Assisted living communities will face stricter regulations and heftier fines for serious abuse or neglect of residents after Colorado health officials last week adopted rules that had been signed into law in 2022.
The Colorado Department of Public Health and Environment last week voted unanimously to adopt rules that had been passed under SB 22-154 in May 2022 by the state legislature and then signed by Gov. Jared Polis (D). The new regulations will go into effect in January.
The bill modifies statutory requirements regarding administrator qualifications, including increasing training requirements from 30 hours to 40 hours; implementing grievance/appeal procedures related to involuntary discharge of a resident; and increasing fines for violations.
Janet Cornell, president of the Colorado Assisted Living Association, told McKnight’s Senior Living that the outcome for some aspects of the bill remain to be determined, particularly the involuntary discharge-related requirements. Residents will now be able to challenge discharges within 14 days of receiving a written 30-day notice, but Cornell said that the state has assured the industry that the new rules will not apply to individuals whose needs cannot be met or who are considered a danger to themselves or others.
Cornell questioned whether the discharge rule will make assisted living safer, adding that CALA is looking for ways to collect data on the issue “so that future decisions can be made from an informed stance of collecting data and reviewing information.”
The bill also changes the schedule for fines, moving from an annual maximum of $2,000 per community to levels ranging from $500 to $10,000 per violation. HIgher fines can be assessed if the violation is considered “egregious.”
“The bill, as written, did not address specifically what is considered egregious in nature, so the state survey team will decide,” Cornell said. “We are eager to see if the increase in fines makes the industry safer and makes poor providers improve their operations, or will this cause good providers to be discouraged enough to shut their doors?”
Cornell said that CDPHE data show that the number of assisted living beds in the state has declined by 350, and the number of communities has dropped from 704 to 663 in the past two-and-a-half years.
“A decline in beds, at a time when the population needing care in assisted living is increasing, is not a good sign for things to come in Colorado for the assisted living industry,” she said. “This decline is also not a win for the people seeking care. Medicaid beds have also declined, as some of the providers that chose to go out of business accepted Medicaid.”
Colorado Health Care Association President and CEO Doug Farmer similarly told McKnight’s Senior Living that the new requirements related to involuntary discharge and the state’s expanded fining authority will need to be watched carefully.
“We know that fines are not the pathway to improved quality, but instead take away the already limited financial resources that should be going toward care for our seniors,” Farmer said. “The fact that the state now has effectively unlimited fining authority is incredibly concerning.”
Sen. Jessie Danielson (D-Wheat Ridge) spearheaded the bill to “hold assisted living facilities accountable” following allegations of neglect and abuse.
