A N
A C T
RELATING TO
ASSISTED LIVING
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Introduced By: Representatives Ginaitt, Anguilla, D Cicilline, and Long |
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Date Introduced: February 05, 2002 |
It is enacted
by the General Assembly as follows:
SECTION 1. Sections 23-17.4-2, 23-17.4-3, 23-17.4-4, 23-17.4-5,
23-17.4-6, 23-17.4-10, 23-17.4-11, 23-17.4-15.2, 23-17.4-15.3, 23-17.4-16,
23-17.4-16.1, 23-17.4-16.2, 23-17.4-16.3 and 23-17.4-27 of the General Laws in
Chapter 23-17.4 entitled "Assisted Living Residence Licensing Act"
are 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.
(1) (2) "Administrator" means any person
who has responsibility for day to day administration or operation of an
assisted living residence.
(2) (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.
(3) (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) 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.
(4) (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).
(5) (6) "Director" means the director of
the Rhode Island department of health.
(6) (7) "Licensing agency" means the Rhode
Island department of health.
(7) (8) "Personal assistance" means the provision
of twenty-four (24) hour adult staffing of the home, and 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 who is an adult,
not requiring medical or nursing care as provided in a health care facility but
may require the administration of medication and who as a result of choice
and/or age, 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 (1) 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) 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 such care is received. For purposes of this
statute, "resident" shall also mean the resident's agent as
designated in writing or legal guardian.
23-17.4-3. Purpose of provisions. -- The purpose of this chapter is to provide for the development, establishment, and enforcement of standards:
(1) For the care of residents in an assisted living residence;
for adults; and
(2) For the maintenance and operation of assisted living
residences for adults, which will: promote a safe and
protective environment for individuals living in those residences.
(i) Promote the dignity, individuality, independence, privacy,
and autonomy of residents;
(ii) Provide a safe and home-like environment;
(iii) Protect the safety, health and welfare of residents;
(3) For the encouragement of quality of life for all residents;
and
(4) For the encouragement of quality in all aspects of the
operations of assisted living residences.
23-17.4-4. License required for assisted living residence operation. -- (a) No person, acting severally or jointly with any other person, shall establish, conduct, or maintain an assisted living residence in this state without a license under this chapter.
(b) No person, acting severally or jointly with any other
person, shall admit or retain a resident in an assisted living residence which
residence (1) does not meet the definition and requirements of this act; or (2)
is not able to provide the services needed by a resident as agreed to in the
service plan required under section 23-17.4-15.6.
23-17.4-5. Application for license. -- An application for
a license shall be made to the licensing agency upon forms provided by it and
shall contain any information that the licensing agency reasonably requires,
which may include affirmative evidence of ability to comply with reasonable
standards, rules, and regulations as are lawfully prescribed under this
chapter. The licensing agency shall require criminal background checks on
owners and operators of licensed assisted living residences.
23-17.4-6. Issuance of license -- Posting -- Transfer. --
(a) Issuance of license. - Upon receipt of an application for a license, the
licensing agency shall issue a license if the applicant and residential care
facility assisted living residence meet the requirements established
under this chapter; the director may shall establish levels of
licensure as provided in subsections (b) and (c) below and any rules and
regulations as may be established in accordance with this chapter herewith.
A license issued under this chapter shall be the property of the state and
loaned to the licensee, and it shall be kept posted in a conspicuous place on
the licensed premises. Each license shall be issued only for the premises and
persons named in the application, and shall not be transferable or assignable
except with the written approval of the licensing agency.
(b) Fire code and structural requirements.
(1) A facility residence with state fire code
deficiencies may be granted a license which may be renewed subject to the
submission of a plan of correction acceptable to the state division of fire
safety, and provided the nature of the deficiencies are such that they do not
jeopardize the health, safety, and welfare of the residents.
(2) A facility residence with residents who are
blind, deaf, and physically disabled shall be subject to the applicable
requirements of the American National Standards Institute (ANSI
standards)(1961), and any other provisions that may be required by rules and
regulations pursuant to this chapter.
(3) A facility residence that elects to comply with
a higher life safety code and is so approved by the state division of fire
safety and meets the department’s requirements for the appropriate level of
licensure may admit residents not capable of self preservation.
(c) Levels of licensure. The department shall establish
requirements for a basic license that apply to all assisted living residences.
