2023 Colorado Revised Statutes › Title 25 - PUBLIC HEALTH AND ENVIRONMENT (§§ 25-1-101 — 25-59-106) › HEALTH CARE (§§ 25-21-101 — 25-59-106) › Article 27 - ASSISTED LIVING RESIDENCES (§§ 25-27-101 — 25-27-114) › Section 25-27-106 - License denial, suspension, or revocation

(1)
When an application for an original license has been denied by the department, the department shall notify the applicant in writing of such denial by mailing a notice to the applicant at the address shown on his or her application. Any applicant believing himself or herself aggrieved by such denial may pursue the remedy for review provided in article
4
of title
24
, C.R.S., if the applicant, within thirty days after receiving such notice, petitions the department to set a date and place for hearing, affording the applicant an opportunity to be heard in person or by counsel. All hearings on the denial of original licenses shall be conducted in conformity with the provisions and procedures specified in article
4
of title
24
, C.R.S.
(2)
(a)
The department may suspend, revoke, or refuse to renew the license of any residence that is out of compliance with the requirements of this article or the rules promulgated thereunder. Such suspension, revocation, or refusal shall be done after a hearing thereon and in conformance with the provisions and procedures specified in article
4
of title
24
, C.R.S.
(b)
(I)
The department may impose intermediate restrictions or conditions on a licensee that may include at least one of the following:
(A)
Retaining a consultant to address corrective measures;
(B)
Monitoring by the department for a specific period;
(C)
Providing additional training to employees, owners, or operators of the residence;
(D)
Complying with a directed written plan, to correct the violation; or
(E)
Paying a civil fine not to exceed ten thousand dollars per violation; except that the department may exceed the cap for an egregious violation that results in death or serious injury to a resident after considering the circumstances surrounding the violation and the factors set forth in subsection (4)(a) of this section.
(II)
(A)
If the department imposes an intermediate restriction or condition that is not a result of a life-threatening situation or due to serious injury or harm to a resident, the licensee shall receive written notice of the restriction or condition. No later than ten days after the date the notice is received from the department, the licensee shall submit a written plan that includes the time frame for completing the plan and addresses the restriction or condition specified.
(B)
If the department imposes an intermediate restriction or condition that is the result of a life-threatening situation or is due to serious injury or harm to a resident, the department shall notify the licensee in writing, by telephone, or in person during an on-site visit. The licensee shall implement the restriction or condition immediately upon receiving notice of the restriction or condition. If the department provides notice of a restriction or condition by telephone or in person, the department shall send written confirmation of the restriction or condition to the licensee within two business days.
(III)
(A)
After submission of an approved written plan, a licensee may first appeal any intermediate restriction or condition on its license to the department through an informal review process as established by the department.
(B)
If the restriction or condition requires payment of a civil fine pursuant to this paragraph (b), the licensee may request that the informal review be conducted in person. In addition, the licensee may request and the department shall grant a stay in payment of the fine until final disposition of the restriction or condition.
(C)
In the event a licensee is not satisfied with the result of the informal review or chooses not to seek informal review, no intermediate restriction or condition on the licensee shall be imposed until after an opportunity for a hearing has been afforded the licensee pursuant to section
24-4-105
, C.R.S.
(IV)
(A)
In the event that the department assesses a civil fine pursuant to this paragraph (b), moneys received by the department shall be transmitted to the state treasurer, who shall credit the same to the assisted living residence improvement cash fund, which fund is hereby created.
(B)
The general assembly shall make annual appropriations from the assisted living residence improvement cash fund for expenditures of the department pursuant to subparagraph (V) of this paragraph (b).
(C)
Notwithstanding any provision of section
24-36-114
, C.R.S., to the contrary, all interest derived from the deposit and investment of moneys from the assisted living residence improvement cash fund created in sub-subparagraph (A) of this subparagraph (IV) shall remain in the assisted living residence improvement cash fund.
(V)
Civil fines collected pursuant to this paragraph (b) shall be used for expenses related to:
(A)
Continuing monitoring required pursuant to this paragraph (b);
(B)
Education for licensees to avoid restrictions or conditions or facilitate the application process or the change of ownership process;
(C)
Education for residents and their families about resolving problems with a residence, rights of residents, and responsibilities of residences;
(D)
Providing technical assistance to any residence for the purpose of complying with changes in rules or state or federal law;
(E)
Relocating residents to other facilities or residences;
(F)
Maintaining the operation of a residence pending correction of violations, as determined necessary by the department;
(G)
Closing a residence; or
(H)
Reimbursing residents for personal funds lost, as determined necessary by the department.
(3)
The department shall revoke or refuse to renew the license of a facility where the owner or licensee has been convicted of a felony or misdemeanor involving moral turpitude or involving conduct which the department determines could pose a risk to the health, safety, and welfare of the residents of such facility. Such revocation or refusal shall be made only after a hearing is provided in accordance with article
4
of title
24
, C.R.S.
(4)
(a)
(I)
Notwithstanding the department's discretion pursuant to subsection (2)(b)(I) of this section concerning the imposition of intermediate restrictions or conditions on a licensee, the department shall impose a fine, in an amount per violation that is calculated to deter further violations, for any violation resulting in actual harm or injury to a resident. Consistent with state board rules pursuant to section
25-27-104(2)
, the amount of the fine may vary depending on the size of the residence, the potential for harm or injury to one or more residents, and whether there is a pattern of potential or actual harm or injury to residents.
(II)
In determining the amount of a fine, the department shall consider:
(A)
The history of harm or injury at the residence;
(B)
The number of injuries to residents for which the cause of the injury is unknown;
(C)
The adequacy of the residence's occurrence investigations and reporting;
(D)
The adequacy of the administrator's supervision of employees to ensure employees are keeping residents safe from harm or injury; and
(E)
The residence's compliance with required mandatory reporting of the mistreatment of residents.
(b)
Notwithstanding the department's discretion pursuant to subsection (2)(b)(I) of this section, the department shall impose a fine, in an amount determined by the department, for any residence that is found to be without an administrator, or an interim administrator, as defined by the state board by rule, on or after January 1, 2024, who meets the requirements established by the state board pursuant to section
25-27-104(2)(g)(I)(B)
.
(5)
Except as provided in subsection (2)(b)(III) of this section, the department may suspend, revoke, or refuse to renew the license of a residence if:
(a)
A resident is subject to mistreatment, as defined in section
26-3.1-101(7)
, that causes injury to the resident;
(b)
The residence's owner or administrator directly caused the mistreatment or the mistreatment resulted from the administrator's failure to adequately train or supervise employees; and
(c)
A directed written plan required by the department pursuant to subsection (2)(b)(I)(D) of this section to correct the violation, in addition to the assessment of civil fines, has not corrected or is not reasonably expected to correct the violations.
(6)
On and after January 1, 2024, the department may refuse to renew the license of a residence if the residence's administrator does not meet the requirements established by the state board pursuant to section
25-27-104(2)(g)(I)(B)
.
Amended by 2022 Ch. 323,§3, eff. 6/2/2022.
L. 85: Entire section added, p. 926, § 5, effective July 1. L. 90: (3) added, p. 1356, § 5, effective July 1. L. 2002: (1) and (2) amended, p. 1321, § 7, effective July 1.