1.1 	A bill for an act
1.2 	relating to human services; modifying nursing home relocation requirements; 
1.3 	removing the limit on certain nursing facility planned closure rate adjustments;
1.4 	amending Minnesota Statutes 2004, sections 144A.161, subdivisions 1, 2, 3, 4, 5, 
1.5 	5a, 5c, 6, 8, by adding a subdivision; 256B.437, subdivision 3.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2004, section 144A.161, subdivision 1, is amended to 
1.8 	read:
1.9 		Subdivision 1.Definitions. The definitions in this subdivision apply to subdivisions 
1.10 	2 to 10.
1.11 	(a) "Closure" means the cessation of operations of a facility and the delicensure and 
1.12 	decertification of all beds within the facility.
1.13 	(b) "Curtailment," "reduction," or "change" refers to any change in operations which 
1.14 	would result in or encourage the relocation of residents.
1.15 	(c) "Facility" means a nursing home licensed pursuant to this chapter, or a certified 
1.16 	boarding care home licensed pursuant to sections  144.50 to  144.56. 
1.17 	(d) "Licensee" means the owner of the facility or the owner's designee or the 
1.18 	commissioner of health for a facility in receivership.
1.19 	(e) "Local agency" "County social services agency" means the county or multicounty 
1.20 	social service agency authorized under sections  393.01 and  393.07, as the agency 
1.21 	responsible for providing social services for the county in which the nursing home is 
1.22 	located. 
1.23 	(f) "Plan" means a process developed under subdivision 3, paragraph (b), for the 
1.24 	closure, curtailment, reduction, or change in operations in a facility and the subsequent 
1.25 	relocation of residents.
2.1 	(g) "Relocation" means the discharge of a resident and movement of the resident to 
2.2 	another facility or living arrangement as a result of the closing, curtailment, reduction, or 
2.3 	change in operations of a nursing home or boarding care home.

2.4 	Sec. 2. Minnesota Statutes 2004, section 144A.161, is amended by adding a 
2.5 	subdivision to read:
2.6 		Subd. 1a.Scope. Where a facility is undertaking closure, curtailment, reduction, or 
2.7 	change in operations, the facility and the county social services agency must comply with 
2.8 	the requirements of this section.

2.9 	Sec. 3. Minnesota Statutes 2004, section 144A.161, subdivision 2, is amended to read:
2.10 		Subd. 2.Initial notice from licensee. (a) A licensee shall notify the following 
2.11 	parties in writing when there is an intent to close or curtail, reduce, or change operations 
2.12 	which would result in or encourage the relocation of residents:
2.13 	(1) the commissioner of health;
2.14 	(2) the commissioner of human services;
2.15 	(3) the local county social services agency;
2.16 	(4) the Office of the Ombudsman for Older Minnesotans; and
2.17 	(5) the Office of the Ombudsman for Mental Health and Mental Retardation.
2.18 	(b) The written notice shall include the names, telephone numbers, facsimile 
2.19 	numbers, and e-mail addresses of the persons in the facility responsible for coordinating 
2.20 	the licensee's efforts in the planning process, and the number of residents potentially 
2.21 	affected by the closure or curtailment, reduction, or change in operations.
2.22 	(c) After providing written notice under this section, and prior to admission, the 
2.23 	facility must fully inform prospective residents and their families of the intent to close or 
2.24 	curtail, reduce, or change operations, and the relocation plan.

