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Section 1788 Of Article 5. Contract From California Health And Safety Code >> Division 2. >> Chapter 10. >> Article 5.

1788
. (a) A continuing care contract shall contain all of the following:
  (1) The legal name and address of each provider.
  (2) The name and address of the continuing care retirement community.
  (3) The resident's name and the identity of the unit the resident will occupy.
  (4) If there is a transferor other than the resident, the transferor shall be a party to the contract and the transferor's name and address shall be specified.
  (5) If the provider has used the name of any charitable or religious or nonprofit organization in its title before January 1, 1979, and continues to use that name, and that organization is not responsible for the financial and contractual obligations of the provider or the obligations specified in the continuing care contract, the provider shall include in every continuing care contract a conspicuous statement that clearly informs the resident that the organization is not financially responsible.
  (6) The date the continuing care contract is signed by the resident and, where applicable, any other transferor.
  (7) The duration of the continuing care contract.
  (8) A list of the services that will be made available to the resident as required to provide the appropriate level of care. The list of services shall include the services required as a condition for licensure as a residential care facility for the elderly, including all of the following:
  (A) Regular observation of the resident's health status to ensure that his or her dietary needs, social needs, and needs for special services are satisfied.
  (B) Safe and healthful living accommodations, including housekeeping services and utilities.
  (C) Maintenance of house rules for the protection of residents.
  (D) A planned activities program, which includes social and recreational activities appropriate to the interests and capabilities of the resident.
  (E) Three balanced, nutritious meals and snacks made available daily, including special diets prescribed by a physician as a medical necessity.
  (F) Assisted living services.
  (G) Assistance with taking medications.
  (H) Central storing and distribution of medications.
  (I) Arrangements to meet health needs, including arranging transportation.
  (9) An itemization of the services that are included in the monthly fee and the services that are available at an extra charge. The provider shall attach a current fee schedule to the continuing care contract.
  (10) The procedures and conditions under which a resident may be voluntarily and involuntarily transferred from a designated living unit. The transfer procedures, at a minimum, shall include provisions addressing all of the following circumstances under which a transfer may be authorized:
  (A) A continuing care retirement community may transfer a resident under the following conditions, taking into account the appropriateness and necessity of the transfer and the goal of promoting resident independence:
  (i) The resident is nonambulatory. The definition of "nonambulatory," as provided in Section 13131, shall either be stated in full in the continuing care contract or be cited. If Section 13131 is cited, a copy of the statute shall be made available to the resident, either as an attachment to the continuing care contract or by specifying that it will be provided upon request. If a nonambulatory resident occupies a room that has a fire clearance for nonambulatory residents, transfer shall not be necessary.
  (ii) The resident develops a physical or mental condition that endangers the health, safety, or well-being of the resident or another person.
  (iii) The resident's condition or needs require the resident's transfer to an assisted living care unit or skilled nursing facility, because the level of care required by the resident exceeds that which may be lawfully provided in the living unit.
  (iv) The resident's condition or needs require the resident's transfer to a nursing facility, hospital, or other facility, and the provider has no facilities available to provide that level of care.
  (B) Before the continuing care retirement community transfers a resident under any of the conditions set forth in subparagraph (A), the community shall satisfy all of the following requirements:
  (i) Involve the resident and the resident's responsible person, as defined in paragraph (6) of subdivision (r) of Section 87101 of Title 22 of the California Code of Regulations, and upon the resident' s or responsible person's request, family members, or the resident's physician or other appropriate health professional, in the assessment process that forms the basis for the level of care transfer decision by the provider. The provider shall offer an explanation of the assessment process. If an assessment tool or tools, including scoring and evaluating criteria, are used in the determination of the appropriateness of the transfer, the provider shall make copies of the completed assessment available upon the request of the resident or the resident's responsible person.
  (ii) Prior to sending a formal notification of transfer, the provider shall conduct a care conference with the resident and the resident's responsible person, and upon the resident's or responsible person's request, family members, and the resident's health care professionals, to explain the reasons for transfer.
  (iii) Notify the resident and the resident's responsible person of the reasons for the transfer in writing.
  (iv) Notwithstanding any other provision of this subparagraph, if the resident does not have impairment of cognitive abilities, the resident may request that his or her responsible person not be involved in the transfer process.
