HF 4348

as introduced - 92nd Legislature (2021 - 2022) Posted on 04/07/2022 01:07pm

A bill for an act
relating to health; modifying provisions governing assisted living licensure for
small facilities; eliminating restrictions on the scope of practice of licensed practical
nurses practicing in assisted living facilities; amending Minnesota Statutes 2020,
sections 144.122; 144A.4799; 144G.41, subdivision 2; 144G.45, subdivision 6;
144G.60, subdivision 3; 144G.72, subdivision 4; 144G.9999, subdivision 2;
Minnesota Statutes 2021 Supplement, sections 144G.08, subdivision 9; 144G.41,
subdivision 1; 144G.45, subdivisions 4, 5; 144G.81, subdivision 3.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

ASSISTED LIVING LICENSURE MODIFICATIONS

Section 1.

Minnesota Statutes 2020, section 144.122, is amended to read:

144.122 LICENSE, PERMIT, AND SURVEY FEES.

(a) The state commissioner of health, by rule, may prescribe procedures and fees for
filing with the commissioner as prescribed by statute and for the issuance of original and
renewal permits, licenses, registrations, and certifications issued under authority of the
commissioner. The expiration dates of the various licenses, permits, registrations, and
certifications as prescribed by the rules shall be plainly marked thereon. Fees may include
application and examination fees and a penalty fee for renewal applications submitted after
the expiration date of the previously issued permit, license, registration, and certification.
The commissioner may also prescribe, by rule, reduced fees for permits, licenses,
registrations, and certifications when the application therefor is submitted during the last
three months of the permit, license, registration, or certification period. Fees proposed to
be prescribed in the rules shall be first approved by the Department of Management and
Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
in an amount so that the total fees collected by the commissioner will, where practical,
approximate the cost to the commissioner in administering the program. All fees collected
shall be deposited in the state treasury and credited to the state government special revenue
fund unless otherwise specifically appropriated by law for specific purposes.

(b) The commissioner may charge a fee for voluntary certification of medical laboratories
and environmental laboratories, and for environmental and medical laboratory services
provided by the department, without complying with paragraph (a) or chapter 14. Fees
charged for environment and medical laboratory services provided by the department must
be approximately equal to the costs of providing the services.

(c) The commissioner may develop a schedule of fees for diagnostic evaluations
conducted at clinics held by the services for children with disabilities program. All receipts
generated by the program are annually appropriated to the commissioner for use in the
maternal and child health program.

(d) The commissioner shall set license fees for hospitals and nursing homes that are not
boarding care homes at the following levels:

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and American Osteopathic Association (AOA) hospitals	$7,655 plus $16 per bed
Non-JCAHO and non-AOA hospitals	$5,280 plus $250 per bed
Nursing home	deleted text begin $183 plus $91 per bed until June 30, 2018. $183 plus $100 per bed between July 1, 2018, and June 30, 2020. deleted text end $183 plus $105 per bed deleted text begin beginning July 1, 2020. deleted text end

The commissioner shall set license fees for outpatient surgical centers, boarding care
homes, supervised living facilities, assisted living facilities, and assisted living facilities
with dementia care at the following levels:

Outpatient surgical centers	$3,712
Boarding care homes	$183 plus $91 per bed
Supervised living facilities	$183 plus $91 per bed deleted text begin . deleted text end
new text begin Assisted living facilities with or without dementia care and a licensed resident capacity of ten or less new text end	new text begin $183 plus $91 per resident new text end
Assisted living facilities with dementia care	$3,000 plus $100 per resident deleted text begin . deleted text end
Assisted living facilities	$2,000 plus $75 per resident deleted text begin . deleted text end

Fees collected under this paragraph are nonrefundable. deleted text begin The fees are nonrefundable even if
received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017,
or later.
deleted text end

(e) Unless prohibited by federal law, the commissioner of health shall charge applicants
the following fees to cover the cost of any initial certification surveys required to determine
a provider's eligibility to participate in the Medicare or Medicaid program:

Prospective payment surveys for hospitals	$	900
Swing bed surveys for nursing homes	$	1,200
Psychiatric hospitals	$	1,400
Rural health facilities	$	1,100
Portable x-ray providers	$	500
Home health agencies	$	1,800
Outpatient therapy agencies	$	800
End stage renal dialysis providers	$	2,100
Independent therapists	$	800
Comprehensive rehabilitation outpatient facilities	$	1,200
Hospice providers	$	1,700
Ambulatory surgical providers	$	1,800
Hospitals	$	4,200
Other provider categories or additional resurveys required to complete initial certification	Actual surveyor costs: average surveyor cost x number of hours for the survey process.

