CONTINUING CARE RETIREMENT COMMUNITIES ACT.-AB

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View NCGA Bill Details2023-2024 Session
House Bill 170 (Public) Filed Wednesday, February 22, 2023
AN ACT TO ENACT THE CONTINUING CARE RETIREMENT COMMUNITIES ACT, AS RECOMMENDED BY THE DEPARTMENT OF INSURANCE.
Intro. by Setzer, Humphrey.

Status: Re-ref to the Com on Insurance, if favorable, Rules, Calendar, and Operations of the House (House action) (Mar 13 2023)
H 170

Bill Summaries:

  • Summary date: Feb 22 2023 - View Summary

    Identical to S 145, filed 2/22/23. 

    Repeals Article 64, Continuing Care Retirement Communities, of GS Chapter 58. Instead, enacts new Article 64A, Continuing Care Retirement Communities, which provides as follows.

    Part 1.

    States the NCGA’s intent to promote the dignity and protect the health, safety, and welfare of older NC citizens by (1) encouraging the development of continuing care retirement communities and (2) requiring providers offering or providing continuing care in the State to be licensed and to be monitored and regulated by the North Carolina Department of Insurance (Department) under this new Article. Specifies that the Article applies to for-profit and non-profit providers.

    Sets out and defines 63 terms as they are used in the Article. Defines a continuing care retirement community as a retirement community consisting of one or more structures where a provider renders or will render some or all services promised in a continuing care or continuing care without lodging contract, whether or not the structures and land that make up the community are constructed, owned, leased, rented, managed, or otherwise contracted for by the provider. Provides that a continuing care retirement community may include one or more structures on a primary or contiguous site or an immediately accessible site. Excludes from the term, a person's personal residence if the residence is not a living unit provided by the provider. Allows a distinct phase of development approved by the Commissioner of Insurance (Commissioner) to be considered to be the continuing care retirement community when a project is being developed in successive distinct phases over a period of time. Specifies that “continuing care retirement community” and “life plan community” are the same thing. Defines provider as a person that offers or undertakes to provide continuing care under a continuing care or continuing care without lodging contract, or that represents themselves as providing continuing care. Defines continuing care as rendering to an individual other than an individual related by blood, marriage, or adoption to the person rendering the care housing in an independent living unit, together with related services, including access, when needed, to progressive levels of health care, including either assisted living care or nursing care, or both, regardless of whether the health care is provided at the continuing care retirement community where the individual resides or another location or through a contractual relationship with a third party, pursuant to a contract effective for the life of the individual or for a period longer than one year. Defines continuing care without lodging  as a program offered by a licensed provider that provides continuing care to an individual who is not yet receiving housing, including programs that offer an individual an opportunity to move to an independent living unit at a future date, if desired, according to the provider's established priority and admissions policies at the continuing care retirement community sponsoring the continuing care without lodging program.

    Allows the Commissioner to adopt rules to implement the Article.

    Prohibits a provider from paying a dividend or other distribution of equity or net assets after the Commissioner has determined that the provider is in a hazardous condition or has been determined to not be in satisfactory actuarial balance in an actuarial study filed with the Commission, or when the payment would have the effect of creating a hazardous condition in the provider or cause the provider to not be in satisfactory actuarial balance.

    Requires a person to have a certification, license, permit, or other approval from the Commissioner before offering or providing continuing care in this State. Sets out eight acts that are considered to be engaging in the business of offering or providing continuing care, including accepting any deposit or any other payment related to continuing care; entering into any non-binding or binding reservation agreement, continuing care contract, or continuing care without lodging contract; commencing construction or converting an existing building for a continuing care retirement community; and expanding the number of independent living units at a continuing care retirement community in an amount equal to or in excess of 20% of existing independent living units.

    Prohibits a provider who intends to collect or does collect entrance fees from leasing land or real property from another person if the land or property is to be used as a material part of a continuing care retirement community operated by the provider without first obtaining approval from the Commissioner. Entrance fees are defined as the sum of any initial, amortized, or deferred transfer of consideration made or promised by, or on behalf of, an individual entering into a continuing care or continuing care without lodging contract. Sets out the factors that the Commissioner must consider when deciding whether to allow an applicant or provider to lease any of the real property of a continuing care retirement community.

