Section 4655. Certification procedures and requirements

1.
  Notwithstanding any other provision of law, an assisted living  operator
  may  apply  to  the  department  to  obtain  an enhanced assisted living
  certificate pursuant to this section.
    (a) Such application shall be on a form approved by the department.
    (b) An assisted living operator may apply for such a  certificate  for
  the entire facility or any number of beds at the facility.
    (c)  To  obtain an enhanced assisted living certificate, the applicant
  must submit a plan to the department setting forth  how  the  additional
  needs  of  residents  will  be  safely  and  appropriately  met  at such
  residence. Such plan shall include,  but  need  not  be  limited  to,  a
  written  description  of  services, staffing levels, staff education and
  training, work experience, and any environmental modifications that have
  been made or will be made to protect the health, safety and  welfare  of
  such persons in the residence.
    (d)  In  addition  to  any  other  requirements of assisted living, an
  operator of enhanced  assisted  living  may  hire  care  staff  directly
  pursuant  to  standards  developed  by the department or contract with a
  home care services agency which has been approved to operate pursuant to
  article thirty-six of this chapter.
    (e) No assisted  living  residence  shall  be  certified  as  enhanced
  assisted  living  unless  and  until  the  applicant obtains the written
  approval of the department.
    2. No resident shall be permitted to continue to age  in  place  under
  the  terms  of  an  enhanced  assisted  living  certificate  unless  the
  operator, the resident's physician, and, if applicable,  the  resident's
  licensed  or certified home care agency, agree that the additional needs
  of the resident can be safely and appropriately met at the residence.  A
  resident   eligible   for   enhanced  assisted  living  or  his  or  her
  representative shall submit to the residence a  written  report  from  a
  physician, which report shall state that:
    (a) the physician has physically examined the resident within the last
  month; and
    (b)  the  resident  is not in need of twenty-four hour skilled nursing
  care or medical care which would require  placement  in  a  hospital  or
  residential health care facility.
    3. The residence must notify a resident that, while the residence will
  make  reasonable  efforts to facilitate the resident's ability to age in
  place pursuant to an individualized service plan, there may be  a  point
  reached   where   the   needs  of  the  resident  cannot  be  safely  or
  appropriately met at  the  residence,  requiring  the  transfer  of  the
  resident   to  a  more  appropriate  facility  in  accordance  with  the
  provisions of this article.
    4. If a resident reaches the point where he  or  she  is  in  need  of
  twenty-four  hour  skilled  nursing  care or medical care required to be
  provided by facilities licensed pursuant to article twenty-eight of this
  chapter or article nineteen, thirty-one  or  thirty-two  of  the  mental
  hygiene law, then the resident must be discharged from the residence and
  the  operator  shall  initiate  proceedings  for  the termination of the
  residency agreement of such resident in accordance with  the  provisions
  of  section  four  hundred  sixty-one-h  of  the  social  services  law.
  Provided, however, a resident may remain at the residence if each of the
  following conditions are met:
    (a) a resident in need of twenty-four hour  skilled  nursing  care  or
  medical care hires appropriate nursing, medical or hospice staff to care
  for his or her increased needs;
    (b)  the  resident's  physician  and  home  care  services agency both
  determine and document that,  with  the  provision  of  such  additional

  nursing,  medical  or hospice care, the resident can be safely cared for
  in the residence, and would not require placement in a hospital, nursing
  home or other facility  licensed  under  article  twenty-eight  of  this
  chapter  or  article  nineteen,  thirty-one  or thirty-two of the mental
  hygiene law;
    (c) the operator agrees to retain the resident and to  coordinate  the
  care  provided  by  the  operator and the additional nursing, medical or
  hospice staff; and
    (d) the resident is otherwise eligible to reside at the residence.
    5. In addition to the requirements otherwise required for licensure as
  assisted living, any residence that  advertises  or  markets  itself  as
  serving  individuals  with special needs, including, but not limited to,
  individuals with  dementia  or  cognitive  impairments,  must  submit  a
  special needs plan to the department setting forth how the special needs
  of  such  residents  will  be  safely  and  appropriately  met  at  such
  residence. Such plan shall include,  but  need  not  be  limited  to,  a
  written  description  of  specialized  services,  staffing levels, staff
  education and training, work experience,  professional  affiliations  or
  special  characteristics relevant to serving persons with special needs,
  and any environmental modifications that have been made or will be  made
  to  protect  the  health,  safety  and  welfare  of  such persons in the
  residence. In approving an application for special needs  certification,
  the  department  shall develop standards to ensure adequate staffing and
  training in order  to  safely  meet  the  needs  of  the  resident.  The
  standards  shall  be  based  upon  recommendations  of  the  task  force
  established by section five of the chapter of the laws of  two  thousand
  four  which  added this section. No residence shall market themselves as
  providing specialized services  unless  and  until  the  department  has
  approved such applicant for a special needs assisted living certificate.
    6. An enhanced assisted living certificate shall not be required of an
  adult care facility, or part thereof, which has obtained approval by the
  department  to  operate  an  assisted living program pursuant to section
  four hundred sixty-one-l of the social services law. Provided,  however,
  such  exemption shall only apply to those beds at the facility which are
  subject to the assisted living program.
    * NB There are 2 § 4655's