11.1 The assisted living residence shall accept only those persons whose needs can be fully met by
the existing staff, physical environment and services already being provided. The assisted living
residence’s ability to meet resident needs shall be based upon a comprehensive pre-admission
assessment of a resident’s physical, mental and social needs; cultural, religious and activity
needs; preferences; and capacity for self-care.
11.2 An assisted living residence shall not allow to move in any person who:
(A) Needs regular 24-hour medical or nursing care,
(B) Is incapable of self-administration of medication and the assisted living residence does
not have staff who are either licensed or qualified under 6 CCR 1011-1, Chapter 24 to
(C) Has an acute physical illness which cannot be managed through medication or
(D) Has physical limitations that restrict mobility unless compensated for by available
auxiliary aids or intermittent staff assistance,
E) Has incontinence issues that cannot be managed by the resident or staff,
(F) Is profoundly disoriented to time, person and place with safety concerns that require a
secure environment and the assisted living residence does not provide a secure
(G) Has a stage 3 or 4 pressure sore and does not meet the criteria in section 12.4,
(H) Has a history of conduct that has been disclosed to the assisted living residence that
would pose a danger to the resident or others unless the ALR reasonably believes that
the conduct can be managed through therapeutic approaches, or
(I) Needs restraints, as defined herein, of any kind except as statutorily allowed for assisted
living residences which are certified to provide services specifically for the mentally ill.
(1) Assisted living residences certified to provide services for the mentally ill shall
have policies, procedures and appropriate staff training regarding the use of
restraint and maintain current documentation to show that less restrictive
measures were and continue to be unsuccessful.
11.3 At the time the resident moves in, the assisted living residence shall ensure that the resident
and/or the resident’s legal representative has received a copy of the written resident agreement
and agreed to the terms set forth therein. The assisted living residence shall ensure that the
agreement is signed and dated by both parties.
11.4 The terms of a resident agreement shall not alter, or be construed to relieve the assisted living
residence of compliance with, any requirement or obligation under relevant federal, state or local
law and regulation.
11.5 The assisted living residence shall review its resident agreements annually and update or amend
them as necessary. Amendments to the resident agreement shall also be signed and dated by
(A) When a change of ownership occurs, the new owner shall either acknowledge and agree
to the terms of each existing resident agreement or establish a new agreement with each
11.6 The written resident agreement shall specify the understanding between the parties concerning,
at a minimum, the following items:
(A) Assisted living residence charges, refunds and deposit policies;
(B) The general type of services and activities provided and not provided by the assisted
living residence and those which the assisted living residence will assist the resident in
(C) A list of specific assisted living residence services included for the agreed upon rates and
charges, along with a list of all available optional services and the specified charge for
(D) The amount of any fee to hold a place for the resident in the assisted living residence
while the resident is absent from the assisted living residence and the circumstances
under which it will be charged;
(E) Responsibility for providing and maintaining bed linens, bath and hygiene supplies, room
furnishings, communication devices and auxiliary aids; and
(F) A guarantee that any security deposit will be fully reimbursed if the assisted living
residence closes without giving resident(s) written notice at least 30 calendar days before
Written Disclosure of Information
11.7 The assisted living residence shall ensure that when a new resident moves in, he or she is
provided with, and acknowledges receipt of, the following information:
(A) How to obtain access to the assisted living residence policies and procedures listed
under section 9.1,
(B) The resident’s right to receive cardiopulmonary resuscitation (CPR) or have a written
advance directive refusing CPR,
(C) Minimum staffing levels, whether the assisted living residence has awake staff 24 hours a
day and the extent to which certified or licensed health care professionals are available
(D) Whether the assisted living residence has an automatic fire sprinkler system,
(E) Whether the assisted living residence uses egress alert devices, including details about
when and where they are used,
(F) Whether the assisted living residence has resident location monitoring devices (such as
video surveillance), when and where they are used, and how the assisted living
residence determines that a resident requires monitoring,
(G) Whether the assisted living residence operates a secure environment and what that
(H) The resident’s individualized care plan that addresses his or her functional capability and
(I) Smoking prohibitions and/or designated areas for smoking,
(J) The readily available on-site location of the assisted living residence’s most recent
inspection report, and
(K) Upon request, a copy of the most recent version of these Chapter 7 rules.