These fees shall be submitted at the time of the application for federal certification and
shall not be refunded. All fees collected after the date that the imposition of fees is not
prohibited by federal law shall be deposited in the state treasury and credited to the state
government special revenue fund.

(f) Notwithstanding section 16A.1283, the commissioner may adjust the fees assessed
on assisted living facilities and assisted living facilities with dementia care under paragraph
(d), in a revenue-neutral manner in accordance with the requirements of this paragraph:

(1) a facility seeking to renew a license shall pay a renewal fee in an amount that is up
to ten percent lower than the applicable fee in paragraph (d) if residents who receive home
and community-based waiver services under chapter 256S and section 256B.49 comprise
more than 50 percent of the facility's capacity in the calendar year prior to the year in which
the renewal application is submitted; and

(2) a facility seeking to renew a license shall pay a renewal fee in an amount that is up
to ten percent higher than the applicable fee in paragraph (d) if residents who receive home
and community-based waiver services under chapter 256S and section 256B.49 comprise
less than 50 percent of the facility's capacity during the calendar year prior to the year in
which the renewal application is submitted.

The commissioner may annually adjust the percentages in clauses (1) and (2), to ensure this
paragraph is implemented in a revenue-neutral manner. The commissioner shall develop a
method for determining capacity thresholds in this paragraph in consultation with the
commissioner of human services and must coordinate the administration of this paragraph
with the commissioner of human services for purposes of verification.

Sec. 2.

Minnesota Statutes 2020, section 144A.4799, is amended to read:

144A.4799 DEPARTMENT OF HEALTH LICENSED HOME CARE PROVIDER new text begin
AND LICENSED ASSISTED LIVING FACILITY new text end ADVISORY COUNCIL.

Subdivision 1.

Membership.

The commissioner of health shall appoint deleted text begin eight deleted text end new text begin ten new text end persons
to a home care and assisted living deleted text begin program deleted text end new text begin facility new text end advisory council consisting of the
following:

(1) three public members as defined in section 214.02 who shall be persons who are
currently receiving home care services new text begin or assisted living services new text end , persons who have received
home care services new text begin or assisted living services new text end within five years of the application date,
persons who have family members receiving home care services new text begin or assisted living services new text end ,
or persons who have family members who have received home care services new text begin or assisted
living services new text end within five years of the application date;

(2) deleted text begin three deleted text end new text begin five new text end Minnesota new text begin assisted living facility licensees or new text end home care licensees
representing basic and comprehensive levels of licensure who may be a managerial official,
an administrator, a supervising registered nurse, or an unlicensed personnel performing
home care tasks new text begin or providing assisted living services. Of these five members, one must be
a representative of Residential Providers Association of Minnesota and one must be a
representative of Residential Care Providers Network new text end ;

(3) one member representing the Minnesota Board of Nursing;

(4) one member representing the Office of Ombudsman for Long-Term Care; and

(5) beginning July 1, 2021, one member of a county health and human services or county
adult protection office.

Subd. 2.

Organizations and meetings.

The advisory council shall be organized and
administered under section 15.059 with per diems and costs paid within the limits of available
appropriations. Meetings will be held quarterly and hosted by the department. Subcommittees
may be developed as necessary by the commissioner. Advisory council meetings are subject
to the Open Meeting Law under chapter 13D.

Subd. 3.

Duties.