In addition, the department shall establish additional licensing levels of
assisted living including, but not limited to:
(a) "Dementia
care" licensure shall be required when one (1) or more resident's dementia
symptoms impact their ability to function as demonstrated by any of the
following:
(i) safety concerns due to elopement risk or other behaviors;
(ii) inappropriate social behaviors that adversely impact the
rights of others;
(iii) inability to self preserve due to dementia;
(iv) a physician's recommendation that the resident needs
dementia support consistent with this level; or if the residence advertises or
represents special dementia services or if the residence segregates residents
with dementia. In addition to the requirements for the basic license, licensing
requirements for the "dementia care" level shall include the
following:
(A) staff training and/or requirements specific to dementia
care as determined by the department;
(B) a registered nurse on staff and available for consultation
at all times;
(C) the residence shall provide for a secure environment
appropriate for the resident population.
(b) "Medication administration" when one (1) or more
residents requires medication administration by appropriately qualified staff
as determined by the department.
23-17.4-10. Regulations, inspections, and investigations. --
(a) The licensing agency shall after public hearing pursuant to reasonable
notice, adopt, amend, promulgate, and enforce any rules, regulations, and
standards with respect to assisted living residences for adults licensed under
this chapter as may be designed to further the accomplishment of the purposes of
this chapter in promoting safe and adequate living environments for individuals
in assisted living residences in the interest of public safety and welfare.
These regulations may provide for the establishment of levels of service
provided by the facility. residence.
(b) The licensing agency shall make or cause to be made any inspections and investigations that it deems necessary by duly authorized agents of the director at any time and frequency determined by the licensing agency.
(c) Upon request of the licensing agency, health agencies and professionals may share resident health status information with the department of health for the purpose of determining each resident's capability of self preservation.
23-17.4-11. Accessibility to residential care and assisted living
facilities and residents. -- Accessibility to assisted
living residences and residents. -- Access to an assisted living
residences for adults and its residents by individuals other than
relatives and friends of the residents shall be permitted at reasonable hours
by duly authorized agents of state and municipal agencies other than the
licensing agency and the division of fire safety, private or public
institutions, organizations, associations, or any other service agencies whose
purpose includes discharging legally authorized responsibilities or rendering
volunteer assistance or service to residents with respect to personal, social,
legal, religious services, or such other as civil and human rights. Access
shall not substantially disrupt the operation of the facility. Anyone entering
the facility shall produce appropriate identification prior to being granted
permission to enter the premises. Entering a resident's room and visitation
privileges with residents by these persons shall be subject to the provisions
of section 23-17.4-16 and the rules and regulations promulgated pursuant to
this chapter.
23-17.4-15.2. Qualifications of a certified administrator. --Administrator
requirements. -- (a) The department of health shall certify a
person to be an administrator of an assisted living residence if the person
meets the following minimum qualifications:
(1) Twenty-one (21) years of age or older;
(2) Good moral and responsible character and reputation;
(3) Literacy in English as defined by regulations promulgated
by the department of health;
(4) Management or administrative ability to carry out the
requirements of this chapter; and
(5) (i) Certification as an assisted living residence administrator
or equivalent training;
(ii) The certification or training, as defined by regulations
promulgated by the department of health, shall include training in at least the
following areas:
(A) Resident care plan;
(B) Characteristics of resident disabilities;
(C) Resident health issues;
(D) Community resources;
(E) Social and recreational activities;
(F) Nutrition and food service;
(G) First aid;
(H) Medication;
(I) Business administration;
(J) Maintenance and housekeeping;
(K) Residents' rights;
(L) State and federal regulations;
(M) Staff management and training;
(N) Mandatory continuing education.
(b) The department may suspend or revoke the certification of
an administrator for cause, including but not limited to failure to maintain
compliance with the qualifications stated in this section, repeated or
intentional violations of this chapter or regulations, or conviction (including
but not limited to a plea of nolo contendere) to charges of resident abuse
under the provisions of chapter 17.8 of this title, or a conviction of a
felony, or exploitation.
(a) Each assisted living residence shall have an administrator
who is certified by the department in accordance with regulations established
pursuant to section 23-17.4-21.1, in charge of the maintenance and operation of
the residence and the services to the residents. The administrator is
responsible for the safe and proper operation of the residence at all times by
competent and appropriate employee(s).
