1.1 	A bill for an act
1.2 	relating to health; allowing access to certain information; removing references to 
1.3 	chapter 144D; requiring documentation on use of patient restraints; clarifying 
1.4 	change of ownership provisions;amending Minnesota Statutes 2024, sections 
1.5 	144.56, subdivision 2b; 144.586, subdivision 2; 144.6502, subdivision 1; 144A.161, 
1.6 	subdivision 1a; 144A.472, subdivision 5; 144A.72, subdivision 2; 144G.08, by 
1.7 	adding subdivisions; 144G.19, by adding a subdivision; 144G.31, subdivision 6; 
1.8 	157.17, subdivisions 2, 5; 295.50, subdivision 4; Minnesota Statutes 2025 
1.9 	Supplement, sections 144A.474, subdivision 11; 295.50, subdivision 9b; proposing 
1.10 	coding for new law in Minnesota Statutes, chapter 144G.
1.11 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.12 	ARTICLE 1
1.13 	ACCESS TO CERTAIN RECORDS

1.14 	Section 1. Minnesota Statutes 2024, section 144A.72, subdivision 2, is amended to read:
1.15 		Subd. 2.Penalties. (a) Failure to comply with this section shall subject the supplemental 
1.16 	nursing services agency to revocation or nonrenewal of its registration. Violations of section 
1.17 	144A.74 are subject to a fine equal to 200 percent of the amount billed or received in excess 
1.18 	of the maximum permitted under that section.
1.19 	(b) The commissioner may request and must be given access to relevant information, 
1.20 	records, incident reports, or other documents in the possession of a facility if they are 
1.21 	considered necessary by the commissioner for verification purposes. The commissioner 
1.22 	may bring enforcement action.

2.1 	ARTICLE 2
2.2 	UPDATING REFERENCES

2.3 	Section 1. Minnesota Statutes 2024, section 144.56, subdivision 2b, is amended to read:
2.4 		Subd. 2b.Boarding care homes. The commissioner shall not adopt or enforce any rule 
2.5 	that limits:
2.6 	(1) a certified boarding care home from providing nursing services in accordance with 
2.7 	the home's Medicaid certification; or
2.8 	(2) a noncertified boarding care home registered under chapter 144D from providing 
2.9 	home care services in accordance with the home's registration.

2.10 	Sec. 2. Minnesota Statutes 2024, section 144.6502, subdivision 1, is amended to read:
2.11 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in this 
2.12 	subdivision have the meanings given.
2.13 	(b) "Commissioner" means the commissioner of health.
2.14 	(c) "Department" means the Department of Health.
2.15 	(d) "Electronic monitoring" means the placement and use of an electronic monitoring 
2.16 	device in the resident's room or private living unit in accordance with this section.
2.17 	(e) "Electronic monitoring device" means a camera or other device that captures, records, 
2.18 	or broadcasts audio, video, or both, that is placed in a resident's room or private living unit 
2.19 	and is used to monitor the resident or activities in the room or private living unit.
2.20 	(f) "Facility" means a facility that is:
2.21 	(1) licensed as a nursing home under chapter 144A;
2.22 	(2) licensed as a boarding care home under sections 144.50 to 144.56; or
2.23 	(3) until August 1, 2021, a housing with services establishment registered under chapter 
2.24 	144D that is either subject to chapter 144G or has a disclosed special unit under section 
2.25 	325F.72; or
2.26 	(4) on or after August 1, 2021, (3) licensed as an assisted living facility under chapter 
2.27 	144G.
2.28 	(g) "Resident" means a person 18 years of age or older residing in a facility.
2.29 	(h) "Resident representative" means one of the following in the order of priority listed, 
2.30 	to the extent the person may reasonably be identified and located:
3.1 	(1) a court-appointed guardian;
3.2 	(2) a health care agent as defined in section 145C.01, subdivision 2; or
3.3 	(3) a person who is not an agent of a facility or of a home care provider designated in 
3.4 	writing by the resident and maintained in the resident's records on file with the facility.

