Chapter 290
2009 -- S 0543 SUBSTITUTE A AS
AMENDED
Enacted 11/13/09
A N A C T
RELATING TO HEALTH AND SAFETY - ASSISTED LIVING RESIDENCE LICENSING ACT
Introduced By: Senators Perry, Sosnowski, Miller, C Levesque, and Sheehan
Date Introduced: February 25, 2009
It is enacted by the
General Assembly as follows:
SECTION 1. Title 23 of the General Laws entitled
"HEALTH AND SAFETY" is hereby
amended by adding thereto the following chapter:
CHAPTER
17.24
THE
ADULT SUPPORTIVE CARE RESIDENCE ACT
23-17.24-1.
Definitions. – As used in this chapter:
(1) “Manager” means
any person who has responsibility for day-to-day administration or
operation of an adult supportive care home. A manager must be a
licensed health care
professional designated by the licensee and approved by the
department.
(2) “Adult supportive
care home” means: (i) A
publicly or privately operated residence
that provides, directly or indirectly, by means of
contracts or arrangements, personal assistance to
meet the resident’s changing needs and preferences,
lodging, and meals to two (2), but not more
than five (5), adults who are unrelated to the licensee or
manager, excluding, however, any
privately operated establishment or facility licensed pursuant
to chapter 17 of this title, and those
facilities licensed by or under the jurisdiction of the
department of mental health, retardation, and
hospitals, the department of children, youth, and families, or
any other state agency; and (ii) Shall
be a duly licensed home nursing care provider or nursing
facility licensed pursuant to the
provisions of chapter 23-17, an assisted living residence
provider licensed pursuant to chapter 23-
17.4 or a licensed adult day
services provider licensed pursuant to chapter 23-1.
(3) “Capable of
self-preservation” means the physical mobility and judgmental ability of
the individual to take appropriate action in emergency
situations. Residents not capable of self-
preservation are limited to facilities that meet more stringent
life safety code requirements as
provided under subdivision 23-17.4-6(b)(3).
(4) “Director” means
the director of the
(5) “Personal
assistance” means the provision of one or more of the following services, as
required by the resident or as reasonably requested by the
resident, on a scheduled or unscheduled
basis, including: (i) Assisting
the resident with personal needs including activities of daily living,
defined as bathing, dressing, grooming, eating, toileting,
mobility and transfer; (ii) Assisting the
resident with self-administration of medication or
administration of medications by appropriately
licensed staff; (iii) Providing or assisting the resident in
arranging for health and supportive
services as may be reasonably required; (iv) Monitoring the
activities of the resident while on the
premises of the residence to ensure his or her health, safety,
and well-being; and (v) Reasonable
recreational, social and personal services.
(6) “Resident” means
an individual not requiring acute medical or skilled nursing care as
provided in a health care facility but who, as a result of
choice and/or physical or mental
limitation, requires personal assistance, lodging and meals and
may require the administration of
medication. A resident must be capable of self-preservation in
emergency situations, unless the
facility meets a more stringent life safety code as required
under subdivision 23-17.4-6(b)(3).
Persons needing medical or skilled nursing care,
including daily professional observation and
evaluation, as provided in a health care facility, and/or
persons who are bed bound or in need of
the assistance of more than one person for ambulation are
not appropriate to reside in adult
supportive care homes. However, an established resident may
receive daily skilled nursing care or
therapy from a licensed health care provider for a condition
that results from a temporary illness
or injury for up to forty-five (45) days subject to an extension
of additional days as approved by
the department, or if the resident is under the care of a
licensed hospice agency provided the adult
supportive care home assumes responsibility for ensuring that
the care is received. For purposes
of this statute, “resident” shall also mean the
resident’s agent as designated in writing or legal
guardian.
23-17.24-2.
Licensure requirements. – (a) No person shall
operate an adult supportive
care home without first obtaining a license from the
(b) The director is
authorized to promulgate regulations for the departmental licensure of
adult supportive care homes including, but not limited to,
minimum requirements for managers,
staffing, staff training, assessments, service plan
development, services to include food service
and housekeeping/laundry, physical and environment
standards for the home, resident rights,
resident records, resident capacity for self-preservation,
residency agreement/contracts and
quality assurance.
