Engrossments
Introduction		Posted on 03/25/2019

A bill for an act
relating to health; establishing an assisted living license and license requirements;
establishing fees and fines; modifying the health care bill of rights and the home
care bill of rights; modifying home care licensing provisions; modifying the powers
and duties of the director of the Office of Health Facility Complaints; modifying
consumer protection for vulnerable adults; modifying the Vulnerable Adults Act;
establishing task forces; requiring reports; authorizing rulemaking; appropriating
money; amending Minnesota Statutes 2018, sections 144.051, subdivisions 4, 5,
6; 144.057, subdivision 1; 144.122; 144.1503; 144A.04, subdivision 5; 144A.10,
subdivision 1; 144A.20, subdivision 1; 144A.24; 144A.26; 144A.43, subdivision
6; 144A.44, subdivision 1; 144A.441; 144A.442; 144A.45, subdivisions 1, 2;
144A.471, subdivisions 7, 9; 144A.472, subdivision 7; 144A.474, subdivisions 8,
9, 11; 144A.475, subdivisions 3b, 5; 144A.476, subdivision 1; 144A.4791,
subdivision 10; 144A.4799; 144A.53, subdivision 1, by adding subdivisions;
256I.03, subdivision 15; 256I.04, subdivision 2a; 611A.033; 626.557, subdivisions
4, 9c, 12b; 626.5572, subdivisions 6, 21; proposing coding for new law in
Minnesota Statutes, chapters 144; 144A; 144G; 630; repealing Minnesota Statutes
2018, sections 144A.472, subdivision 4; 144D.01; 144D.015; 144D.02; 144D.025;
144D.03; 144D.04; 144D.045; 144D.05; 144D.06; 144D.065; 144D.066; 144D.07;
144D.08; 144D.09; 144D.10; 144D.11; 144G.01; 144G.02; 144G.03; 144G.04;
144G.05; 144G.06; 325F.72; Minnesota Rules, part 6400.6970.

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

ARTICLE 1

ASSISTED LIVING LICENSURE

Section 1.

new text begin [144G.10] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin For the purposes of this chapter, the definitions in this
section have the meanings given.
new text end

new text begin Subd. 2. new text end

new text begin Activities of daily living. new text end

new text begin "Activities of daily living" has the meaning given in
section 256B.0659, subdivision 1, paragraph (b).
new text end

new text begin Subd. 3. new text end

new text begin Adult. new text end

new text begin "Adult" means a natural person who has attained the age of 18 years.
new text end

new text begin Subd. 4. new text end

new text begin Agent. new text end

new text begin "Agent" means the person upon whom all notices and orders shall be
served and who is authorized to accept service of notices and orders on behalf of the facility.
new text end

new text begin Subd. 5. new text end

new text begin Alzheimer's disease. new text end

new text begin "Alzheimer's disease" means a type of dementia that
gradually destroys an individual's memory and ability to learn, reason, make judgments,
communicate, and carry out daily activities.
new text end

new text begin Subd. 6. new text end

new text begin Applicant. new text end

new text begin "Applicant" means an individual, legal entity, controlling individual,
or other organization that has applied for licensure under this chapter.
new text end

new text begin Subd. 7. new text end

new text begin Assisted living administrator. new text end

new text begin "Assisted living administrator" means a person
who administers, manages, supervises, or is in general administrative charge of a basic care
facility or assisted living facility, whether or not the individual has an ownership interest
in the facility, and whether or not the person's functions or duties are shared with one or
more individuals and who is licensed by the Board of Executives for Long Term Services
and Supports pursuant to section 144A.26.
new text end

new text begin Subd. 8. new text end

new text begin Assisted living facility. new text end

new text begin "Assisted living facility" means a licensed facility that:
(1) provides sleeping accommodations to one or more adults; and (2) provides assisted
living services. For purposes of this chapter, assisted living facility does not include:
new text end

new text begin (i) emergency shelter, transitional housing, or any other residential units serving
exclusively or primarily homeless individuals, as defined under section 116L.361;
new text end

new text begin (ii) a nursing home licensed under chapter 144A;
new text end

new text begin (iii) a hospital, certified boarding care, or supervised living facility licensed under sections
144.50 to 144.56;
new text end

new text begin (iv) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
9520.0500 to 9520.0670, or under chapter 245D or 245G, except lodging establishments
that provide dementia care services;
new text end

new text begin (v) a lodging establishment serving as a shelter for individuals fleeing domestic violence;
new text end

new text begin (vi) services and residential settings licensed under chapter 245A, including adult foster
care and services and settings governed under the standards in chapter 245D;
new text end

new text begin (vii) private homes where the residents own or rent the home and control all aspects of
the property and building;
new text end

new text begin (viii) a duly organized condominium, cooperative, and common interest community, or
owners' association of the condominium, cooperative, and common interest community
where at least 80 percent of the units that comprise the condominium, cooperative, or
common interest community are occupied by individuals who are the owners, members, or
shareholders of the units;
new text end

new text begin (ix) temporary family health care dwellings as defined in sections 394.307 and 462.3593;
new text end

new text begin (x) settings offering services conducted by and for the adherents of any recognized
church or religious denomination for its members through spiritual means or by prayer for
healing;
new text end

new text begin (xi) housing financed pursuant to sections 462A.37 and 462A.375, units financed with
low-income housing tax credits pursuant to United States Code, title 26, section 42, and
units financed by the Minnesota Housing Finance Agency that are intended to serve
individuals with disabilities or individuals who are homeless;
new text end

new text begin (xii) rental housing developed under United States Code, title 42, section 1437, or United
States Code, title 12, section 1701q;
new text end

new text begin (xiii) rental housing designated for occupancy by only elderly or elderly and disabled
residents under United States Code, title 42, section 1437e, or rental housing for qualifying
families under Code of Federal Regulations, title 24, section 983.56;
new text end

new text begin (xiv) rental housing funded under United States Code, title 42, chapter 89, or United
States Code, title 42, section 8011; or
new text end

new text begin (xv) a basic care facility licensed under this chapter.
new text end

new text begin Subd. 9. new text end

new text begin Assisted living facility and base care facility contract. new text end

new text begin "Assisted living facility
and basic care facility contract" means the legal agreement between an assisted living facility
or a basic care facility, whichever is applicable, and a resident for the provision of housing
and services.
new text end

new text begin Subd. 10. new text end

new text begin Assisted living resident or resident. new text end

new text begin "Assisted living resident" or "resident"
means a person who resides in a licensed assisted living that is subject to the requirements
of this chapter.
new text end

new text begin Subd. 11. new text end

new text begin Assisted living services. new text end

new text begin "Assisted living services" means basic care services
and comprehensive assisted living services.
new text end

new text begin Subd. 12. new text end

new text begin Basic care facility. new text end

new text begin "Basic care facility" means a licensed facility that: (1)
provides sleeping accommodations to one or more adults; and (2) may only provide basic
care services. For purposes of this chapter, basic care facility does not include:
new text end

new text begin (i) emergency shelter, transitional housing, or any other residential units serving
exclusively or primarily homeless individuals, as that term is defined in section 116L.361;
new text end

new text begin (ii) a nursing home licensed under chapter 144A;
new text end

new text begin (iii) a hospital, certified boarding care, or supervised living facility licensed under sections
144.50 to 144.56;
new text end

new text begin (iv) a lodging establishment licensed under chapter 157, except lodging establishments
that provide dementia care services;
new text end

new text begin (v) a lodging establishment serving as a shelter for individuals fleeing domestic violence;
new text end

new text begin (vi) services and residential settings licensed under chapter 245A, including adult foster
care and services and settings governed under standards in chapter 245D;
new text end

new text begin (vii) private homes where the residents own or rent the home and control all aspects of
the property and building;
new text end

new text begin (viii) a duly organized condominium, cooperative and common interest community or
owners' association of the condominium, cooperative, and common interest community
where at least 80 percent of the units that comprise the condominium, cooperative, or
common interest community are occupied by individuals who are the owners, members, or
shareholders of the units;
new text end

new text begin (ix) temporary family health care dwelling as defined in sections 394.307 and 462.3593;
new text end

new text begin (xii) rental housing developed under United States Code, title 42, section 1437, or United
States Code, title 12, section 1701q;
new text end

new text begin (xiv) rental housing funded under United States Code, title 42, chapter 89, or United
States Code, title 42, section 8011; or
new text end

new text begin (xv) an assisted living facility licensed under this chapter.
new text end

new text begin Subd. 13. new text end

new text begin Basic care services. new text end

new text begin "Basic care services" means assistive tasks provided by
licensed or unlicensed personnel that include:
new text end

new text begin (1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, and
bathing;
new text end

new text begin (2) providing standby assistance;
new text end

new text begin (3) providing verbal or visual reminders to the resident to take regularly scheduled
medication, which includes bringing the client previously set-up medication, medication in
original containers, or liquid or food to accompany the medication;
new text end

new text begin (4) providing verbal or visual reminders to the client to perform regularly scheduled
treatments and exercises;
new text end

new text begin (5) preparing modified diets ordered by a licensed health professional;
new text end

new text begin (6) having, maintaining, and documenting a system to visually check on each resident
a minimum of once daily or more than once daily depending on the person-centered care
plan; and
new text end

new text begin (7) supportive services in addition to the provision of at least one of the activities in
clauses (1) to (5).
new text end

new text begin Subd. 14. new text end

new text begin Change of ownership. new text end

new text begin "Change of ownership" means a change in the individual
or legal entity that is responsible for the operation of a facility.
new text end

new text begin Subd. 15. new text end

new text begin Commissioner. new text end

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

new text begin Subd. 16. new text end

new text begin Compliance officer. new text end

new text begin "Compliance officer" means a designated individual
who is qualified by knowledge, training, and experience in health care or risk management
to promote, implement, and oversee the facility's compliance program. The compliance
officer shall also exhibit knowledge of relevant regulations; provide expertise in compliance
processes; and address fraud, abuse, and waste under this chapter and state and federal law.
new text end

new text begin Subd. 17. new text end

new text begin Comprehensive assisted living services. new text end

new text begin "Comprehensive assisted living
services" include any of the basic care services and one or more of the following:
new text end

new text begin (1) services of an advanced practice nurse, registered nurse, licensed practical nurse,
physical therapist, respiratory therapist, occupational therapist, speech-language pathologist,
dietitian or nutritionist, or social worker;
new text end

new text begin (2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed
health professional within the person's scope of practice;
new text end

new text begin (3) medication management services;
new text end

new text begin (4) hands-on assistance with transfers and mobility;
new text end

new text begin (5) treatment and therapies;
new text end

new text begin (6) assisting residents with eating when the clients have complicated eating problems
as identified in the resident record or through an assessment such as difficulty swallowing,
recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
instruments to be fed; or
new text end

new text begin (7) providing other complex or specialty health care services.
new text end

new text begin Subd. 18. new text end

new text begin Control. new text end

new text begin "Control" means the possession, directly or indirectly, of the power
to direct the management, operation, and policies of the licensee or facility, whether through
ownership, voting control, by agreement, by contract, or otherwise.
new text end

new text begin Subd. 19. new text end

new text begin Controlled substance. new text end

new text begin "Controlled substance" has the meaning given in
section 152.01, subdivision 4.
new text end

new text begin Subd. 20. new text end

new text begin Controlling individual. new text end

new text begin (a) "Controlling individual" means an owner of a
facility licensed under this chapter and the following individuals, if applicable:
new text end

new text begin (1) each officer of the organization, including the chief executive officer and chief
financial officer;
new text end

new text begin (2) the individual designated as the authorized agent under section 245A.04, subdivision
1, paragraph (b);
new text end

new text begin (3) the individual designated as the compliance officer under section 256B.04, subdivision
21, paragraph (b); and
new text end

new text begin (4) each managerial official whose responsibilities include the direction of the
management or policies of the facility.
new text end

new text begin (b) Controlling individual also means any owner who directly or indirectly owns five
percent or more interest in:
new text end

new text begin (1) the land on which the facility is located, including a real estate investment trust
(REIT);
new text end

new text begin (2) the structure in which a facility is located;
new text end

new text begin (3) any mortgage, contract for deed, or other obligation secured in whole or part by the
land or structure comprising the facility; or
new text end

new text begin (4) any lease or sublease of the land, structure, or facilities comprising the facility.
new text end

new text begin (c) Controlling individual does not include:
new text end

new text begin (1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
operates a program directly or through a subsidiary;
new text end

new text begin (2) government and government-sponsored entities such as the U.S. Department of
Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the Minnesota
Housing Finance Agency which provide loans, financing, and insurance products for housing
sites;
new text end

new text begin (3) an individual who is a state or federal official, or a state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more facilities, unless the individual is also an officer,
owner, or managerial official of the facility, receives remuneration from the facility, or
owns any of the beneficial interests not excluded in this subdivision;
new text end

new text begin (4) an individual who owns less than five percent of the outstanding common shares of
a corporation:
new text end

new text begin (i) whose securities are exempt under section 80A.45, clause (6); or
new text end

new text begin (ii) whose transactions are exempt under section 80A.46, clause (2);
new text end

new text begin (5) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the license
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxation; or
new text end

new text begin (6) an employee stock ownership plan trust, or a participant or board member of an
employee stock ownership plan, unless the participant or board member is a controlling
individual.
new text end

new text begin Subd. 21. new text end

new text begin Commissioner. new text end

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

new text begin Subd. 22. new text end

new text begin Dementia. new text end

new text begin "Dementia" means the loss of intellectual function of sufficient
severity that interferes with an individual's daily functioning. Dementia affects an individual's
memory and ability to think, reason, speak, and move. Symptoms may also include changes
in personality, mood, and behavior. Irreversible dementias include but are not limited to:
new text end

new text begin (1) Alzheimer's disease;
new text end

new text begin (2) vascular dementia;
new text end

new text begin (3) Lewy body dementia;
new text end

new text begin (4) frontal-temporal lobe dementia;
new text end

new text begin (5) alcohol dementia;
new text end

new text begin (6) Huntington's disease; and
new text end

new text begin (7) Creutzfeldt-Jakob disease.
new text end

new text begin Subd. 23. new text end

new text begin Dementia care unit. new text end

new text begin "Dementia care unit" means a special care unit in a
designated, separate area for individuals with Alzheimer's disease or other dementia that is
locked, segregated, or secured to prevent or limit access by a resident outside the designated
or separated area.
new text end

new text begin Subd. 24. new text end

new text begin Dementia-trained staff. new text end

new text begin "Dementia-trained staff" means any employee that
has completed the minimum training requirements and has demonstrated knowledge and
understanding in supporting individuals with dementia.
new text end

new text begin Subd. 25. new text end

new text begin Designated representative. new text end

new text begin "Designated representative" means one of the
following in the order of priority listed, to the extent the person may reasonably be identified
and located:
new text end

new text begin (1) a court-appointed guardian acting in accordance with the powers granted to the
guardian under chapter 524;
new text end

new text begin (2) a conservator acting in accordance with the powers granted to the conservator under
chapter 524;
new text end

new text begin (3) a health care agent acting in accordance with the powers granted to the health care
agent under chapter 145C;
new text end

new text begin (4) a power of attorney acting in accordance with the powers granted to the
attorney-in-fact under chapter 523; or
new text end

new text begin (5) the resident representative.
new text end

new text begin Subd. 26. new text end

new text begin Dietary supplement. new text end

new text begin "Dietary supplement" means a product taken by mouth
that contains a dietary ingredient intended to supplement the diet. Dietary ingredients may
include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as
enzymes, organ tissue, glandulars, or metabolites.
new text end

new text begin Subd. 27. new text end

new text begin Direct contact. new text end

new text begin "Direct contact" means providing face-to-face care, training,
supervision, counseling, consultation, or medication assistance to residents of a facility.
new text end

new text begin Subd. 28. new text end

new text begin Direct ownership interest. new text end

new text begin "Direct ownership interest" means an individual
or organization with the possession of at least five percent equity in capital, stock, or profits
of an organization, or who is a member of a limited liability company. An individual with
a five percent or more direct ownership is presumed to have an effect on the operation of
the facility with respect to factors affecting the care or training provided.
new text end

new text begin Subd. 29. new text end

new text begin Facility. new text end

new text begin "Facility" means an assisted living facility and a basic care facility.
new text end

new text begin Subd. 30. new text end

new text begin Hands-on assistance. new text end

new text begin "Hands-on assistance" means physical help by another
person without which the resident is not able to perform the activity.
new text end

new text begin Subd. 31. new text end

new text begin Indirect ownership interest. new text end

new text begin "Indirect ownership interest" means an individual
or organization with a direct ownership interest in an entity that has a direct or indirect
ownership interest in a facility of at least five percent or more. An individual with a five
percent or more indirect ownership is presumed to have an effect on the operation of the
facility with respect to factors affecting the care or training provided.
new text end

new text begin Subd. 32. new text end

new text begin Licensed health professional. new text end

new text begin "Licensed health professional" means a person
licensed in Minnesota to practice the professions described in section 214.01, subdivision
2.
new text end

new text begin Subd. 33. new text end

new text begin Licensed resident bed capacity. new text end

new text begin "Licensed resident bed capacity" means the
resident occupancy level requested by a licensee and approved by the commissioner.
new text end

new text begin Subd. 34. new text end

new text begin Licensee. new text end

new text begin "Licensee" means a person or legal entity to whom the commissioner
issues an assisted living license and who is responsible for the management, control, and
operation of a facility. A facility must be managed, controlled, and operated in a manner
that enables it to use its resources effectively and efficiently to attain or maintain the highest
practicable physical, mental, and psychosocial well-being of each resident.
new text end

new text begin Subd. 35. new text end

new text begin Maltreatment. new text end

new text begin "Maltreatment" means conduct described in section 626.5572,
subdivision 15, or the intentional and nontherapeutic infliction of physical pain or injury or
any persistent course of conduct intended to produce mental or emotional distress.
new text end

