First Regular Session Seventy-fifth General Assembly STATE OF COLORADO REVISED This Version Includes All Amendments Adopted on Second Reading in the Second House LLS NO. 25-0771.01 Chelsea Princell x4335 HOUSE BILL 25-1184 House Committees Senate Committees Health & Human Services Health & Human Services A BILL FOR AN ACT C ONCERNING COMMUNITY -BASED CONTINUING CARE SERVICES FOR101 SENIORS AWAITING ADM ISSION TO A LIFE CARE INSTITUTION .102 Bill Summary (Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov .) Under current law, life care institutions provide life and health support services to resident seniors who reside at the life care institution through the help of independent living arrangements, assisted living, or skilled nursing. The bill allows life care institutions to provide community-based continuing care services to seniors in their homes and other services that benefit individuals who are awaiting admission to a SENATE Amended 2nd Reading April 11, 2025 HOUSE 3rd Reading Unamended March 4, 2025 HOUSE 2nd Reading Unamended February 28, 2025 HOUSE SPONSORSHIP Paschal and Hartsook, Bacon, Bird, Boesenecker, Camacho, Clifford, Duran, English, Feret, Hamrick, Jackson, Joseph, Lindsay, Lukens, Marshall, McCluskie, McCormick, Phillips, Stewart K., Valdez SENATE SPONSORSHIP Roberts and Carson, Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment. Capital letters or bold & italic numbers indicate new material to be added to existing law. Dashes through the words or numbers indicate deletions from existing law. life care institution. Be it enacted by the General Assembly of the State of Colorado:1 SECTION 1. In Colorado Revised Statutes, amend 11-49-101 as2 follows:3 11-49-101. Definitions. As used in this article 49, unless the4 context otherwise requires:5 (1) "Aged person" means any person sixty-two years of age or6 older.7 (2) "Board" means the financial services board created in section8 11-44-101.6.9 (3) "Commissioner" means the state commissioner of financial10 services, serving in accordance with section 11-44-102.11 (4) "C OMMUNITY-BASED CONTINUING CARE" OR "CBCC" MEANS12 A PROGRAM PROVIDING OR COMMITTING TO PROVIDE A RANGE OF13 SERVICES TO A PARTICIPANT PURSUANT TO A CONTRACT EFFECTIVE FOR14 THE LIFE OF THE INDIVIDUAL AND IN CONSIDERATION OF THE PAYMENT OF15 A ONE-TIME ENTRANCE FEE OR A MONTHLY FEE . "COMMUNITY-BASED16 CONTINUING CARE" OR "CBCC" ALSO MEANS THE PROVISION OF SERVICES17 TO AN INDIVIDUAL IN THE INDIVIDUAL 'S PRIVATE RESIDENCE, WHEN18 MEDICALLY FEASIBLE, AND PROVIDING FACILITY-BASED LONG-TERM CARE19 SERVICES, WHEN REQUIRED, EITHER DIRECTLY OR INDIRECTLY THROUGH20 AFFILIATED SERVICES OR CONTRACTUAL ARRANGEMENTS .21 (5) "C OMMUNITY-BASED CONTINUING CARE ENTRANCE FEE " OR22 "CBCC ENTRANCE FEE" MEANS AN INITIAL OR DEFERRED TRANSFER TO A23 CBCC PROVIDER OF A SUM OF MONEY OR OTHER PROPERTY MADE OR24 PROMISED TO BE MADE IN ADVANCE OR AT SOME FUTURE TIME AS FULL OR25 1184-2- PARTIAL CONSIDERATION FOR ACCEPTANCE OF AN INDIVIDUAL AS A1 PARTICIPANT.2 (6) "C OMMUNITY-BASED CONTINUING CARE PROVIDER" OR "CBCC3 PROVIDER" MEANS A PROVIDER WHO PROVIDES OR OFFERS TO PROVIDE4 COMMUNITY-BASED CONTINUING CARE TO A PARTICIPANT AND HAS5 OPERATED A LIFE CARE INSTITUTION PURSUANT TO THIS ARTICLE 49 FOR6 AT LEAST THREE YEARS.7 (4) (7) "Entrance fee" means the total of any initial or deferred8 transfer to or for the benefit of a provider MADE PURSUANT TO A LIFE9 CARE CONTRACT, which transfer:10 (a) Is made or promised to be made as