SF 4476
Introduction - 94th Legislature (2025 - 2026)
Posted on 03/18/2026 09:17 a.m.
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A bill for an act
relating to health care facilities; modifying the parties who may be awarded fees
and expenses in certain proceedings involving the state; modifying requirements
for assisted living facilities to provide residents with a means to request assistance;
exempting assisted living facilities from the provider tax; amending Minnesota
Statutes 2024, sections 144G.41, subdivision 1, by adding a subdivision; 295.50,
subdivision 4; Minnesota Statutes 2025 Supplement, sections 15.471, subdivision
6; 295.50, subdivision 9b.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2025 Supplement, section 15.471, subdivision 6, is amended
to read:
Subd. 6.
Party.
(a) Except as modified by paragraph (b), "party" means a person named
or admitted as a party, or seeking and entitled to be admitted as a party, in a court action or
contested case proceeding, or a person admitted by an administrative law judge for limited
purposes, and who is:
(1) an unincorporated business, partnership, corporation, association, or organization,
having not more than 500 employees at the time the civil action was filed or the contested
case proceeding was initiated; and
(2) an unincorporated business, partnership, corporation, association, or organization
whose annual revenues did not exceed deleted text begin $7,000,000deleted text end new text begin $13,500,000new text end at the time the civil action
was filed or the contested case proceeding was initiated.
(b) "Party" also includes a partner, officer, shareholder, member, or owner of an entity
described in paragraph (a), clauses (1) and (2).
(c) deleted text begin "deleted text end Partydeleted text begin "deleted text end does not include a person providing services pursuant to licensure or
reimbursement on a cost basis by deleted text begin the Department of Health,deleted text end the Department of Human
Servicesdeleted text begin ,deleted text end or Direct Care and Treatment when that person is named or admitted or seeking
to be admitted as a party in a matter which involves the licensing or reimbursement rates,
procedures, or methodology applicable to those services.
Sec. 2.
Minnesota Statutes 2024, section 144G.41, subdivision 1, is amended to read:
Subdivision 1.
Minimum requirements.
All assisted living facilities shall:
(1) distribute to residents the assisted living bill of rights;
(2) provide services in a manner that complies with the Nurse Practice Act in sections
148.171 to 148.285;
(3) utilize a person-centered planning and service delivery process;
(4) have and maintain a system for delegation of health care activities to unlicensed
personnel by a registered nurse, including supervision and evaluation of the delegated
activities as required by the Nurse Practice Act in sections 148.171 to 148.285;
(5) new text begin except as specified in subdivision 1c, new text end provide a means for residents to request
assistance for health and safety needs 24 hours per day, seven days per weeknew text begin . A facility
may use person-centered strategies to provide a means for residents to request assistance
and, if effective, may allow residents to use technological devices to request assistancenew text end ;
(6) allow residents the ability to furnish and decorate the resident's unit within the terms
of the assisted living contract;
(7) permit residents access to food at any time;
(8) allow residents to choose the resident's visitors and times of visits;
(9) allow the resident the right to choose a roommate if sharing a unit;
(10) notify the resident of the resident's right to have and use a lockable door to the
resident's unit. The licensee shall provide the locks on the unit. Only a staff member with
a specific need to enter the unit shall have keys, and advance notice must be given to the
resident before entrance, when possible. An assisted living facility must not lock a resident
in the resident's unit;
(11) develop and implement a staffing plan for determining its staffing level that:
(i) includes an evaluation, to be conducted at least twice a year, of the appropriateness
of staffing levels in the facility;
(ii) ensures sufficient staffing at all times to meet the scheduled and reasonably
foreseeable unscheduled needs of each resident as required by the residents' assessments
and service plans on a 24-hour per day basis; and
(iii) ensures that the facility can respond promptly and effectively to individual resident
emergencies and to emergency, life safety, and disaster situations affecting staff or residents
in the facility;
(12) ensure that one or more persons are available 24 hours per day, seven days per
week, who are responsible for responding to the requests of residents for assistance with
health or safety needs. Such persons must be:
(i) awake;
(ii) located in the same building, in an attached building, or on a contiguous campus
with the facility in order to respond within a reasonable amount of time;
(iii) capable of communicating with residents;
(iv) capable of providing or summoning the appropriate assistance; and
(v) capable of following directions; and
(13) provide staff access to an on-call registered nurse 24 hours per day, seven days per
week.
Sec. 3.
Minnesota Statutes 2024, section 144G.41, is amended by adding a subdivision to
read:
new text begin Subd. 1c. new text end
new text begin Exception to requirement to provide means to request assistance. new text end
new text begin
A facility
is not required to provide a means to request assistance for health and safety needs 24 hours
per day, seven days per week, to a resident who:
new text end
new text begin
(1) has moderate to severe cognitive impairment, including but not limited to dementia;
and
new text end
new text begin
(2) based on a nursing assessment conducted under section 144G.70, subdivision 2,
cannot reliably use a telephone, bell, call light, pull cord, pendant, or other alerting device
to request assistance.
new text end
Sec. 4.
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 deleted text begin clausedeleted text end new text begin paragraphnew text end (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 144Ddeleted text end new text begin assisted living facilities licensed under chapter
144Gnew 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 services and supervision of personal care services as defined
in Minnesota Rules, part 9505.0335; 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. 5.
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) deleted text begin "deleted text end Patient servicesdeleted text begin "deleted text end 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 144Ddeleted text end new text begin assisted
living facilities licensed under chapter 144Gnew 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.