new text begin Subd. 36. new text end

new text begin Management agreement. new text end

new text begin "Management agreement" means a written, executed
agreement between a licensee and manager regarding the provision of certain services on
behalf of the licensee.
new text end

new text begin Subd. 37. new text end

new text begin Managerial official. new text end

new text begin "Managerial official" means an individual who has the
decision-making authority related to the operation of the facility and the responsibility for
the ongoing management or direction of the policies, services, or employees of the facility.
new text end

new text begin Subd. 38. new text end

new text begin Medication. new text end

new text begin "Medication" means a prescription or over-the-counter drug. For
purposes of this chapter only, medication includes dietary supplements.
new text end

new text begin Subd. 39. new text end

new text begin Medication administration. new text end

new text begin "Medication administration" means performing
a set of tasks that includes the following:
new text end

new text begin (1) checking the client's medication record;
new text end

new text begin (2) preparing the medication as necessary;
new text end

new text begin (3) administering the medication to the client;
new text end

new text begin (4) documenting the administration or reason for not administering the medication; and
new text end

new text begin (5) reporting to a registered nurse or appropriate licensed health professional any concerns
about the medication, the client, or the client's refusal to take the medication.
new text end

new text begin Subd. 40. new text end

new text begin Medication management. new text end

new text begin "Medication management" means the provision
of any of the following medication-related services to a resident:
new text end

new text begin (1) performing medication setup;
new text end

new text begin (2) administering medications;
new text end

new text begin (3) storing and securing medications;
new text end

new text begin (4) documenting medication activities;
new text end

new text begin (5) verifying and monitoring the effectiveness of systems to ensure safe handling and
administration;
new text end

new text begin (6) coordinating refills;
new text end

new text begin (7) handling and implementing changes to prescriptions;
new text end

new text begin (8) communicating with the pharmacy about the client's medications; and
new text end

new text begin (9) coordinating and communicating with the prescriber.
new text end

new text begin Subd. 41. new text end

new text begin Medication reconciliation. new text end

new text begin "Medication reconciliation" means the process
of identifying the most accurate list of all medications the resident is taking, including the
name, dosage, frequency, and route by comparing the resident record to an external list of
medications obtained from the resident, hospital, prescriber or other provider.
new text end

new text begin Subd. 42. new text end

new text begin Medication setup. new text end

new text begin "Medication setup" means arranging medications by a
nurse, pharmacy, or authorized prescriber for later administration by the resident or by
facility staff.
new text end

new text begin Subd. 43. new text end

new text begin New construction. new text end

new text begin "New construction" means a new building, renovation,
modification, reconstruction, physical changes altering the use of occupancy, or an addition
to a building.
new text end

new text begin Subd. 44. new text end

new text begin Nurse. new text end

new text begin "Nurse" means a person who is licensed under sections 148.171 to
148.285.
new text end

new text begin Subd. 45. new text end

new text begin Occupational therapist. new text end

new text begin "Occupational therapist" means a person who is
licensed under sections 148.6401 to 148.6449.
new text end

new text begin Subd. 46. new text end

new text begin Ombudsman. new text end

new text begin "Ombudsman" means the ombudsman for long-term care.
new text end

new text begin Subd. 47. new text end

new text begin Owner. new text end

new text begin "Owner" means an individual or organization that has a direct or
indirect ownership interest of five percent or more in a facility. For purposes of this chapter,
"owner of a nonprofit corporation" means the president and treasurer of the board of directors
or, for an entity owned by an employee stock ownership plan, means the president and
treasurer of the entity. A government entity that is issued a license under this chapter shall
be designated the owner. An individual with a five percent or more direct or indirect
ownership is presumed to have an effect on the operation of the facility with respect to
factors affecting the care or training provided.
new text end

new text begin Subd. 48. new text end

new text begin Over-the-counter drug. new text end

new text begin "Over-the-counter drug" means a drug that is not
required by federal law to bear the symbol "Rx only."
new text end

new text begin Subd. 49. new text end

new text begin Person-centered planning and service delivery. new text end

new text begin "Person-centered planning
and service delivery" means services as defined in section 245D.07, subdivision 1a, paragraph
(b).
new text end

new text begin Subd. 50. new text end

new text begin Pharmacist. new text end

new text begin "Pharmacist" has the meaning given in section 151.01, subdivision
3.
new text end

new text begin Subd. 51. new text end

new text begin Physical therapist. new text end

new text begin "Physical therapist" means a person who is licensed under
sections 148.65 to 148.78.
new text end

new text begin Subd. 52. new text end

new text begin Physician. new text end

new text begin "Physician" means a person who is licensed under chapter 147.
new text end

new text begin Subd. 53. new text end

new text begin Prescriber. new text end

new text begin "Prescriber" means a person who is authorized by sections 148.235;
151.01, subdivision 23; and 151.37 to prescribe prescription drugs.
new text end

new text begin Subd. 54. new text end

new text begin Prescription. new text end

new text begin "Prescription" has the meaning given in section 151.01,
subdivision 16a.
new text end

new text begin Subd. 55. new text end

new text begin Provisional license. new text end

new text begin "Provisional license" means the initial license the
department issues after approval of a complete written application and before the department
completes the provisional license and determines that the provisional licensee is in substantial
compliance.
new text end

new text begin Subd. 56. new text end

new text begin Regularly scheduled. new text end

new text begin "Regularly scheduled" means ordered or planned to be
completed at predetermined times or according to a predetermined routine.
new text end

new text begin Subd. 57. new text end

new text begin Reminder. new text end

new text begin "Reminder" means providing a verbal or visual reminder to a
resident.
new text end

new text begin Subd. 58. new text end

new text begin Resident. new text end

new text begin "Resident" means a person living in an assisted living facility or a
basic care facility.
new text end

new text begin Subd. 59. new text end

new text begin Resident record. new text end

new text begin "Resident record" means all records that document
information about the services provided to the resident.
new text end

new text begin Subd. 60. new text end

new text begin Resident representative. new text end

new text begin "Resident representative" means a person designated
in writing by the resident and identified in the resident's records on file with the facility.
new text end

new text begin Subd. 61. new text end

new text begin Respiratory therapist. new text end

new text begin "Respiratory therapist" means a person who is licensed
under chapter 147C.
new text end

new text begin Subd. 62. new text end

new text begin Revenues. new text end

new text begin "Revenues" means all money received by a licensee derived from
the provision of home care services, including fees for services and appropriations of public
money for home care services.
new text end

new text begin Subd. 63. new text end

new text begin Service agreement. new text end

new text begin "Service agreement" means the written agreement between
the resident or the resident's representative and the provisional licensee or licensee about
the services that will be provided to the resident.
new text end

new text begin Subd. 64. new text end

new text begin Standby assistance. new text end

new text begin "Standby assistance" means the presence of another
person within arm's reach to minimize the risk of injury while performing daily activities
through physical intervention or cueing to assist a resident with an assistive task by providing
cues, oversight, and minimal physical assistance.
new text end

new text begin Subd. 65. new text end

new text begin Social worker. new text end

new text begin "Social worker" means a person who is licensed under chapter
148D or 148E.
new text end

new text begin Subd. 66. new text end

new text begin Speech-language pathologist. new text end

new text begin "Speech-language pathologist" has the meaning
given in section 148.512.
new text end

new text begin Subd. 67. new text end

new text begin Substantial compliance. new text end

new text begin "Substantial compliance" means the commissioner
has found no Level 4 violations, nor any pattern of or widespread Level 3 violations as
described under section 144G.35, subdivisions 1 and 2.
new text end

new text begin Subd. 68. new text end

new text begin Supportive services. new text end

new text begin "Supportive services" means services that may be offered
or provided in a basic care facility or an assisted living facility and means help with personal
laundry, handling or assisting with personal funds of residents, or arranging for medical
services, health-related services, social services, housekeeping, central dining, recreation,
or transportation. Arranging for services does not include making referrals, or contacting a
service provider in an emergency.
new text end

new text begin Subd. 69. new text end

new text begin Survey. new text end

new text begin "Survey" means an inspection of a licensee or applicant for licensure
for compliance with this chapter.
new text end

new text begin Subd. 70. new text end

new text begin Surveyor. new text end

new text begin "Surveyor" means a staff person of the department who is authorized
to conduct surveys of basic care facilities and assisted living facilities and applicants.
new text end

new text begin Subd. 71. new text end

new text begin Termination of housing or services. new text end

new text begin "Termination of housing or services"
means a discharge, eviction, transfer, or service termination initiated by the facility. A
facility-initiated termination is one which the resident objects to and did not originate through
a resident's verbal or written request. A resident-initiated termination is one where a resident
or, if appropriate, a designated representative provided a verbal or written notice of intent
to leave the facility. A resident-initiated termination does not include the general expression
of a desire to return home or the elopement of residents with cognitive impairment.
new text end

new text begin Subd. 72. new text end

new text begin Treatment or therapy. new text end

new text begin "Treatment" or "therapy" means the provision of care,
other than medications, ordered or prescribed by a licensed health professional and provided
to a resident to cure, rehabilitate, or ease symptoms.
new text end

new text begin Subd. 73. new text end

new text begin Unit of government. new text end

new text begin "Unit of government" means a city, county, town, school
district, other political subdivision of the state, or an agency of the state or federal
government, that includes any instrumentality of a unit of government.
new text end

new text begin Subd. 74. new text end

new text begin Unlicensed personnel. new text end

new text begin "Unlicensed personnel" means individuals not otherwise
licensed or certified by a governmental health board or agency who provide services to a
resident.
new text end

new text begin Subd. 75. new text end

new text begin Verbal. new text end

new text begin "Verbal" means oral and not in writing.
new text end

Sec. 2.

new text begin [144G.11] LICENSURE REQUIRED.
new text end

new text begin Subdivision 1. new text end

new text begin License required. new text end

new text begin Beginning August 1, 2021, an entity may not operate
a basic care facility or an assisted living facility in Minnesota unless it is licensed under
this chapter.
new text end

new text begin Subd. 2. new text end

new text begin Licensure levels. new text end

new text begin (a) The levels in this subdivision are established for a basic
care facility and an assisted living facility licensure.
new text end

new text begin (b) Tier One is a basic care facility that provides basic care services. A Tier One facility
shall not provide comprehensive assisted living services.
new text end

new text begin (c) Tier Two is an assisted living facility that provides basic care services and
comprehensive assisted living services.
new text end

new text begin (d) Tier Three is an assisted living facility that provides basic and comprehensive assisted
living services, and provides services in a secure dementia care unit or wing.
new text end

new text begin Subd. 3. new text end

new text begin Violations; penalty. new text end

new text begin (a) Operating a facility without a valid license is a
misdemeanor punishable by a fine imposed by the commissioner.
new text end

new text begin (b) A controlling individual of the facility in violation of this section is guilty of a
misdemeanor. The provisions of this subdivision shall not apply to any controlling individual
who had no legal authority to affect or change decisions related to the operation of the
facility.
new text end

new text begin (c) The sanctions in this section do not restrict other available sanctions in law.
new text end

Sec. 3.

new text begin [144G.12] REGULATORY AUTHORITY OF COMMISSIONER.
new text end

new text begin Subdivision 1. new text end

new text begin Regulations. new text end

new text begin The commissioner shall regulate facilities pursuant to this
chapter. The regulations shall include the following:
new text end

new text begin (1) provisions to assure, to the extent possible, the health, safety, well-being, and
appropriate treatment of residents while respecting individual autonomy and choice;
new text end

new text begin (2) requirements that facilities furnish the commissioner with specified information
necessary to implement this chapter;
new text end

new text begin (3) standards of training of facility personnel;
new text end

new text begin (4) standards for provision of services;
new text end

new text begin (5) standards for medication management;
new text end

new text begin (6) standards for supervision of services;
new text end

new text begin (7) standards for resident evaluation or assessment;
new text end

new text begin (8) standards for treatments and therapies;
new text end

new text begin (9) requirements for the involvement of a resident's health care provider, the
documentation of the health care provider's orders, if required, and the resident's service
agreement;
new text end

new text begin (10) the maintenance of accurate, current resident records;
new text end

new text begin (11) the establishment of levels of licenses based on services provided; and
new text end

new text begin (12) provisions to enforce these regulations and the basic care and assisted living bill of
rights.
new text end

new text begin Subd. 2. new text end

new text begin Regulatory functions. new text end

new text begin (a) The commissioner shall:
new text end

new text begin (1) license, survey, and monitor without advance notice facilities in accordance with
this chapter;
new text end

new text begin (2) survey every provisional licensee within one year of the provisional license issuance
date subject to the provisional licensee providing licensed services to residents;
new text end

new text begin (3) survey facility licensees annually;
new text end

new text begin (4) investigate complaints of facilities;
new text end

new text begin (5) issue correction orders and assess civil penalties;
new text end

new text begin (6) take action as authorized in sections 144G.21 to 144G.33; and
new text end

new text begin (7) take other action reasonably required to accomplish the purposes of this chapter.
new text end

new text begin (b) After July 1, 2021, the commissioner shall review blueprints for all new facility
construction and must approve the plans before construction may be commenced.
new text end

new text begin (c) The commissioner shall provide on-site review of the construction to ensure that all
physical environment standards are met before the facility license is complete.
new text end

new text begin Subd. 3. new text end

new text begin Rulemaking authorized. new text end

new text begin (a) The commissioner shall adopt rules for all basic
care facilities and assisted living facilities that promote person-centered planning and service
and optimal quality of life, and that ensure resident rights are protected, resident choice is
allowed, and public health and safety is ensured.
new text end

new text begin (b) On July 1, 2019, the commissioner shall begin rulemaking using the process in section
14.389, subdivision 5.
new text end

new text begin (c) The commissioner shall adopt rules that include but are not limited to the following:
new text end

new text begin (1) building design, physical plant standards, environmental health and safety minimum
standards from the most recent version of the Facility Guide Institute's Guidelines for Design
and Construction of Residential Health, Care, and Support Facilities, including appendices;
new text end

new text begin (2) staffing minimums and ratios for each level of licensure to best protect the health
and safety of residents no matter their vulnerability;
new text end

new text begin (3) require provider notices and disclosures to residents and their families;
new text end

new text begin (4) training prerequisites and ongoing training for administrators and caregiving staff;
new text end

new text begin (5) minimum requirements for move-in assessments and ongoing assessments and
practice standards in sections 144A.43 to 144A.47;
new text end

new text begin (6) requirements for licensees to ensure minimum nutrition and dietary standards required
by section 144G.38, subdivision 1, clause (1), item (i), are provided;
new text end

new text begin (7) requirements for supportive services provided by assisted living licensees;
new text end

new text begin (8) procedures for discharge planning and ensuring resident appeal rights;
new text end

new text begin (9) content requirements for all license or provisional license applications;
new text end

new text begin (10) requirements that support facilities to comply with home and community-based
requirements in Code of Federal Regulations, title 42, section 441.301(c);
new text end

new text begin (11) core dementia care requirements and training in all levels of licensure;
new text end

new text begin (12) requirements for Tier Three assisted living facilities in terms of training, care
standards, noticing changes of condition, assessments, and health care;
new text end

new text begin (13) preadmission criteria, initial assessments, and continuing assessments;
new text end

new text begin (14) emergency disaster and preparedness plans;
new text end

new text begin (15) capitalization requirements for facilities;
new text end

new text begin (16) uniform checklist disclosure of services;
new text end

new text begin (17) uniform consumer information guide elements and other data collected; and
new text end

new text begin (18) uniform assessment tool.
new text end

new text begin (d) The commissioner shall publish the proposed rules by December 31, 2019.
new text end

Sec. 4.