2.25 	Sec. 4. Minnesota Statutes 2004, section 144A.161, subdivision 3, is amended to read:
2.26 		Subd. 3.Planning process. (a) The local county social services agency shall, 
2.27 	within five working days of receiving initial notice of the licensee's intent to close or 
2.28 	curtail, reduce, or change operations, provide the licensee and all parties identified in 
2.29 	subdivision 2, paragraph (a), with the names, telephone numbers, facsimile numbers, and 
2.30 	e-mail addresses of those persons responsible for coordinating local county social services
2.31 	agency efforts in the planning process.
2.32 	(b) Within ten working days of receipt of the notice under paragraph (a), the local
2.33 	county social services agency and licensee shall meet to develop the relocation plan. 
3.1 	The local county social services agency shall inform the Departments of Health and 
3.2 	Human Services, the Office of the Ombudsman for Older Minnesotans, and the Office 
3.3 	of the Ombudsman for Mental Health and Mental Retardation of the date, time, and 
3.4 	location of the meeting so that their representatives may attend. The relocation plan 
3.5 	must be completed within 45 days of receipt of the initial notice. However, the plan may 
3.6 	be finalized on an earlier schedule agreed to by all parties. To the extent practicable, 
3.7 	consistent with requirements to protect the safety and health of residents, the commissioner 
3.8 	may authorize the planning process under this subdivision to occur concurrent with the 
3.9 	60-day notice required under subdivision 5a. The plan shall:
3.10 	(1) identify the expected date of closure, curtailment, reduction, or change in 
3.11 	operations;
3.12 	(2) outline the process for public notification of the closure, curtailment, reduction, 
3.13 	or change in operations;
3.14 	(3) identify efforts that will be made to include other stakeholders in the relocation 
3.15 	process;
3.16 	(4) outline the process to ensure 60-day advance written notice to residents, family 
3.17 	members, and designated representatives;
3.18 	(5) present an aggregate description of the resident population remaining to be 
3.19 	relocated and the population's needs;
3.20 	(6) outline the individual resident assessment process to be utilized;
3.21 	(7) identify an inventory of available relocation options, including home and 
3.22 	community-based services;
3.23 	(8) identify a timeline for submission of the list identified in subdivision 5c, 
3.24 	paragraph (b); and
3.25 	(9) identify a schedule for the timely completion of each element of the plan; and
3.26 	(10) identify the steps the licensee and the county social services agency will take to 
3.27 	address the relocation needs of individual residents who may be difficult to place due to 
3.28 	specialized care needs such as behavioral health problems.
3.29 	(c) All parties to the plan shall refrain from any public notification of the intent to 
3.30 	close or curtail, reduce, or change operations until a relocation plan has been established. 
3.31 	If the planning process occurs concurrently with the 60-day notice period, this requirement 
3.32 	does not apply once 60-day notice is given.

3.33 	Sec. 5. Minnesota Statutes 2004, section 144A.161, subdivision 4, is amended to read:
3.34 		Subd. 4.Responsibilities of licensee for resident relocations. The licensee shall 
3.35 	provide for the safe, orderly, and appropriate relocation of residents. The licensee and 
4.1 	facility staff shall cooperate with representatives from the local county social services
4.2 	agency, the Department of Health, the Department of Human Services, the Office of 
4.3 	Ombudsman for Older Minnesotans, and ombudsman for mental health and mental 
4.4 	retardation in planning for and implementing the relocation of residents.

4.5 	Sec. 6. Minnesota Statutes 2004, section 144A.161, subdivision 5, is amended to read:
4.6 		Subd. 5.Licensee responsibilities prior to relocation. (a) The licensee shall 
4.7 	establish an interdisciplinary team responsible for coordinating and implementing the 
4.8 	plan. The interdisciplinary team shall include representatives from the local county social 
4.9 	services agency, the Office of Ombudsman for Older Minnesotans, facility staff that 
4.10 	provide direct care services to the residents, and facility administration.
4.11 	(b) The licensee shall provide a list summary document to the local county social 
4.12 	services agency that includes the following information on each resident to be relocated:
4.13 	(1) name;
4.14 	(2) date of birth;
4.15 	(3) Social Security number;
4.16 	(4) payment source and medical assistance identification number, if applicable;
4.17 	(5) county of financial responsibility;
4.18 	(6) date of admission to the facility;
4.19 	(5) (7) all diagnoses; and
4.20 	(8) the name of and contact information for the resident's physician;
4.21 	(6) (9) the name and contact information for the resident's family or other designated 
4.22 	representative;
4.23 	(10) the names of and contact information for any case managers, if known; and
4.24 	(11) the information on the resident's status related to commitment and probation.
4.25 	(c) The licensee shall consult with the local county social services agency on the 
4.26 	availability and development of available resources and on the resident relocation process.