(b) The licensing agency shall perform a criminal background
records check on any person applying or reapplying for certification as an
administrator. If disqualifying information is found, the licensing agency
shall make a judgment regarding certification for that person.
(b) (c) The department may suspend or revoke the
certification of an administrator for cause, including but not limited to
failure to maintain compliance with the qualifications stated in this section,
repeated or intentional visitations of this chapter or regulations, or
conviction (including but not limited to a plea of non contendere) to charges
of resident abuse under the provisions of chapter 17-8 of this title, or a
conviction of a felony, or exploitation.
23-17.4-15.3. Resident records. -- Each facility residence
shall at a minimum maintain the following information for each resident:
(1) The resident's name;
(2) The resident's last address;
(3) The name of the person or agency referring the resident to the home;
(4) The name, specialty (if any), telephone number, and emergency telephone number of each physician who has treated the resident during the preceding twelve (12) months;
(5) The date the resident began residing in the home;
(6) A list of medications taken by the resident including the dosage;
(7) Written acknowledgements that the resident has received copies of the rights as provided in section 23-17.4-16;
(8) A record of personal property and funds that the resident has entrusted to the facility;
(9) Information about any specific health problems of the resident that may be useful in a medical emergency;
(10) The name, address, and telephone number of a person identified by the resident who should be contacted in the event of an emergency or death of the resident;
(11) Any other health-related emergency, or pertinent information
which the resident requests the home residence to keep on record;
and
(12) Specific records of medication administration as required by
the licensing agency. ;and
(13) Copies of the resident agreement, initial and periodic
assessments and service plan(s).
23-17.4-16. Rights of residents. -- (a) Every assisted
living residence for adults licensed under this chapter shall observe the
following standards and any other appropriate standards as may be prescribed in
rules and regulations promulgated by the licensing agency with respect to each
resident of the facility residence:
(1) Residents are entitled to all rights recognized by state and federal law with respect to discrimination, service decisions (including the right to refuse services), freedom from abuse and neglect, privacy, association, and other areas of fundamental rights including the right to freedom of religious practice. Some of these basic rights include:
(i) To be offered care services without
discrimination as to sex, race, color, religion, national origin, or source of
payment;
(ii) To be free from verbal, sexual, physical, emotional, and mental abuse, corporal punishment, and involuntary seclusion;
(iii) To be free from physical or chemical restraints for the purpose of discipline or convenience and not required to treat the resident's medical symptoms. No chemical or physical restraints will be used except on order of a physician;
(iv) To have their medical information protected by applicable state confidentiality laws;
(v) To have a service animal, consistent with the "reasonable accommodations" clause of the Fair Housing Act, 42 U.S.C. section 3601 et seq. (such as a seeing eye dog); and
(2) In addition to these basic rights enjoyed by other adults, the residents of assisted living also have the right to:
(i) Be treated as individuals and with dignity, and be assured choice and privacy and the opportunity to act autonomously;
(ii) Upon request have access to all records pertaining to the resident, including clinical records, within the next business day or immediately in emergency situations;
(iii) Arrange for services not available through the setting at their own expense as long as the resident remains in compliance with the resident contract and applicable state law and regulations;
(iv) Upon admission and during the resident's stay be fully informed in a language the resident understands of all resident rights and rules governing resident conduct and responsibilities. Each resident shall:
(A) Receive a copy of their rights;
(B) Acknowledge receipt in writing; and
(C) Be informed promptly of any changes;
(v) Remain in their room or apartment unless a change in room or apartment is related to resident preference or to transfer conditions stipulated in their contract;
(vi) Consistent with the terms of the resident contract, furnish their own rooms and maintain personal clothing and possessions as space permits, consistent with applicable life safety, fire, or similar laws, regulations, and ordinances;
(vii) Be encouraged and assisted to exercise rights as a citizen; to voice grievances through a documented grievance mechanism and suggest changes in policies and services to either staff or outside representatives without fear of restraint, interference, coercion, discrimination, or reprisal;
(viii) Have visitors of their choice without restrictions so long as those visitors do not pose a health or safety risk to other residents, staff, or visitors, or a risk to property, and comply with reasonable hours and security procedures;