    Requires all filings required under the Article by applicants and providers to be submitted electronically.

    Allows the Commissioner to waive or modify the Article’s provisions if there is a state of emergency or disaster; there is an incident beyond a provider’s reasonable control that substantially affects the daily business operations of the provider or continuing care retirement community; or there is a sound actuarial, accounting, business principles, or other reasonable reason that does not diminish the Article’s protections. Prohibits any waiver or modification that results in a greater regulator burden, unless agreed to in writing by the applicant or provider.

    Specifies contracts, leases, notices, approvals, studies, and other documents that are confidential and privileged and are not considered public record and are not subject to subpoena or discovery or admissible as evidence in civil actions. Allows the Commissioner to use the same documents and information in furtherance of any regulatory or legal action brought as a part of the Commissioner’s official duties. Sets out the steps the Commissioner must take before making those items public. Requires any information shared with the Commissioner that is not covered under these provisions but a person believes to be confidential or a trade secret to make it as such before submission to the Commissioner. Sets out provisions governing when the Commissioner may (1) share information, including confidential and privileged documents, with regulatory agencies or law enforcement or (2) receive information, including confidential and privileged items, from regulatory and law enforcement officials of other foreign or domestic jurisdictions and how those documents must be treated.

    Prohibits providers from advertising a continuing care retirement community if the ad includes a statement or representation which materially conflicts with the disclosures required under this Article or materially conflicts with any continuing care or continuing care without lodging contract offered by the provider.

    Part 2.

    Requires a permit to accept deposits in order to market a proposed continuing care retirement community to measure its viability. Sets out the process for submitting the application to the Commissioner. Sets out the timeline within which the Commissioner must respond to the application. Sets out the conditions that must be met in order to approve the application. Allows the applicant, after having been issued a permit, to: (1) disseminate materials describing the intent to develop a continuing care retirement community; (2) enter into non-binding reservation agreements; and (3) collect deposits in an amount not to exceed $5,000, to be placed in escrow and released on in accordance with Part 4 of this Article. Providers that have been issued a permit are required to filed periodic status reports.

    Allows a person to apply for a start-up certificate by submitting the required information and paying a $2,00 application fee. Sets out the timeline within which the Commissioner must respond to the application. Sets out the conditions that must be met in order to approve the application. Once the certificate has been issued, requires the Commissioner to: (1) require the provider to submit periodic sales, development, and financial reports and (2) post the disclosure statement of the continuing care retirement community on the Department’s website. Allows the applicant, after having been issued the certificate, to: (1) enter into binding reservation agreements and continuing care contracts; (2) accept entrance fees and deposits greater than $5,000, to be placed in escrow and only released in accordance with Part 4 of this Article; (3) begin site preparation work; and (4) construct model independent living units for marketing.

    Allows a person to apply for a preliminary certificate by submitting the required information. Sets out the timeline within which the Commissioner must respond to the application. Sets out the conditions that must be met in order to approve the application. Once the certificate has been issued, requires the Commissioner to: (1) require the provider to submit periodic sales, development, and financial reports and (2) post the disclosure statement of the continuing care retirement community on the Department’s website. Allows the applicant, after having been issued the certificate, to: (1) construct a continuing care retirement community and (2) convert existing structure(s) into a continuing care retirement community.

    Allows a person to apply for a permanent license by submitting the required information. Sets out the timeline within which the Commissioner must respond to the application. Sets out the conditions that must be met in order to approve the application. Allows for the issuance of a restricted license. Once the license has been issued, requires the Commissioner to: (1) require the provider to submit periodic occupancy and financial statements and (2) post the disclosure statement of the continuing care retirement community on the Department’s website. Allows the applicant, after having been issued a permanent license, to: (1) open the continuing care retirement community and (2) provide continuing care. Allows applicants that receive a restricted permanent license to operate a continuing care retirement community under restrictions established by the Commissioner until the Commissioner issues a permanent license. Provides that when a restricted license is issued, the provider must inform all depositors and residents within 10 business days of all restrictions imposed by the license and conditions that the provider must satisfy to qualify for a permanent license.

