as introduced - 92nd Legislature (2021 - 2022) Posted on 03/23/2022 10:40am
Engrossments | ||
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Introduction | Posted on 03/23/2022 |
A bill for an act
relating to health; modifying a definition of electronic monitoring; modifying
provisions for the home care and assisted living program advisory council;
modifying provisions for assisted living licensure; amending Minnesota Statutes
2020, sections 144.6502, subdivision 1; 144A.4799, subdivisions 1, 3; 144G.08,
by adding a subdivision; 144G.15; 144G.17; 144G.19, by adding a subdivision;
144G.20, subdivisions 1, 4, 5, 8, 9, 12, 15; 144G.30, subdivision 5; 144G.31,
subdivisions 4, 8; 144G.41, subdivisions 7, 8; 144G.42, subdivision 10; 144G.50,
subdivision 2; 144G.52, subdivisions 2, 8, 9; 144G.53; 144G.55, subdivisions 1,
3; 144G.56, subdivisions 3, 5; 144G.57, subdivisions 1, 3, 5; 144G.70, subdivisions
2, 4; 144G.80, subdivision 2; 144G.90, subdivision 1; 144G.91, subdivisions 13,
21, by adding a subdivision; 144G.92, subdivision 1; 144G.93; 144G.95.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Minnesota Statutes 2020, section 144.6502, subdivision 1, is amended to read:
(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.
(b) "Commissioner" means the commissioner of health.
(c) "Department" means the Department of Health.
(d) "Electronic monitoring" means the placement and use of an electronic monitoring
device deleted text begin by a residentdeleted text end in the resident's room or private living unit in accordance with this
section.
(e) "Electronic monitoring device" means a camera or other device that captures, records,
or broadcasts audio, video, or both, that is placed in a resident's room or private living unit
and is used to monitor the resident or activities in the room or private living unit.
(f) "Facility" means a facility that is:
(1) licensed as a nursing home under chapter 144A;
(2) licensed as a boarding care home under sections 144.50 to 144.56;
(3) until August 1, 2021, a housing with services establishment registered under chapter
144D that is either subject to chapter 144G or has a disclosed special unit under section
325F.72; or
(4) on or after August 1, 2021, an assisted living facility.
(g) "Resident" means a person 18 years of age or older residing in a facility.
(h) "Resident representative" means one of the following in the order of priority listed,
to the extent the person may reasonably be identified and located:
(1) a court-appointed guardian;
(2) a health care agent as defined in section 145C.01, subdivision 2; or
(3) a person who is not an agent of a facility or of a home care provider designated in
writing by the resident and maintained in the resident's records on file with the facility.
Minnesota Statutes 2020, section 144A.4799, subdivision 1, is amended to read:
The commissioner of health shall appoint deleted text begin eightdeleted text end new text begin 12new text end persons
to a home care and assisted living program advisory council consisting of the following:
(1) deleted text begin threedeleted text end new text begin twonew text end public members as defined in section 214.02 who shall be persons who
are currently receiving home care services, persons who have received home care services
within five years of the application date, persons who have family members receiving home
care services, or persons who have family members who have received home care services
within five years of the application date;
(2) deleted text begin threedeleted text end new text begin twonew text end Minnesota home care licensees representing basic and comprehensive
levels of licensure who may be a managerial official, an administrator, a supervising
registered nurse, or an unlicensed personnel performing home care tasks;
(3) one member representing the Minnesota Board of Nursing;
(4) one member representing the Office of Ombudsman for Long-Term Carenew text begin and the
Office of Ombudsman for Mental Health and Developmental Disabilitiesnew text end ; deleted text begin and
deleted text end
(5) beginning July 1, 2021, one member of a county health and human services or county
adult protection officedeleted text begin .deleted text end new text begin ;
new text end
new text begin
(6) two Minnesota assisted living facility licensees representing assisted living facilities
and assisted living facilities with dementia care levels of licensure who may be the facility's
assisted living director, managerial official, or clinical nurse supervisor;
new text end
new text begin
(7) one organization representing long-term care providers, home care providers, and
assisted living providers in Minnesota; and
new text end
new text begin
(8) two public members as defined in section 214.02. One public member shall be a
person who either is or has been a resident in an assisted living facility and one public
member shall be a person who has or had a family member living in an assisted living
facility setting.
new text end
Minnesota Statutes 2020, section 144A.4799, subdivision 3, is amended to read:
(a) At the commissioner's request, the advisory council shall provide
advice regarding regulations of Department of Health licensed new text begin assisted living and new text end home
care providers in this chapter, including advice on the following:
(1) community standards for home care practices;
(2) enforcement of licensing standards and whether certain disciplinary actions are
appropriate;
(3) ways of distributing information to licensees and consumers of home care and assisted
livingnew text begin services defined under chapter 144Gnew text end ;
(4) training standards;
(5) identifying emerging issues and opportunities in home care and assisted livingnew text begin services
defined under chapter 144Gnew text end ;
(6) identifying the use of technology in home and telehealth capabilities;
(7) allowable home care licensing modifications and exemptions, including a method
for an integrated license with an existing license for rural licensed nursing homes to provide
limited home care services in an adjacent independent living apartment building owned by
the licensed nursing home; and
(8) recommendations for studies using the data in section 62U.04, subdivision 4, including
but not limited to studies concerning costs related to dementia and chronic disease among
an elderly population over 60 and additional long-term care costs, as described in section
62U.10, subdivision 6.
(b) The advisory council shall perform other duties as directed by the commissioner.
(c) The advisory council shall annually make recommendations to the commissioner for
the purposes in section 144A.474, subdivision 11, paragraph (i). The recommendations shall
address ways the commissioner may improve protection of the public under existing statutes
and laws and include but are not limited to projects that create and administer training of
licensees and their employees to improve residents' lives, supporting ways that licensees
can improve and enhance quality care and ways to provide technical assistance to licensees
to improve compliance; information technology and data projects that analyze and
communicate information about trends of violations or lead to ways of improving client
care; communications strategies to licensees and the public; and other projects or pilots that
benefit clients, families, and the public.