4.27 	Sec. 7. Minnesota Statutes 2004, section 144A.161, subdivision 5a, is amended to read:
4.28 		Subd. 5a.Licensee responsibilities to provide notice. At least 60 days before the 
4.29 	proposed date of closing, curtailment, reduction, or change in operations as agreed to in 
4.30 	the plan, the licensee shall send a written notice of closure or curtailment, reduction, or 
4.31 	change in operations to each resident being relocated, the resident's family member or 
4.32 	designated representative, and the resident's attending physician. The notice must include 
4.33 	the following:
4.34 	(1) the date of the proposed closure, curtailment, reduction, or change in operations;
5.1 	(2) the name, address, telephone number, facsimile number, and e-mail address 
5.2 	of the individual or individuals in the facility responsible for providing assistance and 
5.3 	information;
5.4 	(3) notification of upcoming meetings for residents, families and designated 
5.5 	representatives, and resident and family councils to discuss the relocation of residents;
5.6 	(4) the name, address, and telephone number of the local county social services
5.7 	agency contact person; and
5.8 	(5) the name, address, and telephone number of the Office of Ombudsman for Older 
5.9 	Minnesotans and the ombudsman for mental health and mental retardation.
5.10 	The notice must comply with all applicable state and federal requirements for notice 
5.11 	of transfer or discharge of nursing home residents.

5.12 	Sec. 8. Minnesota Statutes 2004, section 144A.161, subdivision 5c, is amended to read:
5.13 		Subd. 5c.Licensee responsibility regarding placement information. (a) The 
5.14 	licensee shall provide sufficient preparation to residents to ensure safe, orderly, and 
5.15 	appropriate discharge and relocation. The licensee shall assist residents in finding 
5.16 	placements that respond to personal preferences, such as desired geographic location.
5.17 	(b) The licensee shall prepare a resource list with several relocation options for each 
5.18 	resident. The list must contain the following information for each relocation option, 
5.19 	when applicable:
5.20 	(1) the name, address, and telephone and facsimile numbers of each facility with 
5.21 	appropriate, available beds or services;
5.22 	(2) the certification level of the available beds;
5.23 	(3) the types of services available; and
5.24 	(4) the name, address, and telephone and facsimile numbers of appropriate available 
5.25 	home and community-based placements, services, and settings or other options for 
5.26 	individuals with special needs.
5.27 	The list shall be made available to residents and their families or designated 
5.28 	representatives, and upon request to the Office of Ombudsman for Older Minnesotans, 
5.29 	the ombudsman for mental health and Mental Retardation, and the local county social 
5.30 	services agency.
5.31 	(c) The Senior LinkAge line may make available via a Web site the name, address, 
5.32 	and telephone and facsimile numbers of each facility with available beds, the certification 
5.33 	level of the available beds, the types of services available, and the number of beds that are 
5.34 	available as updated daily by the listed facilities. The licensee must provide residents, 
5.35 	their families or designated representatives, the Office of the Ombudsman for Older 
6.1 	Minnesotans, the Office of the Ombudsman for Mental Health and Mental Retardation, 
6.2 	and the local county social services agency with the toll-free number and Web site address 
6.3 	for the Senior LinkAge line.

6.4 	Sec. 9. Minnesota Statutes 2004, section 144A.161, subdivision 6, is amended to read:
6.5 		Subd. 6.Responsibilities of the licensee during relocation. (a) The licensee 
6.6 	shall make arrangements or provide for the transportation of residents to the new facility 
6.7 	or placement within a 50-mile radius, or within a larger radius if no suitable options 
6.8 	are available within 50 miles. The licensee shall provide a staff person to accompany 
6.9 	the resident during transportation, upon request of the resident, the resident's family, or 
6.10 	designated representative. The discharge and relocation of residents must comply with all 
6.11 	applicable state and federal requirements and must be conducted in a safe, orderly, and 
6.12 	appropriate manner. The licensee must ensure that there is no disruption in providing 
6.13 	meals, medications, or treatments of a resident during the relocation process.
6.14 	(b) Beginning the week following development of the initial relocation plan, the 
6.15 	licensee shall submit biweekly weekly status reports to the commissioners of health and 
6.16 	human services or their designees and to the local county social services agency. The 
6.17 	initial status report must identify:
6.18 	(1) the relocation plan developed;
6.19 	(2) the interdisciplinary team members; and
6.20 	(3) the number of residents to be relocated.
6.21 	(c) Subsequent status reports must identify:
6.22 	(1) any modifications to the plan;
6.23 	(2) any change of interdisciplinary team members;
6.24 	(3) the number of residents relocated;
6.25 	(4) the destination to which residents have been relocated;
6.26 	(5) the number of residents remaining to be relocated; and
6.27 	(6) issues or problems encountered during the process and resolution of these issues.