  (v) The notice of transfer shall be made at least 30 days before the transfer is expected to occur, except when the health or safety of the resident or other residents is in danger, or the transfer is required by the resident's urgent medical needs. Under those circumstances, the written notice shall be made as soon as practicable before the transfer.
  (vi) The written notice shall contain the reasons for the transfer, the effective date, the designated level of care or location to which the resident will be transferred, a statement of the resident's right to a review of the transfer decision at a care conference, as provided for in subparagraph (C), and for disputed transfer decisions, the right to review by the Continuing Care Contracts Branch of the State Department of Social Services, as provided for in subparagraph (D). The notice shall also contain the name, address, and telephone number of the department's Continuing Care Contracts Branch.
  (vii) The continuing care retirement community shall provide sufficient preparation and orientation to the resident to ensure a safe and orderly transfer and to minimize trauma.
  (C) The resident has the right to review the transfer decision at a subsequent care conference that shall include the resident, the resident's responsible person, and upon the resident's or responsible person's request, family members, the resident's physician or other appropriate health care professional, and members of the provider's interdisciplinary team. The local ombudsperson may also be included in the care conference, upon the request of the resident, the resident's responsible person, or the provider.
  (D) For disputed transfer decisions, the resident or the resident' s responsible person has the right to a prompt and timely review of the transfer process by the Continuing Care Contracts Branch of the State Department of Social Services.
  (E) The decision of the department's Continuing Care Contracts Branch shall be in writing and shall determine whether the provider failed to comply with the transfer process pursuant to subparagraphs (A) to (C), inclusive. Pending the decision of the Continuing Care Contracts Branch, the provider shall specify any additional care the provider believes is necessary in order for the resident to remain in his or her unit. The resident may be required to pay for the extra care, as provided in the contract.
  (F) Transfer of a second resident when a shared accommodation arrangement is terminated.
  (11) Provisions describing any changes in the resident's monthly fee and any changes in the entrance fee refund payable to the resident that will occur if the resident transfers from any unit, including, but not limited to, terminating his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771.
  (12) The provider's continuing obligations, if any, in the event a resident is transferred from the continuing care retirement community to another facility.
  (13) The provider's obligations, if any, to resume care upon the resident's return after a transfer from the continuing care retirement community.
  (14) The provider's obligations to provide services to the resident while the resident is absent from the continuing care retirement community.
  (15) The conditions under which the resident must permanently release his or her living unit.
  (16) If real or personal properties are transferred in lieu of cash, a statement specifying each item's value at the time of transfer, and how the value was ascertained.
  (A) An itemized receipt that includes the information described above is acceptable if incorporated as a part of the continuing care contract.
  (B) When real property is or will be transferred, the continuing care contract shall include a statement that the deed or other instrument of conveyance shall specify that the real property is conveyed pursuant to a continuing care contract and may be subject to rescission by the transferor within 90 days from the date that the resident first occupies the residential unit.
  (C) The failure to comply with this paragraph shall not affect the validity of title to real property transferred pursuant to this chapter.
  (17) The amount of the entrance fee.
  (18) In the event two parties have jointly paid the entrance fee or other payment that allows them to occupy the unit, the continuing care contract shall describe how any refund of entrance fees is allocated.
  (19) The amount of any processing fee.
  (20) The amount of any monthly care fee.
  (21) For continuing care contracts that require a monthly care fee or other periodic payment, the continuing care contract shall include the following:
  (A) A statement that the occupancy and use of the accommodations by the resident is contingent upon the regular payment of the fee.
  (B) The regular rate of payment agreed upon (per day, week, or month).
  (C) A provision specifying whether payment will be made in advance or after services have been provided.
  (D) A provision specifying the provider will adjust monthly care fees for the resident's support, maintenance, board, or lodging, when a resident requires medical attention while away from the continuing care retirement community.
  (E) A provision specifying whether a credit or allowance will be given to a resident who is absent from the continuing care retirement community or from meals. This provision shall also state, when applicable, that the credit may be permitted at the discretion or by special permission of the provider.
  (F) A statement of billing practices, procedures, and timelines. A provider shall allow a minimum of 14 days between the date a bill is sent and the date payment is due. A charge for a late payment may only be assessed if the amount and any condition for the penalty is stated on the bill.
