BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Jim Beall, Chair


          BILL NO:       AB 1751                                      
          A
          AUTHOR:        Bloom                                        
          B
          VERSION:       June 15, 2014
          HEARING DATE:  June 24, 2014                                
          1
          FISCAL:        Yes                                          
          7
                                                                      
          5
          CONSULTANT:    Sara Rogers                                  
          1

                                        

                                     SUBJECT
                                         
                     Continuing care retirement communities

                                     SUMMARY  

          This bill requires Continuing Care Retirement Community  
          (CCRC) providers to make specified financial statements  
          available to residents on a quarterly basis, rather than  
          semi-annually. Additionally, this bill requires CCRC  
          providers that have governing bodies in the state to  
          include at least one resident, or two residents if the  
          facility has more than 21 members, as voting members of the  
          facility's governing body. This bill requires that  
          providers whose governing bodies administer multiple CCRCs  
          shall provide specified information to the residents'  
          association of any facility that does not have voting  
          representation on the governing body. Additionally, this  
          bill provides that the residents' association or a  
          committee of residents shall nominate prospective residents  
          for the governing body's approval, as specified.

                                     ABSTRACT  


                                                         Continued---




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           Existing law:


           1.Provides for the licensure and regulation of Continuing  
            Care Retirement Communities (CCRCs) by the California  
            Department of Social Services (CDSS) to enact minimum  
            requirements to protect the wellbeing and financial  
            security of residents of CCRCs. (HSC 1770 et seq.)


          2.Establishes the Residential Care Facilities for the  
            Elderly Act, which requires CDSS to license and regulate  
            RCFEs as a separate category within the existing  
            community care licensing structure of CDSS. (HSC 1569 et  
            seq.) 


          3.Provides for the regulation and licensure of skilled  
            nursing facilities by the California Department of Public  
            Health (CDPH). (HSC 1250 et seq.)


          4.Requires a CCRC provider to hold a certificate of  
            authority from CDSS permitting the provider to contract  
            for the provision of continuing care, including medical  
            care, in which a resident over the age of 60 has paid in  
            advance for more than one year for that care. (HSC  
            1771.2)


          5.Provides that the components of care provided by the  
            facility must be separately licensed as otherwise  
            required by state law, including Residential Care  
            Facilities for the Elderly and Skilled Nursing care. (HSC  
            1771.5)


          6.Requires CCRCs to encourage the formation of a residents'  
            association by interested residents who may elect a  
            governing body, to provide space, post notices, and  
            provide assistance as needed. (HSC 1771.7)


          7.Requires the governing body of the provider, or a  
            designated representative, to hold semi-annual meetings  





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            with community residents, and to hold resident meetings  
            at least 30 days prior to any planned monthly care fee  
            increase. (HSC 1771.8)


          8.Requires a provider to make a facility financial  
            statement of activities available to the resident  
            association, comparing actual costs to budgeted costs  
            broken down by expense category. (HSC 1771.8 (f))


          9.Requires a provider to accept at least one resident to  
            participate as a non-voting member of the provider's  
            governing body, or if the provider operates multiple  
            communities to elect to have one non-voting resident for  
            each community or to allow residents to elect a  
            representative for every three communities it operates.  
            (HSC 1771.8 (i))


          10.Requires CCRC providers to submit an annual financial  
            report to CDSS, as specified (HSC 1790).


           This bill:


           1.Increases, from semi-annually to quarterly, the frequency  
            that CCRC providers must make a financial statement of  
            activities available to residents, comparing actual costs  
            to budgeted costs broken down by expense category. 


          2.Requires providers to include a written explanation of  
            all significant budget variances in the financial  
            statement of activities.


          3.Requires providers to conspicuously post annual reports  
            on their Internet websites, within 10 days after being  
            submitted to CDSS.