6.28 	Sec. 10. Minnesota Statutes 2004, section 144A.161, subdivision 8, is amended to read:
6.29 		Subd. 8.Responsibilities of local county social services agency. (a) The local
6.30 	county social services agency shall participate in the meeting as outlined in subdivision 3, 
6.31 	paragraph (b), to develop a relocation plan.
6.32 	(b) The localcounty social services agency shall designate a representative to 
6.33 	the interdisciplinary team established by the licensee responsible for coordinating the 
6.34 	relocation efforts.
7.1 	(c) The localcounty social services agency shall serve as a resource in the relocation 
7.2 	process.
7.3 	(d) Concurrent with the notice sent to residents from the licensee as provided in 
7.4 	subdivision 5a, the localcounty social services agency shall provide written notice to 
7.5 	residents, family, or designated representatives describing:
7.6 	(1) the county's role in the relocation process and in the follow-up to relocations;
7.7 	(2) a localcounty social services agency contact name, address, and telephone 
7.8 	number; and
7.9 	(3) the name, address, and telephone number of the Office of Ombudsman for Older 
7.10 	Minnesotans and the ombudsman for mental health and mental retardation.
7.11 	(e) The localcounty social services agency designee shall meet with appropriate 
7.12 	facility staff to coordinate any assistance in the relocation process. This coordination 
7.13 	shall include participating in group meetings with residents, families, and designated 
7.14 	representatives to explain the relocation process.
7.15 	(f) The localcounty social services agency shall monitor compliance with all 
7.16 	components of the plan. If the licensee is not in compliance, the localcounty social 
7.17 	services agency shall notify the commissioners of the Departments of Health and Human 
7.18 	Services.
7.19 	(g) Except as requested by the resident, family member, or designated representative 
7.20 	and within the parameters of the Vulnerable Adults Act, the localcounty social services 
7.21 	agency may halt a relocation that it deems inappropriate or dangerous to the health or 
7.22 	safety of a resident. The localcounty social services agency shall pursue remedies to 
7.23 	protect the resident during the relocation process, including, but not limited to, assisting 
7.24 	the resident with filing an appeal of transfer or discharge, notification of all appropriate 
7.25 	licensing boards and agencies, and other remedies available to the county under section  
7.26 	626.557, subdivision 10. 
7.27 	(h) A member of the localcounty social services agency staff shall visit residents 
7.28 	relocated within 100 miles of the county within 30 days after the relocation. LocalThis 
7.29 	requirement does not apply to changes in operation where the facility moved to a new 
7.30 	location and residents chose to move to that new location. The requirement also does not 
7.31 	apply to residents admitted after the notice of closure and discharged prior to the actual 
7.32 	closure. County social services agency staff shall interview the resident and family or 
7.33 	designated representative, observe the resident on site, and review and discuss pertinent 
7.34 	medical or social records with appropriate facility staff to:
7.35 	(1) assess the adjustment of the resident to the new placement;
7.36 	(2) recommend services or methods to meet any special needs of the resident; and
8.1 	(3) identify residents at risk.
8.2 	(i) The local county social services agency may conduct subsequent follow-up visits 
8.3 	in cases where the adjustment of the resident to the new placement is in question.
8.4 	(j) Within 60 days of the completion of the follow-up visits, the local county social 
8.5 	services agency shall submit a written summary of the follow-up work to the Departments 
8.6 	of Health and Human Services in a manner approved by the commissioners.
8.7 	(k) The local county social services agency shall submit to the Departments of Health 
8.8 	and Human Services a report of any issues that may require further review or monitoring.
8.9 	(l) The local county social services agency shall be responsible for the safe and 
8.10 	orderly relocation of residents in cases where an emergent need arises or when the licensee 
8.11 	has abrogated its responsibilities under the plan.

