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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>71875</law_id><section_number>38.2-4923</section_number><catch_line>Participant&amp;#8217;s contract</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="49">Continuing Care Providers and Community-Based Continuing Care Providers</unit><unit label="article" level="3" order_by="1" identifier="2">Community-Based Continuing Care Providers</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> In addition to other provisions considered proper to affect the purpose of any <span class="dictionary">community-based continuing care</span> <span class="dictionary">contract</span>, each <span class="dictionary">CBCC</span> <span class="dictionary">contract</span> executed on or after July 1, 2012, shall: <a id="paragraph-258950" class="section-permalink" href="https://vacode.org/38.2-4923/#A"><i class="fa fa-link"/></a></p></section>
						<section id="A1" class="indent-1"><p><span class="prefix-number">1.</span> Provide for <span class="dictionary">community-based continuing care</span>; <a id="paragraph-258951" class="section-permalink" href="https://vacode.org/38.2-4923/#A1"><i class="fa fa-link"/></a></p></section>
						<section id="A2" class="indent-1"><p><span class="prefix-number">2.</span> Show the value of all property transferred, including donations, subscriptions, fees, and any other amounts paid or payable by, or on behalf of, the <span class="dictionary">participant</span>; <a id="paragraph-258952" class="section-permalink" href="https://vacode.org/38.2-4923/#A2"><i class="fa fa-link"/></a></p></section>
						<section id="A3" class="indent-1"><p><span class="prefix-number">3.</span> Specify all services that are to be provided by the <span class="dictionary">CBCC provider</span> to each <span class="dictionary">participant</span> including, in detail, all items that each <span class="dictionary">participant</span> will receive, whether the items will be provided at a certain percentage for a designated time period or for life, and what criteria will be used to distinguish eligibility for certain services; <a id="paragraph-258953" class="section-permalink" href="https://vacode.org/38.2-4923/#A3"><i class="fa fa-link"/></a></p></section>
						<section id="A4" class="indent-1"><p><span class="prefix-number">4.</span> Describe the physical and mental health and financial conditions upon which the <span class="dictionary">CBCC provider</span> may require the <span class="dictionary">participant</span> to relinquish his participation in the program, if any exist; <a id="paragraph-258954" class="section-permalink" href="https://vacode.org/38.2-4923/#A4"><i class="fa fa-link"/></a></p></section>
						<section id="A5" class="indent-1"><p><span class="prefix-number">5.</span> Describe the circumstances under which the <span class="dictionary">participant</span> will be permitted to remain in the program in the event of financial difficulties of the <span class="dictionary">participant</span>; <a id="paragraph-258955" class="section-permalink" href="https://vacode.org/38.2-4923/#A5"><i class="fa fa-link"/></a></p></section>
						<section id="A6" class="indent-1"><p><span class="prefix-number">6.</span> Provide that the <span class="dictionary">CBCC provider</span> shall not cancel any <span class="dictionary">community-based continuing care</span> <span class="dictionary">contract</span> with any <span class="dictionary">participant</span> without good cause. Good cause shall be limited to (i) proof that the <span class="dictionary">participant</span> is a danger to himself or others; (ii) nonpayment by the <span class="dictionary">participant</span> of a monthly or periodic fee; (iii) repeated conduct by the <span class="dictionary">participant</span> that interferes with other <span class="dictionary">participants</span>&#x2019; quiet enjoyment of a facility or service, if applicable; (iv) persistent refusal to comply with reasonable written rules and regulations of the program; (v) a <span class="dictionary">material</span> misrepresentation made intentionally or recklessly by the <span class="dictionary">participant</span> in his application for participation in the program, or related <span class="dictionary">materials</span>, regarding information which, if accurately provided, would have resulted in either a failure of the <span class="dictionary">participant</span> to qualify for participation or a <span class="dictionary">material</span> increase in the cost of providing to the <span class="dictionary">participant</span> the care and services provided under the CBCC <span class="dictionary">contract</span>; or (vi) <span class="dictionary">material</span> breach by the <span class="dictionary">participant</span> of the terms and conditions of the <span class="dictionary">community-based continuing care</span> <span class="dictionary">contract</span>. If a <span class="dictionary">CBCC provider</span> seeks to cancel a CBCC <span class="dictionary">contract</span> and terminate a <span class="dictionary">participant</span>&#x2019;s participation, the provider shall give the <span class="dictionary">participant</span> written notice of, and a reasonable opportunity to cure within a reasonable period, whatever conduct is alleged to warrant the cancellation of the CBCC <span class="dictionary">contract</span>; <a id="paragraph-258956" class="section-permalink" href="https://vacode.org/38.2-4923/#A6"><i class="fa fa-link"/></a></p></section>