          4.Requires providers to include at least one resident, or  
            two residents if the facility has more than 21 members,  





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            as voting members of the facilities governing body, upon  
            the next vacancy or next regularly scheduled selection of  
            the governing body occurring on or after January 1, 2015.


          5.Grants an exception to providers that have no governing  
            body in the state from the above requirement, and  
            requires those providers to appoint a select committee of  
            its governing body members to meet with residents prior  
            to any regularly scheduled governing body meeting at each  
            of its facilities and to ensure that the opinions of  
            residents are relayed to all governing body members of  
            the provider. 


          6.Requires providers whose governing bodies administer  
            multiple communities to provide the same notice of  
            meetings, packets, minutes and other materials to the  
            residents association of any facility that does not have  
            voting representation on the governing body. 


          7.Provides that the residents association or a committee of  
            residents shall nominate prospective residents for the  
            governing body's approval, as specified.


          8.Strikes statutory references to the fulfilled requirement  
            that CDSS provide specified recommendations and written  
            guidelines available to residents and providers by 2003.


                                  FISCAL IMPACT
           
          An Assembly Appropriations Committee analysis states there  
          are minor, absorbable costs to CDSS to oversee  
          implementation of these new CCRC requirements.

                            BACKGROUND AND DISCUSSION  

          According to the author, seniors opting to reside in CCRCs  
          pay hundreds-of-thousands of dollars to buy into CCRCs,  
          often selling their homes and using their life savings to  
          pay entry fees in exchange for a lifetime of residency and  
          care. Additionally, the author states that financial  





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          difficulties at CCRCs can lead to the postponing or  
          abandonment of repairs or maintenance, unexpected increase  
          in monthly fees, loss of the resident's refundable entry  
          fee, or unexpected charges for previously free services.  
          The author states that this bill will ensure residents are  
          represented on provider boards, allowing such boards to  
          better serve the interests of each CCRC and its residents.

           Continuing Care Retirement Community model 

           CCRCs have been likened to long-term care insurance, with  
          seniors paying large entry fees ranging from $50,000 to  
          more than $2 million, in exchange for access to a range of  
          levels of care services, including independent living,  
          assisted living and skilled nursing care intended to meet  
          the care needs of residents over a specified period of time  
          as they age. A portion of the entrance fees, between 90 and  
          50 percent typically are subject to refund upon the death  
          of the resident, or if the resident opts to leave the  
          community. Some facilities offer life care contracts  
          through which a facility agrees to care for the resident  
          for the remainder of the resident's life, regardless of  
          whether the resident outlives his or her financial  
          resources. 

          In addition to entrance fees, residents pay monthly fees,  
          which may be held constant as the resident ages and needs  
          increase, or may increase as the resident needs increasing  
          levels of care. Such monthly fees range widely from $500 to  
          $9,000 a month for independent living, between $3,000 and  
          $7,000 for assisted living, and upwards from $7,000 to  
          $17,000 per month for skilled nursing. 

          There are currently 95 facilities certified as CCRCs in  
          California, 75 of which are nonprofit, frequently operated  
          by religious or philanthropic organizations, and 20 of  
          which are for-profit. There are eight nonprofit  
          multiple-facility providers and 1 for-profit  
          multiple-facility provider (Emeritus). 

           Regulatory Structure

           CCRCs are required to file an application for a "Permit to  
          Accept Deposits/Certificate of Authority" with the  
          Continuing Care Contracts Branch of CDSS. In addition,  





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          facilities that operate an assisted living level of care  
          are required to have those facilities licensed by CDSS as  
          Residential Care Facilities for the Elderly (RCFEs).  
          Facilities operating a skilled nursing level of care must  
          have those facilities licensed by the Department of Public  
          Health.

