
ENROLLED
COMMITTEE SUBSTITUTE
FOR
Senate Bill No. 405
(Senators Plymale, Helmick, Prezioso, Love, Hunter, Rowe, Jenkins, Ross,
Oliverio, Dempsey, Minard and Smith, original sponsors)
____________
[Passed March 8, 2003; in effect from passage.]
____________
AN ACT to repeal article five-h, chapter sixteen of the code of
West Virginia, one thousand nine hundred thirty-one, as
amended; and to amend and reenact articles five-d and five-t
of said chapter, all relating to the changing of personal care
homes and residential board and care homes to assisted living
residences; defining assisted living; defining limited and
intermittent nursing care; establishing limitations and
exceptions to definitions; clarifying licensure requirements;
specifying duties of licensees; providing for residents to
contract for additional services; clarifying responsibilities
of property owners; providing for emergency rules; extending
the care home advisory board for an additional six months;
and
making technical changes throughout.
Be it enacted by the Legislature of West Virginia:

That article five-h, chapter sixteen of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be
repealed; and that articles five-d and five-t of said chapter be
amended and reenacted, all to read as follows:
ARTICLE 5D. ASSISTED LIVING RESIDENCES.
§16-5D-1. Purpose.

(a) It is the policy of this state to encourage and promote
the development and utilization of resources to ensure the
effective care and treatment of persons who are dependent upon the
services of others by reason of physical or mental impairment who
may require limited and intermittent nursing care, including those
individuals who qualify for and are receiving services coordinated
by a licensed hospice. Such care and treatment requires a living
environment for such persons which, to the extent practicable, will
approximate a normal home environment. To this end, the guiding
principle for administration of the laws of the state is that such
persons shall be encouraged and assisted in securing necessary care
and treatment in noninstitutional surroundings.

(b) In recognition that for many such persons effective care
and treatment can only be secured from proprietary, voluntary and
governmental assisted living residences, it is the policy of this
state to encourage, promote and require the maintenance of assisted
living residences so as to ensure protection of the rights and
dignity of those using the services of assisted living residences.

(c) The provisions of this article are hereby declared to be
remedial and shall be liberally construed to effectuate its
purposes and intents.
§16-5D-2. Definitions.

(a) As used in this article, unless a different meaning
appears from the context:

(1) "Assisted living residence" means any living facility
,
residence or place of accommodation, however named, available for
four or more residents, in this state which is advertised, offered,
maintained or operated by the ownership or management, whether for
a consideration or not,
for the express or implied purpose of
having personal assistance or supervision, or both, provided to any
residents therein who are dependent upon the services of others by
reason of physical or mental impairment and who may also require
nursing care at a level that is not greater than
limited and
intermittent nursing care
: Provided, That the care or treatment in
a household, whether for compensation or not, of any person related
by blood or marriage, within the degree of consanguinity of second
cousin to the head of the household, or his or her spouse, may not
be deemed to constitute an assisted living residence within the
meaning of this article. Nothing contained in this article applies
to hospitals, as defined under section one, article five-b of this
chapter; or state institutions, as defined under section three,
article one, chapter twenty-five of this code or section six,
article one, chapter twenty-seven of this code; or personal care
homes operated by the federal government or the state; or
institutions operated for the treatment and care of alcoholic
patients; or offices of physicians; or hotels, boarding homes or
other similar places that furnish to their guests only room and board; or to homes or asylums operated by fraternal orders pursuant
to article three, chapter thirty-five of this code;

(2) "Deficiency" means a statement of the rule and the fact
that compliance has not been established and the reasons therefor;

(3) "Department" means the state department of health and
human resources;

(4) "Division" means the bureau for public health of the state
department of health and human resources;

(5) "Limited and intermittent nursing care" means direct hands
on nursing care of an individual who needs no more than two hours
of nursing care per day for a period of time no longer than ninety
consecutive days per episode: Provided, That such time limitations
shall not apply to an individual who, after having established a
residence in an assisted living residence, subsequently qualifies
for and receives services coordinated by a licensed hospice and
such time limitations shall not apply to home health services
provided by a medicare-certified home health agency
. Limited and
intermittent nursing care may only be provided by or under the
supervision of a registered professional nurse and in accordance
with rules proposed by the secretary for legislative approval in
accordance with the provisions of article three, chapter twenty-
nine-a of this code;

(6) "Nursing care" means those procedures commonly employed in
providing for the physical, emotional and rehabilitational needs of
the ill or otherwise incapacitated which require technical skills
and knowledge beyond that which the untrained person possesses, including, but not limited to, such procedures as: Irrigations,
catheterization, special procedures contributing to rehabilitation
and administration of medication by any method which involves a
level of complexity and skill in administration not possessed by
the untrained person;

(7) "Person" means an individual and every form of
organization, whether incorporated or unincorporated, including any
partnership, corporation, trust, association or political
subdivision of the state;

(8) Personal assistance" means personal services, including,
but not limited to, the following: Help in walking, bathing,
dressing, feeding or getting in or out of bed, or supervision
required because of the age or mental impairment of the resident;

(9) "Resident" means an individual living in an assisted
living residence for the purpose of receiving personal assistance
or limited and intermittent nursing services;

(10) "Secretary" means the secretary of the state department
of health and human resources or his or her designee; and

(11) "Substantial compliance" means a level of compliance with
the rules such that identified deficiencies pose no greater risk to
resident health or safety than the potential for causing minimal
harm.

(b) The secretary may define in rules any term used herein
which is not expressly defined.
§16-5D-3. Powers, duties and rights of secretary.