Minnesota Statutes 2020, section 144G.08, is amended by adding a subdivision to
read:
new text begin
"Serious injury" has the meaning given in section 245.91,
subdivision 6.
new text end
Minnesota Statutes 2020, section 144G.15, is amended to read:
(a) Before issuing a provisional license or license or renewing a license, the commissioner
shall consider an applicant's compliance history in providing care in new text begin this state or any other
state in new text end a facility that provides care to children, the elderly, ill individuals, or individuals
with disabilities.
(b) The applicant's compliance history shall include repeat violation, rule violations, and
any license or certification involuntarily suspended or terminated during an enforcement
process.
(c) The commissioner may deny, revoke, suspend, restrict, or refuse to renew the license
or impose conditions if:
(1) the applicant fails to provide complete and accurate information on the application
and the commissioner concludes that the missing or corrected information is needed to
determine if a license shall be granted;
(2) the applicant, knowingly or with reason to know, made a false statement of a material
fact in an application for the license or any data attached to the application or in any matter
under investigation by the department;
(3) the applicant refused to allow agents of the commissioner to inspect its books, records,
and files related to the license application, or any portion of the premises;
(4) the applicant willfully prevented, interfered with, or attempted to impede in any way:
(i) the work of any authorized representative of the commissioner, the ombudsman for
long-term care, or the ombudsman for mental health and developmental disabilities; or (ii)
the duties of the commissioner, local law enforcement, city or county attorneys, adult
protection, county case managers, or other local government personnel;
(5) the applicantnew text begin , owner, controlling individual, managerial official, or assisted living
director for the facilitynew text end has a history of noncompliance with federal or state regulations that
were detrimental to the health, welfare, or safety of a resident or a client; or
(6) the applicant violates any requirement in this chapter.
(d) If a license is denied, the applicant has the reconsideration rights available under
section 144G.16, subdivision 4.
Minnesota Statutes 2020, section 144G.17, is amended to read:
A license that is not a provisional license may be renewed for a period of up to one year
if the licensee:
(1) submits an application for renewal in the format provided by the commissioner at
least 60 calendar days before expiration of the license;
(2) submits the renewal fee under section 144G.12, subdivision 3;
(3) submits the late fee under section 144G.12, subdivision 4, if the renewal application
is received less than 30 days before the expiration date of the license or after the expiration
of the license;
(4) provides information sufficient to show that the applicant meets the requirements of
licensure, including items required under section 144G.12, subdivision 1; deleted text begin and
deleted text end
new text begin
(5) provides information sufficient to show the licensee provided assisted living services
to at least one resident during the immediately preceding license year and at the assisted
living facility listed on the license; and
new text end
deleted text begin (5)deleted text end new text begin (6)new text end provides any other information deemed necessary by the commissioner.
Minnesota Statutes 2020, section 144G.19, is amended by adding a subdivision to
read:
new text begin
Notwithstanding any other provision of law, a change of
licensee under subdivision 2 does not require the facility to meet the design requirements
of section 144G.45, subdivisions 4 to 6, or 144G.81, subdivision 3.
new text end
Minnesota Statutes 2020, section 144G.20, subdivision 1, is amended to read:
(a) The commissioner may refuse to grant a provisional
license, refuse to grant a license as a result of a change in ownership, refuse to renew a
license, suspend or revoke a license, or impose a conditional license if the owner, controlling
individual, or employee of an assisted living facility:
(1) is in violation of, or during the term of the license has violated, any of the requirements
in this chapter or adopted rules;
(2) permits, aids, or abets the commission of any illegal act in the provision of assisted
living services;
(3) performs any act detrimental to the health, safety, and welfare of a resident;
(4) obtains the license by fraud or misrepresentation;
(5) knowingly makes a false statement of a material fact in the application for a license
or in any other record or report required by this chapter;
(6) denies representatives of the department access to any part of the facility's books,
records, files, or employees;
(7) interferes with or impedes a representative of the department in contacting the facility's
residents;
(8) interferes with or impedes ombudsman access according to section 256.9742,
subdivision 4new text begin , or interferes with or impedes access by the Office of Ombudsman for Mental
Health and Developmental Disabilities according to section 245.94, subdivision 1new text end ;
(9) interferes with or impedes a representative of the department in the enforcement of
this chapter or fails to fully cooperate with an inspection, survey, or investigation by the
department;
(10) destroys or makes unavailable any records or other evidence relating to the assisted
living facility's compliance with this chapter;
(11) refuses to initiate a background study under section 144.057 or 245A.04;
(12) fails to timely pay any fines assessed by the commissioner;
(13) violates any local, city, or township ordinance relating to housing or assisted living
services;
(14) has repeated incidents of personnel performing services beyond their competency
level; or
(15) has operated beyond the scope of the assisted living facility's license category.
(b) A violation by a contractor providing the assisted living services of the facility is a
violation by the facility.
Minnesota Statutes 2020, section 144G.20, subdivision 4, is amended to read:
Notwithstanding the provisions of subdivision 13,
paragraph (a), the commissioner must revoke a license if a controlling individual of the
facility is convicted of a felony or gross misdemeanor that relates to operation of the facility
or directly affects resident safety or care. The commissioner shall notify the facility and the
Office of Ombudsman for Long-Term Care new text begin and the Office of Ombudsman for Mental Health
and Developmental Disabilities new text end 30 calendar days in advance of the date of revocation.
Minnesota Statutes 2020, section 144G.20, subdivision 5, is amended to read:
(a) The owners
and managerial officials of a facility whose Minnesota license has not been renewed or
whose deleted text begin Minnesotadeleted text end license new text begin in this state or any other state new text end has been revoked because of
noncompliance with applicable laws or rules shall not be eligible to apply for nor will be
granted an assisted living facility license under this chapter or a home care provider license
under chapter 144A, or be given status as an enrolled personal care assistance provider
agency or personal care assistant by the Department of Human Services under section
256B.0659, for five years following the effective date of the nonrenewal or revocation. If
the owners or managerial officials already have enrollment status, the Department of Human
Services shall terminate that enrollment.
(b) The commissioner shall not issue a license to a facility for five years following the
effective date of license nonrenewal or revocation if the owners or managerial officials,
including any individual who was an owner or managerial official of another licensed
provider, had a deleted text begin Minnesotadeleted text end license new text begin in this state or any other state new text end that was not renewed or
was revoked as described in paragraph (a).
