CHAPTER 368bb
MANAGED RESIDENTIAL COMMUNITIES

Table of Contents

Sec. 19a-693. Definitions.
Sec. 19a-694. Managed residential communities. Operational requirements.
Sec. 19a-695*. Investigation of complaints.
Sec. 19a-696*. Biennial reviews. Written reports. Remedial orders. Enforcement of remedial orders.
Sec. 19a-697. Resident's bill of rights.
Sec. 19a-698. Residency agreements. Twenty-four-hour skilled nursing care.
Sec. 19a-699. Individualized service plans. Assessment of resident who requires assisted living services.
Sec. 19a-700. Written residency agreements. Required content.
Sec. 19a-701. Regulations.

      Sec. 19a-693. Definitions. As used in this section and sections 19a-694 to 19a-701, inclusive:

      (1) "Activities of daily living" means activities or tasks, that are essential for a person's healthful and safe existence, including, but not limited to, bathing, dressing, grooming, eating, meal preparation, shopping, housekeeping, transfers, bowel and bladder care, laundry, communication, self-administration of medication and ambulation.

      (2) "Assisted living services" means nursing services and assistance with activities of daily living provided to residents living within a managed residential community having supportive services that encourage persons primarily fifty-five years of age or older to maintain a maximum level of independence.

      (3) "Assisted living services agency" means an entity, licensed by the Department of Public Health pursuant to chapter 368v that provides, among other things, nursing services and assistance with activities of daily living to a population that is chronic and stable.

      (4) "Managed residential community" means a for-profit or not-for-profit facility consisting of private residential units that provides a managed group living environment consisting of housing and services for persons who are primarily fifty-five years of age or older. "Managed residential community" does not include any state-funded congregate housing facilities.

      (5) "Department" means the Department of Public Health.

      (6) "Private residential unit" means a private living environment designed for use and occupancy by a resident within a managed residential community that includes a full bathroom and access to facilities and equipment for the preparation and storage of food.

      (7) "Resident" means a person residing in a private residential unit of a managed residential community pursuant to the terms of a written agreement for occupancy of such unit.

      (June Sp. Sess. P.A. 07-2, S. 30.)

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)

      Sec. 19a-694. Managed residential communities. Operational requirements. (a) All managed residential communities operating in the state shall:

      (1) Provide a written residency agreement to each resident in accordance with section 19a-700;

      (2) Afford residents the ability to access services provided by an assisted living services agency. Such services shall be provided in accordance with a service plan developed in accordance with section 19a-699;

      (3) Upon the request of a resident, arrange, in conjunction with the assisted living services agency, for the provision of ancillary medical services on behalf of a resident, including physician and dental services, pharmacy services, restorative physical therapies, podiatry services, hospice care and home health agency services, provided the ancillary medical services are not administered by employees of the managed residential community, unless the resident chooses to receive such services;

      (4) Provide a formally established security program for the protection and safety of residents that is designed to protect residents from intruders;

      (5) Afford residents the rights and privileges guaranteed under title 47a;

      (6) Comply with the provisions of subsection (c) of section 19-13-D105 of the regulations of Connecticut state agencies; and

      (7) Be subject to oversight and regulation by the Department of Public Health.

      (b) No managed residential community shall control or manage the financial affairs or personal property of any resident.

      (June Sp. Sess. P.A. 07-2, S. 31.)

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)

      Sec. 19a-695*. Investigation of complaints. The Department of Public Health shall receive and investigate any complaint alleging that a managed residential community is engaging in, or has engaged in activities, practices or omissions that would constitute a violation of sections 19a-694 to 19a-701, inclusive, the regulations adopted pursuant to section 19a-701, or any other regulation applicable to managed residential communities, including the Public Health Code. The department shall include in its biennial review of a managed residential community, conducted in accordance with section 19a-696, a review of the nature and type of any complaint received concerning the managed residential community, as well as the department's final determination made with respect to such complaint.

      (June Sp. Sess. P.A. 07-2, S. 32.)

      *Note: This section is effective April 1, 2008.

      History: June Sp. Sess. P.A. 07-2 effective April 1, 2008.