In the administration of this article, the secretary has the following powers, duties and rights:

(a) To enforce rules and standards for assisted living
residences which are adopted, promulgated, amended or modified by
the secretary;

(b) To exercise as sole authority all powers relating to the
issuance, suspension and revocation of licenses of assisted living
residences;

(c) To enforce rules adopted, promulgated, amended or modified
by the secretary governing the qualification of applicants for
assisted living residences, including, but not limited to,
educational requirements, financial requirements, personal and
ethical requirements;

(d) To receive and disburse federal funds and to take whatever
action not contrary to law as may be proper and necessary to comply
with the requirements and conditions for the receipt of federal
funds;

(e) To receive and disburse for authorized purposes any moneys
appropriated for the division by the Legislature;

(f) To receive and disburse for purposes authorized by this
article, any funds that may come to the division by gift, grant,
donation, bequest or devise, according to the terms thereof, as
well as funds derived from the division's operation or otherwise;

(g) To make contracts and to execute all instruments necessary
or convenient in carrying out the secretary
's functions and duties;
and all such contracts, agreements and instruments shall be
executed by the secretary
;

(h) To appoint officers, agents, employees and other personnel
and fix their compensation;

(i) To offer and sponsor educational and training programs for
assisted living residences' administrative, management and
operational personnel;

(j) To undertake survey, research and planning projects and
programs relating to administration and operation of assisted
living residences and to the health, care, treatment and service in
general of residents of assisted living residences;

(k) To assess civil penalties for violations of assisted
living residence standards in accordance with section ten of this
article;

(l) To inspect any assisted living residence and any records
maintained therein subject to the provisions of section ten of this
article;

(m) To establish and implement procedures, including informal
conferences, investigations and hearings, subject to applicable
provisions of article three, chapter twenty-nine-a of this code,
and to enforce compliance with the provisions of this article and
with rules issued hereunder by the secretary;

(n) To subpoena witnesses and documents, administer oaths and
affirmations and to examine witnesses under oath for the conduct of
any investigation or hearing. Upon failure of a person without
lawful excuse to obey a subpoena to give testimony and upon
reasonable notice to all persons affected thereby, the secretary
may apply to the circuit court of the county in which the hearing is to be held or to the circuit court of Kanawha County for an
order compelling compliance;

(o) To make complaint or cause proceedings to be instituted
against any person for the violation of the provisions of this
article or of rules issued hereunder by the secretary. Such action
may be taken by the secretary
without the sanction of the
prosecuting attorney of the county in which proceedings are
instituted if the prosecuting attorney fails or refuses to
discharge his or her duty. The circuit court of Kanawha County or
the circuit court of the county in which the conduct has occurred
shall have jurisdiction in all civil enforcement actions brought
under this article and may order equitable relief without bond. In
no such case may the secretary
or any person acting under the
secretary
's direction be required to give security for costs;

(p) To delegate authority to the secretary
's employees and
agents to perform all functions of the secretary
except the making
of final decisions in adjudications; and

(q) To submit an annual report to the governor, the
Legislature and the public. The report shall describe the assisted
living residence licensing and investigatory activities of the
division during the year and the nature and status of other
activities of the division and may include comment on the acts,
policies, practices or procedures of any public or private agency
that affect the rights, health or welfare of residents of assisted
living residences. The annual report shall include a list of all
assisted living residences in the state and such of the following information as the secretary
determines to apply: Whether the
assisted living residences are proprietary or nonproprietary; the
classification of each assisted living residence; the name of the
owner or owners; the total number of beds; the number of private
and semiprivate rooms; the costs per diem for private residents;
the number of full-time employees and their professions;
recreational programs; services and programs available as well as
the costs thereof; and whether or not those assisted living
residences listed accept medicare and medicaid residents. The
report shall also contain the division's recommendations as to
changes in law or policy which it deems necessary or appropriate
for the protection of the rights, health or welfare of residents of
assisted living residences in the state.
§16-5D-4. Administrative and inspection staff.

The secretary
may, as he or she determines necessary, employ
administrative employees, inspectors or other persons as may be
necessary to properly carry out the provisions of this article.
All employees of the division shall be members of the state civil
service system. Inspectors and other employees as may be duly
designated by the secretary
shall act as the secretary's
representatives and, under the direction of the secretary
, shall
enforce the provisions of this article and all duly promulgated
rules of the secretary and, in the discharge of official duties,
shall have the right of entry into any place maintained as an
assisted living residence at any time.
§16-5D-5. Rules; minimum standards for assisted living residences.

(a)
The secretary shall propose rules for legislative approval
in accordance with the provisions of article three, chapter twenty-
nine-a of this code
to carry out the purposes and intent of this
article and to enable the secretary
to exercise the powers and
perform the duties conferred upon the secretary
by this article.

(b) The secretary shall propose rules establishing minimum
standards of operation of assisted living residences, including,
but not limited to, the following:

(1) Administrative policies, including:

(A) An affirmative statement of the right of access to
assisted living residences by members of recognized community
organizations and community legal services programs whose purposes
include rendering assistance without charge to residents,
consistent with the right of residents to privacy; and

(B) A statement of the rights and responsibilities of
residents;

(2) Minimum numbers and qualifications of personnel, including
management, medical and nursing, aides, orderlies and support
personnel, according to the size and classification of the assisted
living residence;

(3) Safety requirements;

(4) Sanitation requirements;

(5) Protective and personal services to be provided;

(6) Dietary services to be provided;

(7) Maintenance of health records;

(8) Social and recreational activities to be made available;

(9) Physical facilities;

(10) Requirements related to provision of limited and
intermittent nursing; and

(11) Such other categories as the secretary determines to be
appropriate to ensure resident's health, safety and welfare.