(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall suspend
or revoke, the license of a facility that includes any individual as an owner or managerial
official who was an owner or managerial official of a facility whose deleted text begin Minnesotadeleted text end license new text begin in
this state or any other state new text end was not renewed or was revoked as described in paragraph (a)
for five years following the effective date of the nonrenewal or revocation.
(d) The commissioner shall notify the facility 30 calendar days in advance of the date
of nonrenewal, suspension, or revocation of the license.
Minnesota Statutes 2020, section 144G.20, subdivision 8, is amended to read:
(a) The commissioner has discretion to
bar any controlling individual of a facility if the person was a controlling individual of any
other nursing homenew text begin , home care provider licensed under chapter 144A, or given status as an
enrolled personal care assistance provider agency or personal care assistant by the Department
of Human Services under section 256B.0659,new text end or assisted living facility in the previous
two-year period and:
(1) during that period of time the nursing homenew text begin , home care provider licensed under
chapter 144A, or given status as an enrolled personal care assistance provider agency or
personal care assistant by the Department of Human Services under section 256B.0659,new text end or
assisted living facility incurred the following number of uncorrected or repeated violations:
(i) two or more repeated violations that created an imminent risk to direct resident care
or safety; or
(ii) four or more uncorrected violations that created an imminent risk to direct resident
care or safety; or
(2) during that period of time, was convicted of a felony or gross misdemeanor that
related to the operation of the nursing homenew text begin , home care provider licensed under chapter
144A, or given status as an enrolled personal care assistance provider agency or personal
care assistant by the Department of Human Services under section 256B.0659,new text end or assisted
living facility, or directly affected resident safety or care.
(b) When the commissioner bars a controlling individual under this subdivision, the
controlling individual may appeal the commissioner's decision under chapter 14.
Minnesota Statutes 2020, section 144G.20, subdivision 9, is amended to read:
Subdivision 8 does not apply
to any controlling individual of the facility who had no legal authority to affect or change
decisions related to the operation of the nursing home deleted text begin ordeleted text end new text begin ,new text end assisted living facilitynew text begin , or home
carenew text end that incurred the uncorrected new text begin or repeated new text end violations.
Minnesota Statutes 2020, section 144G.20, subdivision 12, is amended to read:
(a) Within five business days after proceedings are initiated
by the commissioner to revoke or suspend a facility's license, or a decision by the
commissioner not to renew a living facility's license, the controlling individual of the facility
or a designee must provide to the commissioner deleted text begin anddeleted text end new text begin ,new text end the ombudsman for long-term carenew text begin ,
and the Office of Ombudsman for Mental Health and Developmental Disabilitiesnew text end the names
of residents and the names and addresses of the residents' designated representatives and
legal representatives, and family or other contacts listed in the assisted living contract.
(b) The controlling individual or designees of the facility must provide updated
information each month until the proceeding is concluded. If the controlling individual or
designee of the facility fails to provide the information within this time, the facility is subject
to the issuance of:
(1) a correction order; and
(2) a penalty assessment by the commissioner in rule.
(c) Notwithstanding subdivisions 21 and 22, any correction order issued under this
subdivision must require that the facility immediately comply with the request for information
and that, as of the date of the issuance of the correction order, the facility shall forfeit to the
state a $500 fine the first day of noncompliance and an increase in the $500 fine by $100
increments for each day the noncompliance continues.
(d) Information provided under this subdivision may be used by the commissioner deleted text begin ordeleted text end new text begin ,new text end
the ombudsman for long-term carenew text begin , or the Office of Ombudsman for Mental Health and
Developmental Disabilitiesnew text end only for the purpose of providing affected consumers information
about the status of the proceedings.
(e) Within ten business days after the commissioner initiates proceedings to revoke,
suspend, or not renew a facility license, the commissioner must send a written notice of the
action and the process involved to each resident of the facility, legal representatives and
designated representatives, and at the commissioner's discretion, additional resident contacts.
(f) The commissioner shall provide the ombudsman for long-term care new text begin and the Office
of Ombudsman for Mental Health and Developmental Disabilities new text end with monthly information
on the department's actions and the status of the proceedings.
Minnesota Statutes 2020, section 144G.20, subdivision 15, is amended to read:
(a) The process of suspending, revoking, or refusing to renew
a license must include a plan for transferring affected residents' cares to other providers by
the facility. The commissioner shall monitor the transfer plan. Within three calendar days
of being notified of the final revocation, refusal to renew, or suspension, the licensee shall
provide the commissioner, the lead agencies as defined in section 256B.0911, county adult
protection and case managers, deleted text begin anddeleted text end the ombudsman for long-term carenew text begin , and the Office of
Ombudsman for Mental Health and Developmental Disabilitiesnew text end with the following
information:
(1) a list of all residents, including full names and all contact information on file;
(2) a list of the resident's legal representatives and designated representatives and family
or other contacts listed in the assisted living contract, including full names and all contact
information on file;
(3) the location or current residence of each resident;
(4) the payor sources for each resident, including payor source identification numbers;
and
(5) for each resident, a copy of the resident's service plan and a list of the types of services
being provided.
(b) The revocation, refusal to renew, or suspension notification requirement is satisfied
by mailing the notice to the address in the license record. The licensee shall cooperate with
the commissioner and the lead agencies, county adult protection and case managers, deleted text begin anddeleted text end
the ombudsman for long-term carenew text begin , and the Office of Ombudsman for Mental Health and
Developmental Disabilitiesnew text end during the process of transferring care of residents to qualified
providers. Within three calendar days of being notified of the final revocation, refusal to
renew, or suspension action, the facility must notify and disclose to each of the residents,
or the resident's legal and designated representatives or emergency contact persons, that the
commissioner is taking action against the facility's license by providing a copy of the
revocation, refusal to renew, or suspension notice issued by the commissioner. If the facility
does not comply with the disclosure requirements in this section, the commissioner shall
notify the residents, legal and designated representatives, or emergency contact persons
about the actions being taken. Lead agencies, county adult protection and case managers,
and the Office of Ombudsman for Long-Term Care may also provide this information. The
revocation, refusal to renew, or suspension notice is public data except for any private data
contained therein.