3.5 	Sec. 3. Minnesota Statutes 2024, section 144A.161, subdivision 1a, is amended to read:
3.6 		Subd. 1a.Scope. Where a facility is undertaking a closure, reduction, or change in 
3.7 	operations, or where a housing with services unit registered under chapter 144D is closed 
3.8 	because the space that it occupies is being replaced by a nursing facility bed that is being 
3.9 	reactivated from layaway status, the facility and the county social services agency must 
3.10 	comply with the requirements of this section.

3.11 	Sec. 4. Minnesota Statutes 2024, section 157.17, subdivision 2, is amended to read:
3.12 		Subd. 2.Registration. At the time of licensure or license renewal, a boarding and lodging 
3.13 	establishment or a lodging establishment that provides supportive services or health 
3.14 	supervision services must be registered with the commissioner, and must register annually 
3.15 	thereafter. The registration must include the name, address, and telephone number of the 
3.16 	establishment, the name of the operator, the types of services that are being provided, a 
3.17 	description of the residents being served, the type and qualifications of staff in the facility, 
3.18 	and other information that is necessary to identify the needs of the residents and the types 
3.19 	of services that are being provided. The commissioner shall develop and furnish to the 
3.20 	boarding and lodging establishment or lodging establishment the necessary form for 
3.21 	submitting the registration.
3.22 	Housing with services establishments registered under chapter 144D shall be considered 
3.23 	registered under this section for all purposes except that:
3.24 	(1) the establishments shall operate under the requirements of chapter 144D; and
3.25 	(2) the criminal background check requirements of sections 299C.66 to 299C.71 apply. 
3.26 	The criminal background check requirements of section 144.057 apply only to personnel 
3.27 	providing home care services under sections 144A.43 to 144A.47 and personnel providing 
3.28 	hospice care under sections 144A.75 to 144A.755.

3.29 	Sec. 5. Minnesota Statutes 2024, section 157.17, subdivision 5, is amended to read:
3.30 		Subd. 5.Services that may not be provided in a boarding and lodging establishment 
3.31 	or lodging establishment. Except those facilities registered under chapter 144D, A boarding 
4.1 	and lodging establishment or lodging establishment may not admit or retain individuals 
4.2 	who:
4.3 	(1) would require assistance from establishment staff because of the following needs: 
4.4 	bowel incontinence, catheter care, use of injectable or parenteral medications, wound care, 
4.5 	or dressing changes or irrigations of any kind; or
4.6 	(2) require a level of care and supervision beyond supportive services or health 
4.7 	supervision services.