(ix) Have personal privacy in their medical treatment, written communications and telephone communications, and, to the fullest extent possible, in accommodation, personal care, visits, and meetings;
(x) Have prominently displayed a posting of the facility's grievance procedure, the names, addresses, and telephone numbers of all pertinent resident advocacy groups, the state ombudsperson, and the state licensing agency;
(xi) Choose his or her own physician(s) and have ready access to the name, specialty, and way of contacting the physician(s) responsible for the resident's care;
(xii) Have the facility residence record and
periodically update the address and telephone number of the resident's legal
representative or responsible party;
(xiii) Manage his or her financial affairs. The facility residence
may not require residents to deposit their personal funds with the facility
residence. Upon written authorization of a resident and with the
agreement of the facility residence, the facility residence
holds, safeguards, manages, and accounts for personal funds of the resident as
follows:
(A) Funds in excess of three hundred dollars ($300) must be in an
interest bearing account, separate from any facility residence
operating account that credits all interest on the resident's funds to that
account and the facility residence shall purchase a surety bond
on this account;
(B) A full and separate accounting of each resident's personal funds maintained must be available through quarterly statements and on request of the resident;
(C) Resident funds shall not be commingled with facility residence
funds or with funds of any person other than another resident;
(D) Upon the death of a resident, the facility residence
must convey within thirty (30) days the resident's funds deposited with the facility
residence and a full accounting of those funds to the resident's
responsible party or the administrator of the resident's estate;
(xiv) Have access to representatives of the state ombudsperson and to allow the ombudsperson to examine a resident's records with the permission of the resident and consistent with state law;
(xv) Be informed, in writing, prior to or at the time of admission or at the signing of a residential contract or agreement of:
(A) The scope of the services available through the facilities
residence service program, including health services, and of all related
fees and charges, including charges not covered either under federal and/or
state programs or by other third party payors or by the facility's residence's
basic rate;
(B) The facility's residence's policies regarding
overdue payment including notice provisions and a schedule for late fee
charges;
(C) The facility's residence's policy regarding
acceptance of state and federal government reimbursement for care in the
facility both at time of admission and during the course of residency if the
resident depletes his or her own private resources;
(D) The facility's residence's criteria for admission,
occupancy and discharge termination of residency agreements;
(E) The facility's residence's capacity to serve
residents with physical and cognitive impairments;
(F) Support and any health services that the facility
residence includes in its service package or will make appropriate
arrangements to provide the services;
(xvi) To be encouraged to meet with and participate in activities of social, religious, and community groups at the resident's discretion;
(xvii) Upon provision of at least thirty (30) days notice, if a
resident chooses to leave a facility residence, the resident
shall be refunded any advanced payment made provided that the resident is
current in all payments;
(xviii) To have the facility residence discharge a
resident only for the following reasons and within the following guidelines:
(A) Except in life threatening emergencies and for nonpayment of
fees and costs, the facility residence gives thirty (30) days'
advance written notice of discharge termination of residency
agreement with a statement containing the reason, the effective date of
termination, and the resident's right to an appeal under state law;
(B) If the resident does not meet the requirements for residency criteria stated in the residency agreement or requirements of state or local laws or regulations;
(C) If the resident is a danger to himself or herself or the
welfare of others and the facility residence has attempted to
make a reasonable accommodation without success to address the resident's
behavior in ways that would make discharge termination of residency
agreement or change unnecessary, which would be documented in the
resident's records;
(D) For failure to pay all fees and costs stated in the contract,
resulting in bills more than thirty (30) days outstanding. A resident who has
been given notice to vacate for nonpayment of rent has the right to retain
possession of the premises, up to any time prior to eviction from the premises,
by tendering to the provider the entire amount of fees for services, rent,
interest, and costs then due. The provider may impose reasonable late fees for
overdue payment; provided that the resident has received due notice of those
charges in accordance with the facility's residence's policies.
Chronic and repeated failure to pay rent is a violation of the lease covenant.
