Definitions

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As used in this subchapter:

  1. (1) “Commissioner” means the Insurance Commissioner;

  2. (2)

    1. (A) “Continuing care” means the furnishing of independent living units to individuals and:

      1. (i) Furnishing nursing care or personal care services under an agreement, whether the nursing care or personal care services are provided in the facility or in another setting designated by the agreement for providing continuing care to individuals; and

      2. (ii)

        1. (a) Requiring the payment of an entrance fee by an individual not related by consanguinity or affinity to the provider furnishing the living unit.

        2. (b) Payment may be made by an entrance fee alone, an entrance fee and periodic payments, or by payment of less fees for service.

    2. (B) Agreements to provide continuing care shall include agreements to provide care for any duration, including agreements that are terminable by either party;

  3. (3) “Department” means the State Insurance Department;

  4. (4) “Entrance fee” means an initial or deferred transfer to a provider of a sum of money or other property made or promised to be made as full or partial consideration for acceptance of a specified individual as a resident in a facility which exceeds six (6) months' rental of the living unit. An accommodation fee, admission fee, or other fee of similar form and application shall be considered to be an entrance fee;

  5. (5) “Facility” means a place which provides continuing care;

  6. (6) “Living unit” means a room, apartment, cottage, or other area within a facility set aside for the exclusive use or control of one (1) or more identified individuals;

  7. (7)

    1. (A) “Nursing care” means those services pertaining to the curative, restorative, and preventive aspects of nursing services that are performed by or under the supervision of a registered or licensed nurse.

    2. (B) “Nursing care” does not include general health service such as nutritional counseling, exercise programs, or other preventive medicine techniques;

  8. (8)

    1. (A) “Personal care services” means assistance with meals, dressing, movement, bathing, or other personal needs of maintenance or other direct supervision and oversight of the physical and mental well-being of a person.

    2. (B) “Personal care services” does not include general health services such as nutritional counseling, exercise programs, or other preventive medicine techniques;

  9. (9) “Provider” means the owner or operator, whether a natural person, partnership, or other incorporated association, trust, or corporation whose owner or operator undertakes to provide continuing care for a fee, whether fixed or variable, for the period of care. The fee may be payable in lump sum, in lump sum and monthly maintenance charges, or in installments;

  10. (10) “Refund reserve” means the actuarially determined annual refund amount required to be maintained by a continuing care provider for service of its refund amounts during the next fiscal year of the facility;

  11. (11) “Resident” means an individual entitled to receive continuing care in a facility; and

  12. (12) “Solicit” means all actions of a provider in seeking to have individuals residing in this state pay an application fee and enter into a continuing care agreement by any means, such as, but not limited to, personal, telephone, or mail communication or any other communication directed to and received by any individual in this state and any advertisements in any media distributed or communicated by any means to individuals in this state.


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