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Senate
File
537
-
Introduced
SENATE
FILE
537
BY
CELSI
A
BILL
FOR
An
Act
relating
to
the
requirements
for
authorized
electronic
1
monitoring
in
nursing
facilities,
and
providing
penalties.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
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Section
1.
NEW
SECTION
.
135C.49
Definitions.
1
As
used
in
this
subchapter,
unless
the
context
otherwise
2
requires:
3
1.
“Electronic
monitoring”
means
the
placement
and
use
4
of
an
electronic
monitoring
device
by
a
resident
or
resident
5
representative
in
the
resident’s
room
in
accordance
with
this
6
subchapter.
7
2.
“Electronic
monitoring
device”
means
a
video
camera
that
8
livestream
broadcasts
video
only
that
is
placed
in
a
resident’s
9
room
and
is
used
to
monitor
the
resident
or
activities
in
the
10
room.
“Electronic
monitoring
device”
does
not
include
video
11
phone
calls
or
video
conferencing
where
a
resident
either
12
initiates
or
joins
a
call
or
conference.
13
3.
“Resident”
means
an
individual
admitted
to
a
nursing
14
facility
in
a
manner
prescribed
in
section
135C.23.
15
4.
“Resident
representative”
means
one
of
the
following
in
16
the
order
of
priority
listed,
to
the
extent
the
person
may
17
reasonably
be
identified
and
located:
18
a.
The
guardian
of
the
resident
if
one
has
been
appointed
19
pursuant
to
chapter
633.
20
b.
The
attorney
in
fact
designated
to
make
treatment
21
decisions
for
the
resident
in
accordance
with
chapter
144B.
22
Sec.
2.
NEW
SECTION
.
135C.50
Electronic
monitoring.
23
1.
A
resident,
or
a
resident
representative
when
acting
24
on
behalf
of
a
resident,
may
conduct
electronic
monitoring
25
of
the
resident’s
room
through
the
use
of
an
electronic
26
monitoring
device
placed
in
the
resident’s
room
pursuant
to
27
this
subchapter.
28
2.
A
nursing
facility
or
resident
of
the
nursing
facility
29
shall
not
engage
in
electronic
monitoring
or
the
use
of
30
electronic
monitoring
devices
in
a
resident’s
room
without
the
31
written
consent
of
the
resident
or
resident
representative
when
32
consenting
on
behalf
of
a
resident.
33
3.
Nothing
in
this
section
precludes
the
use
of
electronic
34
monitoring
otherwise
allowed
by
law.
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Sec.
3.
NEW
SECTION
.
135C.51
Consent
to
electronic
1
monitoring.
2
1.
Except
as
otherwise
provided
in
this
subchapter,
3
a
resident
must
consent
to
electronic
monitoring
in
the
4
resident’s
room
in
writing
on
a
notification
and
consent
5
form
prescribed
by
the
department.
If
the
resident
has
6
not
affirmatively
objected
to
electronic
monitoring
and
7
the
resident’s
health
care
professional
determines
that
the
8
resident
lacks
the
ability
to
understand
and
appreciate
the
9
nature
and
consequences
of
electronic
monitoring,
the
resident
10
representative
may
consent
on
behalf
of
the
resident.
For
11
purposes
of
this
subsection,
a
resident
affirmatively
objects
12
when
the
resident
orally,
visually,
or
through
the
use
of
13
auxiliary
aids
or
services
declines
electronic
monitoring.
The
14
resident’s
response
shall
be
documented
on
the
notification
and
15
consent
form.
16
2.
Prior
to
a
resident
representative
consenting
on
behalf
17
of
a
resident,
the
resident
shall
be
asked
if
the
resident
18
wants
electronic
monitoring
to
be
conducted.
The
resident
19
representative
shall
explain
all
of
the
following
to
the
20
resident:
21
a.
The
type
of
electronic
monitoring
device
to
be
used.
22
b.
The
standard
conditions
or
restrictions
that
may
be
23
placed
on
the
electronic
monitoring
device’s
use
including
as
24
specified
in
the
list
of
standard
conditions
or
restrictions
25
contained
in
the
notification
and
consent
form
completed
by
the
26
resident
as
provided
in
section
135C.55.
27
c.
