PA 08-36—SB 665

Human Services Committee

AN ACT CONCERNING CONTINUING CARE FACILITIES AND CONTINUING CARE AT HOME

SUMMARY: This act allows continuing care retirement communities (CCRCs) to provide care to individuals in their own homes if these individuals are given future access to facility care. Prior law allowed a CCRC to provide shelter and medical services only to their residents.

EFFECTIVE DATE: October 1, 2008

1 — DEFINITIONS

The act amends the definition of “continuing-care contract” to allow these agreements to include the provision of care in an individual's home if the individual can receive future access to services and shelter in the CCRC facility. Prior law required a contract to provide shelter and health care services and benefits to an individual in a CCRC facility for at least one year. In exchange, a resident agreed to transfer assets, or pay an entrance fee or periodic charges.

The act does not define the term “care. ” It appears to mean those services and benefits outside the scope of “medical or nursing services or other-health related benefits” which the law defines as nursing facility services, priority admission to a nursing facility, home health care, or assistance with activities of daily living to which a resident is contractually entitled. The act also extends the provision of “care” to individuals living in CCRCs.

The act also amends the definition of a continuing care “provider” to include home care if the recipient can receive future access to services and housing in the CCRC facility. Prior law required providers to administer shelter and medical services only to residents at licensed CCRCs.

5 — NONRESIDENT NURSING HOME PATIENTS

The act removes the limit on the number of extensions the facility may request from the Department of Social Services (DSS) to admit nonresident patients. Prior law allowed facilities to accept nonresident patients for seven years after opening, plus one three-year extension. A facility may accept nonresidents into its nursing home only if (1) it is medically appropriate, (2) the facility applies the same financial eligibility criteria to potential nonresidents that is applied to residents, and (3) the facility annually screens each nonresident to determine whether the patient has sufficient resources to cover at least 42 months of nursing home care.

2 — DISCLOSURE REQUIREMENTS

By law, providers must submit extensive written disclosure statements to prospective residents before entering into a contract or accepting a resident's money or property. These disclosure requirements include the provider's contact information and business experience; any criminal or legal offenses and license suspensions or revocations; all goods and services provided; conditions for contract termination; a description of the facility, including any proposed expansions; and all entrance fees and charges, including a description of past increases over the previous seven years (CGS 17b-522).

The act exempts a provider under contract to provide in-home services from two disclosure requirements: (1) how it will dispose of a resident's personal property if the person dies or transfers to a nursing facility or the provider terminates the contract and (2) financial information for a facility that has not begun operating or is being built in stages.

3 —CONTRACT REQUIREMENTS

Additional Requirements

The act requires continuing care contracts for the provision of in-home services to specify the circumstances in which a resident can still receive services at home with the right to future access to facility care if the resident experiences financial difficulties.

It also requires a CCRC to (1) terminate the contract of an individual who dies before beginning to receive services at home and (2) refund any money or property it received from the deceased to the individual's representative. Prior law required this for a resident unable to initially move into a CCRC due to illness, injury, or death.

Exemptions

The act specifies that contracts providing only in-home services do not have to comply with the requirement that:

1. if construction of the facility has not begun, that the contract will not start until (a) at least half the units have been presold and (b) the developer has received a deposit of 5% of the entrance fee, or $ 10,000 for each presold unit, whichever is less; and

2. if a resident's contract is terminated because the resident fails to initially move into a facility due to illness, injury, or death and the unit was actually available for occupancy, the facility may charge its usual per diem charge for the living unit for the period running from seven days after the contract was executed until the end of the month the contract was terminated.

4 — ENTRANCE FEE ESCROW ACCOUNT

The act exempts contracts to provide in-home services from the law that requires a continuing care facility to set up an escrow account for entrance fees to protect a resident's money in the event that the facility is under construction or the living unit is not ready for occupancy. The fee must be returned to the prospective resident or the resident's representative if the resident exercises his or her right to rescind the contract.

BACKGROUND

Continuing Care Retirement Communities

A CCRC provides elderly people (although there is a no legal age requirement for residency) with a lifetime “continuum of care. ” Residents must usually pay a one-time entry fee, which is often $100,000 or more, and continuing monthly payments, often ranging between $1,000 and $3,000. Thus, people must have considerable assets to live in a CCRC. They usually obtain the entry fee by selling their houses.

At first, the senior lives independently in an apartment and later, when he or she becomes more frail, can receive assisted living services in it or move into an assisted living unit. CCRCs often have small nursing homes on their premises or contract with a nearby nursing home for residents who ultimately need 24-hour nursing care. They also provide some common meals; have common spaces for leisure and recreation programs; and provide housekeeping, laundry, and transportation services. CCRCs must register with DSS and are subject to its regulation.

OLR Tracking: NDSC: PF: dw