(a) At the commissioner's request, the advisory council shall provide
advice regarding regulations of deleted text begin Department of Health deleted text end licensed home care providers deleted text begin in deleted text end new text begin under new text end
this chapter new text begin and assisted living facilities under chapter 144G new text end , including advice on the
following:

(1) community standards for home care practices;

(2) enforcement of licensing standards and whether certain disciplinary actions are
appropriate;

(3) ways of distributing information to licensees and consumers of home care and new text begin
residents of new text end assisted living new text begin facilities new text end ;

(4) training standards;

(5) identifying emerging issues and opportunities in home care and assisted living new text begin
facilities new text end ;

(6) identifying the use of technology in home and telehealth capabilities;

(7) allowable home care licensing modifications and exemptions, including a method
for an integrated license with an existing license for rural licensed nursing homes to provide
limited home care services in an adjacent independent living apartment building owned by
the licensed nursing home; and

(8) recommendations for studies using the data in section 62U.04, subdivision 4, including
but not limited to studies concerning costs related to dementia and chronic disease among
an elderly population over 60 and additional long-term care costs, as described in section
62U.10, subdivision 6.

(b) The advisory council shall perform other duties as directed by the commissioner.

(c) The advisory council shall annually make recommendations to the commissioner for
the purposes in section 144A.474, subdivision 11, paragraph deleted text begin (i) deleted text end new text begin (j) new text end . The recommendations
shall address ways the commissioner may improve protection of the public under existing
statutes and laws and include but are not limited to projects that create and administer
training of licensees and their employees to improve residents' lives, supporting ways that
licensees can improve and enhance quality care and ways to provide technical assistance
to licensees to improve compliance; information technology and data projects that analyze
and communicate information about trends of violations or lead to ways of improving client
care; communications strategies to licensees and the public; and other projects or pilots that
benefit clients, families, and the public.

Sec. 3.

Minnesota Statutes 2021 Supplement, section 144G.41, subdivision 1, is amended
to read:

Subdivision 1.

Minimum requirements.

All assisted living facilities shall:

(1) distribute to residents the assisted living bill of rights;

(2) provide services in a manner that complies with the Nurse Practice Act in sections
148.171 to 148.285;

(3) utilize a person-centered planning and service delivery process;

(4) have and maintain a system for delegation of health care activities to unlicensed
personnel by a registered nurse, including supervision and evaluation of the delegated
activities as required by the Nurse Practice Act in sections 148.171 to 148.285;

(5) provide a means for residents to request assistance for health and safety needs 24
hours per day, seven days per week;

(6) allow residents the ability to furnish and decorate the resident's unit within the terms
of the assisted living contract;

(7) permit residents access to food at any time;

(8) allow residents to choose the resident's visitors and times of visits;

(9) allow the resident the right to choose a roommate if sharing a unit;

(10) notify the resident of the resident's right to have and use a lockable door to the
resident's unit. The licensee shall provide the locks on the unit. Only a staff member with
a specific need to enter the unit shall have keys, and advance notice must be given to the
resident before entrance, when possible. An assisted living facility must not lock a resident
in the resident's unit;

(11) develop and implement a staffing plan for determining its staffing level that:

(i) includes an evaluation, to be conducted at least twice a year, of the appropriateness
of staffing levels in the facility;

(ii) ensures sufficient staffing at all times to meet the scheduled and reasonably
foreseeable unscheduled needs of each resident as required by the residents' assessments
and service plans on a 24-hour per day basis; and

(iii) ensures that the facility can respond promptly and effectively to individual resident
emergencies and to emergency, life safety, and disaster situations affecting staff or residents
in the facility;

(12) ensure that one or more persons are available 24 hours per day, seven days per
week, who are responsible for responding to the requests of residents for assistance with
health or safety needs. Such persons must be:

(i) awake;

(ii) located in the same building, in an attached building, or on a contiguous campus
with the facility in order to respond within a reasonable amount of time;

(iii) capable of communicating with residents;

(iv) capable of providing or summoning the appropriate assistance; and

(v) capable of following directions;

(13) offer to provide or make available at least the following services to residents:

(i) at least three nutritious meals daily with snacks available seven days per week,
according to the recommended dietary allowances in the United States Department of
Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables. The
following apply:

(A) menus must be prepared at least one week in advance, and made available to all
residents. The facility must encourage residents' involvement in menu planning. Meal
substitutions must be of similar nutritional value if a resident refuses a food that is served.
Residents must be informed in advance of menu changes;

