SF 4418

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/18/2026 09:27 a.m.

A bill for an act
relating to health; allowing access to certain information; removing references to
chapter 144D; requiring documentation on use of patient restraints; clarifying
change of ownership provisions; amending Minnesota Statutes 2024, sections
144.56, subdivision 2b; 144.586, subdivision 2; 144.6502, subdivision 1; 144A.161,
subdivision 1a; 144A.472, subdivision 5; 144A.72, subdivision 2; 144G.08, by
adding subdivisions; 144G.19, by adding a subdivision; 144G.31, subdivision 6;
157.17, subdivisions 2, 5; 295.50, subdivision 4; Minnesota Statutes 2025
Supplement, sections 144A.474, subdivision 11; 295.50, subdivision 9b; proposing
coding for new law in Minnesota Statutes, chapter 144G.

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

ARTICLE 1

ACCESS TO CERTAIN RECORDS

Section 1.

Minnesota Statutes 2024, section 144A.72, subdivision 2, is amended to read:

Subd. 2.

Penalties.

new text begin (a) new text end Failure to comply with this section shall subject the supplemental
nursing services agency to revocation or nonrenewal of its registration. Violations of section
144A.74 are subject to a fine equal to 200 percent of the amount billed or received in excess
of the maximum permitted under that section.

new text begin (b) The commissioner may request and must be given access to relevant information,
records, incident reports, or other documents in the possession of a facility if they are
considered necessary by the commissioner for verification purposes. The commissioner
may bring enforcement action.
new text end

ARTICLE 2

UPDATING REFERENCES

Section 1.

Minnesota Statutes 2024, section 144.56, subdivision 2b, is amended to read:

Subd. 2b.

Boarding care homes.

The commissioner shall not adopt or enforce any rule
that limits:

(1) a certified boarding care home from providing nursing services in accordance with
the home's Medicaid certification; or

(2) a noncertified boarding care home deleted text begin registered under chapter 144D deleted text end from providing
home care services in accordance with the home's registration.

Sec. 2.

Minnesota Statutes 2024, section 144.6502, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.

(b) "Commissioner" means the commissioner of health.

(c) "Department" means the Department of Health.

(d) "Electronic monitoring" means the placement and use of an electronic monitoring
device in the resident's room or private living unit in accordance with this section.

(e) "Electronic monitoring device" means a camera or other device that captures, records,
or broadcasts audio, video, or both, that is placed in a resident's room or private living unit
and is used to monitor the resident or activities in the room or private living unit.

(f) "Facility" means a facility that is:

(1) licensed as a nursing home under chapter 144A;

(2) licensed as a boarding care home under sections 144.50 to 144.56; new text begin or
new text end

deleted text begin (3) until August 1, 2021, a housing with services establishment registered under chapter
deleted text end deleted text begin 144D deleted text end deleted text begin that is either subject to chapter deleted text end deleted text begin 144G deleted text end deleted text begin or has a disclosed special unit under section
325F.72; or
deleted text end

deleted text begin (4) on or after August 1, 2021, deleted text end new text begin (3) licensed as new text end an assisted living facility new text begin under chapter
144G new text end .

(g) "Resident" means a person 18 years of age or older residing in a facility.

(h) "Resident representative" means one of the following in the order of priority listed,
to the extent the person may reasonably be identified and located:

(1) a court-appointed guardian;

(2) a health care agent as defined in section 145C.01, subdivision 2; or

(3) a person who is not an agent of a facility or of a home care provider designated in
writing by the resident and maintained in the resident's records on file with the facility.

Sec. 3.

Minnesota Statutes 2024, section 144A.161, subdivision 1a, is amended to read:

Subd. 1a.

Scope.

Where a facility is undertaking a closure, reduction, or change in
operations, deleted text begin or where a housing with services unit registered under chapter 144D is closed
because the space that it occupies is being replaced by a nursing facility bed that is being
reactivated from layaway status, deleted text end the facility and the county social services agency must
comply with the requirements of this section.

Sec. 4.