new text begin [144G.13] APPLICATION FOR LICENSURE.
new text end

new text begin Subdivision 1. new text end

new text begin License application; required information. new text end

new text begin Each application for a
facility license, including a provisional license, must include information sufficient to show
that the applicant meets the requirements of licensure, including:
new text end

new text begin (1) the business name and legal entity name of the operating entity; street address and
mailing address of the facility; and the names, e-mail addresses, telephone numbers, and
mailing addresses of all owners, controlling individuals, managerial officials, and the assisted
living administrator;
new text end

new text begin (2) the name and e-mail address of the managing agent, if applicable;
new text end

new text begin (3) the licensed bed capacity and the license tier;
new text end

new text begin (4) the license fee in the amount specified in subdivision 3;
new text end

new text begin (5) any judgments, private or public litigation, tax liens, written complaints, administrative
actions, or investigations by any government agency against the applicant, owner, controlling
individual, managerial official, or assisted living administrator that are unresolved or
otherwise filed or commenced within the preceding ten years;
new text end

new text begin (6) documentation of compliance with the background study requirements of section
144A.476 for the owner, controlling individuals, and managerial officials. Each application
for a new license must include documentation for the applicant and for each individual with
five percent or more direct or indirect ownership in the applicant;
new text end

new text begin (7) documentation of a background study as required by section 144.057 for any
individual seeking employment, paid or volunteer, with the assisted living establishment;
new text end

new text begin (8) evidence of workers' compensation coverage as required by sections 176.181 and
176.182;
new text end

new text begin (9) disclosure that the provider has no liability coverage or, if the provider has coverage,
documentation of coverage;
new text end

new text begin (10) a copy of the executed lease agreement if applicable;
new text end

new text begin (11) a copy of the management agreement if applicable;
new text end

new text begin (12) a copy of the operations transfer agreement or similar agreement if applicable;
new text end

new text begin (13) a copy of the executed agreement if the facility has contracted services with another
organization or individual for services such as managerial, billing, consultative, or medical
personnel staffing;
new text end

new text begin (14) a copy of the organizational chart that identifies all organizations and individuals
with any ownership interests in the facility;
new text end

new text begin (15) whether any applicant, owner, controlling individual, managerial official, or assisted
living administrator of the facility has ever been convicted of a crime or found civilly liable
for an offense involving moral turpitude, including forgery, embezzlement, obtaining money
under false pretenses, larceny, extortion, conspiracy to defraud, or any other similar offense
or violation, or any violation of section 626.557 or any other similar law in any other state,
or any violation of a federal or state law or regulation in connection with activities involving
any consumer fraud, false advertising, deceptive trade practices, or similar consumer
protection law;
new text end

new text begin (16) whether the applicant or any person employed by the applicant has a record of
defaulting in the payment of money collected for others, including the discharge of debts
through bankruptcy proceedings;
new text end

new text begin (17) documentation that the applicant has designated one or more owners, controlling
individuals, or employees as an agent or agents, which shall not affect the legal responsibility
of any other owner or controlling person under this chapter;
new text end

new text begin (18) the signature of the owner or owners, or an authorized agent of the owner or owners
of the facility applicant. An application submitted on behalf of a business entity must be
signed by at least two owners or controlling individuals;
new text end

new text begin (19) identification of all states where the applicant, or individual having a five percent
or more ownership, currently or previously has been licensed as owner or operator of a
long-term care, community-based, or health care facility or agency where its license or
federal certification has been denied, suspended, restricted, conditioned, or revoked under
a private or state-controlled receivership, or where these same actions are pending under
the laws of any state or federal authority; and
new text end

new text begin (20) any other information required by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Designated agent and personal service. new text end

new text begin (a) An application for a facility or
for renewal of a facility must specify one or more owners, controlling individuals, or
employees as agents:
new text end

new text begin (1) who shall be responsible for dealing with the commissioner on all requirements of
this chapter; and
new text end

new text begin (2) on whom personal service of all notices and orders shall be made, and who shall be
authorized to accept service on behalf of all of the controlling individuals of the facility, in
proceedings under this chapter.
new text end

new text begin (b) Notwithstanding any law to the contrary, personal service on the designated person
or persons named in the application is deemed to be service on all of the controlling
individuals or managerial employees of the facility, and it is not a defense to any action
arising under this chapter that personal service was not made on each controlling individual
or managerial official of the facility. The designation of one or more controlling individuals
or managerial officials under this subdivision shall not affect the legal responsibility of any
other controlling individual or managerial official under this chapter.
new text end

new text begin Subd. 3. new text end

new text begin Application fees. new text end

new text begin (a) An initial applicant or applicant filing a change of
ownership for a basic care or assisted living facility licensure must submit the following
application fee to the commissioner, along with a completed application:
new text end

new text begin (1) Tier One, $.......;
new text end

new text begin (2) Tier Two, $.......; and
new text end

new text begin (3) Tier Three, $........
new text end

new text begin (b) Fees collected under this subdivision shall be deposited in the state treasury and
credited to the state government special revenue fund. All fees are nonrefundable.
new text end

new text begin Subd. 4. new text end

new text begin Fines. new text end

new text begin (a) The penalty for late submission of the renewal application after
expiration of the license is $200. The penalty for practicing after expiration of the license
and before a renewal license is issued is $250 per each day after expiration of the license
until the renewal license issuance date. The facility is still subject to the criminal gross
misdemeanor penalties for operating after license expiration.
new text end

new text begin (b) Fines collected under this subdivision 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 to implement the recommendations of the advisory council established
in section 144A.4799.
new text end

Sec. 5.

new text begin [144G.14] BACKGROUND STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Background studies required. new text end

new text begin Before the commissioner issues a
provisional license, issues a license as a result of an approved change of ownership, or
renews a license, a controlling individual or managerial official is required to complete a
background study under section 144.057. For the purposes of this section, managerial
officials subject to the background check requirement are individuals who provide direct
contact as defined in section 245C.02, subdivision 11. No person may be involved in the
management, operation, or control of a facility if the person has been disqualified under
chapter 245C.
new text end

new text begin Subd. 2. new text end

new text begin Reconsideration. new text end

new text begin (a) If an individual is disqualified under section 144.057 or
chapter 245C, the individual may request reconsideration of the disqualification. If the
individual requests reconsideration and the commissioner sets aside or rescinds the
disqualification, the individual is eligible to be involved in the management, operation, or
control of the facility. If an individual has a disqualification under section 245C.15,
subdivision 1, and the disqualification is affirmed, the individual's disqualification is barred
from a set aside, and the individual must not be involved in the management, operation, or
control of the facility.
new text end

new text begin (b) The commissioner shall not issue a license if the controlling individual or managerial
official has been unsuccessful in having a background study disqualification set aside under
section 144.057 and chapter 245C.
new text end

new text begin Subd. 3. new text end

new text begin Data classification. new text end

new text begin Data collected under this section shall be classified as
private data on individuals under section 13.02, subdivision 12.
new text end

Sec. 6.

new text begin [144G.15] INELIGIBLE APPLICANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Owners and managerial officials; refusal to grant license. new text end

new text begin (a) The
owner and managerial officials of a facility whose Minnesota license has not been renewed
or that has been revoked because of noncompliance with applicable laws or rules shall not
be eligible to apply for nor will be granted a basic care facility license or an assisted living
facility license, 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 owner
and/or managerial officials already have enrollment status, the enrollment will be terminated
by the Department of Human Services.
new text end

new text begin (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 owner or managerial official,
including any individual who was an owner or managerial official of another licensed
provider, had a Minnesota license that was not renewed or was revoked as described in
paragraph (a).
new text end

new text begin (c) Notwithstanding section 144G.21, 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 Minnesota
license was not renewed or was revoked as described in paragraph (a) for five years following
the effective date of the nonrenewal or revocation.
new text end

new text begin (d) The commissioner shall notify the facility 30 days in advance of the date of
nonrenewal, suspension, or revocation of the license.
new text end

new text begin Subd. 2. new text end

new text begin Requesting a stay. new text end

new text begin Within ten days after the receipt of the notification, the
facility may request, in writing, that the commissioner stay the nonrenewal, revocation, or
suspension of the license. The facility shall specify the reasons for requesting the stay; the
steps that will be taken to attain or maintain compliance with the licensure laws and
regulations; any limits on the authority or responsibility of the owners or managerial officials
whose actions resulted in the notice of nonrenewal, revocation, or suspension; and any other
information to establish that the continuing affiliation with these individuals will not
jeopardize resident health, safety, or well-being.
new text end

new text begin Subd. 3. new text end

new text begin Granting a stay. new text end

new text begin The commissioner shall determine whether the stay will be
granted within 30 days of receiving the facility's request. The commissioner may propose
additional restrictions or limitations on the facility's license and require that granting the
stay be contingent upon compliance with those provisions. The commissioner shall take
into consideration the following factors when determining whether the stay should be
granted:
new text end

new text begin (1) the threat that continued involvement of the owners and managerial officials with
the facility poses to resident health, safety, and well-being;
new text end

new text begin (2) the compliance history of the facility; and
new text end

new text begin (3) the appropriateness of any limits suggested by the facility.
new text end

new text begin If the commissioner grants the stay, the order shall include any restrictions or limitation on
the provider's license. The failure of the facility to comply with any restrictions or limitations
shall result in the immediate removal of the stay and the commissioner shall take immediate
action to suspend, revoke, or not renew the license.
new text end

new text begin Subd. 4. new text end

new text begin Controlling individual restrictions. new text end

new text begin The controlling individual of a facility
may not include any person who was a controlling individual of any other nursing home,
basic care facility, or assisted living facility during any period of time in the previous
two-year period:
new text end

new text begin (1) during which time of control the nursing home, basic care facility, or assisted living
facility incurred the following number of uncorrected or repeated violations:
new text end

new text begin (i) two or more uncorrected violations or one or more repeated violations that created
an imminent risk to direct resident care or safety; or
new text end

new text begin (ii) four or more uncorrected violations or two or more repeated violations of any nature,
including Level 2, Level 3, and Level 4 violations as defined in section 144G.35, subdivision
1; or
new text end

new text begin (2) who, during that period, was convicted of a felony or gross misdemeanor that relates
to the operation of the nursing home, basic care facility, or assisted living facility, or directly
affects resident safety or care.
new text end

new text begin Subd. 5. new text end

new text begin Exception. new text end

new text begin The provisions of subdivision 4 do 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 or other basic care facility or assisted living facility that
incurred the uncorrected violations.
new text end

new text begin Subd. 6. new text end

new text begin Stay of adverse action required by controlling individual restrictions. new text end

new text begin (a)
In lieu of revoking, suspending, or refusing to renew the license of a facility where a
controlling individual was disqualified by subdivision 4, clause (1), the commissioner may
issue an order staying the revocation, suspension, or nonrenewal of the facility's license.
The order may but need not be contingent upon the facility's compliance with restrictions
and conditions imposed on the license to ensure the proper operation of the facility and to
protect the health, safety, comfort, treatment, and well-being of the residents in the facility.
The decision to issue an order for a stay must be made within 90 days of the commissioner's
determination that a controlling individual of the facility is disqualified by subdivision 4,
clause (1), from operating a facility.
new text end

new text begin (b) In determining whether to issue a stay and to impose conditions and restrictions, the
commissioner must consider the following factors:
new text end

new text begin (1) the ability of the controlling individual to operate other facilities in accordance with
the licensure rules and laws;
new text end

new text begin (2) the conditions in the nursing home, basic care facility, or assisted living facility that
received the number and type of uncorrected or repeated violations described in subdivision
4, clause (1); and
new text end

new text begin (3) the conditions and compliance history of each of the nursing homes, basic care
facilities, and assisted living facilities owned or operated by the controlling individuals.
new text end

new text begin (c) The commissioner's decision to exercise the authority under this subdivision in lieu
of revoking, suspending, or refusing to renew the license of the facility is not subject to
administrative or judicial review.
new text end

new text begin (d) The order for the stay of revocation, suspension, or nonrenewal of the facility license
must include any conditions and restrictions on the license that the commissioner deems
necessary based on the factors listed in paragraph (b).
new text end

new text begin (e) Prior to issuing an order for stay of revocation, suspension, or nonrenewal, the
commissioner shall inform the controlling individual in writing of any conditions and
restrictions that will be imposed. The controlling individual shall, within ten working days,
notify the commissioner in writing of a decision to accept or reject the conditions and
restrictions. If the facility rejects any of the conditions and restrictions, the commissioner
must either modify the conditions and restrictions or take action to suspend, revoke, or not
renew the facility's license.
new text end

new text begin (f) Upon issuance of the order for a stay of revocation, suspension, or nonrenewal, the
controlling individual shall be responsible for compliance with the conditions and restrictions.
Any time after the conditions and restrictions have been in place for 180 days, the controlling
individual may petition the commissioner for removal or modification of the conditions and
restrictions. The commissioner must respond to the petition within 30 days of receipt of the
written petition. If the commissioner denies the petition, the controlling individual may
request a hearing under the provisions of chapter 14. Any hearing shall be limited to a
determination of whether the conditions and restrictions shall be modified or removed. At
the hearing, the controlling individual bears the burden of proof.
new text end

new text begin (g) The failure of the controlling individual to comply with the conditions and restrictions
contained in the order for stay shall result in the immediate removal of the stay and the
commissioner shall take action to suspend, revoke, or not renew the license.
new text end

new text begin (h) The conditions and restrictions are effective for two years after the date they are
imposed.
new text end

new text begin (i) Nothing in this subdivision shall be construed to limit in any way the commissioner's
ability to impose other sanctions against a facility licensee under the standards in state or
federal law whether or not a stay of revocation, suspension, or nonrenewal is issued.
new text end

Sec. 7.

new text begin [144G.16] CONSIDERATION OF APPLICATIONS.
new text end

new text begin (a) The commissioner shall consider an applicant's performance history, in Minnesota
and in other states, including repeat violations or rule violations, before issuing a provisional
license, license, or renewal license.
new text end

new text begin (b) An applicant must not have a history within the last five years in Minnesota or in
any other state of a license or certification involuntarily suspended or voluntarily terminated
during any enforcement process in a facility that provides care to children, the elderly or ill
individuals, or individuals with disabilities.
new text end

new text begin (c) Failure to provide accurate information or demonstrate required performance history
may result in the denial of a license.
new text end

new text begin (d) The commissioner may deny, revoke, suspend, restrict, or refuse to renew the license
or impose conditions if:
new text end

new text begin (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;
new text end

new text begin (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;
new text end

new text begin (3) the applicant refused to allow representatives or agents of the department to inspect
its books, records, and files, or any portion of the premises;
new text end

new text begin (4) willfully prevented, interfered with, or attempted to impede in any way: (i) the work
of any authorized representative of the department, 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;
new text end

new text begin (5) the applicant has a history of noncompliance with federal or state regulations that
was detrimental to the health, welfare, or safety of a resident or a client; and
new text end

new text begin (6) the applicant violates any requirement in this chapter.
new text end

new text begin (e) For all new licensees after a change in ownership, the commissioner shall complete
a survey within six months after the new license is issued.
new text end

Sec. 8.

new text begin [144G.17] PROVISIONAL LICENSE.
new text end

new text begin Subdivision 1. new text end

new text begin Provisional license. new text end

new text begin (a) Beginning July 1, 2021, for new applicants, the
commissioner shall issue a provisional license to each of the licensure levels specified in
section 144G.11, subdivision 2, which is effective for up to one year from the license
effective date, except that a provisional license may be extended according to subdivision
2, paragraph (c).
new text end

new text begin (b) Basic care facilities and assisted living facilities are subject to evaluation and approval
by the commissioner of the facility's physical environment and its operational aspects before
a change in ownership or capacity, or an addition of services which necessitates a change
in the facility's physical environment.
new text end

new text begin Subd. 2. new text end

new text begin Initial survey of provisional licensees and licensure. new text end

new text begin (a) During the
provisional license period, the commissioner shall survey the provisional licensee after the
commissioner is notified or has evidence that the provisional licensee has residents and is
providing services.
new text end

new text begin (b) Within two days of beginning to provide services, the provisional licensee must
provide notice to the commissioner that it is serving residents by sending an e-mail to the
e-mail address provided by the commissioner. If the provisional licensee does not provide
services during the provisional license period, then the provisional license expires at the
end of the period and the applicant must reapply for the provisional facility license.
new text end

new text begin (c) If the provisional licensee notifies the commissioner that the licensee has residents
within 45 days prior to the provisional license expiration, the commissioner may extend the
provisional license for up to 60 days in order to allow the commissioner to complete the
on-site survey required under this section and follow-up survey visits.
new text end

new text begin (d) If the provisional licensee is in substantial compliance with the survey, the
commissioner shall issue a facility license.
new text end

new text begin Subd. 3. new text end

new text begin Terminated or extended provisional licenses. new text end

new text begin If the provisional licensee is
not in substantial compliance with the survey, the commissioner shall either: (1) not issue
the facility license and terminate the provisional license; or (2) extend the provisional license
for a period not to exceed 90 days and apply conditions to the extension of the provisional
license. If the provisional licensee is not in substantial compliance with the survey within
the time period of the extension or if the provisional licensee does not satisfy the license
conditions, the commissioner may deny the license.
new text end

new text begin Subd. 4. new text end

new text begin Reconsideration. new text end

new text begin (a) If a provisional licensee whose facility license has been
denied or extended with conditions disagrees with the conclusions of the commissioner,
then the provisional licensee may request a reconsideration by the commissioner or
commissioner's designee. The reconsideration request process must be conducted internally
by the commissioner or designee, and chapter 14 does not apply.
new text end

new text begin (b) The provisional licensee requesting the reconsideration must make the request in
writing and must list and describe the reasons why the provisional licensee disagrees with
the decision to deny the facility license or the decision to extend the provisional license
with conditions.
new text end

new text begin (c) The reconsideration request and supporting documentation must be received by the
commissioner within 15 calendar days after the date the provisional license receives the
denial or provisional license with conditions.
new text end

new text begin Subd. 5. new text end

new text begin Continued operation. new text end

new text begin A provisional licensee whose license is denied is
permitted to continue operating during the period of time when:
new text end

new text begin (1) a reconsideration is in process;
new text end

new text begin (2) an extension of the provisional license and terms associated with it is in active
negotiation between the commissioner and the licensee and the commissioner confirms the
negotiation is active; or
new text end

new text begin (3) a transfer of residents to a new facility is underway and not all the residents have
relocated.
new text end

new text begin Subd. 6. new text end

new text begin Requirements for notice and transfer of residents. new text end

new text begin A provisional licensee
whose license is denied must comply with the requirements for notification and transfer of
residents in sections 144G.47 and 144G.48.
new text end

new text begin Subd. 7. new text end

new text begin Fines. new text end

new text begin The fee for failure to comply with the notification requirements in section
144G.47, subdivision 5, is $1,000.
new text end

Sec. 9.

new text begin [144G.18] LICENSE RENEWAL.
new text end

new text begin Except as provided in section ....., a license that is not a provisional license may be
renewed for a period of up to one year if the licensee satisfies the following:
new text end

new text begin (1) submits an application for renewal in the format provided by the commissioner at
least 60 days before expiration of the license;
new text end

new text begin (2) submits the renewal fee under section 144.122;
new text end

new text begin (3) submits the late fee as provided in section 144G.13, subdivision 4, if the renewal
application is received less than 30 days before the expiration date of the license;
new text end

new text begin (4) provides information sufficient to show that the applicant meets the requirements of
licensure, including items required under section 144G.13, subdivision 1; and
new text end

new text begin (5) provides any other information deemed necessary by the commissioner.
new text end

Sec. 10.

