number of units identified in the applicants application.
(q)(reserved)
(r)(1)Refund reserve means the reserve a provider is required to maintain, as provided in Section 1792.6.
(2)(A)Refundable contract means a continuing care contract that includes a promise, expressed or implied, by the provider to pay an entrance fee refund or to repurchase the transferors unit, membership, stock, or other interest in the continuing care retirement community when the promise to refund some or all of the initial entrance fee extends beyond the residents sixth year of residency. Providers that enter into refundable contracts shall be subject to the refund reserve requirements of Section 1792.6.
(B)A continuing care contract that includes a promise to repay all or a portion of an entrance fee that is conditioned upon reoccupancy or resale of the unit previously occupied by the resident shall not be considered a refundable contract for purposes of the refund reserve requirements of Section 1792.6, provided that this conditional promise of repayment is not referred to by the applicant or provider as a refund. A provider may repay all or a portion of an entrance fee that is conditioned upon resale of the unit before the resale of the unit. The repayment of an entrance fee before the resale of the unit shall not cause any other entrance fee to be subject to the refund reserve requirements of Section 1792.6, provided that the provider does not promise, at the time of contracting or thereafter, to make this type of early repayment, represent that the provider intends to make this type of early repayment, or indicate that the provider has a practice of making this type of early repayment.
(3)Resale fee means a levy by the provider against the proceeds from the sale of a transferors equity interest.
(4)Reservation fee refers to consideration collected by an entity that has made a continuing care promise or is proposing to make this promise and has complied with Section 1771.4.
(5)Resident means a person who enters into a continuing care contract with a provider, or who is designated in a continuing care contract to be a person being provided or to be provided services, including care, board, or lodging.
(6)Residential care facility for the elderly means a housing arrangement as defined by Section 1569.2.
(7)Residential living unit means a living unit in a continuing care retirement community that is not used exclusively for assisted living services or nursing services.
(8)Residential temporary relocation means the relocation of one or more residents, except in the case of a natural disaster that is out of the providers control, from one or more residential living units, assisted living units, skilled nursing units, or a wing, floor, or entire continuing care retirement community building, due to a change of use or major repairs or renovations. A residential temporary relocation shall mean a relocation pursuant to this subdivision that lasts for a period of at least nine months but that does not exceed 18 months without the written agreement of the resident.
(s)(reserved)
(t)(1)Termination means the ending of a continuing care contract as provided for in the terms of the continuing care contract.
(2)Transfer trauma means death, depression, or regressive behavior, that is caused by the abrupt and involuntary transfer of an elderly resident from one home to another and results from a loss of familiar physical environment, loss of well-known neighbors, attendants, nurses and medical personnel, the stress of an abrupt break in the small routines of daily life, or the loss of visits from friends and relatives who may be unable to reach the new facility.
(3)Transferor means a person who transfers, or promises to transfer, consideration in exchange for care and related services under a continuing care contract or proposed continuing care contract, for the benefit of another. A transferor shall have the same rights to cancel and obtain a refund as the depositor under the deposit agreement or the resident under a continuing care contract.
SEC. 2.Section 1788 of the Health and Safety Code is amended to read:1788.(a)A continuing care contract shall contain all of the following:
(1)The legal name and address of each provider.
(2)The name and address of the continuing care retirement community.
(3)The residents name and the identity of the unit the resident will occupy.
(4)If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferors name and address shall be specified.
(5)If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
(6)The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
(7)The duration of the continuing care contract.
(8)A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
(A)Regular observation of the residents health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
(B)Safe and healthful living accommodations, including housekeeping services and utilities.
(C)Maintenance of house rules for the protection of residents.
(D)A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
(E)Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
(F)Assisted living services.
(G)Assistance with taking medications.
(H)Central storing and distribution of medications.
(I)Arrangements to meet health needs, including arranging transportation.
(9)An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract. The schedule shall state that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(10)The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
(A)A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
(i)The resident is nonambulatory. The definition of nonambulatory, as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
(ii)The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
(iii)The residents condition or needs require the residents transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
(iv)The residents condition or needs require the residents transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
(B)Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
(i)Involve the resident and the residents responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the residents or responsible persons request, family members, or the residents physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the residents responsible person.
(ii)Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the residents responsible person, and upon the residents or responsible persons request, family members, and the residents health care professionals, to explain the reasons for transfer.
(iii)Notify the resident and the residents responsible person of the reasons for the transfer in writing.
(iv)Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
(v)The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the residents urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
(vi)The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the residents right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the departments Continuing Care Contracts Branch.
(vii)The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
(C)The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the residents responsible person, and upon the residents or responsible persons request, family members, the residents physician or other appropriate health care professional, and members of the providers interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the residents responsible person, or the provider.
(D)For disputed transfer decisions, the resident or the residents responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
(E)The decision of the departments Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
(F)Transfer of a second resident when a shared accommodation arrangement is terminated.
(11)Provisions describing any changes in the residents monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Unless the fee is part of an equity interest contract, a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident.
(12)The providers continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
(13)The providers obligations, if any, to resume care upon the residents return after a transfer from the continuing care retirement community.
(14)The providers obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
(15)The conditions under which the resident must permanently release his or her living unit.
(16)If real or personal properties are transferred in lieu of cash, a statement specifying each items value at the time of transfer, and how the value was ascertained.
(A)An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
(B)When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
(C)The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
(17)The amount of the entrance fee.
(18)In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
(19)The amount of any processing fee.
(20)The amount of any monthly care fee.
(21)For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
(A)A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
(B)The regular rate of payment agreed upon (per day, week, or month).
(C)A provision specifying whether payment will be made in advance or after services have been provided.
(D)A provision specifying the provider will adjust monthly care fees for the residents support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
(E)A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
(F)A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
(G)A statement that the provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(22)All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
(A)For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
(i)Fees shall not be subject to change during the lifetime of the agreement.
(ii)Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
(iii)Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
(B)For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
(23)A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the residents monthly care fees or in the price or scope of any component of care or other services.
(24)A provision indicating whether the residents rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
(25)If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
(26)Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
(27)A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right.
(28)Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days written notice by the provider without cause, or that the provider waives this right.
(29)The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
(30)A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
(A)Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for just cause, good cause, or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes just cause, good cause, or otherwise activates the termination provision:
(i)Filing or lodging a formal complaint with the department or other appropriate authority.
(ii)Participation in an organization or affiliation of residents, or other similar lawful activity.
(B)The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents organization or association.
(C)Nothing in this paragraph diminishes the providers ability to terminate the continuing care contract for good and sufficient cause.
(31)A statement that at least 90 days written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
(32)A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
(33)The policy or terms for refunding or repaying a lump sum of any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund or repaying a lump sum of all or a part of the entrance fee shall also do all of the following:
(A)Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the residents unit.
(B)State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
(i)Amortize the specified amount at the same rate as the residents entrance fee.
(ii)Refund the unamortized balance to the resident at the same time the provider pays the residents entrance fee refund.
(C)State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
(D)State the provider shall make a good-faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. No later than July 1, 2016, a provider shall provide notice to all current residents with contracts applicable to this subparagraph regarding the statement required by this subparagraph as a clarification of the residents existing contract.
(E)For all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the provider shall state the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
(34)The following notice at the bottom of the signatory page:
NOTICE | (date) |
This is a continuing care contract as defined by paragraph (8) of subdivision (c), or subdivision (l) of Section 1771 of the California Health and Safety Code. This continuing care contract form has been approved by the State Department of Social Services as required by subdivision (b) of Section 1787 of the California Health and Safety Code. The basis for this approval was a determination that (provider name) has submitted a contract that complies with the minimum statutory requirements applicable to continuing care contracts. The department does not approve or disapprove any of the financial or health care coverage provisions in this contract. Approval by the department is NOT a guaranty of performance or an endorsement of any continuing care contract provisions. Prospective transferors and residents are strongly encouraged to carefully consider the benefits and risks of this continuing care contract and to seek financial and legal advice before signing.
(35)The provider may not attempt to absolve itself in the continuing care contract from liability for its negligence by any statement to that effect, and shall include the following statement in the contract: Nothing in this continuing care contract limits either the providers obligation to provide adequate care and supervision for the resident or any liability on the part of the provider which may result from the providers failure to provide this care and supervision.
(36)Provisions describing how the provider will proceed in the event of a closure, including an explanation of how the provider will comply with Sections 1793.80, 1793.81, 1793.82, and 1793.83.
(b)A life care contract shall also provide that:
(1)All levels of care, including acute care and physicians and surgeons services, will be provided to a resident.
(2)Care will be provided for the duration of the residents life unless the life care contract is canceled or terminated by the provider during the cancellation period or after the cancellation period for good cause.
(3)A comprehensive continuum of care will be provided to the resident, including skilled nursing, in a facility under the ownership and supervision of the provider on, or adjacent to, the continuing care retirement community premises.
(4)Monthly care fees will not be changed based on the residents level of care or service.
(5)A resident who becomes financially unable to pay his or her monthly care fees shall be subsidized provided the residents financial need does not arise from action by the resident to divest the resident of his or her assets.
(c)Continuing care contracts may include provisions that do any of the following:
(1)Subsidize a resident who becomes financially unable to pay for his or her monthly care fees at some future date. If a continuing care contract provides for subsidizing a resident, it may also provide for any of the following:
(A)The resident shall apply for any public assistance or other aid for which he or she is eligible and that the provider may apply for assistance on behalf of the resident.
(B)The providers decision shall be final and conclusive regarding any adjustments to be made or any action to be taken regarding any charitable consideration extended to any of its residents.
(C)The provider is entitled to payment for the actual costs of care out of any property acquired by the resident subsequent to any adjustment extended to the resident under this paragraph, or from any other property of the resident that the resident failed to disclose.
(D)The provider may pay the monthly premium of the residents health insurance coverage under Medicare to ensure that those payments will be made.
(E)The provider may receive an assignment from the resident of the right to apply for and to receive the benefits, for and on behalf of the resident.
(F)The provider is not responsible for the costs of furnishing the resident with any services, supplies, and medication, when reimbursement is reasonably available from any governmental agency, or any private insurance.
(G)Any refund due to the resident at the termination of the continuing care contract may be offset by any prior subsidy to the resident by the provider.
(2)Limit responsibility for costs associated with the treatment or medication of an ailment or illness existing prior to the date of admission. In these cases, the medical or surgical exceptions, as disclosed by the medical entrance examination, shall be listed in the continuing care contract or in a medical report attached to and made a part of the continuing care contract.
(3)Identify legal remedies that may be available to the provider if the resident makes any material misrepresentation or omission pertaining to the residents assets or health.
(4)Restrict transfer or assignments of the residents rights and privileges under a continuing care contract due to the personal nature of the continuing care contract.
(5)Protect the providers ability to waive a residents breach of the terms or provisions of the continuing care contract in specific instances without relinquishing its right to insist upon full compliance by the resident with all terms or provisions in the contract.
(6)Provide that the resident shall reimburse the provider for any uninsured loss or damage to the residents unit, beyond normal wear and tear, resulting from the residents carelessness or negligence.
(7)Provide that the resident agrees to observe the off-limit areas of the continuing care retirement community designated by the provider for safety reasons. The provider may not include any provision in a continuing care contract that absolves the provider from liability for its negligence.
(8)Provide for the subrogation to the provider of the residents rights in the case of injury to a resident caused by the acts or omissions of a third party, or for the assignment of the residents recovery or benefits in this case to the provider, to the extent of the value of the goods and services furnished by the provider to or on behalf of the resident as a result of the injury.
(9)Provide for a lien on any judgment, settlement, or recovery for any additional expense incurred by the provider in caring for the resident as a result of injury.
(10)Require the residents cooperation and assistance in the diligent prosecution of any claim or action against any third party.
(11)Provide for the appointment of a conservator or guardian by a court with jurisdiction in the event a resident becomes unable to handle his or her personal or financial affairs.
(12)Allow a provider, whose property is tax exempt, to charge the resident, on a pro rata basis, property taxes, or in-lieu taxes, that the provider is required to pay.
(13)Make any other provision approved by the department.
(d)A copy of the residents rights as described in Section 1771.7 shall be attached to every continuing care contract.
(e)A copy of the current audited financial statement of the provider shall be attached to every continuing care contract. For a provider whose current audited financial statement does not accurately reflect the financial ability of the provider to fulfill the continuing care contract obligations, the financial statement attached to the continuing care contract shall include all of the following:
(1)A disclosure that the reserve requirement has not yet been determined or met, and that entrance fees will not be held in escrow.
(2)A disclosure that the ability to provide the services promised in the continuing care contract will depend on successful compliance with the approved financial plan.
(3)A copy of the approved financial plan for meeting the reserve requirements.
(4)Any other supplemental statements or attachments necessary to accurately represent the providers financial ability to fulfill its continuing care contract obligations.
(f)A schedule of the average monthly care fees charged to residents for each type of residential living unit for each of the five years preceding execution of the continuing care contract shall be attached to every continuing care contract. The provider shall update this schedule annually at the end of each fiscal year. If the continuing care retirement community has not been in existence for five years, the information shall be provided for each of the years the continuing care retirement community has been in existence.
(g)If any continuing care contract provides for a health insurance policy for the benefit of the resident, the provider shall attach to the continuing care contract a binder complying with Sections 382 and 382.5 of the Insurance Code.
(h)The provider shall attach to every continuing care contract a completed form in duplicate, captioned Notice of Cancellation. The notice shall be easily detachable, and shall contain, in at least 10-point boldface type, the following statement:
NOTICE OF CANCELLATION | (date) |
Your first date of occupancy under this contract | |
is: _____________________________________________ | |
You may cancel this transaction, without any penalty within 90 calendar days from the above date.
If you cancel, any property transferred, any payments made by you under the contract, and any negotiable instrument executed by you will be returned within 14 calendar days after making possession of the living unit available to the provider. Any security interest arising out of the transaction will be canceled.
If you cancel, you are obligated to pay a reasonable processing fee to cover costs and to pay for the reasonable value of the services received by you from the provider up to the date you canceled or made available to the provider the possession of any living unit delivered to you under this contract, whichever is later.
If you cancel, you must return possession of any living unit delivered to you under this contract to the provider in substantially the same condition as when you took possession.
Possession of the living unit must be made available to the provider within 20 calendar days of your notice of cancellation. If you fail to make the possession of any living unit available to the provider, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any other written notice, or send a telegram
to | |
(Name of provider) | |
|---|---|
at | |
(Address of providers place of business) | |
not later than midnight of_____________(date). | |
I hereby cancel this | |
(Residentsor | |
(a)During the cancellation period, the provider shall pay all refunds owed to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider.
(b)After the cancellation period, any refunds due to a resident under a continuing care contract shall be paid within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later.
(c)In nonequity projects, if the continuing care contract is canceled by either party during the cancellation period or terminated by the provider after the cancellation period, the resident shall be refunded the difference between the total amount of entrance, monthly, and optional fees paid and the amount used for care of the resident.
(d)If a resident has paid additional amounts for upgrades, special features, or modifications to the living unit and the provider terminates the residents continuing care contract, the provider shall amortize those additional amounts at the same rate as the entrance fee and shall refund the unamortized balance to the resident.
(e)(1)A lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of the unit shall not be considered to be a refund and may not be characterized or advertised as a refund. The full lump-sum payment shall be paid to the resident within 14 calendar days after resale of the unit. For contracts signed after January 1, 2016, notwithstanding a providers documented good-faith effort to resell the unit, the resident is entitled to the repayment of a specified portion, pursuant to subparagraphs (A) and (B), of the full lump-sum payment if the unit remains vacant 120 days after the residents termination. This repayment shall not cause the contract in question to be deemed a refundable contract, as defined in paragraph (2) of subdivision (r) of Section 1771.
(A)When a continuing care contract is terminated by the death of a resident, at least 10 percent of the full lump-sum payment shall be paid to the residents estate within 120 days after the residents termination.
(B)When a continuing care contract is terminated for a reason not described in subparagraph (A), at least 20 percent of the full lump-sum payment shall be paid to the resident within 120 days after the residents termination.
(2)Any payment balance that has not been paid to the resident within 120 180 days shall accrue interest at a rate calculated pursuant to paragraph (3). Any payment balance that has not been paid to the resident within 180 240 days shall accrue interest at a rate calculated pursuant to paragraph (4). Interest shall continue to accrue until the date the full lump-sum payment is paid to the resident. This paragraph shall apply only to continuing care contracts entered into on or after January 1, 2016.
(3)Any payments that are not paid to the resident within the 120-day 180-day period pursuant to paragraph (2) shall accrue compound interest every 30 days at a rate not lower than 4 percent.
(4)Any payments that are not paid to the resident within the 180-day 240-day period pursuant to paragraph (2) shall accrue compound interest every 30 days at a rate not lower than 6 percent.
(f)After the death of a resident, a lump-sum payment that is conditioned upon resale of a unit shall be subject to subdivision (e) and the payment and interest, if any, shall be payable to the residents estate.
(g)Except as otherwise obligated by an equity interest contract, once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit.
(h)Nothing in this section shall be construed to limit or alter any legal remedies otherwise available to a resident or his or her estate.
SEC. 4.Section 1788.5 is added to the Health and Safety Code, to read:1788.5.(a)Any resident whose contract calls for a lump-sum payment conditioned upon resale of a unit may file a complaint with the department if the unit has not been resold for more than twelve months after possession of the unit was made available to the provider. A resident may file such a complaint regardless of whether or not the contract includes a provision expressly requiring a good faith effort to resell the unit.
(b)(1)In response to the complaint, the department shall perform an investigation to determine whether the provider has made a sufficient good faith effort to resell or reoccupy the unit. At the departments discretion, the investigation may include any of the following:
(A)Inspections of the unit and the continuing care retirement community.
(B)Interviews of with the provider, staff, and employees.
(C)Opinions and analysis from consultants.
(D)Written submissions from the resident or provider.
(E)A hearing.
(2)The department shall consider whether the provider has adequately refurbished the unit for reletting, made necessary repairs, reasonably marketed the unit to potential residents, and shown the unit to prospective residents.
(c)Following the investigation, the department shall issue a written determination, which includes a statement of the basis for the determination.
(d)A resident, in the case of a determination of sufficient good faith, or a provider, in the case of a determination of lack of sufficient good faith, shall have the right to submit to the department a written request for a formal review of the determination within 20 business days after the department issues the written determination. The party requesting review shall provide all supporting documentation at that time. If no written request for review is made, the departments determination shall be considered final. If a written request for review is made, the review shall be conducted by the deputy director of the Community Care Licensing Division. If the department requires additional information from the resident or provider, it shall be requested within the first 30 business days after receiving the request for review. The resident or provider shall provide this additional information within 20 business days after it is requested by the department. If the deputy director determines that the previous determination was not made in accordance with applicable statutes or regulations of the department, the department shall withdraw its previous determination and issue a new determination. The resident and provider shall be notified in writing of the deputy directors decision within 40 business days from the time when all necessary information has been received by the department. The deputy directors decision is considered final and concludes the administrative appeal rights of the resident and provider.
(e)If the department determines that the provider has not made a sufficient good faith effort to reoccupy or resell the unit, the provider shall repay the full lump-sum payment owed to the resident within 20 business days after the departments determination becomes final, and the provider shall reimburse the department for reasonable costs associated with the investigation of good faith within 20 business days after the department issues a statement of costs. final. The departments final determination and its factual findings, and any interim determination and factual findings, shall be inadmissible in court or any other proceeding, with the exception of any proceeding to enforce this subdivision.
Unless the context otherwise requires, the definitions in this section govern the interpretation of this chapter.
(a)(1)Affiliate means any person, corporation, limited liability company, business trust, trust, partnership, unincorporated association, or other legal entity that directly or indirectly controls, is controlled by, or is under common control with, a provider or applicant.
(2)Affinity group means a grouping of entities sharing a common interest, philosophy, or connection (e.g., military officers, religion).
(3)Annual report means the report each provider is required to file annually with the department, as described in Section 1790.
(4)Applicant means any entity, or combination of entities, that submits and has pending an application to the department for a permit to accept deposits and a certificate of authority.
(5)Assisted living services includes, but is not limited to, assistance with personal activities of daily living, including dressing, feeding, toileting, bathing, grooming, mobility, and associated tasks, to help provide for and maintain physical and psychosocial comfort.
(6)Assisted living unit means the living area or unit within a continuing care retirement community that is specifically designed to provide ongoing assisted living services.
(7)Audited financial statement means financial statements prepared in accordance with generally accepted accounting principles including the opinion of an independent certified public accountant, and notes to the financial statements considered customary or necessary to provide full disclosure and complete information regarding the providers financial statements, financial condition, and operation.
(b)(reserved)
(c)(1)Cancel means to destroy the force and effect of an agreement or continuing care contract.
(2)Cancellation period means the 90-day period, beginning when the resident physically moves into the continuing care retirement community, during which the resident may cancel the continuing care contract, as provided in Section 1788.2.
(3)Care means nursing, medical, or other health-related services, protection or supervision, assistance with the personal activities of daily living, or any combination of those services.
(4)Cash equivalent means certificates of deposit and United States treasury securities with a maturity of five years or less.
(5)Certificate or certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, authorizing a specified provider to enter into one or more continuing care contracts at a single specified continuing care retirement community.
(6)Condition means a restriction, specific action, or other requirement imposed by the department for the initial or continuing validity of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority. A condition may limit the circumstances under which the provider may enter into any new deposit agreement or contract, or may be imposed as a condition precedent to the issuance of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority.
(7)Consideration means some right, interest, profit, or benefit paid, transferred, promised, or provided by one party to another as an inducement to contract. Consideration includes some forbearance, detriment, loss, or responsibility, that is given, suffered, or undertaken by a party as an inducement to another party to contract.
(8)Continuing care contract means a contract that includes a continuing care promise made, in exchange for an entrance fee, the payment of periodic charges, or both types of payments. A continuing care contract may consist of one agreement or a series of agreements and other writings incorporated by reference.
(9)Continuing care promise means a promise, expressed or implied, by a provider to provide one or more elements of care to an elderly resident for the duration of his or her life or for a term in excess of one year. Any such promise or representation, whether part of a continuing care contract, other agreement, or series of agreements, or contained in any advertisement, brochure, or other material, either written or oral, is a continuing care promise.
(10)Continuing care retirement community means a facility located within the State of California where services promised in a continuing care contract are provided. A distinct phase of development approved by the department may be considered to be the continuing care retirement community when a project is being developed in successive distinct phases over a period of time. When the services are provided in residents own homes, the homes into which the provider takes those services are considered part of the continuing care retirement community.
(11)Control means directing or causing the direction of the financial management or the policies of another entity, including an operator of a continuing care retirement community, whether by means of the controlling entitys ownership interest, contract, or any other involvement. A parent entity or sole member of an entity controls a subsidiary entity provider for a continuing care retirement community if its officers, directors, or agents directly participate in the management of the subsidiary entity or in the initiation or approval of policies that affect the continuing care retirement communitys operations, including, but not limited to, approving budgets or the administrator for a continuing care retirement community.
(d)(1)Department means the State Department of Social Services.
(2)Deposit means any transfer of consideration, including a promise to transfer money or property, made by a depositor to any entity that promises or proposes to promise to provide continuing care, but is not authorized to enter into a continuing care contract with the potential depositor.
(3)Deposit agreement means any agreement made between any entity accepting a deposit and a depositor. Deposit agreements for deposits received by an applicant prior to the departments release of funds from the deposit escrow account shall be subject to the requirements described in Section 1780.4.
(4)Depository means a bank or institution that is a member of the Federal Deposit Insurance Corporation or a comparable deposit insurance program.
(5)Depositor means any prospective resident who pays a deposit. Where any portion of the consideration transferred to an applicant as a deposit or to a provider as consideration for a continuing care contract is transferred by a person other than the prospective resident or a resident, that third-party transferor shall have the same cancellation or refund rights as the prospective resident or resident for whose benefit the consideration was transferred.
(6)Director means the Director of Social Services.
(e)(1)Elderly means an individual who is 60 years of age or older.
(2)Entity means an individual, partnership, corporation, limited liability company, and any other form for doing business. Entity includes a person, sole proprietorship, estate, trust, association, and joint venture.
(3)Entrance fee means the sum of any initial, amortized, or deferred transfer of consideration made or promised to be made by, or on behalf of, a person entering into a continuing care contract for the purpose of ensuring care or related services pursuant to that continuing care contract or as full or partial payment for the promise to provide care for the term of the continuing care contract. Entrance fee includes the purchase price of a condominium, cooperative, or other interest sold in connection with a promise of continuing care. An initial, amortized, or deferred transfer of consideration that is greater in value than 12 times the monthly care fee shall be presumed to be an entrance fee.
(4)Equity means the value of real property in excess of the aggregate amount of all liabilities secured by the property.
(5)Equity interest means an interest held by a resident in a continuing care retirement community that consists of either an ownership interest in any part of the continuing care retirement community property or a transferable membership that entitles the holder to reside at the continuing care retirement community.
(6)Equity project means a continuing care retirement community where residents receive an equity interest in the continuing care retirement community property.
(7)Equity securities shall refer generally to large and midcapitalization corporate stocks that are publicly traded and readily liquidated for cash, and shall include shares in mutual funds that hold portfolios consisting predominantly of these stocks and other qualifying assets, as defined by Section 1792.2. Equity securities shall also include other similar securities that are specifically approved by the department.
(8)Escrow agent means a bank or institution, including, but not limited to, a title insurance company, approved by the department to hold and render accountings for deposits of cash or cash equivalents.
(f)Facility means any place or accommodation where a provider provides or will provide a resident with care or related services, whether or not the place or accommodation is constructed, owned, leased, rented, or otherwise contracted for by the provider.
(g)(reserved)
(h)(reserved)
(i)(1)Inactive certificate of authority means a certificate that has been terminated under Section 1793.8.
(2)Investment securities means any of the following:
(A)Direct obligations of the United States, including obligations issued or held in book-entry form on the books of the United States Department of the Treasury or obligations the timely payment of the principal of, and the interest on, which are fully guaranteed by the United States.
(B)Obligations, debentures, notes, or other evidences of indebtedness issued or guaranteed by any of the following:
(i)The Federal Home Loan Bank System.
(ii)The Export-Import Bank of the United States.
(iii)The Federal Financing Bank.
(iv)The Government National Mortgage Association.
(v)The Farmers Farmers Home Administration.
(vi)The Federal Home Loan Mortgage Corporation of the Federal Housing Administration.
(vii)Any agency, department, or other instrumentality of the United States if the obligations are rated in one of the two highest rating categories of each rating agency rating those obligations.
(C)Bonds of the State of California or of any county, city and county, or city in this state, if rated in one of the two highest rating categories of each rating agency rating those bonds.
(D)Commercial paper of finance companies and banking institutions rated in one of the two highest categories of each rating agency rating those instruments.
(E)Repurchase agreements fully secured by collateral security described in subparagraph (A) or (B), as evidenced by an opinion of counsel, if the collateral is held by the provider or a third party during the term of the repurchase agreement, pursuant to the terms of the agreement, subject to liens or claims of third parties, and has a market value, which is determined at least every 14 days, at least equal to the amount so invested.
(F)Long-term investment agreements, which have maturity dates in excess of one year, with financial institutions, including, but not limited to, banks and insurance companies or their affiliates, if the financial institutions paying ability for debt obligations or long-term claims or the paying ability of a related guarantor of the financial institution for these obligations or claims, is rated in one of the two highest rating categories of each rating agency rating those instruments, or if the short-term investment agreements are with the financial institution or the related guarantor of the financial institution, the long-term or short-term debt obligations, whichever is applicable, of which are rated in one of the two highest long-term or short-term rating categories, of each rating agency rating the bonds of the financial institution or the related guarantor, provided that if the rating falls below the two highest rating categories, the investment agreement shall allow the provider the option to replace the financial institution or the related guarantor of the financial institution or shall provide for the investment securities to be fully collateralized by investments described in subparagraph (A), and, provided further, if so collateralized, that the provider has a perfected first security lien on the collateral, as evidenced by an opinion of counsel and the collateral is held by the provider.
(G)Bankers acceptances or certificates of deposit of, or time deposits in, any savings and loan association that meets any of the following criteria:
(i)The debt obligations of the savings and loan association, or in the case of a principal bank, of the bank holding company, are rated in one of the two highest rating categories of each rating agency rating those instruments.
(ii)The certificates of deposit or time deposits are fully insured by the Federal Deposit Insurance Corporation.