Minnesota Statutes 2024, section 157.17, subdivision 2, is amended to read:

Subd. 2.

Registration.

At the time of licensure or license renewal, a boarding and lodging
establishment or a lodging establishment that provides supportive services or health
supervision services must be registered with the commissioner, and must register annually
thereafter. The registration must include the name, address, and telephone number of the
establishment, the name of the operator, the types of services that are being provided, a
description of the residents being served, the type and qualifications of staff in the facility,
and other information that is necessary to identify the needs of the residents and the types
of services that are being provided. The commissioner shall develop and furnish to the
boarding and lodging establishment or lodging establishment the necessary form for
submitting the registration.

deleted text begin Housing with services establishments registered under chapter 144D shall be considered
registered under this section for all purposes except that:
deleted text end

deleted text begin (1) the establishments shall operate under the requirements of chapter 144D; and
deleted text end

deleted text begin (2) the criminal background check requirements of sections 299C.66 to 299C.71 apply.
The criminal background check requirements of section 144.057 apply only to personnel
providing home care services under sections 144A.43 to 144A.47 and personnel providing
hospice care under sections 144A.75 to 144A.755.
deleted text end

Sec. 5.

Minnesota Statutes 2024, section 157.17, subdivision 5, is amended to read:

Subd. 5.

Services that may not be provided in a boarding and lodging establishment
or lodging establishment.

deleted text begin Except those facilities registered under chapter 144D, deleted text end A boarding
and lodging establishment or lodging establishment may not admit or retain individuals
who:

(1) would require assistance from establishment staff because of the following needs:
bowel incontinence, catheter care, use of injectable or parenteral medications, wound care,
or dressing changes or irrigations of any kind; or

(2) require a level of care and supervision beyond supportive services or health
supervision services.

Sec. 6.

Minnesota Statutes 2024, section 295.50, subdivision 4, is amended to read:

Subd. 4.

Health care provider.

(a) "Health care provider" means:

(1) a person whose health care occupation is regulated or required to be regulated by
the state of Minnesota furnishing any or all of the following goods or services directly to a
patient or consumer: medical, surgical, optical, visual, dental, hearing, nursing services,
drugs, laboratory, diagnostic or therapeutic services;

(2) a person who provides goods and services not listed in clause (1) that qualify for
reimbursement under the medical assistance program provided under chapter 256B;

(3) a staff model health plan company;

(4) an ambulance service required to be licensed;

(5) a person who sells or repairs hearing aids and related equipment or prescription
eyewear; or

(6) a person providing patient services, who does not otherwise meet the definition of
health care provider and is not specifically excluded in clause (b), who employs or contracts
with a health care provider as defined in clauses (1) to (5) to perform, supervise, otherwise
oversee, or consult with regarding patient services.

(b) Health care provider does not include:

(1) hospitals; medical supplies distributors, except as specified under paragraph (a),
clause (5); nursing homes licensed under chapter 144A or licensed in any other jurisdiction;
wholesale drug distributors; pharmacies; surgical centers; bus and taxicab transportation,
or any other providers of transportation services other than ambulance services required to
be licensed; supervised living facilities for persons with developmental disabilities, licensed
under Minnesota Rules, parts 4665.0100 to 4665.9900; deleted text begin housing with services establishments
required to be registered under chapter 144D; deleted text end board and lodging establishments providing
only custodial services that are licensed under chapter 157 and registered under section
157.17 to provide supportive services or health supervision services; adult foster homes as
defined in Minnesota Rules, part 9555.5105; day training and habilitation services for adults
with developmental disabilities as defined in section 252.41, subdivision 3; boarding care
homes, as defined in Minnesota Rules, part 4655.0100; and adult day care centers as defined
in Minnesota Rules, part 9555.9600;

(2) home health agencies as defined in Minnesota Rules, part 9505.0175, subpart 15; a
person providing personal care new text begin assistance new text end services and supervision of personal care new text begin assistance
new text end services as defined in deleted text begin Minnesota Rules, part 9505.0335 deleted text end new text begin section 256B.0625, subdivision
19a new text end ; a person providing home care nursing services as defined in Minnesota Rules, part
9505.0360; and home care providers required to be licensed under chapter 144A for home
care services provided under chapter 144A;

