Assisted living housing: what it is and how it is certified

It is the framework created by Act No. 244 of 3 September 2003, the "Act for the Creation of Assisted Living Housing Projects for Older Adults in Puerto Rico", developed by Regulation No. 7299 of the Department of Housing, adopted through the Office of the Ombudsman for Older Adults. A Housing Project is a structure with five or more housing units; a Unit is the part designed to be occupied by one or two people as a private room, with an externally locking door, a bathroom and a kitchenette. The relationship between resident and project is documented in a Residential Contract describing all the rights and responsibilities of both parties.

On the resident’s side: an older adult, defined as any natural person aged sixty or over, who lives in a Residence and receives individualised services under a Residential Contract, and who does not need continuous or supervised medical care. On the operator’s side: a non-profit entity duly authorised under the Corporations Act, or a municipality, obtaining the Department’s certification. And there are three express exclusions: certification may not be obtained by establishments covered by Act 94-1977 or long-term ones providing care, rehabilitation, convalescence or nursing; by hospices serving terminal patients; or by services for older adults with substantial cognitive, physical or other limitations that greatly limit their self-sufficiency.

• Filing a pre-certification application with the preliminary plans, where the intention is to develop the project.Verified against the official source
• Filing a Certification Application with the supporting documents, where the intention is to operate the project.Verified against the official source
• Maintaining a service performance bond of no less than thirty per cent (30%) of the funds assigned, in favour of the Office of the Ombudsman for Older Adults, to guarantee services to beneficiaries.Verified against the official source
• Notifying the Department in writing sixty (60) days before expiry of the intention to renew the certification, and including the Office’s endorsement with its opinion and recommendations.Verified against the official source
• Displaying the Department’s certification in a place visible to every visitor or resident.Verified against the official source

• A one hundred dollar ($100.00) voucher payable to the Department, non-refundable.
• A Certificate of Incorporation and a Good Standing Certificate from the Department of State showing it is organised as a non-profit. Does not apply to municipalities.
• A sworn statement before a notary stating that none of the people working for the Residence has been linked to a violation of any federal or state law or regulation protecting older adults, and that if they previously operated an establishment under Act 94-1977 they did not violate licensing and supervision rules.
• Negative debt certifications from Treasury, CRIM, the Labour Department and the State Insurance Fund Corporation; a five (5) year tax-filing certification; a tax-exemption certification as a non-profit; and evidence of the employer number. The debt certifications and the exemption do not apply to municipalities.
• Copies of policies and bonds in force: public liability insurance, State Insurance Fund, property risk insurance and the service performance bond.
• Health Department licences, a Fire Service certification and the permit from the permits agency, plus a Department of Education certification stating the project does not take part in the USDA food programme.
• The résumés of all members or partners, officers, directors and officials; the promoter’s designation; audited financial statements for the last three years, if applicable; a summary of funds received in the previous fiscal year; the federal-funds matching certification; and a letter of commitment guaranteeing service continuity if federal funds decrease or cease.

1. 1

   Step 1: The line that defines everything

   Before any procedure it helps to place the concept, because it gets confused with everything else. A Resident is an older adult — sixty or over — who lives in a Residence and receives individualised services under a Residential Contract, and who does not need continuous or supervised medical care. The help they receive is with activities of daily living — personal hygiene, toileting, dressing, bathing, eating, walking — and with instrumental activities — preparing food, laundry, housekeeping, shopping, transport, help with finances if the resident asks. If the person needs nursing, convalescence or rehabilitation, this is not it.

2. 2

   Step 2: Who cannot be certified

   Article X is short and decisive. Certification may not be obtained by establishments covered by Act No. 94 of 22 June 1977 — the Establishments for Older Adults Act — nor by long-term establishments providing care, rehabilitation, convalescence or nursing; by hospices serving terminal patients; or by services for older adults with substantial cognitive, physical or other limitations that greatly limit their self-sufficiency. If the project you have in mind falls into any of those three, the route is a different one.

3. 3

   Step 3: Developing and operating are two applications

   Every person or entity intending to develop an assisted living housing project files a pre-certification application with the Department, with the preliminary plans. Every entity intending to operate one files a Certification Application with the supporting documents. They are two different moments and two different procedures: the first looks at the plans, the second at the organisation, the finances, the insurance and the permits.

4. 4

   Step 4: The hundred dollars and the stack of documents

   The Certification Application carries a hundred-dollar voucher payable to the Department, and the regulation clarifies the charge is non-refundable. Behind it come twenty-two lines of documents: incorporation and Good Standing from the Department of State, résumés of all members, officers and directors, a sworn statement on the entity’s record regarding laws protecting older adults, negative debt certifications from Treasury, CRIM, the Labour Department and the State Insurance Fund, a five-year tax-filing certification, tax exemption, employer number, public liability, State Fund and property risk policies plus the performance bond, Health licences, a Fire Service certification, the permits-agency permit, and several more pieces on federal funds and continuity commitments. Municipalities are excepted from several of those lines, and the regulation says so beside each.