(iii)The certificates of deposit or time deposits are secured at all times, in the manner and to the extent provided by law, by collateral security described in subparagraph (A) or (B) with a market value, valued at least quarterly, of no less than the original amount of moneys so invested.
(H)Taxable money market government portfolios restricted to obligations issued or guaranteed as to payment of principal and interest by the full faith and credit of the United States.
(I)Obligations the interest on which is excluded from gross income for federal income tax purposes and money market mutual funds whose portfolios are restricted to these obligations, if the obligations or mutual funds are rated in one of the two highest rating categories by each rating agency rating those obligations.
(J)Bonds that are not issued by the United States or any federal agency, but that are listed on a national exchange and that are rated at least A by Moodys Investors Service, or the equivalent rating by Standard and Poors Corporation or Fitch Investors Service.
(K)Bonds not listed on a national exchange that are traded on an over-the-counter basis, and that are rated at least Aa by Moodys Investors Service or AA by Standard and Poors Corporation or Fitch Investors Service.
(j)(reserved)
(k)(reserved)
(l)Life care contract means a continuing care contract that includes a promise, expressed or implied, by a provider to provide or pay for routine services at all levels of care, including acute care and the services of physicians and surgeons, to the extent not covered by other public or private insurance benefits, to a resident for the duration of his or her life. Care shall be provided under a life care contract in a continuing care retirement community having a comprehensive continuum of care, including a skilled nursing facility, under the ownership and supervision of the provider on or adjacent to the premises. No change may be made in the monthly fee based on level of care. A life care contract shall also include provisions to subsidize residents who become financially unable to pay their monthly care fees.
(m)(1)Monthly care fee means the fee charged to a resident in a continuing care contract on a monthly or other periodic basis for current accommodations and services including care, board, or lodging. Periodic entrance fee payments or other prepayments shall not be monthly care fees.
(2)Monthly fee contract means a continuing care contract that requires residents to pay monthly care fees.
(n)Nonambulatory person means a person who is unable to leave a building unassisted under emergency conditions in the manner described by Section 13131.
(o)(reserved)
(p)(1)Per capita cost means a continuing care retirement communitys operating expenses, excluding depreciation, divided by the average number of residents.
(2)Periodic charges means fees paid by a resident on a periodic basis.
(3)Permanent closure means the voluntary or involuntary termination or forfeiture, as specified in subdivisions (a), (b), (g), (h), and (i) of Section 1793.7, of a providers certificate of authority or license, or another action that results in the permanent relocation of residents. Permanent closure does not apply in the case of a natural disaster or other event out of the providers control.
(4)Permit to accept deposits means a written authorization by the department permitting an applicant to enter into deposit agreements regarding a single specified continuing care retirement community.
(5)Prepaid contract means a continuing care contract in which the monthly care fee, if any, may not be adjusted to cover the actual cost of care and services.
(6)Preferred access means that residents who have previously occupied a residential living unit have a right over other persons to any assisted living or skilled nursing beds that are available at the community.
(7)Processing fee means a payment to cover administrative costs of processing the application of a depositor or prospective resident.
(8)Promise to provide one or more elements of care means any expressed or implied representation that one or more elements of care will be provided or will be available, such as by preferred access.
(9)Proposes means a representation that an applicant or provider will or intends to make a future promise to provide care, including a promise that is subject to a condition, such as the construction of a continuing care retirement community or the acquisition of a certificate of authority.
(10)Provider means an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. Provider also includes any entity that controls an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. The department shall determine whether an entity controls another entity for purposes of this article. No homeowners association, cooperative, or condominium association may be a provider.
(11)Provisional certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, under Section 1786. A provisional certificate of authority shall be limited to the specific continuing care retirement community and number of units identified in the applicants application.
(q)(reserved)
(r)(1)Refund reserve means the reserve a provider is required to maintain, as provided in Section 1792.6.
(2)(A)Refundable contract means a continuing care contract that includes a promise, expressed or implied, by the provider to pay an entrance fee refund or to repurchase the transferors unit, membership, stock, or other interest in the continuing care retirement community when the promise to refund some or all of the initial entrance fee extends beyond the residents sixth year of residency. Providers that enter into refundable contracts shall be subject to the refund reserve requirements of Section 1792.6.
(B)A continuing care contract that includes a promise to repay all or a portion of an entrance fee that is conditioned upon reoccupancy or resale of the unit previously occupied by the resident shall not be considered a refundable contract for purposes of the refund reserve requirements of Section 1792.6, provided that this conditional promise of repayment is not referred to by the applicant or provider as a refund. A provider may repay all or a portion of an entrance fee that is conditioned upon resale of the unit before the resale of the unit. The repayment of an entrance fee before the resale of the unit shall not cause any other entrance fee to be subject to the refund reserve requirements of Section 1792.6, provided that the provider does not promise, at the time of contracting or thereafter, to make this type of early repayment, represent that the provider intends to make this type of early repayment, or indicate that the provider has a practice of making this type of early repayment.
(3)Resale fee means a levy by the provider against the proceeds from the sale of a transferors equity interest.
(4)Reservation fee refers to consideration collected by an entity that has made a continuing care promise or is proposing to make this promise and has complied with Section 1771.4.
(5)Resident means a person who enters into a continuing care contract with a provider, or who is designated in a continuing care contract to be a person being provided or to be provided services, including care, board, or lodging.
(6)Residential care facility for the elderly means a housing arrangement as defined by Section 1569.2.
(7)Residential living unit means a living unit in a continuing care retirement community that is not used exclusively for assisted living services or nursing services.
(8)Residential temporary relocation means the relocation of one or more residents, except in the case of a natural disaster that is out of the providers control, from one or more residential living units, assisted living units, skilled nursing units, or a wing, floor, or entire continuing care retirement community building, due to a change of use or major repairs or renovations. A residential temporary relocation shall mean a relocation pursuant to this subdivision that lasts for a period of at least nine months but that does not exceed 18 months without the written agreement of the resident.
(s)(reserved)
(t)(1)Termination means the ending of a continuing care contract as provided for in the terms of the continuing care contract.
(2)Transfer trauma means death, depression, or regressive behavior, that is caused by the abrupt and involuntary transfer of an elderly resident from one home to another and results from a loss of familiar physical environment, loss of well-known neighbors, attendants, nurses and medical personnel, the stress of an abrupt break in the small routines of daily life, or the loss of visits from friends and relatives who may be unable to reach the new facility.
(3)Transferor means a person who transfers, or promises to transfer, consideration in exchange for care and related services under a continuing care contract or proposed continuing care contract, for the benefit of another. A transferor shall have the same rights to cancel and obtain a refund as the depositor under the deposit agreement or the resident under a continuing care contract.
SEC. 2.Section 1788 of the Health and Safety Code is amended to read:1788.(a)A continuing care contract shall contain all of the following:
(1)The legal name and address of each provider.
(2)The name and address of the continuing care retirement community.
(3)The residents name and the identity of the unit the resident will occupy.
(4)If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferors name and address shall be specified.
(5)If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
(6)The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
(7)The duration of the continuing care contract.
(8)A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
(A)Regular observation of the residents health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
(B)Safe and healthful living accommodations, including housekeeping services and utilities.
(C)Maintenance of house rules for the protection of residents.
(D)A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
(E)Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
(F)Assisted living services.
(G)Assistance with taking medications.
(H)Central storing and distribution of medications.
(I)Arrangements to meet health needs, including arranging transportation.
(9)An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract. The schedule shall state that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(10)The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
(A)A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
(i)The resident is nonambulatory. The definition of nonambulatory, as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
(ii)The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
(iii)The residents condition or needs require the residents transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
(iv)The residents condition or needs require the residents transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
(B)Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
(i)Involve the resident and the residents responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the residents or responsible persons request, family members, or the residents physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the residents responsible person.
(ii)Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the residents responsible person, and upon the residents or responsible persons request, family members, and the residents health care professionals, to explain the reasons for transfer.
(iii)Notify the resident and the residents responsible person of the reasons for the transfer in writing.
(iv)Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
(v)The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the residents urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
(vi)The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the residents right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the departments Continuing Care Contracts Branch.
(vii)The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
(C)The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the residents responsible person, and upon the residents or responsible persons request, family members, the residents physician or other appropriate health care professional, and members of the providers interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the residents responsible person, or the provider.
(D)For disputed transfer decisions, the resident or the residents responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
(E)The decision of the departments Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
(F)Transfer of a second resident when a shared accommodation arrangement is terminated.
(11)Provisions describing any changes in the residents monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Unless the fee is part of an equity interest contract, a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident.
(12)The providers continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
(13)The providers obligations, if any, to resume care upon the residents return after a transfer from the continuing care retirement community.
(14)The providers obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
(15)The conditions under which the resident must permanently release his or her living unit.
(16)If real or personal properties are transferred in lieu of cash, a statement specifying each items value at the time of transfer, and how the value was ascertained.
(A)An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
(B)When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
(C)The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
(17)The amount of the entrance fee.
(18)In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
(19)The amount of any processing fee.
(20)The amount of any monthly care fee.
(21)For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
(A)A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
(B)The regular rate of payment agreed upon (per day, week, or month).
(C)A provision specifying whether payment will be made in advance or after services have been provided.
(D)A provision specifying the provider will adjust monthly care fees for the residents support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
(E)A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
(F)A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
(G)A statement that the provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(22)All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
(A)For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
(i)Fees shall not be subject to change during the lifetime of the agreement.
(ii)Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
(iii)Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
(B)For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
(23)A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the residents monthly care fees or in the price or scope of any component of care or other services.
(24)A provision indicating whether the residents rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
(25)If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
(26)Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
(27)A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right.
(28)Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days written notice by the provider without cause, or that the provider waives this right.
(29)The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
(30)A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
(A)Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for just cause, good cause, or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes just cause, good cause, or otherwise activates the termination provision:
(i)Filing or lodging a formal complaint with the department or other appropriate authority.
(ii)Participation in an organization or affiliation of residents, or other similar lawful activity.
(B)The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents organization or association.
(C)Nothing in this paragraph diminishes the providers ability to terminate the continuing care contract for good and sufficient cause.
(31)A statement that at least 90 days written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
(32)A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
(33)The policy or terms for refunding or repaying a lump sum of any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund or repaying a lump sum of all or a part of the entrance fee shall also do all of the following:
(A)Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the residents unit.
(B)State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
(i)Amortize the specified amount at the same rate as the residents entrance fee.
(ii)Refund the unamortized balance to the resident at the same time the provider pays the residents entrance fee refund.
(C)State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
(D)(i)State the provider shall make a good-faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. No later than July 1, 2016, a provider shall provide notice to all current residents with contracts applicable to this subparagraph regarding the statement required by this subparagraph as a clarification of the residents existing contract.
(ii)The department, in response to a complaint from the resident or the residents estate, may determine if a provider has failed to make a sufficient good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. An insufficient good faith effort on behalf of the provider shall include, but is not limited to, the failure to undergo the facilitys refurbishment process for reletting, the failure to make needed repairs, the failure to reasonably market the unit to potential residents, or the failure to show the unit to prospective residents.
(iii)If the department makes a determination that a provider has failed to make a good faith effort to reoccupy or resell a unit pursuant to clause (ii), the provider shall repay the full lump-sum payment owed to the resident or residents estate within 14 days of the departments determination, and shall reimburse the department for any costs incurred by the department that are associated with the departments determination.
(E)For all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the provider shall state the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
(34)The following notice at the bottom of the signatory page:
NOTICE | (date) |
This is a continuing care contract as defined by paragraph (8) of subdivision (c), or subdivision (l) of Section 1771 of the California Health and Safety Code. This continuing care contract form has been approved by the State Department of Social Services as required by subdivision (b) of Section 1787 of the California Health and Safety Code. The basis for this approval was a determination that (provider name) has submitted a contract that complies with the minimum statutory requirements applicable to continuing care contracts. The department does not approve or disapprove any of the financial or health care coverage provisions in this contract. Approval by the department is NOT a guaranty of performance or an endorsement of any continuing care contract provisions. Prospective transferors and residents are strongly encouraged to carefully consider the benefits and risks of this continuing care contract and to seek financial and legal advice before signing.
(35)The provider may not attempt to absolve itself in the continuing care contract from liability for its negligence by any statement to that effect, and shall include the following statement in the contract: Nothing in this continuing care contract limits either the providers obligation to provide adequate care and supervision for the resident or any liability on the part of the provider which may result from the providers failure to provide this care and supervision.
(36)Provisions describing how the provider will proceed in the event of a closure, including an explanation of how the provider will comply with Sections 1793.80, 1793.81, 1793.82, and 1793.83.
(b)A life care contract shall also provide that:
(1)All levels of care, including acute care and physicians and surgeons services, will be provided to a resident.
(2)Care will be provided for the duration of the residents life unless the life care contract is canceled or terminated by the provider during the cancellation period or after the cancellation period for good cause.
(3)A comprehensive continuum of care will be provided to the resident, including skilled nursing, in a facility under the ownership and supervision of the provider on, or adjacent to, the continuing care retirement community premises.
(4)Monthly care fees will not be changed based on the residents level of care or service.
(5)A resident who becomes financially unable to pay his or her monthly care fees shall be subsidized provided the residents financial need does not arise from action by the resident to divest the resident of his or her assets.
(c)Continuing care contracts may include provisions that do any of the following:
(1)Subsidize a resident who becomes financially unable to pay for his or her monthly care fees at some future date. If a continuing care contract provides for subsidizing a resident, it may also provide for any of the following:
(A)The resident shall apply for any public assistance or other aid for which he or she is eligible and that the provider may apply for assistance on behalf of the resident.
(B)The providers decision shall be final and conclusive regarding any adjustments to be made or any action to be taken regarding any charitable consideration extended to any of its residents.
(C)The provider is entitled to payment for the actual costs of care out of any property acquired by the resident subsequent to any adjustment extended to the resident under this paragraph, or from any other property of the resident that the resident failed to disclose.
(D)The provider may pay the monthly premium of the residents health insurance coverage under Medicare to ensure that those payments will be made.
(E)The provider may receive an assignment from the resident of the right to apply for and to receive the benefits, for and on behalf of the resident.
(F)The provider is not responsible for the costs of furnishing the resident with any services, supplies, and medication, when reimbursement is reasonably available from any governmental agency, or any private insurance.
(G)Any refund due to the resident at the termination of the continuing care contract may be offset by any prior subsidy to the resident by the provider.
(2)Limit responsibility for costs associated with the treatment or medication of an ailment or illness existing prior to the date of admission. In these cases, the medical or surgical exceptions, as disclosed by the medical entrance examination, shall be listed in the continuing care contract or in a medical report attached to and made a part of the continuing care contract.
(3)Identify legal remedies that may be available to the provider if the resident makes any material misrepresentation or omission pertaining to the residents assets or health.
(4)Restrict transfer or assignments of the residents rights and privileges under a continuing care contract due to the personal nature of the continuing care contract.
(5)Protect the providers ability to waive a residents breach of the terms or provisions of the continuing care contract in specific instances without relinquishing its right to insist upon full compliance by the resident with all terms or provisions in the contract.
(6)Provide that the resident shall reimburse the provider for any uninsured loss or damage to the residents unit, beyond normal wear and tear, resulting from the residents carelessness or negligence.
(7)Provide that the resident agrees to observe the off-limit areas of the continuing care retirement community designated by the provider for safety reasons. The provider may not include any provision in a continuing care contract that absolves the provider from liability for its negligence.
(8)Provide for the subrogation to the provider of the residents rights in the case of injury to a resident caused by the acts or omissions of a third party, or for the assignment of the residents recovery or benefits in this case to the provider, to the extent of the value of the goods and services furnished by the provider to or on behalf of the resident as a result of the injury.
(9)Provide for a lien on any judgment, settlement, or recovery for any additional expense incurred by the provider in caring for the resident as a result of injury.
(10)Require the residents cooperation and assistance in the diligent prosecution of any claim or action against any third party.
(11)Provide for the appointment of a conservator or guardian by a court with jurisdiction in the event a resident becomes unable to handle his or her personal or financial affairs.
(12)Allow a provider, whose property is tax exempt, to charge the resident, on a pro rata basis, property taxes, or in-lieu taxes, that the provider is required to pay.
(13)Make any other provision approved by the department.
(d)A copy of the residents rights as described in Section 1771.7 shall be attached to every continuing care contract.
(e)A copy of the current audited financial statement of the provider shall be attached to every continuing care contract. For a provider whose current audited financial statement does not accurately reflect the financial ability of the provider to fulfill the continuing care contract obligations, the financial statement attached to the continuing care contract shall include all of the following:
(1)A disclosure that the reserve requirement has not yet been determined or met, and that entrance fees will not be held in escrow.
(2)A disclosure that the ability to provide the services promised in the continuing care contract will depend on successful compliance with the approved financial plan.
(3)A copy of the approved financial plan for meeting the reserve requirements.
(4)Any other supplemental statements or attachments necessary to accurately represent the providers financial ability to fulfill its continuing care contract obligations.
(f)A schedule of the average monthly care fees charged to residents for each type of residential living unit for each of the five years preceding execution of the continuing care contract shall be attached to every continuing care contract. The provider shall update this schedule annually at the end of each fiscal year. If the continuing care retirement community has not been in existence for five years, the information shall be provided for each of the years the continuing care retirement community has been in existence.
(g)If any continuing care contract provides for a health insurance policy for the benefit of the resident, the provider shall attach to the continuing care contract a binder complying with Sections 382 and 382.5 of the Insurance Code.
(h)The provider shall attach to every continuing care contract a completed form in duplicate, captioned Notice of Cancellation. The notice shall be easily detachable, and shall contain, in at least 10-point boldface type, the following statement:
NOTICE OF CANCELLATION | (date) |
Your first date of occupancy under this contract | |
is: _____________________________________________ | |
You may cancel this transaction, without any penalty within 90 calendar days from the above date.
If you cancel, any property transferred, any payments made by you under the contract, and any negotiable instrument executed by you will be returned within 14 calendar days after making possession of the living unit available to the provider. Any security interest arising out of the transaction will be canceled.
If you cancel, you are obligated to pay a reasonable processing fee to cover costs and to pay for the reasonable value of the services received by you from the provider up to the date you canceled or made available to the provider the possession of any living unit delivered to you under this contract, whichever is later.
If you cancel, you must return possession of any living unit delivered to you under this contract to the provider in substantially the same condition as when you took possession.
Possession of the living unit must be made available to the provider within 20 calendar days of your notice of cancellation. If you fail to make the possession of any living unit available to the provider, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any other written notice, or send a telegram
to | |
(Name of provider) | |
|---|---|
at | |
(Address of providers place of business) | |
not later than midnight of_____________(date). | |
I hereby cancel this | |
(Residentsor | |
(a)During the cancellation period, the provider shall pay all refunds owed to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider.
(b)After the cancellation period, any refunds due to a resident under a continuing care contract shall be paid within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later.
(c)In nonequity projects, if the continuing care contract is canceled by either party during the cancellation period or terminated by the provider after the cancellation period, the resident shall be refunded the difference between the total amount of entrance, monthly, and optional fees paid and the amount used for care of the resident.
(d)If a resident has paid additional amounts for upgrades, special features, or modifications to the living unit and the provider terminates the residents continuing care contract, the provider shall amortize those additional amounts at the same rate as the entrance fee and shall refund the unamortized balance to the resident.
(e)(1)A lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of the unit shall not be considered to be a refund and may not be characterized or advertised as a refund. The full lump-sum payment shall be paid to the resident within 14 calendar days after resale of the unit. For contracts signed after January 1, 2016, notwithstanding a providers documented good-faith effort to resell the unit, the resident is entitled to the repayment of a specified portion, pursuant to subparagraphs (A) and (B), of the full lump-sum payment if the unit remains vacant 120 days after the residents termination. This repayment shall not cause the contract in question to be deemed a refundable contract, as defined in paragraph (2) of subdivision (r) of Section 1771.
(A)When a continuing care contract is terminated by the death of a resident, at least 10 percent of the full lump-sum payment shall be paid to the residents estate within 120 days after the residents termination.
(B)When a continuing care contract is terminated for a reason not described in subparagraph (A), at least 20 percent of the full lump-sum payment shall be paid to the resident within 120 days after the residents termination.
(2)Any payment balance that has not been paid to the resident within 120 days shall accrue interest at a rate calculated pursuant to paragraph (3). Any payment balance that has not been paid to the resident within 180 days shall accrue interest at a rate calculated pursuant to paragraph (4). Interest shall continue to accrue until the date the full lump-sum payment is paid to the resident. This paragraph shall apply only to continuing care contracts entered into on or after January 1, 2016.
(3)Any payments that are not paid to the resident within the 120-day period pursuant to paragraph (2) shall accrue interest compound interest every 30 days at a rate not lower than 4 percent.
(4)Any payments that are not paid to the resident within the 180-day period pursuant to paragraph (2) shall accrue interest compound interest every 30 days at a rate not lower than 6 percent.
(f)After the death of a resident, a lump-sum payment that is conditioned upon resale of a unit shall be subject to subdivision (e) and the payment and interest, if any, shall be payable to the residents estate.
(g)Except as otherwise obligated by an equity interest contract, once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit.
(h)Nothing in this section shall be construed to limit or alter any legal remedies otherwise available to a resident or his or her estate.
SEC. 4.Section 1788.5 is added to the Health and Safety Code, to read:1788.5.(a)Any resident whose contract calls for a lump-sum payment conditioned upon resale of a unit may file a complaint with the department if the unit has not been resold for more than twelve months after possession of the unit was made available to the provider. A resident may file such a complaint regardless of whether or not the contract includes a provision expressly requiring a good faith effort to resell the unit.
(b)(1)In response to the complaint, the department shall perform an investigation to determine whether the provider has made a sufficient good faith effort to resell or reoccupy the unit. At the departments discretion, the investigation may include any of the following:
(A)Inspections of the unit and the continuing care retirement community.
(B)Interviews of provider, staff, and employees.
(C)Opinions and analysis from consultants.
(D)Written submissions from the resident or provider.
(E)A hearing.
(2)The department shall consider whether the provider has adequately refurbished the unit for reletting, made necessary repairs, reasonably marketed the unit to potential residents, and shown the unit to prospective residents.
(c)Following the investigation, the department shall issue a written determination, which includes a statement of the basis for the determination.
(d)A resident, in the case of a determination of sufficient good faith, or a provider, in the case of a determination of lack of sufficient good faith, shall have the right to submit to the department a written request for a formal review of the determination within 20 business days after the department issues the written determination. The party requesting review shall provide all supporting documentation at that time. If no written request for review is made, the departments determination shall be considered final. If a written request for review is made, the review shall be conducted by the deputy director of the Community Care Licensing Division. If the department requires additional information from the resident or provider, it shall be requested within the first 30 business days after receiving the request for review. The resident or provider shall provide this additional information within 20 business days after it is requested by the department. If the deputy director determines that the previous determination was not made in accordance with applicable statutes or regulations of the department, the department shall withdraw its previous determination and issue a new determination. The resident and provider shall be notified in writing of the deputy directors decision within 40 business days from the time when all necessary information has been received by the department. The deputy directors decision is considered final and concludes the administrative appeal rights of the resident and provider.
(e)If the department determines that the provider has not made a sufficient good faith effort to reoccupy or resell the unit, the provider shall repay the full lump-sum payment owed to the resident within 20 business days after the departments determination becomes final, and the provider shall reimburse the department for reasonable costs associated with the investigation of good faith within 20 business days after the department issues a statement of costs. The departments final determination and its factual findings, and any interim determination and factual findings, shall be inadmissible in court or any other proceeding, with the exception of any proceeding to enforce this subdivision.
Unless the context otherwise requires, the definitions in this section govern the interpretation of this chapter.
(a)(1)Affiliate means any person, corporation, limited liability company, business trust, trust, partnership, unincorporated association, or other legal entity that directly or indirectly controls, is controlled by, or is under common control with, a provider or applicant.
(2)Affinity group means a grouping of entities sharing a common interest, philosophy, or connection (e.g., military officers, religion).
(3)Annual report means the report each provider is required to file annually with the department, as described in Section 1790.
(4)Applicant means any entity, or combination of entities, that submits and has pending an application to the department for a permit to accept deposits and a certificate of authority.
(5)Assisted living services includes, but is not limited to, assistance with personal activities of daily living, including dressing, feeding, toileting, bathing, grooming, mobility, and associated tasks, to help provide for and maintain physical and psychosocial comfort.
(6)Assisted living unit means the living area or unit within a continuing care retirement community that is specifically designed to provide ongoing assisted living services.
(7)Audited financial statement means financial statements prepared in accordance with generally accepted accounting principles including the opinion of an independent certified public accountant, and notes to the financial statements considered customary or necessary to provide full disclosure and complete information regarding the providers financial statements, financial condition, and operation.
(b)(reserved)
(c)(1)Cancel means to destroy the force and effect of an agreement or continuing care contract.
(2)Cancellation period means the 90-day period, beginning when the resident physically moves into the continuing care retirement community, during which the resident may cancel the continuing care contract, as provided in Section 1788.2.
(3)Care means nursing, medical, or other health-related services, protection or supervision, assistance with the personal activities of daily living, or any combination of those services.
(4)Cash equivalent means certificates of deposit and United States treasury securities with a maturity of five years or less.
(5)Certificate or certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, authorizing a specified provider to enter into one or more continuing care contracts at a single specified continuing care retirement community.
(6)Condition means a restriction, specific action, or other requirement imposed by the department for the initial or continuing validity of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority. A condition may limit the circumstances under which the provider may enter into any new deposit agreement or contract, or may be imposed as a condition precedent to the issuance of a permit to accept deposits, a provisional certificate of authority, or a certificate of authority.
(7)Consideration means some right, interest, profit, or benefit paid, transferred, promised, or provided by one party to another as an inducement to contract. Consideration includes some forbearance, detriment, loss, or responsibility, that is given, suffered, or undertaken by a party as an inducement to another party to contract.
(8)Continuing care contract means a contract that includes a continuing care promise made, in exchange for an entrance fee, the payment of periodic charges, or both types of payments. A continuing care contract may consist of one agreement or a series of agreements and other writings incorporated by reference.
(9)Continuing care promise means a promise, expressed or implied, by a provider to provide one or more elements of care to an elderly resident for the duration of his or her life or for a term in excess of one year. Any such promise or representation, whether part of a continuing care contract, other agreement, or series of agreements, or contained in any advertisement, brochure, or other material, either written or oral, is a continuing care promise.
(10)Continuing care retirement community means a facility located within the State of California where services promised in a continuing care contract are provided. A distinct phase of development approved by the department may be considered to be the continuing care retirement community when a project is being developed in successive distinct phases over a period of time. When the services are provided in residents own homes, the homes into which the provider takes those services are considered part of the continuing care retirement community.
(11)Control means directing or causing the direction of the financial management or the policies of another entity, including an operator of a continuing care retirement community, whether by means of the controlling entitys ownership interest, contract, or any other involvement. A parent entity or sole member of an entity controls a subsidiary entity provider for a continuing care retirement community if its officers, directors, or agents directly participate in the management of the subsidiary entity or in the initiation or approval of policies that affect the continuing care retirement communitys operations, including, but not limited to, approving budgets or the administrator for a continuing care retirement community.
(d)(1)Department means the State Department of Social Services.
(2)Deposit means any transfer of consideration, including a promise to transfer money or property, made by a depositor to any entity that promises or proposes to promise to provide continuing care, but is not authorized to enter into a continuing care contract with the potential depositor.
(3)Deposit agreement means any agreement made between any entity accepting a deposit and a depositor. Deposit agreements for deposits received by an applicant prior to the departments release of funds from the deposit escrow account shall be subject to the requirements described in Section 1780.4.
(4)Depository means a bank or institution that is a member of the Federal Deposit Insurance Corporation or a comparable deposit insurance program.
(5)Depositor means any prospective resident who pays a deposit. Where any portion of the consideration transferred to an applicant as a deposit or to a provider as consideration for a continuing care contract is transferred by a person other than the prospective resident or a resident, that third-party transferor shall have the same cancellation or refund rights as the prospective resident or resident for whose benefit the consideration was transferred.
(6)Director means the Director of Social Services.
(e)(1)Elderly means an individual who is 60 years of age or older.
(2)Entity means an individual, partnership, corporation, limited liability company, and any other form for doing business. Entity includes a person, sole proprietorship, estate, trust, association, and joint venture.