    Sets the duration of a permit to accept deposits and a start-up certificate at 36 months. Allows a person with a permit to accept deposits or a start-up certificate to request an extension and sets out the information that must be included in the request. Allows the Commissioner to extend the permit or certificate for up to one year if there is satisfactory cause for the delay, and allows the Commissioner to require the provider to update information that was previously filed before approving an extension. Does not limit the number of extensions that may be granted. Provides that if there is no satisfactory cause for the delay, the Commissioner must instruct the escrow agent to refund all deposits held in escrow, plus interest. Requires the provider, within 10 days of denial of an extension, to notify each depositor of the denial, of the expiration of the permit or certificate, and of any right to a deposit refund.

    Sets out the process to be followed when an applicant or provider has material changes or deviation from the information submitted to the Commissioner.

    Sets out the steps to be followed when the Commissioner denies an application, notification, or any other request for approval under this Article. Sets out the process under which applicants can demand a review to determine the reasonableness of the denial.

    Part 3.

    Requires a provider, before marketing and collecting deposits for a proposed expansion of a continuing care retirement community that is 20% or more of existing independent living units, to: (1) notify and obtain written approval from the Commissioner and (2) give all residents written warning of the intent to expand the number of units. Sets out information that must be included in the notice to the Commissioner. Sets out the timeline within which the Commissioner must respond to the notification. Sets out the conditions that must be met in order to approve the expansion notification. Once the notification has been approved, requires the Commissioner to require the provider to submit periodic sales and development reports. Allows the provider, after approval of the expansion notification, to: (1) disseminate materials, including advertisements, describing the intent to expand the number of independent living units at the continuing care retirement community; (2) enter into non-binding reservation agreements, binding reservation agreements, and continuing care contracts for the proposed independent living units; and (3) collect entrance fees and deposits for the proposed independent living units, with deposits placed in escrow and only released in accordance with Part 4 of this Article.

    Requires a provider, before commencing construction of an expansion of a continuing care retirement community that is 20% or more of existing independent living units, to receive the Commissioner’s approval of an expansion notification and apply to the Commissioner for approval to commence construction. Sets out information that must be included with the expansion application, including  a $1,000 application fee. Sets out the timeline within which the Commissioner must respond to the application. Sets out the conditions that must be met in order to approve the expansion application. Once the application has been approved, requires the Commissioner to require the provider to submit periodic sales and development reports. Allows the provider, after approval of the expansion application, to commence construction of the new independent living units at the continuing care retirement community as proposed, and upon completion of construction and the satisfaction of all other legal requirements, open the expansion and provide continuing care to the residents of the new units.

    Requires all entrance fees and deposits collected for independent living units in an expansion that requires approval from the Commissioner to be placed in escrow unless otherwise exempted by the Commissioner.

    Part 4.

    Requires entrance fees and deposits required under the Article to be deposited by the provider in an escrow account and maintained in a segregated account without commingling with other funds. Requires the Commissioner to approve in advance the escrow agent and all terms governing the account. Specifies 12 provisions that must be included in the written escrow agreement between the provider and escrow agent. Requires changes to the agreement to be approved by the Commissioner before they are used. Sets out provisions governing the delivery of the entrance fees or deposits to the escrow agent. Sets out the manners in which the entrance fees and deposits must be maintained by the escrow agent.

    Requires approval from the Commissioner for interest, income, and other gains from funds held in escrow to be released or distributed. Sets out conditions for such approval. Requires interest to be distributed to the provider or depositors when the release of earnings is approved.

    Prohibits using funds in an escrow account as collateral without prior written approval from the Commissioner.