4.8 	Sec. 6. Minnesota Statutes 2024, section 295.50, subdivision 4, is amended to read:
4.9 		Subd. 4.Health care provider. (a) "Health care provider" means:
4.10 	(1) a person whose health care occupation is regulated or required to be regulated by 
4.11 	the state of Minnesota furnishing any or all of the following goods or services directly to a 
4.12 	patient or consumer: medical, surgical, optical, visual, dental, hearing, nursing services, 
4.13 	drugs, laboratory, diagnostic or therapeutic services;
4.14 	(2) a person who provides goods and services not listed in clause (1) that qualify for 
4.15 	reimbursement under the medical assistance program provided under chapter 256B;
4.16 	(3) a staff model health plan company;
4.17 	(4) an ambulance service required to be licensed;
4.18 	(5) a person who sells or repairs hearing aids and related equipment or prescription 
4.19 	eyewear; or
4.20 	(6) a person providing patient services, who does not otherwise meet the definition of 
4.21 	health care provider and is not specifically excluded in clause (b), who employs or contracts 
4.22 	with a health care provider as defined in clauses (1) to (5) to perform, supervise, otherwise 
4.23 	oversee, or consult with regarding patient services.
4.24 	(b) Health care provider does not include:
4.25 	(1) hospitals; medical supplies distributors, except as specified under paragraph (a), 
4.26 	clause (5); nursing homes licensed under chapter 144A or licensed in any other jurisdiction; 
4.27 	wholesale drug distributors; pharmacies; surgical centers; bus and taxicab transportation, 
4.28 	or any other providers of transportation services other than ambulance services required to 
4.29 	be licensed; supervised living facilities for persons with developmental disabilities, licensed 
4.30 	under Minnesota Rules, parts 4665.0100 to 4665.9900; housing with services establishments 
4.31 	required to be registered under chapter 144D; board and lodging establishments providing 
4.32 	only custodial services that are licensed under chapter 157 and registered under section 
5.1 	157.17 to provide supportive services or health supervision services; adult foster homes as 
5.2 	defined in Minnesota Rules, part 9555.5105; day training and habilitation services for adults 
5.3 	with developmental disabilities as defined in section 252.41, subdivision 3; boarding care 
5.4 	homes, as defined in Minnesota Rules, part 4655.0100; and adult day care centers as defined 
5.5 	in Minnesota Rules, part 9555.9600;
5.6 	(2) home health agencies as defined in Minnesota Rules, part 9505.0175, subpart 15; a 
5.7 	person providing personal care assistance services and supervision of personal care assistance 
5.8 	services as defined in Minnesota Rules, part 9505.0335 section 256B.0625, subdivision 
5.9 	19a; a person providing home care nursing services as defined in Minnesota Rules, part 
5.10 	9505.0360; and home care providers required to be licensed under chapter 144A for home 
5.11 	care services provided under chapter 144A;
5.12 	(3) a person who employs health care providers solely for the purpose of providing 
5.13 	patient services to its employees;
5.14 	(4) an educational institution that employs health care providers solely for the purpose 
5.15 	of providing patient services to its students if the institution does not receive fee for service 
5.16 	payments or payments for extended coverage; and
5.17 	(5) a person who receives all payments for patient services from health care providers, 
5.18 	surgical centers, or hospitals for goods and services that are taxable to the paying health 
5.19 	care providers, surgical centers, or hospitals, as provided under section 295.53, subdivision 
5.20 	1, paragraph (b), clause (3) or (4), or from a source of funds that is excluded or exempt from 
5.21 	tax under sections 295.50 to 295.59.

5.22 	Sec. 7. Minnesota Statutes 2025 Supplement, section 295.50, subdivision 9b, is amended 
5.23 	to read:
5.24 		Subd. 9b.Patient services. (a) "Patient services" means inpatient and outpatient services 
5.25 	and other goods and services provided by hospitals, surgical centers, or health care providers. 
5.26 	They include the following health care goods and services provided to a patient or consumer:
5.27 	(1) bed and board;
5.28 	(2) nursing services and other related services;
5.29 	(3) use of hospitals, surgical centers, or health care provider facilities;
5.30 	(4) medical social services;
5.31 	(5) drugs, biologicals, supplies, appliances, and equipment;
5.32 	(6) other diagnostic or therapeutic items or services;
6.1 	(7) medical or surgical services;
6.2 	(8) items and services furnished to ambulatory patients not requiring emergency care; 
6.3 	and
6.4 	(9) emergency services.
6.5 	(b) "Patient services" does not include:
6.6 	(1) services provided to nursing homes licensed under chapter 144A;
6.7 	(2) examinations for purposes of utilization reviews, insurance claims or eligibility, 
6.8 	litigation, and employment, including reviews of medical records for those purposes;
6.9 	(3) services provided to and by community residential mental health facilities licensed 
6.10 	under section 245I.23 or Minnesota Rules, parts 9520.0500 to 9520.0670, and to and by 
6.11 	residential treatment programs for children with a serious mental illness licensed or certified 
6.12 	under chapter 245A;
6.13 	(4) services provided under the following programs: day treatment services as defined 
6.14 	in section 245.462, subdivision 8; assertive community treatment as described in section 
6.15 	256B.0622; adult rehabilitative mental health services as described in section 256B.0623; 
6.16 	crisis response services as described in section 256B.0624; and children's therapeutic services 
6.17 	and supports as described in section 256B.0943;
6.18 	(5) services provided to and by community mental health centers as defined in section 
6.19 	245.62, subdivision 2;
6.20 	(6) services provided to and by assisted living programs and congregate housing 
6.21 	programs;
6.22 	(7) hospice care services;
6.23 	(8) home and community-based waivered services under chapter 256S and sections 
6.24 	256B.49 and 256B.501;
6.25 	(9) targeted case management services under sections 256B.0621; 256B.0625, 
6.26 	subdivisions 20, 20a, 33, and 44; and 256B.094; and
6.27 	(10) services provided to the following: supervised living facilities for persons with 
6.28 	developmental disabilities licensed under Minnesota Rules, parts 4665.0100 to 4665.9900; 
6.29 	housing with services establishments required to be registered under chapter 144D; board 
6.30 	and lodging establishments providing only custodial services that are licensed under chapter 
6.31 	157 and registered under section 157.17 to provide supportive services or health supervision 
6.32 	services; adult foster homes as defined in Minnesota Rules, part 9555.5105; day training 
7.1 	and habilitation services for adults with developmental disabilities as defined in section 
7.2 	252.41, subdivision 3; boarding care homes as defined in Minnesota Rules, part 4655.0100; 
7.3 	adult day care services as defined in section 245A.02, subdivision 2a; and home health 
7.4 	agencies as defined in Minnesota Rules, part 9505.0175, subpart 15, or licensed under 
7.5 	chapter 144A.