(3)Entrance fee means the sum of any initial, amortized, or deferred transfer of consideration made or promised to be made by, or on behalf of, a person entering into a continuing care contract for the purpose of ensuring care or related services pursuant to that continuing care contract or as full or partial payment for the promise to provide care for the term of the continuing care contract. Entrance fee includes the purchase price of a condominium, cooperative, or other interest sold in connection with a promise of continuing care. An initial, amortized, or deferred transfer of consideration that is greater in value than 12 times the monthly care fee shall be presumed to be an entrance fee.
(4)Equity means the value of real property in excess of the aggregate amount of all liabilities secured by the property.
(5)Equity interest means an interest held by a resident in a continuing care retirement community that consists of either an ownership interest in any part of the continuing care retirement community property or a transferable membership that entitles the holder to reside at the continuing care retirement community.
(6)Equity project means a continuing care retirement community where residents receive an equity interest in the continuing care retirement community property.
(7)Equity securities shall refer generally to large and midcapitalization corporate stocks that are publicly traded and readily liquidated for cash, and shall include shares in mutual funds that hold portfolios consisting predominantly of these stocks and other qualifying assets, as defined by Section 1792.2. Equity securities shall also include other similar securities that are specifically approved by the department.
(8)Escrow agent means a bank or institution, including, but not limited to, a title insurance company, approved by the department to hold and render accountings for deposits of cash or cash equivalents.
(f)Facility means any place or accommodation where a provider provides or will provide a resident with care or related services, whether or not the place or accommodation is constructed, owned, leased, rented, or otherwise contracted for by the provider.
(g)(reserved)
(h)(reserved)
(i)(1)Inactive certificate of authority means a certificate that has been terminated under Section 1793.8.
(2)Investment securities means any of the following:
(A)Direct obligations of the United States, including obligations issued or held in book-entry form on the books of the United States Department of the Treasury or obligations the timely payment of the principal of, and the interest on, which are fully guaranteed by the United States.
(B)Obligations, debentures, notes, or other evidences of indebtedness issued or guaranteed by any of the following:
(i)The Federal Home Loan Bank System.
(ii)The Export-Import Bank of the United States.
(iii)The Federal Financing Bank.
(iv)The Government National Mortgage Association.
(v)The Farmers Home Administration.
(vi)The Federal Home Loan Mortgage Corporation of the Federal Housing Administration.
(vii)Any agency, department, or other instrumentality of the United States if the obligations are rated in one of the two highest rating categories of each rating agency rating those obligations.
(C)Bonds of the State of California or of any county, city and county, or city in this state, if rated in one of the two highest rating categories of each rating agency rating those bonds.
(D)Commercial paper of finance companies and banking institutions rated in one of the two highest categories of each rating agency rating those instruments.
(E)Repurchase agreements fully secured by collateral security described in subparagraph (A) or (B), as evidenced by an opinion of counsel, if the collateral is held by the provider or a third party during the term of the repurchase agreement, pursuant to the terms of the agreement, subject to liens or claims of third parties, and has a market value, which is determined at least every 14 days, at least equal to the amount so invested.
(F)Long-term investment agreements, which have maturity dates in excess of one year, with financial institutions, including, but not limited to, banks and insurance companies or their affiliates, if the financial institutions paying ability for debt obligations or long-term claims or the paying ability of a related guarantor of the financial institution for these obligations or claims, is rated in one of the two highest rating categories of each rating agency rating those instruments, or if the short-term investment agreements are with the financial institution or the related guarantor of the financial institution, the long-term or short-term debt obligations, whichever is applicable, of which are rated in one of the two highest long-term or short-term rating categories, of each rating agency rating the bonds of the financial institution or the related guarantor, provided that if the rating falls below the two highest rating categories, the investment agreement shall allow the provider the option to replace the financial institution or the related guarantor of the financial institution or shall provide for the investment securities to be fully collateralized by investments described in subparagraph (A), and, provided further, if so collateralized, that the provider has a perfected first security lien on the collateral, as evidenced by an opinion of counsel and the collateral is held by the provider.
(G)Bankers acceptances or certificates of deposit of, or time deposits in, any savings and loan association that meets any of the following criteria:
(i)The debt obligations of the savings and loan association, or in the case of a principal bank, of the bank holding company, are rated in one of the two highest rating categories of each rating agency rating those instruments.
(ii)The certificates of deposit or time deposits are fully insured by the Federal Deposit Insurance Corporation.
(iii)The certificates of deposit or time deposits are secured at all times, in the manner and to the extent provided by law, by collateral security described in subparagraph (A) or (B) with a market value, valued at least quarterly, of no less than the original amount of moneys so invested.
(H)Taxable money market government portfolios restricted to obligations issued or guaranteed as to payment of principal and interest by the full faith and credit of the United States.
(I)Obligations the interest on which is excluded from gross income for federal income tax purposes and money market mutual funds whose portfolios are restricted to these obligations, if the obligations or mutual funds are rated in one of the two highest rating categories by each rating agency rating those obligations.
(J)Bonds that are not issued by the United States or any federal agency, but that are listed on a national exchange and that are rated at least A by Moodys Investors Service, or the equivalent rating by Standard and Poors Corporation or Fitch Investors Service.
(K)Bonds not listed on a national exchange that are traded on an over-the-counter basis, and that are rated at least Aa by Moodys Investors Service or AA by Standard and Poors Corporation or Fitch Investors Service.
(j)(reserved)
(k)(reserved)
(l)Life care contract means a continuing care contract that includes a promise, expressed or implied, by a provider to provide or pay for routine services at all levels of care, including acute care and the services of physicians and surgeons, to the extent not covered by other public or private insurance benefits, to a resident for the duration of his or her life. Care shall be provided under a life care contract in a continuing care retirement community having a comprehensive continuum of care, including a skilled nursing facility, under the ownership and supervision of the provider on or adjacent to the premises. No change may be made in the monthly fee based on level of care. A life care contract shall also include provisions to subsidize residents who become financially unable to pay their monthly care fees.
(m)(1)Monthly care fee means the fee charged to a resident in a continuing care contract on a monthly or other periodic basis for current accommodations and services including care, board, or lodging. Periodic entrance fee payments or other prepayments shall not be monthly care fees.
(2)Monthly fee contract means a continuing care contract that requires residents to pay monthly care fees.
(n)Nonambulatory person means a person who is unable to leave a building unassisted under emergency conditions in the manner described by Section 13131.
(o)(reserved)
(p)(1)Per capita cost means a continuing care retirement communitys operating expenses, excluding depreciation, divided by the average number of residents.
(2)Periodic charges means fees paid by a resident on a periodic basis.
(3)Permanent closure means the voluntary or involuntary termination or forfeiture, as specified in subdivisions (a), (b), (g), (h), and (i) of Section 1793.7, of a providers certificate of authority or license, or another action that results in the permanent relocation of residents. Permanent closure does not apply in the case of a natural disaster or other event out of the providers control.
(4)Permit to accept deposits means a written authorization by the department permitting an applicant to enter into deposit agreements regarding a single specified continuing care retirement community.
(5)Prepaid contract means a continuing care contract in which the monthly care fee, if any, may not be adjusted to cover the actual cost of care and services.
(6)Preferred access means that residents who have previously occupied a residential living unit have a right over other persons to any assisted living or skilled nursing beds that are available at the community.
(7)Processing fee means a payment to cover administrative costs of processing the application of a depositor or prospective resident.
(8)Promise to provide one or more elements of care means any expressed or implied representation that one or more elements of care will be provided or will be available, such as by preferred access.
(9)Proposes means a representation that an applicant or provider will or intends to make a future promise to provide care, including a promise that is subject to a condition, such as the construction of a continuing care retirement community or the acquisition of a certificate of authority.
(10)Provider means an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. Provider also includes any entity that controls an entity that provides continuing care, makes a continuing care promise, or proposes to promise to provide continuing care. The department shall determine whether an entity controls another entity for purposes of this article. No homeowners association, cooperative, or condominium association may be a provider.
(11)Provisional certificate of authority means the certificate issued by the department, properly executed and bearing the State Seal, under Section 1786. A provisional certificate of authority shall be limited to the specific continuing care retirement community and number of units identified in the applicants application.
(q)(reserved)
(r)(1)Refund reserve means the reserve a provider is required to maintain, as provided in Section 1792.6.
(2)(A)Refundable contract means a continuing care contract that includes a promise, expressed or implied, by the provider to pay an entrance fee refund or to repurchase the transferors unit, membership, stock, or other interest in the continuing care retirement community when the promise to refund some or all of the initial entrance fee extends beyond the residents sixth year of residency. Providers that enter into refundable contracts shall be subject to the refund reserve requirements of Section 1792.6. A
(B)A continuing care contract that includes a promise to repay all or a portion of an entrance fee that is conditioned upon reoccupancy or resale of the unit previously occupied by the resident shall not be considered a refundable contract for purposes of the refund reserve requirements of Section 1792.6, provided that this conditional promise of repayment is not referred to by the applicant or provider as a refund. A provider may repay all or a portion of an entrance fee that is conditioned upon resale of the unit before the resale of the unit. The repayment of an entrance fee before the resale of the unit shall not cause any other entrance fee to be subject to the refund reserve requirements of Section 1792.6, provided that the provider does not promise, at the time of contracting or thereafter, to make this type of early repayment, represent that the provider intends to make this type of early repayment, or indicate that the provider has a practice of making this type of early repayment.
(3)Resale fee means a levy by the provider against the proceeds from the sale of a transferors equity interest.
(4)Reservation fee refers to consideration collected by an entity that has made a continuing care promise or is proposing to make this promise and has complied with Section 1771.4.
(5)Resident means a person who enters into a continuing care contract with a provider, or who is designated in a continuing care contract to be a person being provided or to be provided services, including care, board, or lodging.
(6)Residential care facility for the elderly means a housing arrangement as defined by Section 1569.2.
(7)Residential living unit means a living unit in a continuing care retirement community that is not used exclusively for assisted living services or nursing services.
(8)Residential temporary relocation means the relocation of one or more residents, except in the case of a natural disaster that is out of the providers control, from one or more residential living units, assisted living units, skilled nursing units, or a wing, floor, or entire continuing care retirement community building, due to a change of use or major repairs or renovations. A residential temporary relocation shall mean a relocation pursuant to this subdivision that lasts for a period of at least nine months but that does not exceed 18 months without the written agreement of the resident.
(s)(reserved)
(t)(1)Termination means the ending of a continuing care contract as provided for in the terms of the continuing care contract.
(2)Transfer trauma means death, depression, or regressive behavior, that is caused by the abrupt and involuntary transfer of an elderly resident from one home to another and results from a loss of familiar physical environment, loss of well-known neighbors, attendants, nurses and medical personnel, the stress of an abrupt break in the small routines of daily life, or the loss of visits from friends and relatives who may be unable to reach the new facility.
(3)Transferor means a person who transfers, or promises to transfer, consideration in exchange for care and related services under a continuing care contract or proposed continuing care contract, for the benefit of another. A transferor shall have the same rights to cancel and obtain a refund as the depositor under the deposit agreement or the resident under a continuing care contract.
SECTION 1.SEC. 2.Section 1788 of the Health and Safety Code is amended to read:1788.(a)A continuing care contract shall contain all of the following:
(1)The legal name and address of each provider.
(2)The name and address of the continuing care retirement community.
(3)The residents name and the identity of the unit the resident will occupy.
(4)If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferors name and address shall be specified.
(5)If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
(6)The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
(7)The duration of the continuing care contract.
(8)A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
(A)Regular observation of the residents health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
(B)Safe and healthful living accommodations, including housekeeping services and utilities.
(C)Maintenance of house rules for the protection of residents.
(D)A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
(E)Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
(F)Assisted living services.
(G)Assistance with taking medications.
(H)Central storing and distribution of medications.
(I)Arrangements to meet health needs, including arranging transportation.
(9)An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract. The schedule shall state that a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(10)The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
(A)A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
(i)The resident is nonambulatory. The definition of nonambulatory, as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
(ii)The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
(iii)The residents condition or needs require the residents transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
(iv)The residents condition or needs require the residents transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
(B)Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
(i)Involve the resident and the residents responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the residents or responsible persons request, family members, or the residents physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the residents responsible person.
(ii)Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the residents responsible person, and upon the residents or responsible persons request, family members, and the residents health care professionals, to explain the reasons for transfer.
(iii)Notify the resident and the residents responsible person of the reasons for the transfer in writing.
(iv)Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
(v)The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the residents urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
(vi)The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the residents right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the departments Continuing Care Contracts Branch.
(vii)The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
(C)The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the residents responsible person, and upon the residents or responsible persons request, family members, the residents physician or other appropriate health care professional, and members of the providers interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the residents responsible person, or the provider.
(D)For disputed transfer decisions, the resident or the residents responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
(E)The decision of the departments Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
(F)Transfer of a second resident when a shared accommodation arrangement is terminated.
(11)Provisions describing any changes in the residents monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Unless the fee is part of an equity interest contract, a provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident.
(12)The providers continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
(13)The providers obligations, if any, to resume care upon the residents return after a transfer from the continuing care retirement community.
(14)The providers obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
(15)The conditions under which the resident must permanently release his or her living unit.
(16)If real or personal properties are transferred in lieu of cash, a statement specifying each items value at the time of transfer, and how the value was ascertained.
(A)An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
(B)When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
(C)The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
(17)The amount of the entrance fee.
(18)In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
(19)The amount of any processing fee.
(20)The amount of any monthly care fee.
(21)For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
(A)A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
(B)The regular rate of payment agreed upon (per day, week, or month).
(C)A provision specifying whether payment will be made in advance or after services have been provided.
(D)A provision specifying the provider will adjust monthly care fees for the residents support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
(E)A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
(F)A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
(G)A statement that the provider is prohibited from charging the resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(22)All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
(A)For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
(i)Fees shall not be subject to change during the lifetime of the agreement.
(ii)Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
(iii)Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
(B)For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
(23)A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the residents monthly care fees or in the price or scope of any component of care or other services.
(24)A provision indicating whether the residents rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
(25)If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
(26)Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
(27)A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right.
(28)Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days written notice by the provider without cause, or that the provider waives this right.
(29)The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
(30)A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
(A)Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for just cause, good cause, or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes just cause, good cause, or otherwise activates the termination provision:
(i)Filing or lodging a formal complaint with the department or other appropriate authority.
(ii)Participation in an organization or affiliation of residents, or other similar lawful activity.
(B)The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents organization or association.
(C)Nothing in this paragraph diminishes the providers ability to terminate the continuing care contract for good and sufficient cause.
(31)A statement that at least 90 days written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
(32)A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
(33)The policy or terms for refunding or repaying a lump sum of any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund or repaying a lump sum of all or a part of the entrance fee shall also do all of the following:
(A)Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the residents unit.
(B)State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
(i)Amortize the specified amount at the same rate as the residents entrance fee.
(ii)Refund the unamortized balance to the resident at the same time the provider pays the residents entrance fee refund.
(C)State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
(D)(i)State the provider shall make a good-faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. No later than July 1, 2016, a provider shall provide notice to all current residents with contracts applicable to this subparagraph regarding the statement required by this subparagraph as a clarification of the residents existing contract.
(ii)The department, in response to a complaint from the resident or the residents estate, may determine if a provider has failed to make a sufficient good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. An insufficient good faith effort on behalf of the provider shall include, but is not limited to, the failure to undergo the facilitys refurbishment process for reletting, the failure to make needed repairs, the failure to reasonably market the unit to potential residents, or the failure to show the unit to prospective residents.
(iii)If the department makes a determination that a provider has failed to make a good faith effort to reoccupy or resell a unit pursuant to clause (ii), the provider shall repay the full lump-sum payment owed to the resident or residents estate within 14 days of the departments determination, and shall reimburse the department for any costs incurred by the department that are associated with the departments determination.
(E)For a lump-sum payment, the provider shall state the average and longest amount of time that a lump-sum payment has been delayed.
(E)For all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the provider shall state the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
(34)The following notice at the bottom of the signatory page:
NOTICE | (date) |
This is a continuing care contract as defined by paragraph (8) of subdivision (c), or subdivision (l) of Section 1771 of the California Health and Safety Code. This continuing care contract form has been approved by the State Department of Social Services as required by subdivision (b) of Section 1787 of the California Health and Safety Code. The basis for this approval was a determination that (provider name) has submitted a contract that complies with the minimum statutory requirements applicable to continuing care contracts. The department does not approve or disapprove any of the financial or health care coverage provisions in this contract. Approval by the department is NOT a guaranty of performance or an endorsement of any continuing care contract provisions. Prospective transferors and residents are strongly encouraged to carefully consider the benefits and risks of this continuing care contract and to seek financial and legal advice before signing.
(35)The provider may not attempt to absolve itself in the continuing care contract from liability for its negligence by any statement to that effect, and shall include the following statement in the contract: Nothing in this continuing care contract limits either the providers obligation to provide adequate care and supervision for the resident or any liability on the part of the provider which may result from the providers failure to provide this care and supervision.
(36)Provisions describing how the provider will proceed in the event of a closure, including an explanation of how the provider will comply with Sections 1793.80, 1793.81, 1793.82, and 1793.83.
(b)A life care contract shall also provide that:
(1)All levels of care, including acute care and physicians and surgeons services, will be provided to a resident.
(2)Care will be provided for the duration of the residents life unless the life care contract is canceled or terminated by the provider during the cancellation period or after the cancellation period for good cause.
(3)A comprehensive continuum of care will be provided to the resident, including skilled nursing, in a facility under the ownership and supervision of the provider on, or adjacent to, the continuing care retirement community premises.
(4)Monthly care fees will not be changed based on the residents level of care or service.
(5)A resident who becomes financially unable to pay his or her monthly care fees shall be subsidized provided the residents financial need does not arise from action by the resident to divest the resident of his or her assets.
(c)Continuing care contracts may include provisions that do any of the following:
(1)Subsidize a resident who becomes financially unable to pay for his or her monthly care fees at some future date. If a continuing care contract provides for subsidizing a resident, it may also provide for any of the following:
(A)The resident shall apply for any public assistance or other aid for which he or she is eligible and that the provider may apply for assistance on behalf of the resident.
(B)The providers decision shall be final and conclusive regarding any adjustments to be made or any action to be taken regarding any charitable consideration extended to any of its residents.
(C)The provider is entitled to payment for the actual costs of care out of any property acquired by the resident subsequent to any adjustment extended to the resident under this paragraph, or from any other property of the resident that the resident failed to disclose.
(D)The provider may pay the monthly premium of the residents health insurance coverage under Medicare to ensure that those payments will be made.
(E)The provider may receive an assignment from the resident of the right to apply for and to receive the benefits, for and on behalf of the resident.
(F)The provider is not responsible for the costs of furnishing the resident with any services, supplies, and medication, when reimbursement is reasonably available from any governmental agency, or any private insurance.
(G)Any refund due to the resident at the termination of the continuing care contract may be offset by any prior subsidy to the resident by the provider.
(2)Limit responsibility for costs associated with the treatment or medication of an ailment or illness existing prior to the date of admission. In these cases, the medical or surgical exceptions, as disclosed by the medical entrance examination, shall be listed in the continuing care contract or in a medical report attached to and made a part of the continuing care contract.
(3)Identify legal remedies that may be available to the provider if the resident makes any material misrepresentation or omission pertaining to the residents assets or health.
(4)Restrict transfer or assignments of the residents rights and privileges under a continuing care contract due to the personal nature of the continuing care contract.
(5)Protect the providers ability to waive a residents breach of the terms or provisions of the continuing care contract in specific instances without relinquishing its right to insist upon full compliance by the resident with all terms or provisions in the contract.
(6)Provide that the resident shall reimburse the provider for any uninsured loss or damage to the residents unit, beyond normal wear and tear, resulting from the residents carelessness or negligence.
(7)Provide that the resident agrees to observe the off-limit areas of the continuing care retirement community designated by the provider for safety reasons. The provider may not include any provision in a continuing care contract that absolves the provider from liability for its negligence.
(8)Provide for the subrogation to the provider of the residents rights in the case of injury to a resident caused by the acts or omissions of a third party, or for the assignment of the residents recovery or benefits in this case to the provider, to the extent of the value of the goods and services furnished by the provider to or on behalf of the resident as a result of the injury.
(9)Provide for a lien on any judgment, settlement, or recovery for any additional expense incurred by the provider in caring for the resident as a result of injury.
(10)Require the residents cooperation and assistance in the diligent prosecution of any claim or action against any third party.
(11)Provide for the appointment of a conservator or guardian by a court with jurisdiction in the event a resident becomes unable to handle his or her personal or financial affairs.
(12)Allow a provider, whose property is tax exempt, to charge the resident, on a pro rata basis, property taxes, or in-lieu taxes, that the provider is required to pay.
(13)Make any other provision approved by the department.
(d)A copy of the residents rights as described in Section 1771.7 shall be attached to every continuing care contract.
(e)A copy of the current audited financial statement of the provider shall be attached to every continuing care contract. For a provider whose current audited financial statement does not accurately reflect the financial ability of the provider to fulfill the continuing care contract obligations, the financial statement attached to the continuing care contract shall include all of the following:
(1)A disclosure that the reserve requirement has not yet been determined or met, and that entrance fees will not be held in escrow.
(2)A disclosure that the ability to provide the services promised in the continuing care contract will depend on successful compliance with the approved financial plan.
(3)A copy of the approved financial plan for meeting the reserve requirements.
(4)Any other supplemental statements or attachments necessary to accurately represent the providers financial ability to fulfill its continuing care contract obligations.
(f)A schedule of the average monthly care fees charged to residents for each type of residential living unit for each of the five years preceding execution of the continuing care contract shall be attached to every continuing care contract. The provider shall update this schedule annually at the end of each fiscal year. If the continuing care retirement community has not been in existence for five years, the information shall be provided for each of the years the continuing care retirement community has been in existence.
(g)If any continuing care contract provides for a health insurance policy for the benefit of the resident, the provider shall attach to the continuing care contract a binder complying with Sections 382 and 382.5 of the Insurance Code.
(h)The provider shall attach to every continuing care contract a completed form in duplicate, captioned Notice of Cancellation. The notice shall be easily detachable, and shall contain, in at least 10-point boldface type, the following statement:
NOTICE OF CANCELLATION | (date) |
Your first date of occupancy under this contract | |
is: _____________________________________________ | |
You may cancel this transaction, without any penalty within 90 calendar days from the above date.
If you cancel, any property transferred, any payments made by you under the contract, and any negotiable instrument executed by you will be returned within 14 calendar days after making possession of the living unit available to the provider. Any security interest arising out of the transaction will be canceled.
If you cancel, you are obligated to pay a reasonable processing fee to cover costs and to pay for the reasonable value of the services received by you from the provider up to the date you canceled or made available to the provider the possession of any living unit delivered to you under this contract, whichever is later.
If you cancel, you must return possession of any living unit delivered to you under this contract to the provider in substantially the same condition as when you took possession.
Possession of the living unit must be made available to the provider within 20 calendar days of your notice of cancellation. If you fail to make the possession of any living unit available to the provider, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any other written notice, or send a telegram
to | |
(Name of provider) | |
|---|---|
at | |
(Address of providers place of business) | |
not later than midnight of_____________(date). | |
I hereby cancel this | |
(Residentsor | |
(a)During the cancellation period, the provider shall pay all refunds owed to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider.
(b)After the cancellation period, any refunds due to a resident under a continuing care contract shall be paid within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later.
(c)In nonequity projects, if the continuing care contract is canceled by either party during the cancellation period or terminated by the provider after the cancellation period, the resident shall be refunded the difference between the total amount of entrance, monthly, and optional fees paid and the amount used for care of the resident.
(d)If a resident has paid additional amounts for upgrades, special features, or modifications to the living unit and the provider terminates the residents continuing care contract, the provider shall amortize those additional amounts at the same rate as the entrance fee and shall refund the unamortized balance to the resident.
(e)(1)A lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of the unit shall not be considered to be a refund and may not be characterized or advertised as a refund. The full lump-sum payment shall be paid to the resident within 14 calendar days after resale of the unit. For contracts signed after January 1, 2016, notwithstanding a providers documented good-faith effort to resell the unit, the resident is entitled to the repayment of a specified portion, pursuant to subparagraphs (A) and (B), of the full lump-sum payment if the unit remains vacant 120 days after the residents termination. This repayment shall not cause the contract in question to be deemed a refundable contract, as defined in paragraph (2) of subdivision (r) of Section 1771.
(A)When a continuing care contract is terminated by the death of a resident, at least 10 percent of the full lump-sum payment shall be paid to the residents estate within 120 days after the residents termination.
(B)When a continuing care contract is terminated for a reason not described in subparagraph (A), at least 20 percent of the full lump-sum payment shall be paid to the resident within 120 days after the residents termination.
(2)Any payment balance that has not been paid to the resident within 120 days shall accrue interest at a rate calculated pursuant to paragraph (3). Any payment balance that has not been paid to the resident within 180 days will shall accrue interest at a rate calculated pursuant to paragraph (4). Interest shall continue to accrue until the date the full lump-sum payment is paid to the resident. This paragraph shall apply only to existing and prospective continuing care contracts. contracts entered into on or after January 1, 2016.
(3)Any payments that are not paid to the resident within the 120-day period pursuant to paragraph (2) will shall accrue interest at a rate no not lower than the United States prime lending rate. 4 percent.
(4)Any payments that are not paid to the resident within the 180-day period pursuant to paragraph (2) will shall accrue interest at a rate no not lower than 2 percent plus the United States prime lending rate. 6 percent.
(f)After the death of a resident, a lump-sum payment that is conditioned upon resale of a unit shall be subject to subdivision (e) and the payment and interest, if any, shall be payable to the residents estate.
(g)Except as otherwise obligated by an equity interest contract, once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit.
(h)Nothing in this section shall be construed to limit or alter any legal remedies otherwise available to a resident or his or her estate.
(a)A continuing care contract shall contain all of the following:
(1)The legal name and address of each provider.
(2)The name and address of the continuing care retirement community.
(3)The residents name and the identity of the unit the resident will occupy.
(4)If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferors name and address shall be specified.
(5)If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
(6)The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
(7)The duration of the continuing care contract.
(8)A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
(A)Regular observation of the residents health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
(B)Safe and healthful living accommodations, including housekeeping services and utilities.
(C)Maintenance of house rules for the protection of residents.
(D)A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
(E)Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
(F)Assisted living services.
(G)Assistance with taking medications.
(H)Central storing and distribution of medications.
(I)Arrangements to meet health needs, including arranging transportation.
(9)An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract. The schedule shall state that a provider is prohibited from charging the resident or his or her descendants estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(10)The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
(A)A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
(i)The resident is nonambulatory. The definition of nonambulatory, as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
(ii)The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
(iii)The residents condition or needs require the residents transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
(iv)The residents condition or needs require the residents transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
(B)Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
(i)Involve the resident and the residents responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the residents or responsible persons request, family members, or the residents physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the residents responsible person.
(ii)Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the residents responsible person, and upon the residents or responsible persons request, family members, and the residents health care professionals, to explain the reasons for transfer.
(iii)Notify the resident and the residents responsible person of the reasons for the transfer in writing.
(iv)Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
(v)The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the residents urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
(vi)The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the residents right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the departments Continuing Care Contracts Branch.
(vii)The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
(C)The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the residents responsible person, and upon the residents or responsible persons request, family members, the residents physician or other appropriate health care professional, and members of the providers interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the residents responsible person, or the provider.
(D)For disputed transfer decisions, the resident or the residents responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
(E)The decision of the departments Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
(F)Transfer of a second resident when a shared accommodation arrangement is terminated.
(11)Provisions describing any changes in the residents monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Unless the fee is part of an equity interest contract, a provider is prohibited from charging the resident or his or her descendants estate a monthly fee once a unit has been permanently vacated by the resident.
(12)The providers continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
(13)The providers obligations, if any, to resume care upon the residents return after a transfer from the continuing care retirement community.
(14)The providers obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
(15)The conditions under which the resident must permanently release his or her living unit.
(16)If real or personal properties are transferred in lieu of cash, a statement specifying each items value at the time of transfer, and how the value was ascertained.
(A)An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
(B)When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
(C)The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
(17)The amount of the entrance fee.
(18)In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
(19)The amount of any processing fee.
(20)The amount of any monthly care fee.
(21)For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
(A)A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
(B)The regular rate of payment agreed upon (per day, week, or month).
(C)A provision specifying whether payment will be made in advance or after services have been provided.
