Revision: Dec. 10, 2009, midnight
HB 1363 – AS INTRODUCED
2010 SESSION
01/10
HOUSE BILL 1363
AN ACT relative to continuing care communities.
SPONSORS: Rep. Hammond, Hills 3
COMMITTEE: Health, Human Services and Elderly Affairs
This bill clarifies the law regulating continuing care communities when a person has not yet moved into the facility, but is receiving continuing care services at home.
This bill is a request of the insurance department.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
10-2400
01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Ten
AN ACT relative to continuing care communities.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Continuing Care Communities; Definitions. Amend RSA 420-D:1, III to read as follows:
III. “Continuing care” or “life care” means furnishing to a person, other than one who is related by consanguinity or affinity up to, but not including, the third degree, services provided in the person’s home or in the facility that shall include board or lodging, or both, and may include nursing services, medical services, or other health related services, irrespective of whether the lodging and services are provided at the same location or provided by a third party, pursuant to a contractual agreement extending for the life of such person or for a period of a year or more in consideration of payment of an entrance fee which may also include additional periodic charges for the services provided and including contracts which are terminable by either party.
2 Continuing Care Communities; Definitions. Amend RSA 420-D:1, V to read as follows:
V. “Entrance fee,” “entrance deposit,” or “accommodation fee” means an initial or deferred payment, agreed upon in the contract, of a sum, usually a lump sum, in cash or in kind, to a provider in return for acceptance as a resident [in a facility]. This definition shall not apply to the payment of a sum which is less than the total of periodic payments, as defined in paragraph X of this section, for one year or $10,000.
3 Continuing Care Communities; Definitions. Amend RSA 420-D:1, X-XII to read as follows:
X. “Periodic payments” or “monthly care fees” means those payments in addition to the entrance fee [and] made by a resident to a provider for continuing care during the entire period [of residence in a facility] that the contractual agreement for continuing care is in effect.
XI. “Provider” means a person contracting to provide continuing care at the resident’s home or at a facility. This may be a natural person, partnership, or any other type of business organization, whether organized for profit or not.
XII. “Resident” means a person entitled, pursuant to a contract with the provider, to receive continuing care in [a] the person’s home or facility.
4 Continuing Care Communities; Definitions. Amend RSA 420-D:1, XIV(a) to read as follows:
XIV.(a) “Unearned portion of entrance fee” means that portion of the entrance fee which a provider contracts to return to a resident should the resident [decide to leave a facility] cancel the contract for continuing care. This may be nothing, or the contract may call for the provider to “earn” a specific percentage of the entrance fee per month.
5 New Paragraph; Certificate of Authority Required. Amend RSA 420-D:2 by inserting after paragraph III the following new paragraph:
IV. A provider may contract to provide continuing care to a resident who remains at home and has not moved into a living unit or other room or area within the facility, provided the provider:
(a) Holds a certificate of authority under this chapter and is in good standing, not subject to action by the commissioner pursuant to RSA 420-D:5.
(b) Has direct control and oversight over the provision of services to the resident in the resident’s own home and does not delegate this control and oversight to any third party. Any person employed by the provider to assist the provider in providing control or oversight over provision of services in the resident’s home shall be physically present in the state and available to the resident to address any questions or concerns.
(c) Has procedures in place to ensure that any third party that contracts with the provider to provide services to the resident in the resident’s home is trustworthy and certified, licensed, or otherwise qualified under state law to provide those services.
(d) Provides information satisfactory to the commissioner that any contract to provide continuing care services in the resident’s home will not place the provider in an unsound financial condition and will not be injurious or hazardous to the resident receiving services at home.
6 Continuing Care Communities; Entrance Fee Escrow Account. Amend RSA 420-D:10, I to read as follows:
I. An escrow account for entrance fees shall be established and approved by the commissioner before a certificate of authority under this chapter shall be issued. Entrance fees from any prospective resident paid by the prospective [residents] resident before occupancy of a facility living unit [and which total], or if services are provided in the resident’s home, before the resident begins to receive services under the contractual agreement, and totaling over $1,000 shall be placed in this account. All entrance fees subject to this section shall be placed in the account on the first working day after receipt. Interest on such fees shall be paid at the current market rate as established by the commissioner to the prospective resident if the resident is not allowed by the provider, for any reason, to enter the facility.