The
resident’s
ability
to
decline
all
electronic
28
monitoring.
29
3.
A
resident,
or
resident
representative
when
consenting
30
on
behalf
of
the
resident,
shall
consent
to
electronic
31
monitoring
with
the
standard
conditions
or
restrictions
32
contained
in
the
notification
and
consent
form
completed
by
the
33
resident
as
provided
in
section
135C.55.
34
4.
A
nursing
facility
employee
may
be
present
to
witness
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the
completion
of
the
written
notification
and
consent
form
1
and
to
answer
any
questions
relating
to
conducting
electronic
2
monitoring
in
a
resident’s
room.
3
Sec.
4.
NEW
SECTION
.
135C.52
Consent
to
electronic
4
monitoring
——
shared
room.
5
1.
If
a
resident
resides
in
a
shared
room,
all
of
the
6
following
shall
apply:
7
a.
The
resident,
or
resident
representative,
as
applicable,
8
shall
request
and
obtain
the
written
consent
on
the
9
notification
and
consent
form
of
any
existing
roommate
residing
10
in
the
shared
room,
prior
to
initiating
electronic
monitoring
11
in
the
resident’s
room.
12
b.
The
resident,
or
resident
representative,
as
applicable,
13
who
is
currently
conducting
electronic
monitoring
in
the
14
resident’s
room,
shall
immediately
remove
or
disable
an
15
electronic
monitoring
device
prior
to
a
new
roommate
moving
16
into
a
shared
room,
and
shall
not
resume
electronic
monitoring
17
unless
the
resident
or
resident
representative
requests
18
and
obtains
written
consent
on
the
notification
and
consent
19
form,
of
the
new
roommate
or
the
new
roommate’s
resident
20
representative.
21
2.
a.
An
existing
or
new
roommate,
or
the
roommate’s
22
resident
representative,
as
applicable,
shall
have
thirty
23
calendar
days
from
receipt
of
the
request
for
consent
to
24
electronic
monitoring
to
complete
the
notification
and
consent
25
form.
26
b.
Failure
of
an
existing
or
new
roommate,
or
the
roommate’s
27
resident
representative,
to
complete
the
notification
and
28
consent
form
within
the
thirty-calendar-day
period,
shall
29
be
considered
an
affirmative
objection
to
the
initiating
30
or
resuming
of
electronic
monitoring,
and
the
resident
31
or
resident’s
representative
shall
not
initiate
or
resume
32
electronic
monitoring
in
the
resident’s
room.
33
3.
After
obtaining
an
existing
or
new
roommate’s,
or
the
34
roommate’s
resident
representative’s
signed
notification
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and
consent
form
and
submitting
the
form
to
the
nursing
1
facility
as
required
under
section
135C.54,
the
resident
or
2
resident
representative
may
initiate
or
resume
electronic
3
monitoring
of
the
resident’s
room
only
after
the
expiration
of
4
a
thirty-calendar-day
waiting
period
commencing
on
the
date
5
the
signed
notification
and
consent
form
is
submitted
to
the
6
nursing
facility.
7
4.
The
resident,
the
existing
or
new
roommate,
the
8
resident’s
resident
representative,
or
the
roommate’s
resident
9
representative,
as
applicable,
may
withdraw
consent
to
10
electronic
monitoring
at
any
time
and
the
withdrawal
of
consent
11
shall
be
documented
on
the
original
notification
and
consent
12
form.
13
Sec.
5.
NEW
SECTION
.
135C.53
Refusal
of
roommate
to
consent
14
——
accommodations.
15
1.
If
a
resident
is
residing
in
a
shared
room,
and
the
16
resident
or
resident
representative,
when
acting
on
behalf
of
17
the
resident,
wants
to
initiate
or
resume
electronic
monitoring
18
but
an
existing
or
new
roommate
refuses
to
consent
to
the
19
electronic
monitoring
as
required
under
section
135C.52,
the
20
nursing
facility
shall
make
a
reasonable
attempt
to
accommodate
21
the
resident
or
resident
representative
who
wants
to
conduct
22
electronic
monitoring.
23
2.