(c) The secretary shall include in rules detailed standards
for each of the categories of standards established pursuant to
subsections (b) and (d) of this section and shall classify such
standards as follows:

(1) Class I standards are standards the violation of which, as
the secretary determines, would present either an imminent danger
to the health, safety or welfare of any resident or a substantial
probability that death or serious physical harm would result;

(2) Class II standards are standards which the secretary
determines have a direct or immediate relationship to the health,
safety or welfare of any resident, but which do not create imminent
danger;

(3) Class III standards are standards which the secretary
determines have an indirect or a potential impact on the health,
safety or welfare of any resident.

(d) An assisted living residence shall attain substantial
compliance with standards established pursuant to section five of this article and such other requirements for a license as may be
established by rule under this article.
§16-5D-6. License required; application; fees; duration; renewal.

(a) There shall be one assisted living residence license for
each assisted living residence
. Subject to the provisions of
section seventeen of this article, no person may establish,
operate, maintain, offer or advertise an assisted living residence
within this state unless and until he or she obtains a valid
license therefor as provided in this article, which license remains
unsuspended, unrevoked and unexpired. No public official or
employee may place any person in, or recommend that any person be
placed in, or directly or indirectly cause any person to be placed
in, any assisted living residence, as defined in section two of
this article, which is being operated without a valid license from
the secretary
. The licensee shall be responsible for, and shall
have complete control of, the operation and premises of the
assisted living residence and the personal assistance and
supervision provided to the residents: Provided, That the secretary
may review any leases or any contracts, subcontracts, agreements or
arrangements for the provision of on-site services to the residents
of an assisted living residence to ensure the proper care, safety
and welfare of current or potential residents.
Nothing in this
article shall be construed to prevent or prohibit the ability of a
resident of an assisted living residence to contract or arrange
for, and to receive, privately paid nursing care or personal assistance in addition to those services provided by the licensee,
subject to the consent and cooperation of the licensee and
consistent with the duties and responsibilities imposed by this
section.

(b) Nothing in this article shall be construed to require the
licensing of landlords or property owners who are not involved in
the provision of supervision, personal assistance, limited and
intermittent nursing care or other on-site professional services
for the residents of an assisted living residence or in the
advertising, recruitment of residents, transportation of residents
or other substantial and ongoing services for the operation or
maintenance of the assisted living residence.
(c) The procedure for obtaining a license shall be as follows:

(1) The applicant shall submit an application to the secretary
on a form to be prescribed by the secretary
, containing such
information as may be necessary to show that the applicant is in
compliance with the standards for assisted living residences as
established by this article and the rules lawfully promulgated by
the secretary hereunder. The application and any exhibits thereto
shall provide the following information:

(A) The name and address of the applicant;

(B) The name, address and principal occupation:

(i) Of each person who, as a stockholder or otherwise, has a
proprietary interest of ten percent or more in the applicant;

(ii) Of each officer and director of a corporate applicant;

(iii) Of each trustee and beneficiary of an applicant which is
a trust; and

(iv) Where a corporation has a proprietary interest of twenty-
five percent or more in an applicant, the name, address and
principal occupation of each officer and director of the
corporation;

)(C) The name and address of the owner of the premises of the
assisted living residence or proposed assisted living residence, if
he or she is a different person from the applicant, and in such
case, the name and address:

(i) Of each person who, as a stockholder or otherwise, has a
proprietary interest of ten percent or more in the owner;

(ii) Of each officer and director of a corporate applicant;

(iii) Of each trustee and beneficiary of the owner if it is a
trust; and

(iv) Where a corporation has a proprietary interest of twenty-
five percent or more in the owner, the name and address of each
officer and director of the corporation;

(D) Where the applicant is the lessee or the assignee of the
assisted living residence or the premises of the proposed assisted
living residence, a signed copy of the lease and any assignment
thereof;

(E) The name and address of the assisted living residence or the premises of the proposed assisted living residence;

(F) The proposed bed quota of the assisted living residence
and the proposed bed quota of each unit thereof;

(G) An organizational plan for the assisted living residence
indicating the number of persons employed or to be employed, the
positions and duties of all employees;

(H) The name and address of the individual who is to serve as
administrator;

(I) Such evidence of compliance with applicable laws and rules
governing zoning, buildings, safety, fire prevention and sanitation
as the secretary
may require; and

(J) Such additional information as the secretary
may require.

(d) Upon receipt and review of an application for license made
pursuant to subsection (a) of this section and inspection of the
applicant assisted living residence pursuant to section ten of this
article, the secretary
shall issue a license if he or she finds:

(1) That an individual applicant, and every partner, trustee,
officer, secretary
and controlling person of an applicant which is
not an individual, is a person responsible and suitable to operate
or to direct or participate in the operation of an assisted living
residence by virtue of financial capacity, appropriate business or
professional experience, a record of compliance with lawful orders
of the department, if any, and lack of revocation of a license
during the previous five years;

(2) That the assisted living residence is under the
supervision of an administrator who is qualified by training and
experience; or

(3) That the assisted living residence is in substantial
compliance with standards established pursuant to section five of
this article and such other requirements for a license as the
secretary may establish by rule under this article.

(e) The secretary
may deny an initial or renewal license if
the information provided in an application or report is known by
the applicant to be false or the applicant fails to report required
information or for any other reason permitted by law or rules
promulgated pursuant to this article.

(f) Any license granted by the secretary
shall state the
maximum bed capacity for which it is granted, the date the license
was issued and the expiration date. Licenses shall be issued for
a period not to exceed one year for assisted living residences:
Provided, That any such license in effect for which timely
application for renewal, together with payment of the proper fee
has been made to the state division of health in conformance with
the provisions of this article and the rules issued thereunder and
prior to the expiration date of the license, shall continue in
effect until: (1) One year following the expiration date of the
license; or (2) the date of the revocation or suspension of the
license pursuant to the provisions of this article; or (3) the date
of issuance of a new license, whichever date first occurs. Each license shall be issued only for the premises and persons named in
the application and is not transferable or assignable: Provided,
however, That in the case of the transfer of ownership of an
assisted living residence with an unexpired license, the
application of the new owner for a license shall have the effect of
a license for a period of three months when filed with the
secretary
. Every license shall be posted in a conspicuous place in
the assisted living residence for which it is issued so as to be
accessible to and in plain view of all residents and visitors of
the assisted living residence.