(3) a person who employs health care providers solely for the purpose of providing
patient services to its employees;

(4) an educational institution that employs health care providers solely for the purpose
of providing patient services to its students if the institution does not receive fee for service
payments or payments for extended coverage; and

(5) a person who receives all payments for patient services from health care providers,
surgical centers, or hospitals for goods and services that are taxable to the paying health
care providers, surgical centers, or hospitals, as provided under section 295.53, subdivision
1, paragraph (b), clause (3) or (4), or from a source of funds that is excluded or exempt from
tax under sections 295.50 to 295.59.

Sec. 7.

Minnesota Statutes 2025 Supplement, section 295.50, subdivision 9b, is amended
to read:

Subd. 9b.

Patient services.

(a) "Patient services" means inpatient and outpatient services
and other goods and services provided by hospitals, surgical centers, or health care providers.
They include the following health care goods and services provided to a patient or consumer:

(1) bed and board;

(2) nursing services and other related services;

(3) use of hospitals, surgical centers, or health care provider facilities;

(4) medical social services;

(5) drugs, biologicals, supplies, appliances, and equipment;

(6) other diagnostic or therapeutic items or services;

(7) medical or surgical services;

(8) items and services furnished to ambulatory patients not requiring emergency care;
and

(9) emergency services.

(b) "Patient services" does not include:

(1) services provided to nursing homes licensed under chapter 144A;

(2) examinations for purposes of utilization reviews, insurance claims or eligibility,
litigation, and employment, including reviews of medical records for those purposes;

(3) services provided to and by community residential mental health facilities licensed
under section 245I.23 or Minnesota Rules, parts 9520.0500 to 9520.0670, and to and by
residential treatment programs for children with a serious mental illness licensed or certified
under chapter 245A;

(4) services provided under the following programs: day treatment services as defined
in section 245.462, subdivision 8; assertive community treatment as described in section
256B.0622; adult rehabilitative mental health services as described in section 256B.0623;
crisis response services as described in section 256B.0624; and children's therapeutic services
and supports as described in section 256B.0943;

(5) services provided to and by community mental health centers as defined in section
245.62, subdivision 2;

(6) services provided to and by assisted living programs and congregate housing
programs;

(7) hospice care services;

(8) home and community-based waivered services under chapter 256S and sections
256B.49 and 256B.501;

(9) targeted case management services under sections 256B.0621; 256B.0625,
subdivisions 20, 20a, 33, and 44; and 256B.094; and

(10) services provided to the following: supervised living facilities for persons with
developmental disabilities licensed under Minnesota Rules, parts 4665.0100 to 4665.9900;
deleted text begin housing with services establishments required to be registered under chapter deleted text end deleted text begin 144D deleted text end deleted text begin ; deleted text end board
and lodging establishments providing only custodial services that are licensed under chapter
157 and registered under section 157.17 to provide supportive services or health supervision
services; adult foster homes as defined in Minnesota Rules, part 9555.5105; day training
and habilitation services for adults with developmental disabilities as defined in section
252.41, subdivision 3; boarding care homes as defined in Minnesota Rules, part 4655.0100;
adult day care services as defined in section 245A.02, subdivision 2a; and home health
agencies as defined in Minnesota Rules, part 9505.0175, subpart 15, or licensed under
chapter 144A.

ARTICLE 3

USE OF PATIENT RESTRAINTS

Section 1.

Minnesota Statutes 2024, section 144.586, subdivision 2, is amended to read:

Subd. 2.