A
nursing
facility
has
met
the
requirement
to
make
24
a
reasonable
attempt
to
accommodate
a
resident
or
resident
25
representative
who
wants
to
initiate
or
resume
electronic
26
monitoring
under
subsection
1
when,
upon
notification
of
the
27
nursing
facility
by
a
resident
or
resident
representative
28
that
an
existing
or
new
roommate
has
refused
to
consent
to
29
electronic
monitoring
in
the
shared
room,
the
nursing
facility
30
offers
to
move
the
resident
or
roommate
to
another
shared
room
31
that
is
available
at
the
time
of
the
request
that
accommodates
32
the
resident
or
roommate.
33
3.
If
a
resident
chooses
to
reside
in
a
private
room
in
34
order
to
accommodate
the
use
of
an
electronic
monitoring
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device,
the
resident
shall
be
subject
to
the
private
room
rate.
1
4.
If
a
nursing
facility
is
unable
to
accommodate
a
2
resident’s
request
to
conduct
electronic
monitoring
under
this
3
section,
the
nursing
facility
shall
reevaluate
the
request
4
periodically
until
the
request
is
fulfilled.
5
Sec.
6.
NEW
SECTION
.
135C.54
Notice
and
consent
form
6
submitted
to
nursing
facility.
7
1.
Electronic
monitoring
of
a
resident’s
room
may
be
8
conducted
only
after
all
of
the
following
conditions
are
met:
9
a.
(1)
If
the
resident
resides
in
a
private
room,
the
10
resident,
or
the
resident
representative
when
acting
on
behalf
11
of
the
resident,
completes
a
notification
and
consent
form
and
12
submits
the
signed
and
completed
form
to
the
nursing
facility.
13
(2)
If
the
resident
resides
in
a
shared
room,
the
resident
14
or
the
resident
representative
when
acting
on
behalf
of
15
the
resident,
and
any
roommate
or
the
roommate’s
resident
16
representative,
completes
notification
and
consent
forms
and
17
submit
the
signed
and
completed
forms
to
the
nursing
facility.
18
b.
Any
required
waiting
period
prior
to
the
initiating
or
19
resuming
of
electronic
monitoring
has
expired.
20
2.
Upon
receipt
of
any
required,
completed
notification
21
and
consent
form,
the
nursing
facility
shall
place
a
copy
of
22
the
form
in
the
resident’s
file
and
a
copy
of
the
form
in
any
23
roommate’s
file.
The
nursing
facility
shall
provide
a
copy
24
of
any
notification
and
consent
form
received
to
the
resident
25
and
the
resident’s
roommate,
or
to
the
resident’s
resident
26
representative
or
the
roommate’s
resident
representative,
as
27
applicable.
28
3.
If
a
resident
or
roommate,
or
the
resident
representative
29
or
roommate’s
resident
representative
if
the
representative
30
is
consenting
on
behalf
of
the
resident
or
roommate,
chooses
31
to
withdraw
consent
to
electronic
monitoring,
the
nursing
32
facility
shall
make
available
the
original
notification
and
33
consent
form
so
that
the
original
form
may
be
updated.
Upon
34
receipt
of
the
updated
original
form,
the
nursing
facility
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shall
place
a
copy
of
the
updated
form
in
the
resident’s
file.
1
The
nursing
facility
shall
provide
a
copy
of
the
updated
form
2
to
the
resident
and
the
resident’s
roommate
or
to
the
resident
3
representative
or
roommate’s
resident
representative,
as
4
applicable.
5
4.
If
a
new
roommate,
or
the
new
roommate’s
resident
6
representative
when
consenting
on
behalf
of
the
new
roommate,
7
does
not
consent
to
electronic
monitoring
and
submit
a
8
completed
notification
and
consent
form
to
the
nursing
9
facility,
and
the
resident
or
resident
representative
10
conducting
the
electronic
monitoring
does
not
remove
or
disable
11
an
existing
electronic
monitoring
device,
the
nursing
facility
12
shall
provide
the
resident
or
the
resident
representative,
as
13
applicable,
a
twenty-four-hour
notice
to
remove
or
disable
the
14
electronic
monitoring
device.
If
the
device
is
not
removed
15
or
disabled
within
twenty-four
hours
of
notification
to
the
16
resident
or
resident
representative,
the
nursing
facility
may
17
disable
or
remove
the
electronic
monitoring
device.