    Requires a refund of the escrowed funds upon notice from the provider of the death of a depositor, nonacceptance by the provider, voluntary cancellation, the denial of an application, or upon written notice from the Commissioner.

    Sets out the process for requirements for petitioning the Commissioner for the release of: (1) the first 25% of each escrowed entrance fee and deposit and (2) the remaining 75% of escrowed entrance fees and deposits. Sets out requirements for the release of those funds.

    Part 5.

    Requires a provider to prepare a disclosure statement for each continuing care retirement community operated or to be operated in the State that contains the 34 specified pieces of information, including: (1) specified information about the officers, directors, trustees, managers, managing or general partners, or any person having a 10% or greater equity or beneficial interest in the provider and any person who will be managing the community on a day-to-day basis; (2) names of any other person who will be responsible for the financial and contractual obligations of the provider not already disclosed and the extent of their responsibilities; (3) the number of existing living units, or the number of units to be constructed at the community; (4) a description of any property rights of residents in the community; (5) circumstances under which a resident will be allowed to remain a resident at the community in the event of possible resident financial difficulties; (6) terms and conditions under which a contract may be canceled by the provider, or by the resident, and the conditions under which fees can be refunded; (7) conditions under which a provider may require a resident to move into another unit for their safety or for the provider’s good; and (8) a five-year prospective financial statement. Requires a copy of the most common continuing care and continuing care without lodging contract used by the provider to be attached to each disclosure statement. Sets out requirements for the disclosure statement’s cover page and for the readability of the disclosure statement. Requires the Commissioner to review the statement for completeness. Requires the Commissioner to post the current disclosure statement for each continuing care retirement community on the Department’s website.

    Sets out requirements for the delivery of a disclosure statement to a person or their legal representative with whom a binding reservation agreement, continuing care contract, or continuing care without lodging contract is being entered into. Sets out the required timing for delivery. Allows electronic delivery if the person consents. Requires an acknowledgment of receipt of a disclosure statement. Requires the Commissioner to maintain copies of all disclosure statements and amendments for at least five years.

    Requires providers to file a revised disclosure statement within 150 days following the end of each fiscal year along with an annual filing fee of $2,000. Sets out requirements for the receipt that the Commissioner must provide and requires posting the annual revised disclosure statement on the Department’s website within the specified timeframe. Also requires the provider to make the annual revised statement available to all residents and depositors. Allows for extension of the due date, of no more than 30 days. Provides for a late fee, which can be waived for good cause.

    Sets out conditions under which other revisions may be made to a disclosure statement.

    Part 6.

    Sets out items that must be included in a binding reservation agreement, defined as a binding contractual agreement between a provider and a depositor that requires the payment of a deposit to reserve the right to purchase continuing care, including the right to live in an independent living unit at a continuing care retirement community. Specifies that a purchase and sale agreement for an independent living unit is not considered a binding reservation agreement for the purposes of this Article. Items that must be included in the agreement relate to rescinding the agreement, automatic cancellation of the agreement, the refund of money or other consideration transferred to the provider upon a rescinding or cancellation, and the computation of any refund due to a depositor for cancellation or termination.

    Sets out the provisions that must be included in a continuing care contract.

    Part 7.

    Requires a license for a person to arrange or provide continuing care without lodging. Allows a provider with a permanent license or a restricted permanent license to apply for a continuing care without lodging license. Sets out items that must be included in the application, including a $500 application fee. Sets out the timeline within which the Commissioner must respond to the application. Sets out the conditions that must be met in order to approve the application. Once the application has been approved, allows the Commissioner to require the provider to submit periodic reports to monitor the status of the program. Allows the applicant, after approval of the application, to arrange or provide continuing care without lodging, and requires filing an amended disclosure statement that contains the required information on continuing care without lodging.

    Sets out items that must be included in a continuing care without lodging contract.

    Part 8.

    Requires a provider that has a permanent license or a restricted permanent license to submit an annual report to the Commissioner. Specifies items that must be included related to audited financial statements, five-year prospective financial statements, operating reserve certification, disclosure statements, and dates on which the required semiannual meetings were held. Requires additional information if the provider is also licensed to provide continuing care without lodging. Sets out the timing for filing the annual report and allows an extension for no more than 30 days. Sets out late fees, which may be waived for good cause.

