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 9  AN ACT concerning adult care homes; definitions; amending K.S.A. 1996
10    Supp. 39-923 and repealing the existing section.
11
12  Be it enacted by the Legislature of the State of Kansas:
13    Section 1.  K.S.A. 1996 Supp. 39-923 is hereby amended to read as
14  follows: 39-923. (a) As used in this act:
15    (1)  ``Adult care home'' means any nursing facility, nursing facility for
16  mental health, intermediate care facility for the mentally retarded, as-
17  sisted living facility, residential health care facility, home plus, boarding
18  care home and adult day care facility, all of which classifications of adult
19  care homes are required to be licensed by the secretary of health and
20  environment.
21    (2)  ``Nursing facility'' means any place or facility operating 24 hours
22  a day, seven days a week, caring for six or more individuals not related
23  within the third degree of relationship to the administrator or owner by
24  blood or marriage and who, due to functional impairments, need skilled
25  nursing care to compensate for activities of daily living limitations.
26    (3)  ``Nursing facility for mental health'' means any place or facility
27  operating 24 hours a day, seven days a week caring for six or more indi-
28  viduals not related within the third degree of relationship to the admin-
29  istrator or owner by blood or marriage and who, due to functional im-
30  pairments, need skilled nursing care and special mental health services
31  to compensate for activities of daily living limitations.
32    (4)  ``Intermediate care facility for the mentally retarded'' means any
33  place or facility operating 24 hours a day, seven days a week caring for
34  six or more individuals not related within the third degree of relationship
35  to the administrator or owner by blood or marriage and who, due to
36  functional impairments caused by mental retardation or related condi-
37  tions need services to compensate for activities of daily living limitations.
38    (5)  ``Assisted living facility'' means any place or facility caring for six
39  or more individuals not related within the third degree of relationship to
40  the administrator, operator or owner by blood or marriage and who, by
41  choice or due to functional impairments, may need personal care and
42  may need supervised nursing care to compensate for activities of daily
43  living limitations and in which the place or facility includes apartments
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 1  for residents and provides or coordinates a range of services including
 2  personal care or supervised nursing care available 24 hours a day, seven
 3  days a week for the support of resident independence. The provision of
 4  skilled nursing procedures to a resident in an assisted living facility is not
 5  prohibited by this act. Generally, the skilled services provided in an as-
 6  sisted living facility shall be provided on an intermittent or limited term
 7  basis, or if limited in scope, a regular basis.
 8    (6)  ``Residential health care facility'' means any place or facility or a
 9  contiguous portion of a place or facility caring for six or more individuals
10  not related within the third degree or relationship to the administrator,
11  operator or owner by blood or marriage and who, by choice or due to
12  functional impairments, may need personal care and may need supervised
13  nursing care to compensate for activities of daily living limitations and in
14  which the place or facility includes individual living units and provides or
15  coordinates personal care or supervised nursing care available on a 24-
16  hour, seven-day-a-week basis for the support of resident independence.
17  The provision of skilled nursing procedures to a resident in a residential
18  health care facility is not prohibited by this act. Generally, the skilled
19  services provided in a residential health care facility shall be provided on
20  an intermittent or limited term basis, or if limited in scope, a regular
21  basis.
22    (7)  ``Home plus'' means any residence or facility caring for not more
23  than five individuals not related within the third degree of relationship to
24  the operator or owner by blood or marriage unless the resident in need
25  of care is approved for placement by the secretary of the department of
26  social and rehabilitation services, and who, due to functional impairment,
27  needs personal care and may need supervised nursing care to compensate
28  for activities of daily living limitations. The level of care provided residents
29  shall be determined by preparation of the operator and rules and regu-
30  lations developed by the department of health and environment.
31    (8)  ``Boarding care home'' means any place or facility operating 24
32  hours a day, seven days a week, caring for not more than 10 individuals
33  not related within the third degree of relationship to the operator or
34  owner by blood or marriage and who, due to functional impairment, need
35  supervision of activities of daily living but who are ambulatory and essen-
36  tially capable of managing their own care and affairs.
37    (9)  ``Adult day care'' means any place or facility operating less than
38  24 hours a day caring for individuals not related within the third degree
39  of relationship to the operator or owner by blood or marriage and who,
40  due to functional impairment need supervision of or assistance with ac-
41  tivities of daily living.
42    (10)  ``Place or facility'' means a building or any one or more complete
43  floors of a building, or any one or more complete wings of a building, or
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 1  any one or more complete wings and one or more complete floors of a
 2  building, and the term ``place or facility'' may include multiple buildings.
 3    (11)  ``Skilled nursing care'' means services performed by or under the
 4  immediate supervision of a registered professional nurse and additional
 5  licensed nursing personnel. Skilled nursing includes administration of
 6  medications and treatments as prescribed by a licensed physician or den-
 7  tist; and other nursing functions which require substantial nursing judg-
 8  ment and skill based on the knowledge and application of scientific prin-
 9  ciples.
10    (12)  ``Supervised nursing care'' means services provided by or under
11  the guidance of a licensed nurse with initial direction for nursing proce-
12  dures and periodic inspection of the actual act of accomplishing the pro-
13  cedures; administration of medications and treatments as prescribed by
14  a licensed physician or dentist and assistance of residents with the per-
15  formance of activities of daily living.
16    (13)  ``Resident'' means all individuals kept, cared for, treated,
17  boarded or otherwise accommodated in any adult care home.
18    (14)  ``Person'' means any individual, firm, partnership, corporation,
19  company, association or joint-stock association, and the legal successor
20  thereof.
21    (15)  ``Operate an adult care home'' means to own, lease, establish,
22  maintain, conduct the affairs of or manage an adult care home, except
23  that for the purposes of this definition the word ``own'' and the word
24  ``lease'' shall not include hospital districts, cities and counties which hold
25  title to an adult care home purchased or constructed through the sale of
26  bonds.
27    (16)  ``Licensing agency'' means the secretary of health and environ-
28  ment.
29    (17)  ``Skilled nursing home'' means a nursing facility.
30    (18)  ``Intermediate nursing care home'' means a nursing facility.
31    (19)  ``Apartment'' means a private unit which includes, but is not
32  limited to, a toilet room with bathing facilities, a kitchen, sleeping, living
33  and storage area and a lockable door.
34    (20)  ``Individual living unit'' means a private unit which includes, but
35  is not limited to, a toilet room with bathing facilities, sleeping, living and
36  storage area and a lockable door.
37    (21)  ``Operator'' means an individual who operates an assisted living
38  facility or residential health care facility with fewer than 61 residents, a
39  home plus or adult day care facility and (a) is licensed by the state of
40  Kansas as a nursing home administrator and has thereby met the edu-
41  cational requirements of K.A.R. 28-38-19; or has completed a course ap-
42  proved by the secretary of health and environment on principles of as-
43  sisted living and has successfully passed an examination approved by the
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 1  licensing agency on principles of assisted living and (b) has completed 60
 2  hours of college credit from an accredited community college, college or
 3  university; or (c) has at least five years' experience in the health care field
 4  and has completed a 40-hour field placement. An operator must receive
 5  60 hours of continuing education units in any two-year period. The op-
 6  erator shall be subject to such other requirements as may be established
 7  by the licensing agency by rules and regulations. Any operator shall be
 8  governed by the board of adult care home administrators.
 9    (22)  ``Activities of daily living'' means those personal, functional ac-
10  tivities required by an individual for continued well-being, including but
11  not limited to eating, nutrition, dressing, personal hygiene, mobility, to-
12  ileting.
13    (23)  ``Personal care'' means care provided by staff to assist an indi-
14  vidual with, or to perform activities of daily living.
15    (24)  ``Functional impairment'' means an individual has experienced
16  a decline in physical, mental and psychosocial well-being and as a result,
17  is unable to compensate for the effects of the decline.
18    (25)  ``Kitchen'' means a food preparation area that includes a sink,
19  refrigerator and a microwave oven or stove.
20    (26)  The term ``intermediate personal care home'' for purposes of
21  those individuals applying for or receiving veterans' benefits means resi-
22  dential health care facility.
23    (b)  The term ``adult care home'' shall not include institutions oper-
24  ated by federal or state governments, except institutions operated by the
25  Kansas commission on veterans affairs, hospitals or institutions for the
26  treatment and care of psychiatric patients, child care facilities, maternity
27  centers, hotels, offices of physicians or hospices which are certified to
28  participate in the medicare program under 42 code of federal regulations,
29  chapter IV, section 418.1 et seq. and amendments thereto and which
30  provide services only to hospice patients.
31    (c)  Facilities licensed under K.S.A. 39-1501 et seq. and amendments
32  thereto or K.S.A. 75-3307b and amendments thereto or K.S.A. 39-923
33  and amendments thereto as an intermediate personal care home or with
34  license applications on file with the licensing agency as intermediate per-
35  sonal care homes on or before January 1, 1995, shall have the option of
36  becoming licensed as either an assisted living facility or a residential
37  health care facility without being required to add kitchens or private
38  baths.
39    (d)  Nursing facilities in existence on the effective date of this act
40  changing licensure categories to become residential health care facilities
41  shall be required to provide exempt from providing private bathing facil-
42  ities in a minimum of 20% of the individual living units.
43    (e)  Nursing facilities with less than 60 beds converting a portion of
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 1  the facility to residential health care shall have the option of licensing to
 2  care for less than six individuals within a contiguous portion of the facility.
 3    (e) (f)  Facilities licensed under the adult care home licensure act on
 4  the day immediately preceding the effective date of this act shall continue
 5  to be licensed facilities until the annual renewal date of such license and
 6  may renew such license in the appropriate licensure category under the
 7  adult care home licensure act subject to the payment of fees and other
 8  conditions and limitations of such act.
 9    (f) (g)  The licensing agency may by rule and regulation change the
10  name of the different classes of homes when necessary to avoid confusion
11  in terminology and the agency may further amend, substitute, change and
12  in a manner consistent with the definitions established in this section,
13  further define and identify the specific acts and services which shall fall
14  within the respective categories of facilities so long as the above categories
15  for adult care homes are used as guidelines to define and identify the
16  specific acts.
17    Sec. 2.  K.S.A. 1996 Supp. 39-923 is hereby repealed.
18    Sec. 3.  This act shall take effect and be in force from and after its
19  publication in the statute book.