(g) An original license shall be renewable, conditioned upon
the licensee filing timely application for the extension of the
term of the license accompanied by the fee and contingent upon
evidence of compliance with the provisions of this article and
rules promulgated by the secretary hereunder; the application shall
be accompanied by:

(1) The information required in paragraphs (A), (B) and (C),
subdivision (1) of this subsection.

(2) A balance sheet of the assisted living residence as of the
end of its fiscal year, setting forth assets and liabilities at
such date, including all capital, surplus, reserve, depreciation
and similar accounts;

(3) A statement of operations of the assisted living residence
as of the end of its fiscal year, setting forth all revenues,
expenses, taxes, extraordinary items and other credits or charges; and

(4) A statement of any changes in the name, address,
management or ownership information on file with the secretary
.

(h) In the case of an application for a renewal license, if
all requirements of section five of this article are not met, the
secretary
may in his or her discretion issue a provisional license,
provided that care given in the assisted living residence is
adequate for resident needs and the assisted living residence has
demonstrated improvement and evidences potential for substantial
compliance within the term of the license: Provided, That a
provisional renewal may not be issued for a period greater than one
year, may not be renewed and may not be issued to any assisted
living residence with uncorrected violations of any Class I
standard, as defined in subsection (c), section five of this
article.

(i) A nonrefundable application fee in the amount of
sixty-five dollars for an original assisted living residence
license shall be paid at the time application is made for the
license. An average cost of all direct costs for the initial
licensure for the preceding ten facilities based on the size of the
facility's licensed bed capacity shall be borne by the applicant
and shall be received by the secretary
prior to the issuance of an
initial or amended license. The license fee for renewal of a
license shall be at the rate of six dollars per bed per year for
assisted living residences except the annual rate per bed may be assessed for licenses issued for less than one year. The secretary
may annually adjust the licensure fees for inflation based upon the
consumer price index. The bed capacity for the holder of each
license shall be determined by the secretary
. All license fees
shall be due and payable to the secretary
, annually, and in the
manner set forth in the rules promulgated by the secretary. The
fee and application shall be submitted to the secretary
who shall
retain both the application and fee pending final action on the
application. All fees received by the secretary
under the
provisions of this article shall be deposited in accordance with
section thirteen, article one of this chapter.
§16-5D-7. Cost disclosure; surety for residents' funds.

(a) Each assisted living residence shall disclose in writing
to all prospective residents a complete and accurate list of all
costs which may be incurred by them. Residents are not liable for
any cost not so disclosed.

(b) If the assisted living residence handles any money for
residents within the assisted living residence, the licensee or his
or her authorized representative shall give a bond in an amount
consistent with this subsection and with such surety as the
secretary
shall approve. The bond shall be upon condition that the
licensee shall hold separately and in trust all residents' funds
deposited with the licensee, shall administer the funds on behalf
of the resident in the manner directed by the depositor, shall
render a true and complete account to the depositor and the secretary
when requested, and at least quarterly to the resident,
and upon termination of the deposit, shall account for all funds
received, expended and held on hand. The licensee shall file a
bond in a sum to be fixed by the secretary
based upon the magnitude
of the operations of the applicant, but which sum may not be less
than two thousand five hundred dollars.

(c) Every person injured as a result of any improper or
unlawful handling of the money of a resident of a assisted living
residence may bring an action in a proper court on the bond
required to be posted by the licensee pursuant to this subsection
for the amount of damage suffered as a result thereof to the extent
covered by the bond. Whenever the secretary
determines that the
amount of any bond which is filed pursuant to this subsection is
insufficient to adequately protect the money of residents which is
being handled or whenever the amount of any bond is impaired by any
recovery against the bond, the secretary
may require the licensee
to file an additional bond in such amount as necessary to
adequately protect the money of residents being handled.

(d) The provisions of subsection (b) of this section do not
apply if the licensee handles less than twenty-five dollars per
resident and less than five hundred dollars for all residents in
any month.
§16-5D-8. Investigation of complaints.

(a) The secretary shall establish by rule procedures for
prompt investigation of all complaints of alleged violations by assisted living residences of applicable requirements of state law
or rules, except for such complaints that the secretary
determines
are willfully intended to harass a licensee or are without any
reasonable basis. Such procedures shall include provisions for
ensuring the confidentiality of the complainant and of any other
person so named in the complaint and for promptly informing the
complainant and the assisted living residence involved of the
results of the investigation.

(b) If, after its investigation, the secretary
determines that
the complaint has merit, the secretary
shall take appropriate
disciplinary action and shall advise any injured party of the
possibility of a civil remedy under this article.

(c) No assisted living residence may discharge or in any
manner discriminate against any resident or employee for the reason
that the resident or employee has filed a complaint or participated
in any proceeding specified in this article. Violation of this
prohibition by any assisted living residence constitutes ground for
the suspension or revocation of the license of the assisted living
residence as provided in section eleven of this article. Any type
of discriminatory treatment of a resident or employee by whom, or
upon whose behalf, a complaint has been submitted to the secretary
,
or any proceeding instituted under this article, within one hundred
twenty days of the filing of the complaint or the institution of
the action, shall raise a rebuttable presumption that the action
was taken by the assisted living residence in retaliation for the complaint or action.
§16-5D-9. Inspections.