full or partial consideration11 for the acceptance or maintenance of a specified individual as a resident12 in a facility; and13 (b) Is in the form of:14 (I) Property; or15 (II) A sum of money in an amount that is greater than four times16 the amount of a regular periodic charge under a life care contract at the17 facility.18 (5) (8) "Facility" means the place WITH LIVING UNITS in which a19 provider undertakes to provide life care to a resident.20 (6) (9) "Life care" means care provided, MADE AVAILABLE TO A21 RESIDENT OF A LIVING UNIT BY A PROVIDER pursuant to a life care22 contract, for the life of an aged person, including, but not limited to,23 services such as occupancy of a living unit, health care, nutrition24 assistance, medical services, and nursing services within a living unit25 BOARD, LODGING, NURSING SERVICES, OR OTHER SERVICES REQUIRED BY26 A LIFE CARE CONTRACT.27 1184 -3- (7) (10) "Life care contract" means a written contract to provide1 life care to a person for the duration of the person's life conditioned upon2 the transfer of an entrance fee to the provider of the services in addition3 to or in lieu of the payment of regular periodic charges for the LIFE care4 and services involved. A life care contract under which the entrance fee5 is payable to or for the provider in four or more installments is subject to6 the provisions of the "Uniform Consumer Credit Code", articles 1 to 9 of7 title 5.8 (8) (11) "Living unit" means a room, apartment, or other area that9 is within a facility and set aside for the use of one or more identified10 residents and within which life care is provided MADE AVAILABLE by the11 provider. A resident's living unit may change based on the appropriate12 care needs of the resident.13 (12) "P ARTICIPANT" MEANS AN INDIVIDUAL WHO HAS ENTERED14 INTO A COMMUNITY-BASED CONTINUING CARE CONTRACT .15 (9) (13) "Person" means all corporations, associations,16 partnerships, or individuals, including fraternal or benevolent orders or17 societies.18 (14) "P RIVATE RESIDENCE" MEANS THE PLACE WHERE A CBCC19 PROVIDER PROVIDES CBCC TO A PARTICIPANT AND DOES NOT INCLUDE A20 LIVING UNIT OR A FACILITY.21 (10) (15) (a) "Provider" means a person who undertakes to22 provide services in a facility pursuant to a life care contract.23 (b) "Provider" does not include a unit owners' association, as24 defined in section 38-33.3-103 (3).25 (16) "R ANGE OF SERVICES" MEANS SERVICES THAT ENABLE A26 PARTICIPANT TO LIVE SAFELY IN THE PARTICIPANT'S PRIVATE RESIDENCE.27 1184 -4- (11) (17) "Resident" means any person entitled pursuant to a life1 care contract to receive life care in a facility.2 (12) (18) "Third-party service providers" means any person, other3 than a provider, who is the holder of a management contract with a4 provider or who contracts with a provider to provide life care services to5 residents.6 SECTION 2. In Colorado Revised Statutes, 11-49-103, amend7 (2) as follows:8 11-49-103. Withdrawal or dismissal of person - refund. (2) If9 the provider is an organization described in section 501 (c)(3) of the10 federal "Internal Revenue Code of 1986", as amended, and exempt from11 income taxation under section 501 (a) of the federal "Internal Revenue12 Code of 1986", as amended, it shall be OR HAS A POLICY NOT TO13 TERMINATE A RESIDENT'S LIFE CARE CONTRACT DUE TO THE INABILITY TO14 PAY IF THE RESIDENT IS OTHERWISE COMPLIANT WITH THE LIFE CARE15 CONTRACT, THE PROVIDER IS entitled to make a refund according to a16 schedule provided