HF 2080

as introduced - 93rd Legislature (2023 - 2024) Posted on 03/15/2023 12:01pm

A bill for an act
relating to health; making changes to assisted living facilities and services;
amending Minnesota Statutes 2022, sections 144G.19, subdivision 4; 144G.41,
subdivision 1; 144G.42, subdivision 6; 144G.45, subdivisions 4, 5; 144G.63,
subdivision 1; 144G.70, subdivision 2.

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

Section 1.

Minnesota Statutes 2022, section 144G.19, subdivision 4, is amended to read:

Subd. 4.

Change of licensee.

Notwithstanding any other provision of law, a change of
licensee under subdivision 2 does not require the facility to meet the design requirements
of section 144G.45, subdivisions 4 deleted text begin to 6 deleted text end new text begin and 5 new text end , or 144G.81, subdivision 3.

Sec. 2.

Minnesota Statutes 2022, 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) new text begin except as provided in subitem (C), new text end food must be prepared and served according to
the Minnesota Food Code, Minnesota Rules, chapter 4626; and

(C) deleted text begin the facility cannot require a resident to include and pay for meals in their contract; deleted text end new text begin
the following exceptions to the requirements in the Minnesota Food Code under Minnesota
Rules, chapter 4626, apply to an assisted living facility with a licensed capacity of ten or
fewer residents:
new text end

deleted text begin (ii) deleted text end new text begin (i) new text end weekly housekeeping;

deleted text begin (iii) deleted text end new text begin (ii) new text end weekly laundry service;

deleted text begin (iv) deleted text end new text begin (iii) new text end 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;

deleted text begin (v) deleted text end new text begin (iv) new text end 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;

deleted text begin (vi) deleted text end new text begin (v) new text end provide culturally sensitive programs; deleted text begin and
deleted text end

deleted text begin (vii) deleted text end new text begin (vi) new text end 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; deleted text begin and
deleted text end

new text begin (vii) notwithstanding Minnesota Rules, part 4626.0033, item A, the facility may share
a certified food protection manager (CFPM) with another facility or may employ a CFPM
on a part-time basis;
new text end

new text begin (viii) notwithstanding Minnesota Rules, part 4626.1070, item A, the facility is not
required to install a dedicated handwashing sink but may instead elect to designate one well
of a two-compartment sink as the designated handwashing sink;
new text end

new text begin (ix) notwithstanding Minnesota Rules, parts 4626.1325, item A, subitem (1), and
4626.1335, item A, the facility may have a textured ceiling so long as it is clean and in good
repair; and
new text end

new text begin (x) Minnesota Rules, parts 4626.0545 and 4626.1375, do not apply; and
new text end

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

Sec. 3.

Minnesota Statutes 2022, section 144G.42, subdivision 6, is amended to read:

Subd. 6.

Compliance with requirements for reporting maltreatment of vulnerable
adults; abuse prevention plan.

(a) The assisted living facility must comply with the
requirements for the reporting of maltreatment of vulnerable adults in section 626.557. The
facility must establish and implement a written procedure to ensure that all cases of suspected
maltreatment are reported.

(b) The facility must develop and implement an individual abuse prevention plan for
each deleted text begin vulnerable adult deleted text end new text begin resident receiving assisted living services from the facility new text end . The plan
shall contain an individualized review or assessment of the person's susceptibility to abuse
by another individual, including other deleted text begin vulnerable adults deleted text end new text begin residents new text end ; the person's risk of abusing
other deleted text begin vulnerable adults deleted text end new text begin residents new text end ; and statements of the specific measures to be taken to
minimize the risk of abuse to that person and other deleted text begin vulnerable adults deleted text end new text begin residents new text end . For purposes
of the abuse prevention plan, abuse includes self-abuse.

Sec. 4.

Minnesota Statutes 2022, section 144G.45, subdivision 4, is amended to read:

Subd. 4.

Design requirements.

