SB 193

General Assembly  Substitute Bill No. 193
  February Session, 2026
 AN ACT ESTABLISHING LICENSURE FOR LONG-TERM ACUTE
 CARE HOSPITALS.
 Be it enacted by the Senate and House of Representatives in General
 Assembly convened:
1Section 1. Section 19a-490 of the general statutes is repealed and the
2    following is substituted in lieu thereof (Effective October 1, 2026):
3As used in this chapter, unless the context otherwise requires:
4      (a) "Institution" means a hospital, short-term hospital special hospice,
5   hospice inpatient facility, residential care home, nursing home facility,
6   home health care agency, home health aide agency, behavioral health
7   facility, assisted living services agency, substance abuse treatment
8   facility, outpatient surgical facility, outpatient clinic, clinical laboratory,
9   blood collection facility, source plasma donation center, birth center,
10   long-term acute care hospital, an infirmary operated by an educational
11   institution for the care of students enrolled in, and faculty and
12   employees of, such institution; a facility engaged in providing services
13   for the prevention, diagnosis, treatment or care of human health
14   conditions, including facilities operated and maintained by any state
15   agency; and a residential facility for persons with intellectual disability
16   licensed pursuant to section 17a-227 and certified to participate in the
17   Title XIX Medicaid program as an intermediate care facility for
18   individuals with intellectual disability. "Institution" does not include
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19 any facility for the care and treatment of persons with mental illness or
20 substance use disorder operated or maintained by any state agency,
21 except Whiting Forensic Hospital and the hospital and psychiatric
22 residential treatment facility units of the Albert J. Solnit Children's
23 Center;
24    (b) "Hospital" means an establishment for the lodging, care and
25 treatment of persons suffering from disease or other abnormal physical
26 or mental conditions and includes inpatient psychiatric services in
27 general hospitals;
28    (c) "Residential care home" or "rest home" means a community
29 residence that furnishes, in single or multiple facilities, food and shelter
30 to two or more persons unrelated to the proprietor and, in addition,
31 provides services that meet a need beyond the basic provisions of food,
32 shelter and laundry and may qualify as a setting that allows residents to
33 receive home and community-based services funded by state and
34 federal programs;
35    (d) "Home health care agency" means a public or private
36 organization, or a subdivision thereof, engaged in providing
37 professional nursing services and the following services, available
38 twenty-four hours per day, in the patient's home or a substantially
39 equivalent environment: Home health aide services as defined in this
40 section, physical therapy, speech therapy, occupational therapy or
41 medical social services. The agency shall provide professional nursing
42 services and at least one additional service directly and all others
43 directly or through contract. An agency shall be available to enroll new
44 patients seven days a week, twenty-four hours per day;
45    (e) "Home health aide agency" means a public or private
46 organization, except a home health care agency, which provides in the
47 patient's home or a substantially equivalent environment supportive
48 services which may include, but are not limited to, assistance with
49 personal hygiene, dressing, feeding and incidental household tasks
50 essential to achieving adequate household and family management.
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51 Such supportive services shall be provided under the supervision of a
52 registered nurse and, if such nurse determines appropriate, shall be
53 provided by a social worker, physical therapist, speech therapist or
54 occupational therapist. Such supervision may be provided directly or
55 through contract;
56    (f) "Home health aide services" as defined in this section shall not
57 include services provided to assist individuals with activities of daily
58 living when such individuals have a disease or condition that is chronic
59 and stable as determined by a physician licensed in the state;
60    (g) "Behavioral health facility" means any facility that provides
61 mental health services to persons eighteen years of age or older or
62 substance use disorder services to persons of any age in an outpatient
63 treatment or residential setting to ameliorate mental, emotional,
64 behavioral or substance use disorder issues;
65    (h) "Clinical laboratory" means any facility or other area used for
66 microbiological,        serological,     chemical,       hematological,
67 immunohematological, biophysical, cytological, pathological or other
68 examinations of human body fluids, secretions, excretions or excised or
69 exfoliated tissues for the purpose of providing information for the (1)
70 diagnosis, prevention or treatment of any human disease or
71 impairment, (2) assessment of human health, or (3) assessment of the
72 presence of drugs, poisons or other toxicological substances;
73    (i) "Person" means any individual, firm, partnership, corporation,
74 limited liability company or association;
75   (j) "Commissioner" means the Commissioner of Public Health or the
76 commissioner's designee;
77    (k) "Home health agency" means an agency licensed as a home health
78 care agency or a home health aide agency;
79   (l) "Assisted living services agency" means an agency that provides
80 chronic and stable individuals with services that include, but need not
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81 be limited to, nursing services and assistance with activities of daily
82 living and may have a dementia special care unit or program as defined
83 in section 19a-562;
84    (m) "Outpatient clinic" means an organization operated by a
85 municipality or a corporation, other than a hospital, that provides (1)
86 ambulatory medical care, including preventive and health promotion
87 services, (2) dental care, or (3) mental health services in conjunction with
88 medical or dental care for the purpose of diagnosing or treating a health
89 condition that does not require the patient's overnight care;
90     (n) "Multicare institution" means a hospital that provides outpatient
91 behavioral health services or other health care services, psychiatric
92 outpatient clinic for adults, free-standing facility for the care or
