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Title: Section 900.4 - Requirements for approval

Effective Date

07/27/1994

900.4 Requirements for approval. (a) The application must be complete and in proper form. It shall provide all the information essential for the Life Care Community Council's consideration.

(b) The council shall not act upon an application for a certificate of authority unless all approvals and consents required by law have been obtained including:

(1) approval by the Superintendent of Insurance as to:

(i) the actuarial principles involved;

(ii) the financial feasibility of the facility;

(iii) the form and content of the proposed life care contract between the community and its residents;

(iv) the form and content of any agreements between the community and licensed insurers requiring the insurers to assume, wholly or in part, the cost of medical or health related services to be provided pursuant to the life care contract; and

(v) the rates and rating system, if any, including detailed formula or formulas to be applied by the operator in the calculation of future entrance fees and monthly care fees;

(2) approval by the Commissioner of Social Services of those components of the application pertaining to adult care facility beds, if any;

(3) approval by the Public Health Council as to the establishment of a nursing home or other facilities and services which require the Public Health Council's approval e.g., diagnostic and treatment center, certified home health agency or licensed home care services agency; and

(4) approval by the commissioner as to the construction of a nursing home or other facilities and services which require the commissioner's approval e.g., diagnostic and treatment center, certified home health agency or licensed home care services agency.

(c) The applicant must satisfactorily demonstrate to the council:

(1) that the proposed community will meet a need and will fulfill the purposes of Article 46 of the Public Health Law;

(2) that the applicant has satisfied all of the requirements of Article 46 of the Public Health Law and this part;

(3) that the controlling person of the applicant, the manager, the sole proprietor applicant, general partners of a partnership applicant and the officers and the members of the board of directors of a corporate applicant, management corporation or parent corporation are of such character, experience, competence and standing in the community as to give reasonable assurance of their ability to conduct the affairs of the community in the best interests of the community and in the public interest and to provide proper care for those to be served by the community;

(4) in the case of a public or government agency, that the governing authority of the governmental subdivision applying to operate the life care community has provided reasonable assurance of its ability to conduct the affairs of the life care community in the best interests of the community and in the public interest, and to provide proper care for those to be served by the community; and

(5) that the applicant has the capability to organize, market, manage, promote and operate the community in a financially feasible and capable manner and its ability to meet its obligations pursuant to Article 46 of the Public Health Law; and

(6) the applicant has demonstrated that the combined total number of beds for the nursing facility component and the adult care facility component, if any, is reasonably related to the number of independent living units proposed for the community.

(d) In conducting a character and competence review, the council shall, as applicable, evaluate any controlling persons of the applicant, any sole proprietor applicant, any general partners of a partnership application and any officers and members of the board of directors of a corporate applicant, corporate general partner, parent corporation and in the case of a governmental subdivision as the applicant, the governmental subdivision and the governing body thereof as a whole rather than the individual elected or appointed members thereof, by:

(1) reviewing the findings of inspection reports, resident care reviews, complaint investigations and any other pertinent information relating to the operation of any life care, health care and/or adult care operation located in New York or elsewhere with which the individual has been affiliated as a controlling person, sole proprietor, general partner or governmental operator during the past ten years;

(2) reviewing whether such individual, partnership, corporation, other organization or governmental subdivision exercised supervisory responsibility of the life care, health care and/or adult care operation to assure a consistent pattern of compliance with applicable standards and to prevent conditions which could result in harm to the health, safety or welfare of the residents; (3) determining that, if a violation of applicable standards did occur, that the individual, partnership, corporation, other organization or governmental subdivision implemented an acceptable plan of correction; and

(4) with respect to a manager who will be responsible for the day-to-day operations of the proposed community, the information required pursuant to this subdivision for any life care, health care, and/or adult care operation for which the manager was responsible under a management contract;

(5) considering such other pertinent matters relating to the character, competence and standing in the community of the applicant.

(e) The department may request any additional information required by the council or any of the reviewing agencies. Such information shall be provided to the department within thirty days of the request, unless an extension has been granted. Any request for such extension of time shall set forth the reasons why such information could not be obtained within the prescribed time. The granting of such extension of time shall be at the discretion of the commissioner, provided such extensions are not for more than thirty days and the commissioner is satisfied as to the reasons why such information could be not obtained within the prescribed time. Failure to provide such information within the time prescribed shall constitute an abandonment and withdrawal of the application by the applicant. The commissioner is authorized to deny a request for an extension of time.

(f) The applicant must also supply any authorization the Commissioner requests in order to verify any information contained in the application or to obtain additional information which the Commissioner finds is pertinent to the application. Failure to provide such authorization shall constitute an abandonment and withdrawal of the application.

(g) The council shall have sixty days from the date of the last approvals required under subdivision (b) of this section to either approve or disapprove the application.
 

Volume

VOLUME E (Title 10)

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