Postacute care discharge planning.

new text begin (a) new text end Each hospital, including hospitals
designated as critical access hospitals, must comply with the federal hospital requirements
for discharge planning new text begin , new text end which include:

(1) conducting a discharge planning evaluation that includes an evaluation of:

(i) the likelihood of the patient needing posthospital services and of the availability of
those services; and

(ii) the patient's capacity for self-care or the possibility of the patient being cared for in
the environment from which the patient entered the hospital;

(2) timely completion of the discharge planning evaluation under clause (1) by hospital
personnel so that appropriate arrangements for posthospital care are made before discharge,
and to avoid unnecessary delays in discharge;

(3) including the discharge planning evaluation under clause (1) in the patient's medical
record for use in establishing an appropriate discharge plan. The hospital must discuss the
results of the evaluation with the patient or individual acting on behalf of the patient. The
hospital must reassess the patient's discharge plan if the hospital determines that there are
factors that may affect continuing care needs or the appropriateness of the discharge plan;
and

(4) providing counseling, as needed, for the patient and family members or interested
persons to prepare them for posthospital care. The hospital must provide a list of available
Medicare-eligible home care agencies or skilled nursing facilities that serve the patient's
geographic area, or other area requested by the patient if such care or placement is indicated
and appropriate. Once the patient has designated their preferred providers, the hospital will
assist the patient in securing care covered by their health plan or within the care network.
The hospital must not specify or otherwise limit the qualified providers that are available
to the patient. The hospital must document in the patient's record that the list was presented
to the patient or to the individual acting on the patient's behalf.

new text begin (b) Each hospital, including hospitals designated as critical access hospitals, must
document in the patient's discharge plan instances when a restraint was used to manage the
patient's behavior prior to discharge, including the type of restraint, duration, and frequency.
In cases where the patient is transferred to a licensed or registered provider, the hospital
must notify the provider of the type, duration, and frequency of the restraint. "Restraint"
has the meaning given in section 144G.08, subdivision 61a.
new text end

Sec. 2.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to
read:

new text begin Subd. 26a. new text end

new text begin Imminent risk. new text end

new text begin "Imminent risk" means an immediate and impending threat
to the health, safety, or rights of an individual.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 3.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to
read:

new text begin Subd. 54a. new text end

new text begin Prone restraint. new text end

new text begin "Prone restraint" means the use of manual restraint that
places a resident in a face-down position. Prone restraint does not include the brief physical
holding of a resident who, during an emergency use of a manual restraint, rolls into a prone
position and as quickly as possible the resident is restored to a standing, sitting, or side-lying
position.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 4.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to
read:

new text begin Subd. 61a. new text end

new text begin Restraint. new text end

new text begin "Restraint" means:
new text end

new text begin (1) chemical restraint, as defined in section 245D.02, subdivision 3b;
new text end

new text begin (2) manual restraint, as defined in section 245D.02, subdivision 15a;
new text end

new text begin (3) mechanical restraint, as defined in section 245D.02, subdivision 15b; or
new text end

new text begin (4) any other form of restraint that limits the free and normal movement of body or
limbs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 5.

new text begin [144G.65] TRAINING IN EMERGENCY MANUAL RESTRAINTS.
new text end

new text begin Subdivision 1. new text end

new text begin Training. new text end

new text begin A licensee must ensure that staff who are authorized to apply
an emergency use of a manual restraint complete a minimum of four hours of training from
a qualified individual prior to assuming these responsibilities. Training must include:
new text end

new text begin (1) types of behaviors, de-escalation techniques and their value;
new text end

new text begin (2) principles of person-centered planning and service delivery as identified in section
245D.07, subdivision 1a, paragraph (b);
new text end

new text begin (3) what constitutes the use of a restraint;
new text end

new text begin (4) staff responsibilities related to: (i) prohibited procedures under section 144G.85; (ii)
why prohibited procedures are not effective for reducing or eliminating symptoms or
interfering behavior; and (iii) why prohibited procedures are not safe;
new text end

new text begin (5) the situations when staff must contact 911 services in response to an imminent risk
of harm to the resident or others; and
new text end

new text begin (6) strategies for respecting and supporting each resident's cultural preferences.
new text end