7.6 	ARTICLE 3
7.7 	USE OF PATIENT RESTRAINTS

7.8 	Section 1. Minnesota Statutes 2024, section 144.586, subdivision 2, is amended to read:
7.9 		Subd. 2.Postacute care discharge planning. (a) Each hospital, including hospitals 
7.10 	designated as critical access hospitals, must comply with the federal hospital requirements 
7.11 	for discharge planning, which include:
7.12 	(1) conducting a discharge planning evaluation that includes an evaluation of:
7.13 	(i) the likelihood of the patient needing posthospital services and of the availability of 
7.14 	those services; and
7.15 	(ii) the patient's capacity for self-care or the possibility of the patient being cared for in 
7.16 	the environment from which the patient entered the hospital;
7.17 	(2) timely completion of the discharge planning evaluation under clause (1) by hospital 
7.18 	personnel so that appropriate arrangements for posthospital care are made before discharge, 
7.19 	and to avoid unnecessary delays in discharge;
7.20 	(3) including the discharge planning evaluation under clause (1) in the patient's medical 
7.21 	record for use in establishing an appropriate discharge plan. The hospital must discuss the 
7.22 	results of the evaluation with the patient or individual acting on behalf of the patient. The 
7.23 	hospital must reassess the patient's discharge plan if the hospital determines that there are 
7.24 	factors that may affect continuing care needs or the appropriateness of the discharge plan; 
7.25 	and
7.26 	(4) providing counseling, as needed, for the patient and family members or interested 
7.27 	persons to prepare them for posthospital care. The hospital must provide a list of available 
7.28 	Medicare-eligible home care agencies or skilled nursing facilities that serve the patient's 
7.29 	geographic area, or other area requested by the patient if such care or placement is indicated 
7.30 	and appropriate. Once the patient has designated their preferred providers, the hospital will 
7.31 	assist the patient in securing care covered by their health plan or within the care network. 
7.32 	The hospital must not specify or otherwise limit the qualified providers that are available 
8.1 	to the patient. The hospital must document in the patient's record that the list was presented 
8.2 	to the patient or to the individual acting on the patient's behalf.
8.3 	(b) Each hospital, including hospitals designated as critical access hospitals, must 
8.4 	document in the patient's discharge plan instances when a restraint was used to manage the 
8.5 	patient's behavior prior to discharge, including the type of restraint, duration, and frequency. 
8.6 	In cases where the patient is transferred to a licensed or registered provider, the hospital 
8.7 	must notify the provider of the type, duration, and frequency of the restraint. "Restraint" 
8.8 	has the meaning given in section 144G.08, subdivision 61a.

8.9 	Sec. 2. Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to 
8.10 	read:
8.11 		Subd. 26a.Imminent risk. "Imminent risk" means an immediate and impending threat 
8.12 	to the health, safety, or rights of an individual.

8.13 	EFFECTIVE DATE. This section is effective January 1, 2027.

8.14 	Sec. 3. Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to 
8.15 	read:
8.16 		Subd. 54a.Prone restraint. "Prone restraint" means the use of manual restraint that 
8.17 	places a resident in a face-down position. Prone restraint does not include the brief physical 
8.18 	holding of a resident who, during an emergency use of a manual restraint, rolls into a prone 
8.19 	position and as quickly as possible the resident is restored to a standing, sitting, or side-lying 
8.20 	position.

