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1 STATE OF OKLAHOMA
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2 1st Session of the 60th Legislature (2025)
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3 SENATE BILL 804 By: Pugh
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6 AS INTRODUCED
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7 An Act relating to long-term care; amending 63 O.S.
7 2021, Section 1-890.3, which relates to rules
8 promulgated under the Continuum of Care and Assisted
8 Living Act; directing promulgation of specified
9 rules; updating statutory language; amending 63 O.S.
9 2021, Section 1-890.6, which relates to penalties;
10 requiring employment of certain professionals in
10 specified circumstances; requiring assisted living
11 centers to establish internal quality assurance
11 committee; specifying committee duties and membership
12 composition; providing for codification; and
12 providing an effective date.
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15 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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16 SECTION 1. AMENDATORY 63 O.S. 2021, Section 1-890.3, is
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17 amended to read as follows:
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18 Section 1-890.3. A. The State Board Commissioner of Health
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19 shall promulgate rules necessary to implement the provisions of the
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20 Continuum of Care and Assisted Living Act. Such rules shall
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21 include, but shall not be limited to:
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22 1. A uniform comprehensive resident screening instrument to
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23 measure the needs and capabilities of residents in all settings and
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24 to determine appropriate placements of residents;
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Req. No. 166 Page 1
1 2. Physical plant requirements meeting construction and life
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2 safety codes, with provisions accommodating resident privacy and
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3 independence in assisted living centers and in assisted living
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4 components of continuum of care facilities based on the variable
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5 capabilities of residents;
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6 3. Staffing levels responsive to the variable needs of
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7 residents, with provisions for sharing of staff between components
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8 in a continuum of care facility;
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9 4. Minimum standards for resident care including, but not
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10 limited to, standards pertaining to medical care and administration
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11 of medications. Standards pertaining to medication administration
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12 shall, at a minimum, require the assisted living center or continuum
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13 of care facility to:
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14 a. maintain medication administration records,
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15 b. have medication storage and disposal policies, and
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16 c. follow medication administration orders from a
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17 qualified health care provider;
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18 5. Standards for measuring quality outcomes for residents;
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19 5. 6. Provisions for individualized services chosen by and
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20 designed for each resident;
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21 6. 7. Provisions to prohibit facility staff from disclosing a
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22 resident's financial information to third parties without written
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23 consent of the resident or the designated representative of the
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24 resident;
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Req. No. 166 Page 2
1 7. 8. Procedures for inspections and investigations of licensed
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2 entities to ensure compliance with the Continuum of Care and
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3 Assisted Living Act and rules promulgated by the Board Commissioner;
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4 8. 9. Enumeration of resident rights and responsibilities to be
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5 observed by each facility and its staff. Such resident rights shall
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6 include the freedom of choice regarding any personal attending
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7 physicians and all other providers of medical services and supplies
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8 without a financial penalty or fee charged by the assisted living
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9 center;
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10 9. 10. Provisions for a surety bond or deposit from each
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11 applicant in an amount sufficient to guarantee that obligations to
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12 residents will be performed, with provisions for reduction or waiver
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13 of the surety bond or deposit when the assets of the applicant or
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14 its contracts with other persons are sufficient to reasonably ensure
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15 the performance of its obligations;
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16 10. 11. Provisions for the development of a consumer guide or
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17 similar resource to be posted on the Internet website of the State
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18 Department of Health to assist individuals and families in
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19 understanding the services provided by assisted living centers and
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20 to compare and select a facility; and
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21 11. 12. Provisions for posting results of routine inspections
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22 and any complaint investigations of each assisted living center on
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23 the Internet website of the Department. Such information shall be
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24 regularly updated to include the facility's plan of correction and
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Req. No. 166 Page 3
1 to indicate when a violation of a licensing regulation was corrected
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2 by the facility; and
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3 13. Provisions requiring execution of a plan of care and a
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4 resident service contract with the resident or resident's
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5 representative. Any change in the resident's care including, but
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6 not limited to, the administration of medications or other medical
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7 care shall require the informed consent of the resident or
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8 representative and shall be documented in the plan of care and, as
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9 appropriate, the resident service contract.
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10 B. The nursing care service of a continuum of care facility
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11 shall be subject to the requirements, procedures and remedies set
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12 out in the Nursing Home Care Act, including provisions relating to
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13 resident rights.
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14 C. The adult day care component of a continuum of care facility
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15 shall be subject to requirements and procedures specified under the
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16 Adult Day Care Act.
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17 SECTION 2. AMENDATORY 63 O.S. 2021, Section 1-890.6, is
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18 amended to read as follows:
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19 Section 1-890.6. A. The Continuum of Care and Assisted Living
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20 Act shall not apply to residential care homes, adult companion
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21 homes, domiciliary care units operated by the Oklahoma Department of
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22 Veterans Affairs, the private residences of persons with
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23 developmental disabilities receiving services provided by the
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24 Developmental Disabilities Services Division of the Department of
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1 Human Services or through the a Home- and Community-Based Services
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2 Waiver or the Alternative Disposition Plan Waiver of the Oklahoma
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3 Health Care Authority, or to hotels, motels, boardinghouses, rooming
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4 houses, a home or facility approved and annually reviewed by the
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5 United States Department of Veterans Affairs as a medical foster
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6 home in which care is provided exclusively to three or fewer
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7 veterans, or other places that furnish board or room to their
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8 residents. The Continuum of Care and Assisted Living Act shall not
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9 apply to facilities not charging or receiving periodic compensation
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10 for services rendered and not receiving any county, state or federal
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11 assistance.