However the facility residence must make reasonable efforts to
accommodate temporary financial hardship and provide information on government
or private subsidies available that may be available to help with costs; and
(E) The facility residence makes a good faith effort
to counsel the resident if the resident shows indications of no longer meeting
residence criteria or if service with a termination notice is anticipated;
(xix) To have the facility residence provide for a
safe and orderly discharge move out, including assistance with
identifying a resource to help locate another setting, regardless of reason for
move out;
(xx) To have the resident's responsible person and physician notified when there is:
(A) An accident involving the resident that results in injury and required physician intervention;
(B) A significant change in the resident's physical, mental, or psychosocial status or treatment;
(xxi) To be able to share a room or unit with a spouse or
other consenting resident of the facility residence in accordance
with terms of the resident contract;
(xxii) To live in a safe and clean environment;
(xxiii) To have and use his or her own possessions where reasonable and have an accessible lockable space provided for security of small personal valuables;
(xxiv) To receive a nourishing, palatable, well balanced diet that meets his or her daily nutritional and special medical dietary needs;
(xxv) To attain or maintain the highest practicable physical, mental, and psychosocial well being;
(xxvi) To be allowed to maintain an amount of money to cover reasonable monthly personal expenses, the amount of which shall be at least equal to that amount required for individuals on SSI as provided under section 40-6-27(a)(3); and
(xxvii) To have the facility residence implement
written policies and procedures to ensure that all facility staff are aware of
and protect the resident's rights contained in this section.
(b) For purposes of subdivisions (a)(2)(ii), (iv), (xi), (xiii), (xiv), (xvii), and (xviii)(A), the term "resident" also means the resident's agent as designated in writing or legal guardian.
23-17.4-16.1. Posting and providing a copy of rights of residents. --
Each facility residence shall provide each resident or his or her
representative upon admission a copy of the provisions of section 23-17.4-16,
"Rights of Residents", and shall display in a conspicuous place on
the premises a copy of the "Rights of Residents".
23-17.4-16.2. Special care unit disclosure by facilities. --
Special care unit disclosure by residences. -- (a) Any assisted
living residence which offers to provide or provides care for patients or services
to residents with Alzheimer's disease or other dementia by means of an
Alzheimer's special care unit shall be required to disclose the form of care
or treatment type of services provided, in addition to that care
and treatment those services required by the rules and regulations
for the licensing of assisted living residences. That disclosure shall be made
to the licensing agency and to any person seeking placement in an Alzheimer's
special care unit of an assisted living residence. The information disclosed
shall explain that additional care is provided in each of the following areas:
(1) Philosophy. - The Alzheimer's special care unit's written statement of its overall philosophy and mission which reflects the needs of residents afflicted with dementia.
(2) Pre-admission, admission, and discharge Pre-occupancy,
occupancy, and termination of residence. - The process and criteria for placement
occupancy, transfer, or discharge termination of residency
from the unit.
(3) Assessment, care service planning, and
implementation. - The process used for assessment and establishing the plan of care
service and its implementation, including the method by which the plan
of care service evolves and is responsive to changes in
condition.
(4) Staffing patterns and training ratios. - Staff training and continuing education practices.
(5) Physical environment. - The physical environment and design features appropriate to support the functioning of cognitively impaired adult residents.
(6) Resident activities. - The frequency and types of resident activities.
(7) Family role in care providing support and services.
- The involvement in families and family support programs.
(8) Program costs. - The cost of care and any additional fees.
(b) The licensing agency shall develop a standard disclosure form and shall review the information provided on the disclosure form by the residential care and assisted living facility to verify the accuracy of the information reported on it. Any significant changes in the information provided by the residential care and assisted living facility will be reported to the licensing agency at the time the changes are made.
23-17.4-16.3. Residency agreement or contract. -- (a)
Prior to or as part of the exchange of any funds and prior to
admission procedure, the facility residence shall execute
a residency agreement or contract, signed by both the facility residence
and the resident, that defines the services the facility residence
will provide and the financial agreements between the facility residence
and the resident or the residence's representative.
(b) The department shall establish regulations specifying the minimum
provisions of residency agreements or contracts and a minimum prior
notification time for changes in rates, fees, service charges or any other
payments required by the residence.
(c) Any advanced deposit, application fee, or other
pre-admission payment shall be subject to a signed document explaining fully
the terms of the payment.
(d) In cases of emergency placement, the residency agreement or
contract shall be executed within five (5) working days of admissions.
23-17.4-27. Criminal records review. -- (a) Any person
seeking employment in any facility assisted living residence licensed
under this act and having which is or is required to be licensed or
registered with the department of health, if that employment involves
routine contact with a patient or resident or having access to a
resident's belongings or funds without the presence of other employees,
shall undergo a criminal background check to be initiated processed
prior to or within one week of employment. All employees hired prior to the
enactment of this section shall be exempted from the requirements of this
section.