(D)A provision specifying the provider will adjust monthly care fees for the residents support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
(E)A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
(F)A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
(G)A statement that the provider is prohibited from charging the resident or his or her descendants estate a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract.
(22)All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
(A)For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
(i)Fees shall not be subject to change during the lifetime of the agreement.
(ii)Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
(iii)Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
(B)For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
(23)A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the residents monthly care fees or in the price or scope of any component of care or other services.
(24)A provision indicating whether the residents rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
(25)If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
(26)Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
(27)A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right.
(28)Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days written notice by the provider without cause, or that the provider waives this right.
(29)The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
(30)A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
(A)Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for just cause, good cause, or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes just cause, good cause, or otherwise activates the termination provision:
(i)Filing or lodging a formal complaint with the department or other appropriate authority.
(ii)Participation in an organization or affiliation of residents, or other similar lawful activity.
(B)The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents organization or association.
(C)Nothing in this paragraph diminishes the providers ability to terminate the continuing care contract for good and sufficient cause.
(31)A statement that at least 90 days written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
(32)A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
(33)The policy or terms for refunding or repaying a lump sum of any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund or repaying a lump sum of all or a part of the entrance fee shall also do all of the following:
(A)Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the residents unit.
(B)State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
(i)Amortize the specified amount at the same rate as the residents entrance fee.
(ii)Refund the unamortized balance to the resident at the same time the provider pays the residents entrance fee refund.
(C)State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
(D)State the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. No later than July 1, 2016, a provider shall provide notice to all current residents with contracts applicable to this subparagraph regarding the statement required by this subparagraph as a clarification of the residents existing contract.
(E)For a lump-sum payment, the provider shall state the average and longest amount of time that a lump-sum payment has been delayed.
(34)The following notice at the bottom of the signatory page:
NOTICE | (date) |
This is a continuing care contract as defined by paragraph (8) of subdivision (c), or subdivision (l) of Section 1771 of the California Health and Safety Code. This continuing care contract form has been approved by the State Department of Social Services as required by subdivision (b) of Section 1787 of the California Health and Safety Code. The basis for this approval was a determination that (provider name) has submitted a contract that complies with the minimum statutory requirements applicable to continuing care contracts. The department does not approve or disapprove any of the financial or health care coverage provisions in this contract. Approval by the department is NOT a guaranty of performance or an endorsement of any continuing care contract provisions. Prospective transferors and residents are strongly encouraged to carefully consider the benefits and risks of this continuing care contract and to seek financial and legal advice before signing.
(35)The provider may not attempt to absolve itself in the continuing care contract from liability for its negligence by any statement to that effect, and shall include the following statement in the contract: Nothing in this continuing care contract limits either the providers obligation to provide adequate care and supervision for the resident or any liability on the part of the provider which may result from the providers failure to provide this care and supervision.
(36)Provisions describing how the provider will proceed in the event of a closure, including an explanation of how the provider will comply with Sections 1793.80, 1793.81, 1793.82, and 1793.83.
(b)A life care contract shall also provide that:
(1)All levels of care, including acute care and physicians and surgeons services, will be provided to a resident.
(2)Care will be provided for the duration of the residents life unless the life care contract is canceled or terminated by the provider during the cancellation period or after the cancellation period for good cause.
(3)A comprehensive continuum of care will be provided to the resident, including skilled nursing, in a facility under the ownership and supervision of the provider on, or adjacent to, the continuing care retirement community premises.
(4)Monthly care fees will not be changed based on the residents level of care or service.
(5)A resident who becomes financially unable to pay his or her monthly care fees shall be subsidized provided the residents financial need does not arise from action by the resident to divest the resident of his or her assets.
(c)Continuing care contracts may include provisions that do any of the following:
(1)Subsidize a resident who becomes financially unable to pay for his or her monthly care fees at some future date. If a continuing care contract provides for subsidizing a resident, it may also provide for any of the following:
(A)The resident shall apply for any public assistance or other aid for which he or she is eligible and that the provider may apply for assistance on behalf of the resident.
(B)The providers decision shall be final and conclusive regarding any adjustments to be made or any action to be taken regarding any charitable consideration extended to any of its residents.
(C)The provider is entitled to payment for the actual costs of care out of any property acquired by the resident subsequent to any adjustment extended to the resident under this paragraph, or from any other property of the resident that the resident failed to disclose.
(D)The provider may pay the monthly premium of the residents health insurance coverage under Medicare to ensure that those payments will be made.
(E)The provider may receive an assignment from the resident of the right to apply for and to receive the benefits, for and on behalf of the resident.
(F)The provider is not responsible for the costs of furnishing the resident with any services, supplies, and medication, when reimbursement is reasonably available from any governmental agency, or any private insurance.
(G)Any refund due to the resident at the termination of the continuing care contract may be offset by any prior subsidy to the resident by the provider.
(2)Limit responsibility for costs associated with the treatment or medication of an ailment or illness existing prior to the date of admission. In these cases, the medical or surgical exceptions, as disclosed by the medical entrance examination, shall be listed in the continuing care contract or in a medical report attached to and made a part of the continuing care contract.
(3)Identify legal remedies that may be available to the provider if the resident makes any material misrepresentation or omission pertaining to the residents assets or health.
(4)Restrict transfer or assignments of the residents rights and privileges under a continuing care contract due to the personal nature of the continuing care contract.
(5)Protect the providers ability to waive a residents breach of the terms or provisions of the continuing care contract in specific instances without relinquishing its right to insist upon full compliance by the resident with all terms or provisions in the contract.
(6)Provide that the resident shall reimburse the provider for any uninsured loss or damage to the residents unit, beyond normal wear and tear, resulting from the residents carelessness or negligence.
(7)Provide that the resident agrees to observe the off-limit areas of the continuing care retirement community designated by the provider for safety reasons. The provider may not include any provision in a continuing care contract that absolves the provider from liability for its negligence.
(8)Provide for the subrogation to the provider of the residents rights in the case of injury to a resident caused by the acts or omissions of a third party, or for the assignment of the residents recovery or benefits in this case to the provider, to the extent of the value of the goods and services furnished by the provider to or on behalf of the resident as a result of the injury.
(9)Provide for a lien on any judgment, settlement, or recovery for any additional expense incurred by the provider in caring for the resident as a result of injury.
(10)Require the residents cooperation and assistance in the diligent prosecution of any claim or action against any third party.
(11)Provide for the appointment of a conservator or guardian by a court with jurisdiction in the event a resident becomes unable to handle his or her personal or financial affairs.
(12)Allow a provider, whose property is tax exempt, to charge the resident, on a pro rata basis, property taxes, or in-lieu taxes, that the provider is required to pay.
(13)Make any other provision approved by the department.
(d)A copy of the residents rights as described in Section 1771.7 shall be attached to every continuing care contract.
(e)A copy of the current audited financial statement of the provider shall be attached to every continuing care contract. For a provider whose current audited financial statement does not accurately reflect the financial ability of the provider to fulfill the continuing care contract obligations, the financial statement attached to the continuing care contract shall include all of the following:
(1)A disclosure that the reserve requirement has not yet been determined or met, and that entrance fees will not be held in escrow.
(2)A disclosure that the ability to provide the services promised in the continuing care contract will depend on successful compliance with the approved financial plan.
(3)A copy of the approved financial plan for meeting the reserve requirements.
(4)Any other supplemental statements or attachments necessary to accurately represent the providers financial ability to fulfill its continuing care contract obligations.
(f)A schedule of the average monthly care fees charged to residents for each type of residential living unit for each of the five years preceding execution of the continuing care contract shall be attached to every continuing care contract. The provider shall update this schedule annually at the end of each fiscal year. If the continuing care retirement community has not been in existence for five years, the information shall be provided for each of the years the continuing care retirement community has been in existence.
(g)If any continuing care contract provides for a health insurance policy for the benefit of the resident, the provider shall attach to the continuing care contract a binder complying with Sections 382 and 382.5 of the Insurance Code.
(h)The provider shall attach to every continuing care contract a completed form in duplicate, captioned Notice of Cancellation. The notice shall be easily detachable, and shall contain, in at least 10-point boldface type, the following statement:
NOTICE OF CANCELLATION | (date) |
Your first date of occupancy under this contract | |
is: _____________________________________________ | |
You may cancel this transaction, without any penalty within 90 calendar days from the above date.
If you cancel, any property transferred, any payments made by you under the contract, and any negotiable instrument executed by you will be returned within 14 calendar days after making possession of the living unit available to the provider. Any security interest arising out of the transaction will be canceled.
If you cancel, you are obligated to pay a reasonable processing fee to cover costs and to pay for the reasonable value of the services received by you from the provider up to the date you canceled or made available to the provider the possession of any living unit delivered to you under this contract, whichever is later.
If you cancel, you must return possession of any living unit delivered to you under this contract to the provider in substantially the same condition as when you took possession.
Possession of the living unit must be made available to the provider within 20 calendar days of your notice of cancellation. If you fail to make the possession of any living unit available to the provider, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any other written notice, or send a telegram
to | |
(Name of provider) | |
|---|---|
at | |
(Address of providers place of business) | |
not later than midnight of_____________(date). | |
I hereby cancel this | |
(Residentsor | |
(a)During the cancellation period, the provider shall pay all refunds owed to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider.
(b)After the cancellation period, any refunds due to a resident under a continuing care contract shall be paid within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later.
(c)In nonequity projects, if the continuing care contract is canceled by either party during the cancellation period or terminated by the provider after the cancellation period, the resident shall be refunded the difference between the total amount of entrance, monthly, and optional fees paid and the amount used for care of the resident.
(d)If a resident has paid additional amounts for upgrades, special features, or modifications to the living unit and the provider terminates the residents continuing care contract, the provider shall amortize those additional amounts at the same rate as the entrance fee and shall refund the unamortized balance to the resident.
(e)(1)A lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of the unit shall not be considered to be a refund and may not be characterized or advertised as a refund. The full lump-sum payment shall be paid to the resident within 14 calendar days after resale of the unit. For contracts signed after January 1, 2016, notwithstanding a providers documented good-faith effort to resell the unit, the resident is entitled to the repayment of at least 20 percent a specified portion, pursuant to subparagraphs (A) and (B), of the full lump-sum payment if the unit remains vacant 120 days after the residents termination. This repayment shall not cause the contract in question to be deemed a refundable contract, as defined in paragraph (2) of subdivision (r) of Section 1771.
(A)When a continuing care contract is terminated by the death of a resident, at least 10 percent of the full lump-sum payment shall be paid to the residents estate within 120 days after the residents termination.
(B)When a continuing care contract is terminated for a reason not described in subparagraph (A), at least 20 percent of the full lump-sum payment shall be paid to the resident within 120 days after the residents termination.
(2)Any payment balance that has not been paid to the resident within 120 days shall accrue interest at a rate calculated pursuant to paragraph (3). Any payment balance that has not been paid to the resident within 180 days will accrue interest at a rate calculated pursuant to paragraph (4). Interest shall continue to accrue until the date the full lump-sum payment is paid to the resident. This paragraph shall apply to existing and prospective continuing care contracts.
(3)Any payments that are not paid to the resident within the 120-day period pursuant to paragraph (2) will accrue interest at a rate no lower than the United States prime lending rate.
(4)Any payments that are not paid to the resident within the 180-day period pursuant to paragraph (2) will accrue interest at a rate no lower than 2 percent plus the United States prime lending rate.
(f)After the death of a resident, a lump-sum payment that is conditioned upon resale of a unit shall be subject to subdivision (e) and the payment and interest, if any, shall be payable to the residents estate.
(g)Except as otherwise obligated by an equity interest contract, once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit.
(h)Nothing in this section shall be construed to limit or alter any legal remedies otherwise available to a resident or his or her estate.
(a)A continuing care contract shall contain all of the following:
(1)The legal name and address of each provider.
(2)The name and address of the continuing care retirement community.
(3)The residents name and the identity of the unit the resident will occupy.
(4)If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferors name and address shall be specified.
(5)If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
(6)The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
(7)The duration of the continuing care contract.
(8)A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
(A)Regular observation of the residents health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
(B)Safe and healthful living accommodations, including housekeeping services and utilities.
(C)Maintenance of house rules for the protection of residents.
(D)A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
(E)Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
(F)Assisted living services.
(G)Assistance with taking medications.
(H)Central storing and distribution of medications.
(I)Arrangements to meet health needs, including arranging transportation.
(9)An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract. The schedule shall state that a provider is prohibited from charging the resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident. resident, unless the fee is part of an equity interest contract.
(10)The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
(A)A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
(i)The resident is nonambulatory. The definition of nonambulatory, as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
(ii)The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
(iii)The residents condition or needs require the residents transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
(iv)The residents condition or needs require the residents transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
(B)Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
(i)Involve the resident and the residents responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the residents or responsible persons request, family members, or the residents physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the residents responsible person.
(ii)Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the residents responsible person, and upon the residents or responsible persons request, family members, and the residents health care professionals, to explain the reasons for transfer.
(iii)Notify the resident and the residents responsible person of the reasons for the transfer in writing.
(iv)Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
(v)The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the residents urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
(vi)The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the residents right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the departments Continuing Care Contracts Branch.
(vii)The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
(C)The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the residents responsible person, and upon the residents or responsible persons request, family members, the residents physician or other appropriate health care professional, and members of the providers interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the residents responsible person, or the provider.
(D)For disputed transfer decisions, the resident or the residents responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
(E)The decision of the departments Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
(F)Transfer of a second resident when a shared accommodation arrangement is terminated.
(11)Provisions describing any changes in the residents monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771, and that a Section 1771. Unless the fee is part of an equity interest contract, a provider is prohibited from charging the resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident.
(12)The providers continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
(13)The providers obligations, if any, to resume care upon the residents return after a transfer from the continuing care retirement community.
(14)The providers obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
(15)The conditions under which the resident must permanently release his or her living unit.
(16)If real or personal properties are transferred in lieu of cash, a statement specifying each items value at the time of transfer, and how the value was ascertained.
(A)An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
(B)When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
(C)The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
(17)The amount of the entrance fee.
(18)In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
(19)The amount of any processing fee.
(20)The amount of any monthly care fee.
(21)For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
(A)A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
(B)The regular rate of payment agreed upon (per day, week, or month).
(C)A provision specifying whether payment will be made in advance or after services have been provided.
(D)A provision specifying the provider will adjust monthly care fees for the residents support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
(E)A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
(F)A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
(G)A statement that the provider is prohibited from charging the resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident. resident, unless the fee is part of an equity interest contract.
(22)All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
(A)For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
(i)Fees shall not be subject to change during the lifetime of the agreement.
(ii)Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
(iii)Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
(B)For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
(23)A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the residents monthly care fees or in the price or scope of any component of care or other services.
(24)A provision indicating whether the residents rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
(25)If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
(26)Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
(27)A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right.
(28)Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days written notice by the provider without cause, or that the provider waives this right.
(29)The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
(30)A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
(A)Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for just cause, good cause, or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes just cause, good cause, or otherwise activates the termination provision:
(i)Filing or lodging a formal complaint with the department or other appropriate authority.
(ii)Participation in an organization or affiliation of residents, or other similar lawful activity.
(B)The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents organization or association.
(C)Nothing in this paragraph diminishes the providers ability to terminate the continuing care contract for good and sufficient cause.
(31)A statement that at least 90 days written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
(32)A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
(33)The policy or terms for refunding or repaying a lump sum of any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund or repaying a lump sum of all or a part of the entrance fee shall also do all of the following:
(A)Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the residents unit.
(B)State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
(i)Amortize the specified amount at the same rate as the residents entrance fee.
(ii)Refund the unamortized balance to the resident at the same time the provider pays the residents entrance fee refund.
(C)State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
(D)State the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. No later than July 1, 2016, a provider shall provide notice to all current residents with contracts applicable to this subparagraph regarding the statement required by this subparagraph as a clarification of the residents existing contract.
(E)For a lump-sum payment, the provider shall state the average and longest amount of time that a lump-sum payment has been delayed.
(34)The following notice at the bottom of the signatory page:
NOTICE | (date) |
This is a continuing care contract as defined by paragraph (8) of subdivision (c), or subdivision (l) of Section 1771 of the California Health and Safety Code. This continuing care contract form has been approved by the State Department of Social Services as required by subdivision (b) of Section 1787 of the California Health and Safety Code. The basis for this approval was a determination that (provider name) has submitted a contract that complies with the minimum statutory requirements applicable to continuing care contracts. The department does not approve or disapprove any of the financial or health care coverage provisions in this contract. Approval by the department is NOT a guaranty of performance or an endorsement of any continuing care contract provisions. Prospective transferors and residents are strongly encouraged to carefully consider the benefits and risks of this continuing care contract and to seek financial and legal advice before signing.
(35)The provider may not attempt to absolve itself in the continuing care contract from liability for its negligence by any statement to that effect, and shall include the following statement in the contract: Nothing in this continuing care contract limits either the providers obligation to provide adequate care and supervision for the resident or any liability on the part of the provider which may result from the providers failure to provide this care and supervision.
(36)Provisions describing how the provider will proceed in the event of a closure, including an explanation of how the provider will comply with Sections 1793.80, 1793.81, 1793.82, and 1793.83.
(b)A life care contract shall also provide that:
(1)All levels of care, including acute care and physicians and surgeons services, will be provided to a resident.
(2)Care will be provided for the duration of the residents life unless the life care contract is canceled or terminated by the provider during the cancellation period or after the cancellation period for good cause.
(3)A comprehensive continuum of care will be provided to the resident, including skilled nursing, in a facility under the ownership and supervision of the provider on, or adjacent to, the continuing care retirement community premises.
(4)Monthly care fees will not be changed based on the residents level of care or service.
(5)A resident who becomes financially unable to pay his or her monthly care fees shall be subsidized provided the residents financial need does not arise from action by the resident to divest the resident of his or her assets.
(c)Continuing care contracts may include provisions that do any of the following:
(1)Subsidize a resident who becomes financially unable to pay for his or her monthly care fees at some future date. If a continuing care contract provides for subsidizing a resident, it may also provide for any of the following:
(A)The resident shall apply for any public assistance or other aid for which he or she is eligible and that the provider may apply for assistance on behalf of the resident.
(B)The providers decision shall be final and conclusive regarding any adjustments to be made or any action to be taken regarding any charitable consideration extended to any of its residents.
(C)The provider is entitled to payment for the actual costs of care out of any property acquired by the resident subsequent to any adjustment extended to the resident under this paragraph, or from any other property of the resident that the resident failed to disclose.
(D)The provider may pay the monthly premium of the residents health insurance coverage under Medicare to ensure that those payments will be made.
(E)The provider may receive an assignment from the resident of the right to apply for and to receive the benefits, for and on behalf of the resident.
(F)The provider is not responsible for the costs of furnishing the resident with any services, supplies, and medication, when reimbursement is reasonably available from any governmental agency, or any private insurance.
(G)Any refund due to the resident at the termination of the continuing care contract may be offset by any prior subsidy to the resident by the provider.
(2)Limit responsibility for costs associated with the treatment or medication of an ailment or illness existing prior to the date of admission. In these cases, the medical or surgical exceptions, as disclosed by the medical entrance examination, shall be listed in the continuing care contract or in a medical report attached to and made a part of the continuing care contract.
(3)Identify legal remedies that may be available to the provider if the resident makes any material misrepresentation or omission pertaining to the residents assets or health.
(4)Restrict transfer or assignments of the residents rights and privileges under a continuing care contract due to the personal nature of the continuing care contract.
(5)Protect the providers ability to waive a residents breach of the terms or provisions of the continuing care contract in specific instances without relinquishing its right to insist upon full compliance by the resident with all terms or provisions in the contract.
(6)Provide that the resident shall reimburse the provider for any uninsured loss or damage to the residents unit, beyond normal wear and tear, resulting from the residents carelessness or negligence.
(7)Provide that the resident agrees to observe the off-limit areas of the continuing care retirement community designated by the provider for safety reasons. The provider may not include any provision in a continuing care contract that absolves the provider from liability for its negligence.
(8)Provide for the subrogation to the provider of the residents rights in the case of injury to a resident caused by the acts or omissions of a third party, or for the assignment of the residents recovery or benefits in this case to the provider, to the extent of the value of the goods and services furnished by the provider to or on behalf of the resident as a result of the injury.
(9)Provide for a lien on any judgment, settlement, or recovery for any additional expense incurred by the provider in caring for the resident as a result of injury.
(10)Require the residents cooperation and assistance in the diligent prosecution of any claim or action against any third party.
(11)Provide for the appointment of a conservator or guardian by a court with jurisdiction in the event a resident becomes unable to handle his or her personal or financial affairs.
(12)Allow a provider, whose property is tax exempt, to charge the resident, on a pro rata basis, property taxes, or in-lieu taxes, that the provider is required to pay.
(13)Make any other provision approved by the department.
(d)A copy of the residents rights as described in Section 1771.7 shall be attached to every continuing care contract.
(e)A copy of the current audited financial statement of the provider shall be attached to every continuing care contract. For a provider whose current audited financial statement does not accurately reflect the financial ability of the provider to fulfill the continuing care contract obligations, the financial statement attached to the continuing care contract shall include all of the following:
(1)A disclosure that the reserve requirement has not yet been determined or met, and that entrance fees will not be held in escrow.
(2)A disclosure that the ability to provide the services promised in the continuing care contract will depend on successful compliance with the approved financial plan.
(3)A copy of the approved financial plan for meeting the reserve requirements.
(4)Any other supplemental statements or attachments necessary to accurately represent the providers financial ability to fulfill its continuing care contract obligations.
(f)A schedule of the average monthly care fees charged to residents for each type of residential living unit for each of the five years preceding execution of the continuing care contract shall be attached to every continuing care contract. The provider shall update this schedule annually at the end of each fiscal year. If the continuing care retirement community has not been in existence for five years, the information shall be provided for each of the years the continuing care retirement community has been in existence.
(g)If any continuing care contract provides for a health insurance policy for the benefit of the resident, the provider shall attach to the continuing care contract a binder complying with Sections 382 and 382.5 of the Insurance Code.
(h)The provider shall attach to every continuing care contract a completed form in duplicate, captioned Notice of Cancellation. The notice shall be easily detachable, and shall contain, in at least 10-point boldface type, the following statement:
NOTICE OF CANCELLATION | (date) |
Your first date of occupancy under this contract | |
is: _____________________________________________ | |
You may cancel this transaction, without any penalty within 90 calendar days from the above date.
If you cancel, any property transferred, any payments made by you under the contract, and any negotiable instrument executed by you will be returned within 14 calendar days after making possession of the living unit available to the provider. Any security interest arising out of the transaction will be canceled.
If you cancel, you are obligated to pay a reasonable processing fee to cover costs and to pay for the reasonable value of the services received by you from the provider up to the date you canceled or made available to the provider the possession of any living unit delivered to you under this contract, whichever is later.
If you cancel, you must return possession of any living unit delivered to you under this contract to the provider in substantially the same condition as when you took possession.
Possession of the living unit must be made available to the provider within 20 calendar days of your notice of cancellation. If you fail to make the possession of any living unit available to the provider, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any other written notice, or send a telegram
to | |
(Name of provider) | |
|---|---|
at | |
(Address of providers place of business) | |
not later than midnight of_____________(date). | |
I hereby cancel this | |
(Residentsor | |
(a)During the cancellation period, the provider shall pay all refunds owed to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider.
(b)After the cancellation period, any refunds due to a resident under a continuing care contract shall be paid within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later.
(c)In nonequity projects, if the continuing care contract is canceled by either party during the cancellation period or terminated by the provider after the cancellation period, the resident shall be refunded the difference between the total amount of entrance, monthly, and optional fees paid and the amount used for care of the resident.
(d)If a resident has paid additional amounts for upgrades, special features, or modifications to the living unit and the provider terminates the residents continuing care contract, the provider shall amortize those additional amounts at the same rate as the entrance fee and shall refund the unamortized balance to the resident.
(e)(1)A lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of a the unit shall not be considered to be a refund and may not be characterized or advertised as a refund. The full lump-sum payment shall be paid to the resident within 14 calendar days after resale of the unit. Contracts signed after January 1, 2016, shall require that no later than 90 days after a formerly occupied unit has been vacated, at least 20 percent of the full lump-sum payment be paid to the resident. For contracts signed after January 1, 2016, notwithstanding a providers documented good-faith effort to resell the unit, the resident is entitled to the repayment of at least 20 percent of the full lump-sum payment if the unit remains vacant 120 days after the residents termination. This repayment shall not cause the contract in question to be deemed a refundable contract, as defined in paragraph (2) of subdivision (r) of Section 1771.
(2)Any payment balance that has not been paid to the resident within 90 days will 120 days shall accrue interest at a rate calculated pursuant to paragraph (3). Any payment balance that has not been paid to the resident within 180 days will accrue interest at a rate calculated pursuant to paragraph (4). Interest shall continue to accrue until the date the full lump-sum payment is paid to the resident. This paragraph shall apply to existing and prospective continuing care contracts.
(3)Any payments that are not paid to the resident within the 90-day 120-day period pursuant to paragraph (2) will accrue interest at a rate no lower than 2 percent plus the United States prime lending rate.
(4)Any payments that are not paid to the resident within the 180-day period pursuant to paragraph (2) will accrue interest at a rate no lower than 5 percent 2 percent plus the United States prime lending rate.
(f)After the death of a resident, a lump-sum payment that is conditioned upon resale of a unit shall be subject to subdivision (e) and the payment and interest, if any, shall be payable to the residents estate.
(g)Once Except as otherwise obligated by an equity interest contract, once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit. This subdivision shall apply to existing and prospective continuing care contracts.
(h)Nothing in this section shall be construed to limit or alter any legal remedies otherwise available to a resident or his or her estate.
(a)A continuing care contract shall contain all of the following:
(1)The legal name and address of each provider.
(2)The name and address of the continuing care retirement community.
(3)The residents name and the identity of the unit the resident will occupy.
(4)If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferors name and address shall be specified.
(5)If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
(6)The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
(7)The duration of the continuing care contract.
(8)A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
(A)Regular observation of the residents health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
(B)Safe and healthful living accommodations, including housekeeping services and utilities.
(C)Maintenance of house rules for the protection of residents.
(D)A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
(E)Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
(F)Assisted living services.
(G)Assistance with taking medications.
(H)Central storing and distribution of medications.
(I)Arrangements to meet health needs, including arranging transportation.
(9)An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract. The schedule shall state that a provider is prohibited from charging the resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident.
(10)The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
(A)A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
(i)The resident is nonambulatory. The definition of nonambulatory, as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
(ii)The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
(iii)The residents condition or needs require the residents transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
(iv)The residents condition or needs require the residents transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
(B)Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
(i)Involve the resident and the residents responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the residents or responsible persons request, family members, or the residents physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the residents responsible person.
(ii)Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the residents responsible person, and upon the residents or responsible persons request, family members, and the residents health care professionals, to explain the reasons for transfer.
(iii)Notify the resident and the residents responsible person of the reasons for the transfer in writing.
(iv)Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
(v)The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the residents urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
(vi)The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the residents right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the departments Continuing Care Contracts Branch.
(vii)The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
(C)The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the residents responsible person, and upon the residents or responsible persons request, family members, the residents physician or other appropriate health care professional, and members of the providers interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the residents responsible person, or the provider.
(D)For disputed transfer decisions, the resident or the residents responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
(E)The decision of the departments Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
(F)Transfer of a second resident when a shared accommodation arrangement is terminated.
(11)Provisions describing any changes in the residents monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771, and that a provider is prohibited from charging the resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident.
(12)The providers continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
(13)The providers obligations, if any, to resume care upon the residents return after a transfer from the continuing care retirement community.
(14)The providers obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
(15)The conditions under which the resident must permanently release his or her living unit.
(16)If real or personal properties are transferred in lieu of cash, a statement specifying each items value at the time of transfer, and how the value was ascertained.
(A)An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
(B)When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
(C)The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
(17)The amount of the entrance fee.
(18)In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
(19)The amount of any processing fee.
(20)The amount of any monthly care fee.
(21)For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
(A)A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
(B)The regular rate of payment agreed upon (per day, week, or month).
(C)A provision specifying whether payment will be made in advance or after services have been provided.
(D)A provision specifying the provider will adjust monthly care fees for the residents support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
(E)A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
(F)A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
(G)A statement that the provider is prohibited from charging the resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident.
(22)All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
(A)For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
(i)Fees shall not be subject to change during the lifetime of the agreement.
(ii)Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
(iii)Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
(B)For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
(23)A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the residents monthly care fees or in the price or scope of any component of care or other services.
