Engrossments
Introduction		Posted on 03/07/2006
1st Engrossment		Posted on 05/08/2006
2nd Engrossment		Posted on 05/11/2006

ARTICLE 1

ASSISTED LIVING

Section 1.

new text begin [144A.441] ASSISTED LIVING BILL OF RIGHTS ADDENDUM.
new text end

new text begin Assisted living clients, as defined in section 144G.01, subdivision 3, shall be
provided with the home care bill of rights required by section 144A.44, except that the
home care bill of rights provided to these clients must include the following provision in
place of the provision in section 144A.44, subdivision 1, clause (16):
new text end

new text begin "(16) the right to reasonable, advance notice of changes in services or charges,
including at least 30 days' advance notice of the termination of a service by a provider,
except in cases where:
new text end

new text begin (i) the recipient of services engages in conduct that alters the conditions of
employment as specified in the employment contract between the home care provider
and the individual providing home care services, or creates an abusive or unsafe work
environment for the individual providing home care services;
new text end

new text begin (ii) an emergency for the informal caregiver or a significant change in the recipient's
condition has resulted in service needs that exceed the current service provider agreement
and that cannot be safely met by the home care provider; or
new text end

new text begin (iii) the provider has not received payment for services, for which at least ten days'
advance notice of the termination of a service shall be provided."
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 2.

new text begin [144A.442] TERMINATION OF HOME CARE SERVICES FOR
ASSISTED LIVING CLIENTS.
new text end

new text begin If an arranged home care provider, as defined in section 144D.01, subdivision 2a,
who is not also Medicare certified terminates a service agreement or service plan with
an assisted living client, as defined in section 144G.01, subdivision 3, the home care
provider shall provide the assisted living client and the legal or designated representatives
of the client, if any, with a written notice of termination which includes the following
information:
new text end

new text begin (1) the effective date of termination;
new text end

new text begin (2) the reason for termination;
new text end

new text begin (3) without extending the termination notice period, an affirmative offer to meet with
the assisted living client or client representatives within no more than five business days of
the date of the termination notice to discuss the termination;
new text end

new text begin (4) contact information for a reasonable number of other home care providers in
the geographic area of the assisted living client, as required by Minnesota Rules, part
4668.0050;
new text end

new text begin (5) a statement that the provider will participate in a coordinated transfer of the care
of the client to another provider or caregiver, as required by section 144A.44, subdivision
1, clause (17);
new text end

new text begin (6) the name and contact information of a representative of the home care provider
with whom the client may discuss the notice of termination;
new text end

new text begin (7) a copy of the home care bill of rights; and
new text end

new text begin (8) a statement that the notice of termination of home care services by the home care
provider does not constitute notice of termination of the housing with services contract
with a housing with services establishment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 3.

Minnesota Statutes 2004, section 144A.4605, is amended to read:

144A.4605 deleted text begin ASSISTED LIVING HOME CAREdeleted text end new text begin CLASS Fnew text end PROVIDER.

Subdivision 1.

Definitions.

For purposes of this section, the term "deleted text begin assisted
livingdeleted text end new text begin class Fnew text end home care provider" means a home care provider who provides nursing
services, delegated nursing services, other services performed by unlicensed personnel, or
central storage of medications solely for residents of one or more housing with services
establishments registered under chapter 144D.

Subd. 2.

deleted text begin Assisted livingdeleted text end new text begin Class Fnew text end home care license established.

A home care
provider license category entitled deleted text begin assisted livingdeleted text end new text begin class Fnew text end home care provider is hereby
established. A home care provider may obtain deleted text begin an assisted livingdeleted text end new text begin a class Fnew text end license if the
program meets the following requirements:

(a) nursing services, delegated nursing services, other services performed by
unlicensed personnel, or central storage of medications under the deleted text begin assisted livingdeleted text end new text begin class
Fnew text end license are provided solely for residents of one or more housing with services
establishments registered under chapter 144D;

(b) unlicensed personnel perform home health aide and home care aide tasks
identified in Minnesota Rules, parts 4668.0100, subparts 1 and 2, and 4668.0110, subpart 1.
Qualifications to perform these tasks shall be established in accordance with subdivision 3;

(d) notwithstanding Minnesota Rules, part 4668.0160, subpart 6, item D, client
records shall include:

(1) daily records or a weekly summary of home care services provided;

(2) documentation each time medications are administered to a client; and

(3) documentation on the day of occurrence of any significant change in the client's
status or any significant incident, such as a fall or refusal to take medications.

All entries must be signed by the staff providing the services and entered into the
record no later than two weeks after the end of the service day, except as specified in
clauses (2) and (3);

(e) medication and treatment orders, if any, are included in the client record and
are renewed at least every 12 months, or more frequently when indicated by a clinical
assessment;

(f) the central storage of medications in a housing with services establishment
registered under chapter 144D is managed under a system that is established by a
registered nurse and addresses the control of medications, handling of medications,
medication containers, medication records, and disposition of medications; and

(g) in other respects meets the requirements established by rules adopted under
sections 144A.45 to 144A.47.

Subd. 3.

Training or competency evaluations required.

(a) Unlicensed personnel
must:

(1) satisfy the training or competency requirements established by rule under
sections 144A.45 to 144A.47; or

(2) be trained or determined competent by a registered nurse in each task identified
under Minnesota Rules, part 4668.0100, subparts 1 and 2, when offered to clients in a
housing with services establishment as described in paragraphs (b) to (e).

(b) Training for tasks identified under Minnesota Rules, part 4668.0100, subparts
1 and 2, shall use a curriculum which meets the requirements in Minnesota Rules, part
4668.0130.

(c) Competency evaluations for tasks identified under Minnesota Rules, part
4668.0100, subparts 1 and 2, must be completed and documented by a registered nurse.

(d) Unlicensed personnel performing tasks identified under Minnesota Rules, part
4668.0100, subparts 1 and 2, shall be trained or demonstrate competency in the following
topics:

(1) an overview of sections 144A.43 to 144A.47 and rules adopted thereunder;

(2) recognition and handling of emergencies and use of emergency services;

(3) reporting the maltreatment of vulnerable minors or adults under sections 626.556
and 626.557;

(4) home care bill of rights;

(5) handling of clients' complaints and reporting of complaints to the Office of
Health Facility Complaints;

(6) services of the ombudsman for older Minnesotans;

(7) observation, reporting, and documentation of client status and of the care or
services provided;

(8) basic infection control;

(9) maintenance of a clean, safe, and healthy environment;

(10) communication skills;

(11) basic elements of body functioning and changes in body function that must be
reported to an appropriate health care professional; and

(12) physical, emotional, and developmental needs of clients, and ways to work with
clients who have problems in these areas, including respect for the client, the client's
property, and the client's family.

(e) Unlicensed personnel who administer medications must comply with rules
relating to the administration of medications in Minnesota Rules, part 4668.0100, subpart
2, except that unlicensed personnel need not comply with the requirements of Minnesota
Rules, part 4668.0100, subpart 5.

Subd. 4.

License required.

(a) A housing with services establishment registered
under chapter 144D that is required to obtain a home care license must obtain deleted text begin an assisted
livingdeleted text end new text begin a class Fnew text end home care license according to this section or a class A or class deleted text begin Edeleted text end new text begin Bnew text end license
according to rule. A housing with services establishment that obtains a class deleted text begin Edeleted text end new text begin Bnew text end license
under this subdivision remains subject to the payment limitations in sections 256B.0913,
subdivision 5f, paragraph (b), and 256B.0915, subdivision 3d.

(b) A board and lodging establishment registered for special services as of December
31, 1996, and also registered as a housing with services establishment under chapter
144D, must deliver home care services according to sections 144A.43 to 144A.47, and
may apply for a waiver from requirements under Minnesota Rules, parts 4668.0002 to
4668.0240, to operate a licensed agency under the standards of section 157.17. Such
waivers as may be granted by the department will expire upon promulgation of home care
rules implementing section 144A.4605.

deleted text begin (c) An adult foster care provider licensed by the Department of Human Services and
registered under chapter 144D may continue to provide health-related services under its
foster care license until the promulgation of home care rules implementing this section.
deleted text end

deleted text begin (d) An assisted livingdeleted text end new text begin (c) A class Fnew text end home care provider licensed under this section
must comply with the disclosure provisions of section 325F.72 to the extent they are
applicable.

Subd. 5.

License fees.

The license fees for deleted text begin assisted livingdeleted text end new text begin class Fnew text end home care
providers shall be as follows:

(1) $125 annually for those providers serving a monthly average of 15 or fewer
clients, and for deleted text begin assisted livingdeleted text end new text begin class Fnew text end providers of all sizes during the first year of
operation;

(2) $200 annually for those providers serving a monthly average of 16 to 30 clients;

(3) $375 annually for those providers serving a monthly average of 31 to 50 clients;
and

(4) $625 annually for those providers serving a monthly average of 51 or more
clients.

Subd. 6.

Waiver.

Upon request of the home care provider, the commissioner may
waive the provisions of this section relating to registered nurse duties.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 4.

Minnesota Statutes 2004, section 144D.01, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Arranged home care provider. new text end

new text begin "Arranged home care provider" means a
home care provider licensed under Minnesota Rules, chapter 4668, that provides services
to some or all of the residents of a housing with services establishment and that is either
the establishment itself or another entity with which the establishment has an arrangement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 5.

Minnesota Statutes 2004, section 144D.015, is amended to read:

144D.015 ASSISTED LIVING FACILITY new text begin OR ASSISTED LIVING
RESIDENCE new text end DEFINITION FOR PURPOSES OF LONG-TERM CARE
INSURANCE.

For purposes of consistency with terminology commonly used in long-term
care insurance policiesnew text begin and notwithstanding chapter 144Gnew text end , a housing with services
establishment that is registered under section 144D.03 and that holds, or deleted text begin contractsdeleted text end new text begin makes
arrangementsnew text end with an individual or entity that holdsdeleted text begin , adeleted text end new text begin any type ofnew text end home care license and
all other licenses, permits, registrations, or other governmental approvals legally required
for delivery of the services the establishment offers or provides to its residents, constitutes
an "assisted living facility" or "assisted living residence."

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 6.

Minnesota Statutes 2004, section 144D.02, is amended to read:

144D.02 REGISTRATION REQUIRED.

No entity may establish, operate, conduct, or maintain deleted text begin an elderlydeleted text end new text begin anew text end housing with
services establishment in this state without registering and operating as required in
sections 144D.01 to 144D.06.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 7.

Minnesota Statutes 2004, section 144D.03, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Surcharge for injunctive relief actions. new text end

new text begin The commissioner shall assess
each housing with services establishment that offers or provides assisted living under
chapter 144G a surcharge on the annual registration fee paid under subdivision 1, to pay
for the commissioner's costs related to bringing actions for injunctive relief under section
144G.02, subdivision 2, paragraph (b), on or after July 1, 2007. The commissioner shall
assess surcharges using a sliding scale under which the surcharge amount increases with
the client capacity of an establishment. The commissioner shall adjust the surcharge as
necessary to recover the projected costs of bringing actions for injunctive relief. The
commissioner shall adjust the surcharge in accordance with section 16A.1285.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for annual registrations submitted
on or after July 1, 2007.
new text end

Sec. 8.

Minnesota Statutes 2004, section 144D.03, subdivision 2, is amended to read:

Subd. 2.

Registration information.

The establishment shall provide the following
information to the commissioner in order to be registered:

(1) the business name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners are not natural persons, identification of the type of business entity
of the owner or owners, and the names and addresses of the officers and members of the
governing body, or comparable persons for partnerships, limited liability corporations, or
other types of business organizations of the owner or owners;

(3) the name and mailing address of the managing agent, whether through
management agreement or lease agreement, of the establishment, if different from the
owner or owners, and the name of the on-site manager, if any;

(4) verification that the establishment has entered into deleted text begin an elderlydeleted text end new text begin anew text end housing with
services contract, as required in section 144D.04, with each resident or resident's
representative;

(5) verification that the establishment is complying with the requirements of section
325F.72, if applicable;

(6) the name and address of at least one natural person who shall be responsible
for dealing with the commissioner on all matters provided for in sections 144D.01 to
144D.06, and on whom personal service of all notices and orders shall be made, and who
shall be authorized to accept service on behalf of the owner or owners and the managing
agent, if any; and

(7) the signature of the authorized representative of the owner or owners or, if
the owner or owners are not natural persons, signatures of at least two authorized
representatives of each owner, one of which shall be an officer of the owner.

Personal service on the person identified under clause (6) by the owner or owners in
the registration shall be considered service on the owner or owners, and it shall not be a
defense to any action that personal service was not made on each individual or entity. The
designation of one or more individuals under this subdivision shall not affect the legal
responsibility of the owner or owners under sections 144D.01 to 144D.06.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 9.

Minnesota Statutes 2004, section 144D.04, is amended to read:

144D.04 deleted text begin ELDERLYdeleted text end HOUSING WITH SERVICES CONTRACTS.

Subdivision 1.

Contract required.

No deleted text begin elderlydeleted text end housing with services establishment
may operate in this state unless a written deleted text begin elderlydeleted text end housing with services contract, as defined
in subdivision 2, is executed between the establishment and each resident or resident's
representative and unless the establishment operates in accordance with the terms of the
contract. The resident or the resident's representative shall be given a complete copy of
the contract and all supporting documents and attachments and any changes whenever
changes are made.

Subd. 2.