    Allows the Commissioner to require additional information. Requires the provider to notify the Commissioner and residents when the provider fails to maintain the operating reserve; the 12-month daily average independent living unit occupancy rate has fallen below 85% and remained there for more than 90 days; the provider or any group the provider is a part of has violated any covenant in the debt agreement, or the provider seeks modification, waiver, or extension of the material financial covenants or material payment terms under a mortgage loan, bond indenture, or other long-term financial agreement.

    Prohibits the transfer of a permit, certificate, or license issued under this Article. Requires approval from the Commissioner before a provider or other owing person can sell or transfer any real property used in the operations of a continuing care retirement community or any interest in a community, other than the sale of an independent living unit to a resident or other transferee. Requires a provider to get approval from the Commissioner before consummating any purchase of real property currently leased and used by the provider in the operations of a continuing care retirement community. Sets out requirements for the timing and content of the requests for these transactions. Sets out the timeline within which the Commissioner must respond to the request. Sets out the conditions that must be met in order to approve the request. Allows the Commissioner to revoke or restrict a certificate or license of a provider or take other administrative actions if a provider violates these provisions.

    Requires the Commissioner’s approval to enter into an agreement to merge with, or otherwise acquire control of, a provider holding a certificate or license. Requires the acquiring person to file the request for approval. Sets out the required content for the approval request. Sets out the timeline within which the Commissioner must respond to the request. Sets out the conditions that must be met in order to approve the request. Requires providers to give notice to all affected residents and depositors of the proposed merger or other acquisition of control within 5 business days after receiving approval. Allows the Commissioner to revoke or restrict a certificate or license of a provider or take other administrative actions if a provider violates these provisions.

    Requires a provider to maintain, after the opening of a continuing care retirement community, an operating reserve and sets out reporting requirements.

    Requires a provider to submit an actuarial study to the Commissioner, at least once every three years. Sets out additional requirements governing the study. Exempts from these actuarial study requirements a provider that only offers health care on a fee-for-service basis or only provides a limited discount or a limited number of free days in a long-term care facility; sets out documents that these individuals must provide instead.

    Requires notifying the Commissioner before the provider changes its name or the name of a community it operates. Sets out requirements for notifying residents and depositors of the proposed change. 

    Requires approval from the Commissioner before a provider enters into a contract with a third party for the management of a continuing care retirement community. Sets out required content of the notification given to the Commissioner and for providing notice to residents. Sets out the timeline for the Commissioner’s review of the notification. Sets out conditions under which the Commissioner may disapprove of the proposed third-party manager and conditions under which the provider must immediately remove a third-party manager. 

    Requires the provider to notify the Commissioner before reducing the number of living units at a continuing care retirement community by 20% or more. Specifies the information that must be provided in the notice and for providing notice to residents. 

    Part 9. 

    Requires providers to maintain after the opening of a continuing care retirement center an operating reserve equal to 50% of the total operating costs of the community forecasted or projected for the 12-month period following the period covering the most recent disclosure statement. Provides that once a community achieves a 12-month daily average independent living unit occupancy rate of 90% or higher, a provider is only required to maintain an operating reserve in the amount specified, with amounts ranging from 12.5% to 50% depending on the occupancy rate. Allows the Commissioner to increase the operating reserve amount if the provider is in a hazardous condition. Sets out related resident notification requirements. Sets out provisions for calculating the operating reserve amount. Specifies the types of assets that can be used by a provider to fund the operating reserve.  

    Allows a provider, instead of funding the operating reserve with qualifying assets, to fund all or a portion of the reserve by filing a surety bond or letter of credit. Sets out the requirements for the surety bond or letter of credit. 

    Requires approval from the Commissioner before an operating reserve can be released. Sets out requirements for the request. Allows disapproval of the request to withdraw funds if it is determined that it would not be in the resident’s best interest. Sets out requirements for providing notice to residents. 