new text begin [144G.19] NOTIFICATION OF CHANGES OF INFORMATION.
new text end

new text begin The provisional licensee or licensee shall notify the commissioner in writing prior to
any financial or contractual change and within 60 calendar days after any change in the
information required in section 144G.13, subdivision 1.
new text end

Sec. 11.

new text begin [144G.20] TRANSFER OF LICENSE PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Transfers prohibited. new text end

new text begin Any facility license issued by the commissioner
may not be transferred to another party.
new text end

new text begin Subd. 2. new text end

new text begin New license required. new text end

new text begin (a) Before acquiring ownership of a facility, a prospective
applicant must apply for a new license. The licensee of a basic care facility or an assisted
living facility must change whenever the following events occur, including but not limited
to:
new text end

new text begin (1) the licensee's form of legal organization is changed;
new text end

new text begin (2) the licensee transfers ownership of the facility business enterprise to another party
regardless of whether ownership of some or all of the real property or personal property
assets of the assisted living facility is also transferred;
new text end

new text begin (3) the licensee dissolves, consolidates, or merges with another legal organization and
the licensee's legal organization does not survive;
new text end

new text begin (4) during any continuous 24-month period, 50 percent or more of the licensed entity is
transferred, whether by a single transaction or multiple transactions, to:
new text end

new text begin (i) a different person; or
new text end

new text begin (ii) a person that had less than a five percent ownership interest in the facility at the time
of the first transaction; or
new text end

new text begin (5) any other event or combination of events that results in a substitution, elimination,
or withdrawal of the licensee's control of the facility.
new text end

new text begin (b) The current facility licensee must provide written notice to the department and
residents, or designated representatives, at least 60 calendar days prior to the anticipated
date of the change of licensee.
new text end

new text begin Subd. 3. new text end

new text begin Survey required. new text end

new text begin For all new licensees after a change in ownership, the
commissioner shall complete a survey within six months after the new license is issued.
new text end

ARTICLE 2

SURVEYS AND ENFORCEMENT

Section 1.

new text begin [144G.21] GROUNDS FOR ENFORCEMENT.
new text end

new text begin (a) The commissioner may refuse to grant a provisional license, refuse to grant a license
as a result of a change in ownership, renew a license, suspend or revoke a license, or impose
a conditional license if the owner, controlling individual, or employee of a basic care facility,
assisted living facility, or assisted living facility with dementia care:
new text end

new text begin (1) is in violation of, or during the term of the license has violated, any of the requirements
in this chapter or adopted rules;
new text end

new text begin (2) permits, aids, or abets the commission of any illegal act in the provision of assisted
living services;
new text end

new text begin (3) performs any act detrimental to the health, safety, and welfare of a resident;
new text end

new text begin (4) obtains the license by fraud or misrepresentation;
new text end

new text begin (5) knowingly made or 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;
new text end

new text begin (6) denies representatives of the department access to any part of the facility's books,
records, files, or employees;
new text end

new text begin (7) interferes with or impedes a representative of the department in contacting the facility's
residents;
new text end

new text begin (8) interferes with or impedes a representative of the department in the enforcement of
this chapter or has failed to fully cooperate with an inspection, survey, or investigation by
the department;
new text end

new text begin (9) destroys or makes unavailable any records or other evidence relating to the assisted
living facility's compliance with this chapter;
new text end

new text begin (10) refuses to initiate a background study under section 144.057 or 245A.04;
new text end

new text begin (11) fails to timely pay any fines assessed by the commissioner;
new text end

new text begin (12) violates any local, city, or township ordinance relating to housing or services;
new text end

new text begin (13) has repeated incidents of personnel performing services beyond their competency
level; or
new text end

new text begin (14) has operated beyond the scope of the facility's license category.
new text end

new text begin (b) A violation by a contractor providing the services of the facility is a violation by
facility.
new text end

Sec. 2.

new text begin [144G.22] SUSPENDED OR CONDITIONAL LICENSE.
new text end

new text begin Subdivision 1. new text end

new text begin Terms to suspension or conditional license. new text end

new text begin A suspension or conditional
license designation may include terms that must be completed or met before a suspension
or conditional license designation is lifted. A conditional license designation may include
restrictions or conditions that are imposed on the facility. Terms for a suspension or
conditional license may include one or more of the following and the scope of each will be
determined by the commissioner:
new text end

new text begin (1) requiring a consultant to review, evaluate, and make recommended changes to the
facility's practices and submit reports to the commissioner at the cost of the facility;
new text end

new text begin (2) requiring supervision of the facility or staff practices at the cost of the facility by an
unrelated person who has sufficient knowledge and qualifications to oversee the practices
and who will submit reports to the commissioner;
new text end

new text begin (3) requiring the facility or employees to obtain training at the cost of the facility;
new text end

new text begin (4) requiring the facility to submit reports to the commissioner;
new text end

new text begin (5) prohibiting the facility from admitting any new residents for a specified period of
time; or
new text end

new text begin (6) any other action reasonably required to accomplish the purpose of section 144G.21.
new text end

new text begin Subd. 2. new text end

new text begin Continued operation. new text end

new text begin A facility subject to this section may continue operating
during the period of time residents are being transferred to another service provider.
new text end

Sec. 3.

new text begin [144G.23] IMMEDIATE TEMPORARY SUSPENSION.
new text end

new text begin Subdivision 1. new text end

new text begin Immediate temporary suspension for Level 4 violations. new text end

new text begin (a) In addition
to any other remedies provided by law, the commissioner may, without a prior contested
case hearing, immediately temporarily suspend a license or prohibit delivery of housing or
services by a facility for not more than 90 days or issue a conditional license, if the
commissioner determines that there are:
new text end

new text begin (1) Level 4 violations; or
new text end

new text begin (2) violations that pose an imminent risk of harm to the health or safety of residents.
new text end

new text begin (b) For purposes of this subdivision, "Level 4" has the meaning given in section 144G.35,
subdivision 1.
new text end

new text begin Subd. 2. new text end

new text begin Notice to facility required. new text end

new text begin A notice stating the reasons for the immediate
temporary suspension or conditional license and informing the licensee of the right to an
expedited hearing under section 144G.28, subdivision 3, must be delivered by personal
service to the address shown on the application or the last known address of the licensee.
new text end

new text begin Subd. 3. new text end

new text begin Right to appeal. new text end

new text begin The licensee may appeal an order immediately temporarily
suspending a license or issuing a conditional license. The appeal must be made in writing
by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
the commissioner within five calendar days after the licensee receives notice. If an appeal
is made by personal service, it must be received by the commissioner within five calendar
days after the licensee received the order.
new text end

new text begin Subd. 4. new text end

new text begin Requirements for notice and transfer of residents. new text end

new text begin A licensee whose license
is immediately temporarily suspended must comply with the requirements for notification
and transfer of residents in section 144G.33. The requirements in section 144G.33 remain
if an appeal is requested.
new text end

new text begin Subd. 5. new text end

new text begin Immediately temporarily suspended license for uncorrected Level 3
violations. new text end

new text begin (a) In addition to any other remedy provided by law, the commissioner may,
without a prior contested case hearing, temporarily suspend a license or prohibit delivery
of services by a provider for not more than 90 days, or issue a conditional license if the
commissioner determines that there are Level 3 violations that do not pose an imminent
risk of harm to the health or safety of the facility residents, provided:
new text end

new text begin (1) advance notice is given to the facility;
new text end

new text begin (2) after notice, the facility fails to correct the problem;
new text end

new text begin (3) the commissioner has reason to believe that other administrative remedies are not
likely to be effective; and
new text end

new text begin (4) there is an opportunity for a contested case hearing within 30 days unless there is an
extension granted by an administrative law judge.
new text end

new text begin (b) If the commissioner determines there are Level 4 violations or violations that pose
an imminent risk of harm to the health or safety of the facility residents, the commissioner
may immediately temporarily suspend a license, prohibit delivery of services by a facility,
or issue a conditional license without meeting the requirements of paragraph (a), clauses
(1) to (4).
new text end

new text begin For the purposes of this subdivision, "Level 3" and "Level 4" have the meanings given in
section 144G.35, subdivision 1.
new text end

Sec. 4.

new text begin [144G.24] MANDATORY REVOCATION.
new text end

new text begin Notwithstanding the provisions of section 144G.27, 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
30 days in advance of the date of revocation.
new text end

Sec. 5.

new text begin [144G.25] MANDATORY PROCEEDINGS.
new text end

new text begin (a) The commissioner must initiate proceedings within 60 days of notification to suspend
or revoke a facility's license or must refuse to renew a facility's license if within the preceding
two years the facility has incurred the following number of uncorrected or repeated violations:
new text end

new text begin (1) two or more uncorrected violations or one or more repeated violations that created
an imminent risk to direct resident care or safety; or
new text end

new text begin (2) four or more uncorrected violations or two or more repeated violations of any nature
for which the fines are in the four highest daily fine categories prescribed in rule.
new text end

new text begin (b) Notwithstanding paragraph (a), the commissioner is not required to revoke, suspend,
or refuse to renew a facility's license if the facility corrects the violation.
new text end

Sec. 6.

new text begin [144G.26] NOTICE TO RESIDENTS.
new text end

new text begin (a) Within five working 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 and the ombudsman for long-term care the names of residents and the
names and addresses of the residents' guardians, designated representatives, and family
contacts.
new text end

new text begin (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:
new text end

new text begin (1) a correction order; and
new text end

new text begin (2) a penalty assessment by the commissioner in rule.
new text end

new text begin (c) Notwithstanding sections 144G.31 and 144G.32, any correction order issued under
this section 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.
new text end

new text begin (d) Information provided under this section may be used by the commissioner or the
ombudsman for long-term care only for the purpose of providing affected consumers
information about the status of the proceedings.
new text end

new text begin (e) Within ten working 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 and the resident's designated
representative or, if there is no designated representative and if known, a family member
or interested person.
new text end

new text begin (f) The commissioner shall provide the ombudsman for long-term care with monthly
information on the department's actions and the status of the proceedings.
new text end

Sec. 7.

new text begin [144G.27] NOTICE TO FACILITY.
new text end

new text begin Prior to any suspension, revocation, or refusal to renew a license, the facility shall be
entitled to notice and a hearing as provided by sections 14.57 to 14.69. The hearing must
commence within 60 days after the proceedings are initiated.
new text end

Sec. 8.

new text begin [144G.28] HEARINGS.
new text end

new text begin Subdivision 1. new text end

new text begin Requesting a hearing. new text end

new text begin A request for hearing must be in writing and
must:
new text end

new text begin (1) be mailed or delivered to the commissioner or the commissioner's designee;
new text end

new text begin (2) contain a brief and plain statement describing every matter or issue contested; and
new text end

new text begin (3) contain a brief and plain statement of any new matter that the applicant or assisted
living facility believes constitutes a defense or mitigating factor.
new text end

new text begin Subd. 2. new text end

new text begin Hearings. new text end

new text begin Within 15 business days of receipt of the licensee's timely appeal
of a sanction under this section, other than for a temporary suspension, the commissioner
shall request assignment of an administrative law judge. The commissioner's request must
include a proposed date, time, and place of hearing. A hearing must be conducted by an
administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
90 calendar days of the request for assignment, unless an extension is requested by either
party and granted by the administrative law judge for good cause or for purposes of discussing
settlement. In no case shall one or more extensions be granted for a total of more than 90
calendar days unless there is a criminal action pending against the licensee. If, while a
licensee continues to operate pending an appeal of an order for revocation, suspension, or
refusal to renew a license, the commissioner identifies one or more new violations of law
that meet the requirements of Level 3 or Level 4 violations as defined in section 144G.35,
subdivision 1, the commissioner shall act immediately to temporarily suspend the license.
new text end

new text begin Subd. 3. new text end

new text begin Expedited hearings. new text end

new text begin (a) Within five business days of receipt of the licensee's
timely appeal of a temporary suspension or issuance of a conditional license, the
commissioner shall request assignment of an administrative law judge. The request must
include a proposed date, time, and place of a hearing. A hearing must be conducted by an
administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
30 calendar days of the request for assignment, unless an extension is requested by either
party and granted by the administrative law judge for good cause. The commissioner shall
issue a notice of hearing by certified mail or personal service at least ten business days
before the hearing. Certified mail to the last known address is sufficient. The scope of the
hearing shall be limited solely to the issue of whether the temporary suspension or issuance
of a conditional license should remain in effect and whether there is sufficient evidence to
conclude that the licensee's actions or failure to comply with applicable laws are Level 3
or Level 4 violations as defined in section 144G.35, subdivision 1, or that there were
violations that posed an imminent risk of harm to the resident's health and safety.
new text end

new text begin (b) The administrative law judge shall issue findings of fact, conclusions, and a
recommendation within ten business days from the date of hearing. The parties shall have
ten calendar days to submit exceptions to the administrative law judge's report. The record
shall close at the end of the ten-day period for submission of exceptions. The commissioner's
final order shall be issued within ten business days from the close of the record. When an
appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed,
the commissioner shall issue a final order affirming the temporary immediate suspension
or conditional license within ten calendar days of the commissioner's receipt of the
withdrawal or dismissal. The licensee is prohibited from operation during the temporary
suspension period.
new text end

new text begin (c) When the final order under paragraph (b) affirms an immediate suspension, and a
final licensing sanction is issued under sections 144G.21 and 144G.22 and the licensee
appeals that sanction, the licensee is prohibited from operation pending a final commissioner's
order after the contested case hearing conducted under chapter 14.
new text end

new text begin (d) A licensee whose license is temporarily suspended must comply with the requirements
for notification and transfer of residents under section 144G.33. These requirements remain
if an appeal is requested.
new text end

new text begin Subd. 4. new text end

new text begin Time limits for appeals. new text end

new text begin To appeal the assessment of civil penalties under
section 144G.13, subdivision 4, and an action against a license under sections 144G.21 to
144G.33, a licensee must request a hearing no later than 15 days after the licensee receives
notice of the action.
new text end

Sec. 9.

new text begin [144G.29] INFORMAL CONFERENCE.
new text end

new text begin At any time, the applicant or facility and the commissioner may hold an informal
conference to exchange information, clarify issues, or resolve issues.
new text end

Sec. 10.

new text begin [144G.30] RELICENSURE.
new text end

new text begin If a facility license is revoked, a new application for license may be considered by the
commissioner when the conditions upon which the revocation was based have been corrected
and satisfactory evidence of this fact has been furnished to the commissioner. A new license
may be granted after an inspection has been made and the facility has complied with all
provisions of this chapter and adopted rules.
new text end

Sec. 11.

new text begin [144G.31] INJUNCTIVE RELIEF.
new text end

new text begin In addition to any other remedy provided by law, the commissioner may bring an action
in district court to enjoin a person who is involved in the management, operation, or control
of a facility or an employee of the facility from illegally engaging in activities regulated by
sections under this chapter. The commissioner may bring an action under this section in the
district court in Ramsey County or in the district in which the facility is located. The court
may grant a temporary restraining order in the proceeding if continued activity by the person
who is involved in the management, operation, or control of a facility, or by an employee
of the facility, would create an imminent risk of harm to a resident.
new text end

Sec. 12.

new text begin [144G.32] SUBPOENA.
new text end

new text begin In matters pending before the commissioner under this chapter, the commissioner may
issue subpoenas and compel the attendance of witnesses and the production of all necessary
papers, books, records, documents, and other evidentiary material. If a person fails or refuses
to comply with a subpoena or order of the commissioner to appear or testify regarding any
matter about which the person may be lawfully questioned or to produce any papers, books,
records, documents, or evidentiary materials in the matter to be heard, the commissioner
may apply to the district court in any district, and the court shall order the person to comply
with the commissioner's order or subpoena. The commissioner of health may administer
oaths to witnesses or take their affirmation. Depositions may be taken in or outside the state
in the manner provided by law for taking depositions in civil actions. A subpoena or other
process or paper may be served on a named person anywhere in the state by an officer
authorized to serve subpoenas in civil actions, with the same fees and mileage and in the
same manner as prescribed by law for a process issued out of a district court. A person
subpoenaed under this section shall receive the same fees, mileage, and other costs that are
paid in proceedings in district court.
new text end

Sec. 13.

new text begin [144G.33] PLAN FOR TRANSFER OF RESIDENTS REQUIRED.
new text end

new text begin (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 that will be
monitored by the commissioner. 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,
and the ombudsman for long-term care with the following information:
new text end

new text begin (1) a list of all residents, including full names and all contact information on file;
new text end

new text begin (2) a list of each resident's representative or emergency contact person, including full
names and all contact information on file;
new text end

new text begin (3) the location or current residence of each resident;
new text end

new text begin (4) the payor sources for each resident, including payor source identification numbers;
and
new text end

new text begin (5) for each resident, a copy of the resident's service agreement and a list of the types
of services being provided.
new text end

new text begin (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 county managers, and
the ombudsman for long-term care 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 representative or emergency contact persons, that the commissioner
is taking action against the facility's license by providing a copy of the revocation or
suspension notice issued by the commissioner. If the facility does not comply with the
disclosure requirements in this section, the commissioner, lead agencies, county adult
protection and county managers, and ombudsman for long-term care shall notify the residents,
designated representatives, or emergency contact persons about the actions being taken.
The revocation, refusal to renew, or suspension notice is public data except for any private
data contained therein.
new text end

new text begin (c) A facility subject to this section may continue operating while residents are being
transferred to other service providers.
new text end

Sec. 14.