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12 B. The State Commissioner of Health may ban admissions to, or
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13 deny, suspend, refuse to renew or revoke the license of, any
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14 continuum of care facility or assisted living center which fails to
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15 comply with the Continuum of Care and Assisted Living Act or rules
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16 promulgated by the State Board Commissioner of Health.
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17 C. Any person who has been determined by the Commissioner to
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18 have violated any provision of the Continuum of Care and Assisted
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19 Living Act or any rule promulgated hereunder shall be liable for an
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20 administrative penalty of not more than Five Hundred Dollars
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21 ($500.00) for each day that the violation occurs.
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22 D. 1. The State Department of Health shall develop a
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23 classification system of violations, taking into consideration the
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24 recommendations of the Long-Term Care Facility Advisory Board
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1 Council pursuant to Section 1-1923 of this title, which shall gauge
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2 the severity of the violation and specify graduated penalties based
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3 on:
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4 a. no actual harm with the potential for minimal harm,
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5 b. no actual harm with the potential for more than
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6 minimal harm,
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7 c. actual harm that is not immediate jeopardy, and
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8 d. immediate jeopardy to resident health and safety.
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9 2. Upon discovery of one or more violations, the Department
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10 shall provide a statement of deficiencies containing the violations.
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11 The continuum of care facility or assisted living center shall be
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12 required to correct these violations and submit a plan of correction
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13 that details how the facility or center will correct each violation,
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14 ensure that the violation will not occur in the future and a period
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15 to correct each violation not to exceed sixty (60) days.
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16 3. No fine shall be assessed for any violation that is not
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17 classified as actual harm or immediate jeopardy, unless the
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18 continuum of care facility or assisted living center fails to
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19 correct the violation within the period set forth in the accepted
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20 plan of correction. Fines may be assessed at any time for any
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21 violations that are classified as actual harm or immediate jeopardy.
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22 4. Any new violation unrelated to the original violation and
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23 not classified as actual harm or immediate jeopardy that is
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24 discovered upon a revisitation of a continuum of care facility or
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1 assisted living center shall constitute a new action and shall not
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2 be included in the original citation or assessment of fines or
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3 penalties; provided, that a preexisting violation not corrected in
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4 compliance with the approved plan of correction shall be considered
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5 still in effect.
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6 E. If a continuum of care facility's failure to comply with the
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7 Continuum of Care and Assisted Living Act or rules involves nursing
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8 care services, the Commissioner shall have authority to exercise
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9 additional remedies provided under the Nursing Home Care Act. If a
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10 continuum of care facility's failure to comply with the Continuum of
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11 Care and Assisted Living Act or rules involves adult day care
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12 services, then the Commissioner shall have authority to exercise
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13 additional remedies provided under the Adult Day Care Act.
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14 F. Any assisted living center or continuum of care facility in
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15 which the Department has documented repeat deficiencies regarding
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16 medications including, but not limited to, their storage, use,
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17 delivery, or administration shall, in addition to or as an
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18 alternative to any penalties imposed under this section, be required
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19 to employ the consultant services of a licensed pharmacist or a
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20 licensed Registered Nurse, as applicable. The consultant shall, at
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21 a minimum, provide onsite quarterly consultation until the
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22 Department determines that such consultation services are no longer
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23 required.
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1 G. In taking any action to deny, suspend, deny renewal, or
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2 revoke a license, or to impose an administrative fee, the
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3 Commissioner shall comply with requirements of the Administrative
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4 Procedures Act.
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5 SECTION 3. NEW LAW A new section of law to be codified
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6 in the Oklahoma Statutes as Section 1-890.9 of Title 63, unless
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7 there is created a duplication in numbering, reads as follows:
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8 A. Each assisted living center shall establish and maintain an
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9 internal quality assurance committee that meets at least quarterly.
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10 The committee shall:
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11 1. Monitor trends and incidents;
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12 2. Monitor customer satisfaction measures;
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13 3. Document quality assurance efforts and outcomes;
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14 4. Recommend internal policies on resident care including, but
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15 not limited to, policies on administration of medications; and
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16 5. Perform such other duties or functions as directed by the
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17 State Commissioner of Health through rule.
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18 B. The quality assurance committee shall include at least the
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19 following:
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20 1. A Registered Nurse or physician;
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21 2. The assisted living center administrator;
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22 3. A direct care staff person or a staff person who has
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23 responsibility for administration of medications;
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24 4. A pharmacist consultant; and
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1 5. A person who has an ownership stake in the assisted living
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2 center.
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3 SECTION 4. This act shall become effective November 1, 2025.
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5 60-1-166 DC 1/19/2025 5:43:39 AM
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Req. No. 166 Page 9Every fact on this page links to its source, starting with the official bill record.