(c) The department
may adopt regulations for special care requirements beyond the
personal assistance required in subdivision 23-17.23-1(5) for
adult supportive care homes serving
persons with dementia and/or behavioral health diagnoses.
(d) Criminal
background checks of persons seeking employment at adult supportive care
homes shall be conducted in accordance with the standards
and procedures contained in sections
23-17.4-27, 23-17.4-28 and
23-17.4-30.
(e) An adult
supportive care home shall provide a qualified on-duty staff person over the
age of eighteen (18) on the premises at all times that
any supportive care residents are on the
premises of the home.
23-17.24-3.
Inspections—Corrections of violations—Immediate suspension of
license—Penalties.—(a) An adult supportive care home license shall remain valid unless
voluntarily surrendered, suspended, or revoked in accordance with
this chapter.
(b) Adult supportive
care homes applying for a license shall be inspected at the time of
licensure and at least every eighteen (18) months thereafter.
The department may make an
unannounced inspection of an adult supportive care home at any
time to assure that the home and
licensee are in compliance with this chapter and the rules
adopted under this chapter.
(c) If the department
finds that the home is not in compliance with this chapter or rules
adopted under the authority of this chapter it shall require
the home to correct any violations. The
department has the authority to:
(1) Order the home to
admit no additional persons or to transfer residents to alternate
settings, as corrective actions to secure regulatory
compliance.
(2) Immediately suspend
a license if it finds that conditions in the home constitute an
imminent danger to residents.
(d) Every person or
corporation who shall willfully and continually violate the provisions
of this chapter will be subject to a fine or not less than
three hundred dollars ($300) nor more than
three thousand dollars ($3,000) for each violation of this
section.
SECTION 2. Section 23-17.4-2 of the General Laws in Chapter
23-17.4 entitled
"Assisted Living
Residence Licensing Act" is hereby amended to read as follows:
23-17.4-2.
Definitions. -- As used in this chapter:
(1) "Activities of
daily living (ADLs)" means bathing, dressing,
eating, toileting,
mobility and transfer.
(2)
"Administrator" means any person who has responsibility for day to
day
administration or operation of an assisted living residence.
(3) "Alzheimer's
dementia special care unit or program" means a distinct living
environment within an assisted living residence that has been
physically adapted to accommodate
the particular needs and behaviors of those with
dementia. The unit provides increased staffing,
therapeutic activities designed specifically for those with
dementia and trains its staff on an
ongoing basis on the effective management of the physical and
behavioral problems of those with
dementia. The residents of the unit or program have had a
standard medical diagnostic evaluation
and have been determined to have a diagnosis of
Alzheimer's dementia or another dementia.
(4) "Assisted living
residence" means a publicly or privately operated residence that
provides directly or indirectly by means of contracts or
arrangements personal assistance to meet
the resident's changing needs and preferences, lodging,
and meals to two (2) six (6) or more
adults who are unrelated to the licensee or administrator,
excluding however, any privately
operated establishment or facility licensed pursuant to
chapter 17 of this title, and those facilities
licensed by or under the jurisdiction of the department of
mental health, retardation, and
hospitals, the department of children, youth, and families, or
any other state agency. The
department shall develop levels of licensure for assisted living
residences within this definition as
provided in section 23-17.4-6. Assisted living residences
include sheltered care homes, and board
and care residences or any other entity by any other name
providing the services listed in this
subdivision which meet the definition of assisted living
residences.
(5) "Capable of
self-preservation" means the physical mobility and judgmental ability of
the individual to take appropriate action in emergency
situations. Residents not capable of self-
preservation are limited to facilities that meet more stringent
life safety code requirements as
provided under section 23-17.4-6(b)(3).
(6)
"Director" means the director of the
(7) "Licensing
agency" means the
(8) "Personal
assistance" means the provision of one or more of the following services,
as required by the resident or as reasonably requested
by the resident, on a scheduled or
unscheduled basis, including:
(i)
Assisting the resident with personal needs including activities of daily
living;
(ii) Assisting the
resident with self-administration of medication or administration of
medications by appropriately licensed staff;
(iii) Providing or
assisting the resident in arranging for health and supportive services as
may be reasonably required;
(iv)
Monitoring the activities of the resident while on the premises of the
residence to
ensure his or her health, safety, and well-being; and
(v) Reasonable
recreational, social and personal services.