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)

      Sec. 19a-696*. Biennial reviews. Written reports. Remedial orders. Enforcement of remedial orders. (a) The Department of Public Health shall conduct biennial reviews of all managed residential communities. Biennial reviews conducted by the department in accordance with the provisions of this section, shall be in addition to, and not in lieu of, any inspections of such communities by state or local officials to ensure compliance with the Public Health Code, the State Building Code, the State Fire Code or any local zoning ordinance. In addition to the biennial review, the department may conduct at any time a review of a managed residential community when the department has probable cause to believe that a managed residential community is operating in violation of the provisions of sections 19a-694 to 19a-701, inclusive, the regulations adopted pursuant to section 19a-701, or any other regulation applicable to managed residential communities, including the Public Health Code. The purpose of any biennial or investigatory review shall be to ensure that a managed residential community is operating in compliance with the provisions of sections 19a-694 to 19a-701, inclusive, the regulations adopted pursuant to section 19a-701, or any other regulation applicable to managed residential communities, including the Public Health Code. A biennial review shall include: (1) An inspection of all common areas of the managed residential community, including any common kitchen or meal preparation area located within the community; and (2) an inspection of private residential units, but only if prior to such inspection the residents occupying such units provide written consent to the inspection. In the course of conducting a biennial or investigatory review, an inspector may interview any manager, staff member or resident of the managed residential community. Interviews with any resident shall require the consent of the resident, be confidential and shall be conducted privately.

      (b) The department shall establish an administrative procedure for the preparation, completion and transmittal of written reports prepared as part of any review undertaken pursuant to this section or section 19a-695. If after undertaking any such review the department determines that a managed residential community is in violation of the provisions of sections 19a-694 to 19a-701, inclusive, the department shall provide written notice of its determination of an alleged violation to the managed residential community. Such written notice shall advise the managed residential community of its right to request an administrative hearing in accordance with sections 4-176e to 4-181a, inclusive, to contest such determination. A managed residential community shall request such hearing, in writing, not later than fifteen days after the date of receipt of the notice of an alleged violation from the department. The department may issue such remedial orders as deemed necessary by the department to ensure compliance with the provisions of sections 19a-694 to 19a-701, inclusive. Remedial orders available to the department shall include, but not be limited to, the imposition of a civil penalty against a managed residential community in an amount not to exceed five thousand dollars per violation. The department shall stay the imposition of any remedial order or civil penalty pending the outcome of an administrative hearing. The department shall maintain and make available for public inspection all completed reports, responses from managed residential communities and any remedial orders issued in accordance with the provisions of this section.

      (c) Upon the failure of a managed residential community to comply with a remedial order issued by the department, the Attorney General, at the request of the Commissioner of Public Health, may bring an action in the superior court for the judicial district of Hartford to enforce such order. All actions brought by the Attorney General pursuant to the provisions of this section shall have precedence in the order of trial as provided in section 52-191. The court may issue such orders as are necessary to obtain compliance with the order of the department.

      (June Sp. Sess. P.A. 07-2, S. 33.)

      *Note: This section is effective April 1, 2008.

      History: June Sp. Sess. P.A. 07-2 effective April 1, 2008.

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)

      Sec. 19a-697. Resident's bill of rights. (a) A managed residential community shall have a written bill of rights that prescribes the rights afforded to each resident. A designated staff person from the managed residential community shall provide and explain the bill of rights to the resident at the time that such resident enters into a residency agreement at the managed residential community. The bill of rights shall include, but not be limited to, that each resident has the right to:

      (1) Live in a clean, safe and habitable private residential unit;

      (2) Be treated with consideration, respect and due recognition of personal dignity, individuality and the need for privacy;

      (3) Privacy within a private residential unit, subject to rules of the managed residential community reasonably designed to promote the health, safety and welfare of the resident;

      (4) Retain and use one's own personal property within a private residential unit so as to maintain individuality and personal dignity provided the use of personal property does not infringe on the rights of other residents or threaten the health, safety and welfare of other residents;

      (5) Private communications, including receiving and sending unopened correspondence, telephone access and visiting with persons of one's choice;

      (6) Freedom to participate in and benefit from community services and activities so as to achieve the highest possible level of independence, autonomy and interaction within the community;

      (7) Directly engage or contract with licensed health care professionals and providers of one's choice to obtain necessary health care services in one's private residential unit, or such other space in the managed residential community as may be made available to residents for such purposes;

      (8) Manage one's own financial affairs;

      (9) Exercise civil and religious liberties;

      (10) Present grievances and recommend changes in policies, procedures and services to the manager or staff of the managed residential community, government officials or any other person without restraint, interference, coercion, discrimination or reprisal from the managed residential community, including access to representatives of the department or the Office of the Long-Term Care Ombudsman;

      (11) Upon request, obtain from the managed residential community the name of the service coordinator or any other persons responsible for resident care or the coordination of resident care;

      (12) Confidential treatment of all records and communications to the extent required by state and federal law;

      (13) Have all reasonable requests responded to promptly and adequately within the capacity of the managed residential community and with due consideration given to the rights of other residents;

      (14) Be fully advised of the relationship that the managed residential community has with any assisted living services agency, health care facility or educational institution to the extent that such relationship relates to resident medical care or treatment and to receive an explanation about the relationship;

      (15) Receive a copy of any rules or regulations of the managed residential community;

      (16) Privacy when receiving medical treatment or other services within the capacity of the managed residential community;

      (17) Refuse care and treatment and participate in the planning for the care and services the resident needs or receives, provided the refusal of care and treatment may preclude the resident from being able to continue to reside in the managed residential community; and

      (18) All rights and privileges afforded to tenants under title 47a.

      (b) A managed residential community shall post in a prominent place in the managed residential community the resident's bill of rights, including those rights set forth in subsection (a) of this section. The posting of the resident's bill of rights shall include contact information for the Department of Public Health and the Office of the State Long-Term Care Ombudsman, including the names, addresses and telephone numbers of persons within such agencies who handle questions, comments or complaints concerning managed residential community.

      (June Sp. Sess. P.A. 07-2, S. 34.)

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)

      Sec. 19a-698. Residency agreements. Twenty-four-hour skilled nursing care. No managed residential community shall enter into a written residency agreement with any individual who requires twenty-four-hour skilled nursing care, unless such individual establishes to the satisfaction of both the managed residential community and the assisted living services agency that the individual has, or has arranged for, such twenty-four-hour care and maintains such care as a condition of residency if an assisted living services agency determines that such care is necessary.

      (June Sp. Sess. P.A. 07-2, S. 35.)

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)

      Sec. 19a-699. Individualized service plans. Assessment of resident who requires assisted living services. (a) An assisted living services agency shall develop and maintain an individualized service plan for any resident of a managed residential community that receives assisted living services. Such agency shall develop the individualized service plan after consultation with the resident and following an assessment of the resident by a registered nurse. The individualized service plan shall set forth in lay terms the needs of the resident for assisted living services, the providers or intended providers of needed services, the scope, type and frequency of such services, an itemized cost of such services and any other information that Department of Public Health may require. The individualized service plan and any periodic revisions thereto shall be confidential, in writing, signed by the resident, or the resident's legal representative, and a representative of the assisted living services agency and available for inspection by the resident and the department.

      (b) An assisted living services agency shall maintain written policies and procedures for the initial evaluation and regular, periodic reassessment of the functional and health status and service requirements of each resident who requires assisted living services.

      (June Sp. Sess. P.A. 07-2, S. 36.)

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)

      Sec. 19a-700. Written residency agreements. Required content. A managed residential community shall enter into a written residency agreement with each resident that clearly sets forth the rights and responsibilities of the resident and the managed residential community, including the duties set forth in section 19a-562. The residency agreement shall be set forth in plain language and printed in not less than fourteen-point type. The residency agreement shall be signed by the managed residential community's authorized agent and by the resident, or the resident's legal representative, prior to the resident taking possession of a private residential unit and shall include, at a minimum:

      (1) An itemization of assisted living services, transportation services, recreation services and any other services and goods, lodging and meals to be provided on behalf of the resident by the managed residential community;

      (2) A full and fair disclosure of all charges, fees, expenses and costs to be borne by the resident;

      (3) A schedule of payments and disclosure of all late fees or potential penalties;

      (4) The grievance procedure with respect to enforcement of the terms of the residency agreement;

      (5) The managed residential community's covenant to comply with all municipal, state and federal laws and regulations regarding consumer protection and protection from financial exploitation;

      (6) The managed residential community's covenant to afford residents all rights and privileges afforded under title 47a;

      (7) The conditions under which the agreement can be terminated by either party;

      (8) Full disclosure of the rights and responsibilities of the resident and the managed residential community in situations involving serious deterioration in the health of the resident, hospitalization of the resident or death of the resident, including a provision that specifies that in the event that a resident of the community dies, the estate or family of such resident shall only be responsible for further payment to the community for a period of time not to exceed fifteen days following the date of death of such resident as long as the private residential unit formerly occupied by the resident has been vacated; and

      (9) Any adopted rules of the managed residential community reasonably designed to promote the health, safety and welfare of residents.

      (June Sp. Sess. P.A. 07-2, S. 37.)

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)

      Sec. 19a-701. Regulations. (a) A managed residential community shall meet the requirements of all applicable federal and state laws and regulations, including, but not limited to, the Public Health Code, State Building Code and the State Fire Safety Code, and federal and state laws and regulations governing handicapped accessibility.

      (b) The Commissioner of Public Health shall adopt regulations, in accordance with chapter 54, to carry out the provisions of sections 19a-693 to 19a-701, inclusive.

      (June Sp. Sess. P.A. 07-2, S. 38.)

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)