6 CCR 1011-1 Chapter 07, pt. 13 - RESIDENT RIGHTS

13.1 The assisted living residence shall adopt, and place in a publically visible location, a statement regarding the rights and responsibilities of its residents. The assisted living residence and staff shall observe these rights in the care, treatment, and oversight of the residents. The statement of rights shall include, at a minimum, the following items:

(A) The right to privacy and confidentiality, including:

(1) The right to have private and unrestricted communications with any person of choice;

(2) The right to private telephone calls or use of electronic communication;

(3) The right to receive mail unopened;

(4) The right to have visitors at any time; and

(5) The right to private, consensual sexual activity.

(B) The right to civil and religious liberties, including:

(1) The right to be treated with dignity and respect;

(2) The right to be free from sexual, verbal, physical or emotional abuse, humiliation, intimidation, or punishment;

(3) The right to be free from neglect;

(4) The right to live free from financial exploitation, restraint as defined in this chapter, and involuntary confinement except as allowed by the secure environment requirements of this chapter;

(5) The right to vote;

(6) The right to exercise choice in attending and participating in religious activities;

(7) The right to wear clothing of choice unless otherwise indicated in the care plan; and

(8) The right to care and services that are not conditioned or limited because of a resident's disability, sexual orientation, ethnicity, and/or personal preferences.

(C) The right to personal and community engagement, including:

(1) The right to socialize with other residents and participate in assisted living residence activities, in accordance with the applicable care plan;

(2) The right to full use of the assisted living residence common areas in compliance with written house rules;

(3) The right to participate in resident meetings, voice grievances, and recommend changes in policies and services without fear of reprisal;

(4) The right to participate in activities outside the assisted living residence and request assistance with transportation; and

(5) The right to use of the telephone including access to operator assistance for placing collect telephone calls.

(a) At least one telephone accessible to residents utilizing an auxiliary aid shall be available if the assisted living residence is occupied by one or more residents utilizing such an aid.

(D) The right to choice and personal involvement regarding care and services, including:

(1) The right to be informed and participate in decision making regarding care and services, in coordination with family members who may have different opinions;

(2) The right to be informed about and formulate advance directives;

(3) The right to freedom of choice in selecting a health care service or provider;

(4) The right to expect the cooperation of the assisted living residence in achieving the maximum degree of benefit from those services which are made available by the assisted living residence;

(a) For residents with limited English proficiency or impairments that inhibit communication, the assisted living residence shall find a way to facilitate communication of care needs.

(5) The right to make decisions and choices in the management of personal affairs, funds, and property in accordance with resident ability;

(6) The right to refuse to perform tasks requested by the assisted living residence or staff in exchange for room, board, other goods or services;

(7) The right to have advocates, including members of community organizations whose purposes include rendering assistance to the residents;

(8) The right to receive services in accordance with the resident agreement and the care plan; and

(9) The right to thirty (30) calendar days' written notice of changes in services provided by the assisted living residence including, but not limited to, involuntary change of room or changes in charges for a service. Exceptions to this notice are:

(a) Changes in the resident's medical acuity that result in a documented decline in condition and that constitute an increase in care necessary to protect the health and safety of the resident; and

(b) Requests by the resident or the family for additional services to be added to the care plan.

(10) The right to designate the individuals to be notified in cases of emergency or involuntary discharge.

(E) The right to visitation in compliance with facility policy as set forth in Part 9.2.

Ombudsman Access

13.2 In accordance with the Supporting Older Americans Act of 2020 (P.L. 116-131), and Sections 26-11.5-108 and 25-27-104(2)(d), C.R.S., an assisted living residence shall permit access to the premises and residents by the state long-term care ombudsman and the designated local ombudsman at any time during an ALR's regular business hours or regular visiting hours, and at any other time when access may be required by the circumstances to be investigated.

(A) For the purposes of complying with this Part 13.2, access to residents shall include access to the assisted living residence's contact information for the resident and the resident's representative.

House Rules

13.3 The assisted living residence shall establish written house rules and place them in a publically visible location so that they are always available to residents and visitors.

13.4 The house rules shall list all possible actions which may be taken by the assisted living residence if any rule is knowingly violated by a resident. House rules shall not supersede or contradict any regulation herein, or in any way discourage or hinder a resident's exercise of his or her rights. House rules shall address, at a minimum, the following items:

(A) Smoking, including the use of electronic cigarettes and vaporizers;

(B) Cooking;

(C) Protection of valuables on premises;

(D) Visitors;

(E) Telephone usage, including frequency and duration of calls;

(F) Use of common areas and devices, such as television, radio, and computer;

(G) Consumption of alcohol and marijuana; and

(H) Pets.