8.21 	EFFECTIVE DATE. This section is effective January 1, 2027.

8.22 	Sec. 4. Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to 
8.23 	read:
8.24 		Subd. 61a.Restraint. "Restraint" means:
8.25 	(1) chemical restraint, as defined in section 245D.02, subdivision 3b;
8.26 	(2) manual restraint, as defined in section 245D.02, subdivision 15a;
8.27 	(3) mechanical restraint, as defined in section 245D.02, subdivision 15b; or
8.28 	(4) any other form of restraint that limits the free and normal movement of body or 
8.29 	limbs.

8.30 	EFFECTIVE DATE. This section is effective January 1, 2027.

9.1 	Sec. 5. [144G.65] TRAINING IN EMERGENCY MANUAL RESTRAINTS.
9.2 		Subdivision 1.Training. A licensee must ensure that staff who are authorized to apply 
9.3 	an emergency use of a manual restraint complete a minimum of four hours of training from 
9.4 	a qualified individual prior to assuming these responsibilities. Training must include:
9.5 	(1) types of behaviors, de-escalation techniques and their value;
9.6 	(2) principles of person-centered planning and service delivery as identified in section 
9.7 	245D.07, subdivision 1a, paragraph (b);
9.8 	(3) what constitutes the use of a restraint;
9.9 	(4) staff responsibilities related to: (i) prohibited procedures under section 144G.85; (ii) 
9.10 	why prohibited procedures are not effective for reducing or eliminating symptoms or 
9.11 	interfering behavior; and (iii) why prohibited procedures are not safe;
9.12 	(5) the situations when staff must contact 911 services in response to an imminent risk 
9.13 	of harm to the resident or others; and
9.14 	(6) strategies for respecting and supporting each resident's cultural preferences.
9.15 		Subd. 2.Annual refresher training. The licensee must ensure that staff who apply an 
9.16 	emergency use of a manual restraint complete two hours of refresher training on an annual 
9.17 	basis covering each of the training areas listed in subdivision 1.
9.18 		Subd. 3.Implementation. The assisted living facility must implement all orientation 
9.19 	and training topics covered in this section.
9.20 		Subd. 4.Verification and documentation of orientation and training. For staff who 
9.21 	are authorized to apply an emergency use of a manual restraint, the assisted living facility 
9.22 	must retain evidence in the employee record of each staff person having completed the 
9.23 	orientation and training under this section.
9.24 		Subd. 5.Exemption. This section does not apply to licensees who have a policy 
9.25 	prohibiting the use of restraints.