  (22) All continuing care contracts that include monthly care fees shall address changes in monthly care fees by including either of the following provisions:
  (A) For prepaid continuing care contracts, which include monthly care fees, one of the following methods:
  (i) Fees shall not be subject to change during the lifetime of the agreement.
  (ii) Fees shall not be increased by more than a specified number of dollars in any one year and not more than a specified number of dollars during the lifetime of the agreement.
  (iii) Fees shall not be increased in excess of a specified percentage over the preceding year and not more than a specified percentage during the lifetime of the agreement.
  (B) For monthly fee continuing care contracts, except prepaid contracts, changes in monthly care fees shall be based on projected costs, prior year per capita costs, and economic indicators.
  (23) A provision requiring that the provider give written notice to the resident at least 30 days in advance of any change in the resident's monthly care fees or in the price or scope of any component of care or other services.
  (24) A provision indicating whether the resident's rights under the continuing care contract include any proprietary interests in the assets of the provider or in the continuing care retirement community, or both. Any statement in a contract concerning an ownership interest shall appear in a large-sized font or print.
  (25) If the continuing care retirement community property is encumbered by a security interest that is senior to any claims the residents may have to enforce continuing care contracts, a provision shall advise the residents that any claims they may have under the continuing care contract are subordinate to the rights of the secured lender. For equity projects, the continuing care contract shall specify the type and extent of the equity interest and whether any entity holds a security interest.
  (26) Notice that the living units are part of a continuing care retirement community that is licensed as a residential care facility for the elderly and, as a result, any duly authorized agent of the department may, upon proper identification and upon stating the purpose of his or her visit, enter and inspect the entire premises at any time, without advance notice.
  (27) A conspicuous statement, in at least 10-point boldface type in immediate proximity to the space reserved for the signatures of the resident and, if applicable, the transferor, that provides as follows: "You, the resident or transferor, may cancel the transaction without cause at any time within 90 days from the date you first occupy your living unit. See the attached notice of cancellation form for an explanation of this right."
  (28) Notice that during the cancellation period, the continuing care contract may be canceled upon 30 days' written notice by the provider without cause, or that the provider waives this right.
  (29) The terms and conditions under which the continuing care contract may be terminated after the cancellation period by either party, including any health or financial conditions.
  (30) A statement that, after the cancellation period, a provider may unilaterally terminate the continuing care contract only if the provider has good and sufficient cause.
  (A) Any continuing care contract containing a clause that provides for a continuing care contract to be terminated for "just cause," "good cause," or other similar provision, shall also include a provision that none of the following activities by the resident, or on behalf of the resident, constitutes "just cause," "good cause," or otherwise activates the termination provision:
  (i) Filing or lodging a formal complaint with the department or other appropriate authority.
  (ii) Participation in an organization or affiliation of residents, or other similar lawful activity.
  (B) The provision required by this paragraph shall also state that the provider shall not discriminate or retaliate in any manner against any resident of a continuing care retirement community for contacting the department, or any other state, county, or city agency, or any elected or appointed government official to file a complaint or for any other reason, or for participation in a residents' organization or association.
  (C) Nothing in this paragraph diminishes the provider's ability to terminate the continuing care contract for good and sufficient cause.
  (31) A statement that at least 90 days' written notice to the resident is required for a unilateral termination of the continuing care contract by the provider.
  (32) A statement concerning the length of notice that a resident is required to give the provider to voluntarily terminate the continuing care contract after the cancellation period.
  (33) The policy or terms for refunding any portion of the entrance fee, in the event of cancellation, termination, or death. Every continuing care contract that provides for a refund of all or a part of the entrance fee shall also do all of the following:
  (A) Specify the amount, if any, the resident has paid or will pay for upgrades, special features, or modifications to the resident's unit.
  (B) State that if the continuing care contract is canceled or terminated by the provider, the provider shall do both of the following:
  (i) Amortize the specified amount at the same rate as the resident' s entrance fee.
  (ii) Refund the unamortized balance to the resident at the same time the provider pays the resident's entrance fee refund.
  (C) State that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation, as defined in paragraph (8) of subdivision (r) of Section 1771. Provisions for refunds due to cancellation pursuant to this subparagraph shall be set forth in the contract.
  (34) The following notice at the bottom of the signatory page: