As Amended by House Commettee
         

          Session of 1998
                   
HOUSE BILL No. 2989
         
By Committee on Appropriations
         
2-24
          10             AN ACT concerning adult care homes; amending K.S.A. 1997 Supp.
11             39-923 and repealing the existing section.
12            
13       Be it enacted by the Legislature of the State of Kansas:
14           Section 1. K.S.A. 1997 Supp. 39-923 is hereby amended to read as
15       follows: 39-923. (a) As used in this act:
16           (1) ``Adult care home'' means any nursing facility, nursing facility for
17       mental health, intermediate care facility for the mentally retarded, as-
18       sisted living facility, residential health care facility, home plus, boarding
19       care home and adult day care facility, all of which classifications of adult
20       care homes are required to be licensed by the secretary of health and
21       environment.
22           (2) ``Nursing facility'' means any place or facility operating 24 hours
23       a day, seven days a week, caring for six or more individuals not related
24       within the third degree of relationship to the administrator or owner by
25       blood or marriage and who, due to functional impairments, need skilled
26       nursing care to compensate for activities of daily living limitations.
27           (3) ``Nursing facility for mental health'' means any place or facility
28       operating 24 hours a day, seven days a week caring for six or more indi-
29       viduals not related within the third degree of relationship to the admin-
30       istrator or owner by blood or marriage and who, due to functional im-
31       pairments, need skilled nursing care and special mental health services
32       to compensate for activities of daily living limitations.
33           (4) ``Intermediate care facility for the mentally retarded'' means any
34       place or facility operating 24 hours a day, seven days a week caring for
35       six or more individuals not related within the third degree of relationship
36       to the administrator or owner by blood or marriage and who, due to
37       functional impairments caused by mental retardation or related condi-
38       tions need services to compensate for activities of daily living limitations.
39           (5) ``Assisted living facility'' means any place or facility caring for six
40       or more individuals not related within the third degree of relationship to
41       the administrator, operator or owner by blood or marriage and who, by
42       choice or due to functional impairments, may need personal care and
43       may need supervised nursing care to compensate for activities of daily

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  1       living limitations and in which the place or facility includes apartments
  2       for residents and provides or coordinates a range of services including
  3       personal care or supervised nursing care available 24 hours a day, seven
  4       days a week for the support of resident independence. The provision of
  5       skilled nursing procedures to a resident in an assisted living facility is not
  6       prohibited by this act. Generally, the skilled services provided in an as-
  7       sisted living facility shall be provided on an intermittent or limited term
  8       basis, or if limited in scope, a regular basis.
  9           (6) ``Residential health care facility'' means any place or facility, or a
10       contiguous portion of a place or facility, caring for six or more individuals
11       not related within the third degree or relationship to the administrator,
12       operator or owner by blood or marriage and who, by choice or due to
13       functional impairments, may need personal care and may need supervised
14       nursing care to compensate for activities of daily living limitations and in
15       which the place or facility includes individual living units and provides or
16       coordinates personal care or supervised nursing care available on a 24-
17       hour, seven-day-a-week basis for the support of resident independence.
18       The provision of skilled nursing procedures to a resident in a residential
19       health care facility is not prohibited by this act. Generally, the skilled
20       services provided in a residential health care facility shall be provided on
21       an intermittent or limited term basis, or if limited in scope, a regular
22       basis.
23           (7) ``Home plus'' means any residence or facility caring for not more
24       than five individuals not related within the third degree of relationship to
25       the operator or owner by blood or marriage unless the resident in need
26       of care is approved for placement by the secretary of the department of
27       social and rehabilitation services, and who, due to functional impairment,
28       needs personal care and may need supervised nursing care to compensate
29       for activities of daily living limitations. The level of care provided residents
30       shall be determined by preparation of the operator and rules and regu-
31       lations developed by the department of health and environment.
32           (8) ``Boarding care home'' means any place or facility operating 24
33       hours a day, seven days a week, caring for not more than 10 individuals
34       not related within the third degree of relationship to the operator or
35       owner by blood or marriage and who, due to functional impairment, need
36       supervision of activities of daily living but who are ambulatory and essen-
37       tially capable of managing their own care and affairs.
38           (9) ``Adult day care'' means any place or facility operating less than
39       24 hours a day caring for individuals not related within the third degree
40       of relationship to the operator or owner by blood or marriage and who,
41       due to functional impairment need supervision of or assistance with ac-
42       tivities of daily living.
43           (10) ``Place or facility'' means a building or any one or more complete

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  1       floors of a building, or any one or more complete wings of a building, or
  2       any one or more complete wings and one or more complete floors of a
  3       building, and the term ``place or facility'' may include multiple buildings.
  4           (11) ``Skilled nursing care'' means services performed by or under the
  5       immediate supervision of a registered professional nurse and additional
  6       licensed nursing personnel. Skilled nursing includes administration of
  7       medications and treatments as prescribed by a licensed physician or den-
  8       tist; and other nursing functions which require substantial nursing judg-
  9       ment and skill based on the knowledge and application of scientific prin-
10       ciples.
11           (12) ``Supervised nursing care'' means services provided by or under
12       the guidance of a licensed nurse with initial direction for nursing proce-
13       dures and periodic inspection of the actual act of accomplishing the pro-
14       cedures; administration of medications and treatments as prescribed by
15       a licensed physician or dentist and assistance of residents with the per-
16       formance of activities of daily living.
17           (13) ``Resident'' means all individuals kept, cared for, treated,
18       boarded or otherwise accommodated in any adult care home.
19           (14) ``Person'' means any individual, firm, partnership, corporation,
20       company, association or joint-stock association, and the legal successor
21       thereof.
22           (15) ``Operate an adult care home'' means to own, lease, establish,
23       maintain, conduct the affairs of or manage an adult care home, except
24       that for the purposes of this definition the word ``own'' and the word
25       ``lease'' shall not include hospital districts, cities and counties which hold
26       title to an adult care home purchased or constructed through the sale of
27       bonds.
28           (16) ``Licensing agency'' means the secretary of health and environ-
29       ment.
30           (17) ``Skilled nursing home'' means a nursing facility.
31           (18) ``Intermediate nursing care home'' means a nursing facility.
32           (19) ``Apartment'' means a private unit which includes, but is not
33       limited to, a toilet room with bathing facilities, a kitchen, sleeping, living
34       and storage area and a lockable door.
35           (20) ``Individual living unit'' means a private unit which includes, but
36       is not limited to, a toilet room with bathing facilities, sleeping, living and
37       storage area and a lockable door.
38           (21) ``Operator'' means an individual who operates an assisted living
39       facility or residential health care facility with fewer than 61 residents, a
40       home plus or adult day care facility and has completed a course approved
41       by the secretary of health and environment on principles of assisted living
42       and has successfully passed an examination approved by the licensing
43       agency on principles of assisted living and such other requirements as

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  1       may be established by the licensing agency by rules and regulations.
  2           (22) ``Activities of daily living'' means those personal, functional ac-
  3       tivities required by an individual for continued well-being, including but
  4       not limited to eating, nutrition, dressing, personal hygiene, mobility, to-
  5       ileting.
  6           (23) ``Personal care'' means care provided by staff to assist an indi-
  7       vidual with, or to perform activities of daily living.
  8           (24) ``Functional impairment'' means an individual has experienced
  9       a decline in physical, mental and psychosocial well-being and as a result,
10       is unable to compensate for the effects of the decline.
11           (25) ``Kitchen'' means a food preparation area that includes a sink,
12       refrigerator and a microwave oven or stove.
13           (26) The term ``intermediate personal care home'' for purposes of
14       those individuals applying for or receiving veterans' benefits means resi-
15       dential health care facility.
16           (b) The term ``adult care home'' shall not include institutions oper-
17       ated by federal or state governments, except institutions operated by the
18       Kansas commission on veterans affairs, hospitals or institutions for the
19       treatment and care of psychiatric patients, child care facilities, maternity
20       centers, hotels, offices of physicians or hospices which are certified to
21       participate in the medicare program under 42 code of federal regulations,
22       chapter IV, section 418.1 et seq. and amendments thereto and which
23       provide services only to hospice patients.
24           (c) Facilities licensed under K.S.A. 39-1501 et seq. and amendments
25       thereto or K.S.A. 75-3307b and amendments thereto or K.S.A. 39-923 as
26       an intermediate personal care home or with license applications on file
27       with the licensing agency as intermediate personal care homes on or be-
28       fore January 1, 1995, shall have the option of becoming licensed as either
29       an assisted living facility or a residential health care facility without being
30       required to add kitchens or private baths.
31           (d) Nursing facilities in existence on the effective date of this act
32       changing licensure categories to become residential health care facilities
33       shall be required to provide private bathing facilities in a minimum of
34       20% of the individual living units.
35           (e) Facilities licensed under the adult care home licensure act on the
36       day immediately preceding the effective date of this act shall continue to
37       be licensed facilities until the annual renewal date of such license and
38       may renew such license in the appropriate licensure category under the
39       adult care home licensure act subject to the payment of fees and other
40       conditions and limitations of such act.
41           (f) Nursing facilities with less than 60 beds converting a portion of
42       the facility to residential health care shall have the option of licensing to
43       care for less than six individuals but not less than 10% of the total bed

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  1       count within a contiguous portion of the facility.
  2           (f) (g) The licensing agency may by rule and regulation change the
  3       name of the different classes of homes when necessary to avoid confusion
  4       in terminology and the agency may further amend, substitute, change and
  5       in a manner consistent with the definitions established in this section,
  6       further define and identify the specific acts and services which shall fall
  7       within the respective categories of facilities so long as the above categories
  8       for adult care homes are used as guidelines to define and identify the
  9       specific acts.
10           Sec. 2. K.S.A. 1997 Supp. 39-923 is hereby repealed.
11           Sec. 3. This act shall take effect and be in force from and after its
12       publication in the statute book.
13