Contents of contract.

deleted text begin An elderlydeleted text end new text begin Anew text end housing with services contract, which
need not be entitled as such to comply with this section, shall include at least the following
elements in itself or through supporting documents or attachments:

(1) new text begin the new text end name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners is not a natural person, identification of the type of business entity
of the owner or owners;

(3) the name and mailing address of the managing agent, through management
agreement or lease agreement, of the establishment, if different from the owner or owners;

(4) the name and address of at least one natural person who is authorized to accept
service new text begin of process new text end on behalf of the owner or owners and managing agent;

(5)new text begin anew text end statement describing the registration and licensure status of the establishment
and any provider providing health-related or supportive services under an arrangement
with the establishment;

(6)new text begin thenew text end term of the contract;

(7) new text begin a new text end description of the services to be provided to the resident in the base rate to
be paid by resident;

(8) new text begin a new text end description of any additional servicesnew text begin , including home care services,new text end available
for an additional fee from the establishment directly or through arrangements with the
establishmentnew text begin , and a schedule of fees charged for these servicesnew text end ;

deleted text begin (9) fee schedules outlining the cost of any additional services;
deleted text end

deleted text begin (10)deleted text end new text begin (9) anew text end description of the process through which the contract may be modified,
amended, or terminated;

deleted text begin (11)deleted text end new text begin (10) anew text end description of the establishment's complaint resolution process available
to residents including the toll-free complaint line for the Office of Ombudsman for Older
Minnesotans;

deleted text begin (12)deleted text end new text begin (11)new text end the resident's designated representative, if any;

deleted text begin (13)deleted text end new text begin (12)new text end the establishment's referral procedures if the contract is terminated;

deleted text begin (14) criteriadeleted text end new text begin (13) requirements of residencynew text end used by the establishment to determine
who may new text begin reside or new text end continue to reside in the deleted text begin elderlydeleted text end housing with services establishment;

deleted text begin (15)deleted text end new text begin (14)new text end billing and payment procedures and requirements;

deleted text begin (16)deleted text end new text begin (15) anew text end statement regarding the ability of residents to receive services from
service providers with whom the establishment does not have an arrangement; deleted text begin and
deleted text end

deleted text begin (17)deleted text end new text begin (16) anew text end statement regarding the availability of public funds for payment for
residence or services in the establishmentnew text begin ; and
new text end

new text begin (17) a statement regarding the availability of and contact information for long-
term care consultation services under section 256B.0911 in the county in which the
establishment is locatednew text end .

Subd. 3.

Contracts in permanent files.

deleted text begin Elderlydeleted text end Housing with services contracts
and related documents executed by each resident or resident's representative shall be
maintained by the establishment in files from the date of execution until three years after
the contract is terminated. The contracts and the written disclosures required under section
325F.72, if applicable, shall be made available for on-site inspection by the commissioner
upon request at any time.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 10.

new text begin [144D.045] INFORMATION CONCERNING ARRANGED HOME
CARE PROVIDERS.
new text end

new text begin If a housing with services establishment has one or more arranged home care
providers, the establishment shall arrange to have that arranged home care provider deliver
the following information in writing to a prospective resident, prior to the date on which
the prospective resident executes a contract with the establishment or the prospective
resident's move-in date, whichever is earlier:
new text end

new text begin (1) the name, mailing address, and telephone number of the arranged home care
provider;
new text end

new text begin (2) the name and mailing address of at least one natural person who is authorized to
accept service of process on behalf of the entity described in clause (1);
new text end

new text begin (3) a description of the process through which a home care service agreement or
service plan between a resident and the arranged home care provider, if any, may be
modified, amended, or terminated;
new text end

new text begin (4) the arranged home care provider's billing and payment procedures and
requirements; and
new text end

new text begin (5) any limits to the services available from the arranged provider.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 11.

Minnesota Statutes 2004, section 144D.05, is amended to read:

144D.05 AUTHORITY OF COMMISSIONER.

The commissioner shall, upon receipt of information which may indicate the failure
of the deleted text begin elderlydeleted text end housing with services establishment, a resident, a resident's representative,
or a service provider to comply with a legal requirement to which one or more of them
may be subject, make appropriate referrals to other governmental agencies and entities
having jurisdiction over the subject matter. The commissioner may also make referrals
to any public or private agency the commissioner considers available for appropriate
assistance to those involved.

The commissioner shall have standing to bring an action for injunctive relief
in the district court in the district in which an establishment is located to compel the
deleted text begin elderlydeleted text end housing with services establishment to meet the requirements of this chapter or
other requirements of the state or of any county or local governmental unit to which the
establishment is otherwise subject. Proceedings for securing an injunction may be brought
by the commissioner through the attorney general or through the appropriate county
attorney. The sanctions in this section do not restrict the availability of other sanctions.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 12.

Minnesota Statutes 2004, section 144D.065, is amended to read:

144D.065 ESTABLISHMENTS THAT SERVE PERSONS WITH
ALZHEIMER'S DISEASE OR RELATED DISORDERS.

(a) If a housing with services establishment registered under this chapter markets or
otherwise promotes services for persons with Alzheimer's disease or related disorders,
whether in a segregated or general unit, the deleted text begin facility'sdeleted text end new text begin establishment'snew text end direct care staff and
their supervisors must be trained in dementia care.

(b) Areas of required training include:

(1) an explanation of Alzheimer's disease and related disorders;

(2) assistance with activities of daily living;

(3) problem solving with challenging behaviors; and

(4) communication skills.

(c) The establishment shall provide to consumers in written or electronic form a
description of the training program, the categories of employees trained, the frequency
of training, and the basic topics covered. This information satisfies the disclosure
requirements of section 325F.72, subdivision 2, clause (4).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 13.

new text begin [144G.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope; other definitions. new text end

new text begin For purposes of sections 144G.01 to
144G.05, the following definitions apply. In addition, the definitions provided in section
144D.01 also apply to sections 144G.01 to 144G.05.
new text end

new text begin Subd. 2. new text end

new text begin Assisted living. new text end

new text begin "Assisted living" means a service or package of services
advertised, marketed, or otherwise described, offered, or promoted using the phrase
"assisted living" either alone or in combination with other words, whether orally or in
writing, and which is subject to the requirements of this chapter.
new text end

new text begin Subd. 3. new text end

new text begin Assisted living client. new text end

new text begin "Assisted living client" or "client" means a housing
with services resident who receives assisted living that is subject to the requirements
of this chapter.
new text end

new text begin Subd. 4. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of health.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 14.

new text begin [144G.02] ASSISTED LIVING; PROTECTED TITLE; RESTRICTION
ON USE; REGULATORY FUNCTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Protected title; restriction on use. new text end

new text begin No person or entity may use the
phrase "assisted living," whether alone or in combination with other words and whether
orally or in writing, to advertise, market, or otherwise describe, offer, or promote itself, or
any housing, service, service package, or program that it provides within this state, unless
the person or entity is a housing with services establishment that meets the requirements of
this chapter, or is a person or entity that provides some or all components of assisted living
that meet the requirements of this chapter. A person or entity entitled to use the phrase
"assisted living" shall use the phrase only in the context of its participation in assisted
living that meets the requirements of this chapter. A housing with services establishment
offering or providing assisted living that is not made available to residents in all of its
housing units shall identify the number or location of the units in which assisted living
is available, and may not use the term "assisted living" in the name of the establishment
registered with the commissioner under chapter 144D, or in the name the establishment
uses to identify itself to residents or the public.
new text end

new text begin Subd. 2. new text end

new text begin Authority of commissioner. new text end

new text begin (a) The commissioner, upon receipt of
information that may indicate the failure of a housing with services establishment, the
arranged home care provider, an assisted living client, or an assisted living client's
representative to comply with a legal requirement to which one or more of the entities may
be subject, shall make appropriate referrals to other governmental agencies and entities
having jurisdiction over the subject matter. The commissioner may also make referrals
to any public or private agency the commissioner considers available for appropriate
assistance to those involved.
new text end

new text begin (b) In addition to the authority with respect to licensed home care providers under
sections 144A.45 and 144A.46 and with respect to housing with services establishments
under chapter 144D, the commissioner shall have standing to bring an action for injunctive
relief in the district court in the district in which a housing with services establishment
is located to compel the housing with services establishment or the arranged home care
provider to meet the requirements of this chapter or other requirements of the state or of
any county or local governmental unit to which the establishment or arranged home care
provider is otherwise subject. Proceedings for securing an injunction may be brought by
the commissioner through the attorney general or through the appropriate county attorney.
The sanctions in this section do not restrict the availability of other sanctions.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 15.

new text begin [144G.03] ASSISTED LIVING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Verification in annual registration. new text end

new text begin A registered housing with
services establishment using the phrase "assisted living," pursuant to section 144G.02,
subdivision 1, shall verify to the commissioner in its annual registration pursuant to chapter
144D that the establishment is complying with sections 144G.01 to 144G.05, as applicable.
new text end

new text begin Subd. 2. new text end

new text begin Minimum requirements for assisted living. new text end

new text begin (a) Assisted living shall
be provided or made available only to individuals residing in a registered housing with
services establishment. Except as expressly stated in this chapter, a person or entity
offering assisted living may define the available services and may offer assisted living to
all or some of the residents of a housing with services establishment. The services that
comprise assisted living may be provided or made available directly by a housing with
services establishment or by persons or entities with which the housing with services
establishment has made arrangements.
new text end

new text begin (b) A person or entity entitled to use the phrase "assisted living," according to
section 144G.02, subdivision 1, shall do so only with respect to a housing with services
establishment, or a service, service package, or program available within a housing with
services establishment that, at a minimum:
new text end

new text begin (1) provides or makes available health-related services under a class A or class F
home care license. At a minimum, health-related services must include:
new text end

new text begin (i) assistance with self-administration of medication as defined in Minnesota Rules,
part 4668.0003, subpart 2a, or medication administration as defined in Minnesota Rules,
part 4668.0003, subpart 21a; and
new text end

new text begin (ii) assistance with at least three of the following seven activities of daily living:
bathing, dressing, grooming, eating, transferring, continence care, and toileting.
new text end

new text begin All health-related services shall be provided in a manner that complies with applicable
home care licensure requirements in chapter 144A, sections 148.171 to 148.285, and
Minnesota Rules, chapter 4668;
new text end

new text begin (2) provides necessary assessments of the physical and cognitive needs of assisted
living clients by a registered nurse, as required by applicable home care licensure
requirements in chapter 144A, sections 148.171 to 148.285, and Minnesota Rules, chapter
4668;
new text end

new text begin (3) has and maintains a system for delegation of health care activities to unlicensed
assistive health care personnel by a registered nurse, including supervision and evaluation
of the delegated activities as required by applicable home care licensure requirements in
chapter 144A, sections 148.171 to 148.285, and Minnesota Rules, chapter 4668;
new text end

new text begin (4) provides staff access to an on-call registered nurse 24 hours per day, seven
days per week;
new text end

new text begin (5) has and maintains a system to check on each assisted living client at least daily;
new text end

new text begin (6) provides a means for assisted living clients to request assistance for health and
safety needs 24 hours per day, seven days per week, from the establishment or a person or
entity with which the establishment has made arrangements;
new text end

new text begin (7) has a person or persons available 24 hours per day, seven days per week, who
is responsible for responding to the requests of assisted living clients for assistance with
health or safety needs, who shall be:
new text end

new text begin (i) awake;
new text end

new text begin (ii) located in the same building, in an attached building, or on a contiguous campus
with the housing with services establishment in order to respond within a reasonable
amount of time;
new text end

new text begin (iii) capable of communicating with assisted living clients;
new text end

new text begin (iv) capable of recognizing the need for assistance;
new text end

new text begin (v) capable of providing either the assistance required or summoning the appropriate
assistance; and
new text end

new text begin (vi) capable of following directions;
new text end

new text begin (8) offers to provide or make available at least the following supportive services
to assisted living clients:
new text end

new text begin (i) two meals per day;
new text end

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

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

new text begin (iv) upon the request of the client, reasonable assistance with arranging for
transportation to medical and social services appointments, and the name of or other
identifying information about the person or persons responsible for providing this
assistance;
new text end

new text begin (v) upon the request of the client, reasonable assistance with accessing community
resources and social services available in the community, and the name of or other
identifying information about the person or persons responsible for providing this
assistance; and
new text end

new text begin (vi) periodic opportunities for socialization; and
new text end

new text begin (9) makes available to all prospective and current assisted living clients information
consistent with the uniform format and the required components adopted by the
commissioner under section 144G.06. This information must be made available beginning
no later than six months after the commissioner makes the uniform format and required
components available to providers according to section 144G.06.
new text end

new text begin Subd. 3. new text end

new text begin Exemption from awake-staff requirement. new text end

new text begin (a) A housing with services
establishment that offers or provides assisted living is exempt from the requirement in
subdivision 2, paragraph (b), clause (7), item (i), that the person or persons available and
responsible for responding to requests for assistance must be awake, if the establishment
meets the following requirements:
new text end

new text begin (1) the establishment has a maximum capacity to serve 12 or fewer assisted living
clients;
new text end

new text begin (2) the person or persons available and responsible for responding to requests for
assistance are physically present within the housing with services establishment in which
the assisted living clients reside;
new text end

new text begin (3) the establishment has a system in place that is compatible with the health, safety,
and welfare of the establishment's assisted living clients;
new text end

new text begin (4) the establishment's housing with services contract, as required by section
144D.04, includes a statement disclosing the establishment's qualification for, and
intention to rely upon, this exemption;
new text end

new text begin (5) the establishment files with the commissioner, for purposes of public information
but not review or approval by the commissioner, a statement describing how the
establishment meets the conditions in clauses (1) to (4), and makes a copy of this statement
available to actual and prospective assisted living clients; and
new text end

new text begin (6) the establishment indicates on its housing with services registration, under
section 144D.02 or 144D.03, as applicable, that it qualifies for and intends to rely upon the
exemption under this subdivision.
new text end

new text begin Subd. 4. new text end

new text begin Nursing assessment. new text end

new text begin (a) A housing with services establishment offering or
providing assisted living shall:
new text end

new text begin (1) offer to have the arranged home care provider conduct a nursing assessment by
a registered nurse of the physical and cognitive needs of the prospective resident and
propose a service agreement or service plan prior to the date on which a prospective
resident executes a contract with a housing with services establishment or the date on
which a prospective resident moves in, whichever is earlier; and
new text end

new text begin (2) inform the prospective resident of the availability of and contact information for
long-term care consultation services under section 256B.0911, prior to the date on which a
prospective resident executes a contract with a housing with services establishment or the
date on which a prospective resident moves in, whichever is earlier.
new text end

new text begin (b) An arranged home care provider is not obligated to conduct a nursing assessment
by a registered nurse when requested by a prospective resident if either the geographic
distance between the prospective resident and the provider, or urgent or unexpected
circumstances, do not permit the assessment to be conducted prior to the date on which
the prospective resident executes a contract or moves in, whichever is earlier. When such
circumstances occur, the arranged home care provider shall offer to conduct a telephone
conference whenever reasonably possible.
new text end

new text begin (c) The arranged home care provider shall comply with applicable home care
licensure requirements in chapter 144A, sections 148.171 to 148.285, and Minnesota
Rules, chapter 4668, with respect to the provision of a nursing assessment prior to the
delivery of nursing services and the execution of a home care service plan or service
agreement.
new text end

new text begin Subd. 5. new text end

new text begin Assistance with arranged home care provider. new text end

new text begin The housing with services
establishment shall provide each assisted living client with identifying information about a
person or persons reasonably available to assist the client with concerns the client may
have with respect to the services provided by the arranged home care provider. The
establishment shall keep each assisted living client reasonably informed of any changes in
the personnel referenced in this subdivision. Upon request of the assisted living client,
such personnel or designee shall provide reasonable assistance to the assisted living client
in addressing concerns regarding services provided by the arranged home care provider.
new text end

new text begin Subd. 6. new text end

new text begin Termination of housing with services contract. new text end

new text begin If a housing with
services establishment terminates a housing with services contract with an assisted living
client, the establishment shall provide the assisted living client, and the legal or designated
representative of the assisted living client, if any, with a written notice of termination
which includes the following information:
new text end

new text begin (1) the effective date of termination;
new text end

new text begin (2) the section of the contract that authorizes the termination;
new text end

new text begin (3) without extending the termination notice period, an affirmative offer to meet with
the assisted living client and, if applicable, client representatives, within no more than five
business days of the date of the termination notice to discuss the termination;
new text end

new text begin (4) an explanation that:
new text end

new text begin (i) the assisted living client must vacate the apartment, along with all personal
possessions, on or before the effective date of termination;
new text end

new text begin (ii) failure to vacate the apartment by the date of termination may result in the filing
of an eviction action in court by the establishment, and that the assisted living client may
present a defense, if any, to the court at that time; and
new text end

new text begin (iii) the assisted living client may seek legal counsel in connection with the notice
of termination;
new text end

new text begin (5) a statement that, with respect to the notice of termination, reasonable
accommodation is available for the disability of the assisted living client, if any; and
new text end

new text begin (6) the name and contact information of the representative of the establishment
with whom the assisted living client or client representatives may discuss the notice of
termination.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 16.

