EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0076*
SENATE BILL 76
O2, J3 4lr1287
(PRE–FILED) CF HB 68
By: Senators Lam and Hettleman
Requested: October 30, 2023
Introduced and read first time: January 10, 2024
Assigned to: Finance
A BILL ENTITLED
AN ACT concerning 1
Continuing Care Retirement Communities – Governing Bodies, Grievances, and 2
Entrance Fees 3
FOR the purpose of altering the membership of governing bodies of continuing care 4
retirement communities by increasing the number of subscribers under certain 5
circumstances; altering the number of times select committees of certain providers 6
are required to meet with subscribers each year; requiring the Department of Aging 7
to collect certain information about certain internal grievances; altering the 8
processes for the termination of a continuing care agreement under certain 9
circumstances; altering the process for refunding certain entrance fees under certain 10
circumstances; and generally relating to continuing care retirement communities. 11
BY repealing and reenacting, without amendments, 12
Article – Human Services 13
Section 10–101(a), (e), and (h) 14
Annotated Code of Maryland 15
(2019 Replacement Volume and 2023 Supplement) 16
BY adding to 17
Article – Human Services 18
Section 10–401(v) 19
Annotated Code of Maryland 20
(2019 Replacement Volume and 2023 Supplement) 21
BY repealing and reenacting, with amendments, 22
Article – Human Services 23
Section 10–401(v) and (w), 10–408(b)(3), 10–427, 10–428, and 10–449 24
Annotated Code of Maryland 25
(2019 Replacement Volume and 2023 Supplement) 26
2 SENATE BILL 76
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
That the Laws of Maryland read as follows: 2
Article – Human Services 3
10–101. 4
(a) In this title the following words have the meanings indicated. 5
(e) “Department” means the Department of Aging. 6
(h) “Secretary” means the Secretary of Aging. 7
10–401. 8
(V) “RESIDENT ASSOCIATION ” INCLUDES A RESIDENT ASSOCIATION OR AN 9
EQUIVALENT BODY . 10
[(v)] (W) “Subscriber” means an individual for whom a continuing care 11
agreement is purchased. 12
[(w)] (X) (1) “Surcharge” means a separate and additional charge that: 13
(i) is imposed simultaneously with the entrance fee; and 14
(ii) may be required of some, but not all, subscribers because of a 15
condition or circumstance that applies only to those subscribers. 16
(2) “Surcharge” does not include a second person entrance fee. 17
10–408. 18
(b) (3) A capital improvement or replacement that does not meet the standard 19
of [§ 10–401(w)] § 10–401(X) of this subtitle is not subject to review by the Department 20
under §§ 10–409 through 10–415 of this subtitle. 21
10–427. 22
(a) (1) If a provider has a governing body, at least [one] TWO of the provider’s 23
subscribers shall be [a] full and regular [member] MEMBERS of the governing body. 24
(2) If the provider owns or operates [more than three] MULTIPLE facilities 25
in the State, the governing body shall include at least one of the provider’s subscribers [for 26
every three facilities] FROM EACH FACILITY in the State. 27
SENATE BILL 76 3
(3) [Subject to paragraph (4) of this subsection, a] A member of the 1
governing body who is selected to meet the requirements of this subsection shall be a 2
subscriber at a facility in the State and be [selected according to the same general written 3
standards and criteria used to select other members of the governing body] ELECTED BY 4
THE RESIDENT ASSOCIA TION OF THE FACILITY . 5
(4) [The governing body shall confer with the resident association at each 6
of the provider’s facilities before the subscriber officially joins the governing body] A 7
SUBSCRIBER MEMBER OF A GOVERNING BODY MAY REPORT ON NONCONFIDE NTIAL 8
DELIBERATIONS , ACTIONS, AND POLICIES OF THE GOVERNING BODY TO TH E 9
RESIDENT ASSOCIATION . 10
(5) THE GOVERNING BODY OF EACH OF THE PROVIDER ’S FACILITIES 11
SHALL DIRECT AN OFFI CER OF THE PROVIDER TO MEET AT LEAST QUA RTERLY TO 12
REVIEW AND DISCUSS T HE CURRENT FINANCIAL STATEMENTS OF THE PR OVIDER 13
WITH THE RESIDENT AS SOCIATION OR A COMMI TTEE DESIGNATED BY T HE RESIDENT 14
