An Act
ENROLLED HOUSE
BILL NO. 3919 By: West (Tammy), Caldwell
(Chad), and Pittman of the
House
and
Garvin of the Senate
An Act relating to assisted living centers and
continuum of care facilities ; defining terms;
mandating disclosure from referral agencies;
providing for prohibited conduct; providing duties
for referral agencies; providing compensation for
referrals through written contracts ; providing for
civil penalty; amending 63 O.S. 2021, Section 1 -742,
which relates to prohibited acts and penalties;
adding exception; providing for codification; and
providing an effective date.
SUBJECT: Assisted living centers and continuum of care facilities
BE IT ENACTED BY THE PEOPLE OF T HE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-866.1 of Title 63, unless
there is created a duplication in numbering, reads as follows:
As used in this section:
1. "Assisted living center" means any home or esta blishment
offering, coordinating, or providing services to two or more persons
who:
a. are domiciled therein,
b. are unrelated to the operator, ENR. H. B. NO. 3919 Page 2
c. by choice or functional impairments, need assistance
with personal care or nursing supe rvision,
d. may need intermittent or unscheduled nursing care,
e. may need medication assi stance, and
f. may need assistance with transfer and /or ambulation;
2. "Consumer" means an individual seeking a referral to an
assisted living center or continuum of care facility on behalf of
themselves or someone else as a representative;
3. "Continuum of care facility" means a home, establishment , or
institution providing nursing facility services as defined in
Section 1-1902 of Title 63 of the Oklahoma Statutes and one or both
of the following:
a. assisted living center services as defined in the
Continuum of Care Assisted Living Act, and
b. adult day care center services as defined in Section
1-872 of Title 63 of the Oklahoma Statutes ;
4. "Fee" means a commission paid to an individual or entity in
exchange for referring a consumer to an assisted living center or
continuum of care facility which results in a resident move-in;
5. "Referral" means identifying and referring a consumer to an
assisted living center or continuum of care facility to facilitate
an evaluation, in consultat ion with the community, of whether the
assisted living center or continuum of care facility is a suitable
option for the consumer ;
6. "Referral agency" means an entity that provides referrals to
assisted living centers or continuum of care facilities for a fee
collected from a consumer or an assisted living center or continuum
of care facility. The term does not include:
a. an assisted living center or continuum of care
facility, its owners, or any of its employees or
contractors in their individual capacity, or
ENR. H. B. NO. 3919 Page 3
b. a resident or resident's family member who refers a
consumer to the assisted living center or continuum of
care facility regardless of whether that individual
receives a discount or other remuneration from the
assisted living center or continuum of care facility .
SECTION 2. NEW LAW A new secti on of law to be codified
in the Oklahoma Statutes as Section 1-866.2 of Title 63, unless
there is created a dup lication in numbering, reads as follows:
A. At the time of the referral, a referral agency shall
disclose the following to the consumer:
1. A description of the referral agency's service;
2. A statement on whether the consumer or the assisted living
center or continuum of care facility to which the consumer is
referred is responsible for paying the referral fee; and
3. A statement that the consumer may, without cause or penalty,
stop using the referral agency. The referral agency shall
communicate this decision by the consumer to all assisted living
centers or continuum of care facilities to which the consumer has
been referred upon being notif ied by the consumer that they plan to
stop using the referral agency. Notification by a consumer shall
not affect the contractual agreement between the referral agency and
the assisted living center or continuum of care facilities.
B. The referral agency shall make the disclosure statement
available to a consumer in a clear and conspicuous written physical
or electronic document.
C. The referral agency shall take into account the consumers '
preferences in selecting the assisted living center or continuum of
care facility to which it refers the consumer and cost shall not be
used as the sole facto r in that selection.
D. An assisted living center or continuum of care facility
shall not be required to cont ract with or do business with a
referral agency.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-866.3 of Title 63, unless
there is created a duplication in numbering, reads as follows:
ENR. H. B. NO. 3919 Page 4
A referral agency shall not:
1. Refer a consumer to an assisted living center or continuum
of care facility in which the referral agency has an ownership,
management, or financial interest excluding a de minimis interest,
such as a direct or indirect ownership of less than one percent (1%)
of an assisted living center or continuum of care facility;
2. Hold a power of attorney or hold property in any capacity
for a consumer or for whom a referral is made;
3. Refer a consumer to an assisted living center or continuum
of care facility that, to the referral agency's knowledge, is
unlicensed and is not exempt from licensing under applicable law ;
4. Collect a fee for a consumer transferring from one location
of an assisted living center or continuum of care fa cility to
another location of the same assisted living center or continuum of
care facility unless the consumer has engaged the referral agency to
help facilitate the transfer to a new location and the consumer has
been provided with more than one referral ; or
5. Collect a fee for a referral after the expi ration of the
referral according to the contract between the referral agency and
the assisted living center or continuum of care facility.