						<section id="A7" class="indent-1"><p><span class="prefix-number">7.</span> Provide in clear and understandable language, in print no smaller than the largest type used in the body of the CBCC <span class="dictionary">contract</span>, the terms governing the refund of any portion of the <span class="dictionary">CBCC entrance fee</span> and the terms under which such fee can be used by the <span class="dictionary">CBCC provider</span>; <a id="paragraph-258957" class="section-permalink" href="https://vacode.org/38.2-4923/#A7"><i class="fa fa-link"/></a></p></section>
						<section id="A8" class="indent-1"><p><span class="prefix-number">8.</span> <span class="dictionary">State</span> the terms under which a CBCC <span class="dictionary">contract</span> is cancelled by the death of the <span class="dictionary">participant</span>. The CBCC <span class="dictionary">contract</span> may contain a provision to the effect that, upon the death of the <span class="dictionary">participant</span>, the money paid for the <span class="dictionary">community-based continuing care</span> of such <span class="dictionary">participant</span> shall be considered earned and become the property of the <span class="dictionary">CBCC provider</span>; and <a id="paragraph-258958" class="section-permalink" href="https://vacode.org/38.2-4923/#A8"><i class="fa fa-link"/></a></p></section>
						<section id="A9" class="indent-1"><p><span class="prefix-number">9.</span> Provide for at least 30 days&#x2019; advance notice to the <span class="dictionary">participant</span> before any change in fees, charges, or the scope of care or services may be effective, except for changes required by <span class="dictionary">state</span> or federal assistance programs. <a id="paragraph-258959" class="section-permalink" href="https://vacode.org/38.2-4923/#A9"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> A <span class="dictionary">participant</span> shall have the right to rescind a <span class="dictionary">community-based continuing care</span> <span class="dictionary">contract</span>, without <span class="dictionary">penalty</span> or forfeiture, within seven days after making an initial deposit or executing the <span class="dictionary">contract</span>. A <span class="dictionary">participant</span> shall not be required to initiate the program outlined in the <span class="dictionary">contract</span> before the expiration of the seven-day period. <a id="paragraph-258960" class="section-permalink" href="https://vacode.org/38.2-4923/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> If a <span class="dictionary">participant</span> dies before initiating the program, or is precluded through illness, injury, or incapacity from becoming a <span class="dictionary">participant</span> under the terms of the <span class="dictionary">community-based continuing care</span> <span class="dictionary">contract</span>, the <span class="dictionary">contract</span> is automatically rescinded and the <span class="dictionary">participant</span> or his legal representative shall receive a full refund of all money paid to the <span class="dictionary">CBCC provider</span>, except those costs specifically incurred by the <span class="dictionary">CBCC provider</span> at the request of the <span class="dictionary">participant</span> and set forth in writing in a separate <span class="dictionary">addendum</span>, signed by both parties, to the <span class="dictionary">contract</span>. <a id="paragraph-258961" class="section-permalink" href="https://vacode.org/38.2-4923/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> No standard <span class="dictionary">community-based continuing care</span> <span class="dictionary">contract</span> form shall be used in the Commonwealth until it has been submitted to the <span class="dictionary">Commission</span>. If the <span class="dictionary">Commission</span> determines that the CBCC <span class="dictionary">contract</span> does not comply with the provisions of this article, it shall have the right to take action pursuant to &#xA7; <a class="law" title="Cease and desist orders; injunctions" href="/38.2-4931/">38.2-4931</a> to prevent its use. The failure of the <span class="dictionary">Commission</span> to <span class="dictionary">object</span> to or disapprove of any CBCC <span class="dictionary">contract</span> shall not be <span class="dictionary">evidence</span> that the <span class="dictionary">contract</span> does or does not comply with the provisions of this article. However, individualized amendments to any standard form need not be filed with the <span class="dictionary">Commission</span>. <a id="paragraph-258962" class="section-permalink" href="https://vacode.org/38.2-4923/#D"><i class="fa fa-link"/></a></p></section></text><history>2012, cc. 208, 303.</history><metadata></metadata></law>