(24)A provision indicating whether the residents rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
(25)If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
(26)Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
(27)A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right.
(28)Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days written notice by the provider without cause, or that the provider waives this right.
(29)The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
(30)A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
(A)Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for just cause, good cause, or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes just cause, good cause, or otherwise activates the termination provision:
(i)Filing or lodging a formal complaint with the department or other appropriate authority.
(ii)Participation in an organization or affiliation of residents, or other similar lawful activity.
(B)The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents organization or association.
(C)Nothing in this paragraph diminishes the providers ability to terminate the continuing care contract for good and sufficient cause.
(31)A statement that at least 90 days written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
(32)A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
(33)The policy or terms for refunding or repaying a lump sum of any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund or repaying a lump sum of all or a part of the entrance fee shall also do all of the following:
(A)Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the residents unit.
(B)State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
(i)Amortize the specified amount at the same rate as the residents entrance fee.
(ii)Refund the unamortized balance to the resident at the same time the provider pays the residents entrance fee refund.
(C)State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
(D)State the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. No later than July 1, 2016, a provider shall provide notice to all current residents with contracts applicable to this subparagraph regarding the statement required by this subparagraph as a clarification of the residents existing contract.
(34)The following notice at the bottom of the signatory page:
NOTICE | (date) |
This is a continuing care contract as defined by paragraph (8) of subdivision (c), or subdivision (l) of Section 1771 of the California Health and Safety Code. This continuing care contract form has been approved by the State Department of Social Services as required by subdivision (b) of Section 1787 of the California Health and Safety Code. The basis for this approval was a determination that (provider name) has submitted a contract that complies with the minimum statutory requirements applicable to continuing care contracts. The department does not approve or disapprove any of the financial or health care coverage provisions in this contract. Approval by the department is NOT a guaranty of performance or an endorsement of any continuing care contract provisions. Prospective transferors and residents are strongly encouraged to carefully consider the benefits and risks of this continuing care contract and to seek financial and legal advice before signing.
(35)The provider may not attempt to absolve itself in the continuing care contract from liability for its negligence by any statement to that effect, and shall include the following statement in the contract: Nothing in this continuing care contract limits either the providers obligation to provide adequate care and supervision for the resident or any liability on the part of the provider which may result from the providers failure to provide this care and supervision.
(36)Provisions describing how the provider will proceed in the event of a closure, including an explanation of how the provider will comply with Sections 1793.80, 1793.81, 1793.82, and 1793.83.
(b)A life care contract shall also provide that:
(1)All levels of care, including acute care and physicians and surgeons services, will be provided to a resident.
(2)Care will be provided for the duration of the residents life unless the life care contract is canceled or terminated by the provider during the cancellation period or after the cancellation period for good cause.
(3)A comprehensive continuum of care will be provided to the resident, including skilled nursing, in a facility under the ownership and supervision of the provider on, or adjacent to, the continuing care retirement community premises.
(4)Monthly care fees will not be changed based on the residents level of care or service.
(5)A resident who becomes financially unable to pay his or her monthly care fees shall be subsidized provided the residents financial need does not arise from action by the resident to divest the resident of his or her assets.
(c)Continuing care contracts may include provisions that do any of the following:
(1)Subsidize a resident who becomes financially unable to pay for his or her monthly care fees at some future date. If a continuing care contract provides for subsidizing a resident, it may also provide for any of the following:
(A)The resident shall apply for any public assistance or other aid for which he or she is eligible and that the provider may apply for assistance on behalf of the resident.
(B)The providers decision shall be final and conclusive regarding any adjustments to be made or any action to be taken regarding any charitable consideration extended to any of its residents.
(C)The provider is entitled to payment for the actual costs of care out of any property acquired by the resident subsequent to any adjustment extended to the resident under this paragraph, or from any other property of the resident that the resident failed to disclose.
(D)The provider may pay the monthly premium of the residents health insurance coverage under Medicare to ensure that those payments will be made.
(E)The provider may receive an assignment from the resident of the right to apply for and to receive the benefits, for and on behalf of the resident.
(F)The provider is not responsible for the costs of furnishing the resident with any services, supplies, and medication, when reimbursement is reasonably available from any governmental agency, or any private insurance.
(G)Any refund due to the resident at the termination of the continuing care contract may be offset by any prior subsidy to the resident by the provider.
(2)Limit responsibility for costs associated with the treatment or medication of an ailment or illness existing prior to the date of admission. In these cases, the medical or surgical exceptions, as disclosed by the medical entrance examination, shall be listed in the continuing care contract or in a medical report attached to and made a part of the continuing care contract.
(3)Identify legal remedies that may be available to the provider if the resident makes any material misrepresentation or omission pertaining to the residents assets or health.
(4)Restrict transfer or assignments of the residents rights and privileges under a continuing care contract due to the personal nature of the continuing care contract.
(5)Protect the providers ability to waive a residents breach of the terms or provisions of the continuing care contract in specific instances without relinquishing its right to insist upon full compliance by the resident with all terms or provisions in the contract.
(6)Provide that the resident shall reimburse the provider for any uninsured loss or damage to the residents unit, beyond normal wear and tear, resulting from the residents carelessness or negligence.
(7)Provide that the resident agrees to observe the off-limit areas of the continuing care retirement community designated by the provider for safety reasons. The provider may not include any provision in a continuing care contract that absolves the provider from liability for its negligence.
(8)Provide for the subrogation to the provider of the residents rights in the case of injury to a resident caused by the acts or omissions of a third party, or for the assignment of the residents recovery or benefits in this case to the provider, to the extent of the value of the goods and services furnished by the provider to or on behalf of the resident as a result of the injury.
(9)Provide for a lien on any judgment, settlement, or recovery for any additional expense incurred by the provider in caring for the resident as a result of injury.
(10)Require the residents cooperation and assistance in the diligent prosecution of any claim or action against any third party.
(11)Provide for the appointment of a conservator or guardian by a court with jurisdiction in the event a resident becomes unable to handle his or her personal or financial affairs.
(12)Allow a provider, whose property is tax exempt, to charge the resident, on a pro rata basis, property taxes, or in-lieu taxes, that the provider is required to pay.
(13)Make any other provision approved by the department.
(d)A copy of the residents rights as described in Section 1771.7 shall be attached to every continuing care contract.
(e)A copy of the current audited financial statement of the provider shall be attached to every continuing care contract. For a provider whose current audited financial statement does not accurately reflect the financial ability of the provider to fulfill the continuing care contract obligations, the financial statement attached to the continuing care contract shall include all of the following:
(1)A disclosure that the reserve requirement has not yet been determined or met, and that entrance fees will not be held in escrow.
(2)A disclosure that the ability to provide the services promised in the continuing care contract will depend on successful compliance with the approved financial plan.
(3)A copy of the approved financial plan for meeting the reserve requirements.
(4)Any other supplemental statements or attachments necessary to accurately represent the providers financial ability to fulfill its continuing care contract obligations.
(f)A schedule of the average monthly care fees charged to residents for each type of residential living unit for each of the five years preceding execution of the continuing care contract shall be attached to every continuing care contract. The provider shall update this schedule annually at the end of each fiscal year. If the continuing care retirement community has not been in existence for five years, the information shall be provided for each of the years the continuing care retirement community has been in existence.
(g)If any continuing care contract provides for a health insurance policy for the benefit of the resident, the provider shall attach to the continuing care contract a binder complying with Sections 382 and 382.5 of the Insurance Code.
(h)The provider shall attach to every continuing care contract a completed form in duplicate, captioned Notice of Cancellation. The notice shall be easily detachable, and shall contain, in at least 10-point boldface type, the following statement:
NOTICE OF CANCELLATION | (date) |
Your first date of occupancy under this contract | |
is: _____________________________________________ | |
You may cancel this transaction, without any penalty within 90 calendar days from the above date.
If you cancel, any property transferred, any payments made by you under the contract, and any negotiable instrument executed by you will be returned within 14 calendar days after making possession of the living unit available to the provider. Any security interest arising out of the transaction will be canceled.
If you cancel, you are obligated to pay a reasonable processing fee to cover costs and to pay for the reasonable value of the services received by you from the provider up to the date you canceled or made available to the provider the possession of any living unit delivered to you under this contract, whichever is later.
If you cancel, you must return possession of any living unit delivered to you under this contract to the provider in substantially the same condition as when you took possession.
Possession of the living unit must be made available to the provider within 20 calendar days of your notice of cancellation. If you fail to make the possession of any living unit available to the provider, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any other written notice, or send a telegram
to | |
(Name of provider) | |
|---|---|
at | |
(Address of providers place of business) | |
not later than midnight of_____________(date). | |
I hereby cancel this | |
(Residentsor | |
(a) During the cancellation period, the provider shall pay all refunds owed to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider.
(b) After the cancellation period, any refunds due to a resident under a continuing care contract shall be paid within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later.
(c) In nonequity projects, if the continuing care contract is canceled by either party during the cancellation period or terminated by the provider after the cancellation period, the resident shall be refunded the difference between the total amount of entrance, monthly, and optional fees paid and the amount used for care of the resident.
(d) If a resident has paid additional amounts for upgrades, special features, or modifications to the living unit and the provider terminates the residents continuing care contract, the provider shall amortize those additional amounts at the same rate as the entrance fee and shall refund the unamortized balance to the resident.
(e)(1)A lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of a unit shall not be considered to be a refund and may not be characterized or advertised as a refund. The full lump-sum payment shall be paid to the resident within 14 calendar days after resale of the unit, but in no event later than 90 days after the formerly occupied unit has been vacated. unit. Contracts signed after January 1, 2016, shall require that no later than 90 days after a formerly occupied unit has been vacated, at least 20 percent of the full lump-sum payment be paid to the resident.
(2)Any payments that are not payment balance that has not been paid to the resident within the 90-day period pursuant to paragraph (1) 90 days will accrue interest at a rate calculated pursuant to paragraph (3). Any payment balance that has not been paid to the resident within 180 days will accrue interest at a rate calculated pursuant to paragraph (4). Interest shall continue to accrue until the date the full lump-sum payment is paid to the resident. This paragraph shall apply to existing and prospective continuing care contracts.
(3)Interest rates and calculations pursuant to paragraph (2) are identical to interest rates and calculations set forth in Section 685.010 of the Code of Civil Procedure.
(3)Any payments that are not paid to the resident within the 90-day period pursuant to paragraph (2) will accrue interest at a rate no lower than 2 percent plus the United States prime lending rate.
(4)Any payments that are not paid to the resident within the 180-day period pursuant to paragraph (2) will accrue interest at a rate no lower than 5 percent plus the United States prime lending rate.
(f)After the death of a resident, a lump-sum payment that is conditioned upon resale of a unit shall be subject to subdivision (e) and the payment and interest, if any, shall be payable to the residents estate.
(g)Once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit. This subdivision shall apply to existing and prospective continuing care contracts.
(a) During the cancellation period, the provider shall pay all refunds owed to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider.
(b) After the cancellation period, any refunds due to a resident under a continuing care contract shall be paid within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later.
(c) In nonequity projects, if the continuing care contract is canceled by either party during the cancellation period or terminated by the provider after the cancellation period, the resident shall be refunded the difference between the total amount of entrance, monthly, and optional fees paid and the amount used for care of the resident.
(d) If a resident has paid additional amounts for upgrades, special features, or modifications to the living unit and the provider terminates the residents continuing care contract, the provider shall amortize those additional amounts at the same rate as the entrance fee and shall refund the unamortized balance to the resident.
(e)(1)A lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of a unit shall not be considered to be a refund and may not be characterized or advertised as a refund. The lump sum full lump-sum payment shall be paid to the resident within 14 calendar days after resale of the unit, but in no event later than 90 days after the formerly occupied unit has been vacated.
(2)Any payments that are not paid to the resident within the 90-day period pursuant to paragraph (1) will accrue interest at a rate calculated pursuant to paragraph (3). Interest shall continue to accrue until the date the full lump-sum payment is paid to the resident.
(3)Interest rates and calculations pursuant to paragraph (2) are identical to interest rates and calculations set forth in Section 685.010 of the Code of Civil Procedure.
(f)After the death of a resident, a lump-sum payment that is conditioned upon resale of a unit shall be subject to subdivision (e) and the payment and interest, if any, shall be payable to the residents estate.
(g)Once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit.
|
Date
|
Status
|
|---|---|
| Sep 8, 2015 | Read third time. Passed. (Ayes 53. Noes 26. Page 2951.) Ordered to the Senate. |
| Aug 20, 2015 | From committee with author's amendments. Read second time and amended. Re-referred to Com. on APPR. |
| Aug 26, 2015 | From committee: Do pass. (Ayes 12. Noes 5.) (August 26). |
| Aug 27, 2015 | Read second time. Ordered to third reading. |
| Sep 1, 2015 | Ordered to third reading. |
| Sep 1, 2015 | Read third time and amended. |
| Sep 4, 2015 | Ordered to third reading. |
| Sep 4, 2015 | Read third time and amended. |
| Sep 8, 2015 | In Senate. Concurrence in Assembly amendments pending. |
| Sep 8, 2015 | Read third time. Passed. Ordered to the Senate. |
| Aug 18, 2015 | Read second time. Ordered to third reading. |
| Sep 10, 2015 | Assembly amendments concurred in. (Ayes 37. Noes 0.) Ordered to engrossing and enrolling. |
| Sep 10, 2015 | Assembly amendments concurred in. (Ayes 38. Noes 0. Page 2666.) Ordered to engrossing and enrolling. |
| Sep 10, 2015 | Assembly amendments concurred in. (Ayes 38. Noes 0.) Ordered to engrossing and enrolling. |
| Sep 15, 2015 | Enrolled and presented to the Governor at 9:30 a.m. |
| Oct 11, 2015 | In Senate. Consideration of Governor's veto pending. |
| Oct 11, 2015 | Vetoed by the Governor. |
| Apr 25, 2016 | Last day to consider Governors veto pursuant to Joint Rule 58.5. |
| Apr 25, 2016 | Last day to consider Governor’s veto pursuant to Joint Rule 58.5. |
| May 14, 2015 | Read third time. Passed. (Ayes 31. Noes 4. Page 994.) Ordered to the Assembly. |
| Feb 27, 2015 | From printer. May be acted upon on or after March 29. |
| Mar 12, 2015 | Referred to Com. on HUMAN S. |
| Mar 24, 2015 | Set for hearing April 14. |
| Apr 13, 2015 | April 14 hearing postponed by committee. |
| Apr 14, 2015 | Set for hearing April 28. |
| May 4, 2015 | From committee: Do pass as amended. (Ayes 4. Noes 0. Page 816.) (April 28). |
| May 5, 2015 | Read second time and amended. Ordered to third reading. |
| May 14, 2015 | In Assembly. Read first time. Held at Desk. |
| Feb 26, 2015 | Introduced. Read first time. To Com. on RLS. for assignment. To print. |
| May 14, 2015 | Read third time. Passed. (Ayes 31. Noes 4.) Ordered to the Assembly. |
| May 28, 2015 | Referred to Coms. on HUM. S. and AGING & L.T.C. |
| Jun 25, 2015 | From committee with author's amendments. Read second time and amended. Re-referred to Com. on HUM. S. |
| Jul 2, 2015 | From committee: Do pass as amended and re-refer to Com. on AGING & L.T.C. (Ayes 5. Noes 2.) (June 30). |
| Jul 6, 2015 | Read second time and amended. Re-referred to Com. on AGING & L.T.C. |
| Jul 16, 2015 | From committee: Do pass as amended. (Ayes 5. Noes 2.) (July 14). |
| Aug 17, 2015 | Read second time and amended. Ordered to second reading. |
| Aug 18, 2015 | Re-referred to Com. on APPR. pursuant to Joint Rule 10.5. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Sep 10, 2015 | Unfinished Business SB475 Monning Concurrence | Senate Floor |
Passed |
|
| Sep 8, 2015 | SB 475 Monning Senate Third Reading By BROWN | Assembly Floor |
Passed |
|
| Aug 26, 2015 | Do pass. | Assembly Standing Committee on Appropriations |
Passed |
|
| Jul 14, 2015 | Do pass as amended. | Assembly Standing Committee on Aging and Long-Term Care |
Passed |
|
| Jun 30, 2015 | Do pass as amended and be re-referred to the Committee on [Aging and Long-Term Care] | Assembly Standing Committee on Human Services |
Passed |
|
| May 14, 2015 | Senate 3rd Reading SB475 Monning | Senate Floor |
Passed |
|
| Apr 28, 2015 | Do pass as amended | Senate Standing Committee on Human Services |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| 157 members of Eskaton Village Carmichael | ** Support | Jun 30, 2015 |
| 162 individual residents | ** Support | May 14, 2015 |
| American Baptist Home of the West | ** Against | Aug 26, 2015 |
| Atherton Baptist Homes | ** Against | Jun 30, 2015 |
| Atterdag Village of Solvang | ** Against | May 14, 2015 |
| Be.group | ** Against | May 14, 2015 |
| be.royal oaks | ** Against | May 14, 2015 |
| British Home | ** Against | Jun 30, 2015 |
| Cain Brothers | * Against Unless Amend | Jun 30, 2015 |
| California Advocates for Nursing Home Reform | ** Support | Aug 26, 2015 |
| California Association of Continuing Care Retirement Communities | ** Against | May 14, 2015 |
| California Commission on Aging | ** Support | Sep 10, 2015 |
| California Continuing Care Residents Association | ** Support | Sep 10, 2015 |
| California Long Term Care Ombudsman Association | ** Support | Sep 10, 2015 |
| Cardinal Point Residents Association | ** Support | Sep 10, 2015 |
| Carmel Valley Manor | ** Against | Jun 30, 2015 |
| Casa de las Campanas | ** Against | May 14, 2015 |
| Channing House | ** Against | Aug 26, 2015 |
| Consumer Federation Of California | ** Support | Sep 10, 2015 |
| Continuing Life LLC | ** Against | Jun 30, 2015 |
| Episcopal Communities & Services | ** Against | Aug 26, 2015 |
| Episcopal Communities & Services for Seniors | ** Against | Jun 30, 2015 |
| Episcopal Senior Communities | ** Against | Aug 26, 2015 |
| Eskaton | ** Against | May 14, 2015 |
| Eskaton Village, Carmichael Chapter of CALCRA | ** Support | May 14, 2015 |
| Forest Hill | ** Against | Jun 30, 2015 |
| Foundation Property Management, Inc. | ** Against | Jun 30, 2015 |
| Fountaingrove Lodge | ** Against | May 14, 2015 |
| Fredericka Manor | ** Against | May 14, 2015 |
| Fredericka Manor Retirement Community | ** Against | Jun 30, 2015 |
| Front Porch Communities and Services | ** Against | Jun 30, 2015 |
| Grand Lake Gardens Retirement Community | ** Against | May 14, 2015 |
| Heritage on the Marina | ** Against | Jun 30, 2015 |
| Hillcrest | ** Against | Jun 30, 2015 |
| HUM. S. | ** Against | Jun 30, 2015 |
| La Costa Glen Carlsbad | ** Against | Jun 30, 2015 |
| Lake Park | ** Against | Jun 30, 2015 |
| Los Angeles Jewish Home for the Aging | ** Against | Jun 30, 2015 |
| Motion Picture & Television Fund | ** Against | Jun 30, 2015 |
| National Association Of Social Workers, California Chapter | ** Support | Sep 10, 2015 |
| O'Conner Woods | ** Against | Jun 30, 2015 |
| Palm Village Retirement Community | ** Against | Jun 30, 2015 |
| Residents of Eskaton Village Carmichael of CALCRA | ** Support | Sep 10, 2015 |
| Spring Lake Village | ** Against | Jun 30, 2015 |
| Stoneridge Creek Pleasanton | ** Against | Jun 30, 2015 |
| The British Home in California, Ltd. | ** Against | Aug 26, 2015 |
| The Samarkand Retirement Community | ** Against | Jun 30, 2015 |
| The Terraces of Los Gatos | ** Against | Jun 30, 2015 |
SB 475
Page 8
|
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 |
SB 475 |
VETO
Bill No: SB 475
Amended: 9/4/15
SENATE HUMAN SERVICES COMMITTEE: 4-0, 4/28/15
AYES: McGuire, Hancock, Liu, Nguyen
NO VOTE RECORDED: Berryhill
SENATE FLOOR: 31-4, 5/14/15
AYES: Allen, Anderson, Bates, Beall, Block, Cannella, De León, Gaines, Galgiani, Hall, Hancock, Hernandez, Hertzberg, Hill, Hueso, Jackson, Lara, Leno, Leyva, Liu, McGuire, Mitchell, Monning, Moorlach, Nguyen, Pan, Pavley, Runner, Stone, Wieckowski, Wolk
NOES: Fuller, Morrell, Roth, Vidak
NO VOTE RECORDED: Berryhill, Huff, Mendoza, Nielsen
SENATE FLOOR: 38-0, 9/10/15
AYES: Allen, Anderson, Bates, Beall, Berryhill, Block, Cannella, De León, Fuller, Gaines, Galgiani, Glazer, Hall, Hancock, Hernandez, Hertzberg, Hill, Hueso, Jackson, Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning, Morrell, Nguyen, Nielsen, Pan, Pavley, Roth, Runner, Stone, Vidak, Wieckowski, Wolk
NO VOTE RECORDED: Huff, Moorlach
ASSEMBLY FLOOR: 53-26, 9/8/15 - See last page for vote
SUBJECT: Continuing care contracts: cancellation: payments
SOURCE: California Continuing Care Residents Association
DIGEST: This bill requires that continuing care contracts which condition lump sum contract termination payments on resale of the unit to meet a series of requirements and timelines, to pay interest after a specified period of vacancy, and to meet other requirements. Additionally, this bill creates a complaint process, as specified, for residents if the repayment has not been made within 12 months.
Existing law:
Provides for the licensure and regulation of Continuing Care Retirement Communities (CCRCs) by the California Department of Social Services (CDSS) to enact minimum requirements to protect the wellbeing and financial security of residents of CCRCs. (HSC 1770 et seq.)
Establishes the Residential Care Facilities for the Elderly Act, which requires CDSS to license and regulate RCFEs as a separate category within the existing community care licensing structure of CDSS. (HSC 1569 et seq.)
Provides for the regulation and licensure of skilled nursing facilities by the California Department of Public Health (CDPH). (HSC 1250 et seq.)
Requires a CCRC provider to hold a certificate of authority from CDSS permitting the provider to contract for the provision of continuing care, including medical care, in which a resident over the age of 60 has paid in advance for more than one year for that care. (HSC 1771.2)
Provides that the components of care provided by the facility must be separately licensed as otherwise required by state law, including Residential Care Facilities for the Elderly and Skilled Nursing care. (HSC 1771.5)
Requires a CCRC to pay refunds owned to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later. (HSC 1788.4 (a))
Prohibits characterizing as a refund, a lump sum payment following termination of a continuing care contract that is conditioned upon resale of the unit, and requires the payment to be made within 90 days following resale of the unit. (HSC 1788.4 (e))
This bill:
Prohibits a continuing care retirement community (CCRC) provider from charging a resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. Further requires a continuing care contract to contain, among other things, a statement regarding this prohibition.
Requires a continuing care contract to contain the policy or terms for repaying a lump sum of any portion of the entrance fee, and further requires every continuing care contract that provides for a refund or repaying a lump sum of all or part of the entrance fee to, among other things, do the following:
State that the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit and, by July 1, 2016, notice current residents, as specified, regarding this statement as clarification of the resident’s existing contract; and
State, for all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
Requires, for contracts signed after January 1, 2016, if the unit remains vacant for 120 days after the resident's termination, a repayment of at least 10 percent of the full lump-sum payment if termination is the result of a resident's death, and 20 percent if termination occurs for any other reason. Further specifies that this repayment shall not cause the contract to be deemed a refundable contract requiring a refund reserve, as specified.
Requires, for continuing care contracts entered into on or after January 1, 2016, that any payment balance that has not been paid to a resident within 180 days shall accrue simple interest, to be compounded annually, at a rate of 4 percent. Further requires that any payment balance that has not been paid within 240 days shall accrue simple interest, to be compounded annually, at a rate of 6 percent, and that interest shall continue to accrue until the date the full lump-sum payment is paid to the resident.
Exempts, until January 1, 2017, projects in development prior to January 1, 2016, for which contracts were entered into on or before January 1, 2017, from certain requirements regarding refunds, lump-sum charges and repayment, and interest payments, as specified.
Clarifies that, after the death of a resident, repayment and interest requirements apply to a lump-sum payment that is conditioned upon the resale of a unit and that any payment and interest shall be payable to the resident's estate.
States that these repayment and other requirements shall not be construed to limit or alter any legal remedies otherwise available to the resident or his or her estate.
Establishes a process for a resident to file a complaint with the California Department of Social Services (CDSS) if his or her unit has not been resold for more than 12 months after the unit was made available to the provider, as specified. Further establishes processes for residents and providers to request a review of CDSS's resulting determination and stipulates that if a provider is found to not have made a sufficient good faith effort to reoccupy or resell a unit, that provider shall repay the full lump-sum payment due the resident within 20 business days, as specified.
Background
Continuing Care Retirement Contract Model (CCRCs). CCRCs have been likened to long-term care insurance, with seniors paying large entry fees ranging from $50,000 to more than $2 million, in exchange for access to a range of levels of care services, including independent living, assisted living and skilled nursing care intended to meet the care needs of residents over a specified period of time as they age. There are a wide variety of contractual models available across the state. Some provide for a lump-sum termination of contract payment, based on a portion of the entrance fees (typically ranging from 90 and 50 percent) upon the death of the resident. If the resident opts to leave the community, repayment is conditioned upon the resale of the unit. Other models provide for a refund of a portion of the entrance fees, regardless of resale, at percentage rates that decrease the longer the resident remains in the community. Some facilities offer life care contracts through which a facility agrees to care for the resident for the remainder of the resident’s life, regardless of whether the resident outlives his or her financial resources.
In addition to entrance fees, residents pay monthly fees, which may be held constant as the resident ages and needs increase, or may increase as the resident needs increasing levels of care. Such monthly fees range widely from $500 to $9,000 a month for independent living, between $3,000 and $7,000 for assisted living, and upwards from $7,000 to $17,000 per month for skilled nursing.
There are currently 105 facilities certified as CCRCs in California, 75 of which are nonprofit, and frequently operated by religious or philanthropic organizations. Thirty CCRCs are for-profit. There are eight nonprofit multiple-facility providers and one for-profit multiple-facility provider. According to Leading Age, there are more than 20,000 residents of CCRCs in California.
Regulatory Structure. The bulk of regulatory oversight pertains to the financial solvency of the facilities, in consideration of the substantial investments made by residents. In addition, CCRCs that operate an independent or assisted living level of care are required to have those facilities licensed by CDSS as Residential Care Facilities for the Elderly (RCFEs). Facilities operating a skilled nursing level of care must have those facilities licensed by the Department of Public Health. Furthermore, CDSS is required to review and approve the overall resident contract used by a facility with each resident, however there are few statutory requirements placed on the content of those contracts.
Required Annual Reports. Providers are required to submit an annual report to CDSS describing the facility’s financial condition within four months after their fiscal year end. The reports are required to consist of audited financial statements and required reserve calculations, evidence of fidelity bonds (insuring against dishonest employee conduct) as well as additional information. Additionally, CCRCs that have contracts promising to provide care without substantially increasing monthly fees as needs increase must submit an actuarial study to CDSS every five years regarding the actuarial financial position of the facility.
Required Reserves. CCRC providers are required to maintain a liquid reserve for long-term debt obligations that must be equal to the sum of the prior fiscal year payments for the specific items including interest on debt, rental or lease payments, insurance. Additionally, CCRCs are required to maintain a liquid reserve for operating expenses in an amount that equals or exceeds 75 days net operating expenses, as defined.
CCRCs offering a “refundable contract” are required to maintain a reserve for refunds, held in a trust fund. Providers are permitted to invest up 70 percent of the refund reserves in the real estate that is used to provide care and housing for the residents where they reside. The required amount of the reserve is calculated using a statutorily established formula based on life expectancy of the residents and the portion of the entry fee that is refundable. Importantly, many providers opt against a refundable contract that requires reserves instead offering a “lump sum payment” that is conditioned upon resale of the unit. The latter model does not require the facility to maintain a reserve, since it is assumed that the financial liability is only incurred once the unit has been resold – it is this model which the author cites as having led to long delays in returning entrance fees.
