Bill Summary for S 145

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Summary date: 

Jun 6 2023

Bill Information:

View NCGA Bill Details2023-2024 Session
Senate Bill 145 (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 Johnson.

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Bill summary

Senate committee substitute to the 1st edition makes the following changes.

Part 1.

Amends GS 58-64A-5 (new Article 64A, Continuing Care Retirement Communities, definitions provisions) to remove provision stating that definitions therein apply unless context requires otherwise. Deletes the following defined terms: assisted living care, depositor, expansion, generally accepted accounting principles, immediately accessible site, life plan community, living unit days available, lodging, nursing care, occupancy rates, processing fee, renovation, and restriction. Enacts new definition, continuing care at home (a program offered by a provider holding a permanent license under the Article 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 at home program). Incorporates the statutory definitions of assisted living care (GS 131D-2.1) and nursing care (GS 131E-176), into definition of continuing care. Replaces prior definition of continuing care retirement community so that it now means a retirement community consisting of one or more structures where a provider renders continuing care to residents. A distinct phase of development approved by the Commissioner may be considered to be the continuing care retirement community when a project is being developed in successive distinct phases over a period of time. Narrows scope of entrance fee to exclude consideration that is just promised to be made by the individual entering into the specified contracts. Removes specific reference to bank from what can be considered a person under definition of escrow agent. Clarifies that for purposes of the defined term occupancy rate, the term living unit days available means the maximum number of living unit days that would have been provided if all available living units were filled during the given time period. The total shall equal the sum of all living units, minus any living units that are unavailable for occupancy, on each day for the given time period. For purposes of this definition, defines "occupied living unit days" as the sum of each daily living unit census at the continuing care retirement community for a given time period, excluding any second person occupants. Requires the total to equal the sum of each daily census for the given time period.

Makes conforming changes throughout the Article to refer to newly defined term continuing care at home instead of continuing care without lodging. Makes technical changes.

Amends GS 58-64A-25 (leasing real property for a continuing care retirement community) to refer to applicants in addition to provider.

Amends GS 58-64A-35, which permits the Commissioner to waive or modify any provisions of new Article 64A to remove Commissioner’s authority to do so if there is a sound actuarial, accounting, business principles, or other reasonable reason that does not diminish the Article’s protections. Removes language that prohibited any waiver or modification that results in a greater regulator burden, unless it was agreed to in writing by the applicant or provider.

Removes statements filed with the Commissioner regarding any significant disagreements with a former manager from the confidentiality provisions of GS 58-64A-40. Makes clarifying change.

Part 2.

Enacts new GS 58-64A-67, setting forth a general review schedule in response to the following applications: (1)permit to accept deposits, (2) a start-up certificate, (3) a preliminary certificate, (4) a permanent license, (5) an expansion, (6) a continuing care at home license, (7) an  expansion notification, and (8) a request for approval pursuant to GS 58-64A-215, GS 58-64A-220, or GS 58-64A-240.

Makes conforming change to GS 58-64A-50 to now require that the Commissioner comply with the review schedule set forth in new GS 58-64A-67 (discussed above) when responding to an application for a permit to accept deposits. Makes other clarifying changes.

Amends GS 58-64A-55 (start-up certificates) as follows. Deletes provisions requiring proof of authority for person signing on behalf of an applicant under penalty of perjury if authority is not apparent as well as language specifying means of such proof. Changes requirements for the market study that is required to be submitted as part of the application to no longer require it be acceptable to the Commissioner. Allows Commissioner to require (was, reasonably require) the person applying for a start-up certificate to submit any other data, financial statements, and pertinent information to assist in its determination. Makes conforming change to now require that the Commissioner comply with the review schedule set forth in new GS 58-64A-67 (discussed above).   Changes one of the five listed requirements for approval of a start-up application to now require that the market study and the five-year prospective financial statements included in the applicant’s disclosure statement demonstrate that a market for the proposed continuing care retirement community appears to exist and the continuing care retirement community appears to be financially viable. (Prior version had no reference to market study or financial statements.) Requires the applicant and its governing body, officers, and management to be of good moral character (was, demonstrate integrity) in addition to other listed attributes. 

Amends GS 58-64A-60 (preliminary certificates) as follows. Makes organizational, technical, and clarifying changes. Changes the standard governing the feasibility study to have it project (was, reasonably project) the market and financial viability of the proposed continuing care retirement community.  Makes conforming change to now require that the Commissioner comply with the review schedule set forth in new GS 58-64A-67 (discussed above). Changes provisions governing required actuarial study/projects to specify that the projections must meet metrics determined by the Commissioner (prior version had no reference to determination of metrics by Commissioner).