(B) food must be prepared and served according to the Minnesota Food Code, Minnesota
Rules, chapter 4626 new text begin , except for facilities with a licensed resident capacity of ten residents
or less, to which the standards described in Minnesota Rules, part 4665.2700, apply new text end ; and

(C) the facility cannot require a resident to include and pay for meals in their contract;

(ii) weekly housekeeping;

(iii) weekly laundry service;

(iv) upon the request of the resident, provide direct or reasonable assistance with arranging
for transportation to medical and social services appointments, shopping, and other recreation,
and provide the name of or other identifying information about the persons responsible for
providing this assistance;

(v) upon the request of the resident, provide reasonable assistance with accessing
community resources and social services available in the community, and provide the name
of or other identifying information about persons responsible for providing this assistance;

(vi) provide culturally sensitive programs; and

(vii) have a daily program of social and recreational activities that are based upon
individual and group interests, physical, mental, and psychosocial needs, and that creates
opportunities for active participation in the community at large; and

(14) provide staff access to an on-call registered nurse 24 hours per day, seven days per
week.

Sec. 4.

Minnesota Statutes 2021 Supplement, section 144G.45, subdivision 4, is amended
to read:

Subd. 4.

Design requirements.

(a) All assisted living facilities with deleted text begin six deleted text end new text begin 11 new text end or more
residents must meet the provisions relevant to assisted living facilities in the 2018 edition
of the Facility Guidelines Institute "Guidelines for Design and Construction of Residential
Health, Care and Support Facilities" and of adopted rules. This minimum design standard
must be met for all new licenses new text begin with a licensed resident capacity of 11 residents or more new text end
or new construction new text begin for a facility with a proposed licensed resident capacity of 11 residents
or more new text end . In addition to the guidelines, assisted living facilities shall provide the option of a
bath in addition to a shower for all residents new text begin of facilities with a licensed capacity of 11
residents or more new text end .

(b) If the commissioner decides to update the edition of the guidelines specified in
paragraph (a) for purposes of this subdivision, the commissioner must notify the chairs and
ranking minority members of the legislative committees and divisions with jurisdiction over
health care and public safety of the planned update by January 15 of the year in which the
new edition will become effective. Following notice from the commissioner, the new edition
shall become effective for assisted living facilities beginning August 1 of that year, unless
provided otherwise in law. The commissioner shall, by publication in the State Register,
specify a date by which facilities must comply with the updated edition. The date by which
facilities must comply shall not be sooner than six months after publication of the
commissioner's notice in the State Register.

Sec. 5.

Minnesota Statutes 2021 Supplement, section 144G.45, subdivision 5, is amended
to read:

Subd. 5.

Assisted living facilities; Life Safety Code.

(a) All assisted living facilities
with deleted text begin six deleted text end new text begin 11 new text end or more residents must meet the applicable provisions of the 2018 edition of
the NFPA Standard 101, Life Safety Code, Residential Board and Care Occupancies chapter.
The minimum design standard shall be met for all new licenses new text begin with a licensed resident
capacity of 11 residents or more new text end or new construction new text begin for a facility with a proposed licensed
resident capacity of 11 residents or more new text end .

(b) If the commissioner decides to update the Life Safety Code for purposes of this
subdivision, the commissioner must notify the chairs and ranking minority members of the
legislative committees and divisions with jurisdiction over health care and public safety of
the planned update by January 15 of the year in which the new Life Safety Code will become
effective. Following notice from the commissioner, the new edition shall become effective
for assisted living facilities beginning August 1 of that year, unless provided otherwise in
law. The commissioner shall, by publication in the State Register, specify a date by which
facilities must comply with the updated Life Safety Code. The date by which facilities must
comply shall not be sooner than six months after publication of the commissioner's notice
in the State Register.

Sec. 6.

Minnesota Statutes 2020, section 144G.45, subdivision 6, is amended to read:

Subd. 6.

New construction; plans.