18
5.
If
an
existing
roommate,
or
the
existing
roommate’s
19
resident
representative
when
withdrawing
consent
on
behalf
of
20
the
existing
roommate,
submits
an
updated
notification
and
21
consent
form
withdrawing
consent
and
the
resident
or
resident
22
representative
conducting
electronic
monitoring
does
not
remove
23
or
disable
the
electronic
monitoring
device,
the
nursing
24
facility
shall
provide
the
resident
or
resident
representative
25
a
twenty-four-hour
notice
to
remove
or
disable
the
electronic
26
monitoring
device.
If
the
device
is
not
removed
or
disabled
27
within
twenty-four
hours
of
notification
to
the
resident
or
28
resident
representative,
the
nursing
facility
may
disable
or
29
remove
the
electronic
monitoring
device.
30
Sec.
7.
NEW
SECTION
.
135C.55
Notification
and
consent
form
31
requirements.
32
1.
The
notification
and
consent
form
completed
by
the
33
resident
shall
include,
at
a
minimum,
all
of
the
following
34
information:
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a.
The
resident’s
signed
consent
to
electronic
monitoring
or
1
the
signature
of
the
resident
representative,
if
applicable.
2
If
a
resident
representative
signs
the
notification
and
consent
3
form,
the
form
shall
document
all
of
the
following:
4
(1)
The
date
the
resident
was
asked
if
the
resident
wants
5
electronic
monitoring
to
be
conducted.
6
(2)
The
name
of
any
person
present
when
the
resident
was
7
asked.
8
(3)
An
acknowledgment
that
the
resident
did
not
9
affirmatively
object.
10
(4)
The
source
of
authority
allowing
the
resident
11
representative
to
sign
the
notification
and
consent
form
on
the
12
resident’s
behalf,
including
any
court
order,
as
applicable.
13
b.
The
resident’s
roommate’s
signed
consent
or
the
signature
14
of
the
roommate’s
resident
representative,
if
applicable.
If
a
15
roommate’s
resident
representative
signs
the
notification
and
16
consent
form,
the
form
shall
document
all
of
the
following:
17
(1)
The
date
the
roommate
was
asked
if
the
roommate
wants
18
electronic
monitoring
to
be
conducted.
19
(2)
The
name
of
any
person
present
when
the
roommate
was
20
asked.
21
(3)
An
acknowledgment
that
the
roommate
did
not
22
affirmatively
object.
23
(4)
The
source
of
authority
allowing
the
resident
24
representative
to
sign
the
notification
and
consent
form
on
the
25
roommate’s
behalf,
including
any
court
order,
as
applicable.
26
c.
The
type
of
electronic
monitoring
device
to
be
used.
27
d.
Any
installation
needs,
such
as
mounting
a
device
to
a
28
wall
or
ceiling,
and
the
costs
associated
with
installation
29
and
use,
which
are
to
be
paid
by
the
resident
or
the
resident
30
representative,
and
the
resident’s
liability
for
potential
31
damage
and
repairs
due
to
installation.
32
e.
Fourteen
days’
notice
of
the
proposed
date
of
33
installation
for
scheduling
purposes.
34
f.
A
copy
of
any
contract
for
maintenance
of
the
electronic
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monitoring
device
by
a
commercial
entity.
1
g.
A
list
of
standard
conditions
or
restrictions
for
the
use
2
of
the
electronic
monitoring
device
including
but
not
limited
3
to
all
of
the
following:
4
(1)
Prohibiting
audio
recording.
5
(2)
Prohibiting
video
recording.
6
(3)
Turning
off
the
electronic
monitoring
device
or
7
blocking
the
lens
of
the
electronic
monitoring
device
for
the
8
duration
of
an
exam
or
procedure
by
a
health
care
professional.
9
(4)
Turning
off
the
electronic
monitoring
device
or
10
blocking
the
lens
of
the
electronic
monitoring
device
while
11
dressing
or
bathing
is
performed.
12
(5)
Turning
off
the
electronic
monitoring
device
for
13
the
duration
of
a
visit
with
a
spiritual
adviser,
ombudsman,
14
attorney,
financial
planner,
intimate
partner,
or
other
15
visitor.