9.26 	EFFECTIVE DATE. This section is effective January 1, 2027.

9.27 	Sec. 6. [144G.85] USE OF RESTRAINTS.
9.28 		Subdivision 1.Use of restraints prohibited. Restraints are prohibited except as described 
9.29 	in subdivisions 2 and 4.
9.30 		Subd. 2.Exception. Emergency use of a manual restraint is permitted only when 
9.31 	immediate intervention is needed to protect the resident or others from imminent risk of 
10.1 	physical harm and is the least restrictive intervention to address the risk. The restraint must 
10.2 	be imposed for the least amount of time necessary and removed when there is no longer 
10.3 	imminent risk of physical harm to the resident or other persons in the facility. The use of 
10.4 	restraint under this subdivision must:
10.5 	(1) take into consideration the rights, health, and welfare of the resident;
10.6 	(2) not apply pressure to the back or chest while a resident is in a prone, supine, or 
10.7 	side-lying position; and
10.8 	(3) allow the resident to be free from prone restraint.
10.9 		Subd. 3.Documentation and notification. (a) The resident's legal representative must 
10.10 	be notified within 12 hours of any use of an emergency use of a manual restraint and of the 
10.11 	circumstances that prompted the use. Notification and the use of an emergency use of a 
10.12 	manual restraint must be documented. If known, the advanced practice registered nurse, 
10.13 	physician, or physician assistant must be notified within 12 hours of any use of an emergency 
10.14 	use of a manual restraint.
10.15 	(b) On a form developed by the commissioner, the facility must notify the commissioner 
10.16 	and the ombudsman for long-term care within seven calendar days of the use of any 
10.17 	emergency use of a manual restraint, including when any restraint is first applied or ordered. 
10.18 	The commissioner will monitor reported uses to detect overuse or unauthorized, 
10.19 	inappropriate, or ineffective use of the restraint. The form must include:
10.20 	(1) the name and date of birth of the resident;
10.21 	(2) the date and time of the use of the restraint;
10.22 	(3) the names of staff and any residents who were involved in the incident leading up 
10.23 	to the emergency use of a manual restraint;
10.24 	(4) a description of the incident, including the length of time the restraint was applied 
10.25 	and who was present before and during the incident leading up to the emergency use of a 
10.26 	manual restraint;
10.27 	(5) a description of what less restrictive alternative measures were attempted to de-escalate 
10.28 	the incident and maintain safety that identifies when, how, and for how long the alternative 
10.29 	measures were attempted before the emergency use of a manual restraint was implemented;
10.30 	(6) a description of the mental, physical, and emotional condition of the resident who 
10.31 	was restrained and of other persons involved in the incident leading up to, during, and 
10.32 	following the emergency use of a manual restraint;
11.1 	(7) whether there was any injury to the resident who was restrained or other persons 
11.2 	involved in the incident, including staff, before or as a result of the emergency use of a 
11.3 	manual restraint; and
11.4 	(8) whether there was a debriefing following the incident with the staff, and, if not 
11.5 	contraindicated, with the resident who was restrained and other persons who were involved 
11.6 	in or who witnessed the emergency use of a manual restraint, and the outcome of the 
11.7 	debriefing. If the debriefing was not conducted at the time the incident report was made, 
11.8 	the form should identify whether a debriefing is planned and a plan for mitigating use of 
11.9 	restraints in the future.
11.10 	(c) A copy of the form submitted under paragraph (b) must be maintained in the resident's 
11.11 	record.
11.12 	(d) A copy of the form submitted under paragraph (b) must be sent to the resident's 
11.13 	waiver case manager within seven calendar days of the use of emergency use of manual 
11.14 	restraints. Any use of emergency use of manual restraints on people served under section 
11.15 	256B.49 and chapter 256S must be documented by the case manager in the resident's support 
11.16 	plan, as defined in sections 256B.49, subdivision 15, and 256S.10.
11.17 	(e) The use of restraints by law enforcement officers or other emergency personnel acting 
11.18 	in a licensed capacity does not require the facility to comply with the requirements of this 
11.19 	subdivision.
11.20 		Subd. 4.Ordered treatment. Any use of a restraint, other than the use of an emergency 
11.21 	use of a manual restraint to address an imminent risk, must be the least restrictive option 
11.22 	and comply with the requirements for an ordered treatment under section 144G.72.