ASSOCIATION. 15
(6) The Secretary may waive the requirements of this subsection for a 16
provider in the process of decertifying as a provider, if the Secretary determines that there 17
are no subscribers willing and able to serve on the governing body. 18
(b) (1) If a provider does not have a governing body, the provider shall appoint 19
a select committee of its officers or partners to meet at least [twice a year] QUARTERLY 20
with the resident association at each of its facilities to address concerns of the subscribers 21
and to ensure that the opinions of subscribers are relayed to all officers or partners of the 22
provider. 23
(2) If a facility does not have a resident association, the committee shall 24
meet with a reasonable number of representatives, not required to exceed fifteen, that the 25
subscribers elect. 26
(c) As determined by the provider’s governing body, the provider shall make 27
available to subscribers either the nonconfidential portions of the minutes of each meeting 28
of the governing body or a summary of the nonconfidential portions of the minutes, within 29
1 month of approval of the minutes. 30
10–428. 31
(a) A provider shall establish an internal grievance procedure to address a 32
subscriber’s grievance. 33
(b) The internal grievance procedure shall at least: 34
(1) allow a subscriber or group of subscribers collectively to submit a 35
written grievance to the provider; 36 4 SENATE BILL 76
(2) require the provider to send a written acknowledgment to the 1
subscriber or group of subscribers within 5 days after receipt of the written grievance; 2
(3) require the provider to assign personnel to investigate the grievance; 3
(4) give a subscriber or group of subscribers who file a written grievance 4
the right to meet with management of the provider within 30 days after receipt of the 5
written grievance to present the grievance; and 6
(5) require the provider to respond in writing within 45 days after receipt 7
of the written grievance regarding the investigation and resolution of the grievance. 8
(c) (1) Within 30 days after the conclusion of an internal grievance procedure 9
established under this section, a subscriber, group of subscribers, or provider may seek 10
mediation through one of the Community Mediation Centers in the State or another 11
mediation provider. 12
(2) If a provider, subscriber, or group of subscribers seeks mediation under 13
paragraph (1) of this subsection, the mediation shall be nonbinding. 14
(D) (1) AT LEAST TWICE EACH YEAR, THE DEPARTMENT SHALL COLL ECT 15
FROM EACH PROVIDER I NFORMATION ABOUT INT ERNAL GRIEVANCES FIL ED FOR 16
EACH OF THE PROVIDER’S FACILITIES, INCLUDING: 17
(I) THE NUMBER OF INTERN AL GRIEVANCES FILED ; 18
(II) THE SUBJECT MATTER O F EACH GRIEVANCE FIL ED; 19
(III) WHETHER A GRIEVANCE WENT TO MEDIATION AN D THE 20
OUTCOME OF THE MEDIA TION; AND 21
(IV) THE FINAL DISPOSITIO N OF EACH FILED GRIE VANCE. 22
(2) ON OR BEFORE DECEMBER 1 EACH YEAR, THE DEPARTMENT 23
SHALL REPORT ON THE DATA RECEIVED FROM EACH PROVIDER UNDER PAR AGRAPH 24
(1) OF THIS SUBSECTION . 25
10–449. 26
(a) A continuing care agreement shall allow a subscriber to terminate the 27
agreement by giving a written termination notice to the provider. 28
[(b) If a continuing care agreement is terminated by the subscriber’s election or 29
death within the first 90 days of occupancy, the provider shall pay any contractual entrance 30
fee refund within 30 days after the earlier to occur of: 31 SENATE BILL 76 5
(1) the recontracting of the subscriber’s unit by: 1
(i) another subscriber for whom an entrance fee has been paid; or 2
(ii) another party who is not a subscriber; or 3
(2) the later to occur of: 4
(i) the 90th day after the date the written termination notice is 5
given or the date of death; or 6
(ii) the day the independent living units at the facility have operated 7
at 95% of capacity for the previous 6 months. 8
(c) If a continuing care agreement is terminated by the subscriber’s election or 9
death after the first 90 days of occupancy, the provider shall pay any contractual entrance 10