16
(6)
Prohibiting
drop-in
video
access.
17
(7)
Requiring
visual
verification
when
the
electronic
18
monitoring
device
is
in
use.
19
(8)
Requiring
conspicuously
visible
placement
of
the
20
electronic
monitoring
device
inside
the
resident’s
room.
21
(9)
Prohibiting
the
electronic
monitoring
device
from
being
22
placed
outside
the
resident’s
living
quarters.
23
h.
A
signature
box
to
document
if
the
resident
or
roommate
24
withdraws
consent.
25
2.
A
nursing
facility
shall
make
the
notification
and
26
consent
form
available
to
residents
and
inform
residents
of
the
27
option
to
conduct
electronic
monitoring
of
the
resident’s
room.
28
Sec.
8.
NEW
SECTION
.
135C.56
Cost
and
installation.
29
1.
A
resident
who
chooses
to
conduct
electronic
monitoring
30
shall
do
so
at
the
resident’s
own
expense,
including
payment
31
of
any
purchase,
installation,
maintenance,
removal
costs,
and
32
costs
for
returning
the
resident’s
room
to
preinstallation
33
condition.
34
2.
If
a
resident
chooses
to
place
an
electronic
monitoring
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device
that
uses
internet
technology
for
visual
monitoring,
the
1
resident
shall
be
responsible
for
contracting
with
an
internet
2
service
provider.
3
3.
The
nursing
facility
shall
make
a
reasonable
attempt
to
4
accommodate
the
resident’s
installation
needs.
5
4.
All
electronic
monitoring
device
installations
and
6
supporting
services
shall
comply
with
all
applicable
building
7
codes.
8
5.
A
nursing
facility
shall
not
charge
a
resident
a
fee
9
for
the
costs
of
electricity
used
by
the
electronic
monitoring
10
device.
11
Sec.
9.
NEW
SECTION
.
135C.57
Notice
to
visitors.
12
1.
If
electronic
monitoring
is
being
conducted,
a
nursing
13
facility
shall
post
a
sign
at
each
nursing
facility
entrance
14
accessible
to
visitors
that
states
“Electronic
monitoring
15
devices
may
be
present
in
the
rooms
of
residents
to
observe
16
persons
and
activities”.
17
2.
A
nursing
facility
shall
post
a
sign
clearly
and
18
conspicuously
at
the
entrance
to
a
resident’s
room
where
19
electronic
monitoring
is
being
conducted.
The
notice
shall
20
state
“This
room
is
electronically
monitored”.
21
3.
The
nursing
facility
is
responsible
for
installing
and
22
maintaining
the
signage
required
in
this
section.
23
Sec.
10.
NEW
SECTION
.
135C.58
Obstruction
of
electronic
24
monitoring
devices.
25
A
person
shall
not
knowingly
hamper,
obstruct,
tamper
26
with,
or
destroy
an
electronic
monitoring
device
placed
in
27
a
resident’s
room
without
the
permission
of
the
resident
or
28
resident
representative,
as
applicable.
29
Sec.
11.
NEW
SECTION
.
135C.59
Immunity
from
liability
——
30
licensee
discipline
——
inadmissibility
of
recordings.
31
1.
A
nursing
facility
is
not
civilly
or
criminally
liable
32
for
the
disclosure
of
an
unlawful
recording
captured
by
an
33
electronic
monitoring
device.
34
2.
A
nursing
facility
is
not
civilly
or
criminally
liable
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for
a
violation
of
a
resident’s
right
to
privacy
arising
out
1
of
any
electronic
monitoring
conducted
in
accordance
and
in
2
compliance
with
this
subchapter.
3
3.
The
resident
and
resident
representative,
as
applicable,
4
are
responsible
for
complying
with
local,
state,
and
federal
5
privacy
laws
and
for
firewall
protections
to
prevent
images
6
that
may
violate
obscenity
laws
from
being
inadvertently
shown
7
on
the
internet
via
the
electronic
monitoring
device.
8
4.
A
nursing
facility
that
knowingly
violates
this
9
subchapter
shall
be
subject
to
licensee
discipline.
10
5.
