Minnesota Legislature
HF 3483
1st Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am
Bill Text Versions
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| Introduction | Posted on 03/15/2006 | |
| 1st Engrossment | Posted on 04/03/2006 |
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10.6
A bill for an act
relating to human services; modifying nursing home relocation requirements;
removing the limit on certain nursing facility planned closure rate adjustments;
amending Minnesota Statutes 2004, sections 144A.161, subdivisions 1, 2, 3, 4, 5,
5a, 5c, 6, 8, by adding a subdivision; 256B.437, subdivision 3.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
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. 2.
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. 3.
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. 4.
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. 5.
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. 6.
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. 7.
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. 8.
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. 9.
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.
(c) Subsequent status reports must identify:
(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. 10.
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. 11.
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.
(c) To be considered for approval, an application must include:
(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