new text begin Subd. 2. new text end

new text begin Annual refresher training. new text end

new text begin The licensee must ensure that staff who apply an
emergency use of a manual restraint complete two hours of refresher training on an annual
basis covering each of the training areas listed in subdivision 1.
new text end

new text begin Subd. 3. new text end

new text begin Implementation. new text end

new text begin The assisted living facility must implement all orientation
and training topics covered in this section.
new text end

new text begin Subd. 4. new text end

new text begin Verification and documentation of orientation and training. new text end

new text begin For staff who
are authorized to apply an emergency use of a manual restraint, the assisted living facility
must retain evidence in the employee record of each staff person having completed the
orientation and training under this section.
new text end

new text begin Subd. 5. new text end

new text begin Exemption. new text end

new text begin This section does not apply to licensees who have a policy
prohibiting the use of restraints.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 6.

new text begin [144G.85] USE OF RESTRAINTS.
new text end

new text begin Subdivision 1. new text end

new text begin Use of restraints prohibited. new text end

new text begin Restraints are prohibited except as described
in subdivisions 2 and 4.
new text end

new text begin Subd. 2. new text end

new text begin Exception. new text end

new text begin Emergency use of a manual restraint is permitted only when
immediate intervention is needed to protect the resident or others from imminent risk of
physical harm and is the least restrictive intervention to address the risk. The restraint must
be imposed for the least amount of time necessary and removed when there is no longer
imminent risk of physical harm to the resident or other persons in the facility. The use of
restraint under this subdivision must:
new text end

new text begin (1) take into consideration the rights, health, and welfare of the resident;
new text end

new text begin (2) not apply pressure to the back or chest while a resident is in a prone, supine, or
side-lying position; and
new text end

new text begin (3) allow the resident to be free from prone restraint.
new text end

new text begin Subd. 3. new text end

new text begin Documentation and notification. new text end

new text begin (a) The resident's legal representative must
be notified within 12 hours of any use of an emergency use of a manual restraint and of the
circumstances that prompted the use. Notification and the use of an emergency use of a
manual restraint must be documented. If known, the advanced practice registered nurse,
physician, or physician assistant must be notified within 12 hours of any use of an emergency
use of a manual restraint.
new text end

new text begin (b) On a form developed by the commissioner, the facility must notify the commissioner
and the ombudsman for long-term care within seven calendar days of the use of any
emergency use of a manual restraint, including when any restraint is first applied or ordered.
The commissioner will monitor reported uses to detect overuse or unauthorized,
inappropriate, or ineffective use of the restraint. The form must include:
new text end

new text begin (1) the name and date of birth of the resident;
new text end

new text begin (2) the date and time of the use of the restraint;
new text end

new text begin (3) the names of staff and any residents who were involved in the incident leading up
to the emergency use of a manual restraint;
new text end

new text begin (4) a description of the incident, including the length of time the restraint was applied
and who was present before and during the incident leading up to the emergency use of a
manual restraint;
new text end

new text begin (5) a description of what less restrictive alternative measures were attempted to de-escalate
the incident and maintain safety that identifies when, how, and for how long the alternative
measures were attempted before the emergency use of a manual restraint was implemented;
new text end

new text begin (6) a description of the mental, physical, and emotional condition of the resident who
was restrained and of other persons involved in the incident leading up to, during, and
following the emergency use of a manual restraint;
new text end

new text begin (7) whether there was any injury to the resident who was restrained or other persons
involved in the incident, including staff, before or as a result of the emergency use of a
manual restraint; and
new text end

new text begin (8) whether there was a debriefing following the incident with the staff, and, if not
contraindicated, with the resident who was restrained and other persons who were involved
in or who witnessed the emergency use of a manual restraint, and the outcome of the
debriefing. If the debriefing was not conducted at the time the incident report was made,
the form should identify whether a debriefing is planned and a plan for mitigating use of
restraints in the future.
new text end

new text begin (c) A copy of the form submitted under paragraph (b) must be maintained in the resident's
record.
new text end

