H.F. 110 Section 1. Section 231C.2, subsection 2, Code 2011, is 1 amended to read as follows: 2 2. “Assisted living” means provision of housing 3 with services which may include but are not limited to 4 health-related care, personal care, and assistance with 5 instrumental activities of daily living to three or more 6 tenants in a physical structure which provides a homelike 7 environment. 8 a. “Assisted living” also includes encouragement of family 9 involvement, tenant self-direction, and tenant participation 10 in decisions that emphasize choice, dignity, privacy, 11 individuality, shared risk, and independence. 12 b. “Assisted living” includes the provision of housing and 13 assistance with instrumental activities of daily living only if 14 personal care or health-related care is also included. 15 c. “Assisted living” includes twenty-four hours per 16 day response staff to meet scheduled and unscheduled or 17 unpredictable needs in a manner that promotes maximum dignity 18 and independence and provides supervision, safety, and 19 security. 20 d. “Assisted living” includes a physical structure that 21 provides housing to three or more tenants in which tenants 22 receive services as described in paragraph “b” from a service 23 provider contracting with the housing provider or contracting 24 with or employed by the tenant if both of the following 25 conditions are met: 26 (1) The service provider has a direct or indirect corporate 27 affiliation with at least one entity involved in the ownership 28 or operation of the housing. 29 (2) At least fifty percent of the tenants receive at least 30 one service from a service provider described in subparagraph 31 (1). 32 Sec. 2. Section 231C.3, subsection 3, Code 2011, is amended 33 to read as follows: 34 3. a. The owner or manager of a certified assisted living 35 -1- LSB 1273YH (7) 84 pf/nh 1/ 5

H.F. 110 program shall comply with the rules adopted by the department 1 for an assisted living program. 2 b. A person including a governmental unit , that meets the 3 definition of assisted living pursuant to section 231C.2 shall 4 be considered an assisted living program whether or not the 5 person represents the person to the public as an assisted 6 living program or as a certified assisted living program, and 7 shall not operate in this state unless and until the assisted 8 living program is certified pursuant to this chapter. 9 c. A person, including a governmental unit shall not 10 represent an assisted living program to the public as an 11 assisted living program or as a certified assisted living 12 program unless and until the program is certified pursuant to 13 this chapter . 14 Sec. 3. Section 231C.3, subsection 4, paragraph a, Code 15 2011, is amended to read as follows: 16 a. Services provided by a certified assisted living program 17 may be provided directly by staff of the assisted living 18 program, by individuals contracting with the assisted living 19 program to provide services, or by individuals employed by 20 the tenant or with whom the tenant contracts if the tenant 21 agrees to assume the responsibility and risk of the employment 22 or the contractual relationship. Any provider of services 23 for an assisted living program, by whatever means employed 24 or contracted, shall be subject to oversight and regulation 25 applicable to staffing of an assisted living program. 26 Sec. 4. Section 231C.5, subsection 2, paragraphs b and h, 27 Code 2011, are amended to read as follows: 28 b. A statement regarding the impact of the fee structure 29 on third-party payments, and whether third-party payments and 30 resources are accepted by the assisted living program. The 31 occupancy agreement shall also include a statement regarding 32 whether third-party payment is a basis for involuntary transfer 33 or transfer and the program’s policy regarding retention 34 or involuntary transfer or transfer of a tenant following 35 -2- LSB 1273YH (7) 84 pf/nh 2/ 5

H.F. 110 depletion of private resources. A tenant residing in an 1 assisted living program prior to the effective date of this 2 Act shall not be subject to involuntary transfer or transfer 3 based solely on source of payment, unless the occupancy 4 agreement entered into prior to that date specifically provided 5 otherwise and was signed by the tenant or the tenant’s legal 6 representative. An assisted living program shall amend any 7 occupancy agreement entered into prior to the effective date 8 of this Act to reflect the requirements of this paragraph and 9 shall obtain the signature of the tenant or the tenant’s legal 10 representative acknowledging the amendment to the occupancy 11 agreement no later than one hundred twenty days after the 12 effective date of this Act. 13 h. (1) Occupancy, involuntary transfer, and transfer 14 criteria and procedures, which ensure a safe and orderly 15 transfer. 16 (2) Involuntary transfer and transfer criteria, including 17 criteria relating to third-party payments and resources, 18 shall be explicitly stated in the occupancy agreement and 19 shall also be included in a separate cover letter to the 20 occupancy agreement and signed by the tenant or tenant’s legal 21 representative at the time of initial tenancy. An assisted 22 living program shall amend any occupancy agreement entered 23 into prior to the effective date of this Act to reflect 24 the requirements of this subparagraph and shall obtain the 25 signature of the tenant or the tenant’s legal representative 26 acknowledging the amendment to the occupancy agreement no later 27 than one hundred twenty days after the effective date of this 28 Act. 29 Sec. 5. EFFECTIVE UPON ENACTMENT. This Act, being deemed of 30 immediate importance, takes effect upon enactment. 31 EXPLANATION 32 This bill relates to assisted living programs. 33 The bill amends the definition of “assisted living” to 34 provide that assisted living includes a physical structure 35 -3- LSB 1273YH (7) 84 pf/nh 3/ 5

H.F. 110 that provides housing to three or more tenants, in which 1 tenants receive services defined as assisted living services 2 from a provider contracting with the provider of the housing 3 or contracting with or employed by the tenant, if both of 4 the following conditions are met: the service provider has 5 a direct or indirect corporate affiliation with at least one 6 entity involved in the ownership or operation of the housing; 7 and at least 50 percent of the tenants receive at least one 8 service from such service provider. 9 The bill also provides that a person that meets the 10 definition of “assisted living” shall be considered an assisted 11 living program whether or not the entity represents the entity 12 to the public as an assisted living program or a certified 13 assisted living program, and shall not operate in the state 14 unless and until the assisted living program is certified. 15 Any provider of assisted living services, however employed or 16 contracted, is subject to oversight and regulation applicable 17 to staffing of an assisted living program. 18 The bill amends provisions relating to occupancy agreements 19 for tenants of assisted living programs. The bill provides 20 that the occupancy agreement is to include a statement 21 regarding whether third-party payment is a basis for 22 involuntary transfer or transfer, and the program’s policy 23 regarding retention or involuntary transfer or transfer of a 24 tenant following depletion of private resources. Under the 25 bill, a tenant residing in an assisted living program prior 26 to the effective date of the bill, is not to be subject to 27 involuntary transfer or transfer based solely on source of 28 payment, unless the occupancy agreement entered prior to 29 that date specifically provides otherwise and the tenant or 30 tenant’s legal representative signed the occupancy agreement. 31 Additionally, the occupancy agreement is to explicitly state 32 involuntary transfer and transfer criteria, including criteria 33 relating to third-party payment and resources, and this 34 information is also required to be in a separate cover letter 35 -4- LSB 1273YH (7) 84 pf/nh 4/ 5

H.F. 110 to the occupancy agreement and signed by the tenant or tenant’s 1 legal representative at the time of initial tenancy. Assisted 2 living programs are required to amend occupancy agreements 3 entered into prior to the effective date of the bill to reflect 4 the requirements and obtain the signature of the tenant or 5 the tenant’s legal representative on the amended occupancy 6 agreements no later than 120 days after enactment of the bill. 7 The bill takes effect upon enactment. 8 -5- LSB 1273YH (7) 84 pf/nh 5/ 5