(c) A facility subject to this subdivision may continue operating while residents are being
transferred to other service providers.
Minnesota Statutes 2020, section 144G.30, subdivision 5, is amended to read:
(a) A correction order may be issued whenever the
commissioner finds upon survey or during a complaint investigation that a facility, a
managerial official, new text begin an agent of the facility, new text end or an employee of the facility is not in compliance
with this chapter. The correction order shall cite the specific statute and document areas of
noncompliance and the time allowed for correction.
(b) The commissioner shall mail or e-mail copies of any correction order to the facility
within 30 calendar days after the survey exit date. A copy of each correction order and
copies of any documentation supplied to the commissioner shall be kept on file by the
facility and public documents shall be made available for viewing by any person upon
request. Copies may be kept electronically.
(c) By the correction order date, the facility must document in the facility's records any
action taken to comply with the correction order. The commissioner may request a copy of
this documentation and the facility's action to respond to the correction order in future
surveys, upon a complaint investigation, and as otherwise needed.
Minnesota Statutes 2020, section 144G.31, subdivision 4, is amended to read:
(a) Fines and enforcement actions under this subdivision may
be assessed based on the level and scope of the violations described in subdivisions 2 and
3 as follows and may be imposed immediately with no opportunity to correct the violation
prior to imposition:
(1) Level 1, no fines or enforcement;
(2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism
authorized in section 144G.20 for widespread violations;
(3) Level 3, a fine of $3,000 per violation deleted text begin per incidentdeleted text end , in addition to any enforcement
mechanism authorized in section 144G.20;
(4) Level 4, a fine of $5,000 per deleted text begin incidentdeleted text end new text begin violationnew text end , in addition to any enforcement
mechanism authorized in section 144G.20; and
(5) for maltreatment violations for which the licensee was determined to be responsible
for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000.
A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible
for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury.
(b) When a fine is assessed against a facility for substantiated maltreatment, the
commissioner shall not also impose an immediate fine under this chapter for the same
circumstance.
Minnesota Statutes 2020, section 144G.31, subdivision 8, is amended to read:
Fines collected under this section shall be deposited in a
dedicated special revenue account. On an annual basis, the balance in the special revenue
account shall be appropriated to the commissioner for special projects to improve deleted text begin home
caredeleted text end new text begin resident quality of care and outcomes in assisted living facilities licensed under chapter
144Gnew text end in Minnesota as recommended by the advisory council established in section
144A.4799.
new text begin
This section is effective retroactively for fines collected on or
after August 1, 2021.
new text end
Minnesota Statutes 2020, section 144G.41, subdivision 7, is amended to read:
All facilities must post in a
conspicuous place information about the facilities' grievance procedure, and the name,
telephone number, and e-mail contact information for the individuals who are responsible
for handling resident grievances. The notice must also have the contact information for the
deleted text begin state and applicable regionaldeleted text end Office of Ombudsman for Long-Term Care and the Office of
Ombudsman for Mental Health and Developmental Disabilities, and must have information
for reporting suspected maltreatment to the Minnesota Adult Abuse Reporting Center.new text begin The
notice must also state that if an individual has a complaint about the facility or person
providing services, the individual may contact the Office of Health Facility Complaints at
the Minnesota Department of Health.
new text end
Minnesota Statutes 2020, section 144G.41, subdivision 8, is amended to read:
All facilities shall ensure that every resident has
access to consumer advocacy or legal services by:
(1) providing names and contact information, including telephone numbers and e-mail
addresses of at least three organizations that provide advocacy or legal services to residentsnew text begin ,
one of which must include the designated protection and advocacy organization in Minnesota
that provides advice and representation to individuals with disabilitiesnew text end ;
(2) providing the name and contact information for the Minnesota Office of Ombudsman
for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental
Disabilitiesdeleted text begin , including both the state and regional contact informationdeleted text end ;
(3) assisting residents in obtaining information on whether Medicare or medical assistance
under chapter 256B will pay for services;
(4) making reasonable accommodations for people who have communication disabilities
and those who speak a language other than English; and
(5) providing all information and notices in plain language and in terms the residents
can understand.
Minnesota Statutes 2020, section 144G.42, subdivision 10, is amended to read:
(a) The facility must
meet the following requirements:
(1) have a written emergency disaster plan that contains a plan for evacuation, addresses
elements of sheltering in place, identifies temporary relocation sites, and details staff
assignments in the event of a disaster or an emergency;
(2) post an emergency disaster plan prominently;
(3) provide building emergency exit diagrams to all residents;
(4) post emergency exit diagrams on each floor; and
(5) have a written policy and procedure regarding missing deleted text begin tenantdeleted text end residents.
(b) The facility must provide emergency and disaster training to all staff during the initial
staff orientation and annually thereafter and must make emergency and disaster training
annually available to all residents. Staff who have not received emergency and disaster
training are allowed to work only when trained staff are also working on site.
(c) The facility must meet any additional requirements adopted in rule.
Minnesota Statutes 2020, section 144G.50, subdivision 2, is amended to read:
(a) The contract must include in a conspicuous place
and manner on the contract the legal name and the license number of the facility.
(b) The contract must include the name, telephone number, and physical mailing address,
which may not be a public or private post office box, of:
(1) the facility and contracted service provider when applicable;
(2) the licensee of the facility;
(3) the managing agent of the facility, if applicable; and
(4) the authorized agent for the facility.
(c) The contract must include:
(1) a disclosure of the category of assisted living facility license held by the facility and,
if the facility is not an assisted living facility with dementia care, a disclosure that it does
not hold an assisted living facility with dementia care license;
(2) a description of all the terms and conditions of the contract, including a description
of and any limitations to the housing or assisted living services to be provided for the
contracted amount;
(3) a delineation of the cost and nature of any other services to be provided for an
additional fee;
(4) a delineation and description of any additional fees the resident may be required to
pay if the resident's condition changes during the term of the contract;
(5) a delineation of the grounds under which the resident may be deleted text begin discharged, evicted,
ordeleted text end transferred or have new text begin housing or new text end services terminatednew text begin or be subject to an emergency
relocationnew text end ;
(6) billing and payment procedures and requirements; and
(7) disclosure of the facility's ability to provide specialized diets.