93 treatment of substance abusive or dependent persons, hospital for
94 psychiatric disabilities, as defined in section 17a-495, or a general acute
95 care hospital that provides outpatient behavioral health services that (1)
96 is licensed in accordance with this chapter, (2) has more than one facility
97 or one or more satellite units owned and operated by a single licensee,
98 and (3) offers complex patient health care services at each facility or
99 satellite unit. For purposes of this subsection, "satellite unit" means a
100 location where a segregated unit of services is provided by the multicare
101 institution;
102    (o) "Nursing home" or "nursing home facility" means (1) any chronic
103 and convalescent nursing home or any rest home with nursing
104 supervision that provides nursing supervision under a medical director
105 twenty-four hours per day, or (2) any chronic and convalescent nursing
106 home that provides skilled nursing care under medical supervision and
107 direction to carry out nonsurgical treatment and dietary procedures for
108 chronic diseases, convalescent stages, acute diseases or injuries;
109    (p) "Outpatient dialysis unit" means (1) an out-of-hospital out-patient
110 dialysis unit that is licensed by the department to provide (A) services
111 on an out-patient basis to persons requiring dialysis on a short-term
112 basis or for a chronic condition, or (B) training for home dialysis, or (2)
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113 an in-hospital dialysis unit that is a special unit of a licensed hospital
114 designed, equipped and staffed to (A) offer dialysis therapy on an out-
115 patient basis, (B) provide training for home dialysis, and (C) perform
116 renal transplantations;
117   (q) "Hospice agency" means a public or private organization that
118 provides home care and hospice services to terminally ill patients;
119    (r) "Psychiatric residential treatment facility" means a nonhospital
120 facility with a provider agreement with the Department of Social
121 Services to provide inpatient services to Medicaid-eligible individuals
122 under the age of twenty-one;
123    (s) "Chronic disease hospital" means a long-term hospital having
124 facilities, medical staff and all necessary personnel for the diagnosis,
125 care and treatment of chronic diseases;
126    (t) "Blood collection facility" means a facility that performs blood
127 component collection activities where blood is removed from a human
128 being for the purpose of administering such blood or any of its
129 components to any human being. "Blood collection facility" does not
130 include a facility that performs blood component collection activities to
131 collect source plasma or perform testing that would require licensure as
132 a clinical laboratory. For the purposes of this subsection, "source
133 plasma" means the liquid portion of human blood collected by
134 plasmapheresis and intended as source material for further
135 manufacturing use and does not include single donor plasma products
136 intended for intravenous use, and "plasmapheresis" means a procedure
137 in which blood is removed from a blood donor, the plasma is separated
138 from the formed elements and at least the red blood cells are returned
139 to the blood donor at the time of the donation;
140    (u) "Source plasma donation center" means a facility where source
141 plasma is collected by plasmapheresis. For the purposes of this
142 subsection, "source plasma" means the liquid portion of human blood
143 collected by plasmapheresis and intended as source material for further
144 manufacturing use and does not include single donor plasma products
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145 intended for intravenous use, and "plasmapheresis" means a procedure
146 in which blood is removed from a blood donor, the plasma is separated
147 from the formed elements and at least the red blood cells are returned
148 to the blood donor at the time of the donation; [and]
149    (v) "Birth center" means a freestanding facility that is licensed by the
150 department (1) to provide perinatal, labor, delivery and postpartum
151 care during and immediately after delivery to persons presenting with
152 a low-risk pregnancy and healthy newborns for a period typically less
153 than twenty-four hours, and (2) that is not a hospital licensed pursuant
154 to the provisions of this chapter, or attached to or located in such a
155 hospital. For the purposes of this subsection, "low-risk pregnancy"
156 means an uncomplicated, singleton pregnancy that has vertex
157 presentation and is at low risk for developing complications during
158 labor and birth, as determined by an evaluation and examination
159 conducted by a licensed health care provider acting within the scope of
160 such provider's practice; and
161    (w) "Long-term acute care hospital" means a hospital that is a long-
162 term care hospital, as defined in 42 USC 1395x, as amended from time
163 to time.
164   Sec. 2. Subdivision (4) of subsection (a) of section 19a-491c of the 2026
165 supplement to the general statutes is repealed and the following is
166 substituted in lieu thereof (Effective October 1, 2026):
167    (4) "Long-term care facility" means any facility, agency or provider
168 that is a nursing home, as defined in section 19a-521, a residential care
169 home, as defined in section 19a-521, a home health care agency, hospice
170 agency or home health aide agency, as defined in section 19a-490, as
171 amended by this act, an assisted living services agency, as defined in
172 section 19a-490, as amended by this act, an intermediate care facility for
173 individuals with intellectual disabilities, as defined in 42 USC 1396d(d),
174 except any such facility operated by a Department of Developmental
175 Services' program subject to background checks pursuant to section 17a-
176 227a, a chronic disease hospital, as defined in section 19a-490, as
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177 amended by this act, [or] an agency providing hospice care which is
178 licensed to provide such care by the Department of Public Health or
179 certified to provide such care pursuant to 42 USC 1395x or a long-term
180 acute care hospital, as defined in section 19a-490, as amended by this
181 act.
  This act shall take effect as follows and shall amend the following
  sections:
  Section 1      October 1, 2026  19a-490
  Sec. 2  October 1, 2026  19a-491c(a)(4)
 PH  Joint Favorable Subst.
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