Increasing Safety In Assisted Living Residences

With regard to the involuntary discharge of residents from an assisted living residence (residence), the act:

• Requires a residence to provide written notice to the resident and other specified persons at least 30 days prior to the involuntary discharge, unless the reason for the involuntary discharge is because the resident needs a higher level of care than can be provided in the residence or the resident poses a harm to the resident or to other residents;
• If the involuntary discharge is due to a resident's nonpayment of monthly services and room and board, the residence may discharge the resident 31 days after the resident received the notice of discharge.
• Requires the residence to include certain information and documentation with the written notice; and
• Establishes a process for a resident or other specified persons to challenge an involuntary discharge, including the ability to file a grievance with the residence, a requirement that the residence respond to the grievance, the ability to appeal to the department of public health and environment (department), and the ability to request an administrative hearing, and establishes time frames for the grievance process.

In addition, the act:

• Requires the state board of health (board) to promulgate rules establishing residence administrator standards that require all administrators, on and after January 1, 2024, to have at least one year of experience supervising the delivery of personal care services, or have equivalent experience or education, regardless of the date the administrator was hired, and establishing a fine for the residence if the residence's administrator or interim administrator fails to meet the standards. The act also authorizes the department to refuse to renew a license for a facility without a qualified administrator.
• Requires the residence owner or residence to obtain a check of the Colorado adult protective services data system for any employee providing direct care to residents;
• Requires the residence to comply with provisions concerning involuntary discharge of residents; and
• Establishes a range of fines for violations, including violations that result in harm or injury to residents. The department shall make recommendations to the state board concerning the range of fines after consulting with the statutory advisory committee relating to assisted living residences.

The act removes the $2,000 annual cap on the amount of fines that may be imposed by the department as an intermediate restriction or condition on a residence licensee, replaces it with a fine not to exceed $10,000 per violation, and allows the department to impose a fine in excess of the $10,000 cap for an egregious violation that results in death or serious injury to a resident. The act also requires the department to impose a fine, in an amount determined by the department to deter further violations, for any violation resulting in actual harm or injury to a resident.

The act also allows, but does not require, the department to suspend, revoke, or refuse to renew a residence license if a resident is subject to mistreatment that causes injury to the resident, the residence's owner or administrator either directly caused the mistreatment or the mistreatment resulted from the administrator's failure to adequately train or supervise employees, and other measures to correct the violation have not been or are not expected to be effective.

The act appropriates $74,508 from the general fund to the department to implement the act, and of that amount, $47,680 is reappropriated to the office of the governor for use by the office of information technology to provide information technology services for the department.

(Note: This summary applies to this bill as enacted.)