(d) The contract must include a description of the facility's complaint resolution process
available to residents, including the name and contact information of the person representing
the facility who is designated to handle and resolve complaints.
(e) The contract must include a clear and conspicuous notice of:
(1) the right under section 144G.54 to appeal the termination of an assisted living contract;
(2) the facility's policy regarding transfer of residents within the facility, under what
circumstances a transfer may occur, and the circumstances under which resident consent is
required for a transfer;
(3) contact information for the Office of Ombudsman for Long-Term Care, the
Ombudsman for Mental Health and Developmental Disabilities, and the Office of Health
Facility Complaints;
(4) the resident's right to obtain services from an unaffiliated service provider;
(5) a description of the facility's policies related to medical assistance waivers under
chapter 256S and section 256B.49 and the housing support program under chapter 256I,
including:
(i) whether the facility is enrolled with the commissioner of human services to provide
customized living services under medical assistance waivers;
(ii) whether the facility has an agreement to provide housing support under section
256I.04, subdivision 2, paragraph (b);
(iii) whether there is a limit on the number of people residing at the facility who can
receive customized living services or participate in the housing support program at any
point in time. If so, the limit must be provided;
(iv) whether the facility requires a resident to pay privately for a period of time prior to
accepting payment under medical assistance waivers or the housing support program, and
if so, the length of time that private payment is required;
(v) a statement that medical assistance waivers provide payment for services, but do not
cover the cost of rent;
(vi) a statement that residents may be eligible for assistance with rent through the housing
support program; and
(vii) a description of the rent requirements for people who are eligible for medical
assistance waivers but who are not eligible for assistance through the housing support
program;
(6) the contact information to obtain long-term care consulting services under section
256B.0911; and
(7) the toll-free phone number for the Minnesota Adult Abuse Reporting Center.
Minnesota Statutes 2020, section 144G.52, subdivision 2, is amended to read:
(a) Before issuing a notice of
termination of an assisted living contract, a facility must schedule and participate in a meeting
with the resident and the resident's legal representative and designated representative. The
purposes of the meeting are to:
(1) explain in detail the reasons for the proposed termination; and
(2) identify and offer reasonable accommodations or modifications, interventions, or
alternatives to avoid the termination or enable the resident to remain in the facility, including
but not limited to securing services from another provider of the resident's choosing that
may allow the resident to avoid the termination. A facility is not required to offer
accommodations, modifications, interventions, or alternatives that fundamentally alter the
nature of the operation of the facility.
(b) The meeting must be scheduled to take place at least seven days before a notice of
termination is issued. The facility must make reasonable efforts to ensure that the resident,
legal representative, and designated representative are able to attend the meeting.
(c) The facility must notify the resident that the resident may invite family members,
relevant health professionals, a representative of the Office of Ombudsman for Long-Term
Care, new text begin a representative of the Office of Ombudsman for Mental Health and Developmental
Disabilities, new text end or other persons of the resident's choosing to participate in the meeting. For
residents who receive home and community-based waiver services under chapter 256S and
section 256B.49, the facility must notify the resident's case manager of the meeting.
(d) In the event of an emergency relocation under subdivision 9, where the facility intends
to issue a notice of termination and an in-person meeting is impractical or impossible, the
facility deleted text begin may attempt to schedule and participate in a meeting under this subdivision viadeleted text end new text begin must
usenew text end telephone, video, or other new text begin electronic new text end meansnew text begin to conduct and participate in the meeting
required under this subdivision and rules within Minnesota Rules, chapter 4659new text end .
Minnesota Statutes 2020, section 144G.52, subdivision 8, is amended to read:
The notice required under subdivision 7
must contain, at a minimum:
(1) the effective date of the termination of the assisted living contract;
(2) a detailed explanation of the basis for the termination, including the clinical or other
supporting rationale;
(3) a detailed explanation of the conditions under which a new or amended contract may
be executed;
(4) a statement that the resident has the right to appeal the termination by requesting a
hearing, and information concerning the time frame within which the request must be
submitted and the contact information for the agency to which the request must be submitted;
(5) a statement that the facility must participate in a coordinated move to another provider
or caregiver, as required under section 144G.55;
(6) the name and contact information of the person employed by the facility with whom
the resident may discuss the notice of termination;
(7) information on how to contact the Office of Ombudsman for Long-Term Care new text begin and
the Office of Ombudsman for Mental Health and Developmental Disabilities new text end to request an
advocate to assist regarding the termination;
(8) information on how to contact the Senior LinkAge Line under section 256.975,
subdivision 7, and an explanation that the Senior LinkAge Line may provide information
about other available housing or service options; and
(9) if the termination is only for services, a statement that the resident may remain in
the facility and may secure any necessary services from another provider of the resident's
choosing.
Minnesota Statutes 2020, section 144G.52, subdivision 9, is amended to read:
(a) A facility may remove a resident from the facility
in an emergency if necessary due to a resident's urgent medical needs or an imminent risk
the resident poses to the health or safety of another facility resident or facility staff member.
An emergency relocation is not a termination.
(b) In the event of an emergency relocation, the facility must provide a written notice
that contains, at a minimum:
(1) the reason for the relocation;
(2) the name and contact information for the location to which the resident has been
relocated and any new service provider;
(3) contact information for the Office of Ombudsman for Long-Term Carenew text begin and the Office
of Ombudsman for Mental Health and Developmental Disabilitiesnew text end ;
(4) if known and applicable, the approximate date or range of dates within which the
resident is expected to return to the facility, or a statement that a return date is not currently
known; and
(5) a statement that, if the facility refuses to provide housing or services after a relocation,
the resident has the right to appeal under section 144G.54. The facility must provide contact
information for the agency to which the resident may submit an appeal.
(c) The notice required under paragraph (b) must be delivered as soon as practicable to:
(1) the resident, legal representative, and designated representative;
(2) for residents who receive home and community-based waiver services under chapter
256S and section 256B.49, the resident's case manager; and
(3) the Office of Ombudsman for Long-Term Care if the resident has been relocated
and has not returned to the facility within four days.