new text begin [144G.04] RESERVATION OF RIGHTS.
new text end

new text begin Subdivision 1. new text end

new text begin Use of services. new text end

new text begin Nothing in this chapter requires an assisted living
client to utilize any service provided or made available in assisted living.
new text end

new text begin Subd. 2. new text end

new text begin Housing with services contracts. new text end

new text begin Nothing in this chapter requires a
housing with services establishment to execute or refrain from terminating a housing with
services contract with a prospective or current resident who is unable or unwilling to meet
the requirements of residency, with or without assistance.
new text end

new text begin Subd. 3. new text end

new text begin Provision of services. new text end

new text begin Nothing in this chapter requires the arranged home
care provider to offer or continue to provide services under a service agreement or service
plan to a prospective or current resident of the establishment whose needs cannot be
met by the arranged home care provider.
new text end

new text begin Subd. 4. new text end

new text begin Altering operations; service packages. new text end

new text begin Nothing in this chapter requires
a housing with services establishment or arranged home care provider offering assisted
living to fundamentally alter the nature of the operations of the establishment or the
provider in order to accommodate the request or need for facilities or services by any
assisted living client, or to refrain from requiring, as a condition of residency, that an
assisted living client pay for a package of assisted living services even if the client does
not choose to utilize all or some of the services in the package.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 17.

new text begin [144G.05] REIMBURSEMENT UNDER ASSISTED LIVING SERVICE
PACKAGES.
new text end

new text begin Notwithstanding the provisions of this chapter, the requirements for the Elderly
Waiver program's assisted living payment rates under section 256B.0915, subdivision
3e, shall continue to be effective and providers who do not meet the requirements of
this chapter may continue to receive payment under section 256B.0915, subdivision 3e,
as long as they continue to meet the definitions and standards for assisted living and
assisted living plus set forth in the federally approved Elderly Home and Community
Based Services Waiver Program (Control Number 0025.91). Providers of assisted living
for the Community Alternatives for Disabled Individuals (CADI) and Traumatic Brain
Injury (TBI) waivers shall continue to receive payment as long as they continue to meet
the definitions and standards for assisted living and assisted living plus set forth in the
federally approved CADI and TBI waiver plans.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 18.

new text begin [144G.06] UNIFORM CONSUMER INFORMATION GUIDE.
new text end

new text begin (a) The commissioner of health shall establish an advisory committee consisting
of representatives of consumers, providers, county and state officials, and other
groups the commissioner considers appropriate. The advisory committee shall present
recommendations to the commissioner on:
new text end

new text begin (1) a format for a guide to be used by individual providers of assisted living, as
defined in section 144G.01, that includes information about services offered by that
provider, service costs, and other relevant provider-specific information, as well as a
statement of philosophy and values associated with assisted living, presented in uniform
categories that facilitate comparison with guides issued by other providers; and
new text end

new text begin (2) requirements for informing assisted living clients, as defined in section 144G.01,
of their applicable legal rights.
new text end

new text begin (b) The commissioner, after reviewing the recommendations of the advisory
committee, shall adopt a uniform format for the guide to be used by individual providers,
and the required components of materials to be used by providers to inform assisted
living clients of their legal rights, and shall make the uniform format and the required
components available to assisted living providers.
new text end

Sec. 19. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin (a) The revisor of statutes shall strike all references to the "Class E assisted living
home care programs license," "Class E license," and similar terms in Minnesota Rules,
chapters 4668 and 4669. In sections affected by this instruction, the revisor may make
changes necessary to correct the punctuation, grammar, or structure of the remaining text
and preserve its meaning.
new text end

new text begin (b) The revisor of statutes shall change the term "assisted living home care provider,"
"assisted living license," and similar terms to "Class F home care provider," "Class F
license," and similar terms to "Class F home care provider," "Class F license," and similar
terms, in Minnesota Rules, chapter 4668. In sections affected by this instruction, the
revisor may make changes necessary to correct the punctuation, grammar, or structure of
the remaining text and preserve its meaning.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 20. new text begin APPROPRIATION; ASSISTED LIVING.
new text end

new text begin (a) $140,000 is appropriated from the state government special revenue fund to
the commissioner of health for the biennium ending June 30, 2007, for costs related
to bringing actions for injunctive relief under Minnesota Statutes, section 144G.02,
subdivision 2, paragraph (b).
new text end

new text begin (b) The state government special revenue base is increased by $140,000 in fiscal
year 2008 and $140,000 in fiscal year 2009.
new text end

Sec. 21. new text begin REPEALER.
new text end

new text begin Minnesota Rules, part 4668.0215, new text end new text begin is repealed effective January 1, 2007.
new text end

ARTICLE 2

LONG-TERM CARE

Section 1.

Minnesota Statutes 2004, section 144.0724, subdivision 3, is amended to
read:

Subd. 3.

Resident reimbursement classifications.

(a) Resident reimbursement
classifications shall be based on the minimum data set, version 2.0 assessment instrument,
or its successor version mandated by the Centers for Medicare and Medicaid Services
that nursing facilities are required to complete for all residents. The commissioner of
health shall establish resident classes according to the 34 group, resource utilization
groups, version III or RUG-III model. Resident classes must be established based on the
individual items on the minimum data set and must be completed according to the facility
manual for case mix classification issued by the Minnesota Department of Health. The
facility manual for case mix classification shall be drafted by the Minnesota Department
of Health and presented to the chairs of health and human services legislative committees
by December 31, 2001.

(b) Each resident must be classified based on the information from the minimum
data set according to general domains in clauses (1) to (7):

(1) extensive services where a resident requires intravenous feeding or medications,
suctioning, or tracheostomy care, or is on a ventilator or respirator;

(2) rehabilitation where a resident requires physical, occupational, or speech therapy;

(3) special care where a resident has cerebral palsy; quadriplegia; multiple sclerosis;
pressure ulcers; ulcers; fever with vomiting, weight loss, pneumonia, or dehydration;
surgical wounds with treatment; or tube feeding and aphasia; or is receiving radiation
therapy;

(4) clinically complex status where a resident has tube feeding, burns, coma,
septicemia, pneumonia, internal bleeding, chemotherapy, dialysis, oxygen, transfusions,
foot infections or lesions with treatment, deleted text begin heiplegia/hemiparesisdeleted text end new text begin hemiplegia/hemiparesisnew text end ,
physician visits or order changes, or diabetes with injections and order changes;

(5) impaired cognition where a resident has poor cognitive performance;

(6) behavior problems where a resident exhibits wandering or socially inappropriate
or disruptive behavior, has hallucinations or delusions, is physically or verbally abusive
toward others, or resists care, unless the resident's other condition would place the resident
in other categories; and

(7) reduced physical functioning where a resident has no special clinical conditions.

(c) The commissioner of health shall establish resident classification according to a
34 group model based on the information on the minimum data set and within the general
domains listed in paragraph (b), clauses (1) to (7). Detailed descriptions of each resource
utilization group shall be defined in the facility manual for case mix classification issued
by the Minnesota Department of Health. The 34 groups are described as follows:

(1) SE3: requires four or five extensive services;

(2) SE2: requires two or three extensive services;

(3) SE1: requires one extensive service;

(4) RAD: requires rehabilitation services and is dependent in activity of daily living
(ADL) at a count of 17 or 18;

(5) RAC: requires rehabilitation services and ADL count is 14 to 16;

(6) RAB: requires rehabilitation services and ADL count is ten to 13;

(7) RAA: requires rehabilitation services and ADL count is four to nine;

(8) SSC: requires special care and ADL count is 17 or 18;

(9) SSB: requires special care and ADL count is 15 or 16;

(10) SSA: requires special care and ADL count is seven to 14;

(11) CC2: clinically complex with depression and ADL count is 17 or 18;

(12) CC1: clinically complex with no depression and ADL count is 17 or 18;

(13) CB2: clinically complex with depression and ADL count is 12 to 16;

(14) CB1: clinically complex with no depression and ADL count is 12 to 16;

(15) CA2: clinically complex with depression and ADL count is four to 11;

(16) CA1: clinically complex with no depression and ADL count is four to 11;

(17) IB2: impaired cognition with nursing rehabilitation and ADL count is six to ten;

(18) IB1: impaired cognition with no nursing rehabilitation and ADL count is six
to ten;

(19) IA2: impaired cognition with nursing rehabilitation and ADL count is four or
five;

(20) IA1: impaired cognition with no nursing rehabilitation and ADL count is four
or five;

(21) BB2: behavior problems with nursing rehabilitation and ADL count is six to ten;

(22) BB1: behavior problems with no nursing rehabilitation and ADL count is
six to ten;

(23) BA2: behavior problems with nursing rehabilitation and ADL count is four to
five;

(24) BA1: behavior problems with no nursing rehabilitation and ADL count is
four to five;

(25) PE2: reduced physical functioning with nursing rehabilitation and ADL count
is 16 to 18;

(26) PE1: reduced physical functioning with no nursing rehabilitation and ADL
count is 16 to 18;

(27) PD2: reduced physical functioning with nursing rehabilitation and ADL count
is 11 to 15;

(28) PD1: reduced physical functioning with no nursing rehabilitation and ADL
count is 11 to 15;

(29) PC2: reduced physical functioning with nursing rehabilitation and ADL count
is nine or ten;

(30) PC1: reduced physical functioning with no nursing rehabilitation and ADL
count is nine or ten;

(31) PB2: reduced physical functioning with nursing rehabilitation and ADL count
is six to eight;

(32) PB1: reduced physical functioning with no nursing rehabilitation and ADL
count is six to eight;

(33) PA2: reduced physical functioning with nursing rehabilitation and ADL count
is four or five; and

(34) PA1: reduced physical functioning with no nursing rehabilitation and ADL
count is four or five.

Sec. 2.

Minnesota Statutes 2004, section 144.0724, subdivision 4, is amended to read:

Subd. 4.

Resident assessment schedule.

(a) A facility must conduct and
electronically submit to the commissioner of health case mix assessments that conform
with the assessment schedule defined by Code of Federal Regulations, title 42, section
483.20, and published by the United States Department of Health and Human Services,
Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made
in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0,
August 1996. The commissioner of health may substitute successor manuals or question
and answer documents published by the United States Department of Health and Human
Services, Centers for Medicare and Medicaid Services, to replace or supplement the
current version of the manual or document.

(b) The assessments used to determine a case mix classification for reimbursement
include the following:

(1) a new admission assessment must be completed by day 14 following admission;

(2) an annual assessment must be completed within 366 days of the last
comprehensive assessment;

(3) a significant change assessment must be completed within 14 days of the
identification of a significant change; and

(4) the second quarterly assessment following either a new admission assessment,
an annual assessment, or a significant change assessmentnew text begin , and all quarterly assessments
beginning October 1, 2006new text end . Each quarterly assessment must be completed within 92
days of the previous assessment.

Sec. 3.

Minnesota Statutes 2005 Supplement, section 144A.071, subdivision 1a,
is amended to read:

Subd. 1a.

Definitions.

For purposes of sections 144A.071 to 144A.073, the
following terms have the meanings given them:

(a) "Attached fixtures" has the meaning given in Minnesota Rules, part 9549.0020,
subpart 6.

(b) "Buildings" has the meaning given in Minnesota Rules, part 9549.0020, subpart
7.

(d) "Commenced construction" means that all of the following conditions were met:
the final working drawings and specifications were approved by the commissioner of
health; the construction contracts were let; a timely construction schedule was developed,
stipulating dates for beginning, achieving various stages, and completing construction;
and all zoning and building permits were applied for.

(e) "Completion date" means the date on which deleted text begin a certificate of occupancydeleted text end new text begin clearance
for the construction projectnew text end is issued deleted text begin for a construction projectdeleted text end , or if a deleted text begin certificate of
occupancydeleted text end new text begin clearance for the construction projectnew text end is not required, the date on which the
construction project deleted text begin isdeleted text end new text begin assets arenew text end available for facility use.

(f) "Construction" means any erection, building, alteration, reconstruction,
modernization, or improvement necessary to comply with the nursing home licensure
rules.

(g) "Construction project" means:

(1) a capital asset addition to, or replacement of a nursing home or certified boarding
care home that results in new space or the remodeling of or renovations to existing
facility space; and

(2) the remodeling or renovation of existing facility space the use of which is
modified as a result of the project described in clause (1). This existing space and the
project described in clause (1) must be used for the functions as designated on the
construction plans on completion of the project described in clause (1) for a period of
not less than 24 months.

(h) "Depreciation guidelines" means the most recent publication of "The Estimated
Useful Lives of Depreciable Hospital Assets," issued by the American Hospital
Association, 840 North Lake Shore Drive, Chicago, Illinois, 60611.

(i) "New licensed" or "new certified beds" means:

(1) newly constructed beds in a facility or the construction of a new facility that
would increase the total number of licensed nursing home beds or certified boarding
care or nursing home beds in the state; or

(2) newly licensed nursing home beds or newly certified boarding care or nursing
home beds that result from remodeling of the facility that involves relocation of beds but
does not result in an increase in the total number of beds, except when the project involves
the upgrade of boarding care beds to nursing home beds, as defined in section 144A.073,
subdivision 1. "Remodeling" includes any of the type of conversion, renovation,
replacement, or upgrading projects as defined in section 144A.073, subdivision 1.