    Part 10. 

    Allows the Commissioner to (1) deny an application or any other request or approval or (2) restrict or revoke any permit, certificate, license, or other authorization issued under the Article if the Commissioner finds that the applicant or provider committed one of the 20 specified acts, including: (1) willfully violated any provision of this Article or the Commissioner’s rules or orders; (2) engaged in fraudulent or dishonest business practices; (3) failed to maintain the escrow account; (4) violated a restriction of its permit, certificate, or license; or (5) has been determined to be in a hazardous condition. Requires the Commissioner to first issue a cease-and-desist order; if the order is not or cannot remedy the violation, allows the Commissioner, after notice and hearing, to order revocation. Allows a revocation order to be appealed to the Wake County Superior Court. Allows the Commissioner to remove a restriction upon finding changed circumstances. Sets out requirements for notice to residents. Specifies that revocation does not release a provider from obligations assumed through continuing care and continuing care without lodging contracts. 

    Sets out 14 standards that the Commissioner may consider in determining whether a provider is in a hazardous condition, including: (1) whether the provider is impaired or insolvent; (2) adverse findings reported in examination reports, audit reports, and actuarial opinions, reports, or summaries; (3) whether the provider has failed to establish, maintain, or has substantially depleted the required operating reserve; (4) whether the management of a provider has failed to respond to the Commissioner's inquiries about the condition of the applicant or provider or has furnished false and misleading information in response to an inquiry by the Commissioner; or (5) whether the applicant or provider has experienced or will experience in the foreseeable future cash flow or liquidity problems. 

    Allows the Commissioner, upon determining that a provider is in a hazardous condition, to issue an order, after notice and opportunity for hearing, requiring a provider to (1) submit a corrective action plan within 45 days and (2) notify all residents and depositors within five business days of the Commissioner's order. Requires the corrective action plan to include: (1) proposals of corrective actions the provider intends to take which would reasonably be expected to result in the elimination of the hazardous condition and (2) a date when the provider anticipates it will rectify the problems and deficiencies. Sets out the timeline under which the Commissioner must act on the plan. Allows for submission of a revised plan based on notification from the Commissioner. Requires immediate implementation of an approved plan, distribution of the plan to residents and depositors, and reporting progress to the Commissioner. Allows the Commissioner to engage consults to develop a corrective action plan when a submitted plan is disapproved. 

    Sets out the Commissioner’s investigate and subpoena powers. 

    Makes a provider civilly liable for entering into a binding reservation agreement, continuing care contract, or continuing care without lodging contract without having first delivered a disclosure statement to the person with whom the agreement or contract was entered into, or for entering into a binding reservation agreement, continuing care contract, or continuing care without lodging contract with a person who has relied on a disclosure statement that materially misrepresents or omits a material fact required to be stated or necessary in order to make the statement, in light of the circumstances under which they are made, not misleading. Specifies that liability exists regardless of whether the provider had actual knowledge of the misstatement or omission. Prohibits a person from bringing an action if the person was offered and failed to timely accept an offer of a refund that meets the specified amounts. Requires the action to be brought within three years of the alleged violation. 

    Makes it a Class 1 misdemeanor to willfully and knowingly violate the Article.  

    Sets out the conditions under which a permit, certificate, license, or other approval must be forfeited, after notice and opportunity for hearing. Sets out requirements for notifying residents and depositors of forfeiture. 

    Allows the Commissioner, after determining that a provider is or has been violating the Article, to, after notice and opportunity for hearing, order the provider to cease entering into binding reservation agreements, continuing care contracts, and continuing care without lodging contracts and make a rescission offer to any resident or depositor who entered into such an agreement or contract while the violation was occurring.  Allows for the agreements and contracts to be rescinded without penalty by the resident or depositor. Bars residents and depositors from benefitting from this provision if they have refused or failed to timely accept an offer by the provider to rescind the agreement or contract and refund the full amount paid plus interest (less specified costs). 