(d) Following an emergency relocation, a facility's refusal to provide housing or services
constitutes a termination and triggers the termination process in this section.
Minnesota Statutes 2020, section 144G.53, is amended to read:
(a) If a facility decides to not renew a resident's housing under a contract, the facility
must either (1) provide the resident with 60 calendar days' notice of the nonrenewal and
assistance with relocation planning, or (2) follow the termination procedure under section
144G.52.
(b) The notice must include the reason for the nonrenewal and contact information of
the Office of Ombudsman for Long-Term Carenew text begin and the Office of Ombudsman for Mental
Health and Developmental Disabilitiesnew text end .
(c) A facility must:
(1) provide notice of the nonrenewal to the Office of Ombudsman for Long-Term Care;
(2) for residents who receive home and community-based waiver services under chapter
256S and section 256B.49, provide notice to the resident's case manager;
(3) ensure a coordinated move to a safe location, as defined in section 144G.55,
subdivision 2, that is appropriate for the resident;
(4) ensure a coordinated move to an appropriate service provider identified by the facility,
if services are still needed and desired by the resident;
(5) consult and cooperate with the resident, legal representative, designated representative,
case manager for a resident who receives home and community-based waiver services under
chapter 256S and section 256B.49, relevant health professionals, and any other persons of
the resident's choosing to make arrangements to move the resident, including consideration
of the resident's goals; and
(6) prepare a written plan to prepare for the move.
(d) A resident may decline to move to the location the facility identifies or to accept
services from a service provider the facility identifies, and may instead choose to move to
a location of the resident's choosing or receive services from a service provider of the
resident's choosing within the timeline prescribed in the nonrenewal notice.
Minnesota Statutes 2020, section 144G.55, subdivision 1, is amended to read:
(a) If a facility terminates an assisted living contract,
reduces services to the extent that a resident needs to movenew text begin or obtain a new service provider
because of a reduction or elimination of services or the facility has its license restricted
under section 144G.20new text end , or new text begin the facility new text end conducts a planned closure under section 144G.57,
the facility:
(1) must ensure, subject to paragraph (c), a coordinated move to a safe location that is
appropriate for the resident and that is identified by the facility prior to any hearing under
section 144G.54;
(2) must ensure a coordinated move of the resident to an appropriate service provider
identified by the facility prior to any hearing under section 144G.54, provided services are
still needed and desired by the resident; and
(3) must consult and cooperate with the resident, legal representative, designated
representative, case manager for a resident who receives home and community-based waiver
services under chapter 256S and section 256B.49, relevant health professionals, and any
other persons of the resident's choosing to make arrangements to move the resident, including
consideration of the resident's goals.
(b) A facility may satisfy the requirements of paragraph (a), clauses (1) and (2), by
moving the resident to a different location within the same facility, if appropriate for the
resident.
(c) A resident may decline to move to the location the facility identifies or to accept
services from a service provider the facility identifies, and may choose instead to move to
a location of the resident's choosing or receive services from a service provider of the
resident's choosing within the timeline prescribed in the termination notice.
(d) Sixty days before the facility plans to reduce or eliminate one or more services for
a particular resident, the facility must provide written notice of the reduction new text begin or elimination
new text end that includes:
(1) a detailed explanation of the reasons for the reduction new text begin or elimination new text end and the date of
the reduction;
(2) the contact information for the Office of Ombudsman for Long-Term Carenew text begin , the Office
of Ombudsman for Mental Health and Developmental Disabilities,new text end and the name and contact
information of the person employed by the facility with whom the resident may discuss the
reduction new text begin or elimination new text end of services;
(3) a statement that if the services being reduced new text begin or eliminated new text end are still needed by the
resident, the resident may remain in the facility and seek services from another provider;
and
(4) a statement that if the reduction new text begin or elimination new text end makes the resident need to move, the
facility must participate in a coordinated move of the resident to another provider or
caregiver, as required under this section.
(e) In the event of an unanticipated reduction new text begin or elimination new text end in services caused by
extraordinary circumstances, the facility must provide the notice required under paragraph
(d) as soon as possible.
(f) If the facility, a resident, a legal representative, or a designated representative
determines that a reduction in services will make a resident need to move to a new location,
the facility must ensure a coordinated move in accordance with this section, and must provide
notice to the Office of Ombudsman for Long-Term Care.
(g) Nothing in this section affects a resident's right to remain in the facility and seek
services from another provider.
Minnesota Statutes 2020, section 144G.55, subdivision 3, is amended to read:
The facility must prepare a relocation plan to prepare
for the move to deleted text begin thedeleted text end new text begin anew text end new new text begin safe new text end location or new text begin appropriate new text end service providernew text begin , as required by this
sectionnew text end .
Minnesota Statutes 2020, section 144G.56, subdivision 3, is amended to read:
(a) A facility must provide at least 30 calendar days' advance
written notice to the resident and the resident's legal and designated representative of a
facility-initiated transfer. The notice must include:
(1) the effective date of the proposed transfer;
(2) the proposed transfer location;
(3) a statement that the resident may refuse the proposed transfer, and may discuss any
consequences of a refusal with staff of the facility;
(4) the name and contact information of a person employed by the facility with whom
the resident may discuss the notice of transfer; and
(5) contact information for the Office of Ombudsman for Long-Term Carenew text begin and the Office
of Ombudsman for Mental Health and Developmental Disabilitiesnew text end .
(b) Notwithstanding paragraph (a), a facility may conduct a facility-initiated transfer of
a resident with less than 30 days' written notice if the transfer is necessary due to:
(1) conditions that render the resident's room or private living unit uninhabitable;
(2) the resident's urgent medical needs; or
(3) a risk to the health or safety of another resident of the facility.
Minnesota Statutes 2020, section 144G.56, subdivision 5, is amended to read:
(a) In situations where there is a curtailment,
reduction, or capital improvement within a facility necessitating transfers, the facility must:
(1) minimize the number of transfers it initiates to complete the project or change in
operations;
(2) consider individual resident needs and preferences;
(3) provide reasonable accommodations for individual resident requests regarding the
transfers; and
(4) in advance of any notice to any residents, legal representatives, or designated
representatives, provide notice to the Office of Ombudsman for Long-Term Care anddeleted text begin , when
appropriate,deleted text end the Office of Ombudsman for Mental Health and Developmental Disabilities
of the curtailment, reduction, or capital improvement and the corresponding needed transfers.
