Section 900.1 - Definitions

Section 900.1 Definitions. For purposes of this Part, unless the context indicates otherwise, the following definitions shall apply:

(a) Adult care facility shall mean an adult home or an enriched housing program established pursuant to Article 7 of the Social Services Law which provides long-term residential care and services to adults who, though not requiring continual medical and nursing care as provided by facilities licensed or operated pursuant to article 28 of the Public Health Law or articles 19, 23, 29 and 31 of the Mental Hygiene Law, are, by reason of physical or other limitations associated with age, physical or mental disabilities or other factors, unable or substantially unable to live independently.

(b) Application fee shall mean a sum of money other than an entrance fee deposit or entrance fee collected from an individual upon application for admission to the community.

(c) Board shall mean the provision of meals consisting of food and drink appropriate for the physical needs and medical conditions of residents, including the provision of therapeutic diets appropriate for the individual resident.

(d) Certificate or certificate of authority shall mean an authorization in writing, approved by the Life Care Community Council and issued by the Commissioner of Health, for an operator to operate a life care community and to enter into life care contracts pertaining to such community.

(e) Commissioner shall mean the Commissioner of Health.

(f) Contracts or agreements shall mean life care contracts as defined in this section.

(g) Controlling person shall mean a person who, either directly or indirectly, or through one or more intermediaries, possesses the ability to direct or cause the direction of the actions, management or policies of a person, whether through the ownership of voting securities or voting rights, by contract (except a commercial contract for goods or non-management services) or otherwise; but no person shall be deemed to control another person solely by reason of his or her being a corporate officer or director of such other person (providing such officer or director is not acting in concert with others to represent another corporation). Control shall be presumed to exist if any person, directly or indirectly, owns, controls or holds with the power to vote ten percent or more of the voting securities or voting rights of any other person or is a member of a not-for-profit corporation which member is other than a natural person.

(h) Council shall mean the Life Care Community Council, established pursuant to Section 4602 of Article 46 of the Public Health Law.

(i) Entrance fee shall mean an initial or deferred transfer to an operator, as defined in this section, of a sum of money, made or promised to be made by an individual or individuals entering into a life care contract, for the purpose of ensuring services pursuant to such a contract.

(j) Facility shall mean any place in which an operator provides a resident with the services of a life care community, pursuant to a contract, whether such place is constructed, owned, leased, rented or otherwise contracted for by the operator.

(k) Home health care shall mean services and items provided to residents of the community in other than nursing home beds, either directly or through a contract arrangement. Such services shall be provided under a plan established and periodically reviewed by a physician and shall include, but not be limited to, part-time or intermittent nursing care by or under the supervision of a registered professional nurse (R.N.), physical therapy, occupational therapy, speech-language pathology, medical social services, medical supplies, equipment and appliances and home health aide services.

(l) Life care contract shall mean a single contract to provide an individual, for the duration of such individual's life, the services provided by the life care community. Payment for services provided under the life care contract can be made:

(1) fully through the entrance fee and monthly fees; or

(2) through the entrance fee, monthly fees and under an arrangement in which the costs of the resident's nursing facility and/or home health care services are paid for in whole or in part by long term care insurance or medical assistance payments in accordance with the Long Term Care Security Program for Long Term Care pursuant to section 367-f of the Social Services Law, section 3229 of the Insurance Law and section 4623 of the Public Health Law.

(m) Life care community or community shall mean a facility or facilities established to provide, pursuant to a life care contract, a comprehensive, cohesive living arrangement for the elderly, oriented to the enhancement of the quality of life and which at a minimum:

(1) provides independent living units;

(2) provides board including the availability of three meals per day, payment for which is subject to the terms specified in the life care contract; (3) provides a range of health care and social services, subject to such terms as may be included within the contract which shall include, but not be limited to home health care, nursing care, and the services of an on-site or affiliated nursing home;

(4) provides access to specialized rehabilitative services such as physical therapy, occupational therapy, speech-language pathology and audiology;

(5) provides access to physician services; and

(6) provides access to prescription drugs.

(n) Life care, health care and/or adult care operation shall mean:

(1) any community which requires or would require, if located in New York State, approval by the Life Care Community Council;

(2) any facility or program which requires or would require if located in New York State, establishment approval by the Public Health Council; or

(3) any facility or program which requires or would require if located in New York State, approval by the New York State Department of Social Services, the New York State Office of Mental Health or the New York State Office of Mental Retardation and Developmental Disabilities.

(o) Living unit or independent living unit shall mean an apartment, room, cottage, or other area within a community set aside for the exclusive use of one or more residents exclusive of a room in the nursing home, adult care facility or other specialized unit within the community.

(p) Monthly care fee shall mean the monthly cost to a resident for the prepayment of any services, including rent, rendered pursuant to a contract, exclusive of entrance fees or other prepayments, and any other regular periodic charges to the resident, determined on a monthly basis, pursuant to the provisions of a contract.

(q) Nursing home, also referred to in this Part and Part 901 as a residential health care facility or nursing facility, shall mean a facility, institution, or portion thereof subject to Article 28 of the New York State Public Health Law, providing therein, lodging for twenty-four or more consecutive hours to three or more nursing home residents who are not related to the operator by marriage or by blood within the third degree of cosanguinity, who need regular nursing services or other professional services but who shall not need the services of a general hospital.

(r) Operator shall mean a legal entity operating a life care community pursuant to a certificate of authority.

(s) Parent corporation means a corporation which, directly or indirectly, or through one or more intermediaries, possesses the ability to direct or cause the direction of the actions, management or policies of any partnership or corporation which is applying for approval to operate or which already operates a life care community.

(t) Person shall mean an individual, corporation, governmental subdivision or other legal entity, including a joint venture or any combination of the foregoing acting in concert.

(u) Principal stockholder means any person or organization that owns, holds or has the power to vote ten percent or more of the issued and outstanding voting shares of stock of a corporation.

(v) Qualified consulting actuary shall mean an individual who either:

(1) is a member of the American Academy of Actuaries and has, based on the Academy's qualification standards, the necessary, training and experience pertaining to life care communities; or

(2) demonstrates to the satisfaction of the Superintendent that based on his/her knowledge, training and experience that he/she has the necessary knowledge pertaining to life care communities.

(w) Resident shall mean any individual who, pursuant to a contract, is entitled to reside in and receive services from a life care community.

(x) Social services shall mean those services which may include, but not be limited to counseling, case management, and information and referral.

(y) Superintendent shall mean the Superintendent of Insurance.
 

Effective Date: 
Wednesday, July 27, 1994
Doc Status: 
Complete