new text begin [144G.34] SURVEYS AND INVESTIGATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Regulatory powers. new text end

new text begin (a) The department of health is the exclusive state
agency charged with the responsibility and duty of surveying and investigating all facilities
required to be licensed under this chapter. The commissioner of health shall enforce all
sections of this chapter and the rules adopted under this chapter.
new text end

new text begin (b) The commissioner may request and be given access to relevant information, records,
incident reports, and other documents in the possession of the facility if the commissioner
considers them necessary for the discharge of responsibilities. For purposes of surveys and
investigations, and securing information to determine compliance with licensure laws and
rules, the commissioner need not present a release, waiver, or consent to the individual. The
identities of residents must be kept private as defined in section 13.02, subdivision 12.
new text end

new text begin Subd. 2. new text end

new text begin Surveys. new text end

new text begin The commissioner shall conduct surveys of each basic care facility
and assisted living facility. The commissioner shall conduct a survey of each facility on a
frequency of at least once every three years. Survey frequency may be based on the license
level, the provider's compliance history, the number of clients served, or other factors as
determined by the department deemed necessary to ensure the health, safety, and welfare
of residents and compliance with the law. Each assisted living facility subject to a follow-up
survey required under subdivision 7 must be surveyed annually by the commissioner for
three years following a required follow-up survey.
new text end

new text begin Subd. 3. new text end

new text begin Scheduling surveys. new text end

new text begin Surveys and investigations shall be conducted without
advance notice to the facilities. Surveyors may contact the facility on the day of a survey
to arrange for someone to be available at the survey site. The contact does not constitute
advance notice.
new text end

new text begin Subd. 4. new text end

new text begin Information provided by facility; providing resident records. new text end

new text begin (a) The facility
shall provide accurate and truthful information to the department during a survey,
investigation, or other licensing activities.
new text end

new text begin (b) Upon request of a surveyor, facilities shall provide a list of current and past residents
or designated representatives that includes addresses and telephone numbers and any other
information requested about the services to residents within a reasonable period of time.
new text end

new text begin Subd. 5. new text end

new text begin Correction orders. new text end

new text begin (a) A correction order may be issued whenever the
commissioner finds upon survey or during a complaint investigation that a facility, a
managerial official, or an employee of the provider 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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin Subd. 6. new text end

new text begin Follow-up surveys. new text end

new text begin The commissioner may conduct follow-up surveys to
determine if the facility has corrected deficient issues and systems identified during a survey
or complaint investigation. Follow-up surveys may be conducted via phone, e-mail, fax,
mail, or onsite reviews. Follow-up surveys, other than complaint investigations, shall be
concluded with an exit conference and written information provided on the process for
requesting a reconsideration of the survey results.
new text end

new text begin Subd. 7. new text end

new text begin Required follow-up surveys. new text end

new text begin For facilities that have Level 3 or Level 4
violations under section 144G.35, subdivision 1, the department shall conduct a follow-up
survey within 90 calendar days of the survey. When conducting a follow-up survey, the
surveyor shall focus on whether the previous violations have been corrected and may also
address any new violations that are observed while evaluating the corrections that have been
made.
new text end

new text begin Subd. 8. new text end

new text begin Notice of noncompliance. new text end

new text begin If the commissioner finds that the applicant or a
facility has not corrected violations by the date specified in the correction order or conditional
license resulting from a survey or complaint investigation, the commissioner shall provide
a notice of noncompliance with a correction order by e-mailing the notice of noncompliance
to the facility. The noncompliance notice must list the violations not corrected.
new text end

Sec. 15.

new text begin [144G.35] VIOLATIONS AND FINES.
new text end

new text begin Subdivision 1. new text end

new text begin Levels of violations. new text end

new text begin Correction orders for violations are categorized by
level as follows:
new text end

new text begin (1) Level 1 is a violation that has no potential to cause more than a minimal impact on
the resident and does not affect health or safety;
new text end

new text begin (2) Level 2 is a violation that did not harm a resident's health or safety but had the
potential to have harmed a resident's health or safety, but was not likely to cause serious
injury, impairment, or death;
new text end

new text begin (3) Level 3 is a violation that harmed a resident's health or safety, not including serious
injury, impairment, or death, or a violation that has the potential to lead to serious injury,
impairment, or death; and
new text end

new text begin (4) Level 4 is a violation that results in serious injury, impairment, or death;
new text end

new text begin Subd. 2. new text end

new text begin Scope of violations. new text end

new text begin Levels of violations are categorized by scope as follows:
new text end

new text begin (1) isolated, when one or a limited number of residents are affected or one or a limited
number of staff are involved or the situation has occurred only occasionally;
new text end

new text begin (2) pattern, when more than a limited number of residents are affected, more than a
limited number of staff are involved, or the situation has occurred repeatedly but is not
found to be pervasive; and
new text end

new text begin (3) widespread, when problems are pervasive or represent a systemic failure that has
affected or has the potential to affect a large portion or all of the residents.
new text end

new text begin Subd. 3. new text end

new text begin Fines. new text end

new text begin Fines and enforcement actions under this section may be assessed based
on the level and scope of the violations described in subdivisions 1 and 2 as follows, and
for Level 3 and Level 4 violations shall be imposed immediately with no opportunity to
correct the violation prior to imposition:
new text end

new text begin (1) Level 1, no fines or enforcement;
new text end

new text begin (2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement
mechanisms authorized in sections 144G.21 to 144G.33 for widespread violations;
new text end

new text begin (3) Level 3, a fine of $3,000 per violation per incident plus $100 for each resident affected
by the violation, in addition to any of the enforcement mechanisms authorized in sections
144G.21 to 144G.33;
new text end

new text begin (4) Level 4, a fine of $5,000 per incident plus $200 for each resident, in addition to any
of the enforcement mechanisms authorized in sections 144G.21 to 144G.33; and
new text end

new text begin (5) for maltreatment violations as defined in the Minnesota Vulnerable Adults Act in
section 626.557 including abuse, neglect, financial exploitation, and drug diversion that are
determined against the facility, an immediate fine shall be imposed of $5,000 per incident,
plus $200 for each resident affected by the violation.
new text end

new text begin Subd. 4. new text end

new text begin Payment of fines. new text end

new text begin (a) For every violation except Level 1 and Level 2 violations,
the commissioner shall issue an immediate fine. The licensee must still correct the violation
in the time specified. The issuance of an immediate fine may occur in addition to any
enforcement mechanism authorized under sections 144G.21 to 144G.33. The immediate
fine may be appealed as allowed under section 144G.36.
new text end

new text begin (b) For Level 1 and Level 2 violations, the commissioner shall provide the licensee an
opportunity to correct the violations by a date specified in the correction order. If the
commissioner finds that the licensee has not corrected the violations by the date specified
in the correction order or conditional license resulting from a survey or complaint
investigations, the commissioner may issue a fine. The commissioner shall issue a notice
of noncompliance with a correction order, which must list the violations not corrected, by
e-mailing notice of noncompliance to the facility.
new text end

new text begin (c) The licensee must pay the fines assessed on or before the payment date specified. If
the licensee fails to fully comply with the order, the commissioner may issue a second fine
or suspend the license until the licensee complies by paying the fine. A timely appeal shall
stay payment of the fine until the commissioner issues a final order.
new text end

new text begin (d) A licensee shall promptly notify the commissioner in writing when a violation
specified in the order is corrected. If upon reinspection the commissioner determines that
a violation has not been corrected as indicated by the order, the commissioner may issue
an additional fine. The commissioner shall notify the licensee by mail to the last known
address in the licensing record that a second fine has been assessed. The licensee may appeal
the second fine as provided under section 144G.36.
new text end

new text begin (e) A facility that has been assessed a fine under this section has a right to a
reconsideration or hearing under section 144G.36 and chapter 14.
new text end

new text begin Subd. 5. new text end

new text begin Payment of fines required. new text end

new text begin When a fine has been assessed, the licensee may
not avoid payment by closing, selling, or otherwise transferring the license to a third party.
In such an event, the licensee shall be liable for payment of the fine.
new text end

new text begin Subd. 6. new text end

new text begin Additional penalties. new text end

new text begin In addition to any fine imposed under this section, the
commissioner may assess a penalty amount based on costs related to an investigation that
results in a final order assessing a fine or other enforcement action authorized by this chapter.
new text end

new text begin Subd. 7. new text end

new text begin Deposit of fines. new text end

new text begin Fines collected under this section shall be deposited in the
state government special revenue fund and credited to an account separate from the revenue
collected under section 144A.472. Subject to an appropriation by the legislature, the revenue
from the fines collected must be used by the commissioner for special projects to improve
home care in Minnesota as recommended by the advisory council established in section
144A.4799.
new text end

Sec. 16.

new text begin [144G.36] RECONSIDERATION OF CORRECTION ORDERS AND FINES.
new text end

new text begin Subdivision 1. new text end

new text begin Reconsideration process required. new text end

new text begin The commissioner shall make
available to facilities a correction order reconsideration process. This process may be used
to challenge the correction order issued, including the level and scope described in section
144G.35, subdivisions 1 and 2, and any fine assessed.
new text end

new text begin Subd. 2. new text end

new text begin No reconsideration for provisional licensees. new text end

new text begin This section does not apply to
provisional licensees.
new text end

new text begin Subd. 3. new text end

new text begin Reconsideration process. new text end

new text begin (b) A facility may request from the commissioner,
in writing, a correction order reconsideration regarding any correction order issued to the
facility. The written request for reconsideration must be received by the commissioner
within 15 calendar days of the correction order receipt date. The correction order
reconsideration shall not be reviewed by any surveyor, investigator, or supervisor that
participated in writing or reviewing the correction order being disputed. The correction
order reconsiderations may be conducted in person, by telephone, by another electronic
form, or in writing, as determined by the commissioner. The commissioner shall respond
in writing to the request from a facility for a correction order reconsideration within 60 days
of the date the facility requests a reconsideration. The commissioner's response shall identify
the commissioner's decision regarding each citation challenged by the facility.
new text end

new text begin Subd. 4. new text end

new text begin Reconsideration findings. new text end

new text begin The findings of a correction order reconsideration
process shall be one or more of the following:
new text end

new text begin (1) supported in full: the correction order is supported in full, with no deletion of findings
to the citation;
new text end

new text begin (2) supported in substance: the correction order is supported, but one or more findings
are deleted or modified without any change in the citation;
new text end

new text begin (3) correction order cited an incorrect licensing requirement: the correction order is
amended by changing the correction order to the appropriate statute and/or rule;
new text end

new text begin (4) correction order was issued under an incorrect citation: the correction order is amended
to be issued under the more appropriate correction order citation;
new text end

new text begin (5) the correction order is rescinded;
new text end

new text begin (6) fine is amended: it is determined that the fine assigned to the correction order was
applied incorrectly; or
new text end

new text begin (7) the level or scope of the citation is modified based on the reconsideration.
new text end

new text begin Subd. 5. new text end

new text begin Updating the correction order website. new text end

new text begin (a) During the correction order
reconsideration request, the issuance of the correction orders under reconsideration are not
stayed, but the department shall post information on the website with the correction order
that the licensee has requested a reconsideration and that the review is pending.
new text end

new text begin (b) If the correction order findings are changed by the commissioner, the commissioner
shall update the correction order website.
new text end

Sec. 17.

new text begin [144G.37] INNOVATION VARIANCES.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "innovation variance" means a
specified alternative to a requirement of this chapter. An innovation variance may be granted
to allow a facility to offer services of a type or in a manner that is innovative, will not impair
the services provided, will not adversely affect the health, safety, or welfare of the residents,
and is likely to improve the services provided. The innovative variance cannot change any
of the resident's rights under sections 144G.70 to 144G.79.
new text end

new text begin Subd. 2. new text end

new text begin Conditions. new text end

new text begin The commissioner may impose conditions on granting an innovation
variance that the commissioner considers necessary.
new text end

new text begin Subd. 3. new text end

new text begin Duration and renewal. new text end

new text begin The commissioner may limit the duration of any
innovation variance and may renew a limited innovation variance.
new text end

new text begin Subd. 4. new text end

new text begin Applications; innovation variance. new text end

new text begin An application for innovation variance
from the requirements of this chapter may be made at any time, must be made in writing to
the commissioner, and must specify the following:
new text end

new text begin (1) the statute or rule from which the innovation variance is requested;
new text end

new text begin (2) the time period for which the innovation variance is requested;
new text end

new text begin (3) the specific alternative action that the licensee proposes;
new text end

new text begin (4) the reasons for the request; and
new text end

new text begin (5) justification that an innovation variance will not impair the services provided, will
not adversely affect the health, safety, or welfare of residents, and is likely to improve the
services provided.
new text end

new text begin The commissioner may require additional information from the facility before acting on
the request.
new text end

new text begin Subd. 5. new text end

new text begin Grants and denials. new text end

new text begin The commissioner shall grant or deny each request for
an innovation variance in writing within 45 days of receipt of a complete request. Notice
of a denial shall contain the reasons for the denial. The terms of a requested innovation
variance may be modified upon agreement between the commissioner and the facility.
new text end

new text begin Subd. 6. new text end

new text begin Violation of innovation variances. new text end

new text begin A failure to comply with the terms of an
innovation variance shall be deemed to be a violation of this chapter.
new text end

new text begin Subd. 7. new text end

new text begin Revocation or denial of renewal. new text end

new text begin The commissioner shall revoke or deny
renewal of an innovation variance if:
new text end

new text begin (1) it is determined that the innovation variance is adversely affecting the health, safety,
or welfare of the residents;
new text end

new text begin (2) the facility has failed to comply with the terms of the innovation variance;
new text end

new text begin (3) the facility notifies the commissioner in writing that it wishes to relinquish the
innovation variance and be subject to the statute previously varied; or
new text end

new text begin (4) the revocation or denial is required by a change in law.
new text end

ARTICLE 3

FACILITY RESPONSIBILITIES

Section 1.

new text begin [144G.38] MINIMUM FACILITY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Minimum requirements. new text end

new text begin All licensed facilities shall:
new text end

new text begin (1) distribute to residents, families, and resident representatives the basic care and assisted
living bill of rights in section 144G.76;
new text end

new text begin (2) provide health-related services in a manner that complies with applicable home care
licensure requirements in chapter 144A and the Nurse Practice Act in sections 148.171 to
148.285;
new text end

new text begin (3) utilize person-centered planning and service delivery process as defined in section
245D.07;
new text end

new text begin (4) have and maintain a system for delegation of health care activities to unlicensed
personnel by a registered nurse, including supervision and evaluation of the delegated
activities as required by applicable home care licensure requirements in chapter 144A and
the Nurse Practice Act in sections 148.171 to 148.285;
new text end

new text begin (5) provide a means for residents to request assistance for health and safety needs 24
hours per day, seven days per week;
new text end

new text begin (6) allow residents the ability to furnish and decorate the resident's unit within the terms
of the lease;
new text end

new text begin (7) permit residents access to food at any time;
new text end

new text begin (8) allow residents to choose the resident's visitors and times of visits;
new text end

new text begin (9) allow the resident the right to choose a roommate if sharing a unit;
new text end

new text begin (10) notify the resident of the resident's right to have and use a lockable door to the
resident's unit. The landlord shall provide the locks on the unit. Only a staff member with
a specific need to enter the unit shall have keys, and advance notice must be given to the
resident before entrance, when possible;
new text end

new text begin (11) have a person or persons available 24 hours per day, seven days per week, who is
responsible for responding to the requests of residents for assistance with health or safety
needs, who shall be:
new text end

new text begin (i) awake;
new text end

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

new text begin (iii) capable of communicating with residents;
new text end

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

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

new text begin (12) offer to provide or make available at least the following services to residents:
new text end

new text begin (i) at least three daily nutritious meals with snacks available seven days per week,
according to the recommended dietary allowances in the United States Department of
Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables. The
following apply:
new text end

new text begin (A) modified special diets that are appropriate to residents' needs and choices;
new text end

new text begin (B) menus prepared at least one week in advance, and made available to all residents.
The facility must encourage residents' involvement in menu planning. Meal substitutions
must be of similar nutritional value if a resident refuses a food that is served. Residents
must be informed in advance of menu changes;
new text end

new text begin (C) food must be prepared and served according to the Minnesota Food Code, Minnesota
Rules, chapter 4626; and
new text end

new text begin (D) the facility cannot require a resident to include and pay for meals in their residency
contract;
new text end

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

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

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

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

new text begin (vi) have a daily program of social and recreational activities that are based upon
individual and group interests, physical, mental, and psychosocial needs, and that creates
opportunities for active participation in the community at large.
new text end

new text begin Subd. 2. new text end

new text begin Clinical nurse supervision. new text end

new text begin All assisted living facilities must have a clinical
nurse supervisor who is a registered nurse licensed in Minnesota.
new text end

new text begin Subd. 3. new text end

new text begin Infection control program required. new text end

new text begin The facility shall establish and maintain
an infection control program.
new text end

Sec. 2.

new text begin [144G.39] HOUSING AND SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Responsibility for housing and services. new text end

new text begin The facility is directly
responsible to the resident for all housing and service-related matters provided, irrespective
of a management contract. Housing and service-related matters include but are not limited
to the handling of complaints, the provision of notices, and the initiation of any adverse
action against the resident involving housing or services provided by the facility.
new text end

new text begin Subd. 2. new text end

new text begin Uniform checklist disclosure of services. new text end

new text begin (a) On and after July 1, 2020, a
facility must provide to prospective residents, the prospective resident's designated
representative, and any other person or persons the resident chooses:
new text end

new text begin (1) a written checklist listing all services permitted under the facility's license and
identifying all services the facility offers to provide under the assisted living facility and
basic care facility contract; and
new text end

new text begin (2) an oral explanation of the services offered under the contract.
new text end

new text begin (b) The requirements of paragraph (a) must be completed prior to the execution of the
resident contract.
new text end

new text begin (c) The commissioner must, in consultation with all interested stakeholders, design the
uniform checklist disclosure form for use as provided under paragraph (a).
new text end

new text begin Subd. 3. new text end

new text begin Uniform consumer information guide. new text end

new text begin The facility must make available to
all prospective and current residents a copy of the uniform consumer information guide.
new text end

new text begin Subd. 4. new text end

new text begin Reservation of rights. new text end

new text begin Nothing in this chapter:
new text end

new text begin (1) requires a resident to utilize any service provided by or through, or made available
in, a facility;
new text end

new text begin (2) prevents a facility from requiring, as a condition of the contract, that the resident pay
for a package of services even if the resident does not choose to use all or some of the
services in the package;
new text end

new text begin (3) requires a facility to fundamentally alter the nature of the operations of the facility
in order to accommodate a resident's request; or
new text end

new text begin (4) affects the duty of a facility to grant a resident's request for reasonable
accommodations.
new text end

