PRINTER'S NO. 1618
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
1198
Session of
2022
INTRODUCED BY BROOKS AND J. WARD, APRIL 26, 2022
REFERRED TO HEALTH AND HUMAN SERVICES, APRIL 26, 2022
AN ACT
Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
act to consolidate, editorially revise, and codify the public
welfare laws of the Commonwealth," in departmental powers and
duties as to licensing, providing for prelicensure waiver of
physical site requirements and further providing for
regulations and for rules and regulations for personal care
home and assisted living residences.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of June 13, 1967 (P.L.31, No.21), known
as the Human Services Code, is amended by adding a section to
read:
Section 1010. Prelicensure Waiver of Physical Site
Requirements.--(a) Each waiver submitted by an entity
interested in assisted living residence licensure shall be
considered on a case-by-case basis based on the specific merits.
In evaluating a physical site waiver request, the department
shall consider the following:
(1) The commensurate benefit to the consumers if the waiver
is approved.
(2) Whether the entity will meet the needs of the residents
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
as their acuity and care needs increase.
(3) Consumer choice as it relates to the waiver request.
(4) Appropriate policies and procedures the entity has or
will put in place to ensure an equivalent level of health,
safety and well-being for the protection of the residents.
(5) Up to three years of compliance history of the entity
making the waiver request, if available.
(b) A physical site waiver shall remain valid until such
time as the assisted living residence completes a structural
renovation project impacting the existing waiver. If the
assisted living residence undergoes a change of ownership, the
existing physical site waiver shall remain valid and be
transferred to the new owner. If the new owner completes a
structural renovation project impacting the existing waiver, the
waiver shall be deemed invalid.
(c) Physical site waiver requests include, but are not
limited to, requests relating to:
(1) Living unit square footage.
(2) Living units that share a bathroom.
(3) Other physical site components.
(d) A copy of the approved waiver request and the
department's written decision shall be posted in a conspicuous
and public place within the assisted living residence.
Section 2. Section 1021(a)(2)(iv) and (v) of the act are
amended and the subsection is amended by adding a paragraph to
read:
Section 1021. Regulations.--(a) * * *
(2) Regulations for assisted living residences shall:
* * *
(iv) Require that each living unit contain a private
20220SB1198PN1618 - 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
bathroom, living and bedroom space, kitchen capacity, which may
mean electrical outlets to have small appliances such as a
microwave and refrigerator, closets and adequate space for
storage and a door with a lock, except where a lock or
appliances in a unit under special care designation would pose a
risk or be unsafe. A living unit shall not be required to have a
bathtub or shower in the bathroom, but an assisted living
residence shall maintain adequate bathing facilities to
accommodate all residents residing in the assisted living
residence with at least one bathtub or shower for every ten
residents. Bathing facilities shall allow for resident privacy
and independence.
(v) Establish minimum square footage requirements for
individual living units [which excludes bathrooms and closet
space]. Exceptions to the size of the living unit may be made at
the discretion of the department.
* * *
(3) Within sixty days of the effective date of this
paragraph, the department shall take all necessary actions,
including the submission of required documents to the Centers
for Medicare and Medicaid Services, to include assisted living
services and supplemental health care services as covered
medical assistance services in the Community HealthChoices
Program and to allow licensed assisted living residences to be
certified as a medical assistance provider for these services.
* * *
Section 3. Section 1057.3(a)(12), (e)(5) and (g)(1), (4),
(5), (6), (7) and (8) of the act are amended to read:
Section 1057.3. Rules and Regulations for Personal Care Home
and Assisted Living Residences.--(a) The rules and regulations
20220SB1198PN1618 - 3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
for the licensing of personal care homes and assisted living
residences promulgated by the department shall require that:
* * *
(12) Each assisted living residence demonstrate the ability
to provide supplemental health care services in a manner duly
protective of the health, safety and well-being of its residents
utilizing employes or other qualified individuals certified
pursuant to subsection (f), independent contractors or
contractual arrangements with other health care facilities or
practitioners licensed, registered or certified to the extent
required by law to provide such service. To the extent
prominently disclosed in a written admission agreement, an
assisted living residence may require residents to use providers
of supplemental health care services designated by the assisted
living residence.
* * *
(e) An assisted living residence may not admit, retain or
serve a consumer with any of the following conditions or health
care needs unless an exception, upon the written request of the
assisted living residence, is granted by the department:
* * *
[(5) Nasogastric tubes.]
* * *
(g) An assisted living residence may admit, retain or serve
a consumer for whom a determination is made by the department,
upon the written request of the assisted living residence, that
the consumer's specific health care needs can be met by a
provider of assisted living services or within an assisted
living residence, in conformity with standards set by the
department through regulation, including a consumer requiring:
20220SB1198PN1618 - 4 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
(1) gastric tubes, except that a determination shall not be
required if the consumer is capable of self-care of the gastric
tube or a licensed health care professional or other qualified
individual certified pursuant to subsection (f) cares for the
gastric tube;
* * *
[(4) a sliding scale insulin administration, except that a
determination shall not be required if the consumer is capable
of self-administration or a licensed health care professional or
other qualified individual administers the insulin;
(5) intermittent intravenous therapy, except that a
determination shall not be required if a licensed health care
professional manages the therapy;
(6) insertions, sterile irrigation and replacement of a
catheter, except that a determination shall not be required for
routine maintenance of a urinary catheter if the consumer is
capable of self-administration or a licensed health care
professional administers the catheter;
(7) oxygen, except a determination shall not be required if
the consumer is capable of self-administration or a licensed
health care professional or other qualified individual
administers the oxygen;
(8) inhalation therapy, except that a determination shall
not be required if the consumer is capable of self-
administration or a licensed health care professional or other
qualified individual administers the therapy;]
* * *
Section 4. This act shall take effect immediately.
20220SB1198PN1618 - 5 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28