          Required Annual Reports

          Providers are required to submit an annual report to CDSS  
          describing the facility's financial condition within four  
          months after their fiscal year end. The reports are  
          required to consist of audited financial statements and  
          required reserve calculations, evidence of fidelity bonds  
          (insuring against dishonest employee conduct) as well as  
          additional information. This includes a certification, if  
          applicable, that reserves for prepaid continuing care  
          contracts, statutory reserves, and refund reserves are  
          being maintained; details on status, description, and  
          amount of all reserves maintained, and on per capita  
          operation costs; disclosure accumulated or expended funds  
          for identified purposes, as specified; details of any  
          increase in monthly care fees, including the basis for  
          determining the increase, and the data used to calculate  
          the increase; the auditor's opinion as to compliance with  
          applicable statutes, and any other information CDSS may  
          require.

          Providers are also required to submit a "Key Indicators  
          Report" disclosing key financial ratios and other key  
          indicators within 30 days following the submission of each  
          annual report. Additionally, CCRCs that have contracts  
          promising to provide care without substantially increasing  
          monthly fees as needs increase must submit an actuarial  
          study to CDSS every five years regarding the actuarial  
          financial position of the facility.

          Required Reserves

          CCRC providers are required to maintain a liquid reserve a  
          reserve for long-term debt obligations that must be equal  
          to the sum of the prior fiscal year payments for the  
          following:

          (1) All regular principal and interest payments paid by the  





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          provider for fully amortizing long-term debt. If a provider  
          has incurred new long-term debt during the immediately  
          preceding fiscal year, the required reserve is 12 times the  
          provider's most recent monthly payment on the debt.
          (2) Facility rental or leasehold payments, and any related  
          payments such as lease insurance.
          (3) Any debt that provides for a balloon payment. If the  
          balloon payment debt was incurred within the immediately  
          preceding fiscal year, the required reserve is 12 times the  
          provider's most recent monthly payment on the debt.


          Additionally, CCRCs are required to maintain a liquid  
          reserve for operating expenses in an amount that equals or  
          exceeds 75 days' net operating expenses, as defined. 

          CCRCs offering a refundable contract are required to  
          maintain a reserve for refunds, held in a trust fund.  
          Providers are permitted to invest up 70 percent of the  
          refund reserves in the real estate that is used to provide  
          care and housing for the residents where they reside  
          (limited to 50 percent of the providers' net equity in the  
          real estate). The required amount of the reserve is  
          calculated using a statutorily established formula based on  
          life expectancy for the residents and the portion of the  
          entry fee that is refundable.

          Financial Stability of CCRCs

          Earlier this year, residents of a Palo Alto CCRC (Vi at  
          Palo Alto) filed a class action lawsuit against the  
          provider and its parent company which states that the  
          facility maintained no financial reserve intended to pay  
          for expected refunds (in violation of state law) and that  
          nearly $200 million dollars had been passed to a parent  
          corporation in Chicago that has no liability to pay for  
          refunds if the provider is unable to refund entrance fees.  
          Additionally, the lawsuit alleges that the provider  
          improperly included charges in the resident's increasing  
          monthly fees that include certain taxes, earthquake  
          insurance and marketing costs that are not attributable to  









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          the residents.<1> 

          This class action lawsuit has many similarities to a 2007  
          lawsuit against the Vi La Jolla which stated that the  
          facility had improperly transferred $85 million in entrance  
          fees to the parent company, leaving the facility unable to  
          pay refunds, and leading to unnecessary increases in  
          monthly fees and decreases in the quality of care. The  
          lawsuit was settled leading to a $2,270,000 lump-sum  
          payment to residents ($1.4 million of which was paid as  
          attorney's fees), a 3 percent ceiling on monthly fee  
          increases and other improvements to the availability and  
          quality of care.<2>

          Many CCRCs maintain the refund reserve in the form of  
          real-estate investments, including the property where  
          residents are cared for. Refunds then are paid to residents  
          who leave by reselling the apartments or cottages, or by  
          bringing in new entrance fees. However, the recent  
          recession is blamed for causing the bankruptcies of 6 to 8  
          CCRCs nationally and caused serious financial hardship in  
          others as many prospective residents were unable to sell  
          their homes to finance the entrance fees. Additionally, a  
          large portion of the required reserves are permitted to be  
          invested in real estate, the value of which plummeted,  
          leading to additional financial instability in many  
          facilities.