(j) "Project construction costs" means the cost of the following items that have
a completion date within 12 months before or after the completion date of the project
described in item (g), clause (1):

(1) facility capital asset additions;

(2) replacements;

(3) renovations;

(4) remodeling projects;

(5) construction site preparation costs;

(6) related soft costs; and

(7) the cost of new technology implemented as part of the construction project
and depreciable equipment directly identified to the project, if the construction costs for
clauses (1) to (6) exceed the threshold for additions and replacements stated in section
256B.431, subdivision 16. Technology and depreciable equipment shall be included in the
project construction costs unless a written election is made by the facility, to not include
it in the facility's appraised value for purposes of Minnesota Rules, part 9549.0020,
subpart 5. Debt incurred for purchase of technology and depreciable equipment shall be
included as allowable debt for purposes of Minnesota Rules, part 9549.0060, subpart 5,
items A and C, unless the written election is to not include it. Any new technology and
depreciable equipment included in the project construction costs that the facility elects
not to include in its appraised value and allowable debt shall be treated as provided in
section 256B.431, subdivision 17, paragraph (b). Written election under this paragraph
must be included in the facility's request for the rate change related to the project, and
this election may not be changed.

(k) "Technology" means information systems or devices that make documentation,
charting, and staff time more efficient or encourage and allow for care through alternative
settings including, but not limited to, touch screens, monitors, hand-helds, swipe cards,
motion detectors, pagers, telemedicine, medication dispensers, and equipment to monitor
vital signs and self-injections, and to observe skin and other conditions.

Sec. 4.

Minnesota Statutes 2004, section 144A.071, subdivision 4a, is amended to read:

Subd. 4a.

Exceptions for replacement beds.

It is in the best interest of the state
to ensure that nursing homes and boarding care homes continue to meet the physical
plant licensing and certification requirements by permitting certain construction projects.
Facilities should be maintained in condition to satisfy the physical and emotional needs
of residents while allowing the state to maintain control over nursing home expenditure
growth.

The commissioner of health in coordination with the commissioner of human
services, may approve the renovation, replacement, upgrading, or relocation of a nursing
home or boarding care home, under the following conditions:

(a) to license or certify beds in a new facility constructed to replace a facility or to
make repairs in an existing facility that was destroyed or damaged after June 30, 1987, by
fire, lightning, or other hazard provided:

(i) destruction was not caused by the intentional act of or at the direction of a
controlling person of the facility;

(ii) at the time the facility was destroyed or damaged the controlling persons of the
facility maintained insurance coverage for the type of hazard that occurred in an amount
that a reasonable person would conclude was adequate;

(iii) the net proceeds from an insurance settlement for the damages caused by the
hazard are applied to the cost of the new facility or repairs;

(iv) the new facility is constructed on the same site as the destroyed facility or on
another site subject to the restrictions in section 144A.073, subdivision 5;

(v) the number of licensed and certified beds in the new facility does not exceed the
number of licensed and certified beds in the destroyed facility; and

(vi) the commissioner determines that the replacement beds are needed to prevent an
inadequate supply of beds.

Project construction costs incurred for repairs authorized under this clause shall not be
considered in the dollar threshold amount defined in subdivision 2;

(b) to license or certify beds that are moved from one location to another within a
nursing home facility, provided the total costs of remodeling performed in conjunction
with the relocation of beds does not exceed $1,000,000;

(d) to license or certify beds that are moved from an existing state nursing home to
a different state facility, provided there is no net increase in the number of state nursing
home beds;

(e) to certify and license as nursing home beds boarding care beds in a certified
boarding care facility if the beds meet the standards for nursing home licensure, or in a
facility that was granted an exception to the moratorium under section 144A.073, and if
the cost of any remodeling of the facility does not exceed $1,000,000. If boarding care
beds are licensed as nursing home beds, the number of boarding care beds in the facility
must not increase beyond the number remaining at the time of the upgrade in licensure.
The provisions contained in section 144A.073 regarding the upgrading of the facilities
do not apply to facilities that satisfy these requirements;

(f) to license and certify up to 40 beds transferred from an existing facility owned and
operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the
same location as the existing facility that will serve persons with Alzheimer's disease and
other related disorders. The transfer of beds may occur gradually or in stages, provided
the total number of beds transferred does not exceed 40. At the time of licensure and
certification of a bed or beds in the new unit, the commissioner of health shall delicense
and decertify the same number of beds in the existing facility. As a condition of receiving
a license or certification under this clause, the facility must make a written commitment
to the commissioner of human services that it will not seek to receive an increase in its
property-related payment rate as a result of the transfers allowed under this paragraph;

(g) to license and certify nursing home beds to replace currently licensed and certified
boarding care beds which may be located either in a remodeled or renovated boarding care
or nursing home facility or in a remodeled, renovated, newly constructed, or replacement
nursing home facility within the identifiable complex of health care facilities in which the
currently licensed boarding care beds are presently located, provided that the number of
boarding care beds in the facility or complex are decreased by the number to be licensed
as nursing home beds and further provided that, if the total costs of new construction,
replacement, remodeling, or renovation exceed ten percent of the appraised value of
the facility or $200,000, whichever is less, the facility makes a written commitment to
the commissioner of human services that it will not seek to receive an increase in its
property-related payment rate by reason of the new construction, replacement, remodeling,
or renovation. The provisions contained in section 144A.073 regarding the upgrading of
facilities do not apply to facilities that satisfy these requirements;

(h) to license as a nursing home and certify as a nursing facility a facility that is
licensed as a boarding care facility but not certified under the medical assistance program,
but only if the commissioner of human services certifies to the commissioner of health that
licensing the facility as a nursing home and certifying the facility as a nursing facility will
result in a net annual savings to the state general fund of $200,000 or more;

(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing
home beds in a facility that was licensed and in operation prior to January 1, 1992;

(j) to license and certify new nursing home beds to replace beds in a facility acquired
by the Minneapolis Community Development Agency as part of redevelopment activities
in a city of the first class, provided the new facility is located within three miles of the site
of the old facility. Operating and property costs for the new facility must be determined
and allowed under section 256B.431 or 256B.434;

(k) to license and certify up to 20 new nursing home beds in a community-operated
hospital and attached convalescent and nursing care facility with 40 beds on April 21,
1991, that suspended operation of the hospital in April 1986. The commissioner of human
services shall provide the facility with the same per diem property-related payment rate
for each additional licensed and certified bed as it will receive for its existing 40 beds;

(l) to license or certify beds in renovation, replacement, or upgrading projects as
defined in section 144A.073, subdivision 1, so long as the cumulative total costs of the
facility's remodeling projects do not exceed $1,000,000;

(m) to license and certify beds that are moved from one location to another for the
purposes of converting up to five four-bed wards to single or double occupancy rooms
in a nursing home that, as of January 1, 1993, was county-owned and had a licensed
capacity of 115 beds;

(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified
nursing facility located in Minneapolis to layaway all of its licensed and certified nursing
home beds. These beds may be relicensed and recertified in a newly constructed teaching
nursing home facility affiliated with a teaching hospital upon approval by the legislature.
The proposal must be developed in consultation with the interagency committee on
long-term care planning. The beds on layaway status shall have the same status as
voluntarily delicensed and decertified beds, except that beds on layaway status remain
subject to the surcharge in section 256.9657. This layaway provision expires July 1, 1998;

(o) to allow a project which will be completed in conjunction with an approved
moratorium exception project for a nursing home in southern Cass County and which is
directly related to that portion of the facility that must be repaired, renovated, or replaced,
to correct an emergency plumbing problem for which a state correction order has been
issued and which must be corrected by August 31, 1993;

(p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified
nursing facility located in Minneapolis to layaway, upon 30 days prior written notice to
the commissioner, up to 30 of the facility's licensed and certified beds by converting
three-bed wards to single or double occupancy. Beds on layaway status shall have the
same status as voluntarily delicensed and decertified beds except that beds on layaway
status remain subject to the surcharge in section 256.9657, remain subject to the license
application and renewal fees under section 144A.07 and shall be subject to a $100 per bed
reactivation fee. In addition, at any time within three years of the effective date of the
layaway, the beds on layaway status may be:

(1) relicensed and recertified upon relocation and reactivation of some or all of
the beds to an existing licensed and certified facility or facilities located in Pine River,
Brainerd, or International Falls; provided that the total project construction costs related to
the relocation of beds from layaway status for any facility receiving relocated beds may
not exceed the dollar threshold provided in subdivision 2 unless the construction project
has been approved through the moratorium exception process under section 144A.073;

(2) relicensed and recertified, upon reactivation of some or all of the beds within the
facility which placed the beds in layaway status, if the commissioner has determined a
need for the reactivation of the beds on layaway status.

The property-related payment rate of a facility placing beds on layaway status
must be adjusted by the incremental change in its rental per diem after recalculating the
rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The
property-related payment rate for a facility relicensing and recertifying beds from layaway
status must be adjusted by the incremental change in its rental per diem after recalculating
its rental per diem using the number of beds after the relicensing to establish the facility's
capacity day divisor, which shall be effective the first day of the month following the
month in which the relicensing and recertification became effective. Any beds remaining
on layaway status more than three years after the date the layaway status became effective
must be removed from layaway status and immediately delicensed and decertified;

(q) to license and certify beds in a renovation and remodeling project to convert 12
four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing
home that, as of January 1, 1994, met the following conditions: the nursing home was
located in Ramsey County; had a licensed capacity of 154 beds; and had been ranked
among the top 15 applicants by the 1993 moratorium exceptions advisory review panel.
The total project construction cost estimate for this project must not exceed the cost
estimate submitted in connection with the 1993 moratorium exception process;

(r) to license and certify up to 117 beds that are relocated from a licensed and
certified 138-bed nursing facility located in St. Paul to a hospital with 130 licensed
hospital beds located in South St. Paul, provided that the nursing facility and hospital are
owned by the same or a related organization and that prior to the date the relocation is
completed the hospital ceases operation of its inpatient hospital services at that hospital.
After relocation, the nursing facility's status under section 256B.431, subdivision 2j, shall
be the same as it was prior to relocation. The nursing facility's property-related payment
rate resulting from the project authorized in this paragraph shall become effective no
earlier than April 1, 1996. For purposes of calculating the incremental change in the
facility's rental per diem resulting from this project, the allowable appraised value of
the nursing facility portion of the existing health care facility physical plant prior to the
renovation and relocation may not exceed $2,490,000;

(s) to license and certify two beds in a facility to replace beds that were voluntarily
delicensed and decertified on June 28, 1991;

(t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed
nursing home and 21-bed boarding care home facility in Minneapolis, notwithstanding
the licensure and certification after July 1, 1995, of the Minneapolis facility as a 147-bed
nursing home facility after completion of a construction project approved in 1993 under
section 144A.073, to be laid away upon 30 days' prior written notice to the commissioner.
Beds on layaway status shall have the same status as voluntarily delicensed or decertified
beds except that they shall remain subject to the surcharge in section 256.9657. The
16 beds on layaway status may be relicensed as nursing home beds and recertified at
any time within five years of the effective date of the layaway upon relocation of some
or all of the beds to a licensed and certified facility located in Watertown, provided that
the total project construction costs related to the relocation of beds from layaway status
for the Watertown facility may not exceed the dollar threshold provided in subdivision
2 unless the construction project has been approved through the moratorium exception
process under section 144A.073.

The property-related payment rate of the facility placing beds on layaway status
must be adjusted by the incremental change in its rental per diem after recalculating the
rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The
property-related payment rate for the facility relicensing and recertifying beds from
layaway status must be adjusted by the incremental change in its rental per diem after
recalculating its rental per diem using the number of beds after the relicensing to establish
the facility's capacity day divisor, which shall be effective the first day of the month
following the month in which the relicensing and recertification became effective. Any
beds remaining on layaway status more than five years after the date the layaway status
became effective must be removed from layaway status and immediately delicensed
and decertified;

(u) to license and certify beds that are moved within an existing area of a facility or
to a newly constructed addition which is built for the purpose of eliminating three- and
four-bed rooms and adding space for dining, lounge areas, bathing rooms, and ancillary
service areas in a nursing home that, as of January 1, 1995, was located in Fridley and had
a licensed capacity of 129 beds;

(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County
to a 160-bed facility in Crow Wing County, provided all the affected beds are under
common ownership;

(w) to license and certify a total replacement project of up to 49 beds located in
Norman County that are relocated from a nursing home destroyed by flood and whose
residents were relocated to other nursing homes. The operating cost payment rates for
the new nursing facility shall be determined based on the interim and settle-up payment
provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of
section 256B.431, except that subdivision 26, paragraphs (a) and (b), shall not apply until
the second rate year after the settle-up cost report is filed. Property-related reimbursement
rates shall be determined under section 256B.431, taking into account any federal or state
flood-related loans or grants provided to the facility;

(x) to license and certify a total replacement project of up to 129 beds located
in Polk County that are relocated from a nursing home destroyed by flood and whose
residents were relocated to other nursing homes. The operating cost payment rates for
the new nursing facility shall be determined based on the interim and settle-up payment
provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of
section 256B.431, except that subdivision 26, paragraphs (a) and (b), shall not apply until
the second rate year after the settle-up cost report is filed. Property-related reimbursement
rates shall be determined under section 256B.431, taking into account any federal or state
flood-related loans or grants provided to the facility;

(y) to license and certify beds in a renovation and remodeling project to convert 13
three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and
add improvements in a nursing home that, as of January 1, 1994, met the following
conditions: the nursing home was located in Ramsey County, was not owned by a hospital
corporation, had a licensed capacity of 64 beds, and had been ranked among the top 15
applicants by the 1993 moratorium exceptions advisory review panel. The total project
construction cost estimate for this project must not exceed the cost estimate submitted in
connection with the 1993 moratorium exception process;

(z) to license and certify up to 150 nursing home beds to replace an existing 285
bed nursing facility located in St. Paul. The replacement project shall include both the
renovation of existing buildings and the construction of new facilities at the existing
site. The reduction in the licensed capacity of the existing facility shall occur during the
construction project as beds are taken out of service due to the construction process. Prior
to the start of the construction process, the facility shall provide written information to the
commissioner of health describing the process for bed reduction, plans for the relocation
of residents, and the estimated construction schedule. The relocation of residents shall be
in accordance with the provisions of law and rule;