Amends the statement requirement for a permanent license (GS 58-64A-65) by making technical and conforming changes. Removes discretion for the Commissioner to permit lesser amounts of signed binding reservation agreements or continuing care contracts under the amounts specified in GS 58-64-65. Makes conforming change to now require that the Commissioner comply with the review schedule set forth in new GS 58-64A-67 (discussed above). Changes the explanation requirements accompanying a provisional license so that the Commission must explain the conditions the applicant (was, provider) must satisfy to qualify for a permanent license.  Makes clarifying, technical, and organizational changes.

Changes references from person to provider in GS 58-64A-70 (expiration of a permit to accept deposits and start-up certificates).

Makes clarifying changes to when the applicant must submit a request of review of the Commissioner’s denial under GS 58-64A-74 (pertaining to denials of applications, notifications, or other requests for approval).

Part 3.

Makes conforming change to GS 58-64A-75 (exemption notifications) to now require that the Commissioner comply with the review schedule set forth in new GS 58-64A-67 (discussed above). Makes clarifying and technical changes.

Changes references from provider to applicant throughout GS 58-64A-80 (expansion applications). Changes the standard governing the feasibility study to have it project (was, reasonably project) the market and financial viability of the proposed expansion. Makes conforming change to now require that the Commissioner comply with the review schedule set forth in new GS 58-64A-67 (discussed above). Makes clarifying changes.

Part 4.

Changes one of the 12 provisions required by GS 58-64A-120 (escrow agreements) to be included the written escrow agreement between the provider and escrow agent so that it must specify that funds deposited shall (was, may) not be subject to any liens or charges by the escrow agent.

Makes technical change to GS 58-64A-130 (entrance fee and deposit delivery to the escrow agent).

Makes organizational changes to GS 58-64A-140 (earnings from funds held in escrow).

Amends GS 58-64A-135(b) (investment of funds in escrow) to require that any investment not diminish the funds held in escrow below the amounts required by the Article (was, investments “may” not diminish the funds).

Amends the delayed refund provisions of GS 58-64A-150 (refunds of escrowed entrance fees and deposits) to allow a provider or an escrow agent (was, just escrow agent) to demonstrate good cause for an extension of a delayed refund beyond one year. Makes organizational changes.

Amends GS 58-64A-155 (release of escrowed entrance fees and deposits) as follows. Changes one of the three required certifications for release of the first 25% of the each escrowed entrance fee and deposit to now make the provider demonstrate that they have received a commitment for any permanent mortgage loan or other long-term financing of the proposed continuing care retirement community or expansion, and more than 70% of any conditions of the commitment prior to disbursement of funds thereunder have been satisfied. (Prior version did not have 70% requirement.)   Makes clarifying changes.

Part 5.

Makes clarifying and technical changes to GS 58-64A-160 (pertaining to disclosure statements).

Changes reference from prospective resident to a person in GS 58-64A-165 when noting who must sign an acknowledgement of receipt of the specified disclosure statement. Makes a clarifying change.

Part 6.

Amends GS 58-64A-185 by requiring that a binding reservation agreement include a provision that the depositor (was, person) entering into the agreement may rescind the agreement within 30 days of the specified occurrences.

Amends GS 58-64A-190 by requiring that a continuing care contract include a provision that the resident (was, person) contracting with the provider may rescind the contract within 30 days of the specified occurrences.

Part 7.

Amends GS 58-64A-195, concerning applications for a continuing care at home license, as follows. Amends the items that must be included in an application to include a market study prepared by a person experienced in the preparation of market studies for continuing care at home or similar programs that demonstrates sufficient interest in a continuing care at home program (was, experienced in the preparation of market studies for continuing care without lodging or similar programs, and acceptable to the Commissioner, that demonstrates sufficient interest in a continuing care without lodging program). Make a conforming change to require compliance with the review schedule in GS 58-64A-67 in responding to an application. Amends the criteria that must be met for an application to be approved by making clarifying changes and to specify that the sufficient consumer interest in the proposed continuing care at home program must be as evidenced by the market study; also specifies that the Commissioner must determine whether the proposed program will have a detrimental impact on the overall operation of the applicant and continuing care retirement community. Makes additional clarifying changes.

Amends GS 58-64A-200 by requiring a continuing at home contract include a provision that the resident (was, person) contracting with the provider may rescind the contract within 30 days of the specified occurrences. Makes additional clarifying changes.

Part 8.

Amends GS 58-64A-205 by requiring the annual report to include audited financial statements of the provider’s most recent fiscal year (was, audited financial statements as of the end of the provider's most recent fiscal year).

Amends GS 58-64A-210 by making a clarifying change.