in its agreement with the resident so long as the17 schedule provides for amortization of the amount paid by the resident18 over a period of not less than sixty months or over the life expectancy of19 the resident if the expectancy is less than sixty months. In such case, the20 refund may be delayed for a reasonable period thereafter until the21 securing by the provider of a substitute fee from another resident or22 prospective resident. The provider may also deduct from any such refund23 amounts due it from the resident for damage done or for any other24 legitimate offsetting item.25 SECTION 3. In Colorado Revised Statutes, 11-49-105, add (4)26 as follows:27 1184 -5- 11-49-105. Reserve requirements. (4) A CBCC PROVIDER SHALL1 MAINTAIN SEPARATE RESERVES TIED TO AN ACTUARIAL ASSESSMENT , IN2 THE FORM AND MANNER REQUIRED BY THE COMMISSIONER , IN ORDER FOR3 THE PROVIDER TO FULLY PERFORM ITS OBLIGATIONS UNDER ITS4 COMMUNITY-BASED CONTINUING CARE CONTRACTS .5 SECTION 4. In Colorado Revised Statutes, 11-49-106, amend6 (1), (2), and (3) as follows:7 11-49-106. Annual report by providers - fee. (1) Each A8 provider AND CBCC PROVIDER shall file an annual report REPORTS with9 the commissioner within ninety days after the end of its THEIR fiscal year10 that contains CONTAIN the certified financial statements for each facility11 OR PROGRAM and such other information as may be required by the12 commissioner. The annual report shall REPORTS MUST be made in a form13 prescribed by the commissioner.14 (2) A provider AND CBCC PROVIDER shall amend its THEIR annual15 report REPORTS on file with the commissioner if an amendment is16 necessary to prevent the report REPORTS from containing a material17 misstatement of fact or omission of a material fact.18 (3) A provider AND CBCC PROVIDER shall make its THEIR annual19 report REPORTS available to residents OR PARTICIPANTS upon request.20 SECTION 5. In Colorado Revised Statutes, amend 11-49-107 as21 follows:22 11-49-107. Examination - fees. The commissioner may conduct23 an examination of the affairs of any A provider OR CBCC PROVIDER as24 often as the commissioner deems it necessary for the protection of the25 interests of the people of this state. Providers AND CBCC PROVIDERS shall26 maintain copies of their books and records in Colorado to provide access27 1184 -6- for the purposes of this article 49. The commissioner shall assess each1 provider at least semiannually, to cover the annual direct and indirect2 costs of examinations, supervision, and administration conducted3 pursuant to the provisions of this section. The assessments shall MUST be4 calculated in terms of cents per thousand dollars of total escrowed5 entrance fees and reserves maintained. The assessment calculation, or6 ratio of the assessment charged to total escrowed entrance fees and7 reserves maintained, shall MUST be alike in all cases. On or before the8 dates specified by the commissioner, each association PROVIDER AND9 CBCC PROVIDER shall pay its assessment. If deemed necessary, the10 commissioner may estimate a per diem rate to be charged for11 examinations and charge a provider OR CBCC PROVIDER for the actual12 cost of any examination documented by the commissioner.13 SECTION 6. In Colorado Revised Statutes, amend 11-49-109 as14 follows:15 11-49-109. Violation. Any A person acting in the capacity of a16 provider OR CBCC PROVIDER who enters into a life care contract OR17 CBCC CONTRACT, or extends the term of an existing life care