Sec. 3.

new text begin [144G.40] BUSINESS OPERATION.
new text end

new text begin Subdivision 1. new text end

new text begin Display of license. new text end

new text begin The original current license must be displayed at the
main entrance of the facility. The facility must provide a copy of the license to any person
who requests it.
new text end

new text begin Subd. 2. new text end

new text begin Quality management. new text end

new text begin The facility shall engage in quality management
appropriate to the size of the facility and relevant to the type of services provided. The
quality management activity means evaluating the quality of care by periodically reviewing
resident services, complaints made, and other issues that have occurred and determining
whether changes in services, staffing, or other procedures need to be made in order to ensure
safe and competent services to residents. Documentation about quality management activity
must be available for two years. Information about quality management must be available
to the commissioner at the time of the survey, investigation, or renewal.
new text end

new text begin Subd. 3. new text end

new text begin Facility restrictions. new text end

new text begin (a) This subdivision does not apply to licensees that are
Minnesota counties or other units of government.
new text end

new text begin (b) A facility or staff person cannot accept a power-of-attorney from residents for any
purpose, and may not accept appointments as guardians or conservators of residents.
new text end

new text begin (c) A facility cannot serve as a resident's representative.
new text end

new text begin Subd. 4. new text end

new text begin Resident finances and property. new text end

new text begin (a) A facility may assist residents with
household budgeting, including paying bills and purchasing household goods, but may not
otherwise manage a resident's property. A facility must provide a resident with receipts for
all transactions and purchases paid with the resident's funds. When receipts are not available,
the transaction or purchase must be documented. A facility must maintain records of all
such transactions.
new text end

new text begin (b) A facility or staff person may not borrow a resident's funds or personal or real
property, nor in any way convert a resident's property to the facility's or staff person's
possession.
new text end

new text begin (c) Nothing in this subdivision precludes a facility or staff from accepting gifts of minimal
value or precludes the acceptance of donations or bequests made to a facility that are exempt
from income tax under section 501(c) of the Internal Revenue Code of 1986.
new text end

new text begin Subd. 5. new text end

new text begin Employee records. new text end

new text begin (a) The facility must maintain current records of each paid
employee, regularly scheduled volunteers providing services, and each individual contractor
providing services. The records must include the following information:
new text end

new text begin (1) evidence of current professional licensure, registration, or certification if licensure,
registration, or certification is required by this statute or other rules;
new text end

new text begin (2) records of orientation, required annual training and infection control training, and
competency evaluations;
new text end

new text begin (3) current job description, including qualifications, responsibilities, and identification
of staff persons providing supervision;
new text end

new text begin (4) documentation of annual performance reviews that identify areas of improvement
needed and training needs;
new text end

new text begin (5) for individuals providing facility services, verification that required health screenings
under section 144A.4798 have taken place and the dates of those screenings; and
new text end

new text begin (6) documentation of the background study as required under section 144.057.
new text end

new text begin (b) Each employee record must be retained for at least three years after a paid employee,
volunteer, or contractor ceases to be employed by or under contract with the facility. If a
facility ceases operation, employee records must be maintained for three years.
new text end

new text begin Subd. 6. new text end

new text begin Resident records. new text end

new text begin (a) The facility must maintain records for each resident for
whom it is providing services. Entries in the resident records must be current, legible,
permanently recorded, dated, and authenticated with the name and title of the person making
the entry.
new text end

new text begin (b) Resident records, whether written or electronic, must be protected against loss,
tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable
relevant federal and state laws. The facility shall establish and implement written procedures
to control use, storage, and security of resident's records and establish criteria for release
of resident information.
new text end

new text begin (c) The facility may not disclose to any other person any personal, financial, medical,
or other information about the resident, except:
new text end

new text begin (1) as may be required by law;
new text end

new text begin (2) to employees or contractors of the facility, another facility, other health care
practitioner or provider, or inpatient facility needing information in order to provide services
to the resident, but only the information that is necessary for the provision of services;
new text end

new text begin (3) to persons authorized in writing by the resident or the resident's representative to
receive the information, including third-party payers; and
new text end

new text begin (4) to representatives of the commissioner authorized to survey or investigate facilities
under this chapter or federal laws.
new text end

new text begin Subd. 7. new text end

new text begin Access to resident records. new text end

new text begin The facility must ensure that the appropriate records
are readily available to employees and contractors authorized to access the records. Resident
records must be maintained in a manner that allows for timely access, printing, or
transmission of the records. The records must be made readily available to the commissioner
upon request.
new text end

new text begin Subd. 8. new text end

new text begin Contents of resident records. new text end

new text begin Contents of a resident record include the
following for each resident:
new text end

new text begin (1) identifying information, including the resident's name, date of birth, address, and
telephone number;
new text end

new text begin (2) the name, address, and telephone number of an emergency contact, family members,
designated representative, if any, or others as identified;
new text end

new text begin (3) names, addresses, and telephone numbers of the resident's health and medical service
providers, if known;
new text end

new text begin (4) health information, including medical history, allergies, and when the provider is
managing medications, treatments or therapies that require documentation, and other relevant
health records;
new text end

new text begin (5) the resident's advance directives, if any;
new text end

new text begin (6) the facility's current and previous assessments and service agreements;
new text end

new text begin (7) all records of communications pertinent to the resident's services;
new text end

new text begin (8) documentation of significant changes in the resident's status and actions taken in
response to the needs of the resident, including reporting to the appropriate supervisor or
health care professional;
new text end

new text begin (9) documentation of incidents involving the resident and actions taken in response to
the needs of the resident, including reporting to the appropriate supervisor or health care
professional;
new text end

new text begin (10) documentation that services have been provided as identified in the service
agreement;
new text end

new text begin (11) documentation that the resident has received and reviewed the basic care and assisted
living bill of rights;
new text end

new text begin (12) documentation of complaints received and any resolution;
new text end

new text begin (13) a discharge summary, including service termination notice and related
documentation, when applicable; and
new text end

new text begin (14) other documentation required under this chapter and relevant to the resident's
services or status.
new text end

new text begin Subd. 9. new text end

new text begin Transfer of resident records. new text end

new text begin If a resident transfers to another facility or
another health care practitioner or provider, or is admitted to an inpatient facility, the facility,
upon request of the resident or the resident's representative, shall take steps to ensure a
coordinated transfer including sending a copy or summary of the resident's record to the
new facility or the resident, as appropriate.
new text end

new text begin Subd. 10. new text end

new text begin Record record retention. new text end

new text begin Following the resident's discharge or termination
of services, a facility must retain a resident's record for at least five years or as otherwise
required by state or federal regulations. Arrangements must be made for secure storage and
retrieval of resident records if the facility ceases business.
new text end

new text begin Subd. 11. new text end

new text begin Notice to residents of changes. new text end

new text begin A facility must provide prompt written notice
to the resident or designated representative of any change of legal name, telephone number,
and physical mailing address, which may not be a public or private post office box, of:
new text end

new text begin (1) the licensee of the facility;
new text end

new text begin (2) the manager of the facility, if applicable; and
new text end

new text begin (3) the agent authorized to accept legal process on behalf of the facility.
new text end

new text begin Subd. 12. new text end

new text begin Compliance officer. new text end

new text begin Every assisted living facility shall have a compliance
officer who is a licensed assisted living administrator under chapter 144A.
new text end

Sec. 4.

new text begin [144G.41] MANAGEMENT AGREEMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Notification. new text end

new text begin (a) If the proposed or current licensee uses a manager, the
licensee must have a written management agreement that is consistent with this chapter.
new text end

new text begin (b) The proposed or current licensee must notify the commissioner of its use of a manager
upon:
new text end

new text begin (1) initial application for a license;
new text end

new text begin (2) retention of a manager following initial application;
new text end

new text begin (3) change of managers; and
new text end

new text begin (4) modification of an existing management agreement.
new text end

new text begin (c) The proposed or current licensee must provide to the commissioner a written
management agreement, including an organizational chart showing the relationship between
the proposed or current licensee, management company, and all related organizations.
new text end

new text begin (d) The written management agreement must be submitted:
new text end

new text begin (1) 60 days before:
new text end

new text begin (i) the initial licensure date;
new text end

new text begin (ii) the proposed change of ownership date; or
new text end

new text begin (iii) the effective date of the management agreement; or
new text end

new text begin (2) 30 days before the effective date of any amendment to an existing management
agreement.
new text end

new text begin (e) The proposed licensee or the current licensee must notify the residents and their
representatives 60 days before entering into a new management agreement.
new text end

new text begin (f) A proposed licensee must submit a management agreement attestation form, as
required by the license application.
new text end

new text begin Subd. 2. new text end

new text begin Management agreement; licensee. new text end

new text begin (a) The licensee is responsible for:
new text end

new text begin (1) the daily operations and provisions of services in the facility;
new text end

new text begin (2) ensuring the facility is operated in a manner consistent with all applicable laws and
rules;
new text end

new text begin (3) ensuring the manager acts in conformance with the management agreement; and
new text end

new text begin (4) ensuring the manager does not present as, or give the appearance that the manager
is the licensee.
new text end

new text begin (b) The licensee must not give the manager responsibilities that are so extensive that the
licensee is relieved of daily responsibility for the daily operations and provision of services
in the assisted living facility. If the licensee does so, the commissioner must determine that
a change of ownership has occurred.
new text end

new text begin (c) The licensee and manager must act in accordance with the terms of the management
agreement. If the commissioner determines they are not, then the department may impose
enforcement remedies.
new text end

new text begin (d) The licensee may enter into a management agreement only if the management
agreement creates a principal/agent relationship between the licensee and manager.
new text end

new text begin (e) The manager shall not subcontract the manager's responsibilities to a third party.
new text end

new text begin Subd. 3. new text end

new text begin Terms of agreement. new text end

new text begin A management agreement at a minimum must:
new text end

new text begin (1) describe the responsibilities of the licensee and manager, including items, services,
and activities to be provided;
new text end

new text begin (2) require the licensee's governing body, board of directors, or similar authority to
appoint the administrator;
new text end

new text begin (3) provide for the maintenance and retention of all records in accordance with this
chapter and other applicable laws;
new text end

new text begin (4) allow unlimited access by the commissioner to documentation and records according
to applicable laws or regulations;
new text end

new text begin (5) require the manager to immediately send copies of inspections and notices of
noncompliance to the licensee;
new text end

new text begin (6) state that the licensee is responsible for reviewing, acknowledging, and signing all
facility initial and renewal license applications;
new text end

new text begin (7) state that the manager and licensee shall review the management agreement annually
and notify the commissioner of any change according to applicable regulations;
new text end

new text begin (8) acknowledge that the licensee is the party responsible for complying with all laws
and rules applicable to the facility;
new text end

new text begin (9) require the licensee to maintain ultimate responsibility over personnel issues relating
to the operation of the facility and care of the residents including but not limited to staffing
plans, hiring, and performance management of employees, orientation, and training;
new text end

new text begin (10) state the manager will not present as, or give the appearance that the manager is
the licensee; and
new text end

new text begin (11) state that a duly authorized manager may execute resident leases or agreements on
behalf of the licensee, but all such resident leases or agreements must be between the licensee
and the resident.
new text end

new text begin Subd. 4. new text end

new text begin Commissioner review. new text end

new text begin The commissioner may review a management agreement
at any time. Following the review, the department may require:
new text end

new text begin (1) the proposed or current licensee or manager to provide additional information or
clarification;
new text end

new text begin (2) any changes necessary to:
new text end

new text begin (i) bring the management agreement into compliance with this chapter; and
new text end

new text begin (ii) ensure that the licensee has not been relieved of the responsibility for the daily
operations of the facility; and
new text end

new text begin (3) the licensee to participate in monthly meetings and quarterly on-site visits to the
facility.
new text end

new text begin Subd. 5. new text end

new text begin Resident funds. new text end

new text begin (a) If the management agreement delegates day-to-day
management of resident funds to the manager, the licensee:
new text end

new text begin (1) retains all fiduciary and custodial responsibility for funds that have been deposited
with the facility by the resident;
new text end

new text begin (2) is directly accountable to the resident for such funds; and
new text end

new text begin (3) must ensure any party responsible for holding or managing residents' personal funds
is bonded or obtains insurance in sufficient amounts to specifically cover losses of resident
funds and provides proof of bond or insurance.
new text end

new text begin (b) If responsibilities for the day-to-day management of the resident funds are delegated
to the manager, the manager must:
new text end

new text begin (1) provide the licensee with a monthly accounting of the resident funds; and
new text end

new text begin (2) meet all legal requirements related to holding and accounting for resident funds.
new text end

Sec. 5.

new text begin [144G.42] RESIDENT COMPLAINT AND INVESTIGATIVE PROCESS.
new text end

new text begin (a) The facility must have a written policy and system for receiving, investigating,
reporting, and attempting to resolve complaints from its residents and designated
representatives. The policy should clearly identify the process by which residents may file
a complaint or concern about the services and an explicit statement that the facility will not
discriminate or retaliate against a resident for expressing concerns or complaints. A facility
must have a process in place to conduct investigations of complaints made by the resident
and the designated representative about the services in the resident's plan that are or are not
being provided or other items covered in the basic care and assisted living bill of rights.
This complaint system must provide reasonable accommodations for any special needs of
the resident, if requested.
new text end

new text begin (b) The facility must document the complaint, name of the resident, investigation, and
resolution of each complaint filed. The facility must maintain a record of all activities
regarding complaints received, including the date the complaint was received, and the
facility's investigation and resolution of the complaint. This complaint record must be kept
for each event for at least two years after the date of entry and must be available to the
commissioner for review.
new text end

new text begin (c) The required complaint system must provide for written notice to each resident and
designated representative that includes:
new text end

new text begin (1) the resident's right to complain to the facility about the services received;
new text end

new text begin (2) the name or title of the person or persons with the facility to contact with complaints;
new text end

new text begin (3) the method of submitting a complaint to the facility; and
new text end

new text begin (4) a statement that the provider is prohibited against retaliation according to paragraph
(d).
new text end

new text begin (d) A facility must not take any action that negatively affects a resident in retaliation for
a complaint made or a concern expressed by the resident and the designated representative.
new text end

Sec. 6.

new text begin [144G.43] MALTREATMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Reporting maltreatment. new text end

new text begin All facilities must comply with the requirements
for the reporting of maltreatment of vulnerable adults in section 626.557. Each facility must
establish and implement a written procedure to ensure that all cases of suspected maltreatment
are reported.
new text end

new text begin Subd. 2. new text end

new text begin Abuse prevention plans. new text end

new text begin Each facility must develop and implement an
individual abuse prevention plan for each vulnerable adult. The plan shall contain an
individualized review or assessment of the person's susceptibility to abuse by another
individual, including other vulnerable adults; the person's risk of abusing other vulnerable
adults; and statements of the specific measures to be taken to minimize the risk of abuse to
that person and other vulnerable adults. For purposes of the abuse prevention plan, abuse
includes self-abuse.
new text end

new text begin Subd. 3. new text end

new text begin Posting information about reporting crimes and maltreatment. new text end

new text begin A facility
shall support protection and safety through access to the state's systems for reporting
suspected criminal activity and suspected vulnerable adult maltreatment by:
new text end

new text begin (1) posting the 911 emergency number in common areas and near telephones provided
by the assisted living facility;
new text end

new text begin (2) posting information and the reporting number for the common entry point under
section 626.557 to report suspected maltreatment of a vulnerable adult; and
new text end

new text begin (3) providing reasonable accommodations with information and notices in plain language.
new text end

Sec. 7.

new text begin [144G.44] INFECTION CONTROL AND PREVENTION.
new text end

new text begin A facility must establish and maintain a comprehensive tuberculosis infection control
program according to the most current tuberculosis infection control guidelines issued by
the United States Centers for Disease Control and Prevention (CDC), Division of
Tuberculosis Elimination, as published in the CDC's Morbidity and Mortality Weekly Report
(MMWR). The program must include a tuberculosis infection control plan that covers all
paid and unpaid employees, contractors, students, and volunteers. The Department of Health
shall provide technical assistance regarding implementation of the guidelines.
new text end

Sec. 8.

new text begin [144G.45] DISASTER PLANNING AND EMERGENCY PREPAREDNESS.
new text end

new text begin (a) Each facility must meet the following requirements:
new text end

new text begin (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;
new text end

new text begin (2) post an emergency disaster plan prominently;
new text end

new text begin (3) provide building emergency exit diagrams to all residents;
new text end

new text begin (4) post emergency exit diagrams on each floor; and
new text end

new text begin (5) have a written policy and procedure regarding missing tenant residents.
new text end

new text begin (b) Each 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.
new text end

new text begin (c) Each facility must meet any additional requirements adopted in rule.
new text end

ARTICLE 4

CONTRACTS, TERMINATIONS, AND RELOCATIONS

Section 1.