(a) The secretary
and any duly designated employee or agent
thereof shall have the right to enter upon and into the premises of
any assisted living residence at any time for which a license has
been issued, for which an application for license has been filed
with the secretary
, or which the secretary
has reason to believe is
being operated or maintained as an assisted living residence
without a license. If entry is refused by the owner or person in
charge of the assisted living residence, the secretary
shall apply
to the circuit court of the county in which the assisted living
residence is located or the circuit court of Kanawha County for an
order authorizing inspection and the court shall issue an
appropriate order if it finds good cause.

(b) The secretary
, by the secretary's
authorized employees or
agents, shall conduct at least one inspection prior to issuance of
a license pursuant to section six of this article and shall conduct
periodic unannounced inspections thereafter to determine compliance
by the assisted living residence with applicable statutes and rules
promulgated thereunder. All assisted living residences shall
comply with rules of the state fire commission. The state fire
marshal, by his or her employees or authorized agents, shall make
all fire, safety and like inspections. The secretary
may provide
for such other inspections as the secretary
may deem necessary to
carry out the intent and purpose of this article. If after investigating a complaint the secretary
determines that the
complaint is substantiated and that an immediate and serious threat
to a resident's health or safety exists, the secretary
may invoke
any remedies available pursuant to section eleven of this article.
Any assisted living residence aggrieved by a determination or
assessment made pursuant to this section shall have the right to an
administrative appeal as set forth in section twelve of this
article.
§16-5D-10. Reports of inspections; plans of correction; assessment
of penalties and use of funds derived therefrom;
hearings.

(a) Reports of all inspections made pursuant to section nine
of this article shall be in writing and filed with the secretary
and shall list all deficiencies in the assisted living residence's
compliance with the provisions of this article and the rules
adopted by the secretary hereunder. The secretary
shall send a
copy of the report to the assisted living residence by certified
mail, return receipt requested, and shall specify a time within
which the assisted living residence shall submit a plan for
correction of deficiencies, which plan shall be approved, rejected
or modified by the secretary
. The surveyors shall allow audio
taping of the exit conference for licensure inspections with all
costs directly associated with the taping to be paid by the
assisted living residence provided that an original tape is
provided to surveyors at the end of taping.

(b) Upon an assisted living residence's failure to submit a
plan of correction which is approved by the secretary
, or to
correct any deficiency within the time specified in an approved
plan of correction, the secretary
may assess civil penalties as
hereinafter provided or may initiate any other legal or
disciplinary action as provided by this article.

(c) Nothing in this section may be construed to prohibit the
secretary
from enforcing a rule, administratively or in court,
without first affording formal opportunity to make correction under
this section, where, in the opinion of the secretary
, the violation
of the rule jeopardizes the health or safety of residents or where
the violation of the rule is the second or subsequent violation
occurring during a period of twelve full months.

(d) Civil penalties assessed against assisted living
residences shall be classified according to the nature of the
violation as defined in subsection (c), section five of this
article and rules promulgated thereunder by the secretary, as
follows: For each violation of a Class I standard, a civil penalty
of not less than fifty nor more than five hundred dollars shall be
imposed; for each violation of a Class II standard, a civil penalty
of not less than twenty-five nor more than fifty dollars shall be
imposed; for each violation of a Class III standard, a civil
penalty of not less than ten nor more than twenty-five dollars
shall be imposed. Each day a violation continues, after the date
of citation, shall constitute a separate violation. The date of citation is the date the facility receives the written statement of
deficiencies.

(e) The secretary
shall assess a civil penalty not to exceed
two thousand dollars against any individual who notifies, or causes
to be notified, an assisted living residence of the time or date on
which an inspection is scheduled to be conducted under this
article.

(f) If the secretary
assesses a penalty under this section,
the secretary
shall cause delivery of notice of the penalty by
personal service or by certified mail. The notice shall state the
amount of the penalty, the action or circumstance for which the
penalty is assessed, the requirement that the action or
circumstance violates and the basis upon which the secretary
assessed the penalty and selected the amount of the penalty.

(g) The secretary
shall, in a civil judicial proceeding,
recover any unpaid assessment which has not been contested under
section twelve of this article within thirty days of receipt of
notice of the assessment or which has been affirmed under the
provisions of that section and not appealed within thirty days of
receipt of the secretary's
final order or which has been affirmed
on judicial review, as provided in section thirteen of this
article. All money collected by assessments of civil penalties or
interest shall be paid into a special resident benefit account and
shall be applied by the secretary
only for the protection of the
health or property of residents of assisted living residences operated within the state that the secretary
finds to be deficient,
including payment for the costs of relocation of residents to other
facilities, operation of an assisted living residence pending
correction of deficiencies or closure and reimbursement of
residents for personal funds lost.

(h) The opportunity for a hearing on an action taken under
this section shall be as provided in section twelve of this
article. In addition to any other rights of appeal conferred upon
an assisted living residence pursuant to this section, an assisted
living residence shall have the right to request a hearing and seek
judicial review pursuant to sections twelve and thirteen of this
article to contest the citing by the secretary
of a deficiency on
an inspection report, irrespective of whether the deficiency
results in the imposition of a civil penalty.
§16-5D-11. License limitation, suspension, revocation; ban on
admissions; continuation of disciplinary
proceedings; closure, transfer of residents,
appointment of temporary management; assessment of
interest; collection of assessments; hearings.

(a) The secretary
shall, by order, impose a ban on the
admission of residents or reduce the bed quota of the assisted
living residence, or any combination thereof, where he or she finds
upon inspection of the assisted living residence that the licensee
is not providing adequate care under the assisted living
residence's existing bed quota and that reduction in quota or imposition of a ban on admissions, or any combination thereof,
would place the licensee in a position to render adequate care.
Any notice to a licensee of reduction in quota or ban on new
admissions shall include the terms of the order, the reasons
therefor and the date set for compliance.