Disclosure Statements. California statute requires CDSS to issue a disclosure statement form that facilities provide to residents, which includes general information such as the provider’s and owner’s name, address, and telephone number, names of any affiliated facilities, any accreditation of the provider, distance to the nearest shopping center, number of units and other detailed information.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No
According to the Assembly Appropriations Committee, this bill may contain minor and absorbable costs, likely less than $50,000 (General Fund) per year for CDSS to investigate complaints.
California Continuing Care Residents Association (source)
California Commission on Aging
California Long Term Care Ombudsman Association
Cardinal Point Residents Association
Consumer Federation of California
National Association of Social Workers, California Chapter
Residents of Eskaton Village Carmichael of CALCRA
162 individuals
None received
The bill’s sponsor, the California Continuing Care Residents Association, writes that “the CCRC model of care is different than that of other residential care facilities around the state. When seniors make a decision to move into a CCRC, they pay a substantial entrance fee and additional monthly fees in exchange for a lifetime of residency and care that meets the ongoing and advancing needs of aging … Current law leaves families without recourse to demand the return of an entrance fee within a reasonable time, and there is no way to ensure that CCRC providers are making a good faith effort to re-sell these vacant units. SB 475 helps the investments the seniors make in their long-term care and ensures that CCRC providers remain accountable for returning payments and refunds to seniors and their families within a reasonable time.”
According to the author, this bill “levels the playing field for the CCRC resident in a manner that will result in more timely repayments and adds an incentive for a CCRC to resale a unit in the form of interest on the unpaid remaining balance."
GOVERNOR'S VETO MESSAGE:
I am returning Senate Bill 475 without my signature.
This bill would change the way Continuing Care Retirement Communities repay a resident's entrance fee under the purchase contract, and establish interest penalties if repayment is not made and the unit has not been resold within a time certain. The bill would also establish a process at the Department of Social Services to investigate whether a good faith effort was made to resell the unit.
As California's aging population continues to grow, the need for elder care and housing options will also increase. One of the options is Continuing Care Retirement Communities, which provide retirees with housing and varying levels of care and services throughout the remainder of their lives.
While it is important that residents who buy into these communities be treated fairly, this bill would change the terms of contracts entered into by willing participants. It would also insert the department into the resolution of contract disputes. For these reasons, I am not signing this bill.
ASSEMBLY FLOOR: 53-26, 9/8/15
AYES: Alejo, Bloom, Bonilla, Bonta, Brown, Burke, Calderon, Campos, Chau, Chiu, Chu, Cooley, Cooper, Dababneh, Daly, Dodd, Eggman, Frazier, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Roger Hernández, Holden, Irwin, Jones-Sawyer, Levine, Linder, Lopez, Low, McCarty, Medina, Mullin, Nazarian, O'Donnell, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Mark Stone, Thurmond, Ting, Weber, Williams, Wood, Atkins
NOES: Achadjian, Travis Allen, Baker, Bigelow, Brough, Chang, Dahle, Beth Gaines, Gallagher, Grove, Hadley, Harper, Jones, Kim, Lackey, Maienschein, Mathis, Mayes, Melendez, Obernolte, Olsen, Patterson, Steinorth, Wagner, Waldron, Wilk
NO VOTE RECORDED: Chávez
Prepared by: Mark Teemer / HUMAN S. / (916) 651-1524
11/4/15 14:04:05
SB 475
Page 7
|
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 |
UNFINISHED BUSINESS
Bill No: SB 475
Amended: 9/4/15
SENATE HUMAN SERVICES COMMITTEE: 4-0, 4/28/15
AYES: McGuire, Hancock, Liu, Nguyen
NO VOTE RECORDED: Berryhill
SENATE FLOOR: 31-4, 5/14/15
AYES: Allen, Anderson, Bates, Beall, Block, Cannella, De León, Gaines, Galgiani, Hall, Hancock, Hernandez, Hertzberg, Hill, Hueso, Jackson, Lara, Leno, Leyva, Liu, McGuire, Mitchell, Monning, Moorlach, Nguyen, Pan, Pavley, Runner, Stone, Wieckowski, Wolk
NOES: Fuller, Morrell, Roth, Vidak
NO VOTE RECORDED: Berryhill, Huff, Mendoza, Nielsen
ASSEMBLY FLOOR: 53-26, 9/08/15 - See last page for vote
SUBJECT: Continuing care contracts: cancellation: payments
SOURCE: California Continuing Care Residents Association
DIGEST: This bill requires that continuing care contracts which condition lump sum contract termination payments on resale of the unit to meet a series of requirements and timelines, to pay interest after a specified period of vacancy, and to meet other requirements. Additionally, this bill creates a complaint process, as specified, for residents if the repayment has not been made within 12 months.
Assembly Amendments add a section of definitions, clarify the conditions under which repayment of fees is required, clarify that specified provisions of this bill do not apply to equity interest contracts, require providers to disclose the length of time for sale of a unit for contracts in which refunds are conditioned upon resale, exempt projects in development, as specified, from repayment provisions, add a complaint process, and make other technical changes.
Existing law:
Provides for the licensure and regulation of Continuing Care Retirement Communities (CCRCs) by the California Department of Social Services (CDSS) to enact minimum requirements to protect the wellbeing and financial security of residents of CCRCs. (HSC 1770 et seq.)
Establishes the Residential Care Facilities for the Elderly Act, which requires CDSS to license and regulate RCFEs as a separate category within the existing community care licensing structure of CDSS. (HSC 1569 et seq.)
Provides for the regulation and licensure of skilled nursing facilities by the California Department of Public Health (CDPH). (HSC 1250 et seq.)
Requires a CCRC provider to hold a certificate of authority from CDSS permitting the provider to contract for the provision of continuing care, including medical care, in which a resident over the age of 60 has paid in advance for more than one year for that care. (HSC 1771.2)
Provides that the components of care provided by the facility must be separately licensed as otherwise required by state law, including Residential Care Facilities for the Elderly and Skilled Nursing care. (HSC 1771.5)
Requires a CCRC to pay refunds owned to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later. (HSC 1788.4 (a))
Prohibits characterizing as a refund, a lump sum payment following termination of a continuing care contract that is conditioned upon resale of the unit, and requires the payment to be made within 90 days following resale of the unit. (HSC 1788.4 (e))
This bill:
Prohibits a continuing care retirement community (CCRC) provider from charging a resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. Further requires a continuing care contract to contain, among other things, a statement regarding this prohibition.
Requires a continuing care contract to contain the policy or terms for repaying a lump sum of any portion of the entrance fee, and further requires every continuing care contract that provides for a refund or repaying a lump sum of all or part of the entrance fee to, among other things, do the following:
State that the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit and, by July 1, 2016, notice current residents, as specified, regarding this statement as clarification of the resident’s existing contract; and
State, for all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
Requires, for contracts signed after January 1, 2016, if the unit remains vacant for 120 days after the resident's termination, a repayment of at least 10 percent of the full lump-sum payment if termination is the result of a resident's death, and 20 percent if termination occurs for any other reason. Further specifies that this repayment shall not cause the contract to be deemed a refundable contract requiring a refund reserve, as specified.
Requires, for continuing care contracts entered into on or after January 1, 2016, that any payment balance that has not been paid to a resident within 180 days shall accrue simple interest, to be compounded annually, at a rate of 4 percent. Further requires that any payment balance that has not been paid within 240 days shall accrue simple interest, to be compounded annually, at a rate of 6 percent, and that interest shall continue to accrue until the date the full lump-sum payment is paid to the resident.
Exempts, until January 1, 2017, projects in development prior to January 1, 2016, for which contracts were entered into on or before January 1, 2017, from certain requirements regarding refunds, lump-sum charges and repayment, and interest payments, as specified.
Clarifies that, after the death of a resident, repayment and interest requirements apply to a lump-sum payment that is conditioned upon the resale of a unit and that any payment and interest shall be payable to the resident's estate.
States that these repayment and other requirements shall not be construed to limit or alter any legal remedies otherwise available to the resident or his or her estate.
Establishes a process for a resident to file a complaint with the California Department of Social Services (CDSS) if his or her unit has not been resold for more than 12 months after the unit was made available to the provider, as specified. Further establishes processes for residents and providers to request a review of CDSS's resulting determination and stipulates that if a provider is found to not have made a sufficient good faith effort to reoccupy or resell a unit, that provider shall repay the full lump-sum payment due the resident within 20 business days, as specified.
Background
Continuing Care Retirement Contract Model (CCRCs). CCRCs have been likened to long-term care insurance, with seniors paying large entry fees ranging from $50,000 to more than $2 million, in exchange for access to a range of levels of care services, including independent living, assisted living and skilled nursing care intended to meet the care needs of residents over a specified period of time as they age. There are a wide variety of contractual models available across the state. Some provide for a lump-sum termination of contract payment, based on a portion of the entrance fees (typically ranging from 90 and 50 percent) upon the death of the resident. If the resident opts to leave the community, repayment is conditioned upon the resale of the unit. Other models provide for a refund of a portion of the entrance fees, regardless of resale, at percentage rates that decrease the longer the resident remains in the community. Some facilities offer life care contracts through which a facility agrees to care for the resident for the remainder of the resident’s life, regardless of whether the resident outlives his or her financial resources.
In addition to entrance fees, residents pay monthly fees, which may be held constant as the resident ages and needs increase, or may increase as the resident needs increasing levels of care. Such monthly fees range widely from $500 to $9,000 a month for independent living, between $3,000 and $7,000 for assisted living, and upwards from $7,000 to $17,000 per month for skilled nursing.
There are currently 105 facilities certified as CCRCs in California, 75 of which are nonprofit, and frequently operated by religious or philanthropic organizations. Thirty CCRCs are for-profit. There are eight nonprofit multiple-facility providers and one for-profit multiple-facility provider. According to Leading Age, there are more than 20,000 residents of CCRCs in California.
Regulatory Structure. The bulk of regulatory oversight pertains to the financial solvency of the facilities, in consideration of the substantial investments made by residents. In addition, CCRCs that operate an independent or assisted living level of care are required to have those facilities licensed by CDSS as Residential Care Facilities for the Elderly (RCFEs). Facilities operating a skilled nursing level of care must have those facilities licensed by the Department of Public Health. Furthermore, CDSS is required to review and approve the overall resident contract used by a facility with each resident, however there are few statutory requirements placed on the content of those contracts.
Required Annual Reports. Providers are required to submit an annual report to CDSS describing the facility’s financial condition within four months after their fiscal year end. The reports are required to consist of audited financial statements and required reserve calculations, evidence of fidelity bonds (insuring against dishonest employee conduct) as well as additional information. Additionally, CCRCs that have contracts promising to provide care without substantially increasing monthly fees as needs increase must submit an actuarial study to CDSS every five years regarding the actuarial financial position of the facility.
Required Reserves. CCRC providers are required to maintain a liquid reserve for long-term debt obligations that must be equal to the sum of the prior fiscal year payments for the specific items including interest on debt, rental or lease payments, insurance. Additionally, CCRCs are required to maintain a liquid reserve for operating expenses in an amount that equals or exceeds 75 days net operating expenses, as defined.
CCRCs offering a “refundable contract” are required to maintain a reserve for refunds, held in a trust fund. Providers are permitted to invest up 70 percent of the refund reserves in the real estate that is used to provide care and housing for the residents where they reside. The required amount of the reserve is calculated using a statutorily established formula based on life expectancy of the residents and the portion of the entry fee that is refundable. Importantly, many providers opt against a refundable contract that requires reserves instead offering a “lump sum payment” that is conditioned upon resale of the unit. The latter model does not require the facility to maintain a reserve, since it is assumed that the financial liability is only incurred once the unit has been resold – it is this model which the author cites as having led to long delays in returning entrance fees.
Disclosure Statements. California statute requires CDSS to issue a disclosure statement form that facilities provide to residents, which includes general information such as the provider’s and owner’s name, address, and telephone number, names of any affiliated facilities, any accreditation of the provider, distance to the nearest shopping center, number of units and other detailed information.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No
According to the Assembly Appropriations Committee, this bill may contain minor and absorbable costs, likely less than $50,000 (General Fund) per year for CDSS to investigate complaints.
California Continuing Care Residents Association (Source)
California Commission on Aging
California Long Term Care Ombudsman Association
Cardinal Point Residents Association
Consumer Federation of California
National Association of Social Workers, California Chapter
Residents of Eskaton Village Carmichael of CALCRA
162 individuals
None received
ARGUMENTS IN SUPPORT: The bill’s sponsor, the California Continuing Care Residents Association, writes that “the CCRC model of care is different than that of other residential care facilities around the state. When seniors make a decision to move into a CCRC, they pay a substantial entrance fee and additional monthly fees in exchange for a lifetime of residency and care that meets the ongoing and advancing needs of aging … Current law leaves families without recourse to demand the return of an entrance fee within a reasonable time, and there is no way to ensure that CCRC providers are making a good faith effort to re-sell these vacant units. SB 475 helps the investments the seniors make in their long-term care and ensures that CCRC providers remain accountable for returning payments and refunds to seniors and their families within a reasonable time.”
According to the author, this bill “levels the playing field for the CCRC resident in a manner that will result in more timely repayments and adds an incentive for a CCRC to resale a unit in the form of interest on the unpaid remaining balance."
ASSEMBLY FLOOR: 53-26, 9/08/15
AYES: Alejo, Bloom, Bonilla, Bonta, Brown, Burke, Calderon, Campos, Chau, Chiu, Chu, Cooley, Cooper, Dababneh, Daly, Dodd, Eggman, Frazier, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Roger Hernández, Holden, Irwin, Jones-Sawyer, Levine, Linder, Lopez, Low, McCarty, Medina, Mullin, Nazarian, O'Donnell, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Mark Stone, Thurmond, Ting, Weber, Williams, Wood, Atkins
NOES: Achadjian, Travis Allen, Baker, Bigelow, Brough, Chang, Dahle, Beth Gaines, Gallagher, Grove, Hadley, Harper, Jones, Kim, Lackey, Maienschein, Mathis, Mayes, Melendez, Obernolte, Olsen, Patterson, Steinorth, Wagner, Waldron, Wilk
NO VOTE RECORDED: Chávez
Prepared by: Mareva Brown / HUMAN S. / (916) 651-1524
9/9/15 9:49:58
**** END ****
SB 475
Page 3
SENATE THIRD READING
SB 475
(Monning)
As Amended September 4, 2015
Majority vote
SENATE VOTE: 31-4
Committee |
Votes |
Ayes |
Noes |
Human Services |
5-2 |
Chu, Calderon, Lopez, Mark Stone, Thurmond |
Mayes, Maienschein |
Aging |
5-2 |
Brown, Gipson, Gray, Levine, Lopez |
Hadley, Mathis |
Appropriations |
12-5 |
Gomez, Bloom, Bonta, Calderon, Gordon, Eggman, Eduardo Garcia, Holden, Quirk, Rendon, Weber, Wood |
Bigelow, Chang, Gallagher, Jones, Wagner |
SUMMARY: Imposes additional repayment and other requirements on certain continuing care contracts once a unit has been vacated. Specifically, this bill:
Prohibits a continuing care retirement community (CCRC) provider from charging a resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. Further requires a continuing care contract to contain, among other things, a statement regarding this prohibition.
Requires a continuing care contract to contain the policy or terms for repaying a lump sum of any portion of the entrance fee, and further requires every continuing care contract that provides for a refund or repaying a lump sum of all or part of the entrance fee to, among other things, do the following:
State that the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit and, by July 1, 2016, notice current residents, as specified, regarding this statement as clarification of the resident’s existing contract; and
State, for all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
Requires, for contracts signed after January 1, 2016, if the unit remains vacant for 120 days after the resident's termination, a repayment of at least 10% of the full lump-sum payment if termination is the result of a resident's death, and 20% if termination occurs for any other reason. Further specifies that this repayment shall not cause the contract to be deemed a refundable contract requiring a refund reserve, as specified.
Requires, for continuing care contracts entered into on or after January 1, 2016, that any payment balance that has not been paid to a resident within 180 days shall accrue simple interest, to be compounded annually, at a rate of 4%. Further requires that any payment balance that has not been paid within 240 days shall accrue simple interest, to be compounded annually, at a rate of 6% and that interest shall continue to accrue until the date the full lump-sum payment is paid to the resident.
Exempts, until January 1, 2017, projects in development prior to January 1, 2016, for which contracts were entered into on or before January 1, 2017, from certain requirements regarding refunds, lump-sum charges and repayment, and interest payments, as specified.
Clarifies that, after the death of a resident, repayment and interest requirements apply to a lump-sum payment that is conditioned upon the resale of a unit and that any payment and interest shall be payable to the resident's estate.
States that these repayment and other requirements shall not be construed to limit or alter any legal remedies otherwise available to the resident or his or her estate.
Establishes a process for a resident to file a complaint with the Department of Social Services (DSS) if his or her unit has not been resold for more than 12 months after the unit was made available to the provider, as specified. Further establishes processes for residents and providers to request a review of DSS's resulting determination and stipulates that if a provider is found to not have made a sufficient good faith effort to reoccupy or resell a unit, that provider shall repay the full lump-sum payment due the resident within 20 business days, as specified.
FISCAL EFFECT: According to the Assembly Appropriations Committee, this bill may contain minor and absorbable costs, likely less than $50,000 (General Fund) per year to DSS to investigate complaints.
COMMENTS:
Continuing Care Retirement Communities: CCRCs offer individuals 60 years or older a housing option that includes long-term care services that are typically provided for the lifetime of the resident. CCRCs offer a long-term continuing care contract, which is an agreement between a provider and a resident promising that a range of services will be provided to the resident at the CCRC (sometimes at an additional cost, depending on the type of contract). These services include housing, residential services, and nursing care.
Continuing care contracts can vary widely across CCRCs, with differing provisions on costs, payment methods, services provided, and other elements. Continuing care contracts typically require an individual to pay an entrance fee and monthly fees. Entrance fees can range widely, typically from $100,000 to $1 million, and monthly fees vary depending in part on the level of services included in the contract. CCRC contracts are sometimes referred to by three "types": Type A contracts (also known as life care contracts), are the most expensive and are all-inclusive agreements wherein all housing, services and healthcare are covered by the entrance fee and monthly fees; Type B contracts typically offer discounted healthcare services for limited amounts of time, after which services can be purchased; and Type C contracts offer the lowest entrance and monthly fees, but require residents to be responsible for paying for healthcare services at market rates.
Also, continuing care contracts may be refundable or non-refundable. Refundable contracts refund a portion of the entrance fees, sometimes on a scale that decreases over time the percentage of the entrance fee that is refunded. These types of contracts require a CCRC to maintain a reserve for refunds (in addition to other reserves required for the operation of a CCRC). Alternatively, many CCRC providers choose instead to offer a repayment of a designated portion of the entrance fee – a "lump-sum payment" – that is conditioned upon resale of the unit. A reserve is not required in this case, as it is assumed that the resale of the unit will result in the new resident's entrance fee covering the cost of repaying a portion of the former resident's entrance fee. In California, there are currently no requirements that resale and/or repayment of entrance fees take place within a certain period of time.
There are currently nearly 100 CCRCs in California, with over 20,000 units. Roughly 65% of CCRC providers are non-profit. The Community Care Licensing Division of DSS oversees CCRCs by: a) ensuring that licensing laws and regulations are followed (CCRCs are required to obtain a certificate of authority and an RCFE license; they must also obtain a SNF license through the Department of Public Health (DPH) if offering skilled nursing services), and b) reviewing and approving CCRC applications and monitoring CCRCs’ financial condition and their ability to uphold their contractual obligations to residents.
Need for this bill: According to the author, "Under current law, Continuing Care Retirement Community (CCRC) contracts that base the repayment of a resident’s entrance fee upon the resale of the unit and not upon vacancy are unfair arrangements for consumers and there is little incentive to resale those units in a timely manner. In many cases the CCRC provider is able to take advantage of this type of contract, which can lead to seniors or their estates experiencing significant delays in the repayment of entrance fees. For example, a CCRC in Pacific Grove had not paid $530,600 to the estate of a resident who died more than 3 years ago because the refund was conditioned upon resale of the unit. [This bill] levels the playing field for the CCRC resident in a manner that will result in more timely repayments and adds an incentive for a CCRC to resale a unit in the form of interest on the unpaid remaining balance. The resident safeguards in the bill balance the need for steadfast repayment while ensuring the CCRC can remain fiscally solvent so the current residents are not adversely impacted."
Analysis Prepared by: Daphne Hunt / HUM. S. / (916) 319-2089 FN: 0002166
SB 475
Page 3
SENATE THIRD READING
SB 475
(Monning)
As Amended September 1, 2015
Majority vote
SENATE VOTE: 31-4
Committee |
Votes |
Ayes |
Noes |
Human Services |
5-2 |
Chu, Calderon, Lopez, Mark Stone, Thurmond |
Mayes, Maienschein |
Aging |
5-2 |
Brown, Gipson, Gray, Levine, Lopez |
Hadley, Mathis |
Appropriations |
12-5 |
Gomez, Bloom, Bonta, Calderon, Gordon, Eggman, Eduardo Garcia, Holden, Quirk, Rendon, Weber, Wood |
Bigelow, Chang, Gallagher, Jones, Wagner |
SUMMARY: Imposes additional repayment and other requirements on certain continuing care contracts once a unit has been vacated. Specifically, this bill:
Prohibits a continuing care retirement community (CCRC) provider from charging a resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. Further requires a continuing care contract to contain, among other things, a statement regarding this prohibition.
Requires a continuing care contract to contain the policy or terms for repaying a lump sum of any portion of the entrance fee, and further requires every continuing care contract that provides for a refund or repaying a lump sum of all or part of the entrance fee to, among other things, do the following:
State that the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit and, by July 1, 2016, notice current residents, as specified, regarding this statement as clarification of the resident’s existing contract; and
State, for all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
Requires, for contracts signed after January 1, 2016, if the unit remains vacant for 120 days after the resident's termination, a repayment of at least 10% of the full lump-sum payment if termination is the result of a resident's death, and 20% if termination occurs for any other reason. Further specifies that this repayment shall not cause the contract to be deemed a refundable contract requiring a refund reserve, as specified.
Requires, for continuing care contracts entered into on or after January 1, 2016, that any payment balance that has not been paid to a resident within 180 days shall accrue compound interest every 30 days at a rate not lower than 4%. Further requires that any payment balance that has not been paid within 240 days will accrue compound interest every 30 days at a rate not lower than 6% and that interest shall continue to accrue until the date the full lump-sum payment is paid to the resident.
Clarifies that, after the death of a resident, repayment and interest requirements apply to a lump-sum payment that is conditioned upon the resale of a unit and that any payment and interest shall be payable to the resident's estate.
States that these repayment and other requirements shall not be construed to limit or alter any legal remedies otherwise available to the resident or his or her estate.
Establishes a process for a resident to file a complaint with the Department of Social Services (DSS) if his or her unit has not been resold for more than 12 months after the unit was made available to the provider, as specified. Further establishes processes for residents and providers to request a review of DSS's resulting determination and stipulates that if a provider is found to not have made a sufficient good faith effort to reoccupy or resell a unit, that provider shall repay the full lump-sum payment due the resident within 20 business days, as specified.
FISCAL EFFECT: According to the Assembly Appropriations Committee, this bill may contain minor and absorbable costs, likely less than $50,000 (General Fund) per year to DSS to investigate complaints.
COMMENTS:
Continuing Care Retirement Communities: CCRCs offer individuals 60 years or older a housing option that includes long-term care services that are typically provided for the lifetime of the resident. CCRCs offer a long-term continuing care contract, which is an agreement between a provider and a resident promising that a range of services will be provided to the resident at the CCRC (sometimes at an additional cost, depending on the type of contract). These services include housing, residential services, and nursing care.
Continuing care contracts can vary widely across CCRCs, with differing provisions on costs, payment methods, services provided, and other elements. Continuing care contracts typically require an individual to pay an entrance fee and monthly fees. Entrance fees can range widely, typically from $100,000 to $1 million, and monthly fees vary depending in part on the level of services included in the contract. CCRC contracts are sometimes referred to by three "types": Type A contracts (also known as life care contracts), are the most expensive and are all-inclusive agreements wherein all housing, services and healthcare are covered by the entrance fee and monthly fees; Type B contracts typically offer discounted healthcare services for limited amounts of time, after which services can be purchased; and Type C contracts offer the lowest entrance and monthly fees, but require residents to be responsible for paying for healthcare services at market rates.
Also, continuing care contracts may be refundable or non-refundable. Refundable contracts refund a portion of the entrance fees, sometimes on a scale that decreases over time the percentage of the entrance fee that is refunded. These types of contracts require a CCRC to maintain a reserve for refunds (in addition to other reserves required for the operation of a CCRC). Alternatively, many CCRC providers choose instead to offer a repayment of a designated portion of the entrance fee – a "lump-sum payment" – that is conditioned upon resale of the unit. A reserve is not required in this case, as it is assumed that the resale of the unit will result in the new resident's entrance fee covering the cost of repaying a portion of the former resident's entrance fee. In California, there are currently no requirements that resale and/or repayment of entrance fees take place within a certain period of time.
There are currently nearly 100 CCRCs in California, with over 20,000 units. Roughly 65% of CCRC providers are non-profit. The Community Care Licensing Division of DSS oversees CCRCs by: a) ensuring that licensing laws and regulations are followed (CCRCs are required to obtain a certificate of authority and an RCFE license; they must also obtain a SNF license through the Department of Public Health (DPH) if offering skilled nursing services), and b) reviewing and approving CCRC applications and monitoring CCRCs’ financial condition and their ability to uphold their contractual obligations to residents.
Need for this bill: According to the author, "Under current law, Continuing Care Retirement Community (CCRC) contracts that base the repayment of a resident’s entrance fee upon the resale of the unit and not upon vacancy are unfair arrangements for consumers and there is little incentive to resale those units in a timely manner. In many cases the CCRC provider is able to take advantage of this type of contract, which can lead to seniors or their estates experiencing significant delays in the repayment of entrance fees. For example, a CCRC in Pacific Grove had not paid $530,600 to the estate of a resident who died more than 3 years ago because the refund was conditioned upon resale of the unit. [This bill] levels the playing field for the CCRC resident in a manner that will result in more timely repayments and adds an incentive for a CCRC to resale a unit in the form of interest on the unpaid remaining balance. The resident safeguards in the bill balance the need for steadfast repayment while ensuring the CCRC can remain fiscally solvent so the current residents are not adversely impacted."
Analysis Prepared by: Daphne Hunt / HUM. S. / (916) 319-2089 FN: 0001877
SB 475
Page 3
SENATE THIRD READING
SB 475
(Monning)
As Amended August 20, 2015
Majority vote
SENATE VOTE: 31-4
Committee |
Votes |
Ayes |
Noes |
Human Services |
5-2 |
Chu, Calderon, Lopez, Mark Stone, Thurmond |
Mayes, Maienschein |
Aging |
5-2 |
Brown, Gipson, Gray, Levine, Lopez |
Hadley, Mathis |
Appropriations |
12-5 |
Gomez, Bloom, Bonta, Calderon, Gordon, Eggman, Eduardo Garcia, Holden, Quirk, Rendon, Weber, Wood |
Bigelow, Chang, Gallagher, Jones, Wagner |
SUMMARY: Imposes additional repayment and other requirements on certain continuing care contracts once a unit has been vacated. Specifically, this bill:
Prohibits a continuing care retirement community (CCRC) provider from charging a resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. Further requires a continuing care contract to contain, among other things, a statement regarding this prohibition.
Requires a continuing care contract to contain the policy or terms for repaying a lump sum of any portion of the entrance fee, and further requires every continuing care contract that provides for a refund or repaying a lump sum of all or part of the entrance fee to, among other things, do the following:
State that the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit and, by July 1, 2016, notice current residents, as specified, regarding this statement as clarification of the resident’s existing contract; and
State, for all contracts with a repayment of all or a portion of the entrance fee conditioned upon the resale of the unit, the average and longest amount of time that it has taken to resell a unit within the last five calendar years.
Requires, for contracts signed after January 1, 2016, if the unit remains vacant for 120 days after the resident's termination, a repayment of at least 10% of the full lump-sum payment if termination is the result of a resident's death, and 20% if termination occurs for any other reason. Further specifies that this repayment shall not cause the contract to be deemed a refundable contract requiring a refund reserve, as specified.
