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HB 491

AN ACT relating to long-term care facilities.

2026 Regular Session Introduced by D.J. Johnson

HB 491 allows residents in long-term care facilities to authorize electronic monitoring in their private rooms with informed consent, detailing use, retention, access, and protecti

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Bill Summary · HB 491

HB 491 (2026 Regular Session, Kentucky) — An Act relating to long-term care facilities

Purpose and intent

  • Establishes a framework for residents of long-term care facilities to authorize the installation and use of electronic monitoring devices (EMDs) in their private rooms.
  • Aims to enhance resident safety and accountability by allowing monitored rooms, with consent from residents or their legal representatives, while addressing privacy, consent, and disclosure issues.

Key provisions and changes

  • Definitions (Section 1):

    • Clarifies terms: attorney-in-fact, cabinet (Cabinet for Health and Family Services), electronic monitoring device (video, audio, or both), guardian, long-term care facility, and resident.

  • Consent to install EMDs (Subsections 2–5):

    • Residents or their guardians/attorneys-in-fact may authorize an EMD in the resident’s room.
    • Consent requires a form created by the cabinet and payment of device-related costs (excluding electricity). The facility may provide public-use internet if available.
    • Residents may withdraw consent at any time; withdrawal must be recorded in the clinical record.
    • If a resident refuses, the guardian/attorney-in-fact’s consent is superseded unless a court orders otherwise.

  • Room-sharing considerations (Subsections 6–9):

    • If another resident shares the room, that resident or their guardian/ATT must also consent before installation.
    • If the co-occupant refuses, the facility should attempt to accommodate by moving one resident (with consent) to another room.
    • Consent may include conditions (e.g., camera direction); conditions must be followed.

  • New resident integration (Subsection 10):

    • If a new resident moves into a monitored room, the new resident and their guardian/attorney-in-fact must consent before ongoing monitoring.

  • Forms and recordkeeping (Subsections 11–13):

    • The cabinet must create a standardized form detailing consent, device type, monitoring, and liability waivers.
    • Completed forms must be stored in the resident’s clinical record; forms must be available upon request.

  • Installation logistics (Subsections 14–15):

    • EMDs must be installed in a clearly visible location.
    • Facilities must provide reasonable accommodations (secure mounting, power access, scheduling).

  • Use of recordings (Subsections 16–18):

    • Recordings may be used to promote safety or investigate incidents; not for routine staff evaluation.
    • Retention: at least 3 months or until final resolution of related proceedings.
    • Recordings may be viewed only by the resident, guardian/ATT, or law enforcement, unless otherwise authorized.

  • Notice and non-discrimination (Subsections 18–19):

    • Facilities must post a conspicuous notice at the entrance to a monitored room.
    • No admission/discharge discrimination or retaliation for choosing monitoring.

  • Protection, tampering, and liability (Subsections 20–24):

    • Prohibits obstructing or destroying devices/recordings by non-residents/representatives.
    • Unauthorized viewing by others is restricted to the resident, guardians/ATT, or law enforcement unless consent is given.
    • Good-faith compliance provides civil/criminal immunity for privacy violations stemming from resident-directed monitoring; does not immunize abuse or neglect.
    • Disclosures may still be used as evidence in criminal/civil proceedings.
    • Sections state that these provisions do not immunize abuse/neglect and do not limit standard of care.

  • Regulatory and effective date (Subsections 25–27):

    • The cabinet will promulgate administrative regulations under KRS Chapter 13A to implement the section.
    • The section excludes EMDs installed by law enforcement for bona fide law enforcement purposes.
    • Violations involving tampering with devices or recordings are Class B misdemeanors (up to 90 days in jail).

Who is affected

  • Residents of long-term care facilities who choose to authorize electronic monitoring in their rooms.
  • Guardians or attorneys-in-fact acting on behalf of residents.
  • Co-residing residents in shared rooms (and their guardians/ATT) when monitoring involves a shared space.
  • Long-term care facilities (providers) responsible for installation, maintenance, notices, recordkeeping, and compliance.
  • Law enforcement as a potential receiver of access to recordings under authorized circumstances.
  • The Cabinet for Health and Family Services to develop forms and regulations implementing the law.

Procedural and timeline aspects

  • Facilities must obtain consent via cabinet-created form and document withdrawals/consents in the resident’s clinical record.
  • Shared-room consent requires another resident’s consent; if not possible, facilities should attempt to relocate the resident seeking monitoring.
  • The cabinet must create the consent form and establish regulations; the act itself provides the framework but relies on regulatory implementation through KRS 13A.
  • Recordings retention is minimum 3 months or longer if tied to ongoing proceedings.
  • Violations by tampering are subject to Class B misdemeanor penalties.

Local government and fiscal notes

  • Local government impact is indeterminable but potentially negative due to costs associated with enforcement and potential misdemeanor prosecutions.
  • No explicit funding allocation is provided; implementation costs would primarily fall on facilities and affected individuals for installation, internet access, and related expenses.

Summary

HB 491 creates a structured, resident-directed framework for electronic monitoring in long-term care facility rooms, balancing safety and privacy. It requires informed consent from residents and, when applicable, co-residents, with clear rules on use, retention, access, and non-discrimination. The cabinet will issue the necessary forms and regulations to implement these provisions. Violations related to tampering are criminalized as Class B misdemeanors.

Compiled from official sources — confirm details with the bill’s official record.

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