fee refund within 60 days after the subscriber’s death or the effective date of termination, 11
if on the date of death or at any time between the date the written termination notice is 12
given and the effective date of termination: 13
(1) the subscriber resides in a unit at a higher level of care than the level 14
of care in which the subscriber resided on initially entering the facility; and 15
(2) the last unit in which the subscriber resided at the initial level of care 16
on entering the facility has been occupied by or reserved for another subscriber who has 17
paid an entrance fee.] 18
(B) (1) IF A CONTINUING CARE AGREEMENT IS TERMINA TED: 19
(I) BY WRITTEN NOTICE GI VEN BY A SUBSCRIBER , THE 20
TERMINATION DATE OF THE CONTINUING CARE AGREEMENT SHALL BE O N THE DATE 21
ON WHICH THE SUBSCRIBER VACATED THE UNIT AND REMOVED ALL PERSONAL 22
PROPERTY OF THE SUBS CRIBER FROM THE UNIT ; OR 23
(II) ON THE SUBSCRIBER ’S DEATH, THE TERMINATION OF THE 24
CONTINUING CARE AGRE EMENT SHALL BE EFFEC TIVE ON THE DATE OF THE 25
SUBSCRIBER’S DEATH. 26
(2) WHEN A CONTINUING CAR E AGREEMENT IS TERMI NATED BY THE 27
SUBSCRIBER’S ELECTION OR DEATH , THE PROVIDER SHALL P AY ANY CONTRACTUAL 28
ENTRANCE FEE REFUND . 29
(C) (1) IF A CONTINUING CARE AGREEMENT PROVIDES F OR A 30
REFUNDABLE ENTRANCE FEE CONDITIONED ON T HE REOCCUPANCY OR 31 6 SENATE BILL 76
RECONTRACTING OF THE SUBSCRIBER’S UNIT, THE PROVIDER SHALL A SSIGN THE 1
UNIT A SEQUENTIAL RE FUND NUMBER TO DETER MINE THE ORDER OF RE FUNDABLE 2
ENTRANCE FEES TO BE PAID. 3
(2) WHEN A SEQUENTIAL REF UND NUMBER IS ASSIGN ED UNDER 4
PARAGRAPH (1) OF THIS SUBSECTION , THE PROVIDER SHALL R ECORD: 5
(I) THE DATE WHEN THE NU MBER WAS ASSIGNED ; AND 6
(II) THE NUMBER OF VACATE D AND AVAILABLE UNIT S AT THE 7
FACILITY ON THE DATE THE NUMBER WAS ASSIGNED. 8
(D) (1) EXCEPT AS PROVIDED IN SUBSECTION (E) OF THIS SECTION , 9
BEGINNING 60 DAYS AFTER THE EFFEC TIVE DATE OF TERMINA TION OF A 10
CONTINUING CARE AGRE EMENT, THE SUBSCRIBER OR TH E SUBSCRIBER ’S ESTATE 11
SHALL HAVE THE RIGHT TO RECEIVE A REFUND IN THE AM OUNT EQUAL TO ANY 12
ENTRANCE FEE PROVIDE D IN THE CONTINUING CARE AGREEMENT LESS THE 13
AMOUNT OF ANY : 14
(I) UNPAID FEES OR CHARG ES INCURRED BY THE S UBSCRIBER, 15
INCLUDING MONTHLY SE RVICES FEES; AND 16
(II) CHARITABLE ASSISTANC E PROVIDED BY THE PROVIDER TO 17
THE SUBSCRIBER . 18
(2) AFTER A CONTINUING CA RE AGREEMENT TERMINA TES, THE 19
BALANCE ESTABLISHED UNDER PARAGRAPH (1) OF THIS SUBSECTION S HALL BE 20
PAYABLE TO THE SUBSC RIBER OR SUBSCRIBER ’S ESTATE IN THE ORDE R OF THE 21
SEQUENTIAL REFUND NU MBER ASSIGNED UNDER SUBSECTION (C) OF THIS SECTION. 22
(E) NOTWITHSTANDING OTHER PROVISIONS OF LAW , A PROVIDER SHALL 23
PAY THE BALANCE OF A NY CONTRACTUAL ENTRA NCE FEE REFUND WITHI N 60 DAYS 24
OF THE TERMINATION D ATE IF ON THE TERMIN ATION DATE A SUBSCRI BER RESIDED 25
IN A UNIT AT A HIGHE R LEVEL OF CARE THAN THE LEVEL OF CA RE IN WHICH THE 26
SUBSCRIBER RESIDED W HEN THE SUBSCRIBER I NITIALLY RESIDED AT THE 27
FACILITY. 28
[(d)] (F) This section does not prohibit a provider from requiring that a 29
subscriber’s unit be vacated before any contractual entrance fee refund is paid as a result 30
of the subscriber’s election to terminate a continuing care agreement. 31
(G) EVERY 6 MONTHS, A PROVIDER SHALL SUB MIT TO THE DEPARTMENT A 32
REPORT THAT INCLUDES , FOR THE PRIOR 6 MONTHS: 33
SENATE BILL 76 7
(1) THE NUMBER OF SATISF IED ENTRANCE FEE REF UNDS; 1
(2) THE DOLLAR AMOUNT OF EACH SATIS FIED ENTRANCE FEE 2
REFUND; 3
(3) THE OUTSTANDING SEQU ENTIAL LIST OF ENTRA NCE FEE 4
REFUNDS, INCLUDING DOLLAR AMO UNTS DUE; 5
(4) THE CURRENT PERCENTA GE OF UNITS AT A FACILITY THAT ARE 6
OCCUPIED; AND 7
(5) THE AVERAGE LENGTH O F TIME THE PROVIDER TAKES TO 8
CONTRACT OR RECONTRA CT UNITS. 9
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall be construed to 10
apply only prospectively and may not be applied or interpreted to have any effect on or 11
application to any cause of action arising before the effective date of this Act. 12
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 13
October 1, 2024. 14