          Residential Care Facilities for the Elderly

          There are approximately 8,000 Assisted Living, Board and  
          Care, and Continuing Care Retirement homes that are  
          licensed as RCFEs in California. These residences are  
          designed to provide homelike options to residents who need  
          some help with activities such as cooking, bathing, or  
          getting dressed, but do not need continuous, 24-hour  
          assistance or nursing care. 
          -------------------------


          <1>  
          http://www.naccrau.com/Library/ViLitigation2014/Documents/co 
          mplaint.pdf

          <2>  
          http://www.lawconger.com/images/images/Short/Judgment%2010-3 
          -2008.pdf





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          Industry Concerns

          The California Association of CCRCs (CACCRC), an industry  
          organization representing for-profit CCRC providers states  
          that many of its members are "closely held corporations"  
          that do not have governing bodies of the type envisioned by  
          this bill, but instead are Limited Liability Corporations,  
          or sole proprietorships controlled by a small number of  
          individuals or investors. According to CACCRC, it would not  
          be appropriate to require resident representation in  
          decision-making for these closely held private entities  
          that are controlled by individuals who have in many cases  
          invested their entire life savings into the facility. 


          CACCRCs letter to oppose the bill unless amended states AB  
          1751 is "especially problematic to providers whose  
          governing bodies do not resemble the types of large boards  
          of directors that typically serve as the governing bodies  
          of not-for-profit corporations. Requiring a resident as a  
          "voting board member" may work well within a non-profit  
          structure, where the resident member is one of 21 (or more)  
          board members, however this proposal poses a practical  
          problem when working within a for-profit structure. When  
          the provider of a continuing care retirement community is a  
          closely held corporation, a small partnership, a Limited  
          Liability Company, or other similar configuration, the  
          "governing body" often consists of a small number of people  
          who are investors in the entity. In many cases, placing a  
          resident with a voting right in the pool of a few owners  
          would give them a sizable percentage of the voting power to  
          a private company, giving them say equal to an owner. AB  
          1751 is just not practical with regard to for-profit  
          entities and would essentially hand control of a private  
          company to the resident council - a "regulatory taking" of  
          a private organization."


          Additionally, CACCRC states that there are currently  
          numerous systems, policies and procedures and committees by  
          which a resident can influence operations of the CCRC  
          Community. The letter states that formal, lengthy Resident  
          Surveys by a third party company are performed ever third  





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          year and cover resident views on every management  
          department within the resident community. The survey also  
          attempts to measure the overall quality of life within the  
          community (and written resident comments are solicited).  
          Comparisons are made to previous years' results. The survey  
          results are then broken down and provided to the Director  
          of each department who in turn is required to address  
          deficiencies with an action plan. 


                                     COMMENTS


           The provisions of this bill establish certain requirements  
          on CCRC providers that operate solely in California, and  
          provide an exception to those providers that do not have a  
          governing body in state. The author intends further  
          amendments to address concerns of CACCRCs that provide a  
          further exception to for-profit providers that are a  
          "closely held corporation." Staff notes that these  
          amendments may create a substantial disparity between  
          requirements imposed on non-profit providers as compared  
          with for-profit or out-of-state providers. 

                                   PRIOR VOTES  

          Assembly Floor           52 - 23
          Assembly Appropriations       11 - 5
          Assembly Aging and Long Term Care   5 - 2


                                    POSITIONS  

          Support:       California Advocates for Nursing Home Reform
                         California State Retirees
                         Consumer Federation of California
                         National Association of Social Workers        
                                                                 


          Oppose:        California Association of Continuing Care  
                         Retirement-  
                         Communities 







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