Resident Meetings

13.5 Each assisted living residence shall hold regular meetings with residents, staff, family, and friends of residents so that all have the opportunity to voice concerns and make recommendations concerning assisted living residence care, services, activities, policies, and procedures.

13.6 Meetings shall be held at least quarterly with an opportunity for more frequent meetings if requested.

13.7 Written minutes of such meetings shall be maintained and made readily available for review by residents or family members.

13.8 Before the next regularly scheduled meeting, assisted living residence staff shall respond in writing to any suggestions or issues raised at the prior meeting.

13.9 Residents and family members shall also have the opportunity to meet without the presence of assisted living residence staff.

Internal Grievance and Complaint Resolution Process

13.10 Each assisted living residence shall develop and implement an internal process to ensure the routine and prompt handling of grievances or complaints brought by residents, family members, or advocates. The process for raising and addressing grievances and complaints shall be placed in a visible on-site location along with full contact information for the following agencies:

(A) The state long-term care ombudsman and local ombudsman;

(B) The Adult Protection Services of the appropriate county Department of Social Services;

(C) The advocacy services of the area's agency on aging;

(D) The Colorado Department of Public Health and Environment; and

(E) The Colorado Department of Health Care Policy and Financing, in those cases where the assisted living residence is licensed to provide services specifically for persons with intellectual and developmental disabilities.

Investigation of Abuse and Neglect Allegations or Injuries of Unknown Origin

13.11 The assisted living residence shall investigate all allegations of abuse, neglect, or exploitation of residents in accordance with Part 5.3 and its written policy which shall include, but not be limited to, the following:

(A) Reporting requirements to the appropriate agencies such as the adult protection services of the appropriate county Department of Social Services, and to the assisted living residence administrator;

(B) A requirement that the assisted living residence notify the legal representative about the allegation within 24 hours of the assisted living residence becoming aware of the allegation;

(C) The process for investigating such allegations;

(D) How the assisted living residence will document the investigation process to evidence the required reporting and that a thorough investigation was conducted;

(E) A requirement that the resident shall be protected from potential future abuse and neglect, and/or exploitation while the investigation is being conducted;

(F) A requirement that if the alleged neglect or abuse is verified, the assisted living residence shall take appropriate corrective action; and

(G) A requirement that a copy of the report with the investigation findings shall be retained by the facility and available for Department review.

13.12 The assisted living residence shall develop and implement policies and procedures for the identification, reporting, and investigation of injuries of unknown origin. Such policies and procedures shall include, but not be limited to, the following requirements:

(A) The assisted living residence shall identify and document resident injuries for which the origin of the injury was not observed by or otherwise known by staff, and either:

(1) The resident cannot explain how the injury occurred; or

(2) The resident can explain the source of the injury, but the source could be addressed to prevent future injuries.

(B) The assisted living residence shall document the following:

(1) The investigation and identification of any injury identified in (A), above.

(2) The implementation and outcome of the following for injuries for which the investigation determines the source/origin:

(a) Compliance with Part 13.11, when the source/origin of the injury is suspected to be abuse, neglect, or exploitation; or

(b) The steps taken to prevent or mitigate future injuries of like nature for both the injured resident and other residents when the source/origin of the injury is not suspected abuse, neglect, or exploitation. Such steps may include, but not be limited to:

(i) Staff or volunteer corrective action and/or additional training; or

(ii) Modification of the assisted living residence's policies, procedures or physical environment.

(3) When the source of the injury remains undetermined, the steps taken to monitor the resident in an effort identify and prevent similar injuries.

(C) All documentation of the investigation, outcomes, and steps taken shall be retained by the assisted living residence, including, but not limited to, details of any interviews and/or records used in the investigation. Such documentation shall be made available for review at the Department's request.

(1) Documentation on the investigation, outcomes, and steps taken may be maintained separately from the resident record, in which case a summary of the investigation and steps taken shall be included in the resident's care plan and progress notes.

(D) The assisted living residence shall notify the resident's representative of the outcome of the investigation and steps taken.

Notes

6 CCR 1011-1 Chapter 07, pt. 13

46 CR 24, December 25, 2023, effective 11/15/2023, exp. 3/14/2024 (Emergency) 46 CR 24, December 25, 2023, effective 1/14/2024