SECTION 4. NEW LAW A new section of law t o be codified
in the Oklahoma Statutes as Section 1-866.4 of Title 63, unless
there is created a duplica tion in numbering, reads as follows:
A referral agency shall:
1. Use a nationally accredited service provi der to obtain
criminal history record informa tion upon hire, on a referral agency
employee who has direct contact with a consumer; provided, however,
that a referral agency employee who physically ent ers an assisted
living center or continuum of care facil ity with the purpose of
making a referral on behalf of a consumer, shall obtain a criminal
background check, in accordance with paragraph 1 of subsection I of
Section 1-1947 of Title 63 of the Oklahoma Statutes;
2. Maintain liability insurance coverage fo r negligent acts or
omissions by the referral agency or its employees;
ENR. H. B. NO. 3919 Page 5
3. Audit each assisted living center or continuum of care
facility to which the referral agency provides referrals to ensure
that any applicable license is in good standing and maintain a
record of that audit;
4. Provide all referral agency employees whose job
responsibilities require direct contact with a consumer with
introductory training, including training on the referral agency's
code of conduct, before the employee begins perfo rming those
responsibilities;
5. Provide an assisted living center or continuum of care
facility with the time and date on which any referral has been made
to the assisted living center or continuum of care facility in a
clear and conspicuous written physical or elec tronic document on or
before the date the consumer is admitted; and
6. After November 1, 2024, provide any new written contract
with an assisted living center or continuum of care fac ility for
which it is making referrals the length of time that a referral
agency shall be paid from the da te that the referral was made to the
assisted living center or continuum of care facili ty not to exceed
thirty-six (36) months.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statute s as Section 1-866.5 of Title 63, unless
there is created a duplication in numbering, reads as foll ows:
A. A written contract entered into between a referral agency
and an assisted living center or continuum of care facility may
provide for the compensati on of a referral agency for all referrals
made to an assisted living center or continuum of care facility ;
such compensation may include, without limitation, amounts based on
volume or value of referrals or business otherwise generated between
the parties.
B. Compensation paid to a referral agency that complies with
the requirements set forth in this section will not be grounds for
disciplinary action against a long-term care administrator pursuant
to OAC 310:679-10-20 or any other rule or statu te regulating long-
term care administrators.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Sec tion 1-866.6 of Title 63, unless
there is created a duplication in numbering, reads as follows: ENR. H. B. NO. 3919 Page 6
A. A referral agency that violates this act is subject to a
civil penalty in an am ount equal to Five Hundred Dollars ($500.00)
for each violation.
B. The Attorney General or a district attorney may bring an
action to recover a civil penalty imposed unde r subsection A of this
section and to restrain and enjoin a violation of this act. The
Attorney General or a district attorney may recover attorney fees
and litigation costs incurred in bringing the action.
SECTION 7. AMENDATORY 63 O.S. 2021, Section 1 -742, is
amended to read as follows:
Section 1-742. A. 1. Any person who intentionally or
knowingly pays to or accepts anything of valu e from any person,
firm, association of persons, partnership or corporation fo r
securing or soliciting patients for any health care professional,
health care provider, or other entity providing health care services
in this state, upon conviction, shall be g uilty of a misdemeanor and
shall be punished by a fine of not less than Five H undred Dollars
($500.00) and not more than Two T housand Dollars ($2,000.00).
2. In addition to any other penalties or remedies provided by
law:
a. a violation of this section by a health care
professional or health care provider shall be grounds
for disciplinary action by the state agency licensing,
certifying or registering such professional or
provider, and
b. the state agency licensing, certifying , or registering
such professional or provider may institute an action
to enjoin violation or potential viola tion of this
section.
B. This section shall no t be construed to prohibit:
1. Advertising, except that advertising which:
a. is false, misleading or deceptive,
b. advertises professional superiority or the performance
of a professional service in a superior manner, and ENR. H. B. NO. 3919 Page 7
c. is not readily subject to ver ification;
2. Remuneration for advertising, m arketing, or other services
that are provided for the purpose of securing or solicitin g
patients, provided the remuneration is:
a. set in advance,
b. consistent with the fair market value of the services,
and
c. not based on the volume or value of any patie nt
referrals or business otherwise generated between the
parties; and
3. Any payment, business arrangements, or payments practice not
prohibited by 42 U.S.C., Sect ion 1320a-7b(b), or any regulations
promulgated pursuant thereto.
C. This section shall not apply to licensed insurers, including
but not limited to, group hospital service corp orations or health
maintenance organizations which reimburse, provide, offer t o
provide, or administer hospital, medical, d ental, or other health-
related benefits under a h ealth benefits plan for which it is the
payor when it is providing those services und er a health benefits
plan, or referral agency as defined in paragraph 4 of Section 1 of
this act.
D. For purposes of this section:
1. "Health care professional" means any person who offers or
provides counseling or health or mental health care under a li cense,
certification or registration issued pursuant to Title 59 of the
Oklahoma Statutes; and
2. "Health care provider" means any hospital or related
institution offering or providing health care services licensed
pursuant to Section 1 -702 of this title.
SECTION 8. This act shall become effective November 1, 2024.
ENR. H. B. NO. 3919 Page 8
Passed the House of Representatives the 14th day of March, 2024.
Presiding Officer of the House
of Representatives
Passed the Senate the 16th day of April, 2024.
Presiding Officer of the Senate
OFFICE OF THE GOVERNOR
Received by the Office of the Governor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Oklahoma this _________
day of ___________________, 20_______, at _______ o'clock _______ M.
_________________________________
Governor of the State of Oklahoma
OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary o f State this __________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________