contract OR18 CBCC CONTRACT, without acting in compliance with the provisions of 19 this article 49 commits a class 2 misdemeanor.20 SECTION 7. In Colorado Revised Statutes, amend 11-49-110 as21 follows:22 11-49-110. Article does not apply to facilities licensed by23 department of public health and environment. The provisions of this24 article 49 shall not apply to any hospital or other facility that the25 department of public health and environment is authorized to license26 pursuant to part 1 of article 1.5 and part 1 of article 3 of title 25; except27 1184 -7- that nursing care facilities, and assisted living residences, AND HOME1 HEALTH AGENCIES that are part of the facility of a provider as defined in2 section 11-49-101 shall be ARE subject to the provisions of this article 49.3 SECTION 8. In Colorado Revised Statutes, 11-49-111, add (2),4 (3), and (4) as follows:5 11-49-111. Life care contract and CBCC contract - content.6 (2) A COMMUNITY-BASED CONTINUED CARE CONTRACT MUST BE WRITTEN7 IN A CLEAR AND COHERENT MANNER USING WORDS WITH COMMON AND8 EVERYDAY MEANINGS AND MUST :9 (a) S HOW THE VALUE OF ALL PROPERTY TRANSFERRED , INCLUDING10 DONATIONS, SUBSCRIPTIONS, FEES, AND ANY OTHER AMOUNTS PAID OR11 PAYABLE BY, OR ON BEHALF OF, THE PARTICIPANT;12 (b) S HOW ALL SERVICES THAT ARE PROVIDED BY THE CBCC13 PROVIDER TO THE PROSPECTIVE PARTICIPANT , INCLUDING, IN DETAIL, ALL14 ITEMS THAT THE PARTICIPANT WILL RECEIVE, WHETHER THE ITEMS WILL BE15 PROVIDED FOR A DESIGNATED TIME PERIOD OR FOR THE LIFE OF THE16 PARTICIPANT, AND THE MONTHLY CHARGE FOR THE SERVICE ;17 (c) B E ACCOMPANIED BY A FINANCIAL STATEMENT SHOWING IN18 REASONABLE DETAIL THE FINANCIAL C ONDITION OF THE CBCC PROVIDER,19 INCLUDING A STATEMENT OF EARNINGS FOR THE PREVIOUS THIRTY -SIX20 MONTHS, THAT MUST BE FURNISHED TO THE PROSPECTIVE PARTICIPANT ;21 (d) D ESCRIBE THE PHYSICAL HEALTH , MENTAL HEALTH, AND22 FINANCIAL CONDITIONS OF THE PARTICIPANT UNDER WHICH THE CBCC23 PROVIDER MAY REQUIRE THE PARTICIPANT TO END THEIR PARTICIPATION24 IN THE PROGRAM;25 (e) D ESCRIBE THE CIRCUMSTANCES UNDER WHICH A PARTICIPANT26 MAY REMAIN IN THE PROGRAM IN THE EVENT THAT A PARTICIPANT IS27 1184 -8- UNABLE TO PRODUCE A REQUIRED PAYMENT ;1 (f) (I) P ROVIDE THAT THE CBCC PROVIDER SHALL NOT CANCEL A2 COMMUNITY-BASED CONTINUING CARE CONTRACT WITH THE PARTICIPANT3 WITHOUT SHOWING GOOD CAUSE . GOOD CAUSE IS LIMITED TO THE4 FOLLOWING:5 (A) P ROOF THAT THE PARTICIPANT IS A DANGER TO THEMSELF OR6 OTHERS;7 (B) P ERSISTENT NONPAYMENT BY THE PARTICIPANT OF A8 MONTHLY OR PERIODIC FEE;9 (C) R EPEATED CONDUCT BY THE PARTICIPANT THAT INTERFERES10 WITH OTHER PARTICIPANTS' QUIET ENJOYMENT OF A FACILITY OR SERVICE;11 (D) P ERSISTENT REFUSAL TO COMPLY WITH WRITTEN RULES AND12 REGULATIONS OF THE PROGRAM ;13 (E) A MATERIAL MISREPRESENTATION MADE INTENTIONALLY OR14 RECKLESSLY BY THE PARTICIPANT IN THEIR APPLICATION FOR15 PARTICIPATION IN THE PROGRAM, OR RELATED MATERIALS, REGARDING16 INFORMATION THAT, IF ACCURATELY PROVIDED, WOULD RESULT IN EITHER17 THE PARTICIPANT NOT QUALIFYING FOR PARTICIPATION OR A MATERIAL18 INCREASE IN THE COST OF PROVIDING THE CARE AND SERVICES PROVIDED19 UNDER THE CBCC CONTRACT TO THE PARTICIPANT; OR20 (F) A MATERIAL BREACH BY THE PARTICIPANT OF THE TERMS AND21 CONDITIONS OF THE COMMUNITY -BASED CONTINUING CARE CONTRACT .22 (II) I F A CBCC PROVIDER INTENDS TO CANCEL A CBCC CONTRACT23 AND TERMINATE A PARTICIPANT 'S PARTICIPATION, THE PROVIDER MUST24 GIVE THE PARTICIPANT WRITTEN NOTICE OF , AND A REASONABLE25 