SF 652

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 02:14am

A bill for an act
relating to health; modifying certain nursing home and home care regulations;
amending Minnesota Statutes 2008, sections 144A.04, subdivision 11, by adding
subdivisions; 144A.45, by adding a subdivision; 144A.4605, subdivision 2.

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

Section 1.

Minnesota Statutes 2008, section 144A.04, is amended by adding a
subdivision to read:

new text begin Subd. 8a. new text end

new text begin Tuberculosis screening for nursing home residents. new text end

new text begin Notwithstanding
Minnesota Rules, part 4658.0810, screening for nursing facility residents shall be
consistent with current guidelines issued by the Center for Disease Control. No later than
August 1, 2009, and within a reasonable period of time following any update to the Center
for Disease Control tuberculosis screening recommendations for nursing facility residents,
the commissioner of health shall issue guidance for home care agencies explaining the
process they must follow to meet the Center for Disease Control guidelines.
new text end

Sec. 2.

Minnesota Statutes 2008, section 144A.04, is amended by adding a subdivision
to read:

new text begin Subd. 8b. new text end

new text begin Tuberculosis screening for nursing home staff. new text end

new text begin Notwithstanding
Minnesota Rules, part 4658.0815, nursing home staff who have direct contact with
residents must be screened for tuberculosis consistent with current guidelines issued by the
Center for Disease Control. No later than August 1, 2009, and within a reasonable period
of time following any update to the Center for Disease Control tuberculosis screening
recommendations for health care staff, the commissioner of health shall issue guidance
for home care agencies explaining the process they must follow to meet the Center for
Disease Control guidelines.
new text end

Sec. 3.

Minnesota Statutes 2008, section 144A.04, subdivision 11, is amended to read:

Subd. 11.

Incontinent residents.

Notwithstanding Minnesota Rules, part
4658.0520, an incontinent resident must be checked according to a specific time interval
written in the resident's care plan. new text begin Unless the nursing home is certified to participate in the
Medicare program or the medical assistance program, new text end the resident's attending physician
must authorize in writing any interval longer than two hours unless the resident, if
competent, or a family member or legally appointed conservator, guardian, or health care
agent of a resident who is not competent, agrees in writing to waive physician involvement
in determining this interval, and this waiver is documented in the resident's care plan.

Sec. 4.

Minnesota Statutes 2008, section 144A.04, is amended by adding a subdivision
to read:

new text begin Subd. 12. new text end

new text begin Resident positioning. new text end

new text begin Notwithstanding Minnesota Rules, part 4658.0525,
subpart 4, the position of residents unable to change their own position must be changed at
least every two hours, including periods of time after the resident has been put to bed for
the night, unless the physician has documented that repositioning every two hours during
this time period is unnecessary or the physician has ordered a different interval. Unless the
nursing home is certified to participate in the Medicare program or the medical assistance
program, the resident's attending physician must authorize in writing any interval longer
than two hours unless the resident, if competent, or a family member or legally appointed
conservator, guardian, or health care agent of a resident who is not competent, agrees in
writing to waive physician involvement in determining this interval, and this waiver
is documented in the resident's care plan.
new text end

Sec. 5.

Minnesota Statutes 2008, section 144A.45, is amended by adding a subdivision
to read:

new text begin Subd. 1b. new text end

new text begin Tuberculosis screening for home care staff. new text end

new text begin Notwithstanding Minnesota
Rules, part 4668.0065, subparts 1 and 2, home care staff who have direct contact
with clients must be screened for tuberculosis prior to any direct contact with clients.
Tuberculosis screening for home care staff shall be consistent with current guidelines
issued by the Center for Disease Control. No later than August 1, 2009, and within
a reasonable period of time following any update to the Center for Disease Control
tuberculosis screening recommendations for health care staff, the commissioner of health
shall issue guidance for home care agencies explaining the process they must follow to
meet the Center for Disease Control guidelines.
new text end

Sec. 6.

Minnesota Statutes 2008, section 144A.4605, subdivision 2, is amended to read:

Subd. 2.

Class F home care license established.

A home care provider license
category entitled class F home care provider is hereby established. A home care provider
may obtain a class F 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 class F 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. new text begin Also, a registered nurse may delegate to unlicensed personnel the task of verifying the
dose of insulin that a client dials up on an insulin pen. new text end Qualifications to perform these
tasks shall be established in accordance with subdivision 3;

(c) periodic supervision of unlicensed personnel is provided as required by rule;

(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.