Minnesota Statutes 2020, section 144G.57, subdivision 1, is amended to read:
In the event that an assisted living facility elects
to voluntarily close the facility, the facility must notify the commissioner deleted text begin anddeleted text end new text begin ,new text end the Office
of Ombudsman for Long-Term Carenew text begin , and the Office of Ombudsman for Mental Health and
Developmental Disabilitiesnew text end in writing by submitting a proposed closure plan.
Minnesota Statutes 2020, section 144G.57, subdivision 3, is amended to read:
(a) The plan
shall be subject to the commissioner's approval and subdivision 6. The facility shall take
no action to close the residence prior to the commissioner's approval of the plan. The
commissioner shall approve or otherwise respond to the plan deleted text begin as soon as practicabledeleted text end new text begin within
14 calendar daysnew text end .
(b) The commissioner may require the facility to work with a transitional team comprised
of department staff, staff of the Office of Ombudsman for Long-Term Care, new text begin the Office of
Ombudsman for Mental Health and Developmental Disabilities, new text end and other professionals the
commissioner deems necessary to assist in the proper relocation of residents.
Minnesota Statutes 2020, section 144G.57, subdivision 5, is amended to read:
After the commissioner has approved the relocation plan
and at least 60 calendar days before closing, except as provided under subdivision 6, the
facility must notify residents, designated representatives, and legal representatives of the
closure, the proposed date of closure, the contact information of the ombudsman for long-term
carenew text begin and the ombudsman for mental health and developmental disabilitiesnew text end , and that the
facility will follow the termination planning requirements under section 144G.55, and final
accounting and return requirements under section 144G.42, subdivision 5. For residents
who receive home and community-based waiver services under chapter 256S and section
256B.49, the facility must also provide this information to the resident's case manager.
Minnesota Statutes 2020, section 144G.70, subdivision 2, is amended to read:
(a) Residents who are not
receiving any new text begin assisted living new text end services shall not be required to undergo an initial nursing
assessment.
(b) An assisted living facility shall conduct a nursing assessment by a registered nurse
of the physical and cognitive needs of the prospective resident and propose a temporary
service plan prior to the date on which a prospective resident executes a contract with a
facility or the date on which a prospective resident moves in, whichever is earlier. If
necessitated by either the geographic distance between the prospective resident and the
facility, or urgent or unexpected circumstances, the assessment may be conducted using
telecommunication methods based on practice standards that meet the resident's needs and
reflect person-centered planning and care delivery.
(c) Resident reassessment and monitoring must be conducted no more than 14 calendar
days after initiation of services. Ongoing resident reassessment and monitoring must be
conducted as needed based on changes in the needs of the resident and cannot exceed 90
calendar days from the last date of the assessment.
(d) For residents only receiving assisted living services specified in section 144G.08,
subdivision 9, clauses (1) to (5), the facility shall complete an individualized initial review
of the resident's needs and preferences. The initial review must be completed within 30
calendar days of the start of services. Resident monitoring and review must be conducted
as needed based on changes in the needs of the resident and cannot exceed 90 calendar days
from the date of the last review.
(e) A facility must 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 facility or the date on which
a prospective resident moves in, whichever is earlier.
Minnesota Statutes 2020, section 144G.70, subdivision 4, is amended to read:
(a) No later
than 14 calendar days after the date that services are first provided, an assisted living facility
shall finalize a current written service plan.
(b) The service plan and any revisions must include a signature or other authentication
by the facility and by the resident documenting agreement on the services to be provided.
The service plan must be revised, if needed, based on resident reassessment under subdivision
2. The facility must provide information to the resident about changes to the facility's fee
for services and how to contact the Office of Ombudsman for Long-Term Carenew text begin and the
Office of Ombudsman for Mental Health and Developmental Disabilitiesnew text end .
(c) The facility must implement and provide all services required by the current service
plan.
(d) The service plan and the revised service plan must be entered into the resident record,
including notice of a change in a resident's fees when applicable.
(e) Staff providing services must be informed of the current written service plan.
(f) The service plan must include:
(1) a description of the services to be provided, the fees for services, and the frequency
of each service, according to the resident's current assessment and resident preferences;
(2) the identification of staff or categories of staff who will provide the services;
(3) the schedule and methods of monitoring assessments of the resident;
(4) the schedule and methods of monitoring staff providing services; and
(5) a contingency plan that includes:
(i) the action to be taken if the scheduled service cannot be provided;
(ii) information and a method to contact the facility;
(iii) the names and contact information of persons the resident wishes to have notified
in an emergency or if there is a significant adverse change in the resident's condition,
including identification of and information as to who has authority to sign for the resident
in an emergency; and
(iv) the circumstances in which emergency medical services are not to be summoned
consistent with chapters 145B and 145C, and declarations made by the resident under those
chapters.
Minnesota Statutes 2020, section 144G.80, subdivision 2, is amended to read:
(a) An applicant for licensure as an assisted living
facility with dementia care must have the ability to provide services in a manner that is
consistent with the requirements in this section. The commissioner shall consider the
following criteria, including, but not limited to:
(1) the experience of the deleted text begin applicant indeleted text end new text begin applicant's assisted living director, managerial
official, and clinical nurse supervisornew text end managing residents with dementia or previous long-term
care experience; and
(2) the compliance history of the applicant in the operation of any care facility licensed,
certified, or registered under federal or state law.
(b) If the deleted text begin applicant doesdeleted text end new text begin applicant's assisted living director, managerial official, and
clinical nurse supervisor donew text end not have experience in managing residents with dementia, the
applicant must employ a consultant for at least the first six months of operation. The
consultant must meet the requirements in paragraph (a), clause (1), and make
recommendations on providing dementia care services consistent with the requirements of
this chapter. The consultant must (1) have two years of work experience related to dementia,
health care, gerontology, or a related field, and (2) have completed at least the minimum
core training requirements in section 144G.64. The applicant must document an acceptable
plan to address the consultant's identified concerns and must either implement the
recommendations or document in the plan any consultant recommendations that the applicant
chooses not to implement. The commissioner must review the applicant's plan upon request.