If
a
resident
fails
to
comply
with
the
nursing
facility
11
policies
and
residency
agreement
relating
to
the
use
of
an
12
electronic
monitoring
device,
nursing
facility
staff
may
13
report
the
failure
to
the
office
of
long-term
care
ombudsman
14
and
law
enforcement,
as
applicable.
Continued
failure
by
a
15
resident
to
comply
with
such
nursing
facility
policies
and
16
residency
agreement
may
constitute
grounds
for
termination
of
a
17
resident’s
residency
agreement.
18
Sec.
12.
NEW
SECTION
.
135C.60
Resident
protections.
19
1.
A
nursing
facility
shall
not
do
any
of
the
following:
20
a.
Refuse
to
admit
a
potential
resident
or
remove
a
resident
21
because
the
nursing
facility
disagrees
with
the
potential
22
resident’s
or
the
resident’s
decisions
regarding
electronic
23
monitoring,
whether
the
decision
is
made
by
a
resident
or
a
24
resident
representative
acting
on
behalf
of
the
resident.
25
b.
Retaliate
or
discriminate
against
any
resident
for
26
consenting
or
refusing
to
consent
to
electronic
monitoring.
27
c.
Prevent
the
placement
or
use
of
an
electronic
monitoring
28
device
by
a
resident
who
has
provided
the
nursing
facility
29
with
any
notification
and
consent
form
as
required
under
this
30
subchapter.
31
2.
Any
contractual
provision
prohibiting,
limiting,
32
or
otherwise
modifying
the
rights
and
obligations
in
this
33
subchapter
is
contrary
to
public
policy
and
is
void
and
34
unenforceable.
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Sec.
13.
NEW
SECTION
.
135C.61
Report
to
the
department.
1
A
nursing
facility
shall
report
to
the
department,
during
2
the
nursing
facility’s
recertification
survey,
the
number
of
3
electronic
monitoring
device
notification
and
consent
forms
4
received
by
the
nursing
facility.
5
Sec.
14.
Section
633.635,
subsection
3,
Code
2025,
is
6
amended
by
adding
the
following
new
paragraph:
7
NEW
PARAGRAPH
.
d.
Consenting
to
electronic
monitoring
8
conducted
in
accordance
with
chapter
135C.
9
Sec.
15.
DIRECTIVE
TO
DEPARTMENT
OF
INSPECTIONS,
APPEALS,
10
AND
LICENSING.
The
department
of
inspections,
appeals,
and
11
licensing
shall
prescribe
by
rule
pursuant
to
chapter
17A
the
12
notification
and
consent
form
described
in
this
Act,
and
shall
13
make
the
form
available
on
the
department’s
internet
site.
14
Sec.
16.
CODE
EDITOR
DIRECTIVE.
The
Code
editor
may
codify
15
the
provisions
of
this
Act
as
a
new
subchapter
of
chapter
135C
16
entitled
“Electronic
Monitoring”.
17
EXPLANATION
18
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
19
the
explanation’s
substance
by
the
members
of
the
general
assembly.
20
This
bill
provides
for
authorized
electronic
monitoring
in
21
nursing
facilities.
22
The
bill
provides
that
a
nursing
facility
resident
or
a
23
resident
representative,
as
applicable,
may
conduct
electronic
24
monitoring
of
the
resident’s
room
through
the
use
of
electronic
25
monitoring
devices
placed
in
the
resident’s
room
pursuant
26
to
the
bill.
The
bill
specifies
the
consents
that
must
be
27
obtained
for
a
resident
to
conduct
electronic
monitoring
in
the
28
resident’s
room,
including
from
any
roommate;
the
process
to
29
be
followed
if
a
roommate
refuses
to
consent;
the
provision
30
of
notification
to
the
nursing
facility;
the
notification
and
31
consent
form
requirements;
the
responsibility
for
costs
and
32
installation
relating
to
the
electronic
monitoring;
notice
33
to
visitors;
prohibited
obstruction
of
electronic
monitoring
34
devices;
immunity
from
liability,
and
licensee
discipline;
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resident
protections;
and
reporting
requirements.
The
bill
1
also
directs
the
department
of
inspections
and
appeals
to
2
prescribe
the
notification
and
consent
form
described
in
3
the
bill
and
to
make
the
form
available
on
the
department’s
4
internet
site.
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