(a) All assisted living facilities with six 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. deleted text begin This deleted text end new text begin Except as provided in paragraph
(b), the new text end minimum design standard must be met for all new licenses or new construction. 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 (b) The minimum design standard is not required for a new license when the applicant
seeks a license under section 144G.16 to provide services in an existing building, so long
as the use complies with all applicable state and local governing laws, regulations, standards,
ordinances, and codes for fire safety, building, and zoning requirements as required by
section 144G.45, subdivision 3, and provided use of the building does not constitute a
distinct hazard to life under section 144G.45, subdivision 2, paragraph (g).
new text end

deleted text begin (b) deleted text end new text begin (c) new text end 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 2022, section 144G.45, subdivision 5, is amended to read:

Subd. 5.

Assisted living facilities; Life Safety Code.

(a) All assisted living facilities
with six 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.
new text begin Except as provided in paragraph (b), new text end the minimum design standard shall be met for all new
licenses or new construction.

new text begin (b) The minimum design standard is not required for a new license when the applicant
seeks a license under section 144G.16 to provide services in an existing building, so long
as the use complies with all applicable state and local governing laws, regulations, standards,
ordinances, and codes for fire safety, building, and zoning requirements as required by
section 144G.45, subdivision 3, and provided use of the building does not constitute a
distinct hazard to life under section 144G.45, subdivision 2, paragraph (g).
new text end

deleted text begin (b) deleted text end new text begin (c) new text end 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 2022, section 144G.63, subdivision 1, is amended to read:

Subdivision 1.

Orientation of staff and supervisors.

new text begin (a) new text end All staff providing and
supervising direct services must complete an orientation to assisted living facility licensing
requirements and regulations before providing assisted living services to residents. The
orientation may be incorporated into the training required under subdivision 5. The orientation
need only be completed once for each staff person and is not transferable to another facility new text begin ,
except as provided in paragraph (b) new text end .

new text begin (b) A staff member is not required to repeat the orientation required under subdivision
2 if the staff member transfers from one licensed assisted living facility to another facility
that is operated by the same licensee or by a licensee that is affiliated with the same corporate
organization as the licensee of the first facility, or to another facility that is managed by the
same entity as the manager of the first facility. The facility to which the staff member
transfers shall document that the staff member completed the orientation at the prior facility.
new text end

Sec. 7.

Minnesota Statutes 2022, section 144G.70, subdivision 2, is amended to read:

Subd. 2.

Initial reviews, assessments, and monitoring.

(a) Residents who are not
receiving any assisted living services shall not be required to undergo an initial nursing
assessment.

(b) An assisted living facility shall conduct a nursing assessment by a registered nurse
of the physical and cognitive needs of the prospective resident and propose a temporary
service plan prior to the date on which a prospective resident executes a contract with a
facility or the date on which a prospective resident moves in, whichever is earlier. If
necessitated by either the geographic distance between the prospective resident and the
facility, or urgent or unexpected circumstances, the assessment may be conducted using
telecommunication methods based on practice standards that meet the resident's needs and
reflect person-centered planning and care delivery.

(c) Resident reassessment and monitoring must be conducted no more than 14 calendar
days after initiation of services. Ongoing resident reassessment and monitoring must be
conducted as needed based on changes in the needs of the resident and cannot exceed 90
calendar days from the last date of the assessment. new text begin Notwithstanding Minnesota Rules, part
4659.0140, subparts 2, item B, subitem (4), and 4, item A, an assessment that is conducted
for purposes of meeting the 90-day reassessment requirement under this paragraph, and that
is not triggered by a change in a resident's condition, may be a focused assessment conducted
and signed by a licensed nurse other than a registered nurse.
new text end

(d) For residents only receiving assisted living services specified in section 144G.08,
subdivision 9, clauses (1) to (5), the facility shall complete an individualized initial review
of the resident's needs and preferences. The initial review must be completed within 30
calendar days of the start of services. Resident monitoring and review must be conducted
as needed based on changes in the needs of the resident and cannot exceed 90 calendar days
from the date of the last review.

(e) A facility must inform the prospective resident of the availability of and contact
information for long-term care consultation services under section 256B.0911, prior to the
date on which a prospective resident executes a contract with a facility or the date on which
a prospective resident moves in, whichever is earlier.