(a) For all new licensure and construction new text begin for a
facility with a proposed licensed resident capacity of 11 residents or more new text end beginning on or
after August 1, 2021, the following must be provided to the commissioner:

(1) architectural and engineering plans and specifications for new construction must be
prepared and signed by architects and engineers who are registered in Minnesota. Final
working drawings and specifications for proposed construction must be submitted to the
commissioner for review and approval;

(2) final architectural plans and specifications must include elevations and sections
through the building showing types of construction, and must indicate dimensions and
assignments of rooms and areas, room finishes, door types and hardware, elevations and
details of nurses' work areas, utility rooms, toilet and bathing areas, and large-scale layouts
of dietary and laundry areas. Plans must show the location of fixed equipment and sections
and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions
must be indicated. The roof plan must show all mechanical installations. The site plan must
indicate the proposed and existing buildings, topography, roadways, walks and utility service
lines; and

(3) final mechanical and electrical plans and specifications must address the complete
layout and type of all installations, systems, and equipment to be provided. Heating plans
must include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers,
boilers, breeching, and accessories. Ventilation plans must include room air quantities,
ducts, fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing
plans must include the fixtures and equipment fixture schedule; water supply and circulating
piping, pumps, tanks, riser diagrams, and building drains; the size, location, and elevation
of water and sewer services; and the building fire protection systems. Electrical plans must
include fixtures and equipment, receptacles, switches, power outlets, circuits, power and
light panels, transformers, and service feeders. Plans must show location of nurse call signals,
cable lines, fire alarm stations, and fire detectors and emergency lighting.

(b) Unless construction is begun within one year after approval of the final working
drawing and specifications, the drawings must be resubmitted for review and approval.

(c) The commissioner must be notified within 30 days before completion of construction
so that the commissioner can make arrangements for a final inspection by the commissioner.

(d) At least one set of complete life safety plans, including changes resulting from
remodeling or alterations, must be kept on file in the facility.

Sec. 7.

Minnesota Statutes 2021 Supplement, section 144G.81, subdivision 3, is amended
to read:

Subd. 3.

Assisted living facilities with dementia care and secured dementia care
unit; Life Safety Code.

(a) All assisted living facilities with dementia care new text begin with 11 residents
or more new text end and a secured dementia care unit must meet the applicable provisions of the 2018
edition of the NFPA Standard 101, Life Safety Code, Healthcare (limited care) chapter. The
minimum design standards shall be met for all new licenses new text begin with a licensed resident capacity
of 11 residents or more new text end or new construction new text begin for a facility with a proposed licensed resident
capacity of 11 residents or more new text end .

(b) If the commissioner decides to update the Life Safety Code for purposes of this
subdivision, the commissioner must notify the chairs and ranking minority members of the
legislative committees and divisions with jurisdiction over health care and public safety of
the planned update by January 15 of the year in which the new Life Safety Code will become
effective. Following notice from the commissioner, the new edition shall become effective
for assisted living facilities with dementia care and a secured dementia care unit beginning
August 1 of that year, unless provided otherwise in law. The commissioner shall, by
publication in the State Register, specify a date by which these facilities must comply with
the updated Life Safety Code. The date by which these facilities must comply shall not be
sooner than six months after publication of the commissioner's notice in the State Register.

Sec. 8.

Minnesota Statutes 2020, section 144G.9999, subdivision 2, is amended to read:

Subd. 2.

Membership.

The task force shall include representation from:

(1) nonprofit Minnesota-based organizations dedicated to patient safety or innovation
in health care safety and quality;

(2) Department of Health staff with expertise in issues related to safety and adverse
health events;

(3) consumer organizations;

(4) direct care providers or their representatives;

(5) organizations representing long-term care providers and home care providers in
Minnesota new text begin , including at least one representative from each of the following organizations:
new text end

new text begin (i) Residential Providers Association of Minnesota; and
new text end

new text begin (ii) Residential Care Providers Network new text end ;

(6) the ombudsman for long-term care or a designee;

(7) national patient safety experts; and

(8) other experts in the safety and quality improvement field.

The task force shall have at least one public member who either is or has been a resident in
an assisted living setting and one public member who has or had a family member living
in an assisted living setting. The membership shall be voluntary except that public members
may be reimbursed under section 15.059, subdivision 3.

ARTICLE 2

LICENSED PRACTICAL NURSING IN ASSISTED LIVING FACILITIES

Section 1.

Minnesota Statutes 2021 Supplement, section 144G.08, subdivision 9, is
amended to read:

Subd. 9.