11.23 	EFFECTIVE DATE. This section is effective January 1, 2027.

11.24 	ARTICLE 4
11.25 	CHANGE OF OWNERSHIP

11.26 	Section 1. Minnesota Statutes 2024, section 144A.472, subdivision 5, is amended to read:
11.27 		Subd. 5. Changes in ownership. (a) A home care license issued by the commissioner 
11.28 	may not be transferred to another party. Before acquiring ownership of or a controlling 
11.29 	interest in a home care provider business, a prospective owner must apply for a new license. 
11.30 	A change of ownership is a transfer of operational control of the home care provider business 
11.31 	and includes:
11.32 	(1) transfer of the business to a different or new corporation;
12.1 	(2) in the case of a partnership, the dissolution or termination of the partnership under 
12.2 	chapter 323A, with the business continuing by a successor partnership or other entity;
12.3 	(3) relinquishment of control of the provider to another party, including to a contract 
12.4 	management firm that is not under the control of the owner of the business' assets;
12.5 	(4) transfer of the business by a sole proprietor to another party or entity; or
12.6 	(5) transfer of ownership or control of 50 percent or more of the controlling interest of 
12.7 	a home care provider business not covered by clauses (1) to (4).
12.8 	(b) An employee who was employed by the previous owner of the home care provider 
12.9 	business prior to the effective date of a change in ownership under paragraph (a), and who 
12.10 	will be employed by the new owner in the same or a similar capacity, shall be treated as if 
12.11 	no change in employer occurred, with respect to orientation, training, tuberculosis testing, 
12.12 	background studies, and competency testing and training on the policies identified in 
12.13 	subdivision 1, clause (14), and subdivision 2, if applicable.
12.14 	(c) Notwithstanding paragraph (b), a new owner of a home care provider business must 
12.15 	ensure that employees of the provider receive and complete training and testing on any 
12.16 	provisions of policies that differ from those of the previous owner within 90 days after the 
12.17 	date of the change in ownership.
12.18 	(d) After a change of ownership, the new licensee is responsible for any outstanding 
12.19 	fines and any fines assessed following the effective date of the change of ownership. 
12.20 	Additionally, the new licensee is responsible for bringing the facility into compliance with 
12.21 	all existing ordered, imposed, or agreed-upon corrections and conditions.

12.22 	Sec. 2. Minnesota Statutes 2025 Supplement, section 144A.474, subdivision 11, is amended 
12.23 	to read:
12.24 		Subd. 11.Fines. (a) Fines and enforcement actions under this subdivision may be assessed 
12.25 	based on the level and scope of the violations described in paragraph (b) and imposed 
12.26 	immediately with no opportunity to correct the violation first as follows:
12.27 	(1) Level 1, no fines or enforcement;
12.28 	(2) Level 2, a fine of $500 per violation, in addition to any of the enforcement 
12.29 	mechanisms authorized in section 144A.475;
12.30 	(3) Level 3, a fine of $1,000 per incident, in addition to any of the enforcement 
12.31 	mechanisms authorized in section 144A.475;
13.1 	(4) Level 4, a fine of $3,000 per incident, in addition to any of the enforcement 
13.2 	mechanisms authorized in section 144A.475;
13.3 	(5) Level 5, a fine of $5,000 per violation, in addition to any enforcement mechanism 
13.4 	authorized in section 144A.475; and
13.5 	(6) for maltreatment violations for which the licensee was determined to be responsible 
13.6 	for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000. 
13.7 	A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible 
13.8 	for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury.
13.9 	The fines in clauses (1) to (5) are increased and immediate fine imposition is authorized 
13.10 	for both surveys and investigations conducted.
13.11 	When a fine is assessed against a facility for substantiated maltreatment, the commissioner 
13.12 	shall not also impose an immediate fine under this chapter for the same circumstance.
13.13 	(b) Correction orders for violations are categorized by both level and scope and fines 
13.14 	shall be assessed as follows:
13.15 	(1) level of violation:
13.16 	(i) Level 1 is a violation that will cause only minimal impact on the client and does not 
13.17 	affect health or safety;
13.18 	(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential 
13.19 	to have harmed a client's health or safety, but was not likely to cause serious injury, 
13.20 	impairment, or death;
13.21 	(iii) Level 3 is a violation that harmed a client's health or safety, or a violation that had 
13.22 	the potential to cause more than minimal harm to the client;
13.23 	(iv) Level 4 is a violation that harmed a client's health or safety, not including serious 
13.24 	injury or death, or a violation that was likely to lead to serious injury or death; and
13.25 	(v) Level 5 is a violation that results in serious injury or death; and
13.26 	(2) scope of violation:
13.27 	(i) isolated, when one or a limited number of clients are affected or one or a limited 
13.28 	number of staff are involved or the situation has occurred only occasionally;
13.29 	(ii) pattern, when more than a limited number of clients are affected, more than a limited 
13.30 	number of staff are involved, or the situation has occurred repeatedly but is not found to be 
13.31 	pervasive; and
14.1 	(iii) widespread, when problems are pervasive or represent a systemic failure that has 
14.2 	affected or has the potential to affect a large portion or all of the clients.
14.3 	(c) If the commissioner finds that the applicant or a home care provider has not corrected 
14.4 	violations by the date specified in the correction order or conditional license resulting from 
14.5 	a survey or complaint investigation, the commissioner shall provide a notice of 
14.6 	noncompliance with a correction order by email to the applicant's or provider's last known 
14.7 	email address. The noncompliance notice must list the violations not corrected.
14.8 	(d) For every violation identified by the commissioner, the commissioner shall issue an 
14.9 	immediate fine pursuant to paragraph (a). The license holder must still correct the violation 
14.10 	in the time specified. The issuance of an immediate fine can occur in addition to any 
14.11 	enforcement mechanism authorized under section 144A.475. The immediate fine may be 
14.12 	appealed as allowed under this subdivision.
14.13 	(e) The license holder must pay the fines assessed on or before the payment date specified. 
14.14 	If the license holder fails to fully comply with the order, the commissioner may issue a 
14.15 	second fine or suspend the license until the license holder complies by paying the fine. A 
14.16 	timely appeal shall stay payment of the fine until the commissioner issues a final order.
14.17 	(f) A license holder shall promptly notify the commissioner in writing when a violation 
14.18 	specified in the order is corrected. If upon reinspection the commissioner determines that 
14.19 	a violation has not been corrected as indicated by the order, the commissioner may issue a 
14.20 	second fine. The commissioner shall notify the license holder by mail to the last known 
14.21 	address in the licensing record that a second fine has been assessed. The license holder may 
14.22 	appeal the second fine as provided under this subdivision.
14.23 	(g) A home care provider that has been assessed a fine under this subdivision has a right 
14.24 	to a reconsideration or a hearing under this section and chapter 14.
14.25 	(h) When a fine has been assessed, the license holder may not avoid payment by closing, 
14.26 	selling, or otherwise transferring the licensed program to a third party the license. In such 
14.27 	an event, the license holder shall be liable for payment of the fine. In the event of a change 
14.28 	of ownership, the new licensee is responsible for any outstanding fines and any fines assessed 
14.29 	following the effective date of the change of ownership regardless of the date of the violation.
14.30 	(i) In addition to any fine imposed under this section, the commissioner may assess a 
14.31 	penalty amount based on costs related to an investigation that results in a final order assessing 
14.32 	a fine or other enforcement action authorized by this chapter.
15.1 	(j) Fines collected under paragraph (a) shall be deposited in a dedicated special revenue 
15.2 	account. On an annual basis, the balance in the special revenue account shall be appropriated 
15.3 	to the commissioner to implement the recommendations of the advisory council established 
15.4 	in section 144A.4799. The commissioner must publish on the department's website an annual 
15.5 	report on the fines assessed and collected, and how the appropriated money was allocated.