(c) The commissioner shall conduct an on-site inspection prior to the issuance of an
assisted living facility with dementia care license to ensure compliance with the physical
environment requirements.
(d) The label "Assisted Living Facility with Dementia Care" must be identified on the
license.
Minnesota Statutes 2020, section 144G.90, subdivision 1, is amended to read:
(a) An assisted
living facility must provide the resident a written notice of the rights under section 144G.91
before the initiation of services to that resident. The facility shall make all reasonable efforts
to provide notice of the rights to the resident in a language the resident can understand.
(b) In addition to the text of the assisted living bill of rights in section 144G.91, the
notice shall also contain the following statement describing how to file a complaint or report
suspected abuse:
"If you want to report suspected abuse, neglect, or financial exploitation, you may contact
the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about
the facility or person providing your services, you may contact the Office of Health Facility
Complaints, Minnesota Department of Health. new text begin If you would like to request advocacy services,
new text end you may deleted text begin alsodeleted text end contact the Office of Ombudsman for Long-Term Care or the Office of
Ombudsman for Mental Health and Developmental Disabilities."
(c) The statement must include contact information for the Minnesota Adult Abuse
Reporting Center and the telephone number, website address, e-mail address, mailing
address, and street address of the Office of Health Facility Complaints at the Minnesota
Department of Health, the Office of Ombudsman for Long-Term Care, and the Office of
Ombudsman for Mental Health and Developmental Disabilities. The statement must include
the facility's name, address, e-mail, telephone number, and name or title of the person at
the facility to whom problems or complaints may be directed. It must also include a statement
that the facility will not retaliate because of a complaint.
(d) A facility must obtain written acknowledgment from the resident of the resident's
receipt of the assisted living bill of rights or shall document why an acknowledgment cannot
be obtained. Acknowledgment of receipt shall be retained in the resident's record.
Minnesota Statutes 2020, section 144G.91, subdivision 13, is amended to read:
(a) Residents have the right to consideration
of their privacy, individuality, and cultural identity as related to their social, religious, and
psychological well-being. Staff must respect the privacy of a resident's space by knocking
on the door and seeking consent before entering, except in an emergency or deleted text begin where clearly
inadvisable ordeleted text end unless otherwise documented in the resident's service plan.
(b) Residents have the right to have and use a lockable door to the resident's unit. The
facility shall provide locks on the resident's unit. Only a staff member with a specific need
to enter the unit shall have keys. This right may be restricted in certain circumstances if
necessary for a resident's health and safety and documented in the resident's service plan.
(c) Residents have the right to respect and privacy regarding the resident's service plan.
Case discussion, consultation, examination, and treatment are confidential and must be
conducted discreetly. Privacy must be respected during toileting, bathing, and other activities
of personal hygiene, except as needed for resident safety or assistance.
Minnesota Statutes 2020, section 144G.91, subdivision 21, is amended to read:
Residents have the right to the
immediate access by:
(1) the resident's legal counsel;
(2) any representative of the protection and advocacy system designated by the state
under Code of Federal Regulations, title 45, section 1326.21; or
(3) any representative of the Office of Ombudsman for Long-Term Carenew text begin or the Office
of Ombudsman for Mental Health and Developmental Disabilitiesnew text end .
Minnesota Statutes 2020, section 144G.91, is amended by adding a subdivision
to read:
new text begin
Residents must be free from any physical or chemical restraints
imposed for purposes of discipline or convenience.
new text end
Minnesota Statutes 2020, section 144G.92, subdivision 1, is amended to read:
A facility or agent of a facility may not retaliate
against a resident or employee if the resident, employee, or any person acting on behalf of
the resident:
(1) files a good faith complaint or grievance, makes a good faith inquiry, or asserts any
right;
(2) indicates a good faith intention to file a complaint or grievance, make an inquiry, or
assert any right;
(3) files, in good faith, or indicates an intention to file a maltreatment report, whether
mandatory or voluntary, under section 626.557;
(4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
problems or concerns to the director or manager of the facility, the Office of Ombudsman
for Long-Term Care, new text begin the Office of Ombudsman for Mental Health and Developmental
Disabilities, new text end a regulatory or other government agency, or a legal or advocacy organization;
(5) advocates or seeks advocacy assistance for necessary or improved care or services
or enforcement of rights under this section or other law;
(6) takes or indicates an intention to take civil action;
(7) participates or indicates an intention to participate in any investigation or
administrative or judicial proceeding;
(8) contracts or indicates an intention to contract to receive services from a service
provider of the resident's choice other than the facility; or
(9) places or indicates an intention to place a camera or electronic monitoring device in
the resident's private space as provided under section 144.6502.
Minnesota Statutes 2020, section 144G.93, is amended to read:
Upon execution of an assisted living contract, every facility must provide the resident
with the names and contact information, including telephone numbers and e-mail addresses,
of:
(1) nonprofit organizations that provide advocacy or legal services to residents including
but not limited to the designated protection and advocacy organization in Minnesota that
provides advice and representation to individuals with disabilities; and
(2) the Office of Ombudsman for Long-Term Caredeleted text begin , including both the state and regional
contact informationdeleted text end new text begin and the Office of Ombudsman for Mental Health and Developmental
Disabilitiesnew text end .
Minnesota Statutes 2020, section 144G.95, is amended to read:
new text begin (a) new text end The Office of Ombudsman for Long-Term
Care and representatives of the office are immune from liability for conduct described in
section 256.9742, subdivision 2.
new text begin
(b) The Office of Ombudsman for Mental Health and Developmental Disabilities and
representatives of the office are immune from liability for conduct described in section
245.96.
new text end
new text begin (a) new text end All forms and notices received by the Office of
Ombudsman for Long-Term Care under this chapter are classified under section 256.9744.
new text begin
(b) All data collected or received by the Office of Ombudsman for Mental Health and
Developmental Disabilities are classified under section 245.94.
new text end