    Sets out the conditions under which the Commissioner may order payment of a penalty (of $100-$1,000 per violation) or petition the court for an order directing payment of restitution. 

    Prohibits a provider from actively soliciting, approving the solicitation of, or entering into new binding reservation agreements, continuing care contracts, or continuing care without lodging contracts in this State after the provider knew, or reasonably should have known, that the provider was impaired or insolvent except with the Commissioner’s written permission. 

    Part 11. 

    Sets out the conditions under which the Commissioner may commence supervision proceedings or apply to the Wake County Superior Court or federal bankruptcy court that may have previously taken jurisdiction over the provider or community for an order directing or authorizing the Commissioner to rehabilitate or to liquidate a provider or continuing care retirement community. Sets out requirements for providing notice to residents and depositors. Sets out the conditions under which the rehabilitation may be terminated and the community and its assets and affairs are returned to the provider’s management. Requires an order for rehabilitation to be refused or vacated if the provider posts a bond, as specified. 

    Allows, when the Commissioner has been appointed as a receiver for a provider or a continuing care retirement community, the Department of Health and Human Services to accept and approve the addition of adult care home beds or nursing beds for a continuing care retirement community owned by, or operated by, the provider, if it appears to the Court that (1) the best interests of the provider or (2) the welfare of persons who have previously contracted with the provider or may contract with the provider, may be best served by the addition of adult care home beds or nursing beds. 

    Provides that in the event of liquidation of a provider, all continuing care and continuing care without lodging contracts executed by the provider are deemed preferred claims against all of the provider’s assets (although claims are subordinate to the liquidator’s cost of administration or any secured claim). 

    Part 12.

    Gives a resident of a continuing care retirement community operated by a licensed provider the right of self-organization, the right to be represented by an individual of the resident's own choosing, and the right to engage in concerted activities to keep informed on the community’s operations or for other mutual aid or protection. Specifies that this includes the right to establish a residents' council. 

    Requires the provider’s board of directors or other governing body to hold in-person semiannual meetings with the residents of each continuing care retirement community operated by the provider in this State for free discussions of subjects include specified topics. Specifies that a provider is allowed to make a semiannual meeting available via electronic means to residents who are unable to attend in person. Sets out requirements for providing notice of the meetings. Sets out emergency conditions under which the meetings can be held electronically.  

    Section 13.

    Provides that no act, agreement, or statement of any resident, or of an individual purchasing continuing care for a resident under any continuing care or continuing care without lodging contract, is a valid waiver of any provision of this Article intended for the benefit or protection of the resident or the individual purchasing continuing care for the resident.  

    Establishes the 12 member Continuing Care Advisory Committee comprised of providers, residents, and professionals involved in the continuing care retirement community industry. Sets out additional membership requirements and sets membership terms at 3 years, with two consecutive terms allowed. Requires the Committee to: (1) act in an advisory capacity to the Commissioner on matters pertaining to the operation and regulation of continuing care retirement communities and continuing care without lodging programs; (2) report to the Commissioner on developments in the continuing care retirement community industry and problems or concerns of providers and residents; and (3) recommend changes in relevant statutes and rules.  

    Provides that this Article does not affect the authority of the Department of Health and Human Services or any successor agency otherwise provided by law to license or regulate any long-term care facility. Exempts continuing care retirement communities and providers licensed under this Article that are also subject to the provisions of the North Carolina Condominium Act from the provisions of GS Chapter 39A (Transfer Fee Covenants Prohibited), if the continuing care retirement community's declaration of condominium does not require the payment of any fee or charge not otherwise provided for in a resident's continuing care contract, or other separate contract for the provisions of membership or services. 

    Allows the Commissioner, or designee, to visit a provider to examine its books and records. Also allows the Commissioner, or designee, to examine a person with a contractual or financial relationship with the provider, to the extent necessary to ascertain the provider’s financial condition, if the provider relies on a contractual or financial relationship with another person in order to meet the Article’s financial requirements. 

    Applies to contracts issued, renewed, or amended on or after October 1, 2023.