15.6 	Sec. 3. Minnesota Statutes 2024, section 144G.19, is amended by adding a subdivision to 
15.7 	read:
15.8 		Subd. 6.Correction orders and fines. After a change of ownership, the new licensee 
15.9 	is responsible for any outstanding fines and any fines assessed following the effective date 
15.10 	of the change of ownership regardless of the date of the violation. Additionally, the new 
15.11 	licensee is responsible for bringing the facility into compliance with all existing ordered, 
15.12 	imposed or agreed-upon corrections and conditions.

15.13 	Sec. 4. Minnesota Statutes 2024, section 144G.31, subdivision 6, is amended to read:
15.14 		Subd. 6.Payment of fines required. When a fine has been assessed, the licensee may 
15.15 	not avoid payment by closing, selling, or otherwise transferring the license to a third party
15.16 	the license. In such an event, the licensee shall be liable for payment of the fine. In the event 
15.17 	of a change of ownership, the new licensee is responsible for any outstanding fines and any 
15.18 	fines assessed following the effective date of the change of ownership regardless of the date 
15.19 	of the violation.

	ARTICLE 1	ACCESS TO CERTAIN RECORDS........	Page.Ln 1.12	
	ARTICLE 2	UPDATING REFERENCES........	Page.Ln 2.1	
	ARTICLE 3	USE OF PATIENT RESTRAINTS........	Page.Ln 7.6	
	ARTICLE 4	CHANGE OF OWNERSHIP........	Page.Ln 11.24