(b) The secretary
may suspend or revoke a license issued under
this article if he or she finds upon inspection that there has been
a substantial failure to comply with the provisions of this article
or the standards or rules promulgated pursuant hereto.

(c) Whenever a license is limited, suspended or revoked
pursuant to this section, the secretary
shall file an
administrative complaint stating facts constituting a ground or
grounds for the limitation, suspension or revocation. Upon the
filing of the administrative complaint, the secretary
shall notify
the licensee in writing of the filing of the administrative
complaint, enclosing a copy of the complaint, and shall advise the
licensee of the availability of a hearing pursuant to section
twelve of this article. The notice and copy of the administrative
complaint shall be served on the licensee by certified mail, return
receipt requested.

(d) The suspension, expiration, forfeiture or cancellation by
operation of law or order of the secretary
of a license issued by
the secretary
or the withdrawal of an application for a license
after it has been filed with the secretary
, may not deprive the
secretary
of the secretary's
authority to institute or continue a disciplinary proceeding or a proceeding for the denial of a license
application against the licensee or applicant upon any ground
provided by law or to enter an order denying the license
application or suspending or revoking the license or otherwise
taking disciplinary action on any such ground.

(e) In addition to other remedies provided in this article,
upon petition from the secretary
, the circuit court of the county
in which the conduct has occurred or is occurring, or the circuit
court of Kanawha County, may determine that an assisted living
residence's deficiencies under this article constitute an emergency
immediately jeopardizing the health, safety, welfare or rights of
its residents and issue an order to:

(1) Close the assisted living residence;

(2) Transfer residents in the assisted living residence to
other facilities; or

(3) Appoint temporary management to oversee the operation of
the assisted living residence and to assure the health, safety,
welfare and rights of the assisted living residence's residents
where there is a need for temporary management while:

(A) There is an orderly closure of the assisted living
residence; or

(B) Improvements are made in order to bring the assisted
living residence into compliance with all the applicable
requirements of this article.

(f) If the secretary
petitions a circuit court for the closure
of an assisted living residence, the transfer of residents or the
appointment of a temporary management, the circuit court shall hold
a hearing no later than seven days thereafter, at which time the
secretary
and the licensee or operator of the assisted living
residence may participate and present evidence.

(g) A circuit court may divest the licensee or operator of
possession and control of an assisted living residence in favor of
temporary management. The temporary management shall be
responsible to the court and shall have such powers and duties as
the court may grant to direct all acts necessary or appropriate to
conserve the property and promote the health, safety, welfare and
rights of the residents of the assisted living residence,
including, but not limited to, the replacement of management and
staff, the hiring of consultants, the making of any necessary
expenditures to close the assisted living residence or to repair or
improve the assisted living residence so as to return it to
compliance with applicable requirements and the power to receive,
conserve and expend funds, including payments on behalf of the
licensee or operator of the assisted living residence. Priority
shall be given to expenditures for current direct resident care or
the transfer of residents.

(h) The person charged with temporary management: (i) Shall be
an officer of the court; (ii) shall be paid by the licensee; (iii)
is not liable for conditions at the assisted living residence which existed or originated prior to his or her appointment; (iv) is not
personally liable, except for his or her own gross negligence and
intentional acts which result in injuries to persons or damage to
property at the assisted living residence during his or her
temporary management.

(i) No person may impede the operation of temporary
management. There shall be an automatic stay for a ninety-day
period subsequent to the establishment of temporary management of
any action that would interfere with the functioning of the
assisted living residence, including, but not limited to,
cancellation of insurance policies, termination of utility
services, attachments to working capital accounts, foreclosures,
evictions and repossessions of equipment used in the assisted
living residence.

(j) A temporary management established for the purpose of
making improvements in order to bring the assisted living residence
into compliance with applicable requirements may not be terminated
until the court has determined that the assisted living residence
has the management capability to ensure continued compliance with
all applicable requirements, except if the court has not made such
determination within six months of the establishment of the
temporary management, the temporary management terminates by
operation of law at that time and the assisted living residence
shall be closed. After the termination of the temporary
management, the person who was responsible for the temporary management shall make an accounting to the court and after
deducting from receipts the costs of the temporary management,
expenditures and civil penalties and interest no longer subject to
appeal, in that order, any excess shall be paid to the licensee or
operator of the assisted living residence.

(k) The assessments for penalties and for costs of actions
taken under this article shall have interest assessed at five
percent per annum beginning thirty days after receipt of notice of
the assessment or thirty days after receipt of the secretary
's
final order following a hearing, whichever is later. All
assessments against an assisted living residence that are unpaid
shall be added to the assisted living residence's licensure fee and
may be filed as a lien against the property of the licensee or
operator of the assisted living residence. Funds received from
assessments shall be deposited as funds received as provided in
section ten of this article.

(l) The secretary shall have the power to promulgate emergency
rules that expand the power of the secretary
in excess of that
provided in this article to the extent required to comply with
federal requirements, but any such rules shall expand the power of
the secretary
to the minimum extent required by federal
requirements. The rules are subject to the provisions of article
three, chapter twenty-nine-a of this code.

(m) The opportunity for a hearing on an action by the
secretary
taken under this section shall be as provided in section twelve of this article.
§16-5D-12. Administrative appeals for civil assessments, license
limitation, suspension or revocation.

(a) Any licensee or applicant aggrieved by an order issued
pursuant to sections five, six, ten or eleven of this article may
request a formal or informal hearing with the secretary
or program
manager in order to contest the order as contrary to law or
unwarranted by the facts or both. If the contested matter is not
resolved at the informal hearing, the licensee or applicant may
request a formal hearing before the secretary
. An informal hearing
is not a prerequisite for requesting a formal hearing.