OPPORTUNITY TO CURE WITHIN A REASONABLE PERIOD , THE CONDUCT26 THAT WARRANTS THE CANCELLATION OF THE CBCC CONTRACT. THE27 1184 -9- NOTICE MUST SPECIFY WHICH OF THE CIRCUMSTANCES DESCRIBED IN1 SUBSECTION (2)(f)(I) OF THIS SECTION OCCURRED THAT WARRANTS2 TERMINATION OF THE CBCC CONTRACT.3 (g) P ROVIDE IN CLEAR AND UNDERSTANDABLE LANGUAGE , IN4 PRINT NO LARGER THAN THE LARGEST TYPE USED IN THE BODY OF THE5 CBCC CONTRACT, THE TERMS GOVERNING A REFUND OF A PORTION OF THE6 CBCC ENTRANCE FEE AND THE MANNER IN WHICH THE CBCC PROVIDER7 MAY USE THE FUNDS FROM THE CBCC ENTRANCE FEE IF NOT REFUNDED;8 (h) S TATE THE TERMS THAT A CBCC CONTRACT IS CANCELLED BY9 THE DEATH OF THE PARTICIPANT. THE CBCC CONTRACT MAY CONTAIN A10 PROVISION TO THE EFFECT THAT, UPON THE DEATH OF THE PARTICIPANT,11 THE MONEY PAID FOR THE COMMUNITY -BASED CONTINUING CARE OF THE12 PARTICIPANT IS CONSIDERED EARNED AND IS PROPERTY OF THE CBCC13 PROVIDER.14 (i) P ROVIDE A PARTICIPANT WITH AT LEAST A THIRTY-DAY NOTICE15 PRIOR TO A CHANGE IN FEES , CHARGES, OR THE SCOPE OF CARE OR16 SERVICES, EXCEPT FOR CHANGES REQUIRED BY STATE OR FEDERAL LAW .17 (3) A PARTICIPANT HAS THE RIGHT TO RESCIND A CBCC18 CONTRACT AND RECEIVE A FULL REFUND OF THE CBCC ENTRANCE FEE19 WITHIN SEVEN DAYS AFTER MAKING AN INITIAL DEPOSIT OR EXECUTING20 THE CBCC CONTRACT. A PARTICIPANT IS NOT REQUIRED TO BEGIN THE21 PROVISION OF CARE OR SERVICES OUTLINED IN THE PARTICIPANT 'S CBCC22 CONTRACT BEFORE THE EXPIRATION OF THE SEVEN -DAY PERIOD.23 (4) I F A PARTICIPANT DIES BEFORE THE PROGRAM BEGINS , OR IS24 PRECLUDED FROM PARTICIPATING IN THE PROGRAM DUE TO ILLNESS ,25 INJURY, OR INCAPACITY, THE CONTRACT AUTOMATICALLY RESCINDS AND26 THE PARTICIPANT OR THE PARTICIPANT 'S LEGAL REPRESENTATIVE MUST27 1184 -10- RECEIVE A FULL REFUND OF ALL MONEY PAID TO THE CBCC PROVIDER,1 EXCEPT COSTS SPECIFICALLY INCURRED BY THE CBCC PROVIDER AT THE2 REQUEST OF THE PARTICIPANT AND SET FORTH IN WRITING IN A SEPARATE3 ADDENDUM SIGNED BY BOTH PARTIES TO THE CONTRACT .4 SECTION 9. In Colorado Revised Statutes, 11-49-112, amend5 (1) introductory portion and (1)(f); and repeal (1)(e) as follows:6 11-49-112. Register. (1) Every provider AND CBCC PROVIDER7 shall maintain a register setting forth the following facts concerning each8 person OR PARTICIPANT residing in the A life care institution OR9 RECEIVING CBCC:10 (e) Mother's maiden name;11 (f) The person responsible for each resident's care and12 maintenance; AND13 SECTION 10. In Colorado Revised Statutes, amend 11-49-11314 as follows:15 11-49-113. Advertisements and solicitations of life care16 contracts and CBCC contracts - requirements. Any report, circular,17 public announcement, certificate, or financial statement, or any other18 printed matter or advertising material that is designed for or used to solicit19 or induce persons to enter into any life care contract OR CBCC20 CONTRACT, and that lists or refers to the name of any individual or21 organization as being interested in or connected with the person,22 association, or corporation to perform the contract, shall MUST clearly23 state the extent of financial responsibility assumed by that individual or24 organization for the person, association, or corporation and the fulfillment25 of its contracts.26 SECTION 11. In Colorado Revised Statutes, 30-28-115, amend27 1184 -11- (2)(b)(II) as follows:1 30-28-115. Public welfare to be promoted - legislative2 declaration - construction. (2) (b) (II) The general assembly declares3 that the