(aa) to allow the commissioner of human services to license an additional 36 beds to
provide residential services for the physically handicapped under Minnesota Rules, parts
9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that
the total number of licensed and certified beds at the facility does not increase;

(bb) to license and certify a new facility in St. Louis county with 44 beds constructed
to replace an existing facility in St. Louis County with 31 beds, which has resident rooms
on two separate floors and an antiquated elevator that creates safety concerns for residents
and prevents nonambulatory residents from residing on the second floor. The project shall
include the elimination of three- and four-bed rooms;

(cc) to license and certify four beds in a 16-bed certified boarding care home in
Minneapolis to replace beds that were voluntarily delicensed and decertified on or
before March 31, 1992. The licensure and certification is conditional upon the facility
periodically assessing and adjusting its resident mix and other factors which may
contribute to a potential institution for mental disease declaration. The commissioner of
human services shall retain the authority to audit the facility at any time and shall require
the facility to comply with any requirements necessary to prevent an institution for mental
disease declaration, including delicensure and decertification of beds, if necessary;

(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with
80 beds as part of a renovation project. The renovation must include construction of
an addition to accommodate ten residents with beginning and midstage dementia in a
self-contained living unit; creation of three resident households where dining, activities,
and support spaces are located near resident living quarters; designation of four beds
for rehabilitation in a self-contained area; designation of 30 private rooms; and other
improvements;

(ee) to license and certify beds in a facility that has undergone replacement or
remodeling as part of a planned closure under section 256B.437;

(ff) to license and certify a total replacement project of up to 124 beds located
in Wilkin County that are in need of relocation from a nursing home significantly
damaged by flood. The operating cost payment rates for the new nursing facility shall
be determined based on the interim and settle-up payment provisions of Minnesota
Rules, part 9549.0057, and the reimbursement provisions of section 256B.431, except
that section 256B.431, subdivision 26, paragraphs (a) and (b), shall not apply until the
second rate year after the settle-up cost report is filed. Property-related reimbursement
rates shall be determined under section 256B.431, taking into account any federal or state
flood-related loans or grants provided to the facility;

(gg) to allow the commissioner of human services to license an additional nine beds
to provide residential services for the physically handicapped under Minnesota Rules,
parts 9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that
the total number of licensed and certified beds at the facility does not increase;

(hh) to license and certify up to 120 new nursing facility beds to replace beds in a
facility in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the
new facility is located within four miles of the existing facility and is in Anoka County.
Operating and property rates shall be determined and allowed under section 256B.431 and
Minnesota Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 256B.435. The
provisions of section 256B.431, subdivision 26, paragraphs (a) and (b), do not apply until
the second rate year following settle-up; or

(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County
that, as of March 25, 2001, is in the active process of closing, to a 122-licensed bed
nonprofit nursing facility located in the city of Columbia Heights or its affiliate. The
transfer is effective when the receiving facility notifies the commissioner in writing of the
number of beds accepted. The commissioner shall place all transferred beds on layaway
status held in the name of the receiving facility. The layaway adjustment provisions of
section 256B.431, subdivision 30, do not apply to this layaway. The receiving facility
may only remove the beds from layaway for recertification and relicensure at the receiving
facility's current site, or at a newly constructed facility located in Anoka County. The
receiving facility must receive statutory authorization before removing these beds from
layaway statusnew text begin , or may remove these beds from layaway status if removal from layaway
status is part of a moratorium exception project approved by the commissioner under
section 144A.073new text end .

Sec. 5.

Minnesota Statutes 2004, section 144A.10, is amended by adding a subdivision
to read:

new text begin Subd. 6e. new text end

new text begin Use of fines. new text end

new text begin When the commissioner of health determines the use of,
or provides recommendations on the use of fines collected under subdivisions 6 or 6b,
two representatives of the nursing home industry, appointed by nursing home trade
associations, and two consumer representatives as appointed by the commissioner must
be included in the process of developing or preparing any information, reviews, or
recommendations on the use of the fines. This includes, but is not limited to, including
two representatives of the nursing home industry in any committee designed to provide
information and recommendations for the use of the fines.
new text end

Sec. 6.

Minnesota Statutes 2004, section 144A.161, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

The definitions in this subdivision apply to subdivisions
2 to 10.

(a) "Closure" means the cessation of operations of a facility and the delicensure and
decertification of all beds within the facility.

(b) "Curtailment," "reduction," or "change" refers to any change in operations which
would result in or encourage the relocation of residents.

(c) "Facility" means a nursing home licensed pursuant to this chapter, or a certified
boarding care home licensed pursuant to sections 144.50 to 144.56.

(d) "Licensee" means the owner of the facility or the owner's designee or the
commissioner of health for a facility in receivership.

(e) deleted text begin "Local agency"deleted text end new text begin "County social services agency"new text end means the county or multicounty
social service agency authorized under sections 393.01 and 393.07, as the agency
responsible for providing social services for the county in which the nursing home is
located.

(f) "Plan" means a process developed under subdivision 3, paragraph (b), for the
closure, curtailment, reduction, or change in operations in a facility and the subsequent
relocation of residents.

(g) "Relocation" means the discharge of a resident and movement of the resident to
another facility or living arrangement as a result of the closing, curtailment, reduction, or
change in operations of a nursing home or boarding care home.

Sec. 7.

Minnesota Statutes 2004, section 144A.161, is amended by adding a
subdivision to read:

new text begin Subd. 1a. new text end

new text begin Scope. new text end

new text begin Where a facility is undertaking closure, curtailment, reduction, or
change in operations, the facility and the county social services agency must comply with
the requirements of this section.
new text end

Sec. 8.

Minnesota Statutes 2004, section 144A.161, subdivision 2, is amended to read:

Subd. 2.

Initial notice from licensee.

(a) A licensee shall notify the following
parties in writing when there is an intent to close or curtail, reduce, or change operations
which would result in or encourage the relocation of residents:

(1) the commissioner of health;

(2) the commissioner of human services;

(3) the deleted text begin localdeleted text end new text begin county social servicesnew text end agency;

(4) the Office of the Ombudsman for Older Minnesotans; and

(5) the Office of the Ombudsman for Mental Health and Mental Retardation.

(b) The written notice shall include the names, telephone numbers, facsimile
numbers, and e-mail addresses of the persons in the facility responsible for coordinating
the licensee's efforts in the planning process, and the number of residents potentially
affected by the closure or curtailment, reduction, or change in operations.

new text begin (c) After providing written notice under this section, and prior to admission, the
facility must fully inform prospective residents and their families of the intent to close or
curtail, reduce, or change operations, and the relocation plan.
new text end

Sec. 9.

Minnesota Statutes 2004, section 144A.161, subdivision 3, is amended to read:

Subd. 3.

Planning process.

(a) The deleted text begin localdeleted text end new text begin county social servicesnew text end agency shall,
within five working days of receiving initial notice of the licensee's intent to close or
curtail, reduce, or change operations, provide the licensee and all parties identified in
subdivision 2, paragraph (a), with the names, telephone numbers, facsimile numbers, and
e-mail addresses of those persons responsible for coordinating deleted text begin localdeleted text end new text begin county social servicesnew text end
agency efforts in the planning process.

(b) Within ten working days of receipt of the notice under paragraph (a), the deleted text begin localdeleted text end new text begin
county social servicesnew text end agency and licensee shall meet to develop the relocation plan.
The deleted text begin localdeleted text end new text begin county social servicesnew text end agency shall inform the Departments of Health and
Human Services, the Office of the Ombudsman for Older Minnesotans, and the Office
of the Ombudsman for Mental Health and Mental Retardation of the date, time, and
location of the meeting so that their representatives may attend. The relocation plan
must be completed within 45 days of receipt of the initial notice. However, the plan may
be finalized on an earlier schedule agreed to by all parties. To the extent practicable,
consistent with requirements to protect the safety and health of residents, the commissioner
may authorize the planning process under this subdivision to occur concurrent with the
60-day notice required under subdivision 5a. The plan shall:

(1) identify the expected date of closure, curtailment, reduction, or change in
operations;

(2) outline the process for public notification of the closure, curtailment, reduction,
or change in operations;

(3) identify efforts that will be made to include other stakeholders in the relocation
process;

(4) outline the process to ensure 60-day advance written notice to residents, family
members, and designated representatives;

(5) present an aggregate description of the resident population remaining to be
relocated and the population's needs;

(6) outline the individual resident assessment process to be utilized;

(7) identify an inventory of available relocation options, including home and
community-based services;

(8) identify a timeline for submission of the list identified in subdivision 5c,
paragraph (b); deleted text begin and
deleted text end

(9) identify a schedule for the timely completion of each element of the plannew text begin ; and
new text end

new text begin (10) identify the steps the licensee and the county social services agency will take to
address the relocation needs of individual residents who may be difficult to place due to
specialized care needs such as behavioral health problemsnew text end .

(c) All parties to the plan shall refrain from any public notification of the intent to
close or curtail, reduce, or change operations until a relocation plan has been established.
If the planning process occurs concurrently with the 60-day notice period, this requirement
does not apply once 60-day notice is given.

Sec. 10.

Minnesota Statutes 2004, section 144A.161, subdivision 4, is amended to read:

Subd. 4.

Responsibilities of licensee for resident relocations.

The licensee shall
provide for the safe, orderly, and appropriate relocation of residents. The licensee and
facility staff shall cooperate with representatives from the deleted text begin localdeleted text end new text begin county social servicesnew text end
agency, the Department of Health, the Department of Human Services, the Office of
Ombudsman for Older Minnesotans, and ombudsman for mental health and mental
retardation in planning for and implementing the relocation of residents.

Sec. 11.

Minnesota Statutes 2004, section 144A.161, subdivision 5, is amended to read:

Subd. 5.

Licensee responsibilities prior to relocation.

(a) The licensee shall
establish an interdisciplinary team responsible for coordinating and implementing the
plan. The interdisciplinary team shall include representatives from the deleted text begin localdeleted text end new text begin county social
servicesnew text end agency, the Office of Ombudsman for Older Minnesotans, facility staff that
provide direct care services to the residents, and facility administration.

(b) The licensee shall provide a deleted text begin listdeleted text end new text begin summary documentnew text end to the deleted text begin localdeleted text end new text begin county social
servicesnew text end agency that includes the following information on each resident to be relocated:

(1) name;

(2) date of birth;

(3) Social Security number;

(4) new text begin payment source and new text end medical assistance identification numbernew text begin , if applicablenew text end ;

new text begin (5) county of financial responsibility;
new text end

new text begin (6) date of admission to the facility;
new text end

deleted text begin (5)deleted text end new text begin (7)new text end all diagnoses; deleted text begin and
deleted text end

new text begin (8) the name of and contact information for the resident's physician;
new text end

deleted text begin (6)deleted text end new text begin (9)new text end the name and contact information for the resident's family or other designated
representativenew text begin ;
new text end

new text begin (10) the names of and contact information for any case managers, if known; and
new text end

new text begin (11) the information on the resident's status related to commitment and probationnew text end .

(c) The licensee shall consult with the deleted text begin localdeleted text end new text begin county social servicesnew text end agency on the
availability and development of available resources and on the resident relocation process.

Sec. 12.

Minnesota Statutes 2004, section 144A.161, subdivision 5a, is amended to
read:

Subd. 5a.

Licensee responsibilities to provide notice.

At least 60 days before the
proposed date of closing, curtailment, reduction, or change in operations as agreed to in
the plan, the licensee shall send a written notice of closure or curtailment, reduction, or
change in operations to each resident being relocated, the resident's family member or
designated representative, and the resident's attending physician. The notice must include
the following:

(1) the date of the proposed closure, curtailment, reduction, or change in operations;

(2) the name, address, telephone number, facsimile number, and e-mail address
of the individual or individuals in the facility responsible for providing assistance and
information;

(3) notification of upcoming meetings for residents, families and designated
representatives, and resident and family councils to discuss the relocation of residents;

(4) the name, address, and telephone number of the deleted text begin localdeleted text end new text begin county social servicesnew text end
agency contact person; and

(5) the name, address, and telephone number of the Office of Ombudsman for Older
Minnesotans and the ombudsman for mental health and mental retardation.

The notice must comply with all applicable state and federal requirements for notice
of transfer or discharge of nursing home residents.

Sec. 13.

Minnesota Statutes 2004, section 144A.161, subdivision 5c, is amended to
read:

Subd. 5c.

Licensee responsibility regarding placement information.

(a) The
licensee shall provide sufficient preparation to residents to ensure safe, orderly, and
appropriate discharge and relocation. The licensee shall assist residents in finding
placements that respond to personal preferences, such as desired geographic location.

(b) The licensee shall prepare a resource list with several relocation options for each
resident. The list must contain the following information for each relocation option,
when applicable:

(1) the name, address, and telephone and facsimile numbers of each facility with
appropriate, available beds or services;

(2) the certification level of the available beds;

(3) the types of services available; and

(4) the name, address, and telephone and facsimile numbers of appropriate available
home and community-based placements, services, and settings or other options for
individuals with special needs.

The list shall be made available to residents and their families or designated
representatives, and upon request to the Office of Ombudsman for Older Minnesotans,
the ombudsman for mental health and Mental Retardation, and the deleted text begin localdeleted text end new text begin county social
servicesnew text end agency.

(c) The Senior LinkAge line may make available via a Web site the name, address,
and telephone and facsimile numbers of each facility with available beds, the certification
level of the available beds, the types of services available, and the number of beds that are
available as updated daily by the listed facilities. The licensee must provide residents,
their families or designated representatives, the Office of the Ombudsman for Older
Minnesotans, the Office of the Ombudsman for Mental Health and Mental Retardation,
and the deleted text begin localdeleted text end new text begin county social servicesnew text end agency with the toll-free number and Web site address
for the Senior LinkAge line.

Sec. 14.

Minnesota Statutes 2004, section 144A.161, subdivision 6, is amended to read:

Subd. 6.

Responsibilities of the licensee during relocation.

(a) The licensee
shall make arrangements or provide for the transportation of residents to the new facility
or placement within a 50-mile radius, or within a larger radius if no suitable options
are available within 50 miles. The licensee shall provide a staff person to accompany
the resident during transportation, upon request of the resident, the resident's family, or
designated representative. The discharge and relocation of residents must comply with all
applicable state and federal requirements and must be conducted in a safe, orderly, and
appropriate manner. The licensee must ensure that there is no disruption in providing
meals, medications, or treatments of a resident during the relocation process.