8.12 	Sec. 11. Minnesota Statutes 2004, section 256B.437, subdivision 3, is amended to read:
8.13 		Subd. 3.Applications for planned closure of nursing facilities. (a) By August 
8.14 	15, 2001, the commissioner of human services shall implement and announce a program 
8.15 	for closure or partial closure of nursing facilities. Names and identifying information 
8.16 	provided in response to the announcement shall remain private unless approved, according 
8.17 	to the timelines established in the plan. The announcement must specify:
8.18 	(1) the criteria in subdivision 4 that will be used by the commissioner to approve or 
8.19 	reject applications;
8.20 	(2) the information that must accompany an application; and
8.21 	(3) that applications may combine planned closure rate adjustments with moratorium 
8.22 	exception funding, in which case a single application may serve both purposes.
8.23 	Between August 1, 2001, and June 30, 2003, the commissioner may approve planned 
8.24 	closures of up to 5,140 nursing facility beds, less the number of beds delicensed in 
8.25 	facilities during the same time period without approved closure plans or that have notified 
8.26 	the commissioner of health of their intent to close without an approved closure plan. 
8.27 	Beginning July 1, 2004, the commissioner may negotiate a planned closure rate adjustment 
8.28 	for nursing facilities providing the proposal has no cost to the state. For planned closure 
8.29 	rate adjustments negotiated after March 1, 2006, the limit of $2,080 in subdivision 6, 
8.30 	paragraph (a), clause (1), shall not apply. The removal of the limit in subdivision 6, 
8.31 	paragraph (a), clause (1), shall not constitute an increase to the amount specified in 
8.32 	subdivision 6, paragraph (a), clause (1), for the purposes of subdivision 6, paragraph (f).
8.33 	(b) A facility or facilities reimbursed under section  256B.431 or  256B.434 with a 
8.34 	closure plan approved by the commissioner under subdivision 5 may assign a planned 
8.35 	closure rate adjustment to another facility or facilities that are not closing or in the case of 
9.1 	a partial closure, to the facility undertaking the partial closure. A facility may also elect to 
9.2 	have a planned closure rate adjustment shared equally by the five nursing facilities with 
9.3 	the lowest total operating payment rates in the state development region designated under 
9.4 	section  462.385, in which the facility that is closing is located. The planned closure 
9.5 	rate adjustment must be calculated under subdivision 6. Facilities that delicense beds 
9.6 	without a closure plan, or whose closure plan is not approved by the commissioner, are not 
9.7 	eligible to assign a planned closure rate adjustment under subdivision 6, unless they are 
9.8 	delicensing five or fewer beds, or less than six percent of their total licensed bed capacity, 
9.9 	whichever is greater, are located in a county in the top three quartiles of beds per 1,000 
9.10 	persons aged 65 or older, and have not delicensed beds in the prior three months. Facilities 
9.11 	meeting these criteria are eligible to assign the amount calculated under subdivision 6 to 
9.12 	themselves. If a facility is delicensing the greater of six or more beds, or six percent or 
9.13 	more of its total licensed bed capacity, and does not have an approved closure plan or is 
9.14 	not eligible for the adjustment under subdivision 6, the commissioner shall calculate the 
9.15 	amount the facility would have been eligible to assign under subdivision 6, and shall use 
9.16 	this amount to provide equal rate adjustments to the five nursing facilities with the lowest 
9.17 	total operating payment rates in the state development region designated under section  
9.18 	462.385, in which the facility that delicensed beds is located. 
9.19 	(c) To be considered for approval, an application must include:
9.20 	(1) a description of the proposed closure plan, which must include identification of 
9.21 	the facility or facilities to receive a planned closure rate adjustment;
9.22 	(2) the proposed timetable for any proposed closure, including the proposed dates 
9.23 	for announcement to residents, commencement of closure, and completion of closure;
9.24 	(3) if available, the proposed relocation plan for current residents of any facility 
9.25 	designated for closure. If a relocation plan is not available, the application must include a 
9.26 	statement agreeing to develop a relocation plan designed to comply with section  144A.161; 
9.27 	(4) a description of the relationship between the nursing facility that is proposed for 
9.28 	closure and the nursing facility or facilities proposed to receive the planned closure rate 
9.29 	adjustment. If these facilities are not under common ownership, copies of any contracts, 
9.30 	purchase agreements, or other documents establishing a relationship or proposed 
9.31 	relationship must be provided;
9.32 	(5) documentation, in a format approved by the commissioner, that all the nursing 
9.33 	facilities receiving a planned closure rate adjustment under the plan have accepted joint 
9.34 	and several liability for recovery of overpayments under section  256B.0641, subdivision 
9.35 	2, for the facilities designated for closure under the plan; and 
10.1 	(6) an explanation of how the application coordinates with planning efforts under 
10.2 	subdivision 2. If the planning group does not support a level of nursing facility closures 
10.3 	that the commissioner considers to be reasonable, the commissioner may approve a 
10.4 	planned closure proposal without its support.
10.5 	(d) The application must address the criteria listed in subdivision 4.

10.6 	EFFECTIVE DATE. This section is effective retroactively from March 1, 2006.