(9) "Resident"
means an individual not requiring medical or nursing care as provided in
a health care facility but who as a result of choice
and/or physical or mental limitation requires
personal assistance, lodging and meals and may require the administration
of medication. A
resident must be capable of self-preservation in emergency
situations, unless the facility meets a
more stringent life safety code as required under section
23-17.4-6(b)(3). Persons needing
medical or skilled nursing care, including daily professional
observation and evaluation, as
provided in a health care facility, and/or persons who are
bedbound or in need of the assistance of
more than one person for ambulation, are not appropriate
to reside in assisted living residences.
However, an established resident may receive daily
skilled nursing care or therapy from a
licensed health care provider for a condition that results
from a temporary illness or injury for up
to twenty-one (21) forty-five (45) days
subject to an extension of additional days as approved by
the department, or if the resident is under the care of a
licensed hospice agency provided the
assisted living residence assumes responsibility for ensuring
that the care is received. For
purposes of this statute, "resident" shall also mean
the resident's agent as designated in writing or
legal guardian.
SECTION 3. Section 42-66.7-3 of the General Laws in Chapter
42-66.7 entitled "Long-
Term Care Ombudsperson Act
of 1995" is hereby amended to read as follows:
42-66.7-3.
Definitions. -- As used in this chapter:
(1) An "act"
of any facility or government agency includes any failure or refusal to act
by any facility or government agency.
(2)
"Administrator" means any person who is charged with the general
administration or
supervision of a facility whether or not that person has an
ownership interest and whether or not
that person's functions and duties are shared with one or
more other persons.
(3) "Elderly"
means any person sixty (60) years of age or older who is a resident of any
facility.
(4)
"Facility" means any facility or institution, home care provider or
home nursing care
provider, whether public or private, offering health or health
related services for the
institutionalized elderly, and which is subject to regulation,
visitation, inspection, or supervision
by any government agency. "Facilities"
include, but are not limited to, nursing homes,
intermediate care facilities, extended care facilities, convalescent
homes, rehabilitation centers,
home care agencies, homes for the aged, veterans' homes,
boarding homes, and adult supportive
care,
residential care and assisted living residences.
(5) "Government
agency" means any department, division, office, bureau, board,
commission, authority, non-profit community organization, or any
other agency or
instrumentality created by any municipality or by the state, or to
which the state is a party, which
is responsible for the regulation, inspection, visitation,
or supervision of facilities or which
provides services to residents of facilities.
(6)
"Ombudsperson" means the person or persons designated by the
director. That person
or persons shall have expertise and experience in the
fields of social work, long-term care, and
advocacy, and shall be qualified and experienced in
communicating with the elderly.
(7)
"Resident" means any person age sixty (60) years of age or older who
is receiving
treatment, care, or housing in any facility in all of its
aspects including, but not limited to,
admission, retention, confinement, period of residence,
transfer, discharge, and in any instances
directly related to that status. Residents include patients
and clients. Residents shall also include
disabled persons under sixty (60) years of age residing in
nursing homes, or clients of residential
and assisted living facilities and home care
providers/home nursing care providers and long-term
care units at the
(8)
"Interfere" means willing and continuous conduct which prevents the
ombudsperson
from performing her or his official duties.
(9) "Official
duties" means work pursuant to the long-term care ombudsperson program
authorized by the federal Older Americans Act or the long-term
care ombudsperson program
authorized by state law and carried out under the auspices and
general direction of the state long-
term care ombudsperson.
(10)
"Director" means the director of the department of elderly affairs.
(11) "Person"
means any individual, trust, or estate, partnership, limited liability
corporation, corporation (including associations, joint stock
companies, and insurance
companies), state, or political subdivision or instrumentality
of a state.
(12) "Health
oversight agency" means, for the purposes of this chapter, the department
of
elderly affairs or the person or entity designated as the
state's long-term care ombudsperson by
the director of the department of elderly affairs,
including the employees or agents of such person
or entity, when they are acting to fulfill the duties
and responsibilities of the state's long-term care
ombudsperson program in which health information is necessary to
oversee the health system and
in accordance with the U.S. Health Insurance Portability
and Accountability Act (HIPAA) of
1996.
SECTION 4. This act shall take effect upon passage.
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LC01509/SUB A/3
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