(b) Beginning the week following development of the initial relocation plan, the
licensee shall submit deleted text begin biweeklydeleted text end new text begin weeklynew text end status reports to the commissioners of health and
human services or their designees and to the deleted text begin localdeleted text end new text begin county social servicesnew text end agency. The
initial status report must identify:

(1) the relocation plan developed;

(2) the interdisciplinary team members; and

(3) the number of residents to be relocated.

(1) any modifications to the plan;

(2) any change of interdisciplinary team members;

(3) the number of residents relocated;

(4) the destination to which residents have been relocated;

(5) the number of residents remaining to be relocated; and

(6) issues or problems encountered during the process and resolution of these issues.

Sec. 15.

Minnesota Statutes 2004, section 144A.161, subdivision 8, is amended to read:

Subd. 8.

Responsibilities of deleted text begin localdeleted text end new text begin county social servicesnew text end agency.

(a) The deleted text begin localdeleted text end
new text begin county social services new text end agency shall participate in the meeting as outlined in subdivision 3,
paragraph (b), to develop a relocation plan.

(b) The deleted text begin localdeleted text end new text begin county social services new text end agency shall designate a representative to
the interdisciplinary team established by the licensee responsible for coordinating the
relocation efforts.

(c) The deleted text begin localdeleted text end new text begin county social services new text end agency shall serve as a resource in the relocation
process.

(d) Concurrent with the notice sent to residents from the licensee as provided in
subdivision 5a, the deleted text begin localdeleted text end new text begin county social services new text end agency shall provide written notice to
residents, family, or designated representatives describing:

(1) the county's role in the relocation process and in the follow-up to relocations;

(2) a deleted text begin localdeleted text end new text begin county social services new text end agency contact name, address, and telephone
number; and

(3) the name, address, and telephone number of the Office of Ombudsman for Older
Minnesotans and the ombudsman for mental health and mental retardation.

(e) The deleted text begin localdeleted text end new text begin county social services new text end agency designee shall meet with appropriate
facility staff to coordinate any assistance in the relocation process. This coordination
shall include participating in group meetings with residents, families, and designated
representatives to explain the relocation process.

(f) The deleted text begin localdeleted text end new text begin county social services new text end agency shall monitor compliance with all
components of the plan. If the licensee is not in compliance, the deleted text begin localdeleted text end new text begin county social
services new text end agency shall notify the commissioners of the Departments of Health and Human
Services.

(g) Except as requested by the resident, family member, or designated representative
and within the parameters of the Vulnerable Adults Act, the deleted text begin localdeleted text end new text begin county social services
new text end agency may halt a relocation that it deems inappropriate or dangerous to the health or
safety of a resident. The deleted text begin localdeleted text end new text begin county social services new text end agency shall pursue remedies to
protect the resident during the relocation process, including, but not limited to, assisting
the resident with filing an appeal of transfer or discharge, notification of all appropriate
licensing boards and agencies, and other remedies available to the county under section
626.557, subdivision 10.

(h) A member of the deleted text begin localdeleted text end new text begin county social services new text end agency staff shall visit residents
relocated within 100 miles of the county within 30 days after the relocation. deleted text begin Localdeleted text end new text begin This
requirement does not apply to changes in operation where the facility moved to a new
location and residents chose to move to that new location. The requirement also does not
apply to residents admitted after the notice of closure and discharged prior to the actual
closure. County social services new text end agency staff shall interview the resident and family or
designated representative, observe the resident on site, and review and discuss pertinent
medical or social records with appropriate facility staff to:

(1) assess the adjustment of the resident to the new placement;

(2) recommend services or methods to meet any special needs of the resident; and

(3) identify residents at risk.

(i) The deleted text begin localdeleted text end new text begin county social servicesnew text end agency may conduct subsequent follow-up visits
in cases where the adjustment of the resident to the new placement is in question.

(j) Within 60 days of the completion of the follow-up visits, the deleted text begin localdeleted text end new text begin county social
servicesnew text end agency shall submit a written summary of the follow-up work to the Departments
of Health and Human Services in a manner approved by the commissioners.

(k) The deleted text begin localdeleted text end new text begin county social servicesnew text end agency shall submit to the Departments of Health
and Human Services a report of any issues that may require further review or monitoring.

(l) The deleted text begin localdeleted text end new text begin county social servicesnew text end agency shall be responsible for the safe and
orderly relocation of residents in cases where an emergent need arises or when the licensee
has abrogated its responsibilities under the plan.

Sec. 16.

Minnesota Statutes 2005 Supplement, section 256B.0918, subdivision 1,
is amended to read:

Subdivision 1.

Program criteria.

Beginning on or after October 1, 2005, within
the limits of appropriations specifically available for this purpose, the commissioner shall
provide funding to qualified provider applicants for employee scholarships for education
in nursing and other health care fields. Employee scholarships must be for a course of
study that is expected to lead to career advancement with the provider or in the field
of long-term care, including home care or care of persons with disabilities, or nursing.
Providers that secure this funding must use it to award scholarships to employees who
work an average of at least 20 hours per week for the provider. new text begin Executive new text end management
staffnew text begin without direct care dutiesnew text end , registered nurses, and therapists are not eligible to receive
scholarships under this section.

Sec. 17.

Minnesota Statutes 2005 Supplement, section 256B.0918, subdivision 3,
is amended to read:

Subd. 3.

Provider selection criteria.

To be considered for scholarship funding,
the provider shall submit a completed application within the time frame specified by the
commissioner. In awarding funding, the commissioner shall consider the following:

(1) the size of the provider as measured in annual billing to the medical assistance
program. To be eligible, a provider must receive at least deleted text begin $500,000deleted text end new text begin $300,000 new text end annually
in medical assistance payments;

(2) the percentage of employees meeting the scholarship program recipient
requirements;

(3) staff retention rates for paraprofessionals; and

(4) other criteria determined by the commissioner.

Sec. 18.

Minnesota Statutes 2005 Supplement, section 256B.0918, subdivision 4,
is amended to read:

Subd. 4.

Funding specifics.

Within the limits of appropriations specifically
available for this purpose, for the rate period beginning on or after October 1, 2005, to
September 30, 2007, the commissioner shall provide to each provider listed in subdivision
2 and awarded funds under subdivision 3 a medical assistance rate increase to fund
scholarships up to deleted text begin two-tenthsdeleted text end new text begin three-tenths new text end percent of the medical assistance reimbursement
rate. The commissioner shall require providers to repay any portion of funds awarded
under subdivision 3 that is not used to fund scholarships. If applications exceed available
funding, funding shall be targeted to providers that employ a higher percentage of
paraprofessional staff or have lower rates of turnover of paraprofessional staff. During
the subsequent years of the program, the rate adjustment may be recalculated, at the
discretion of the commissioner. In making a recalculation the commissioner may consider
the provider's success at granting scholarships based on the amount spent during the
previous year and the availability of appropriations to continue the program.

Sec. 19.

Minnesota Statutes 2005 Supplement, section 256B.434, subdivision 4,
is amended to read:

Subd. 4.

Alternate rates for nursing facilities.

(a) For nursing facilities which
have their payment rates determined under this section rather than section 256B.431, the
commissioner shall establish a rate under this subdivision. The nursing facility must enter
into a written contract with the commissioner.

(b) A nursing facility's case mix payment rate for the first rate year of a facility's
contract under this section is the payment rate the facility would have received under
section 256B.431.

(c) A nursing facility's case mix payment rates for the second and subsequent years
of a facility's contract under this section are the previous rate year's contract payment
rates plus an inflation adjustment and, for facilities reimbursed under this section or
section 256B.431, an adjustment to include the cost of any increase in Health Department
licensing fees for the facility taking effect on or after July 1, 2001. The index for the
inflation adjustment must be based on the change in the Consumer Price Index-All Items
(United States City average) (CPI-U) forecasted by the commissioner of finance's national
economic consultant, as forecasted in the fourth quarter of the calendar year preceding
the rate year. The inflation adjustment must be based on the 12-month period from the
midpoint of the previous rate year to the midpoint of the rate year for which the rate is
being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001,
July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, and July
1, 2008, this paragraph shall apply only to the property-related payment rate, except
that adjustments to include the cost of any increase in Health Department licensing fees
taking effect on or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to
the property payment rate under this section and section 256B.431 shall be effective on
October 1. In determining the amount of the property-related payment rate adjustment
under this paragraph, the commissioner shall determine the proportion of the facility's
rates that are property-related based on the facility's most recent cost report. deleted text begin Beginning
October 1, 2006, facilities reimbursed under this section shall be allowed to receive a
property rate adjustment for building projects under section 144A.071, subdivision 2.
deleted text end

new text begin (d) The commissioner shall develop additional incentive-based payments of up to
five percent above a facility's operating payment rate for achieving outcomes specified
in a contract. The commissioner may solicit contract amendments and implement those
which, on a competitive basis, best meet the state's policy objectives. The commissioner
shall limit the amount of any incentive payment and the number of contract amendments
under this paragraph to operate the incentive payments within funds appropriated for this
purpose. The contract amendments may specify various levels of payment for various
levels of performance. Incentive payments to facilities under this paragraph may be in
the form of time-limited rate adjustments or supplemental payments. In establishing the
specified outcomes and related criteria, the commissioner shall consider the following
state policy objectives:
new text end

new text begin (1) successful diversion or discharge of residents to the residents' prior home or
other community-based alternatives;
new text end

new text begin (2) adoption of new technology to improve quality or efficiency;
new text end

new text begin (3) improved quality as measured in the Nursing Home Report Card;
new text end

new text begin (4) reduced acute care costs; and
new text end

new text begin (5) any additional outcomes proposed by a nursing facility that the commissioner
finds desirable.
new text end

Sec. 20.

Minnesota Statutes 2004, section 256B.434, is amended by adding a
subdivision to read:

new text begin Subd. 4f. new text end

new text begin Construction project rate adjustments effective October 1, 2006. new text end

new text begin (a)
Effective October 1, 2006, facilities reimbursed under this section may receive a property
rate adjustment for construction projects exceeding the threshold in section 256B.431,
subdivision 16, and under the threshold in section 144A.071, subdivision 2, clause (a). For
these projects, capital assets purchased shall be counted as construction project costs for a
rate adjustment request made by a facility if they are: (1) purchased within 24 months
of the completion of the construction project; (2) purchased after the completion date of
any prior construction project; and (3) are not purchased prior to July 14, 2005. Except
as otherwise provided in this subdivision, the definitions, rate calculation methods, and
principles in sections 144A.071 and 256B.431 and Minnesota Rules, parts 9549.0010
to 9549.0080, shall be used to calculate rate adjustments for allowable construction
projects under this subdivision and section 144A.073. Facilities completing construction
projects between October 1, 2005, and October 1, 2006, are eligible to have a property
rate adjustment effective October 1, 2006. Facilities completing projects after October 1,
2006, are eligible for a property rate adjustment effective on the first day of the month
following the completion date.
new text end

new text begin (b) Notwithstanding subdivision 18, as of July 14, 2005, facilities with rates set
under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, that
commenced a construction project on or after October 1, 2004, and do not have a contract
under subdivision 3 by September 30, 2006, are eligible to request a rate adjustment under
section 256B.431, subdivision 10, through September 30, 2006. If the request results
in the commissioner determining a rate adjustment is allowable, the rate adjustment is
effective on the first of the month following project completion. These facilities shall
be allowed to accumulate construction project costs for the period October 1, 2004, to
September 30, 2006.
new text end

new text begin (c) Facilities shall be allowed construction project rate adjustments no sooner than
12 months after completing a previous construction project. Facilities must request the
rate adjustment according to section 256B.431, subdivision 10.
new text end

new text begin (d) Capacity days shall be computed according to Minnesota Rules, part 9549.0060,
subpart 11. For rate calculations under this section, the number of licensed beds in the
nursing facility shall be the number existing after the construction project is completed
and the number of days in the nursing facility's reporting period shall be 365.
new text end

new text begin (e) The value of assets to be recognized for a total replacement project as defined
in section 256B.431, subdivision 17d, shall be computed as described in clause (1). The
value of assets to be recognized for all other projects shall be computed as described
in clause (2):
new text end

new text begin (1) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
number of beds allowed under subdivision 3a, paragraph (c), shall be used to compute the
maximum amount of assets allowable in a facility's property rate calculation. If a facility's
current request for a rate adjustment results from the completion of a construction
project that was previously approved under section 144A.073, the assets to be used in
the rate calculation cannot exceed the lesser of the amount determined under sections
144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable costs of
the construction project. A current request that is not the result of a project under section
144A.073 cannot exceed the limit under section 144A.071, subdivision 2, paragraph (a).
Applicable credits must be deducted from the cost of the construction project.
new text end

new text begin (2) (i) Replacement-cost-new limits under section 256B.431, subdivision 17e, and
the number of beds allowed under section 256B.431, subdivision 3a, paragraph (c), shall
be used to compute the maximum amount of assets allowable in a facility's property
rate calculation.
new text end

new text begin (ii) The value of a facility's assets to be compared to the amount in item (i) begins
with the total appraised value from the last rate notice a facility received when its rates
were set under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080.
This value shall be indexed by the factor in section 256B.431, subdivision 3f, paragraph
(a), for each rate year the facility received an inflation factor on its property-related rate
when its rates were set under this section. The value of assets listed as previous capital
additions, capital additions, and special projects on the facility's base year rate notice
and the value of assets related to a construction project for which the facility received a
rate adjustment when its rates were determined under this section shall be added to the
indexed appraised value.
new text end

new text begin (iii) The maximum amount of assets to be recognized in computing a facility's rate
adjustment after a project is completed is the lesser of the aggregate replacement-cost-new
limit computed in (i) minus the assets recognized in (ii) or the actual allowable costs of
the construction project.
new text end

new text begin (iv) If a facility's current request for a rate adjustment results from the completion of
a construction project that was previously approved under section 144A.073, the assets to
be added to the rate calculation cannot exceed the lesser of the amount determined under
sections 144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable
costs of the construction project. A current request that is not the result of a project under
section 144A.073 cannot exceed the limit stated in section 144A.071, subdivision 2,
paragraph (a). Assets disposed of as a result of a construction project and applicable
credits must be deducted from the cost of the construction project.
new text end

new text begin (f) For construction projects approved under section 144A.073, allowable debt can
never exceed the cost of the assets purchased, the threshold limit in section 144A.071,
subdivision 2, or the replacement-cost-new limit less previously existing capital debt.
new text end