7 New Subparagraph; Entrance Fees. Amend RSA 420-D:10, III by inserting after subparagraph (b) the following new subparagraph:
(c) If the resident does not move into a living unit or other area within the facility but receives services at home, when the resident is eligible to receive or begin to receive services under the contractual agreement.
8 Continuing Care Communities; Contracts With Residents. Amend RSA 420-D:12, I to read as follows:
I. Each contract between a provider and a resident shall:
(a) Be written in plain, non-technical language.
(b) Cover only one resident, or 2 if sharing the same unit, and shall include the total amount transferred by the resident, or on behalf of the resident, to the provider. If securities or real or personal property are transferred to the provider instead of cash, the provider shall describe exactly the securities, property, or other goods transferred and the market value of securities or the professional appraised value of property or goods as of the date they were tendered.
(c) State specifically and in full detail all services and items to be provided to the resident including the locations where services and items will be provided, the duration of such services, and how often they are to be provided. The contract shall also describe which services or items are included in the agreement for continuing care and which services or items will be made available by the provider at an extra cost to the resident.
(d) State the conditions upon which the provider may evict a resident and the conditions upon which a resident may terminate his or her residency. A statement as to what portion of the entrance fee shall be returned under each condition shall also be included in accordance with RSA 420-D:12, II.
(e) State the conditions upon which the provider or resident may terminate the contractual agreement. A statement as to what portion of the entrance fee shall be returned and under what conditions shall also be included in accordance with RSA 420-D:12, II.
[(e)] (f) Describe conditions required for a person to continue as a resident.
[(f)] (g) Describe any conditions under which a person delinquent in his or her periodic payments may remain and if there is a specific time limit.
[(g)] (h) State the entrance fees and periodic payment changes that may occur if a resident marries or if a spouse joins a resident in a living unit. It shall also state the fee changes that may occur if either one of the 2 people who occupy the same living unit dies or otherwise leaves that living unit.
[(h)] (i) Describe the terms and conditions under which a provider or a resident may cancel an agreement for continuing care. The contract shall also state that a minimum of 30 days’ notice of cancellation must be given, except that a written medical finding by 2 doctors that a resident is a danger to himself or others shall require only reasonable notice.
[(i)] (j) Describe in clear detail all the terms under which a contract is cancelled upon the departure or death of a resident.
[(j)] (k) State the basis upon which the entrance fees are earned by the provider at the death of a resident, what portion, if any, shall be turned over to the estate of the resident, and the formula for calculating all amounts earned by the provider.
[(k)] (l) Describe the conditions under which periodic payments may change. The contract shall state that a 60-day notice is required before a change in periodic payments shall take effect, except those periodic payments required by federal or state assistance programs.
[(l)] (m) State that periodic payments for care paid in a lump sum shall not be changed during the period covered, unless the resident is receiving federal or state assistance and the change is mandated by those programs.
[(m)] (n) Provide a period of 10 days during which a prospective resident may cancel a contract and have his or her deposit returned and that there is no requirement to move in during those 10 days.
[(n)] (o) Provide that, within the 10 days under subparagraph [(m)] (n), the provider shall make a full refund of all money, securities, goods, or property tendered by the prospective resident, except for any non-refundable initial application fee that does not exceed one month’s periodic charges and any payments for actual services or goods provided to the prospective resident.
[(o)] (p) Describe under what conditions a resident may be transferred to another living unit or another part of the facility together with the financial adjustments to be made as a result of such changes.
[(p)] (q) Provide for full refund, except any initial non-refundable application fee of less than one month’s periodic payment, if, before occupancy, death occurs or if there is a medically certified incapacity to move in.
9 Effective Date. This act shall take effect January 1, 2011.