establishment of group homes for the aged for the exclusive use4 of not more than eight persons sixty years of age or older per home is a5 matter of statewide concern. The general assembly further finds and6 declares that it is the policy of this state to enable and assist persons sixty7 years of age or older who do not need nursing facilities and who so elect8 to live in normal residential surroundings, including single-family9 residential units. Group homes for the aged shall MUST be distinguished10 from nursing facilities, as defined in section 25.5-4-103 (14) SECTION11 25.5-4-103, and institutions providing life care, as defined in section12 11-49-101 (6) SECTION 11-49-101. Every county having adopted or that13 shall adopt THAT ADOPTS a zoning ordinance shall provide for the location14 of group homes for the aged. A group home for the aged established15 under this subsection (2)(b)(II) shall MUST not be located within seven16 hundred fifty feet of another such group home, unless otherwise provided17 for by the county.18 SECTION 12. In Colorado Revised Statutes, 31-23-303, amend19 (2)(b)(II) as follows:20 31-23-303. Legislative declaration. (2) (b) (II) The general21 assembly declares that the establishment of group homes for the aged for22 the exclusive use of not more than eight persons sixty years of age or23 older per home is a matter of statewide concern. The general assembly24 further finds and declares that it is the policy of this state to enable and25 assist persons sixty years of age or older who do not need nursing26 facilities, and who so elect, to live in normal residential surroundings,27 1184 -12- including single-family residential units. Group homes for the aged shall1 MUST be distinguished from nursing facilities, as defined in section2 25.5-4-103 (14) SECTION 25.5-4-103, and institutions providing life care,3 as defined in section 11-49-101 (6) SECTION 11-49-101. Every4 municipality having adopted or that shall adopt THAT ADOPTS a zoning5 ordinance shall provide for the location of group homes for the aged. A6 group home for the aged established under this subsection (2)(b) shall7 MUST not be located within seven hundred fifty feet of another such group8 home, unless otherwise provided for by the municipality. Nothing in this9 subsection (2)(b) shall be construed to exempt the group homes from10 compliance with any state, county, or municipal health, safety, and fire11 codes. On April 29, 1976, every person sixty years of age or older who12 resides in a skilled or intermediate health-care facility and who may be13 transferred or discharged therefrom to a group home for the aged shall not14 be so discharged or transferred unless he or she has received ninety days'15 advance written notice thereof or has agreed in writing to the proposed16 transfer or discharge.17 SECTION 13. Act subject to petition - effective date. This act18 takes effect at 12:01 a.m. on the day following the expiration of the19 ninety-day period after final adjournment of the general assembly; except20 that, if a referendum petition is filed pursuant to section 1 (3) of article V21 of the state constitution against this act or an item, section, or part of this22 act within such period, then the act, item, section, or part will not take23 effect unless approved by the people at the general election to be held in24 November 2026 and, in such case, will take effect on the date of the25 official declaration of the vote thereon by the governor.26 1184 -13-