new text begin (g) For construction projects that were not approved under section 144A.073,
allowable debt is limited to the lesser of the threshold in section 144A.071, subdivision 2,
for such construction projects or the applicable limit in paragraph (e), clause (1) or (2),
less previously existing capital debt. Amounts of debt taken out that exceed the costs of a
construction project shall not be allowed regardless of the use of the funds.
new text end

new text begin For all construction projects being recognized, interest expense and average debt
shall be computed based on the first 12 months following project completion. "Previously
existing capital debt" means capital debt recognized on the last rate determined under
section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, and the amount of
debt recognized for a construction project for which the facility received a rate adjustment
when its rates were determined under this section.
new text end

new text begin For a total replacement project as defined in section 256B.431, subdivision 17d, the
value of previously existing capital debt shall be zero.
new text end

new text begin (h) In addition to the interest expense allowed from the application of paragraph (f),
the amounts allowed under section 256B.431, subdivision 17a, paragraph (a), clauses (2)
and (3), will be added to interest expense.
new text end

new text begin (i) The equity portion of the construction project shall be computed as the allowable
assets in paragraph (e), less the average debt in paragraph (f). The equity portion must
be multiplied by 5.66 percent and the allowable interest expense in paragraph (f) must
be added. This sum must be divided by 95 percent of capacity days to compute the
construction project rate adjustment.
new text end

new text begin (j) For projects that are not a total replacement of a nursing facility, the amount
in paragraph (i) is adjusted for nonreimbursable areas and then added to the current
property-related per diem of the facility.
new text end

new text begin (k) For projects that are a total replacement of a nursing facility, the amount
in paragraph (i) becomes the new property-related per diem after being adjusted for
nonreimbursable areas. Any amounts existing in a facility's rate before the effective date
of the construction project for equity incentives under section 256B.431, subdivision 16;
capital repairs and replacements under section 256B.431, subdivision 15; or refinancing
incentives under section 256B.431, subdivision 19, shall be removed from the facility's
rates.
new text end

new text begin (l) No additional equipment allowance is allowed under Minnesota Rules, part
9549.0060, subpart 10, as the result of construction projects under this section. Allowable
equipment shall be included in the construction project costs.
new text end

new text begin (m) Capital assets purchased after the completion date of a construction project shall
be counted as construction project costs for any future rate adjustment request made by a
facility under section 144A.071, subdivision 2, clause (a), if they are purchased within 24
months of the completion of the future construction project.
new text end

new text begin (n) In subsequent rate years, the property-related rate for a facility that results from
the application of this subdivision shall be the amount inflated in subdivision 4.
new text end

new text begin (o) Construction projects are eligible for an equity incentive under section 256B.431,
subdivision 16. When computing the equity incentive for a construction project under
this subdivision, only the allowable costs and allowable debt related to the construction
project shall be used. The equity incentive shall not be a part of the property-related per
diem and not inflated under subdivision 4.
new text end

Sec. 21.

Minnesota Statutes 2004, section 256B.434, is amended by adding a
subdivision to read:

new text begin Subd. 4g. new text end

new text begin Facility rate increase effective October 1, 2007; Otter Tail County.
new text end

new text begin For the rate year beginning October 1, 2007, a nursing facility in Otter Tail County
that was licensed for 57 beds as of December 31, 2004, shall receive a rate increase to
increase its operating rate to the 60th percentile of the operating rates of all other Otter
Tail County nursing facilities. The commissioner shall determine the 60th percentile of
the case mix portion of the operating rates with a RUGS weight of 1.0 of all other Otter
Tail County nursing facilities and then apply the case mix weights. The 60th percentile of
the other operating per diem for all other Otter Tail County nursing facilities will be added
to the above-determined case mix rates to compute the operating payment rates. The
nonoperating components of the facility's rates will not be adjusted under this subdivision.
new text end

Sec. 22.

Minnesota Statutes 2004, section 256B.434, is amended by adding a
subdivision to read:

new text begin Subd. 4h. new text end

new text begin Nursing facility rate increase effective October 1, 2007; Martin
County. new text end

new text begin For the rate year beginning October 1, 2007, the commissioner shall provide to a
nursing facility in Martin County licensed for 93 beds as of January 1, 2006, an increase in
the total operating payment rate of $5 per resident day for all case mix classes.
new text end

Sec. 23.

Minnesota Statutes 2004, section 256B.437, subdivision 3, is amended to read:

Subd. 3.

Applications for planned closure of nursing facilities.

(a) By August
15, 2001, the commissioner of human services shall implement and announce a program
for closure or partial closure of nursing facilities. Names and identifying information
provided in response to the announcement shall remain private unless approved, according
to the timelines established in the plan. The announcement must specify:

(1) the criteria in subdivision 4 that will be used by the commissioner to approve or
reject applications;

(2) the information that must accompany an application; and

(3) that applications may combine planned closure rate adjustments with moratorium
exception funding, in which case a single application may serve both purposes.

Between August 1, 2001, and June 30, 2003, the commissioner may approve planned
closures of up to 5,140 nursing facility beds, less the number of beds delicensed in
facilities during the same time period without approved closure plans or that have notified
the commissioner of health of their intent to close without an approved closure plan.
Beginning July 1, 2004, the commissioner may negotiate a planned closure new text begin rate adjustment
new text end for nursing facilities providing the proposal has no cost to the state.new text begin For planned closure
rate adjustments negotiated after March 1, 2006, the limit of $2,080 in subdivision 6,
paragraph (a), clause (1), shall not apply. The removal of the limit in subdivision 6,
paragraph (a), clause (1), shall not constitute an increase to the amount specified in
subdivision 6, paragraph (a), clause (1), for the purposes of subdivision 6, paragraph (f).
new text end

(b) A facility or facilities reimbursed under section 256B.431 or 256B.434 with a
closure plan approved by the commissioner under subdivision 5 may assign a planned
closure rate adjustment to another facility or facilities that are not closing or in the case of
a partial closure, to the facility undertaking the partial closure. A facility may also elect to
have a planned closure rate adjustment shared equally by the five nursing facilities with
the lowest total operating payment rates in the state development region designated under
section 462.385, in which the facility that is closing is located. The planned closure
rate adjustment must be calculated under subdivision 6. Facilities that delicense beds
without a closure plan, or whose closure plan is not approved by the commissioner, are not
eligible to assign a planned closure rate adjustment under subdivision 6, unless they are
delicensing five or fewer beds, or less than six percent of their total licensed bed capacity,
whichever is greater, are located in a county in the top three quartiles of beds per 1,000
persons aged 65 or older, and have not delicensed beds in the prior three months. Facilities
meeting these criteria are eligible to assign the amount calculated under subdivision 6 to
themselves. If a facility is delicensing the greater of six or more beds, or six percent or
more of its total licensed bed capacity, and does not have an approved closure plan or is
not eligible for the adjustment under subdivision 6, the commissioner shall calculate the
amount the facility would have been eligible to assign under subdivision 6, and shall use
this amount to provide equal rate adjustments to the five nursing facilities with the lowest
total operating payment rates in the state development region designated under section
462.385, in which the facility that delicensed beds is located.

(1) a description of the proposed closure plan, which must include identification of
the facility or facilities to receive a planned closure rate adjustment;

(2) the proposed timetable for any proposed closure, including the proposed dates
for announcement to residents, commencement of closure, and completion of closure;

(3) if available, the proposed relocation plan for current residents of any facility
designated for closure. If a relocation plan is not available, the application must include a
statement agreeing to develop a relocation plan designed to comply with section 144A.161;

(4) a description of the relationship between the nursing facility that is proposed for
closure and the nursing facility or facilities proposed to receive the planned closure rate
adjustment. If these facilities are not under common ownership, copies of any contracts,
purchase agreements, or other documents establishing a relationship or proposed
relationship must be provided;

(5) documentation, in a format approved by the commissioner, that all the nursing
facilities receiving a planned closure rate adjustment under the plan have accepted joint
and several liability for recovery of overpayments under section 256B.0641, subdivision
2, for the facilities designated for closure under the plan; and

(6) an explanation of how the application coordinates with planning efforts under
subdivision 2. If the planning group does not support a level of nursing facility closures
that the commissioner considers to be reasonable, the commissioner may approve a
planned closure proposal without its support.

(d) The application must address the criteria listed in subdivision 4.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from March 1, 2006.
new text end

Sec. 24.

Minnesota Statutes 2004, section 256B.438, subdivision 4, is amended to read:

Subd. 4.

Resident assessment schedule.

(a) Nursing facilities shall conduct and
submit case mix assessments according to the schedule established by the commissioner
of health under section 144.0724, subdivisions 4 and 5.

(b) The resident reimbursement classifications established under section 144.0724,
subdivision 3, shall be effective the day of admission for new admission assessments. The
effective date for significant change assessments shall be the assessment reference date.
The effective date for annual and deleted text begin seconddeleted text end quarterly assessments shall be the first day of the
month following assessment reference date.

new text begin (c) Effective October 1, 2006, the commissioner shall rebase payment rates
to account for the change in the resident assessment schedule in section 144.0724,
subdivision 4, paragraph (b), clause (4), in a facility specific budget neutral manner,
according to subdivision 7, paragraph (b). The rebased payment rates shall apply only for
the rate period October 1, 2006, through September 30, 2008.
new text end

Sec. 25.

Minnesota Statutes 2004, section 256B.69, subdivision 9, is amended to read:

Subd. 9.

Reporting.

new text begin (a) new text end Each demonstration provider shall submit information as
required by the commissioner, including data required for assessing client satisfaction,
quality of care, cost, and utilization of services for purposes of project evaluation. The
commissioner shall also develop methods of data new text begin reporting and new text end collection deleted text begin from county
advocacy activitiesdeleted text end in order to provide aggregate enrollee information on encounters
and outcomes to determine access and quality assurance. Required information shall be
specified before the commissioner contracts with a demonstration provider.

new text begin (b) Aggregate nonpersonally identifiable health plan encounter data, aggregate
spending data for major categories of service as reported to the commissioners of health
and commerce under section 62D.08, subdivision 3, paragraph (a), and criteria for
service authorization and service use are public data that the commissioner shall make
available and use in public reports. The commissioner shall require each health plan and
county-based purchasing plan to provide:
new text end

new text begin (1) encounter data for each service provided, using standard codes and unit of
service definitions set by the commissioner, in a form that the commissioner can report by
age, eligibility groups, and health plan; and
new text end

new text begin (2) criteria, written policies, and procedures required to be disclosed under section
62M.10, subdivision 7, and Code of Federal Regulations, title 42, part 438.210(b)(1), used
for each type of service for which authorization is required.
new text end

Sec. 26.

Minnesota Statutes 2005 Supplement, section 256B.69, subdivision 23,
is amended to read:

Subd. 23.

Alternative services; elderly and disabled persons.

(a) The
commissioner may implement demonstration projects to create alternative integrated
delivery systems for acute and long-term care services to elderly persons and persons
with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
coordination, improve access to quality services, and mitigate future cost increases.
The commissioner may seek federal authority to combine Medicare and Medicaid
capitation payments for the purpose of such demonstrationsnew text begin and may contract with
Medicare-approved special needs plans to provide Medicaid servicesnew text end . Medicare funds
and services shall be administered according to the terms and conditions of the federal
deleted text begin waiverdeleted text end new text begin contractnew text end and demonstration provisions. For the purpose of administering medical
assistance funds, demonstrations under this subdivision are subject to subdivisions 1 to
22. The provisions of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these
demonstrations, with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457,
subpart 1, items B and C, which do not apply to persons enrolling in demonstrations
under this section. An initial open enrollment period may be provided. Persons who
disenroll from demonstrations under this subdivision remain subject to Minnesota Rules,
parts 9500.1450 to 9500.1464. When a person is enrolled in a health plan under these
demonstrations and the health plan's participation is subsequently terminated for any
reason, the person shall be provided an opportunity to select a new health plan and shall
have the right to change health plans within the first 60 days of enrollment in the second
health plan. Persons required to participate in health plans under this section who fail
to make a choice of health plan shall not be randomly assigned to health plans under
these demonstrations. Notwithstanding section 256L.12, subdivision 5, and Minnesota
Rules, part 9505.5220, subpart 1, item A, if adopted, for the purpose of demonstrations
under this subdivision, the commissioner may contract with managed care organizations,
including counties, to serve only elderly persons eligible for medical assistance, elderly
and disabled persons, or disabled persons only. For persons with primary diagnoses of
mental retardation or a related condition, serious and persistent mental illness, or serious
emotional disturbance, the commissioner must ensure that the county authority has
approved the demonstration and contracting design. Enrollment in these projects for
persons with disabilities shall be voluntary. The commissioner shall not implement any
demonstration project under this subdivision for persons with primary diagnoses of
mental retardation or a related condition, serious and persistent mental illness, or serious
emotional disturbance, without approval of the county board of the county in which the
demonstration is being implemented.

(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
under this section projects for persons with developmental disabilities. The commissioner
may capitate payments for ICF/MR services, waivered services for mental retardation or
related conditions, including case management services, day training and habilitation and
alternative active treatment services, and other services as approved by the state and by the
federal government. Case management and active treatment must be individualized and
developed in accordance with a person-centered plan. Costs under these projects may not
exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
and until two years after the pilot project implementation date, subcontractor participation
in the long-term care developmental disability pilot is limited to a nonprofit long-term
care system providing ICF/MR services, home and community-based waiver services,
and in-home services to no more than 120 consumers with developmental disabilities in
Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
prior to expansion of the developmental disability pilot project. This paragraph expires
two years after the implementation date of the pilot project.

(c) Before implementation of a demonstration project for disabled persons, the
commissioner must provide information to appropriate committees of the house of
representatives and senate and must involve representatives of affected disability groups
in the design of the demonstration projects.

(d) A nursing facility reimbursed under the alternative reimbursement methodology
in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
provide services under paragraph (a). The commissioner shall amend the state plan and
seek any federal waivers necessary to implement this paragraph.

(e) The commissioner, in consultation with the commissioners of commerce and
health, may approve and implement programs for all-inclusive care for the elderly (PACE)
according to federal laws and regulations governing that program and state laws or rules
applicable to participating providers. The process for approval of these programs shall
begin only after the commissioner receives grant money in an amount sufficient to cover
the state share of the administrative and actuarial costs to implement the programs during
state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
account in the special revenue fund and are appropriated to the commissioner to be used
solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
not required to be licensed or certified as a health plan company as defined in section
62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county
and found to be eligible for services under the elderly waiver or community alternatives
for disabled individuals or who are already eligible for Medicaid but meet level of
care criteria for receipt of waiver services may choose to enroll in the PACE program.
Medicare and Medicaid services will be provided according to this subdivision and
federal Medicare and Medicaid requirements governing PACE providers and programs.
PACE enrollees will receive Medicaid home and community-based services through the
PACE provider as an alternative to services for which they would otherwise be eligible
through home and community-based waiver programs and Medicaid State Plan Services.
The commissioner shall establish Medicaid rates for PACE providers that do not exceed
costs that would have been incurred under fee-for-service or other relevant managed care
programs operated by the state.