Assisted living services.

"Assisted living services" includes one or more of
the following:

(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, and
bathing;

(2) providing standby assistance;

(3) providing verbal or visual reminders to the resident to take regularly scheduled
medication, which includes bringing the resident previously set up medication, medication
in original containers, or liquid or food to accompany the medication;

(4) providing verbal or visual reminders to the resident to perform regularly scheduled
treatments and exercises;

(5) preparing specialized diets ordered by a licensed health professional;

(6) services of an advanced practice registered nurse, registered nurse, licensed practical
nurse, physical therapist, respiratory therapist, occupational therapist, speech-language
pathologist, dietitian or nutritionist, or social worker;

(7) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed
health professional new text begin or licensed practical nurse new text end within the person's scope of practice;

(8) medication management services;

(9) hands-on assistance with transfers and mobility;

(10) treatment and therapies;

(11) assisting residents with eating when the residents have complicated eating problems
as identified in the resident record or through an assessment such as difficulty swallowing,
recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
instruments to be fed;

(12) providing other complex or specialty health care services; and

(13) supportive services in addition to the provision of at least one of the services listed
in clauses (1) to (12).

Sec. 2.

Minnesota Statutes 2021 Supplement, section 144G.41, subdivision 1, is amended
to read:

Subdivision 1.

Minimum requirements.

All assisted living facilities shall:

(1) distribute to residents the assisted living bill of rights;

(2) provide services in a manner that complies with the Nurse Practice Act in sections
148.171 to 148.285;

(3) utilize a person-centered planning and service delivery process;

(4) have and maintain a system for delegation of health care activities to unlicensed
personnel by a registered nurse new text begin and for assignment of nursing tasks to unlicensed personnel
by a licensed practical nurse new text end , including supervision and evaluation of the delegated new text begin or
assigned new text end activities as required by the Nurse Practice Act in sections 148.171 to 148.285;

(5) provide a means for residents to request assistance for health and safety needs 24
hours per day, seven days per week;

(6) allow residents the ability to furnish and decorate the resident's unit within the terms
of the assisted living contract;

(7) permit residents access to food at any time;

(8) allow residents to choose the resident's visitors and times of visits;

(9) allow the resident the right to choose a roommate if sharing a unit;

(10) notify the resident of the resident's right to have and use a lockable door to the
resident's unit. The licensee shall provide the locks on the unit. Only a staff member with
a specific need to enter the unit shall have keys, and advance notice must be given to the
resident before entrance, when possible. An assisted living facility must not lock a resident
in the resident's unit;

(11) develop and implement a staffing plan for determining its staffing level that:

(i) includes an evaluation, to be conducted at least twice a year, of the appropriateness
of staffing levels in the facility;

(ii) ensures sufficient staffing at all times to meet the scheduled and reasonably
foreseeable unscheduled needs of each resident as required by the residents' assessments
and service plans on a 24-hour per day basis; and

(iii) ensures that the facility can respond promptly and effectively to individual resident
emergencies and to emergency, life safety, and disaster situations affecting staff or residents
in the facility;

(12) ensure that one or more persons are available 24 hours per day, seven days per
week, who are responsible for responding to the requests of residents for assistance with
health or safety needs. Such persons must be:

(i) awake;

(ii) located in the same building, in an attached building, or on a contiguous campus
with the facility in order to respond within a reasonable amount of time;

(iii) capable of communicating with residents;

(iv) capable of providing or summoning the appropriate assistance; and

(v) capable of following directions;

(13) offer to provide or make available at least the following services to residents:

(i) at least three nutritious meals daily with snacks available seven days per week,
according to the recommended dietary allowances in the United States Department of
Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables. The
following apply:

(A) menus must be prepared at least one week in advance, and made available to all
residents. The facility must encourage residents' involvement in menu planning. Meal
substitutions must be of similar nutritional value if a resident refuses a food that is served.
Residents must be informed in advance of menu changes;

(B) food must be prepared and served according to the Minnesota Food Code, Minnesota
Rules, chapter 4626; and

(C) the facility cannot require a resident to include and pay for meals in their contract;

(ii) weekly housekeeping;