Requires, for continuing care contracts entered into on or after January 1, 2016, that any payment balance that has not been paid to a resident within 120 days shall accrue compound interest every 30 days at a rate not lower than 4%. Further requires that any payment balance that has not been paid within 180 days will accrue compound interest every 30 days at a rate not lower than 6% and that interest shall continue to accrue until the date the full lump-sum payment is paid to the resident.
Clarifies that, after the death of a resident, repayment and interest requirements apply to a lump-sum payment that is conditioned upon the resale of a unit and that any payment and interest shall be payable to the resident’s estate.
States that these repayment and other requirements shall not be construed to limit or alter any legal remedies otherwise available to the resident or his or her estate.
Establishes a process for a resident to file a complaint with the Department of Social Services (DSS) if his or her unit has not been resold for more than 12 months after the unit was made available to the provider, as specified. Further establishes processes for residents and providers to request a review of DSS's resulting determination and stipulates that if a provider is found to not have made a sufficient good faith effort to reoccupy or resell a unit, that provider shall repay the full lump-sum payment due the resident within 20 business days and must also reimburse DSS for costs associated with investigating good faith, as specified.
FISCAL EFFECT: According to the Assembly Appropriations Committee, this bill may contain minor and absorbable costs, likely less than $50,000 (General Fund) per year to DSS to investigate complaints.
COMMENTS:
Continuing Care Retirement Communities: CCRCs offer individuals 60 years or older a housing option that includes long-term care services that are typically provided for the lifetime of the resident. CCRCs offer a long-term continuing care contract, which is an agreement between a provider and a resident promising that a range of services will be provided to the resident at the CCRC (sometimes at an additional cost, depending on the type of contract). These services include housing, residential services, and nursing care.
Continuing care contracts can vary widely across CCRCs, with differing provisions on costs, payment methods, services provided, and other elements. Continuing care contracts typically require an individual to pay an entrance fee and monthly fees. Entrance fees can range widely, typically from $100,000 to $1 million, and monthly fees vary depending in part on the level of services included in the contract. CCRC contracts are sometimes referred to by three "types": Type A contracts (also known as life care contracts), are the most expensive and are all-inclusive agreements wherein all housing, services and healthcare are covered by the entrance fee and monthly fees; Type B contracts typically offer discounted healthcare services for limited amounts of time, after which services can be purchased; and Type C contracts offer the lowest entrance and monthly fees, but require residents to be responsible for paying for healthcare services at market rates.
Also, continuing care contracts may be refundable or non-refundable. Refundable contracts refund a portion of the entrance fees, sometimes on a scale that decreases over time the percentage of the entrance fee that is refunded. These types of contracts require a CCRC to maintain a reserve for refunds (in addition to other reserves required for the operation of a CCRC). Alternatively, many CCRC providers choose instead to offer a repayment of a designated portion of the entrance fee – a "lump-sum payment" – that is conditioned upon resale of the unit. A reserve is not required in this case, as it is assumed that the resale of the unit will result in the new resident's entrance fee covering the cost of repaying a portion of the former resident's entrance fee. In California, there are currently no requirements that resale and/or repayment of entrance fees take place within a certain period of time.
There are currently nearly 100 CCRCs in California, with over 20,000 units. Roughly 65% of CCRC providers are non-profit. The Community Care Licensing Division of DSS oversees CCRCs by: a) ensuring that licensing laws and regulations are followed (CCRCs are required to obtain a certificate of authority and an RCFE license; they must also obtain a SNF license through the Department of Public Health (DPH) if offering skilled nursing services), and b) reviewing and approving CCRC applications and monitoring CCRCs’ financial condition and their ability to uphold their contractual obligations to residents.
Need for this bill: According to the author, "Under current law, Continuing Care Retirement Community (CCRC) contracts that base the repayment of a resident’s entrance fee upon the resale of the unit and not upon vacancy are unfair arrangements for consumers and there is little incentive to resale those units in a timely manner. In many cases the CCRC provider is able to take advantage of this type of contract, which can lead to seniors or their estates experiencing significant delays in the repayment of entrance fees. For example, a CCRC in Pacific Grove had not paid $530,600 to the estate of a resident who died more than 3 years ago because the refund was conditioned upon resale of the unit. [This bill] levels the playing field for the CCRC resident in a manner that will result in more timely repayments and adds an incentive for a CCRC to resale a unit in the form of interest on the unpaid remaining balance. The resident safeguards in the bill balance the need for steadfast repayment while ensuring the CCRC can remain fiscally solvent so the current residents are not adversely impacted."
Analysis Prepared by: Daphne Hunt / HUM. S. / (916) 319-2089 FN: 0001599
Date of Hearing: August 26, 2015
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Jimmy Gomez, Chair
SB 475
(Monning) – As Amended August 20, 2015
Policy Committee: |
Human Services |
Vote: |
5 - 2 |
|
Aging and Long Term Care |
|
5 - 2 |
|
|
|
|
Urgency: No State Mandated Local Program: No Reimbursable: No
SUMMARY:
This bill forbids a continuing care retirement community (CCRC) from assessing a resident or his or her estate a monthly fee once a unit has been permanently vacated by the resident under certain conditions, and alters refund or repayment requirements of a lump sum entrance fee, under certain conditions. Recent amendments clarify accrued interest requirements and recast the Department of Social Services' (DSS) complaint investigation process.
FISCAL EFFECT:
Minor and absorbable costs, likely less than $50,000 (GF) per year to the DSS to investigate complaints.
COMMENTS.
Purpose. According to the author, “Continuing Care Retirement Community (CCRC) contracts that base the repayment of a resident’s entrance fee upon the resale of the unit and not upon vacancy are unfair arrangements for consumers and there is little incentive to resale those units in a timely manner. In many cases the CCRC provider is able to take advantage of this type of contract, which can lead to seniors or their estates experiencing significant delays in the repayment of entrance fees. SB 475 levels the playing field for the CCRC resident in a manner that will result in more timely repayments.”
Background. CCRCs offer a long-term continuing care contract, which is an agreement between a provider and a resident promising that a range of services will be provided to the resident at the CCRC (sometimes at an additional cost, depending on the type of contract). These services include housing, residential services, and nursing care.
Continuing care contracts vary widely across CCRCs, with differing provisions on costs, payment methods, services provided, and other elements. Continuing care contracts typically require an individual to pay an entrance fee and monthly fees. Entrance fees can range widely, typically from $100,000 to $1 million, and monthly fees vary depending in part on the level of services included in the contract
Continuing care contracts may be refundable or non-refundable. Refundable contracts refund a portion of the entrance fees, sometimes on a scale that decreases over time the percentage of the entrance fee that is refunded. These types of contracts require a CCRC to maintain a reserve for refunds (in addition to other reserves required for the operation of a CCRC). Alternatively, many CCRC providers choose instead to offer a repayment of a designated portion of the entrance fee – a “lump-sum payment” – that is conditioned upon resale of the unit. A reserve is not required in this case, as it is assumed that the resale of the unit will result in the new resident’s entrance fee covering the cost of repaying a portion of the former resident’s entrance fee. In California, there are currently no requirements that resale and/or repayment of entrance fees take place within a certain period of time.
There are over 100 CCRCs in California, with over 20,000 units. Approximately 65% of CCRC providers are non-profit. The Community Care Licensing Division of DSS reviews and approves CCRC applications and otherwise regulates their operation.
Arguments in Support. Senior and long term care advocates assert that when seniors move into a CCRC it comes with a substantial entrance fee and additional monthly fees in exchange for lifetime care and residency. These entrance fees represent significant investments. Many seniors sell their homes to pay the fee, and find security in a contract to return it, if necessary. Supporters argue that when the fee is “conditioned upon the resale of the unit,” the obligation for the CCRC to return the fee is diminished - refunds can be delayed for years, or indefinitely, and with no corresponding interest rate to compensate for the slow process to refund the fee. Sometimes, providers charge monthly maintenance and upkeep against the balance of the fee while the refund awaits issuance to the former resident, or the estate. Thus, there is little or no incentive to sell the unit. Former residents have waited years, and sometimes engaged in disheartening legal battles to obtain their refund. Current law leaves families with little or no leverage or recourse to demand fair return of entrance fees. SB 475 changes that and helps seniors protect their investments.
Arguments in Opposition. CCRC providers are concerned that the interest rate charged against outstanding entry fee refund balances could unintentionally restrict access to CCRCs and create potential expenses for remaining residents of CCRCs. They also argue that the bill could reduce a provider’s willingness to offer refundable contracts, (currently the most favored model), and the bill does not offer protections against a so-called “run” on a community, where a domino-like effect of one resident exiting may cause others to seek to exit, thereby de-stabilizing the entire community.
They also would prefer that DSS use objective criteria when determining whether a provider has made a sufficient "good faith effort" to resell or reoccupy a vacated unit, rather than the subjective approach currently in the bill.
Prior Legislation.
AB 1433 (Eng) Chapter 443, Statutes of 2010, defined “residential temporary relocations” in continuing care contracts of residents who live in CCRCs, and established related rights, requirements, and procedures.
AB 407 (Beall) Chapter 442, Statutes of 2009, imposed patient protection requirements on CCRCs in the event of their closure.
SB 489 (Steinberg, 2007) would have established procedures and protections for both permanent and temporary closures of CCRCs. That bill was vetoed by the Governor.
Analysis Prepared by: Jennifer Swenson / APPR. / (916) 319-2081
SB 475
Page 6
Date of Hearing: June 30, 2015
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Kansen Chu, Chair
SB 475
(Monning) – As Amended June 25, 2015
SENATE VOTE: 31-4
SUBJECT: Continuing care contracts: cancellation: payments.
SUMMARY: Imposes additional repayment and other requirements on certain continuing care contracts once a unit has been vacated.
Specifically, this bill:
Prohibits a continuing care retirement community (CCRC) provider from charging a resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident, unless the fee is part of an equity interest contract. Further requires a continuing care contract to contain, among other things, a statement regarding this prohibition.
Requires a continuing care contract to contain the policy or terms for repaying a lump sum of any portion of the entrance fee, and further requires every continuing care contract that provides for a refund or repaying a lump sum of all or part of the entrance fee to, among other things, do the following:
State that the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit and, by July 1, 2016, notice current residents, as specified, regarding this statement as clarification of the resident’s existing contract; and
State, for a lump-sum payment, the average and longest amount of time that a lump-sum payment has been delayed.
Requires, for contracts signed after January 1, 2016, a repayment of at least 20% of the full lump-sum payment if the unit remains vacant for 120 days after the resident’s termination. Further specifies that this repayment shall not cause the contract to be deemed a refundable contract requiring a refund reserve, as specified.
Requires, for existing and prospective continuing care contracts, that any payment balance that has not been paid to a resident within 120 days shall accrue interest at a rate no lower than the United States prime lending rate. Further requires that any payment balance that has not been paid within 180 days will accrue interest at a rate no lower than 2% plus the United States prime lending rate and that interest shall continue to accrue until the date the full lump-sum payment is paid to the resident.
Clarifies that, after the death of a resident, repayment and interest requirements apply to a lump-sum payment that is conditioned upon the resale of a unit and that any payment and interest shall be payable to the resident’s estate.
States that these repayment and other requirements shall not be construed to limit or alter any legal remedies otherwise available to the resident or his or her estate.
EXISTING LAW:
Establishes the California Residential Care Facilities for the Elderly Act to provide for the licensure and regulation of Residential Care Facilities for the Elderly (RCFEs) as a separate category within the existing licensing structure of the Department of Social Services (DSS). (HSC 1569 et seq.)
Provides for the licensure and regulation of Skilled Nursing Facilities (SNFs) by the Department of Public Health. (HSC 1250 et seq.)
Defines a “continuing care contract” to mean a contract that includes a promise by a provider to provide one or more elements of care to an elderly resident, as specified, in exchange for an entrance fee and/or the payment of periodic charges. (HSC 1771(c)(8))
Defines a “continuing care retirement community” (CCRC) to mean a facility located in the state where services promised in a continuing care contract are provided. Further allows that, when services are provided in residents’ own homes, the homes into which the provider takes those services are to be considered a part of the CCRC. (HSC 1771(c)(10))
Provides for the certification and regulation of CCRCs by DSS. (HSC 1170 et seq.)
Requires an applicant for a certificate of authority to operate a CCRC to obtain appropriate licenses for the entire CCRC as otherwise required by law, including RCFE and/or SNF licenses. (HSC 1771.5)
Requires a continuing care contract to contain numerous specified elements including, but not limited to, the duration of the contract, the list of services that will be made available to the resident as required to provide the appropriate level of care, an itemization of the services included in the monthly fee and services available for an extra charge, and others. Further requires additional information and disclosures to be attached to the continuing care contract. (HSC 1788(a), (d) through (h))
Establishes requirements regarding the cancellation of a continuing care contract. (HSC 1788.2)
Requires a lump-sum payment that is conditioned upon resale of a unit to be paid to the resident within 14 calendar days after resale of the unit. Futher requires that this payment not be considered, characterized, or advertised as a refund. (HSC 1788.4(e))
FISCAL EFFECT: This bill has been keyed non-fiscal by the Office of Legislative Counsel.
COMMENTS:
Continuing Care Retirement Communities: CCRCs offer individuals 60 years or older a housing option that includes long-term care services that are typically provided for the lifetime of the resident. CCRCs offer a long-term continuing care contract, which is an agreement between a provider and a resident promising that a range of services will be provided to the resident at the CCRC (sometimes at an additional cost, depending on the type of contract). These services include housing, residential services, and nursing care.
Continuing care contracts can vary widely across CCRCs, with differing provisions on costs, payment methods, services provided, and other elements. Continuing care contracts typically require an individual to pay an entrance fee and monthly fees. Entrance fees can range widely, typically from $100,000 to $1 million, and monthly fees vary depending in part on the level of services included in the contract. CCRC contracts are sometimes referred to by three “types”: Type A contracts (also known as life care contracts), are the most expensive and are all-inclusive agreements wherein all housing, services and healthcare are covered by the entrance fee and monthly fees; Type B contracts typically offer discounted healthcare services for limited amounts of time, after which services can be purchased; and Type C contracts offer the lowest entrance and monthly fees, but require residents to be responsible for paying for healthcare services at market rates.
Also, continuing care contracts may be refundable or non-refundable. Refundable contracts refund a portion of the entrance fees, sometimes on a scale that decreases over time the percentage of the entrance fee that is refunded. These types of contracts require a CCRC to maintain a reserve for refunds (in addition to other reserves required for the operation of a CCRC). Alternatively, many CCRC providers choose instead to offer a repayment of a designated portion of the entrance fee – a “lump-sum payment” – that is conditioned upon resale of the unit. A reserve is not required in this case, as it is assumed that the resale of the unit will result in the new resident’s entrance fee covering the cost of repaying a portion of the former resident’s entrance fee. In California, there are currently no requirements that resale and/or repayment of entrance fees take place within a certain period of time.
There are currently nearly 100 CCRCs in California, with over 20,000 units. Roughly 65% of CCRC providers are non-profit. The Community Care Licensing Division of DSS oversees CCRCs by: a) ensuring that licensing laws and regulations are followed (CCRCs are required to obtain a certificate of authority and an RCFE license; they must also obtain a SNF license through the Department of Public Health (DPH) if offering skilled nursing services), and b) reviewing and approving CCRC applications and monitoring CCRCs’ financial condition and their ability to uphold their contractual obligations to residents.
Need for this bill: For contracts that condition the repayment of entrance fees (or some portion thereof) on the resale of a resident’s unit, supporters of this bill argue that instances exist where years pass before individuals or their estates receive their repayment; therefore, they argue for requiring repayment of 20% of the full lump-sum payment within 120 days, and the accrual of interest on the remaining applicable balance thereafter. Additionally, proponents of this bill point to cases where monthly fees continue to be charged against an entrance fee balance after a resident has passed away and their residence has been vacated, and argue for the prohibition of this practice.
According to the author, “Under current law, Continuing Care Retirement Community (CCRC) contracts that base the repayment of a resident’s entrance fee upon the resale of the unit and not upon vacancy are unfair arrangements for consumers and there is little incentive to resale those units in a timely manner. In many cases the CCRC provider is able to take advantage of this type of contract, which can lead to seniors or their estates experiencing significant delays in the repayment of entrance fees. For example, a CCRC in Pacific Grove had not paid $530,600 to the estate of a resident who died more than 3 years ago because the refund was conditioned upon resale of the unit. [This bill] levels the playing field for the CCRC resident in a manner that will result in more timely repayments and adds an incentive for a CCRC to resale a unit in the form of interest on the unpaid remaining balance. The resident safeguards in the bill balance the need for steadfast repayment while ensuring the CCRC can remain fiscally solvent so the current residents are not adversely impacted.”
California Continuing Care Residents Association (CALCRA), the sponsor of this bill, states that, “Current law leaves families without recourse to recover an entrance fee refund within a reasonable time and there is no way to ensure that CCRC providers are making a good faith effort to re-sell these vacant units. [This bill] helps protect the investments seniors make in their long-term care and ensures that CCRC providers remain accountable for returning payments and refunds to seniors and their families within a reasonable time. This bill also prohibits a CCRC provider from charging the resident, or their estate, for any costs associated with the unit once the unit has been vacated and is made available for re-sale.”
Opposition: A number of CCRC providers have expressed opposition to this bill, with one key contention being the requirement to pay 20% of the full lump-sum payment within months of a resident vacating the unit through death or moving, and without the guarantee that the unit will be reoccupied and another entrance fee collected within that timeframe. Opponents of this bill state that this requirement would seriously jeopardize the financial stability of CCRCs, and potentially threaten a “run on the bank” if multiple residents terminate contracts simultaneously. Some providers claim that, even if a reserve is not statutorily required for the repayment stipulations contained in this bill, some financial lenders and institutions may require such a reserve, and good accounting practices simply warrant it.
CCRC providers claim that the financial instability and need for large reserves that would result from this bill would, in the end, harm the consumer by translating into significantly increased entrance and monthly fees and/or, as LeadingAge California argues, reducing “the willingness of providers to offer repayment contracts, which can be the most affordable method of accessing CCRCs.” Erickson Living writes that, if this bill were to be enacted, “repayments to estates would take precedence over ensuring the financial stability for more than 100 communities and tens‐of‐thousands of frail seniors living in California CCRCs.”
Staff comments: California, along with the nation as a whole, faces an aging population – by 2020, it is projected that 1 in 5 Californians will be 60 or older. A variety of housing and long-term care models will be needed to meet the increasing demand attending this demographic shift and the differing needs of this diverse population. For some individuals, CCRCs may present an attractive option. This bill seeks to ensure that those individuals, and their beneficiaries, are not unduly burdened by questionably lengthy waits for repayment of entrance fees upon the resident vacating the unit through moving or passing away. However, requiring CCRC providers to repay 20% in 120 days may incentivize (while not requiring) these providers to maintain higher reserves; as a result, providers may, in turn, ultimately pass costs on to consumers through increased entrance fees and monthly charges. Additionally, residents who are choosing to move from a CCRC and permanently cancel their contracts may often need prompt repayment of some portion of their entrance fees so that they may afford relocation – say, in the example of a CCRC resident who would like to move to another part of the state to be near his or her family. While the estates of CCRC residents who pass away should also receive entrance fee repayments in a timely manner, there is arguably greater urgency on the part of CCRC residents who choose to cancel their contracts and relocate.
Recognizing the importance of: a) balancing the needs and interests of former CCRC residents and their families with those of current and prospective CCRC residents, and b) prioritizing the urgency of repayments to living residents, committee staff recommends that the percentage of repayment required within 120 days be reduced for lump-sum payments due to estates.
Recommended amendments:
Based on the concerns raised above, committee staff recommends that the 120-day repayment requirement be maintained at 20% for living CCRC residents who choose to cancel their contracts, and reduced to 10% for repayments due to estates upon the death of a resident.
DOUBLE REFERRAL. This bill has been double-referred. Should this bill pass out of this committee, it will be referred to the Assembly Committee on Aging and Long-Term Care.
REGISTERED SUPPORT / OPPOSITION:
Support
California Continuing Care Residents Association (CALCRA) sponsor
157 members of Eskaton Village Carmichael
California Advocates for Nursing Home Reform (CANHR)
California Commission on Aging (CCoA)
California Long-Term Care Ombudsman Association (CLTCOA)
Cardinal Point Residents Association
Consumer Federation of California (CFC)
National Association of Social Workers, CA Chapter (NASW-CA)
161 Individuals
Opposition
American Baptist Homes of the West
Atherton Baptist Homes
British Home
Carmel Valley Manor
Channing House
Continuing Life LLC
Episcopal Communities & Services for Seniors
Episcopal Senior Communities
Forest Hill
Foundation Property Management, Inc.
Fredericka Manor Retirement Community
Front Porch Communities and Services
Heritage on the Marina
Hillcrest
La Costa Glen Carlsbad
Lake Park
Los Angeles Jewish Home for the Aging
Motion Picture & Television Fund (MPTF)
O’Conner Woods
Palm Village Retirement Community
Spring Lake Village
Stoneridge Creek Pleasanton
The Samarkand Retirement Community
The Terraces of Los Gatos
Analysis Prepared by: Daphne Hunt / HUM. S. / (916) 319-2089
SB 475
Page 8
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Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 |
THIRD READING
Bill No: SB 475
Amended: 5/5/15
SENATE HUMAN SERVICES COMMITTEE: 4-0, 4/28/15
AYES: McGuire, Hancock, Liu, Nguyen
NO VOTE RECORDED: Berryhill
SUBJECT: Continuing care contracts: cancellation: payments
SOURCE: California Continuing Care Residents Association
DIGEST: This bill requires that continuing care contracts which condition lump sum contract termination payments on resale of the unit provide at least 20 percent of the lump sum payment to the resident, or the resident’s estate, no later than 90 days after the unit is vacated. This bill also provides that any payment balance not paid to the resident within 90 days be subject to an annual interest rate of two percent plus the United States prime lending rate, and any payment balance not paid to the resident within 180 days be subject to an annual interest rate of five percent plus the United States prime lending rate. It further prohibits the provider from making further charges for maintenance or housekeeping to the resident, the resident’s estate, or against the lump sum payment on a vacated unit, and requires the continuing care contract to include specified disclosures.
Existing law:
Provides for the licensure and regulation of Continuing Care Retirement Communities (CCRCs) by the California Department of Social Services (CDSS) to enact minimum requirements to protect the wellbeing and financial security of residents of CCRCs. (HSC 1770 et seq.)
Requires a CCRC provider to hold a certificate of authority from CDSS permitting the provider to contract for the provision of continuing care, including medical care, in which a resident over the age of 60 has paid in advance for more than one year for that care. (HSC 1771.2)
Provides that the components of care provided by the facility must be separately licensed as otherwise required by state law, including Residential Care Facilities for the Elderly and Skilled Nursing care. (HSC 1771.5)
Requires a CCRC to pay a lump-sum payment to a resident after termination of a continuing care contract that is conditioned upon resale of a unit within 14 calendar days after resale of the unit. (HSC 1788.4 (e))
This bill:
Provides that, for a continuing care contract signed after January 1, 2016, and for which a lump sum payment following termination of the contract is conditioned upon resale of the unit, at least 20 percent of the lump sum payment shall be paid in no event later than 90 days after the formerly occupied unit has been vacated.
Provides that a payment balance that has not been paid to the resident within 90 days will accrue interest at the rate no lower than two percent plus the United States prime lending rate. Applies this provision to current and prospective contracts.
Provides that a payment balance that has not been paid to the resident within 180 days will accrue interest at the rate no lower than five percent plus the United States prime lending rate. Applies this provision to current and prospective contracts.
Prohibits a CCRC provider from making further charges to the resident or his or her estate, or against the lump sum payment for purposes of continued monthly payments to the provider, or for maintenance or housekeeping of the vacated unit.
Requires continuing care contracts to disclose that a provider is prohibited from charging the resident or his or her descendants a monthly fee once a unit has been permanently vacated by the resident.
Requires continuing care contracts to disclose that a provider shall make a good faith effort to reoccupy or resell a unit for which a lump sum payment is conditioned upon resale of the unit, and requires a provider to provide notice to all current residents regarding this disclosure as a clarification of the resident’s existing contract.
Comments
Purpose of the bill. According to the author, CCRC residents and their heirs have experienced long delays in receiving termination of contract payments from CCRC providers after the resident terminates a contract or passes away. The author states that providers often have little incentive to re-occupy a unit that has an outstanding entrance fee in a timely manner, instead preferring to first sell and occupy units that do not have outstanding entrance fees (as in the case of facility expansions). The author additionally states that while the unit is unoccupied, some contracts permit the provider to charge monthly maintenance fees that are deducted from the entrance fees.
Further, the author cites the example of two constituents who claim that a CCRC provider has not repaid two terminations of contract lump sum payments of $250,000 and $562,000 to the estates of the individuals after the apartments failed to sell following the residents death. Additionally, a Sacramento resident writes that one provider continued to charge his father’s estate $4,161 per month in fees after his father passed away while the unit remained unsold. He writes that, while his father’s unit accrued monthly fees to the provider, other units which did not accrue fees were sold first. He writes that this provider is empowered to “drain his father’s estate down to nothing,” with no recourse.
Another individual writes that a CCRC provider refused to provide the 80 percent lump sum termination of contract payment after his aunt’s unit failed to sell for more than two years, despite a desirable ocean view from a high level floor. The individual states that this provider had recently developed a new large tower of units and had failed to provide the older units with any of the updates common when a unit becomes unoccupied (such as new carpets and paint), including his aunt’s, and apparently was directing new sales toward the new tower which required no entrance fee repayments. More than two years later, following extensive letters and complaints, and after reaching out the Attorney General of California, the unit was updated and quickly purchased.
Continuing Care Retirement Contract Model. Continuing care retirement contracts have been likened to long-term care insurance, with seniors paying large entry fees ranging from $50,000 to more than $2 million, in exchange for access to a range of levels of care services, including independent living, assisted living and skilled nursing care intended to meet the care needs of residents over a specified period of time as they age. There are a wide variety of contractual models available across the state. Some provide for a lump sum termination of contract payment, based on a portion of the entrance fees (typically ranging from 90 and 50 percent) upon the death of the resident. If the resident opts to leave the community, repayment is conditioned upon the resale of the unit. Other models provide for a refund of a portion of the entrance fees, regardless of resale, at percentage rates that decrease the longer the resident remains in the community. Some facilities offer life care contracts through which a facility agrees to care for the resident for the remainder of the resident’s life, regardless of whether the resident outlives his or her financial resources.
In addition to entrance fees, residents pay monthly fees, which may be held constant as the resident ages and needs increase, or may increase as the resident needs increasing levels of care. Such monthly fees range widely from $500 to $9,000 a month for independent living, between $3,000 and $7,000 for assisted living, and upwards from $7,000 to $17,000 per month for skilled nursing.
There are currently 105 facilities certified as CCRCs in California, 75 of which are nonprofit, and frequently operated by religious or philanthropic organizations. Thirty CCRCs are for-profit. There are eight nonprofit multiple-facility providers and one for-profit multiple-facility provider. According to Leading Age, there are more than 20,000 residents of CCRCs in California.
Regulatory Structure. Current regulations pertaining to CCRCs largely ensure the financial solvency of facilities, considering that the substantial investments made by residents often comprise a resident’s life savings. In addition, CCRCs that operate an independent or assisted living level of care are required to have those facilities licensed by CDSS as Residential Care Facilities for the Elderly. Facilities operating a skilled nursing level of care must have those facilities licensed by the Department of Public Health. Furthermore, CDSS is required to review and approve the overall resident contract used by a facility with each resident, however there are few statutory requirements placed on the content of those contracts. Additionally, CCRCs must file an application for a “Permit to Accept Deposits/Certificate of Authority” with the Continuing Care Contracts Branch of CDSS.
Providers are additionally required to submit an annual report to CDSS describing the facility’s financial condition within four months after their fiscal year end and a “Key Indicators Report” disclosing key financial ratios and other key indicators within 30 days following the submission of each annual report. Additionally, CCRCs that have contracts promising to provide care without substantially increasing monthly fees as needs increase must submit an actuarial study to CDSS every five years regarding the actuarial financial position of the facility.
Required Reserves. CCRC providers are required to maintain a liquid reserve for long-term debt obligations that must be equal to the sum of the prior fiscal year payments for the following:
All regular principal and interest payments paid by the provider for fully amortizing long-term debt. If a provider has incurred new long-term debt during the immediately preceding fiscal year, the required reserve is 12 times the provider’s most recent monthly payment on the debt.
Facility rental or leasehold payments, and any related payments such as lease insurance.
