Chapter 550

2006 -- H 7232 SUBSTITUTE A

Enacted 07/10/06

A N A C T

RELATING TO ASSISTED LIVING

Introduced By: Representatives Dennigan, Rose, Almeida, Kennedy, and Slater

Date Introduced: February 14, 2006

It is enacted by the General Assembly as follows:

SECTION 1. Section 23-17.4-6, 23-17.4-7, 23-17.4-10, 23-17.4-15.8, and 23-17.4-16.5

of the General Laws in Chapter 23-17.4 entitled "Assisted Living Residence Licensing Act" are

hereby amended to read as follows:

23-17.4-6. 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 assisted living residence meet the requirements established under this chapter; the director

shall establish levels of licensure as provided in subsections (b) and (c) below and any rules and

regulations may be established in accordance 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 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 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 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.

that apply to all assisted living residences. In addition, the department shall establish additional

licensing levels of assisted living including, but not limited to:

(1) "Dementia care" licensure shall be required when one or more residents have a

physician's diagnosis of dementia or an assessment, as required by section 23-17.4-15.6,

indicating dementia-related functional impairments, and meet any of the following:

(i) Safety concerns due to evidence of elopement or other dementia behaviors;

(ii) Inappropriate social behaviors that repeatedly infringe upon 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.

(2) In addition to the requirements for the basic license, licensing requirements for the

"dementia care" level shall include the following:

(i) Staff training and/or requirements specific to dementia care as determined by the

department;

(ii) A registered nurse on staff and available for consultation at all times; and at least one

staff person with appropriate training and education as determined by regulation, on duty at all

times in Alzheimer's dementia special care units;

(iii) The residence shall provide for a secure environment appropriate for the resident

population.

(3) "Medication administration" when one or more residents requires medication

administration by appropriately qualified staff as determined by the department.

23-17.4-7. Expiration and renewal of license. -- A license, unless sooner suspended or

revoked, shall expire by limitation on the 31st day of December following its issuance and may

be renewed from year to year after completion of an annual unannounced on-site inspection,

report, and approval by the licensing agency and the division of fire safety. The annual inspection

shall be made any time prior to the date of expiration of the license. The report shall contain

information in any form that the licensing agency shall prescribe by regulation. The licensing

agency shall, on an annual basis, cause no less than ten percent (10%) of all assisted living annual

inspections to be conducted, in whole or in part, on nights and/or on weekends.

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 residence.

(b) ~~The~~ In addition to the annual inspection required by section 23-17.4-7, 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. The licensing agency shall establish regulations to determine the frequency of inspections

that shall include, but not limited to, the residence's past compliance with regulations, complaint

investigations, quality of care issues and license type.

resident health status information with the department of health for the purpose of determining

each resident's capability of self preservation.

(d) Each assisted living residence licensed under this chapter shall have a plan for

preventing the hazards of resident wandering from the facility. This plan shall be submitted to the

licensing agency in a format determined by the director.

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. The requirements shall include staff training on dementia

care issues and practices as follows. All staff of dementia-level licensed residences that have

direct contact with residents shall have four (4) hours of initial training on dementia-care issues

and practices and two (2) hours of continued education annually thereafter. Training on dementia

care issues and practices provided and documented at any licensed assisted living residence or

nursing facility or by an entity authorized to provide continuing education credits may be counted

toward meeting these requirements. At least one qualified awake and on duty staff person shall be

on the premises at all times.

23-17.4-16.5. Disclosure. -- 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.

(7) Policy regarding acceptance of state and federal reimbursement programs.

SECTION 2. Chapter 23-17.4 of the General Laws entitled "Assisted Living Residence

Licensing Act" is hereby amended by adding thereto the following section:

23-17.4-36. Retaliation prohibited. – No discriminatory, disciplinary, or retaliatory

action shall be taken against any officer or employee of a residence by the residence; nor against

any guardian or family member of any resident; nor against any resident of the residence; nor

against any volunteer or any other person for any communication by him or her to the department

involving information given or disclosed by him or her in good faith regarding a violation of this

chapter.

SECTION 3. This act shall take effect on January 1, 2007.

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LC02171/SUB A

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