Management of Resident Funds/Property
11.8 An assisted living residence shall not assume power of attorney or guardianship over a resident
unless by court order, nor shall an assisted living residence require a resident to execute or
assign a loan, advance, financial interest, mortgage or other property in exchange for future
11.9 An assisted living residence shall not be required to handle resident funds or property.
11.10 An assisted living residence that chooses to handle resident funds or property, shall have a policy
regarding the management of such funds and shall comply with the following criteria:
(A) There shall be a written authorization that specifies the terms and duration of the financial
management services to be performed by the assisted living residence. Such
authorization shall be signed by the resident or resident’s legal representative and
(B) Upon entering into an agreement with a resident for financial management services, the
assisted living residence shall exercise fiduciary responsibility for these funds and
property, including, but not limited to, maintaining any funds over the amount of five
hundred dollars ($500) in an interest-bearing account, separate from the general
operating fund of the ALR, which interest shall accrue to the resident.
(C) The assisted living residence shall post a surety bond in an amount sufficient to protect
the residents’ personal funds.
(D) The assisted living residence shall maintain a continuous, dated record of all financial
transactions. The record shall begin with the date of the first handling of the personal
funds of the resident and shall be kept on file for at least three years following termination
of the resident’s stay in the assisted living residence. Such record shall be available for
inspection by the Department.
(E) The assisted living residence shall provide the resident or legal representative a receipt
each time funds are disbursed along with a quarterly report identifying the beginning and
ending account balance along with a description of each and every transaction since the
11.11 The assisted living residence shall arrange to discharge any resident who:
(A) Has an acute physical illness which cannot be managed through medication or
(B) Has physical limitations that restrict mobility, and which cannot be compensated for by
available auxiliary aids or intermittent staff assistance,
(C) Has incontinence issues that cannot be managed by the resident or staff,
(D) Has a stage 3 or stage 4 pressure sore and does not meet the criteria in section 12.4,
(E) Is profoundly disoriented to time, person and place with safety concerns that require a
secure environment and the assisted living residence does not provide a secure
(F) Exhibits conduct that poses a danger to self or others and the assisted living residence is
unable to sufficiently address those issues through therapeutic approach, and/or
(G) Needs more services than can be routinely provided by the assisted living residence or
an external service provider.
11.12 The assisted living residence may also discharge a resident for:
(A) Nonpayment of basic services in accordance with the resident agreement; or
(B) The resident’s failure to comply with a valid, signed resident agreement.
11.13 Where a resident has demonstrated that he or she has become a danger to self or others, the
assisted living residence shall promptly implement the following process pending discharge:
(A) Take all appropriate measures necessary to protect other residents;
(B) Reassess the resident to be discharged and revise his or her care plan to identify the
resident’s current needs and what services the assisted living residence will provide to
meet those needs; and
(C) Ensure all staff are aware of any new directives placed in the care plan and are properly
trained to provide supervision and actions consistent with the care plan.
11.14 The assisted living residence shall coordinate a voluntary or involuntary discharge with the
resident, the resident’s legal representative and/or the appropriate agency. Prior to discharging a
resident because of increased care needs, the assisted living residence shall make documented
efforts to meet those needs through other means.
11.15 In the event a resident is transferred to another health care entity for additional care, the assisted
living residence shall arrange to evaluate the resident prior to re-admission or discharge the
resident in accordance with the discharge procedures specified below.
11.16 The assisted living residence shall provide written notice of any discharge to the resident or legal
representative 30 calendar days in advance of discharge except in cases of imminent physical
harm to or by the resident or medical emergency, whereupon the assisted living residence shall
notify the legal representative as soon as possible.
11.17 A copy of any involuntary discharge notice shall be sent to the state and/or local long-term care
ombudsman, within five (5) calendar days of the date that it is provided to the resident or the
resident’s legal representative.