new text begin [144G.46] RESIDENCY CONTRACT REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Contract required. new text end

new text begin An assisted living facility or basic care facility may
not offer or provide housing or services to a resident unless it has executed a written contract
with the resident.
new text end

new text begin Subd. 2. new text end

new text begin Requirements of contract. new text end

new text begin The contract must be signed by both the resident
or the designated representative and the licensee or an agent of the facility, and contain all
the terms concerning the provision of housing and services, whether provided directly by
the facility or by management agreement.
new text end

new text begin Subd. 3. new text end

new text begin Provision of blank contracts. new text end

new text begin A facility must:
new text end

new text begin (1) offer to prospective residents and provide to the Office of Ombudsman for Long-Term
Care a complete unsigned copy of its contract; and
new text end

new text begin (2) give a complete copy of any signed contract and any addendums, and all supporting
documents and attachments, to the resident or the designated representative promptly after
a contract and any addendum has been signed by the resident or the designated representative.
new text end

new text begin Subd. 4. new text end

new text begin Contracts are consumer contracts. new text end

new text begin A contract under this section is a consumer
contract under sections 325G.29 to 325G.37.
new text end

new text begin Subd. 5. new text end

new text begin Choice of designated representative. new text end

new text begin Before or at the time of execution of
the contract, the facility must offer the resident the opportunity to identify a designated or
resident representative or both in writing in the contract. The contract must contain a page
or space for the name and contact information of the designated or resident representative
or both and a box the resident must initial if the resident declines to name a designated or
resident representative. Notwithstanding subdivision 6, the resident has the right at any time
to rescind the declination or add or change the name and contact information of the designated
or resident representative.
new text end

new text begin Subd. 6. new text end

new text begin Additions and amendments to contract . new text end

new text begin The resident must agree in writing
to any additions or amendments to the contract. Upon agreement between the resident or
resident's designated representative and the facility, a new contract or an addendum to the
existing contract must be executed and signed.
new text end

new text begin Subd. 7. new text end

new text begin Contract contents; contact information. new text end

new text begin (a) The contract must include in a
conspicuous place and manner on the contract the legal name and the license number of the
facility.
new text end

new text begin (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:
new text end

new text begin (1) the facility and service provider when applicable;
new text end

new text begin (2) the licensee of the facility;
new text end

new text begin (3) the managing agent of the facility, if applicable; and
new text end

new text begin (4) at least one natural person who is authorized to accept service of process on behalf
of the facility.
new text end

new text begin Subd. 8. new text end

new text begin Contract contents; terms and conditions. new text end

new text begin The contract must include:
new text end

new text begin (1) a description of all the terms and conditions of the contract, including a description
of and any limitations to the housing and/or services to be provided for the contracted
amount;
new text end

new text begin (2) a delineation of the cost and nature of any other services to be provided for an
additional fee;
new text end

new text begin (3) 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;
new text end

new text begin (4) a delineation of the grounds under which the resident may be discharged, evicted,
or transferred or have services terminated; and
new text end

new text begin (5) billing and payment procedures and requirements.
new text end

new text begin Subd. 9. new text end

new text begin Contract contents; complaint resolution procedure. new text end

new text begin 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.
new text end

new text begin Subd. 10. new text end

new text begin Contract contents; required disclosures and notices. new text end

new text begin The contract must
include a clear and conspicuous notice of:
new text end

new text begin (1) the right under section 144G.48 to challenge a discharge, eviction, or transfer or
service termination;
new text end

new text begin (2) the facility's policy regarding transfer of residents within the facility, under what
circumstances a transfer may occur, and whether or not consent of the resident being asked
to transfer is required;
new text end

new text begin (3) the toll-free complaint line for the MAARC, the Office of Ombudsman for Long-Term
Care, and the Office of Health Facility Complaints;
new text end

new text begin (4) the resident's right to obtain services from an unaffiliated service provider;
new text end

new text begin (5) the availability of public funds for eligible residents to pay for housing or services,
or both; and
new text end

new text begin (6) the contact information to obtain long-term care consulting services under section
256B.0911.
new text end

new text begin Subd. 11. new text end

new text begin Additional contract requirements for assisted living facilities. new text end

new text begin (a) Assisted
living facility contracts must include the requirements in paragraph (b). A restriction of a
resident's rights under this subdivision is allowed only if determined necessary for health
and safety reasons identified by the facility's registered nurse in an initial assessment or
reassessment, as defined under section 144G.63, and documented in the written service
agreement under section 144G.64. Any restrictions of those rights for individuals served
under sections 256B.0915 and 256B.49 must be documented in the resident's coordinated
service and support plan (CSSP), as defined under sections 256B.0915, subdivision 6, and
256B.49, subdivision 15.
new text end

new text begin (b) The contract must include a statement:
new text end

new text begin (1) regarding the ability of a resident to furnish and decorate the resident's unit within
the terms of the lease;
new text end

new text begin (2) regarding the resident's right to access food at any time;
new text end

new text begin (3) regarding a resident's right to choose the resident's visitors and times of visits;
new text end

new text begin (4) regarding the resident's right to choose a roommate if sharing a unit; and
new text end

new text begin (5) notifying the resident of the resident's right to have and use a lockable door to the
resident's unit. The landlord shall provide the locks on the unit. Only a staff member with
a specific need to enter the unit shall have keys, and advance notice must be given to the
resident before entrance, when possible.
new text end

new text begin Subd. 12. new text end

new text begin Waivers of liability prohibited. new text end

new text begin The contract must not include a waiver of
facility liability for the health and safety or personal property of a resident. The contract
must not include any provision that the facility knows or should know to be deceptive,
unlawful, or unenforceable under state or federal law, nor include any provision that requires
or implies a lesser standard of care or responsibility than is required by law.
new text end

new text begin Subd. 13. new text end

new text begin Contract in permanent file. new text end

new text begin The contract and related documents executed
by each resident or the designated representative must be maintained by the facility in files
from the date of execution until three years after the contract is terminated or expires. The
contracts and all associated documents will be available for on-site inspection by the
commissioner at any time. The documents shall be available for viewing or copies shall be
made available to the resident and the resident's representative at any time.
new text end

Sec. 2.

new text begin [144G.47] INVOLUNTARY DISCHARGES AND SERVICE
TERMINATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Prerequisite to termination of housing or services. new text end

new text begin Before terminating
a resident's housing or services, an assisted living establishment must explain in detail the
reasons for the termination and work with the resident and the resident's designated
representative to avoid the termination by identifying and offering reasonable
accommodations, interventions, or alternatives within the scope of services provided by the
assisted living establishment.
new text end

new text begin Subd. 2. new text end

new text begin Notice of contract termination required. new text end

new text begin If the assisted living establishment
and the resident or resident's designated representative cannot identify a mutually agreeable
method of avoiding a termination of an assisted living contract, the assisted living
establishment must issue to the resident or the resident's designated representative a notice
of contract termination.
new text end

new text begin Subd. 3. new text end

new text begin Required content of a notice of contract termination. new text end

new text begin The notice required
under subdivision 2 must contain, at a minimum:
new text end

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

new text begin (2) a detailed explanation of the basis for the termination, including, but not limited to,
clinical or other supporting rationale;
new text end

new text begin (3) a detailed explanation of the conditions under which a new or amended assisted
living contract may be executed between the assisted living establishment and the resident
or the resident's designated representative;
new text end

new text begin (4) a list of known providers in the immediate geographic area;
new text end

new text begin (5) a statement that the resident has the right to appeal the termination of an assisted
living contract that contained as a term of the contract the provision by the establishment
of services, an explanation of how and to whom to appeal, and contact information for the
Office of Administrative Hearings;
new text end

new text begin (6) a statement that the termination of an assisted living contract that does not contain
as a term of the contract the provision by the establishment of services is governed
exclusively by the terms of the lease contained in the assisted living contract and the resident
has the rights and protections available under chapter 504B;
new text end

new text begin (7) information on how to contact the ombudsman for long-term care;
new text end

new text begin (8) an offer to meet with the individual within five days of receiving notice for assistance
with transition planning;
new text end

new text begin (9) a statement that the assisted living establishment must participate in a coordinated
transfer of care of the resident to another provider or caregiver, as required under section
144G.49; and
new text end

new text begin (10) the name and contact information of a person employed by the assisted living
establishment with whom the resident may discuss the notice of termination.
new text end

new text begin Subd. 4. new text end

new text begin Notice period for nonemergency assisted living contract terminations. new text end

new text begin A
licensed assisted living establishment may terminate an assisted living contract 30 calendar
days after issuing the notice of contract termination required under subdivision 2, unless
the conditions of subdivision 5 are met.
new text end

new text begin Subd. 5. new text end

new text begin Notice period for emergency assisted living contract terminations. new text end

new text begin A licensed
assisted living establishment may terminate an assisted living contract ten calendar days
after issuing the notice of contract termination if:
new text end

new text begin (1) the resident engages in conduct that alters the terms of the assisted living contract
or creates an abusive or unsafe work environment for the employees of the assisted living
establishment, or creates an abusive or unsafe environment for other residents;
new text end

new text begin (2) a significant change in the resident's condition has resulted in service needs that are
beyond the scope of services the assisted living establishment has indicated in its assisted
living contract that it will provide or that cannot be safely met without additional services
provided by the establishment for which the resident is either unwilling or unable to pay,
or without additional services being provided directly to the resident by another licensed
provider that are either unavailable or for which the resident is unable or unwilling to pay;
or
new text end

new text begin (3) the establishment has not received payment for services.
new text end

Sec. 3.

new text begin [144G.48] APPEAL OF TERMINATION OF HOUSING SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Right to appeal. new text end

new text begin Residents of assisted living establishments have the
right to appeal the termination of an assisted living contract that contained as a term of the
contract the provision of services by the assisted living establishment.
new text end

new text begin Subd. 2. new text end

new text begin Permissible grounds for appeal. new text end

new text begin Permissible grounds for an appeal of an
assisted living contract that contained as a term of the contract the provision of services by
the assisted living establishment are limited to the following:
new text end

new text begin (1) the assisted living establishment was motivated to terminate the contract as retaliation
against the resident for exercising the resident's rights;
new text end

new text begin (2) a factual dispute between the assisted living establishment and the resident concerning
the underlying reason for an emergency termination of the assisted living contract; or
new text end

new text begin (3) termination would result in great harm or potential great harm to the resident as
determined by a totality of the circumstances. A contract termination cannot be overturned
under this clause if the establishment has alleged and demonstrated nonpayment. If an
administrative law judge finds sufficient evidence to overturn a contract termination under
this clause, the resident will be given an additional 30 days' notice, after which the case will
be reviewed to determine whether there is a sufficient alternative.
new text end

new text begin Subd. 3. new text end

new text begin Appeals process. new text end

new text begin (a) Any appeal of a termination of an assisted living contract
under this section must be filed with the Office of Administrative Hearings within five
business days of receipt of a notice of contract termination.
new text end

new text begin (b) An appeal hearing must occur within ten business days of filing of appeal.
new text end

new text begin (c) An administrative law judge must issue a decision within ten business days of the
appeal hearing.
new text end

new text begin Subd. 4. new text end

new text begin Service provision while appeal pending. new text end

new text begin Pending the outcome of an appeal
of the termination of an assisted living contract, if additional services are needed to meet
the health or safety needs of the resident, the resident or designated resident representative
is responsible for arranging and covering the costs for those additional services.
new text end

Sec. 4.

new text begin [144G.49] HOUSING AND SERVICE TERMINATION PLANNING.
new text end

new text begin Subdivision 1. new text end

new text begin Duties of facility. new text end

new text begin If a facility terminates housing or services, the facility:
new text end

new text begin (1) in the event of a termination of housing, has an affirmative duty to ensure a
coordinated and orderly transfer of the resident to a safe location that is appropriate for the
resident, and the facility must identify that location prior to any appeal hearing;
new text end

new text begin (2) in the event of a termination of services, has an affirmative duty to ensure a
coordinated and orderly transfer of the resident to an appropriate service provider, if services
are still needed and desired by the resident, and the facility must identify the provider prior
to any appeal hearing; and
new text end

new text begin (3) must consult and cooperate with the resident, the resident's designated representatives,
resident representatives, family members, any interested professionals, including case
managers, and applicable agencies to make arrangements to relocate the resident, including
consideration of the resident's goals.
new text end

new text begin Subd. 2. new text end

new text begin Safe location. new text end

new text begin A safe location is not a private home where the occupant is
unwilling or unable to care for the resident, a homeless shelter, a hotel, or a motel. A facility
may not terminate a resident's housing or services if the resident will, as a result of the
termination, become homeless, as that term is defined in section 116L.361, subdivision 5,
or if an adequate and safe discharge location or adequate and needed service provider has
not been identified.
new text end

new text begin Subd. 3. new text end

new text begin Written relocation plan required. new text end

new text begin The facility must prepare a written relocation
plan. The plan must:
new text end

new text begin (1) contain all the necessary steps to be taken to reduce transfer trauma; and
new text end

new text begin (2) specify the measures needed until relocation that protect the resident and meet the
resident's health and safety needs.
new text end

new text begin Subd. 4. new text end

new text begin No relocation without receiving setting accepting. new text end

new text begin A facility may not relocate
the resident unless the place to which the resident will be relocated indicates acceptance of
the resident.
new text end

new text begin Subd. 5. new text end

new text begin No termination of services without another provider. new text end

new text begin If a resident continues
to need and desire the services provided by the facility, the facility may not terminate services
unless another service provider has indicated that it will provide those services.
new text end

new text begin Subd. 6. new text end

new text begin Information that must be conveyed. new text end

new text begin If a resident is relocated to another facility
or a nursing home provider, the facility must timely convey to that provider:
new text end

new text begin (1) the resident's full name, date of birth, and insurance information;
new text end

new text begin (2) the name, telephone number, and address of the resident's representatives and resident
representatives, if any;
new text end

new text begin (3) the resident's current documented diagnoses that are relevant to the services being
provided;
new text end

new text begin (4) the resident's known allergies that are relevant to the services being provided;
new text end

new text begin (5) the name and telephone number of the resident's physician, if known, and the current
physician orders that are relevant to the services being provided;
new text end

new text begin (6) all medication administration records that are relevant to the services being provided;
new text end

new text begin (7) the most recent resident assessment, if relevant to the services being provided; and
new text end

new text begin (8) copies of health care directives, "do not resuscitate" orders, and any guardianship
orders or powers of attorney.
new text end

Sec. 5.

new text begin [144G.50] PLANNED CLOSURES.
new text end

new text begin Subdivision 1. new text end

new text begin Closure plan required. new text end

new text begin In the event that a facility elects to voluntarily
close the facility, the facility must notify the commissioner and the Office of Ombudsman
for Long-Term Care in writing by submitting a proposed closure plan.
new text end

new text begin Subd. 2. new text end

new text begin Content of closure plan. new text end

new text begin The facility's proposed closure plan must include:
new text end

new text begin (1) the procedures and actions the facility will implement to notify residents of the
closure, including a copy of the written notice to be given to residents, designated
representatives, resident representatives, or family;
new text end

new text begin (2) the procedures and actions the facility will implement to ensure all residents receive
appropriate termination planning in accordance with section 144G.49;
new text end

new text begin (3) assessments of the needs and preferences of individual residents; and
new text end

new text begin (4) procedures and actions the facility will implement to maintain compliance with this
chapter until all residents have relocated.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner's approval required prior to implementation. new text end

new text begin (a) The plan
shall be subject to the commissioner's approval and, subject to section 144G.51, 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 as soon as practicable.
new text end

new text begin (b) The commissioner of health may require the facility to work with a transitional team
comprised of department staff, staff of the Office of Ombudsman for Long-Term Care, and
other professionals the commissioner deems necessary to assist in the proper relocation of
residents.
new text end

new text begin Subd. 4. new text end

new text begin Termination planning and final accounting requirements. new text end

new text begin Prior to
termination, the facility must follow the termination planning requirements under section
144G.49 for residents. The facility must implement the plan approved by the commissioner
and ensure that arrangements for relocation and continued care that meet each resident's
social, emotional, and health needs are effectuated prior to closure.
new text end

new text begin Subd. 5. new text end

new text begin Notice to residents. new text end

new text begin After the commissioner has approved the relocation plan
and at least 60 days before closing, except as provided under section 144G.51, the facility
must notify residents, designated representatives, and resident representatives or, if a resident
has no designated representative or resident representative, a family member, if known, of
the closure, the proposed date of closure, the contact information of the ombudsman for
long-term care, and that the facility will follow the termination planning requirements under
section 144G.49.
new text end

Sec. 6.

new text begin [144G.51] EMERGENCY CLOSURES.
new text end

new text begin (a) In the event the facility must close because the commissioner deems the facility can
no longer remain open, the facility must meet all requirements in section 144G.50, except
for any requirements the commissioner finds would endanger the health and safety of
residents. In the event the commissioner determines a closure must occur with less than 60
days' notice, the facility shall provide notice to residents as soon as practicable or as directed
by the commissioner.
new text end

new text begin (b) Upon request from the commissioner, a facility must provide the commissioner with
any documentation related to the appropriateness of its relocation plan or to any assertion
that the facility lacks the funds to comply with section 144G.50, or that remaining open
would otherwise endanger the health and safety of residents pursuant to paragraph (a).
new text end

Sec. 7.

new text begin [144G.511] RIGHTS UNDER LANDLORD TENANT LAW.
new text end

new text begin Nothing in sections 144G.46 to 144G.51 affects the rights and remedies available under
chapter 504B, except to the extent those rights or remedies are inconsistent with these
sections.
new text end

Sec. 8.