(b) The director of the department of health may by rule identify those positions requiring criminal background checks. The employee, through the employer, shall apply to the bureau of criminal identification of the state police or local police department for a statewide criminal records check. Fingerprinting shall not be required. Upon the discovery of any disqualifying information as defined in section 23-17.4-30 and in accordance with the rule promulgated by the director of health, the bureau of criminal identification of the state police or the local police department will inform the applicant in writing of the nature of the disqualifying information; and, without disclosing the nature of the disqualifying information, will notify the employer in writing that disqualifying information has been discovered.
(c) An employee against whom disqualifying information has been
found may request that a copy of the criminal background report be sent to the
employer. who The administrator shall make a judgment
regarding the continued employment of the employee.
(d) In those situations in which no disqualifying information has been found, the bureau of criminal identification (BCI) of the state police or the local police shall inform the applicant and the employer in writing of this fact.
(e) The employer shall maintain on file, subject to inspection by the department of health, evidence that criminal records checks have been initiated on all employees seeking employment after October 1, 1991, and the results of the checks. Failure to maintain that evidence would be grounds to revoke the license or registration of the employer.
(f) It shall be the responsibility of the bureau of criminal identification (BCI) of the state police or the local police department to conduct the criminal records check to the applicant for employment without charge to either the employee or employer.
SECTION 2. Sections 23-17.4-15.5, 23-17.4-21, 23-17.4-22,
23-17.4-23, 23-17.4-24, 23-17.4-25 and 23-17.4-26 of the General Laws in
Chapter 23-17.4 entitled "Assisted Living Residence Licensing Act"
are hereby repealed.
23-17.4-15.5. Initial evaluation and service plan. --
(a) Prior to admission of a prospective resident, an agent of the facility
shall conduct an evaluation to determine the facility's ability to meet the
prospective resident's needs and preferences.
(b) Within a reasonable time after admission to a facility,
each resident shall have a written service plan put in place based on an
initial evaluation and periodic review of the resident's health, physical,
social, functional, activity and cognitive needs and preferences that is
developed with the input of the resident and their family and friends, if
requested by the resident, and signed by the resident and facility agent. The
service plan shall: (1) include the identified need for services and the type,
frequency and duration of services or interventions to be provided, arranged
for, or coordinated by the facility and any responsibility for service
arrangement and management that will be the responsibility of the resident, and
(2) be reviewed at least annually or at any time that the resident's needs
change substantially and revised as appropriate.
23-17.4-21. Permanent advisory commission. -- There
is established a permanent advisory commission on residential and assisted
living care. The purpose of the commission shall be the coordination of policy
for the state regarding laws, rules, and regulations governing the care of
residents in an assisted living residence, and the maintenance and operation of
the assisted living residences; to act as a grievance committee to which
complaints may be made concerning problems that transcend more than one state
agency or department; and to provide a forum where problems may be addressed
relating to assisted living residences.
23-17.4-22. Membership of commission. [Effective until January 7,
2003.] -- (a) The permanent advisory commission on assisted
living residences shall be composed of nineteen (19) members as follows:
(1) The director of the department of health or designee;
(2) The director of the department of human services or
designee;
(3) The director of the department of mental health,
retardation, and hospitals or designee;
(4) The director of the department of elderly affairs or
designee;
(5) The state fire marshal or designee;
(6) The attorney general or designee;
(7) One public member to be appointed by the governor;
(8) An advocate for developmentally disabled persons;
(9) An advocate for mentally ill persons;
(10) An advocate for physically disabled persons;
(11) A representative of the Rhode Island Retired Teachers
Association;
(12) A representative of the Rhode Island chapter of the
American Association of Retired Persons;
(13) A state representative, to be appointed by the speaker of
the house;
(14) An administrator of a for-profit licensed assisted living residence
to be recommended by the Rhode Island Association of Residential Care
Facilities;
(15) An administrator of a licensed not-for-profit assisted
living residence to be recommended by the Rhode Island Association of
Facilities for the Aging;
(16) Two (2) residents of licensed assisted living residences;
(17) A state senator; and
(18) An administrator of a multilevel facility that includes
both residential care/assisted living and nursing care, to be appointed by the
majority leader of the senate.
(b) The commission shall annually elect one of its members as
chair to preside over meetings of the commission.
(c) The commission shall meet at the call of the speaker of the
house of representatives.
