Continuing Care Retirement Community 2024 Annual Statement

General Filing Instructions

This annual statement is for use by Continuing Care Retirement Communities authorized pursuant to Article 46 of the Public Health Law.

Each Continuing Care Retirement Community may submit an electronic version of page 1 of the Jurat and the Certificate of Compliance which must be affixed with original signatures of the officers and a notary.

Instructions with updates regarding electronic filing of the New York Continuing Care Retirement Community Annual Statement with the Department of Financial Services and Department of Health can be found below. A copy of the Annual Statement and Instructions are available below.

The Department of Financial Services recommends that each Continuing Care Retirement Community download the forms packet and return the annual statement material via email. A Continuing Care Retirement Community may also contact the Department of Financial Services as indicated below to request a hard copy of the annual statement filing material.

Specific Filing Information

The Continuing Care Retirement Community Filing Instructions and Forms packet is a compressed zipped file. The Jurat, Certificate of Compliance, and Interrogatories are Microsoft Word files. The Statement Blank is a Microsoft Excel file. The instructions and forms are set to standard 8.5" x 11" paper size.

Continuing Care Retirement Community Filing Instructions and Forms packet (.zip file)

After downloading, unzip the file to obtain the following files:

• General Filing Instructions 2024 (MS Word)
• Jurat (pages 1 and 2 of the Statement) 2024 (MS Word)
• Statement Blank 2024 (MS Excel)
• Interrogatories 2024 (MS Word)
• Certificate of Compliance 2024 (MS Word)
• Instructions for completing the Annual Statement 2024 (PDF)

Due Date and Mailing

The annual statement is required to be filed within four months of the close of the community's fiscal year (all statement filings are expected to be made timely).

All required documents with a copy of the jurat file, blank file, certificate of compliance, interrogatories file, audited financial statement, and any supporting material, when submitted by email, must be submitted to the Department of Financial Services (email: Andre Blackman: Ergys Shanaj; Sylvia Lawson, Mark Brandes, Include also the DFS Regulatory Inbox, plus copy Mike Heeran at the Department of Health.

When requested in hard copy, an original version of any required filing documents will be sent by hard copy to the addresses indicated below, with two paper copies submitted to the Department of Financial Services and one paper copy to the Department of Health. However, the Jurat and Certificate of Compliance must be provided with ORIGINAL signatures when submitted to the Department of Financial Services.

Questions?

If you need help filling out your forms, contact: Health Bureau, Mr. Ergys Shanaj (212) 480-3878 or Mr. Andre Blackman (212) 709-7619, email to: [email protected] and [email protected].