3.1 Applicants for an initial or renewal license shall follow the licensure procedures outlined in 6 CCR
1011-1, Chapter 2, Parts 2.3 through 2.10.
(A) In addition, each license renewal applicant shall annually submit, in the form and manner
prescribed by the Department, information about the facility’s operations, resident care
3.2 The Department may issue a provisional license to an applicant for the purpose of operating an
assisted living residence for one period of 90 days if the applicant is temporarily unable to
conform to all the minimum standards required under these regulations, except no license shall
be issued to an applicant if the operation of the applicant’s facility will adversely affect the health,
safety, and welfare of the residents of such facility.
(A) As a condition of obtaining a provisional license, the applicant shall provide the
Department with proof that it is attempting to conform and comply with applicable
standards. No provisional license shall be granted prior to the submission of a criminal
background check in accordance with § 25-27-105 (2.5), C.R.S.
3.3 Each owner or applicant shall request a background check.
(A) If an owner or applicant for an initial assisted living residence license has lived in
Colorado for more than three years at the time of the initial application, said individual
shall request from the Colorado Bureau of Investigation (CBI) a state fingerprint-based
criminal history record check with notification of future arrests.
(B) If an owner or applicant for an initial assisted living residence license has lived in
Colorado for three years or less at the time of the initial application, said individual shall
request a fingerprint-based criminal history record check generated by the Federal
Bureau of Investigation through the CBI.
(C) The cost of obtaining such information shall be borne by the individual or individuals who
are the subject of such check. The information shall be forwarded by the CBI directly to
3.4 No license shall be issued or renewed by the Department if an owner, applicant and/ or licensee
of the assisted living residence has been convicted of a felony or of a misdemeanor, which felony
or misdemeanor involves moral turpitude or involves conduct that the Department determines
could pose a risk to the health, safety, or welfare of residents of the assisted living residence.
3.5 An assisted living residence shall not care for more residents than the number of beds for which it
is currently licensed.
Unless otherwise specified, all license fees paid to the Department shall be non-refundable.
3.6 Initial Licenses
For initial license applications submitted on or after July 1, 2018, the applicable fee, as set forth
below, shall accompany the license application.
3 to 8 licensed beds: $6,300.
9 to 19 licensed beds: $7,300.
20 to 49 licensed beds: $8,750.
50 to 99 licensed beds: $11,550
100 or more licensed beds: $14,750
Qualifying disproportionate share facility: $3,000
3.7 Renewal Fees
(A) For licenses that expire before July 1, 2018, the applicable fee as set forth below, shall
accompany the renewal application:
$180 per facility plus $47 per bed.
$180 per facility plus $19 per bed for a high Medicaid utilization facility.
(B) For licenses that expire on or after July 1, 2018, the applicable fee(s), as set forth below,
shall accompany the renewal application:
$360 per facility plus $67 per bed.
$360 per facility plus $23 per bed for a high Medicaid utilization facility.
$350 per secure environment that is separate and distinct from a non-secure
(C) For licenses that expire on or after July 1, 2019, the applicable fee(s), as set forth below,
shall accompany the renewal application:
$360 per facility plus $103 per bed.
$360 per facility plus $38 per bed for a high Medicaid utilization facility.
$350 per secure environment that is separate and distinct from a non-secure
3.8 Provisional Licensure. Any facility approved by the Department for a provisional license, shall
submit a fee of $1,000 for the provisional licensure period.
3.9 Change of Ownership
(A) The applicable fee, as set forth below, shall accompany a facility’s application for change
Three to 19 licensed beds: $6,250.
20 to 49 licensed beds: $7,800.
50 to 99 licensed beds: $10,600
100 licensed beds and more: $13,700
(B) If the same purchaser buys more than one facility from the same seller in a single
business transaction, the change of ownership fee shall be the fee noted above for the
largest facility and $4,500 for each additional facility included in the transaction. The
appropriate fee total shall be submitted with the application.
3.10 Other License Fees
(A) A facility applying for a change of mailing address, shall submit a fee of $75 with the
application.For purposes of this subsection, a corporate change of address for multiple
facilities shall be considered one change of address.
(B) A facility applying for a change of name shall submit a fee of $75 with the application.
(C) A facility applying for an increased number of licensed beds shall submit a fee of $500
with the application.
(D) A facility applying for a change of administrator shall submit a fee of $500 with the
(E) A facility seeking to open a new secure environment shall submit a fee of $1,600 with the
first submission of the applicable building plans.
3.11 The level of the deficiency shall be based upon the number of sample residents affected and the
level of harm, as follows:
Level A – isolated potential for harm for one or more residents.
Level B – a pattern of potential for harm for one or more residents.
Level C – isolated actual harm affecting one or more residents.
Level D – a pattern of actual harm affecting one or more residents.