5. 5

   Step 5: The thirty per cent bond

   It is the heaviest financial requirement and the least anticipated. Every entity must maintain a bond of no less than thirty per cent of the funds assigned, to guarantee services to beneficiaries, and that bond must be made in favour of the Office of the Ombudsman for Older Adults. It is not a charge the Department collects: it is a guarantee to be posted, and its size depends on the project’s funds.

6. 6

   Step 6: The evaluation deadlines

   The application and supporting documents are evaluated by the Department in coordination with the Office within sixty working days. At the end, the Department notifies whether certification will issue. If it does not, the promoter or entity is notified of the reasons and given thirty working days to comment or remedy. If they neither comment nor remedy to the Department’s satisfaction, the decision becomes final and firm. If they remedy to full satisfaction, the Department issues the certification within the next thirty days. The certification is valid two years from issue and must be displayed in a place visible to every visitor or resident.

7. 7

   Step 7: Who decides: the Evaluating Committee

   The Secretary creates a five-member Evaluating Committee: two officials or employees of the Department or its attached agencies — one chairing and one acting as secretary — one from the Ombudsman’s Office, one from the Health Department and one from the Department of the Family. It meets once a month in ordinary session, with a quorum of three, and its agreements require a simple majority. Its decisions on each application are adopted in writing in a document titled "Recomendación", which must contain the summary of the offers and the grounds for awarding or rejecting each item, dated and signed by all participating members. Any member may dissent and their dissenting vote forms part of the record.

8. 8

   Step 8: Three speeds when something goes wrong

   The Secretary may revoke, deny, modify or refuse to renew a certification where the promoter fails to comply, and must notify in writing within the next ten days by certified mail with return receipt, specifying the grounds and the right of appeal. If the deficiencies place residents’ health and safety at serious risk, instead of revoking they may suspend: the residence keeps operating but may not accept new residents until it corrects, and that decision is notified within the next seventy-two hours. The regulation conditions suspension: it cannot be taken until the promoter has been previously notified they are not complying, that limiting new admissions is being considered, and has had a reasonable term to correct. Once corrected, the no-new-residents decision is revoked. And there is a third speed: emergency revocation, where deficiencies place residents’ health and safety at serious risk, in which the Department revokes immediately and notifies within the next twenty-four hours, also taking every necessary measure to secure those residents’ welfare.

9. 9

   Step 9: Advertising before being certified

   The regulation contemplates the case and conditions it. If any person or entity wishes to promote a project within the act’s conceptual framework and no operating certification has been issued, the promoter must inform the Department in writing of their intention to apply, and state in the promotional or advertising materials that the promoted project has not completed the Department’s certification process. That is: you may advertise, but you must say so.

10. 10

    Step 10: Renewal and the offence

    To renew, the sponsoring group, promoter or entity must notify the Department in writing sixty days before the certification expires, submitting the same Article VI documents plus the Office’s endorsement with its opinion and recommendations on the entity. And Article XIII closes with the risk of doing none of this: anyone operating or administering without proper certification a housing project or residence within the assisted living conceptual framework commits a misdemeanour and, if convicted, will be punished with a fine not exceeding five thousand dollars or jail up to six months, or both penalties, at the court’s discretion.

Before the Department of Housing, which evaluates in coordination with the Office of the Ombudsman for Older Adults. The regulation also describes the funding route: the Department, coordinating with the Office, publishes once a year in a general-circulation newspaper an invitation to an orientation for entities interested in submitting proposals, and proposals are prepared per that orientation’s instructions and in the model format provided, signed by the sponsoring group’s president. An indispensable document to request funds is evidence of certification or of a certification application.

• Confusing assisted living with a retirement home or an Act 94-1977 establishment: the regulation expressly excludes the latter.
• Seeking assisted living for someone who needs continuous or supervised medical care.
• Filing without the hundred-dollar voucher, which is also non-refundable.
• Not budgeting for the performance bond of thirty per cent of the funds assigned.
• Letting the thirty working days to remedy after a denial pass: the decision becomes final and firm.
• Advertising a project as assisted living without saying it has not completed the certification process.
• Requesting renewal late: it is notified in writing sixty days before expiry.
• Operating without certification: it is a misdemeanour, with a fine up to $5,000, up to six months in jail, or both.

These are the government pages this guide is based on.

• Departamento de la Vivienda

  Vivienda

  docs.pr.gov

• Department of Housing regulations

  vivienda

  www.vivienda.pr.gov