(b) Informal hearings shall be held within twenty business
days of the secretary's
receipt of timely request for appeal unless
the licensee or applicant consents to a postponement or
continuance. In no event may the informal hearing occur more than
thirty business days after the secretary
receives a timely request
for appeal. Neither the licensee or applicant nor the secretary
may be represented by an attorney at the informal hearing. Within
ten business days of the conclusion of the informal hearing, the
secretary
, program manager or designee shall issue an informal
hearing order, including the basis for the decision. If the order
is not favorable to the licensee or applicant, the licensee or
applicant may request an appeal and a formal hearing. The
secretary
shall notify the administrative hearing examiner of the
request for appeal within five business days of receiving the request for an appeal and a formal hearing.

(c) If the applicant or licensee requests a formal hearing
without a prior informal hearing or if an applicant or licensee
appeals the order issued as a result of the informal hearing, the
secretary
shall proceed in accordance with the department's rules
of procedure for contested case hearings and declaratory rulings
and the pertinent provisions of article five, chapter twenty-nine-a
of this code.

(d) Following a formal hearing, the secretary
shall make and
enter a written order either dismissing the complaint or taking
other action as is authorized in this article. The written order
of the secretary
shall be accompanied by findings of fact and
conclusions of law as specified in section three, article five,
chapter twenty-nine-a of this code and a copy of the order and
accompanying findings and conclusions shall be served upon the
licensee and his or her attorney of record, if any, by certified
mail, return receipt requested. If the secretary
suspends an
assisted living residence's license, the order shall also specify
the conditions giving rise to the suspension to be corrected by the
licensee during the period of suspension in order to entitle the
licensee to reinstatement of the license. If the secretary
revokes
a license, the secretary
may stay the effective date of revocation
by not more than ninety days upon a showing that the delay is
necessary to assure appropriate placement of residents. The order
of the secretary
shall be final unless vacated or modified upon judicial review of the order in accordance with the provisions of
section thirteen of this article.

(e) In addition to all other powers granted by this chapter,
the secretary
may hold the case under advisement and make a
recommendation as to requirements to be met by the licensee in
order to avoid either suspension or revocation. In such a case,
the secretary
shall enter an order accordingly and so notify the
licensee and his or her attorney of record, if any, by certified
mail, return receipt requested. If the licensee meets the
requirements of the order, the secretary
shall enter an order
showing satisfactory compliance and dismissing the complaint and
shall so notify the licensee and the licensee's attorney of record,
if any, by certified mail, return receipt requested.
§16-5D-13. Judicial review.

(a) Any licensee adversely affected by an order of the
secretary
rendered after a hearing held in accordance with the
provisions of section twelve of this article is entitled to
judicial review thereof. All of the pertinent provisions of
section four, article five, chapter twenty-nine-a of this code
shall apply to and govern with like effect as if the provisions of
said section were set forth in extenso in this section.

(b) The judgment of the circuit court shall be final unless
reversed, vacated or modified on appeal to the supreme court of
appeals in accordance with the provisions of section one, article
six, chapter twenty-nine-a of this code.
§16-5D-14. Legal counsel and services for the secretary.

(a) Legal counsel and services for the secretary
in all
administrative hearings and all proceedings in any circuit court
and the supreme court of appeals shall be provided by the attorney
general, his or her assistants or an attorney employed by the
secretary
in proceedings in any circuit court by the prosecuting
attorney of the county as well, all without additional
compensation.

(b) The governor may appoint counsel for the secretary
who
shall perform such legal services in representing the interests of
residents in assisted living residences in matters under the
jurisdiction of the secretary
as the governor shall direct. It
shall be the duty of such counsel to appear for the residents in
all cases where they are not represented by counsel. The
compensation of such counsel shall be fixed by the governor.
§16-5D-15. Unlawful acts; penalties; injunctions; private right of
action.

(a) Whoever advertises, announces, establishes or maintains or
is engaged in establishing or maintaining an assisted living
residence without a license granted under section six of this
article, or who prevents, interferes with or impedes in any way the
lawful enforcement of this article shall be guilty of a misdemeanor
and, upon conviction thereof, shall be punished for the first
offense by a fine of not more than one hundred dollars or by
imprisonment in jail for a period of not more than ninety days, or by both such fine and imprisonment, at the discretion of the court.
For each subsequent offense, the fine may be increased to not more
than two hundred fifty dollars, with imprisonment in jail for a
period of not more than ninety days, or both such fine and
imprisonment at the discretion of the court. Each day of a
continuing violation after conviction shall be considered a
separate offense.

(b) The secretary
may in his or her discretion bring an action
to enforce compliance with this article or any rule, or order
hereunder, whenever it appears to the secretary
that any person has
engaged in, or is engaging in, an act or practice in violation of
this article or any rule or order hereunder, or whenever it appears
to the secretary
that any person has aided, abetted or caused or is
aiding, abetting or causing such an act or practice. Upon
application by the secretary
, the circuit court of the county in
which the conduct has occurred or is occurring shall have
jurisdiction to grant without bond a permanent or temporary
injunction, decree or restraining order.

(c) Whenever the secretary
refuses to grant or renew a license
or revokes a license required by law to operate or conduct an
assisted living residence or orders a person to refrain from
conduct violating the rules of the secretary and the person deeming
himself aggrieved by the refusal, revocation or order appeals the
action of the secretary
, the court may, during pendency of the
appeal, issue a restraining order or injunction upon proof that the operation of the assisted living residence or its failure to comply
with the order of the secretary
adversely affects the well-being or
safety of the residents of the assisted living residence. Should
a person who is refused a license or the renewal of a license to
operate or conduct an assisted living residence or whose license to
operate is revoked or who has been ordered to refrain from conduct
or activity which violates the rules of the secretary, fail to
appeal or should such appeal be decided favorably to the secretary
,
then the court shall issue a permanent injunction upon proof that
the person is operating or conducting an assisted living residence
without a license as required by law or has continued to violate
the rules of the secretary.