Any debt that provides for a balloon payment. If the balloon payment debt was incurred within the immediately preceding fiscal year, the required reserve is 12 times the provider’s most recent monthly payment on the debt.
Additionally, CCRCs are required to maintain a liquid reserve for operating expenses in an amount that equals or exceeds 75 days net operating expenses, as defined.
CCRCs offering a “refundable contract” are required to maintain a reserve for refunds, held in a trust fund, however this bill addresses a different form of contract in which a lump sum payment is conditioned upon resale of the unit. Such contracts allow providers to avoid those reserve requirements pertaining to the entrance fee repayment since repayment is conditioned upon resale.
Other States. Similar CCRC entrance fee repayment issues have been litigated in other states. In one similar case last year in Michigan (Mildred A Steward v Henry Ford Village Inc.), the court stated:
“It appears in any event that defendant [the facility] maintains complete control, under the Agreement, of when and how the unit comes to be re-occupied, and therefore of when and how the condition precedent to defendant’s obligation to refund plaintiff’s entrance deposit is satisfied. Such broad discretion implies a duty to exercise good faith. Burkhardt, 57 Mich App at 652; Ferrell 137 Mich App at 243.”
The concept of good faith is a common legal standard that applies generally to all contracts under the Uniform Commercial Code Section 1304. This law also states that, “[e]very contract imposes upon each party a duty of good faith and fair dealing in the performance of the contract such that neither party can do anything that will have the effect of destroying or injuring the right of the other party to receive the fruits of the contract.”(1 Witkin Sum. Cal. Law Contracts Sec. 797(a).)
Many residents of CCRCs are dependent on the good faith of the facility to obtain their conditional lump-sum payment. As amended, this bill requires the contract to include a statement that the provider shall make a good faith effort to resell a unit, however it does not define a “good faith effort”, nor does it require a provider to disclose the good faith efforts the facility commits to making.
FISCAL EFFECT: Appropriation: No Fiscal Com.: No Local: No
California Continuing Care Residents Association (source)
California Long Term Care Ombudsman Association
California Advocates for Nursing Home Reform
California Commission on Aging
Cardinal Point Residents Association
Consumer Federation of California
National Association of Social Workers, California Chapter
Eskaton Village, Carmichael Chapter of CALCRA
162 individual residents
American Baptist Home of the West
Atherton Baptist Homes
Atterdag Village of Solvang
be.group
be.royal oaks
California Association of Continuing Care Retirement Communities
Casa de las Campanas
Channing House
Continuing Life
Episcopal Communities & Services
Episcopal Senior Communities
Eskaton
Front Porch Communities and Services
Forest Hill
Fountaingrove Lodge
Fredericka Manor
Grand Lake Gardens Retirement Community
Hillcrest
La Costa Glen, Carlsbad
Lake Park, Community Care Retirement Community
Leading Age
Los Angeles Jewish Home
Meadows of Napa Valley
Monte Cedro
O’Connor Woods
Palm Village Retirement Community
Pilgrim Place
Plymouth Village
Pacific Retirement Services
Rosewood Senior Living
Terraces of Los Gatos
The Canterbury
The Covington
The Tamalpais, Marin
Saratoga Retirement Community
Sierra View Homes
Spring Lake Village
St. John’s Retirement Village, Inc.
Stoneridge Creek Pleasanton
58 individual residents
ARGUMENTS IN SUPPORT: The California Continuing Care Residents Association (CALCRA) writes in support that a number of seniors and their families have waited years to receive their refund payments from CCRCs. CALCRA states that current law leaves families without recourse to demand the return of an entrance fee within a reasonable time and there is no way to ensure that CCRC providers are making a good faith effort to resell these vacant unit.
CALCRA further states that, although the provider is responsible for reselling the unit, there is often no incentive to sell units subject to an entrance fee repayment because the provider has no obligation to pay interest on the outstanding payment. In many cases other vacant units which don’t have a repayment obligation are sold while those awaiting a repayment remain on the market. CALCRA states that this bill protects the investments seniors make in their long-term care and ensures that CCRC providers remain accountable for returning payments within a reasonable time.
ARGUMENTS IN OPPOSITION: Leading Age and the California Association of Continuing Care Retirement Communities (CACCRC), and numerous individual providers, write in opposition that repayment upon resale provisions are a popular contract model for residents, that the incidents identified by the author represent a small minority of the 20,000 existing contracts and that this bill will limit consumer choice for future residents.
Additionally, they write that there are no provisions to stop a “run” on a facility if there were multiple vacancies at one time, and that even a small percentage of move-outs would put the CCRC and all other residents at financial risk.
Leading Age further states that the interest rates provided for in this bill are excessive and could jeopardize the financial stability of communities in the event of another real estate slow-down. Further, both organizations state that the bill could cause providers with debt to default on their bond covenants that stipulate the CCRC’s entrance fee repayment liabilities as a condition of financing and that the bill would likely trigger refund reserve requirements which could cause CCRCs to fail liquidity requirements, deteriorate their credit ratings, and affect their future ability to borrow.
Finally, Leading Age states that because the interest components are applied to existing contracts, instead of only to prospective contracts, the bill unconstitutionally impairs the financial terms of existing contracts.
Prepared by: Sara Rogers / HUMAN S. / (916) 651-1524
5/6/15 16:49:48
**** END ****
SB 475 (Monning) Page 14 of 14
SENATE COMMITTEE ON HUMAN SERVICES
Senator McGuire, Chair
2015 - 2016 Regular
Bill No: SB 475
Author: |
Monning |
||
Version: |
February 26, 2015 |
Hearing Date: |
April 28, 2015 |
Urgency: |
No |
Fiscal: |
No |
Consultant: |
Sara Rogers |
||
Subject: Continuing care contracts: cancellation: payments
SUMMARY
This bill requires that continuing care contracts which condition lump sum contract termination payments on resale of the unit shall instead provide the lump sum payment to the resident, or the resident’s estate, no later than 90 days after the unit is vacated. This bill also provides that any payments not paid to the resident within the 90 day period will be subject to a 10 percent annual interest rate. It prohibits the provider from making further charges for maintenance or housekeeping to the resident, the resident’s estate, or against the lump sum payment on a vacated unit.
ABSTRACT
Existing law:
Provides for the licensure and regulation of Continuing Care Retirement Communities (CCRCs) by the California Department of Social Services (CDSS) to enact minimum requirements to protect the wellbeing and financial security of residents of CCRCs. (HSC 1770 et seq.)
Establishes the Residential Care Facilities for the Elderly Act, which requires CDSS to license and regulate RCFEs as a separate category within the existing community care licensing structure of CDSS. (HSC 1569 et seq.)
Provides for the regulation and licensure of skilled nursing facilities by the California Department of Public Health (CDPH). (HSC 1250 et seq.)
Requires a CCRC provider to hold a certificate of authority from CDSS permitting the provider to contract for the provision of continuing care, including medical care, in which a resident over the age of 60 has paid in advance for more than one year for that care. (HSC 1771.2)
Provides that the components of care provided by the facility must be separately licensed as otherwise required by state law, including Residential Care Facilities for the Elderly and Skilled Nursing care. (HSC 1771.5)
Requires a CCRC to pay refunds owned to a resident within 14 calendar days after a resident makes possession of the living unit available to the provider or 90 calendar days after death or receipt of notice of termination, whichever is later. (HSC 1788.4 (a))
Prohibits characterizing as a refund, a lump sum payment following termination of a continuing care contract that is conditioned upon resale of the unit, and requires the payment to be made within 90 days following resale of the unit. (HSC 1788.4 (e))
This bill:
Provides that a lump sum payment following termination of contract that is conditioned upon resale of the unit be paid in no event later than 90 days after the formerly occupied unit has been vacated.
Provides that payments that are not paid to the resident within the 90 day period will accrue interest at the rate set forth in 685.010 of the Code of Civil Procedure, pertaining to enforcement of judgments, the rate set being 10 percent per annum on the principal amount of a money judgment remaining unsatisfied.
Prohibits a CCRC provider from making further charges to the resident or his or her estate, or against the lump sum payment for purposes of continued monthly payments to the provider, or for maintenance or housekeeping of the vacated unit.
FISCAL IMPACT
This bill has been deemed non-fiscal by legislative counsel.
BACKGROUND AND DISCUSSION
Purpose of the bill:
According to the author, Continuing Care Retirement Community (CCRC) residents and their heirs have experienced long delays in receiving termination of contract payments from CCRC providers after the resident terminates a contract or passes away. The author states that providers often have little incentive the re-occupy a unit that has an outstanding entrance fee in a timely manner, instead preferring to first sell and occupy units that do not have outstanding entrance fees (as in the case of facility expansions). The author additionally states that while the unit is unoccupied, some contracts permit the provider to charge monthly maintenance fees that are deducted from the entrance fees.
Further, the author cites the example of two constituents who claim that a CCRC provider has not repaid two terminations of contract lump sum payments of $250,000 and $562,000 to the estates of the individuals after the apartments failed to sell following the residents death. Additionally, a Sacramento resident writes that one provider continued to charge his father’s estate $4,161 per month in fees after his father passed away while the unit remained unsold. He writes that, while his father’s unit accrued monthly fees to the provider, other units which did not accrue fees were sold first. He writes that this provider is empowered to “drain his father’s estate down to nothing,” with no recourse.
Another individual writes that a CCRC provider refused to provide the 80 percent lump sum termination of contract payment after his aunt’s unit failed to sell for more than two years, despite a desirable ocean view from a high level floor. The individual states that this provider had recently developed a new large tower of units and had failed to provide the older units with any of the updates common when a unit becomes unoccupied (such as new carpets and paint), including his aunt’s, and apparently was directing new sales toward the new tower which required no entrance fee repayments. More than two years later, following extensive letters and complaints, and after reaching out the Attorney General of California, the unit was updated and quickly purchased.
Continuing Care Retirement Contract Model
Continuing care retirement contracts (CCRCs) have been likened to long-term care insurance, with seniors paying large entry fees ranging from $50,000 to more than $2 million, in exchange for access to a range of levels of care services, including independent living, assisted living and skilled nursing care intended to meet the care needs of residents over a specified period of time as they age. There are a wide variety of contractual models available across the state. Some provide for a lump sum termination of contract payment, based on a portion of the entrance fees (typically ranging from 90 and 50 percent) upon the death of the resident. If the resident opts to leave the community, repayment is conditioned upon the resale of the unit. Other models provide for a refund of a portion of the entrance fees, regardless of resale, at percentage rates that decrease the longer the resident remains in the community. Some facilities offer life care contracts through which a facility agrees to care for the resident for the remainder of the resident’s life, regardless of whether the resident outlives his or her financial resources.
In addition to entrance fees, residents pay monthly fees, which may be held constant as the resident ages and needs increase, or may increase as the resident needs increasing levels of care. Such monthly fees range widely from $500 to $9,000 a month for independent living, between $3,000 and $7,000 for assisted living, and upwards from $7,000 to $17,000 per month for skilled nursing.
There are currently 105 facilities certified as CCRCs in California, 75 of which are nonprofit, and frequently operated by religious or philanthropic organizations. Thirty CCRCs are for-profit. There are eight nonprofit multiple-facility providers and one for-profit multiple-facility provider. According to Leading Age, there are more than 20,000 residents of CCRCs in California.
Regulatory Structure
The overall regulatory structure for CCRCs pertains to the financial solvency of the facilities, in consideration of the substantial investments made by residents, which often comprise a resident’s life savings. In addition, CCRCs that operate an independent or assisted living level of care are required to have those facilities licensed by CDSS as Residential Care Facilities for the Elderly (RCFEs). Facilities operating a skilled nursing level of care must have those facilities licensed by the Department of Public Health. Furthermore, CDSS is required to review and approve the overall resident contract used by a facility with each resident, however there are few statutory requirements placed on the content of those contracts. Additionally, CCRCs must file an application for a “Permit to Accept Deposits/Certificate of Authority” with the Continuing Care Contracts Branch of CDSS.
Required Annual Reports
Providers are required to submit an annual report to CDSS describing the facility’s financial condition within four months after their fiscal year end. The reports are required to consist of audited financial statements and required reserve calculations, evidence of fidelity bonds (insuring against dishonest employee conduct) as well as additional information. This includes a certification, if applicable, that reserves for prepaid continuing care contracts, statutory reserves, and refund reserves are being maintained; details on status, description, and amount of all reserves maintained, and on per capita operation costs; disclosure accumulated or expended funds for identified purposes, as specified; details of any increase in monthly care fees, including the basis for determining the increase, and the data used to calculate the increase; the auditor’s opinion as to compliance with applicable statutes, and any other information CDSS may require.
Providers are also required to submit a “Key Indicators Report” disclosing key financial ratios and other key indicators within 30 days following the submission of each annual report. Additionally, CCRCs that have contracts promising to provide care without substantially increasing monthly fees as needs increase must submit an actuarial study to CDSS every five years regarding the actuarial financial position of the facility.
Required Reserves
CCRC providers are required to maintain a liquid reserve for long-term debt obligations that must be equal to the sum of the prior fiscal year payments for the following:
All regular principal and interest payments paid by the provider for fully amortizing long-term debt. If a provider has incurred new long-term debt during the immediately preceding fiscal year, the required reserve is 12 times the provider’s most recent monthly payment on the debt.
Facility rental or leasehold payments, and any related payments such as lease insurance.
Any debt that provides for a balloon payment. If the balloon payment debt was incurred within the immediately preceding fiscal year, the required reserve is 12 times the provider’s most recent monthly payment on the debt.
Additionally, CCRCs are required to maintain a liquid reserve for operating expenses in an amount that equals or exceeds 75 days net operating expenses, as defined.
CCRCs offering a “refundable contract” are required to maintain a reserve for refunds, held in a trust fund. Providers are permitted to invest up 70 percent of the refund reserves in the real estate that is used to provide care and housing for the residents where they reside (limited to 50 percent of the providers’ net equity in the real estate). The required amount of the reserve is calculated using a statutorily established formula based on life expectancy of the residents and the portion of the entry fee that is refundable. Importantly, many providers opt against a refundable contract that requires reserves instead offering a “lump sum payment” that is conditioned upon resale of the unit. The latter model does not require the facility to maintain a reserve, since it is assumed that the financial liability is only incurred once the unit has been resold – it is this model which the author cites as having led to long delays in returning entrance fees.
Disclosure Statements
California statute requires CDSS to issue a disclosure statement form that facilities provide to residents, which includes the following information:
General information such as the provider’s name, address, and telephone number, the type of ownership, names of the continuing care retirement community's owner and operator, the names of any affiliated facilities, and any direct religious affiliation.
Whether the provider is accredited and by what organization.
The year the continuing care retirement community opened and the distance to the nearest shopping center and hospital.
Whether the continuing care retirement community offers life care contracts or continuing care contracts.
The number of the continuing care retirement community's units including size and level of care and whether the facility is single or multi-story.
The continuing care retirement community's percentage occupancy at the provider's most recent fiscal year end.
The form of contracts offered, the range of entrance fees, the percentages of a resident's entrance fees that may be refunded, and the health care benefits included in contract.
A listing of common area amenities and other services included with the monthly service fee, and a listing of those amenities and services that are available for an additional charge.
Specified financial information including income, expenses, cash-flow, information about lenders, debt-to-asset ratio, and other information.
The average monthly service fees charged during the most recent five years, and the percentage changes in the average from year to year.
Provider concerns
Leading Age writes in opposition that repayment upon resale provisions are an important resident protection mechanism in CCRCs, popular with residents, and that this bill would cause financial chaos by putting CCRC residents at risk of losing their investments in the community. Additionally, Leading Age writes that there are no provisions to “stop a run on the bank” if there were multiple vacancies at one time, and that even a small percentage of move-outs would put the CCRC and all other residents at financial risk.
Further, Leading Age writes that the bill would cause providers with debt to default on their bond covenants that stipulate the CCRC’s entrance fee repayment liabilities as a condition of financing. According to Leading Age, the bill would also likely trigger refund reserve requirements which could cause CCRCs to fail liquidity requirements, deteriorate their credit ratings, and affect their future ability to borrow. Finally, Leading Age writes that this bill would have the unintended consequence of effectively eliminating the popular repayable entrance fee option as a choice for CCRC residents.
Related legislation:
AB 261 (Chesbro, Chapter 290, Statutes of 2013) prohibits Residential Care Facilities for the Elderly, including most CCRC providers from requiring advance notice for terminating an admission agreement upon the death of a resident. Additionally provides that no fees shall accrue once all personal property belonging to the deceased is removed from the unit.
AB 1761 (Bloom, Chapter 699, Statutes of 2014) requires CCRC providers to make specified financial statements available to residents on a quarterly basis, rather than semi-annually. Additionally, requires CCRC providers that have governing bodies in the state to include at least one resident, or two residents if the facility has more than 21 members, as voting members of the facility’s governing body.
COMMENTS
As drafted, there is disagreement regarding whether federal contract law permits the provisions of this bill to affect existing contracts. Moreover, if the author seeks to apply the provisions of this bill to the existing 20,000 CCRC contracts, the fiscal implications for facilities that have not budgeted for a mandatory 90-day repayment of entrance fees are substantially different than if the provisions only apply prospectively to new contracts. Staff recommends the bill make clear the author’s intent to apply the provisions of this bill to existing contracts, or to limit the scope to future contracts.
The bill as drafted requires repayment of an entrance fee no later than 90 days after the unit has been vacated, regardless of whether the unit has been re-occupied, which has the practical effect of disallowing contracts where repayments are truly conditioned upon re-occupation of the unit.
Staff notes that consumers may, in a determination of their best interests, wish to enter into such contracts for the purpose of safeguarding their long term care as they age, and that this option for financing long term care may be particularly attractive for middle income Californians not eligible for safety net programs.
Staff further notes that contracts providing for a guaranteed 100 percent repayment within 90 days would imply the need for the facility to establish a reserve account - in order to be financially prepared to make such a payment (or multiple payments) without jeopardizing the fiscal solvency of the facility. This may impose significant financial costs to CCRCs, the majority of which are non-profit organizations. Furthermore, should any repayment obligations apply to existing contracts, this may pose a financial threat to many CCRCs in which many consumers have invested their life savings.
As drafted, the bill first requires that “in no event” shall entrance fee repayments occur later than 90 days, but the next paragraph provides that entrance fee repayments delayed longer than 90 days shall accrue interest payments. Additionally, staff notes, that in setting the interest rates applying to delayed repayments, the bill imposes an interest rate applying to enforcement of judgments – a 10 percent rate that is significantly above market interest rates.
Staff notes that similar instances have been litigated in other states. In one similar case last year in Michigan (Mildred A Steward v Henry Ford Village Inc.), the court stated:
“It appears in any event that defendant [the facility] maintains complete control, under the Agreement, of when and how the unit comes to be re-occupied, and therefore of when and how the condition precedent to defendant’s obligation to refund plaintiff’s entrance deposit is satisfied. Such broad discretion implies a duty to exercise good faith. Burkhardt, 57 Mich App at 652; Ferrell 137 Mich App at 243.”
The concept of good faith is a common legal standard that applies generally to all contracts under the Uniform Commercial Code Section 1304. This law also states that, “[e]very contract imposes upon each party a duty of good faith and fair dealing in the performance of the contract such that neither party can do anything that will have the effect of destroying or injuring the right of the other party to receive the fruits of the contract.” (1 Witkin Sum. Cal. Law Contracts Sec. 797(a).) 1
Many residents of CCRCs are dependent on the good faith of the facility to obtain their conditional lump-sum payment. Staff notes that CDSS may have existing regulatory authority to intervene on behalf of the residents cited by the author, if the facility is not acting to occupy a unit in good faith, or alternatively, the author may wish to consider defining the specific good faith responsibilities of facilities and provide CDSS authority to enforce them.
Staff recommends the author additionally consider adding to the disclosure requirements for facilities to ensure that residents are fully aware of the longest and median length of time that a lump sum payment conditioned upon resale has been delayed in that facility. Additionally, the author may wish to consider amending the marketing and promotional materials requirements that facilities are accountable to in advertising this model of contract.
Staff notes the author has proposed the following amendments in response to the above comments raised by the committee:
Page 2, Line 24-33:
(e) (1) A lump-sum payment to a resident after termination of a continuing care contract
that
is conditioned upon resale of a unit shall not be considered to be a
refund and may not be characterized or advertised as a refund. The
full lump-sum
payment shall be paid to the resident within 14 calendar days after
resale of the unit,
but in no event later than 90 days after the formerly occupied unit
has been vacated.
Contracts signed
after January 1, 2016 shall require that no later than 90 days after
a formerly occupied unit has been vacated, at least 20% of the full
lump-sum payment shall be paid to the resident.
(2) Any
payments
payment
balance
that are
not has
not been paid
to the resident within the
90-day period pursuant to paragraph (1)
90 days
will accrue interest at a rate calculated pursuant to paragraph (3).
Any payment
balance that has not been paid to the resident within 180 days will
accrue interest at a rate calculated pursuant to paragraph
(4).
Interest shall continue to accrue until the date the full lump-sum
payment is paid to the resident. Subparagraph
(2) shall apply to existing and prospective continuing care
contracts.
Page 3, Lines 1-5:
(3) Interest
rates and calculations pursuant to paragraph (2) are identical to
interest rates and calculations set forth in Section 685.010 of the
Code of Civil Procedure. Any
payment balance that is not paid to the resident within the 90-day
period pursuant to paragraph (2) will accrue interest at a rate no
lower than 2.0 percent plus the United States prime lending rate.
(4) Any payments that are not paid to the resident within the 180-day period pursuant to paragraph (2) will accrue interest at a rate no lower than 5.0 percent plus the United States prime lending rate.
Page 3, Lines 10-15:
(g) Once the unit has been vacated and made available to the provider, the provider shall not make any further charges to the resident or his or her estate or charges against the lump-sum payment that is due to the resident for purposes of continued monthly payments to the provider or for maintenance or housekeeping on the vacated unit. This subparagraph shall apply to existing and prospective continuing care contracts.
New Bill Section to Amend Section 1788:
(a) A continuing care contract shall contain all of the following:
(1) The legal name and address of each provider.
(2) The name and address of the continuing care retirement community.
(3) The resident’s name and the identity of the unit the resident will occupy.
(4) If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferor’s name and address shall be specified.
(5) If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
(6) The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
(7) The duration of the continuing care contract.
(8) A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
(A) Regular observation of the resident’s health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
(B) Safe and healthful living accommodations, including housekeeping services and utilities.
(C) Maintenance of house rules for the protection of residents.
(D) A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
(E) Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
(F) Assisted living services.
(G) Assistance with taking medications.
(H) Central storing and distribution of medications.
(I) Arrangements to meet health needs, including arranging transportation.
(9) An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract. The schedule shall state that a provider is prohibited from charging the resident or descendants a monthly fee once a unit has been permanently vacated by the resident.
(10) The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
(A) A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
(i) The resident is nonambulatory. The definition of “nonambulatory,” as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
(ii) The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
(iii) The resident’s condition or needs require the resident’s transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
(iv) The resident’s condition or needs require the resident’s transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
(B) Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
(i) Involve the resident and the resident’s responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the resident’s or responsible person’s request, family members, or the resident’s physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the resident’s responsible person.
(ii) Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the resident’s responsible person, and upon the resident’s or responsible person’s request, family members, and the resident’s health care professionals, to explain the reasons for transfer.
(iii) Notify the resident and the resident’s responsible person of the reasons for the transfer in writing.
(iv) Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
(v) The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the resident’s urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
(vi) The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the resident’s right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the department’s Continuing Care Contracts Branch.
(vii) The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
(C) The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the resident’s responsible person, and upon the resident’s or responsible person’s request, family members, the resident’s physician or other appropriate health care professional, and members of the provider’s interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the resident’s responsible person, or the provider.
(D) For disputed transfer decisions, the resident or the resident’s responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
(E) The decision of the department’s Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
(F) Transfer of a second resident when a shared accommodation arrangement is terminated.
(11) Provisions describing any changes in the resident’s monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771, and that a provider is prohibited from charging the resident or descendants a monthly fee once a unit has been permanently vacated by the resident.
(12) The provider’s continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
(13) The provider’s obligations, if any, to resume care upon the resident’s return after a transfer from the continuing care retirement community.
(14) The provider’s obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
(15) The conditions under which the resident must permanently release his or her living unit.
(16) If real or personal properties are transferred in lieu of cash, a statement specifying each item’s value at the time of transfer, and how the value was ascertained.
(A) An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
(B) When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
(C) The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
(17) The amount of the entrance fee.
(18) In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
(19) The amount of any processing fee.
(20) The amount of any monthly care fee.
(21) For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
(A) A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
(B) The regular rate of payment agreed upon (per day, week, or month).
(C) A provision specifying whether payment will be made in advance or after services have been provided.
(D) A provision specifying the provider will adjust monthly care fees for the resident’s support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
(E) A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
(F) A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
(G) A statement that the provider is prohibited from charging the resident or descendants a monthly fee once a unit has been permanently vacated by the resident.
(22) All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
(A) For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
(i) Fees shall not be subject to change during the lifetime of the agreement.
(ii) Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
(iii) Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
(B) For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
(23) A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the resident’s monthly care fees or in the price or scope of any component of care or other services.
(24) A provision indicating whether the resident’s rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
(25) If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
(26) Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
(27) A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: “You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right.”
(28) Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days’ written notice by the provider without cause, or that the provider waives this right.
(29) The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
(30) A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
(A) Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for “just cause,” “good cause,” or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes “just cause,” “good cause,” or otherwise activates the termination provision:
(i) Filing or lodging a formal complaint with the department or other appropriate authority.
(ii) Participation in an organization or affiliation of residents, or other similar lawful activity.
(B) The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents’ organization or association.
(C) Nothing in this paragraph diminishes the provider’s ability to terminate the continuing care contract for good and sufficient cause.
(31) A statement that at least 90 days’ written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
(32) A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
(33) The policy or terms for refunding or repaying a lump-sum of any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund or repaying a lump-sum of of all or a part of the entrance fee shall also do all of the following:
(A) Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the resident’s unit.
(B) State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
(i) Amortize the specified amount at the same rate as the resident’s entrance fee.
(ii) Refund the unamortized balance to the resident at the same time the provider pays the resident’s entrance fee refund.
(C) State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
(D) State the provider shall make a good faith effort to reoccupy or resell a unit for which a lump-sum payment is conditioned upon resale of the unit. No later than July 1, 2016, a provider shall provide notice to all current residents with contracts applicable to this subparagraph regarding the above statement as a clarification of the resident’s existing contract.
With regard to one individual referenced by the author, who was charged $4,161 a month against his deceased father’s estate for an indefinite amount of time pending resale of the unit, staff notes that existing law pursuant to AB 261 (Chesbro, Chapter 290, Statutes of 2013) prohibits RCFE’s from assessing monthly fees once all personal property belonging to a deceased resident is removed from the unit.
However, the bill exempted RCFE’s operated by CCRCs, which is inconsistent with the provisions of this bill. Staff recommends the author consider amending HSC 1569.652 to eliminate the exemption provided to continuing care equity projects.
POSITIONS
Support:
Cardinal Point Residents Association
Consumer Federation of California
National Association of Social Workers, California Chapter
Eskaton Village, Carmichael Chapter of CALCRA
162 individulas
Opposition:
American Baptist Home of the West
Atherton Baptist Homes
Atterdag Village of Solvang
be.group
be.royal oaks
California Association of Continuing Care Retirement Communities
Casa de las Campanas
Channing House
Continuing Life
Episcopal Communities & Services
Episcopal Senior Communities
Eskaton
Front Porch Communities and Services
Forest Hill
Fountaingrove Lodge
Grand Lake Gardens Retirement Community
Hillcrest
La Costa Glen, Carlsbad
Lake Park, Community Care Retirement Community
Leading Age
Meadows of Napa valley
O’Connor Woods
Palm Village Retirement Community
Plymouth Village
Pacific Retirement Services
Rosewood Senior Living
Terraces of Los Gatos
The Tamalpais, Marin
Saratoga Retirement Community
Sierra View Homes
Spring Lake Village
St. John’s Retirement Village, Inc.
Stoneridge Creek Pleasanton
58 individuals
-- END –
1 Senate Judiciary Committee
Discussed in Hearing
Senate Floor
Assembly Floor
Assembly Floor
Assembly Floor
Assembly Standing Committee on Appropriations
Assembly Standing Committee on Human Services
Senate Floor
Bill Author
Bill Co-Author(s):