new text begin (d) A copy of the form submitted under paragraph (b) must be sent to the resident's
waiver case manager within seven calendar days of the use of emergency use of manual
restraints. Any use of emergency use of manual restraints on people served under section
256B.49 and chapter 256S must be documented by the case manager in the resident's support
plan, as defined in sections 256B.49, subdivision 15, and 256S.10.
new text end

new text begin (e) The use of restraints by law enforcement officers or other emergency personnel acting
in a licensed capacity does not require the facility to comply with the requirements of this
subdivision.
new text end

new text begin Subd. 4. new text end

new text begin Ordered treatment. new text end

new text begin Any use of a restraint, other than the use of an emergency
use of a manual restraint to address an imminent risk, must be the least restrictive option
and comply with the requirements for an ordered treatment under section 144G.72.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

ARTICLE 4

CHANGE OF OWNERSHIP

Section 1.

Minnesota Statutes 2024, section 144A.472, subdivision 5, is amended to read:

Subd. 5.

Changes in ownership.

(a) A home care license issued by the commissioner
may not be transferred to another party. Before acquiring ownership of or a controlling
interest in a home care provider business, a prospective owner must apply for a new license.
A change of ownership is a transfer of operational control of the home care provider business
and includes:

(1) transfer of the business to a different or new corporation;

(2) in the case of a partnership, the dissolution or termination of the partnership under
chapter 323A, with the business continuing by a successor partnership or other entity;

(3) relinquishment of control of the provider to another party, including to a contract
management firm that is not under the control of the owner of the business' assets;

(4) transfer of the business by a sole proprietor to another party or entity; or

(5) transfer of ownership or control of 50 percent or more of the controlling interest of
a home care provider business not covered by clauses (1) to (4).

(b) An employee who was employed by the previous owner of the home care provider
business prior to the effective date of a change in ownership under paragraph (a), and who
will be employed by the new owner in the same or a similar capacity, shall be treated as if
no change in employer occurred, with respect to orientation, training, tuberculosis testing,
background studies, and competency testing and training on the policies identified in
subdivision 1, clause (14), and subdivision 2, if applicable.

(c) Notwithstanding paragraph (b), a new owner of a home care provider business must
ensure that employees of the provider receive and complete training and testing on any
provisions of policies that differ from those of the previous owner within 90 days after the
date of the change in ownership.

new text begin (d) After a change of ownership, the new licensee is responsible for any outstanding
fines and any fines assessed following the effective date of the change of ownership.
Additionally, the new licensee is responsible for bringing the facility into compliance with
all existing ordered, imposed, or agreed-upon corrections and conditions.
new text end

Sec. 2.

Minnesota Statutes 2025 Supplement, section 144A.474, subdivision 11, is amended
to read:

Subd. 11.

Fines.

(a) Fines and enforcement actions under this subdivision may be assessed
based on the level and scope of the violations described in paragraph (b) and imposed
immediately with no opportunity to correct the violation first as follows:

(1) Level 1, no fines or enforcement;

(2) Level 2, a fine of $500 per violation, in addition to any of the enforcement
mechanisms authorized in section 144A.475;

(3) Level 3, a fine of $1,000 per incident, in addition to any of the enforcement
mechanisms authorized in section 144A.475;

(4) Level 4, a fine of $3,000 per incident, in addition to any of the enforcement
mechanisms authorized in section 144A.475;

(5) Level 5, a fine of $5,000 per violation, in addition to any enforcement mechanism
authorized in section 144A.475; and

(6) for maltreatment violations for which the licensee was determined to be responsible
for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000.
A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible
for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury.

The fines in clauses (1) to (5) are increased and immediate fine imposition is authorized
for both surveys and investigations conducted.

When a fine is assessed against a facility for substantiated maltreatment, the commissioner
shall not also impose an immediate fine under this chapter for the same circumstance.