(d) Any assisted living residence that deprives a resident of
any right or benefit created or established for the well-being of
the resident by the terms of any contract, by any state statute or
rule or by any applicable federal statute or regulation shall be
liable to the resident for injuries suffered as a result of the
deprivation. Upon a finding that a resident has been deprived of
such a right or benefit and that the resident has been injured as
a result of the deprivation and unless there is a finding that the
assisted living residence exercised all care reasonably necessary
to prevent and limit the deprivation and injury to the resident,
compensatory damages shall be assessed in an amount sufficient to
compensate the resident for the injury. In addition, where the
deprivation of any right or benefit is found to have been willful
or in reckless disregard of the lawful rights of the resident, punitive damages may be assessed. A resident may also maintain an
action pursuant to this section for any other type of relief,
including injunctive and declaratory relief, permitted by law.
Exhaustion of any available administrative remedies may not be
required prior to commencement of suit hereunder.

(e) The amount of damages recovered by a resident, in an
action brought pursuant to this section, are exempt for purposes of
determining initial or continuing eligibility for medical
assistance under article four, chapter nine of this code and may
neither be taken into consideration nor required to be applied
toward the payment or part payment of the cost of medical care or
services available under said article.

(f) Any waiver by a resident or his or her legal
representative of the right to commence an action under this
section, whether oral or in writing, shall be null and void as
contrary to public policy.

(g) The penalties and remedies provided in this section are
cumulative and shall be in addition to all other penalties and
remedies provided by law.
§16-5D-16. Availability of reports and records.

The secretary
shall make available for public inspection and
at a nominal cost provide copies of all inspections and other
reports of assisted living residences filed with or issued by the
secretary. Nothing contained in this section may be construed or
deemed to allow the public disclosure of confidential medical, social, personal or financial records of any resident. The
secretary shall propose rules for legislative approval in
accordance with the provisions of article three, chapter twenty-
nine-a of this code as may be necessary to give effect to the
provisions of this section and to preserve the confidentiality of
medical, social, personal or financial records of residents.
§16-5D-17. Licenses and rules in force.

(a) All licenses for personal care homes and residential board
and care homes which are in force on the first day of July, two
thousand three, shall continue in full force and effect during the
period for which issued unless sooner revoked as provided in this
article.

(b) All rules in effect on the first day of July, one thousand
nine hundred ninety-seven, which were adopted by the secretary
relating to licensing personal care homes and residential board and
care homes shall remain in full force and effect until altered,
amended or repealed by the secretary.

(c) Notwithstanding any other provisions of this article, the
secretary
shall promulgate emergency rules pursuant to the
provisions of section fifteen, article three, chapter twenty-nine-a
of this code by the first date of September, two thousand three, to
implement this program.
§16-5D-18. Separate accounts for residents' personal funds;
consent for use; records; penalties.

(a) Each assisted living residence subject to the provisions
of this article shall hold in a separate account and in trust each
resident's personal funds deposited with the assisted living
residence.

(b) No person may use or cause to be used for any purpose the
personal funds of any resident admitted to any assisted living
residence unless consent for the use thereof has been obtained from
the resident or from a committee or guardian or relative.

(c) Each assisted living residence shall maintain a true and
complete record of all receipts for any disbursements from the
personal funds account of each resident in the assisted living
residence, including the purpose and payee of each disbursement,
and shall render a true account of the record to the resident or
his or her representative upon demand and upon termination of the
resident's stay in the assisted living residence.

(d) Any person or corporation who violates any provision of
this section is guilty of a misdemeanor and, upon conviction
thereof, shall be fined not more than one thousand dollars or
imprisoned in jail not more than one year, or both fined and
imprisoned.
ARTICLE 5T. CARE HOME ADVISORY BOARD.
§16-5T-1. Care home advisory board created; membership; terms;
meetings; compensation; termination.

(a) The care home advisory board, as previously created and constituted under this section, is hereby continued to gather
information concerning personal care homes, as defined and
regulated in article five-d of this chapter, and residential board
and care homes, as defined and regulated in article five-h of this
chapter, and make its findings and recommendations to the governor
and the Legislature.

(b) The care home advisory board shall have seven members: The
president of the Senate or his or her designee; the speaker of the
House of Delegates or his or her designee; the secretary of the
department of health and human resources or his or her designee; an
operator of a facility originally licensed as a personal care home
in this state; an operator of a facility originally licensed as a
residential board and care home in this state; and two members of
the public at large, one of whom shall be an advocate for consumer
rights.

(c) The governor shall appoint the members to the board by and
with the advice and consent of the Senate. Appointments under the
provision of this article shall be for a three-year term or the
unexpired term, except in the initial appointments as follows: One
citizen member shall be appointed for a two-year term; one citizen
member shall be appointed for a three-year term; and the care home
operator members shall be appointed for a one-year term.
Subsequent appointments to the committee shall be for three-year
terms. No member shall serve more than two successive terms.

(d) The advisory board shall meet at least four times annually at the times and places in the state that it determines. A
majority of the members constitutes a quorum for the purpose of
conducting business. The secretary of the department of health and
human resources or his or her designee shall serve as chair of the
advisory board.

(e) Members of the advisory board are not entitled to
compensation for services performed as members, but are entitled to
reimbursement for all reasonable and necessary expenses actually
incurred in the performance of their duties, which shall be paid
from the funds of the department of health and human resources.

(f) The care home advisory board shall continue to exist until
the last day of December, two thousand three, unless sooner
terminated, continued or reestablished by act of the Legislature.