23-17.4-22. Membership of commission. [Effective January 7, 2003.] --
(a) The permanent advisory commission on assisted living residences shall be
composed of nineteen (19) members as follows:
(1) The director of the department of health or designee;
(2) The director of the department of human services or designee;
(3) The director of the department of mental health,
retardation, and hospitals or designee;
(4) The director of the department of elderly affairs or
designee;
(5) The state fire marshal or designee;
(6) The attorney general or designee;
(7) One public member to be appointed by the governor;
(8) An advocate for developmentally disabled persons;
(9) An advocate for mentally ill persons;
(10) An advocate for physically disabled persons;
(11) A representative of the Rhode Island Retired Teachers Association;
(12) A representative of the Rhode Island chapter of the
American Association of Retired Persons;
(13) A state representative, to be appointed by the speaker of
the house;
(14) An administrator of a for-profit licensed assisted living
residence to be recommended by the Rhode Island Association of Residential Care
Facilities;
(15) An administrator of a licensed not-for-profit assisted
living residence to be recommended by the Rhode Island Association of
Facilities for the Aging;
(16) Two (2) residents of licensed assisted living residences;
(17) A state senator; and
(18) An administrator of a multilevel facility that includes
both residential care/assisted living and nursing care, to be appointed by the
president of the senate.
(b) The commission shall annually elect one of its members as
chair to preside over meetings of the commission.
(c) The commission shall meet at the call of the speaker of the
house of representatives.
23-17.4-23. Length of term -- Compensation. --
(a) Each member of the commission appointed according to section 23-17.4-22
shall serve a term of two (2) years or until the time that the member's
successor is appointed and qualified.
(b) The commission members shall serve without compensation.
23-17.4-24. Commission
meetings public. -- The meetings of the permanent advisory
commission on sheltered care, of which there shall be not less than three (3)
annually, shall be open to the public and the public shall be duly notified of
the date, time, and location of each meeting.
23-17.4-25. Recommendations of commission. --
The commission on sheltered care shall offer recommendations for the betterment
of the sheltered care industry to the appropriate state agencies and the
general assembly whenever necessary.
23-17.4-26. Powers
of commission cumulative. -- The powers and authority of the
permanent advisory commission on sheltered care as stated in this chapter are
in addition to and not in lieu of the powers and authority of any other state
agency, department, or division.
SECTION 3. Chapter 23-17.4 of the General Laws entitled
"Assisted Living Residence Licensing Act" is hereby amended by adding
thereto the following sections:
23-17.4-10.1. Quality assurance. -- Each assisted living residence shall
develop, implement and maintain a documented, ongoing quality assurance program.
23-17.4-10.2. Penalty for violation of section
23-17.4-10. --
Every person or corporation who shall willfully and continually violate the
provisions of this chapter will be subject to a fine of not less than three
hundred dollars ($300) or more than two thousand dollars ($2,000) for each
violation of this section.
23-17.4-15.1.1. Administrator requirements. -- (a) Each assisted living
residence shall have an administrator who is certified by the department in
accordance with regulations established pursuant to section 23-17.4-21.1, in
charge of the maintenance and operation of the residence and the services to
the residents. The administrator is responsible for the safe and proper
operation of the residence at all times by competent and appropriate
employee(s).
(b) The
licensing agency shall perform a criminal background records check on any
person applying or reapplying for certification as an administrator. If
disqualifying information is found, the licensing agency shall make a judgment
regarding certification for that person.
23-17.4-15.6. Assessments. -- (a) Prior to the admission of a
resident, or the signing of a residency agreement with a resident, the
administrator shall have a comprehensive assessment of the resident's health,
physical, social, functional, activity, and cognitive needs and preferences
conducted by a registered nurse. This assessment shall be used to determine if
the resident's needs and preferences can be met by the assisted living
residence and the conclusions shall be shared with the resident or the
resident's representative. If a reasonable accommodation can enable a resident
to live in an assisted living residence, the nature of that accommodation and a
plan for implementation or reason for denial should be included in an
assessment.
(b) The
assessment shall be reviewed and updated on a periodic basis and each time a
resident's condition changes significantly. In case of an emergency admission,
the required assessment shall take place within five (5) working days.
23-17.4-15.7. Service plans. -- Within a reasonable time after
move-in, the administrator shall be responsible for the development of a
written service plan based on the initial assessment. The service plan shall
include at least:
(1) the
services and interventions needed;
(2)
description, frequency and duration of the service or intervention; and
(3) party
responsible for arranging the service.
