Increasing Safety In Assisted Living Residences

Section 1 of the bill, with regard to the involuntary discharge of residents from an assisted living residence (residence):

• 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. The bill establishes time frames for the grievance process.

Section 2 requires the state board of health (state board) to promulgate rules that:

• Require all residence administrators, on and after January 1, 2024, to meet or exceed the minimum educational training, and experience standards established by the state board regardless of the date the administrator was hired , and section 3 establishes a fine for the residence if the residence's administrator fails to meet the standards;
• Require the residence owner or residence to conduct a check of the Colorado adult protective services data system for any person responsible for the care and welfare of residents;
• Require the residence to comply with provisions concerning involuntary discharge of residents; and
• Establish 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.

Section 3 replaces 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 license and requires the department to impose a fine for any violation resulting in actual harm or injury to a resident. The new cap on fines is $20,000 in a calendar year; except that the department may exceed the cap for an egregious violation that results in death or serious injury to a resident. The bill allows the department to determine the amount of the fine, consistent with state board rules, based on factors listed in the bill including, in part:

• The size of the residence and the number of residents impacted by the violation;
• The actual or potential harm to one or more residents;
• Prior violations or a pattern of violations; and
• The level of fine that will deter future violations.

Section 3 also:

• Requires 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 a directed written plan to correct the violation, in addition to the assessment of civil fines, has not or is not reasonably expected to correct the violations; and
• Permits the department to refuse to renew a license if the residence administrator does not meet or exceed the minimum educational, training, and experience standards established by the state board.

The bill appropriates $74,509 from the general fund to the department to implement the bill. The appropriation is made with the assumption that the department will require 0.3 FTE to implement the bill. Of the appropriated amount, $47,680 is reappropriated to the office of the governor for use by the office of information technology for information technology services.

(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)