(iii) weekly laundry service;

(iv) upon the request of the resident, provide direct or reasonable assistance with arranging
for transportation to medical and social services appointments, shopping, and other recreation,
and provide the name of or other identifying information about the persons responsible for
providing this assistance;

(v) upon the request of the resident, provide reasonable assistance with accessing
community resources and social services available in the community, and provide the name
of or other identifying information about persons responsible for providing this assistance;

(vi) provide culturally sensitive programs; and

(vii) have a daily program of social and recreational activities that are based upon
individual and group interests, physical, mental, and psychosocial needs, and that creates
opportunities for active participation in the community at large; and

(14) provide staff access to an on-call registered nurse 24 hours per day, seven days per
week.

Sec. 3.

Minnesota Statutes 2020, section 144G.41, subdivision 2, is amended to read:

Subd. 2.

Policies and procedures.

Each assisted living facility must have policies and
procedures in place to address the following and keep them current:

(1) requirements in section 626.557, reporting of maltreatment of vulnerable adults;

(2) conducting and handling background studies on employees;

(3) orientation, training, and competency evaluations of staff, and a process for evaluating
staff performance;

(4) handling complaints regarding staff or services provided by staff;

(5) conducting initial evaluations of residents' needs and the providers' ability to provide
those services;

(6) conducting initial and ongoing resident evaluations and assessments of resident
needs, including assessments by a registered nurse or appropriate new text begin nurse or new text end licensed health
professional, and how changes in a resident's condition are identified, managed, and
communicated to staff and other health care providers as appropriate;

(7) orientation to and implementation of the assisted living bill of rights;

(8) infection control practices;

(9) reminders for medications, treatments, or exercises, if provided;

(10) conducting appropriate screenings, or documentation of prior screenings, to show
that staff are free of tuberculosis, consistent with current United States Centers for Disease
Control and Prevention standards;

(11) ensuring that nurses and licensed health professionals have current and valid licenses
to practice;

(12) medication and treatment management;

(13) delegation of tasks by registered nurses or licensed health professionals;

(14) new text begin assignment by licensed practical nurses of nursing activities or tasks to other licensed
practical nurses;
new text end

new text begin (15) assignment by licensed practical nurses of nursing tasks or activities to unlicensed
personnel;
new text end

new text begin (16) monitoring by licensed practical nurses of nursing tasks or activities assigned to
unlicensed personnel;
new text end

new text begin (17) new text end supervision of registered nurses and licensed health professionals; and

deleted text begin (15) deleted text end new text begin (18) new text end supervision of unlicensed personnel performing delegated tasks.

Sec. 4.

Minnesota Statutes 2020, section 144G.60, subdivision 3, is amended to read:

Subd. 3.

Licensed health professionals and nurses.

(a) Licensed health professionals
and nurses providing services as employees of a licensed facility must possess a current
Minnesota license or registration to practice.

(b) Licensed health professionals and deleted text begin registered deleted text end nurses must be competent in assessing
resident needs, planning appropriate services to meet resident needs, implementing services,
and supervising staff if assigned.

(c) Nothing in this deleted text begin section deleted text end new text begin chapter new text end limits or expands the rights of nurses or licensed
health professionals to provide services within the scope of their licenses or registrations,
as provided by law.

Sec. 5.

Minnesota Statutes 2020, section 144G.72, subdivision 4, is amended to read:

Subd. 4.

Administration of treatments and therapy.

Ordered or prescribed treatments
or therapies must be administered by a nurse, physician, or other licensed health professional
authorized to perform the treatment or therapy, or may be delegated or assigned to unlicensed
personnel by the licensed health professional according to the appropriate practice standards
for delegation or assignment. When administration of a treatment or therapy is delegated
or assigned to unlicensed personnel, the facility must ensure that the deleted text begin registered deleted text end nurse or
authorized licensed health professional has:

(1) instructed the unlicensed personnel in the proper methods with respect to each resident
and the unlicensed personnel has demonstrated the ability to competently follow the
procedures;

(2) specified, in writing, specific instructions for each resident and documented those
instructions in the resident's record; and

(3) communicated with the unlicensed personnel about the individual needs of the
resident.