The service plan
shall be developed by a qualified person and shall be signed by both parties.
The service plan shall be reviewed by both parties periodically and each time a
resident's condition changes significantly and all changes shall be
acknowledged in writing by both parties.
23-17.4-15.8. Staff. -- The administrator shall be
responsible for ensuring sufficient and qualified staff to provide a safe and
healthy environment and to provide the services specified on each resident's
service plan. The department shall establish requirements for staff
qualifications and training for each level of license. At least one (1)
qualified staff person shall be on the premises at all times.
23-17.4-15.9. Activities. -- The department shall establish
requirements for recreational and other activities for each level of license.
23-17.4-16.5. Disclosure. -- (a) Each assisted living
residence shall disclose certain information about the residence to each
potential resident, the resident's interested family, and the resident's agent as
early as practical in the decision-making process and at least prior to the
admission decision being made. The disclosed information shall be in print
format and shall include at a minimum:
(1)
Identification of the residence and its owner and operator;
(2) Level of
license;
(3) Admission
and discharge criteria;
(4) Services
available;
(5) Financial
terms to include all fees and deposits, including any first month rental
arrangements, and the residence's policy regarding notification to tenants of
increases in fees, rates, services and deposits;
(6) Terms of
the residency agreement.
23-17.4-21.1. Assisted living administrator
certification board. -- (a) Within the department there is established an assisted
living administrator certification board to be appointed by the director of
health with the approval of the governor consisting of seven (7) members as
follows: two (2) members of the board are persons with at least five (5) years
experience in operating an assisted living residence; one (1) member of the
board is an active assisted living administrator who is not an assisted living
owner; two (2) members are persons representing assisted living consumers or
family members; and two (2) members are representatives of the assisted living
industry or are assisted living employees.
(b) Members
shall be appointed to three (3) year terms. No member shall serve for more than
two (2) terms. The director, with the approval of the governor, shall appoint
all vacancies, as they occur for the remainder of a term or until a successor
is appointed.
(c) The
director may remove, after a hearing and with the approval of the governor, any
member of the board for neglect of any duty required by law or for any
incompetency, unprofessional or dishonorable conduct. Before beginning a term,
a member shall take an oath prescribed by law for state officers, a record of
which shall be filed with the secretary of state.
(d) The
director shall appoint a chairperson.
(e) Four (4)
members of the board shall constitute a quorum.
(f) The board
shall serve without compensation.
(g) Meetings
of the board shall be called by the director or the director's designee, or a
majority of the board members.
(h) The
director shall provide for a staff person of the department to serve as an
administrative agent for the board.
23-17.4-21.2. Functions of the department of
health. --
It is the function of the department of health to:
(1) Develop,
impose, and enforce standards which must be met by individuals in order to
receive a certificate as an assisted living administrator. These standards are
designed to insure that assisted living administrators will be individuals who
are of good character and are suitable, and who, by training or experience in
the field of institutional administration, are qualified to serve as assisted
living administrators;
(2) Establish
and carry out procedures designed to insure that individuals certified as
assisted living administrators will, during any period that they serve as
assisted living administrators, comply with the requirements of those standards;
(3) Receive,
investigate, and take appropriate action with respect to any charge or
complaint filed with the department to the effect that any individual certified
as an assisted living administrator has failed to comply with the requirements
of those standards;
(4) Conduct a
continuing study and investigation of assisted living administrators within the
state, with a view to improving the standards imposed for the certification of those
administrators, and of procedures and methods for enforcing those standards
with respect to certified assisted living administrators.
23-17.4-21.3. Functions of assisted living
certification board. -- It is the function of the board to:
(1) Conduct examinations
as required by the department and to act in an advisory capacity to the
department in all matters pertaining to the certification of assisted living
administrators;
(2) Develop
and apply appropriate techniques, including examinations and investigations,
for determining whether an individual meets those standards, subject to the
approval of the director;
(3) Recommend
to the department the issuance of licenses and registrations to individuals
determined, after application of those techniques, to meet those standards; and
to recommend to the director the revocation or suspension of licenses or
registrations previously issued in any case where the individual holding that
license or registration is determined substantially to have failed to conform to
the requirements of those standards; and
(4) Adopt,
with the approval of the director of health, rules and regulations governing a
mandatory program of continuing education for assisted living administrators.
SECTION 4. This act shall take effect upon passage.