Level E (Immediate Jeopardy) – actual or potential for serious injury or harm for one or more
3.12 When a Level E deficiency is cited, the assisted living residence shall immediately remove the
cause of the immediate jeopardy risk and provide the Department with written evidence that the
risk has been removed. Plans of Correction
3.13 Pursuant to §25-27-105 (2), C.R.S., an assisted living residence shall submit a written plan
detailing the measures that will be taken to correct any deficiencies.
(A) Plans of correction shall be in the format prescribed by the Department and conform to
the requirements set forth in 6 CCR 1011-1, Chapter 2, Part 2.11.4,
(B) The Department has the discretion to approve, impose, modify or reject a plan of
correction as set forth in 6 CCR 1011-1, Chapter 2, Part 2.11.4.
Intermediate Restrictions or Conditions
3.14 Section 25-27-106, C.R.S., allows the Department to impose intermediate restrictions or
conditions on a licensee that may include at least one of the following:
(A) Retaining a consultant to address corrective measures including deficient practice
resulting from systemic failure;
(B) Monitoring by the Department for a specific period;
(C) Providing additional training to employees, owners, or operators of the residence;
(D) Complying with a directed written plan, to correct the violation; or
(E) Paying a civil fine not to exceed two thousand dollars ($2,000) in a calendar year.
3.15 Intermediate restrictions or conditions may be imposed for Level A, B and C deficiencies when
the Department finds the assisted living residence has violated statutory or regulatory
requirements. The factors that may be considered include, but are not limited to, the following:
(A) The level of actual or potential harm to a resident(s),
(B) The number of residents affected,
(C) Whether the conduct leading to the imposition of the restriction are isolated or a pattern,
(D) The licensee’s prior history of noncompliance in general, and specifically with reference
to the cited deficiencies.
3.16 For all cases where the deficiency list includes Levels D or E deficiencies, the assisted living
residence shall comply with at least one intermediate restriction or condition. In addition, for all
level E deficiencies, the assisted living residence shall:
(A) Pay a civil fine of $500, not to exceed $2,000 in a calendar year,
(B) Immediately correct the circumstances that gave rise to the immediate jeopardy situation,
(C) Comply with any other restrictions or conditions required by the Department.
Appealing the Imposition of Intermediate Restrictions/Conditions
3.17 A licensee may appeal the imposition of an intermediate restriction or condition pursuant to
procedures established by the Department and as provided by §25-27-106, C.R.S.
(A) Informal Review
Informal review is an administrative review process conducted by the Department that
does not include an evidentiary hearing.
(1) A licensee may submit a written request for informal review of the imposition of
an intermediate restriction no later than ten (10) business days after the date
notice is received from the Department of the restriction or condition. If an
extension of time is needed, the assisted living residence shall request an
extension in writing from the Department prior to the submittal due date. An
extension of time may be granted by the Department not to exceed seven
calendar days. Informal review may be conducted after the plan of correction has
(2) For civil fines, the licensee may request in writing that the informal review be
conducted in person, which would allow the licensee to orally address the
(B) Formal Review
A licensee may appeal the imposition of an intermediate restriction or condition in
accordance with the Administrative Procedure Act (APA) at §24-4-105, C.R.S. A licensee
is not required to submit to the Department’s informal review before pursuing formal
review under the APA.
(1) For life-threatening situations, the licensee shall implement the restriction or
condition immediately upon receiving notice of the restriction or condition.
(2) For situations that are not life-threatening, the restriction or condition shall be
implemented in accordance with the type of condition as set forth below:
(a) For restriction/conditions other than fines, immediately upon the
expiration of the opportunity for appeal or from the date that the
Department’s decision is upheld after all administrative appeals have
(b) For fines, within 30 calendar days from the date the Department’s
decision is upheld after all administrative appeals have been exhausted.
Supported Living Program Oversight
3.18 An assisted living residence that is certified to participate in the Supported Living Program
administered by the Department of Healthcare Policy and Financing shall comply with both
HCPF’s regulations concerning that program and the applicable portions of this chapter. The
Department shall coordinate with HCPF in regulatory interpretation of both license and
certification requirements to ensure that the intent of similar regulations is congruently met.
4.1 The licensee shall assume responsibility for all services provided by the assisted living residence.
4.2 The licensee shall ensure the provision of facilities, personnel and services necessary for the
welfare and safety of residents.
4.3 The licensee shall ensure that all marketing, advertising and promotional information published or
otherwise distributed by the assisted living residence accurately represents the ALR and the care,
treatment and services that it provides.
4.4 The licensee shall establish, and ensure the maintenance of, a system of financial management
and accountability for the assisted living residence.
4.5 The licensee shall appoint an administrator who meets the minimum qualifications set forth in this
regulation and delegate to that individual the executive authority and responsibility for the
administration of the assisted living residence.