Amends GS 58-64A-215 as follows. Requires a provider to request approval of the specified sales, transfers, and purchase of property used in the operations of a continuing care retirement community by filing a request for approval with the Commissioner (was, by providing written notice to the Commissioner). Makes conforming changes. Amends the items that must be in the request for approval (previously in the written notice), to include a description of the financial impact on the applicant (was, on the provider). Makes a conforming change to require compliance with the review schedule in GS 58-64A-67 in responding to a request for approval. Amends the requirements to be met for the approval of the request for approval to include that the transaction does not jeopardize the financial stability of the application (was, of the provider). Makes additional clarifying changes.

Amends GS 65-64A-220, which requires Commissioner approval to enter into an agreement to merge with, or otherwise acquire control of, a provider holding a certificate or license under this Article. Amends the information that must be included in a request for approval as follows. Specifies that that names and addresses that must be included are for each acquiring person (was, each person by whom or on whose behalf the merger or other acquisition of control is to be effected). No longer provides that when the source of the consideration is a loan made in the lender's ordinary course of business the identity of the lender must remain confidential, if requested. Requires inclusion of a description of any changes in the provision of goods and services to the provider and residents (was, a description of any change in the persons who currently provide goods and services to the provider and residents, including health care and management). Makes additional technical changes.

Further amends the statute by making a conforming change to require compliance with the review schedule in GS 58-64A-67 in responding to a request for approval. Amends the conditions that must be met for approval of a request for approval by making clarifying changes and adding the requirement that the request for approval comply with the statute.

Amends GS 58-64A-230, concerning the actuarial study by requiring the study to specifically state the reason when the actuary is unable to form an opinion (was, form a needed opinion). Makes additional technical changes.

Amends GS 58-64A-240 to require a provider to request approval from the Commissioner (was, notify and receive the approval of the Commissioner) before entering into a contract with a third party for the management of a continuing care retirement community; makes conforming changes. No longer requires the inclusion, when applicable, of a statement as to whether there were any significant disagreements with the former manager. Makes a conforming change to require compliance with the review schedule in GS 58-64A-67 in responding to a request for approval. Amends the provision that requires the provider to remove a third-party manager immediately upon discovery of either of the two listed conditions by no longer requiring that the conditions had not been disclosed in the required notice to the Commissioner or in any disclosure statement filed with the Commissioner.

Part 9.

Amends GS 58-64A-270 by making clarifying changes.

Amends GS 58-64A-280 to require submitting a request for the release of an operation reserve at least 10 business days before the proposed date of the release (was, proposed date of the withdrawal). Provides that the Commissioner may disapprove any request to release (was, withdrawal) the funds if the release (was, withdrawal) is not in the residents’ best interests.

Part 10.

Amends GS 58-64A-285 by amending the conditions under which the Commissioner may deny an application or any other request for approval, or restrict or revoke any permit, certificate, license, or other authorization issued under the Article, by making clarifying and technical changes.

Amends GS 58-64A-295 by amending the required content of a corrective action plan, which must be completed when the Commissioner has determined that a provider is in a hazardous condition, to require that it include proposals of corrective actions the provider intends to take that would be expected (was, would be reasonably expected) to result in the elimination of the hazardous condition. Limits the requirements that apply to a revised corrective action plan by specifying that they are required when a revised corrective action plan is applicable. Makes a clarifying change.

Amends GS 58-64A-300 by amending the provision that gives the Commission or his designee, for purposes of any investigation or proceeding under this Article, all the powers given to him for insurance companies, by no longer specifying that the Commissioner may administer oaths and affirmations, subpoena witnesses, compel their attendance, take evidence, and require the production of any books, papers, correspondence, memoranda, agreements, or other documents or records deemed relevant or material to the inquiry.

Part 12.

Amends GS 58-64A-360 by changing the purpose of the semiannual meetings that the board of directors or other governing body of a provider or its designated representative must hold with the residents of each continuing care retirement community, to require free discussions of subjects affecting and concerning the continuing care retirement community and its residents (was, for free discussions of subjects, including, but not limited to, income, expenditures, and financial matters, trends, and problems as they apply to the continuing care retirement community and discussions of proposed changes in policies, programs, fees, facilities, and services). No longer sets out examples of the members of the governing body of the provider who must attend the meetings. No longer allows a provider to petition the Commissioner for a waiver if, in the provider’s opinion, a semiannual meeting cannot reasonably be held. Makes an additional clarifying change.

Part 13.

Amends GS 58-64A-370 by amending the membership of the Continuing Care Advisory Committee to require at least two (was, four) representatives of, and nominated by, the North Carolina Continuing Care Residents Association and two (was, four) representatives of, and nominated by, LeadingAge North Carolina. Removes the requirement that the Commissioner notify the Committee in writing of proposed statute or rule changes and hearings related to the administration of this Article.

Amends the act’s effective date by adding that it applies to contracts entered into on or after October 1, 2023.