(f) The commissioner shall seek federal approval to expand the Minnesota disability
health options (MnDHO) program established under this subdivision in stages, first to
regional population centers outside the seven-county metro area and then to all areas
of the state.new text begin Until January 1, 2008, expansion for MnDHO projects that include home
and community-based services is limited to the two projects and service areas in effect
on March 1, 2006. Enrollment in integrated MnDHO programs that include home and
community-based services shall remain voluntary. Costs for home and community-based
services included under MnDHO must not exceed costs that would have been incurred
under the fee-for-service program. In developing program specifications for expansion of
integrated programs, the commissioner shall involve and consult the state-level stakeholder
group established in subdivision 28, paragraph (d), including consultation on whether and
how to include home and community-based waiver programs. Plans for further expansion
of MnDHO projects shall be presented to the chairs of the house and senate committees
with jurisdiction over health and human services policy and finance by February 1, 2007.
new text end

(g) Notwithstanding section 256B.0261, health plans providing services under this
section are responsible for home care targeted case management and relocation targeted
case management. Services must be provided according to the terms of the waivers and
contracts approved by the federal government.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 27.

Minnesota Statutes 2004, section 256B.69, is amended by adding a
subdivision to read:

new text begin Subd. 28. new text end

new text begin Medicare special needs plans and medical assistance basic health
care for persons with disabilities. new text end

new text begin (a) The commissioner may contract with qualified
Medicare-approved special needs plans to provide medical assistance basic health care
services to persons with disabilities, including those with developmental disabilities.
Basic health care services include:
new text end

new text begin (1) those services covered by the medical assistance state plan except for ICF/MR
services, home and community-based waiver services, case management for persons with
developmental disabilities under section 256B.0625, subdivision 20a, and personal care
and certain home care services defined by the commissioner in consultation with the
stakeholder group established under paragraph (d);
new text end

new text begin (2) basic health care services may also include risk for up to 100 days of nursing
facility services for persons who reside in a noninstitutional setting and home health
services related to rehabilitation as defined by the commissioner after consultation with
the stakeholder group; and
new text end

new text begin (3) the commissioner may exclude other medical assistance services from the basic
health care benefit set. Enrollees in these plans can access any excluded services on the
same basis as other medical assistance recipients who have not enrolled.
new text end

new text begin Unless a person is otherwise required to enroll in managed care, enrollment in these
plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
enrollment with an option to opt out is not voluntary enrollment.
new text end

new text begin (b) Beginning January 1, 2007, the commissioner may contract with qualified
Medicare special needs plans to provide basic health care services under medical
assistance to persons who are dually eligible for both Medicare and Medicaid and those
Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
The commissioner shall consult with the stakeholder group under paragraph (d) in
developing program specifications for these services. The commissioner shall report to
the chairs of the house and senate committees with jurisdiction over health and human
services policy and finance by February 1, 2007, on implementation of these programs and
the need for increased funding for the ombudsman for managed care and other consumer
assistance and protections needed due to enrollment in managed care of persons with
disabilities. Payment for Medicaid services provided under this subdivision for the months
of May and June will be made no earlier than July 1 of the same calendar year.
new text end

new text begin (c) Beginning January 1, 2008, the commissioner may expand contracting under this
subdivision to all persons with disabilities not otherwise required to enroll in managed
care.
new text end

new text begin (d) The commissioner shall establish a state-level stakeholder group to provide
advice on managed care programs for persons with disabilities, including both MnDHO
and contracts with special needs plans that provide basic health care services as described
in paragraphs (a) and (b). The stakeholder group shall provide advice on program
expansions under this subdivision and subdivision 23, including:
new text end

new text begin (1) implementation efforts;
new text end

new text begin (2) consumer protections; and
new text end

new text begin (3) program specifications such as quality assurance measures, data collection and
reporting, and evaluation of costs, quality, and results.
new text end

new text begin (e) Each plan under contract to provide medical assistance basic health care services
shall establish a local or regional stakeholder group, including representatives of the
counties covered by the plan, members, consumer advocates, and providers, for advice on
issues that arise in the local or regional area.
new text end

Sec. 28.

Laws 2005, First Special Session chapter 4, article 9, section 5, subdivision 8,
is amended to read:

Subd. 8.

Board of Nursing

3,078,000

3,631,000

new text begin new text end

BASE ADJUSTMENT. The base for the
board of nursing is increased by $141,000
in fiscal year 2008 and by $216,000 in fiscal
year 2009.

BOARD OF NURSING
APPROPRIATIONS INCREASE. Of
this appropriation, $120,000 the first year
and $126,000 the second year are for the
increased cost of board operations, excluding
salary increases and $85,000 each year is to
hire an advanced practice registered nurse.

TRANSFERS FROM SPECIAL
REVENUE FUND. Of this appropriation,
the following transfers shall be made as
directed from the state government special
revenue fund:

(a) $392,000 in fiscal year 2006, $864,000
in fiscal year 2007, $930,000 in fiscal year
2008, and $930,000 in fiscal year 2009
shall be transferred to the general fund
and is appropriated to the Department
of Human Services to offset the state
share of the medical assistance program
costs of the long-term care and home and
community-based care employee scholarship
program and associated administrative costs.
At the end of each biennium, any funds
not expended for the scholarship program
and associated administrative costs shall
be deleted text begin transferred to the state government
special revenue funddeleted text end new text begin carried over to the
next biennium for the same purposenew text end .
Notwithstanding section 15, this paragraph
expires June 30, deleted text begin 2009deleted text end new text begin 2011new text end .

(b) $125,000 the first year and $200,000 the
second year shall be transferred to the health
professional education loan forgiveness
program account for loan forgiveness
for nurses under Minnesota Statutes,
section 144.1501. This appropriation shall
become part of base level funding for the
commissioner for the biennium beginning
July 1, 2007, but shall not be part of base
level funding for the biennium beginning
July 1, 2009. Notwithstanding section 15,
this paragraph expires on June 30, 2009.

Sec. 29. new text begin STAKEHOLDER PARTICIPATION.
new text end

new text begin The commissioner of human services shall confer with one or more stakeholder
groups of interested persons, including representatives of recipients, advocacy groups,
counties, providers, and health plans to provide information and advice on the development
of any substantial proposals for changes in the medical assistance program authorized by
the federal Deficit Reduction Act of 2005, Public Law 109-171. In addition, for any
substantial Deficit Reduction Act-related medical assistance change that affects recipients
and that is proposed outside of the legislative or rulemaking process, the commissioner
shall convene a stakeholder meeting and provide a 30-day comment period before the
change becomes effective. If the time frame required to comply with a federal mandate
precludes the 30-day advance notice, notice shall be given to the stakeholder group as
soon as possible.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 30. new text begin ICF/MR PLAN.
new text end

new text begin The commissioner of human services shall consult with ICF/MR providers,
advocates, counties, and consumer families to develop a stakeholder plan and legislation
concerning the future services provided to people served in ICFs/MR. The plan shall be
reported to the house and senate committees with jurisdiction over health and human
services policy and finance issues by December 15, 2008. In preparing the plan, the
commissioner shall consider:
new text end

new text begin (1) consumer choice of services;
new text end

new text begin (2) consumers' service needs, including, but not limited to, active treatment;
new text end

new text begin (3) the total cost of providing services in ICFs/MR and alternative delivery systems
for individuals currently residing in ICFs/MR;
new text end

new text begin (4) the impact of the payment shift to counties for ICFs/MR with more than six beds;
new text end

new text begin (5) whether it is the policy of the state to maintain an ICF/MR system and, if so,
the plan shall:
new text end

new text begin (i) define the purpose, types of services, and intended recipients of ICF/MR services;
new text end

new text begin (ii) define the capacity needed to maintain ICF/MR services for designated
populations;
new text end

new text begin (iii) evaluate incentives for counties to maintain ICF/MR services;
new text end

new text begin (iv) ensure that mechanisms are provided to adequately fund the transition to the
defined services, maintain the designated capacity, and are adjustable to meet increased
service demands; and
new text end

new text begin (v) address the extent to which there is consensus among stakeholders; and
new text end

new text begin (6) if alternative services are recommended to support the people now receiving
services in an ICF/MR, the plan shall provide for transition planning and ensure adequate
state and federal financial resources are available to meet the needs of ICF/MR recipients.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 31. new text begin ADDITIONAL WAIVER ALLOCATIONS.
new text end

new text begin Notwithstanding the waiver growth limits in Laws 2005, First Special Session
chapter 4, article 9, section 2, paragraph (d), the commissioner may allocate an additional
waiver allocation under Minnesota Statutes, section 256B.49, for a recipient of personal
care assistant services who is eligible for and chooses waivered services and received
personal care assistant services from a provider who was billing for a service delivery
model for that recipient other than individual or shared care on March 1, 2006.
new text end

Sec. 32. new text begin REPORT ON NEW CASE MIX INDICES.
new text end

new text begin The commissioner of human services shall report to the legislature by December
15, 2006, a mechanism to implement the case mix indices recommended in the 2004
Minnesota Nursing Facility Staff Time Measurement Study.
new text end

Sec. 33. new text begin COMMISSIONER OF HUMAN SERVICES; CONTINUING CARE
MANAGEMENT BASE LEVEL ADJUSTMENT.
new text end

new text begin The general fund base for continuing care management is increased by $20,000 in
fiscal year 2008 and by $30,000 in fiscal year 2009.
new text end

Sec. 34.

new text begin REPAYMENT DELAY.
new text end

new text begin A county that overspent its allowed amounts in calendar year 2004 or 2005 under
the waivered services program for persons with developmental disabilities shall not be
required to pay back the amount of overspending until May 31, 2007.
new text end

HF 3144

Bill Text Versions

Current Version - 2nd Engrossment

ARTICLE 1

ASSISTED LIVING

Section 1.

new text begin [144A.441] ASSISTED LIVING BILL OF RIGHTS ADDENDUM. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 2.

new text begin [144A.442] TERMINATION OF HOME CARE SERVICES FOR ASSISTED LIVING CLIENTS. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 3.

144A.4605 deleted text begin ASSISTED LIVING HOME CAREdeleted text end new text begin CLASS Fnew text end PROVIDER.

Subdivision 1.

Definitions.

Subd. 2.

deleted text begin Assisted livingdeleted text end new text begin Class Fnew text end home care license established.

Subd. 3.

Training or competency evaluations required.

Subd. 4.

License required.

Subd. 5.

License fees.

Subd. 6.

Waiver.

new text begin EFFECTIVE DATE. new text end

Sec. 4.

new text begin Subd. 2a. new text end

new text begin Arranged home care provider. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 5.

144D.015 ASSISTED LIVING FACILITY new text begin OR ASSISTED LIVING RESIDENCE new text end DEFINITION FOR PURPOSES OF LONG-TERM CARE INSURANCE.

new text begin EFFECTIVE DATE. new text end

Sec. 6.

144D.02 REGISTRATION REQUIRED.

new text begin EFFECTIVE DATE. new text end

Sec. 7.

new text begin Subd. 1a. new text end

new text begin Surcharge for injunctive relief actions. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 8.

Subd. 2.

Registration information.

new text begin EFFECTIVE DATE. new text end

Sec. 9.

144D.04 deleted text begin ELDERLYdeleted text end HOUSING WITH SERVICES CONTRACTS.

Subdivision 1.

Contract required.

Subd. 2.

Contents of contract.

Subd. 3.

Contracts in permanent files.

new text begin EFFECTIVE DATE. new text end

Sec. 10.

new text begin [144D.045] INFORMATION CONCERNING ARRANGED HOME CARE PROVIDERS. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 11.

144D.05 AUTHORITY OF COMMISSIONER.

new text begin EFFECTIVE DATE. new text end

Sec. 12.

144D.065 ESTABLISHMENTS THAT SERVE PERSONS WITH ALZHEIMER'S DISEASE OR RELATED DISORDERS.

new text begin EFFECTIVE DATE. new text end

Sec. 13.

new text begin [144G.01] DEFINITIONS. new text end

new text begin Subdivision 1. new text end

new text begin Scope; other definitions. new text end

new text begin Subd. 2. new text end

new text begin Assisted living. new text end

new text begin Subd. 3. new text end

new text begin Assisted living client. new text end

new text begin Subd. 4. new text end

new text begin Commissioner. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 14.

new text begin [144G.02] ASSISTED LIVING; PROTECTED TITLE; RESTRICTION ON USE; REGULATORY FUNCTIONS. new text end

new text begin Subdivision 1. new text end

new text begin Protected title; restriction on use. new text end

new text begin Subd. 2. new text end

new text begin Authority of commissioner. new text end

new text begin EFFECTIVE DATE. new text end

new text begin [144A.441] ASSISTED LIVING BILL OF RIGHTS ADDENDUM.
new text end

new text begin [144A.442] TERMINATION OF HOME CARE SERVICES FOR
ASSISTED LIVING CLIENTS.
new text end

144D.015 ASSISTED LIVING FACILITY new text begin OR ASSISTED LIVING
RESIDENCE new text end DEFINITION FOR PURPOSES OF LONG-TERM CARE
INSURANCE.

new text begin [144D.045] INFORMATION CONCERNING ARRANGED HOME
CARE PROVIDERS.
new text end

144D.065 ESTABLISHMENTS THAT SERVE PERSONS WITH
ALZHEIMER'S DISEASE OR RELATED DISORDERS.

new text begin [144G.01] DEFINITIONS.
new text end

new text begin [144G.02] ASSISTED LIVING; PROTECTED TITLE; RESTRICTION
ON USE; REGULATORY FUNCTIONS.
new text end

new text begin [144G.03] ASSISTED LIVING REQUIREMENTS.
new text end

new text begin [144G.04] RESERVATION OF RIGHTS.
new text end

new text begin [144G.05] REIMBURSEMENT UNDER ASSISTED LIVING SERVICE
PACKAGES.
new text end

new text begin [144G.06] UNIFORM CONSUMER INFORMATION GUIDE.
new text end

Sec. 19. new text begin REVISOR'S INSTRUCTION.
new text end

Sec. 20. new text begin APPROPRIATION; ASSISTED LIVING.
new text end

Sec. 21. new text begin REPEALER.
new text end