(b) Correction orders for violations are categorized by both level and scope and fines
shall be assessed as follows:

(1) level of violation:

(i) Level 1 is a violation that will cause only minimal impact on the client and does not
affect health or safety;

(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
to have harmed a client's health or safety, but was not likely to cause serious injury,
impairment, or death;

(iii) Level 3 is a violation that harmed a client's health or safety, or a violation that had
the potential to cause more than minimal harm to the client;

(iv) Level 4 is a violation that harmed a client's health or safety, not including serious
injury or death, or a violation that was likely to lead to serious injury or death; and

(v) Level 5 is a violation that results in serious injury or death; and

(2) scope of violation:

(i) isolated, when one or a limited number of clients are affected or one or a limited
number of staff are involved or the situation has occurred only occasionally;

(ii) pattern, when more than a limited number of clients are affected, more than a limited
number of staff are involved, or the situation has occurred repeatedly but is not found to be
pervasive; and

(iii) widespread, when problems are pervasive or represent a systemic failure that has
affected or has the potential to affect a large portion or all of the clients.

(c) If the commissioner finds that the applicant or a home care provider has not corrected
violations by the date specified in the correction order or conditional license resulting from
a survey or complaint investigation, the commissioner shall provide a notice of
noncompliance with a correction order by email to the applicant's or provider's last known
email address. The noncompliance notice must list the violations not corrected.

(d) For every violation identified by the commissioner, the commissioner shall issue an
immediate fine pursuant to paragraph (a). The license holder must still correct the violation
in the time specified. The issuance of an immediate fine can occur in addition to any
enforcement mechanism authorized under section 144A.475. The immediate fine may be
appealed as allowed under this subdivision.

(e) The license holder must pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies by paying the fine. A
timely appeal shall stay payment of the fine until the commissioner issues a final order.

(f) A license holder shall promptly notify the commissioner in writing when a violation
specified in the order is corrected. If upon reinspection the commissioner determines that
a violation has not been corrected as indicated by the order, the commissioner may issue a
second fine. The commissioner shall notify the license holder by mail to the last known
address in the licensing record that a second fine has been assessed. The license holder may
appeal the second fine as provided under this subdivision.

(g) A home care provider that has been assessed a fine under this subdivision has a right
to a reconsideration or a hearing under this section and chapter 14.

(h) When a fine has been assessed, the license holder may not avoid payment by closing deleted text begin ,
selling, or otherwise transferring the licensed program to a third party deleted text end new text begin the license new text end . In such
an event, the license holder shall be liable for payment of the fine. new text begin In the event of a change
of ownership, the new licensee is responsible for any outstanding fines and any fines assessed
following the effective date of the change of ownership regardless of the date of the violation.
new text end

(i) In addition to any fine imposed under this section, the commissioner may assess a
penalty amount based on costs related to an investigation that results in a final order assessing
a fine or other enforcement action authorized by this chapter.

(j) Fines collected under paragraph (a) shall be deposited in a dedicated special revenue
account. On an annual basis, the balance in the special revenue account shall be appropriated
to the commissioner to implement the recommendations of the advisory council established
in section 144A.4799. The commissioner must publish on the department's website an annual
report on the fines assessed and collected, and how the appropriated money was allocated.

Sec. 3.

Minnesota Statutes 2024, section 144G.19, is amended by adding a subdivision to
read:

new text begin Subd. 6. new text end

new text begin Correction orders and fines. new text end

new text begin After a change of ownership, the new licensee
is responsible for any outstanding fines and any fines assessed following the effective date
of the change of ownership regardless of the date of the violation. Additionally, the new
licensee is responsible for bringing the facility into compliance with all existing ordered,
imposed or agreed-upon corrections and conditions.
new text end

Sec. 4.

Minnesota Statutes 2024, section 144G.31, subdivision 6, is amended to read:

Subd. 6.

Payment of fines required.

When a fine has been assessed, the licensee may
not avoid payment by closing deleted text begin , selling, or otherwise transferring the license to a third party deleted text end new text begin
the license new text end . In such an event, the licensee shall be liable for payment of the fine. new text begin In the event
of a change of ownership, the new licensee is responsible for any outstanding fines and any
fines assessed following the effective date of the change of ownership regardless of the date
of the violation.
new text end