new text begin [144G.52] TRANSFER OF RESIDENTS WITHIN FACILITY.
new text end

new text begin Subdivision 1. new text end

new text begin Relocation. new text end

new text begin (a) A facility must provide for the safe, orderly, and
appropriate transfer of residents within the facility.
new text end

new text begin (b) If a basic care and assisted living contract permits resident transfers within the facility,
the facility must provide at least 30 days' advance notice of the transfer to the resident and
the resident's designated representative.
new text end

new text begin (c) In situations where there is a curtailment, reduction, capital improvement, or change
in operations within a facility, the facility must minimize the number of transfers needed
to complete the project or change in operations, consider individual resident needs and
preferences, and provide reasonable accommodation for individual resident requests regarding
the room transfer. The facility must provide notice to the Office of Ombudsman for
Long-Term Care and, when appropriate, the Office of Ombudsman for Mental Health and
Developmental Disabilities in advance of any notice to residents, residents' designated
representatives, and families when all of the following circumstances apply:
new text end

new text begin (1) the transfers of residents within the facility are being proposed due to curtailment,
reduction, capital improvements, or change in operations;
new text end

new text begin (2) the transfers of residents within the facility are not temporary moves to accommodate
physical plan upgrades or renovation; and
new text end

new text begin (3) the transfers involve multiple residents being moved simultaneously.
new text end

new text begin Subd. 2. new text end

new text begin Notice required before relocation within location. new text end

new text begin (a) A facility must:
new text end

new text begin (1) notify a resident and the resident's representative, if any, at least 14 days prior to a
proposed nonemergency relocation to a different room at the same location; and
new text end

new text begin (2) obtain consent from the resident and the resident's representative, if any.
new text end

new text begin (b) A resident must be allowed to stay in the resident's room. If a resident consents to a
move, any needed reasonable modifications must be made to the new room to accommodate
the resident's disabilities.
new text end

new text begin Subd. 3. new text end

new text begin Evaluation. new text end

new text begin A facility shall evaluate the resident's individual needs before
deciding whether the room the resident will be moved to fits the resident's psychological,
cognitive, and health care needs, including the accessibility of the bathroom.
new text end

new text begin Subd. 4. new text end

new text begin Restriction on relocation. new text end

new text begin A person who has been a private-pay resident for
at least one year and resides in a private room, and whose payments subsequently will be
made under the medical assistance program under chapter 256B, may not be relocated to a
shared room without the consent of the resident or the resident's representative, if any.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

ARTICLE 5

STAFFING REQUIREMENTS

Section 1.

new text begin [144G.53] STAFF REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Background studies required. new text end

new text begin (a) Employees, contractors, and volunteers
of the facility are subject to the background study required by section 144.057, and may be
disqualified under chapter 245C. Nothing in this subdivision shall be construed to prohibit
the facility from requiring self-disclosure of criminal conviction information.
new text end

new text begin (b) Termination of an employee in good faith reliance on information or records obtained
under this subdivision regarding a confirmed conviction does not subject the assisted living
facility to civil liability or liability for unemployment benefits.
new text end

new text begin Subd. 2. new text end

new text begin Qualifications, training, and competency. new text end

new text begin All staff persons providing services
must be trained and competent in the provision of services consistent with current practice
standards appropriate to the resident's needs and be informed of the basic care and assisted
living bill of rights under section 144G.76.
new text end

new text begin Subd. 3. new text end

new text begin Licensed health professionals and nurses. new text end

new text begin (a) Licensed health professionals
and nurses providing services as employees of a licensed facility must possess a current
Minnesota license or registration to practice.
new text end

new text begin (b) Licensed health professionals and registered nurses must be competent in assessing
resident needs, planning appropriate services to meet resident needs, implementing services,
and supervising staff if assigned.
new text end

new text begin (c) Nothing in this subdivision limits or expands the rights of nurses or licensed health
professionals to provide services within the scope of their licenses or registrations, as
provided by law.
new text end

new text begin Subd. 4. new text end

new text begin Unlicensed personnel. new text end

new text begin (a) Unlicensed personnel providing services must have:
new text end

new text begin (1) successfully completed a training and competency evaluation appropriate to the
services provided by the facility and the topics listed in section 144G.54, subdivision 2,
paragraph (a); or
new text end

new text begin (2) demonstrated competency by satisfactorily completing a written or oral test on the
tasks the unlicensed personnel will perform and on the topics listed in section 144G.54,
subdivision 2, paragraph (a); and successfully demonstrated competency of topics in section
144G.54, subdivision 2, paragraph (a), clauses (5), (7), and (8), by a practical skills test.
new text end

new text begin Unlicensed personnel providing basic care services shall not perform delegated nursing or
therapy tasks.
new text end

new text begin (b) Unlicensed personnel performing delegated nursing tasks in an assisted living facility
must:
new text end

new text begin (1) have successfully completed training and demonstrated competency by successfully
completing a written or oral test of the topics in section 144G.54, subdivision 2, paragraphs
(a) and (b), and a practical skills test on tasks listed in section 144G.54, subdivision 2,
paragraphs (a) , clauses (5) and (7), and (b), clauses (3), (5), (6), and (7), and all the delegated
tasks they will perform;
new text end

new text begin (2) satisfy the current requirements of Medicare for training or competency of home
health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
section 483 or 484.36; or
new text end

new text begin (3) have, before April 19, 1993, completed a training course for nursing assistants that
was approved by the commissioner.
new text end

new text begin (c) Unlicensed personnel performing therapy or treatment tasks delegated or assigned
by a licensed health professional must meet the requirements for delegated tasks in section
144G.55, subdivision 2, and any other training or competency requirements within the
licensed health professional's scope of practice relating to delegation or assignment of tasks
to unlicensed personnel.
new text end

new text begin Subd. 5. new text end

new text begin Temporary staff. new text end

new text begin When a facility contracts with a temporary staffing agency,
those individuals must meet the same requirements required by this section for personnel
employed by the facility and shall be treated as if they are staff of the facility.
new text end

Sec. 2.

new text begin [144G.54] COMPETENCY EVALUATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Requirements for instructors and competency evaluations. new text end

new text begin Instructors
and competency evaluators must meet the following requirements:
new text end

new text begin (1) training and competency evaluations of unlicensed personnel providing basic care
services must be conducted by individuals with work experience and training in providing
basic care services; and
new text end

new text begin (2) training and competency evaluations of unlicensed personnel providing comprehensive
assisted living services must be conducted by a registered nurse, or another instructor may
provide training in conjunction with the registered nurse.
new text end

new text begin Subd. 2. new text end

new text begin Required elements of competency evaluations. new text end

new text begin (a) Training and competency
evaluations for all unlicensed personnel must include the following:
new text end

new text begin (1) documentation requirements for all services provided;
new text end

new text begin (2) reports of changes in the resident's condition to the supervisor designated by the
facility;
new text end

new text begin (3) basic infection control, including blood-borne pathogens;
new text end

new text begin (4) maintenance of a clean and safe environment;
new text end

new text begin (5) appropriate and safe techniques in personal hygiene and grooming, including:
new text end

new text begin (i) hair care and bathing;
new text end

new text begin (ii) care of teeth, gums, and oral prosthetic devices;
new text end

new text begin (iii) care and use of hearing aids; and
new text end

new text begin (iv) dressing and assisting with toileting;
new text end

new text begin (6) training on the prevention of falls;
new text end

new text begin (7) standby assistance techniques and how to perform them;
new text end

new text begin (8) medication, exercise, and treatment reminders;
new text end

new text begin (9) basic nutrition, meal preparation, food safety, and assistance with eating;
new text end

new text begin (10) preparation of modified diets as ordered by a licensed health professional;
new text end

new text begin (11) communication skills that include preserving the dignity of the resident and showing
respect for the resident and the resident's preferences, cultural background, and family;
new text end

new text begin (12) awareness of confidentiality and privacy;
new text end

new text begin (13) understanding appropriate boundaries between staff and residents and the resident's
family;
new text end

new text begin (14) procedures to use in handling various emergency situations; and
new text end

new text begin (15) awareness of commonly used health technology equipment and assistive devices.
new text end

new text begin (b) In addition to paragraph (a), training and competency evaluation for unlicensed
personnel providing comprehensive assisted living services must include:
new text end

new text begin (1) observing, reporting, and documenting resident status;
new text end

new text begin (2) basic knowledge of body functioning and changes in body functioning, injuries, or
other observed changes that must be reported to appropriate personnel;
new text end

new text begin (3) reading and recording temperature, pulse, and respirations of the resident;
new text end

new text begin (4) recognizing physical, emotional, cognitive, and developmental needs of the resident;
new text end

new text begin (5) safe transfer techniques and ambulation;
new text end

new text begin (6) range of motioning and positioning; and
new text end

new text begin (7) administering medications or treatments as required.
new text end

Sec. 3.

new text begin [144G.55] DELEGATION AND SUPERVISION.
new text end

new text begin Subdivision 1. new text end

new text begin Availability of contact staff. new text end

new text begin (a) A basic care facility must have a person
available to staff for consultation on items relating to the provision of services or about the
resident.
new text end

new text begin (b) Assisted living facilities must have a registered nurse available for consultation to
staff performing delegated nursing tasks and must have an appropriate licensed health
professional available if performing other delegated services such as therapies.
new text end

new text begin (c) The appropriate contact person must be readily available either in person, by
telephone, or by other means to the staff at times when the staff is providing services.
new text end

new text begin Subd. 2. new text end

new text begin Delegation. new text end

new text begin (a) A registered nurse or licensed health professional may delegate
tasks only to staff who are competent and possess the knowledge and skills consistent with
the complexity of the tasks and according to the appropriate Minnesota practice act. The
assisted living facility must establish and implement a system to communicate up-to-date
information to the registered nurse or licensed health professional regarding the current
available staff and their competency so the registered nurse or licensed health professional
has sufficient information to determine the appropriateness of delegating tasks to meet
individual resident needs and preferences.
new text end

new text begin (b) When the registered nurse or licensed health professional delegates tasks, that person
must ensure that prior to the delegation the unlicensed personnel is trained in the proper
methods to perform the tasks or procedures for each resident and are able to demonstrate
the ability to competently follow the procedures and perform the tasks. If an unlicensed
personnel has not regularly performed the delegated assisted living task for a period of 24
consecutive months, the unlicensed personnel must demonstrate competency in the task to
the registered nurse or appropriate licensed health professional. The registered nurse or
licensed health professional must document instructions for the delegated tasks in the
resident's record.
new text end

new text begin Subd. 3. new text end

new text begin Supervision of basic care staff. new text end

new text begin (a) Staff who perform basic care services must
be supervised periodically where the services are being provided to verify that the work is
being performed competently and to identify problems and solutions to address issues
relating to the staff's ability to provide the services. The supervision of the unlicensed
personnel must be done by staff of the facility having the authority, skills, and ability to
provide the supervision of unlicensed personnel and who can implement changes as needed,
and train staff.
new text end

new text begin (b) Supervision includes direct observation of unlicensed personnel while the unlicensed
personnel are providing the services and may also include indirect methods of gaining input
such as gathering feedback from the resident. Supervisory review of staff must be provided
at a frequency based on the staff person's competency and performance.
new text end

new text begin Subd. 4. new text end

new text begin Supervision of delegated tasks and therapy. new text end

new text begin (a) Staff who perform delegated
nursing or therapy tasks must be supervised by an appropriate licensed health professional
or a registered nurse per the assisted living facility's policy where the services are being
provided to verify that the work is being performed competently and to identify problems
and solutions related to the staff person's ability to perform the tasks. Supervision of staff
performing medication or treatment administration shall be provided by a registered nurse
or appropriate licensed health professional and must include observation of the staff
administering the medication or treatment and the interaction with the resident.
new text end

new text begin (b) The direct supervision of staff performing delegated tasks must be provided within
30 days after the date on which the individual begins working for the facility and first
performs the delegated tasks for residents and thereafter as needed based on performance.
This requirement also applies to staff who have not performed delegated tasks for one year
or longer.
new text end

new text begin Subd. 5. new text end

new text begin Documentation of supervision. new text end

new text begin A facility must retain documentation of
supervision activities in the personnel records.
new text end

Sec. 4.

new text begin [144G.56] ORIENTATION AND ANNUAL TRAINING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Orientation of staff and supervisors. new text end

new text begin All staff providing and supervising
direct services must complete an orientation to facility licensing requirements and regulations
before providing services to residents. The orientation may be incorporated into the training
required under subdivision 6. The orientation need only be completed once for each staff
person and is not transferable to another facility.
new text end

new text begin Subd. 2. new text end

new text begin Content. new text end

new text begin (a) The orientation must contain the following topics:
new text end

new text begin (1) an overview of this chapter;
new text end

new text begin (2) an introduction and review of the facility's policies and procedures related to the
provision of assisted living services by the individual staff person;
new text end

new text begin (3) handling of emergencies and use of emergency services;
new text end

new text begin (4) compliance with and reporting of the maltreatment of vulnerable adults under section
626.557;
new text end

new text begin (5) basic care and assisted living bill of rights under section 144G.76;
new text end

new text begin (6) protection-related rights under section 144G.77;
new text end

new text begin (7) handling of residents' complaints, reporting of complaints, and where to report
complaints, including information on the Minnesota Adult Abuse Reporting Center and the
Office of Health Facility Complaints;
new text end

new text begin (8) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
Office of Ombudsman for Mental Health and Developmental Disabilities, Minnesota Adult
Abuse Reporting Center (MAARC), Managed Care Ombudsman at the Department of
Human Services, county-managed care advocates, or other relevant advocacy services; and
new text end

new text begin (9) a review of the types of assisted living services the employee will be providing and
the facility's tier of licensure.
new text end

new text begin (b) In addition to the topics in paragraph (a), orientation may also contain training on
providing services to residents with hearing loss. Any training on hearing loss provided
under this subdivision must be high quality and research based, may include online training,
and must include training on one or more of the following topics:
new text end

new text begin (1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and the challenges it poses to communication;
new text end

new text begin (2) health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or
new text end

new text begin (3) information about strategies and technology that may enhance communication and
involvement, including communication strategies, assistive listening devices, hearing aids,
visual and tactile alerting devices, communication access in real time, and closed captions.
new text end

new text begin Subd. 3. new text end

new text begin Verification and documentation of orientation. new text end

new text begin Each facility shall retain
evidence in the employee record of each staff person having completed the orientation
required by this section.
new text end

new text begin Subd. 4. new text end

new text begin Orientation to resident. new text end

new text begin Staff providing services must be oriented specifically
to each individual resident and the services to be provided. This orientation may be provided
in person, orally, in writing, or electronically.
new text end

new text begin Subd. 5. new text end

new text begin Training required relating to Alzheimer's disease and related disorders. new text end

new text begin All
direct care staff and supervisors providing direct services must receive training that includes
a current explanation of Alzheimer's disease and related disorders, effective approaches to
use to problem solve when working with a resident's challenging behaviors, and how to
communicate with residents who have Alzheimer's or related disorders.
new text end

new text begin Subd. 6. new text end

new text begin Required annual training. new text end

new text begin (a) All staff that perform direct services must
complete at least eight hours of annual training for each 12 months of employment. The
training may be obtained from the facility or another source and must include topics relevant
to the provision of assisted living services. The annual training must include:
new text end

new text begin (1) training on reporting of maltreatment of vulnerable adults under section 626.557;
new text end

new text begin (2) review of the basic care and assisted living bill of rights in section 144G.76;
new text end

new text begin (3) review of infection control techniques used in the home and implementation of
infection control standards including a review of hand washing techniques; the need for and
use of protective gloves, gowns, and masks; appropriate disposal of contaminated materials
and equipment, such as dressings, needles, syringes, and razor blades; disinfecting reusable
equipment; disinfecting environmental surfaces; and reporting communicable diseases;
new text end

new text begin (4) effective approaches to use to problem solve when working with a resident's
challenging behaviors, and how to communicate with residents who have Alzheimer's
disease or related disorders;
new text end

new text begin (5) review of the facility's policies and procedures relating to the provision of assisted
living services and how to implement those policies and procedures; and
new text end

new text begin (6) review of protection-related rights as stated in section 144G.77.
new text end

new text begin (b) In addition to the topics in paragraph (a), annual training may also contain training
on providing services to residents with hearing loss. Any training on hearing loss provided
under this subdivision must be high quality and research based, may include online training,
and must include training on one or more of the following topics:
new text end

new text begin (1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and challenges it poses to communication;
new text end

new text begin (2) the health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or
new text end

new text begin Subd. 7. new text end

new text begin Documentation. new text end

new text begin A facility must retain documentation in the employee records
of staff who have satisfied the orientation and training requirements of this section.
new text end

new text begin Subd. 8. new text end

new text begin Implementation. new text end

new text begin A facility must implement all orientation and training topics
covered in this section.
new text end

Sec. 5.

new text begin [144G.57] TRAINING IN DEMENTIA CARE REQUIRED.
new text end

new text begin Subdivision 1. new text end

new text begin Assisted living facility dementia training requirements. new text end

new text begin (a) Assisted
living facilities must meet the following training requirements:
new text end

new text begin (1) supervisors of direct-care staff must have at least eight hours of initial training on
topics specified under paragraph (b) within 120 working hours of the employment start
date, and must have at least two hours of training on topics related to dementia care for each
12 months of employment thereafter;
new text end

new text begin (2) direct-care employees must have completed at least eight hours of initial training on
topics specified under paragraph (b) within 160 working hours of the employment start
date. Until this initial training is complete, an employee must not provide direct care unless
there is another employee on site who has completed the initial eight hours of training on
topics related to dementia care and who can act as a resource and assist if issues arise. A
trainer of the requirements under paragraph (b) or a supervisor meeting the requirements
in clause (1) must be available for consultation with the new employee until the training
requirement is complete. Direct-care employees must have at least two hours of training on
topics related to dementia for each 12 months of employment thereafter;
new text end

new text begin (3) staff who do not provide direct care, including maintenance, housekeeping, and food
service staff, must have at least four hours of initial training on topics specified under
paragraph (b) within 160 working hours of the employment start date, and must have at
least two hours of training on topics related to dementia care for each 12 months of
employment thereafter; and
new text end

new text begin (4) new employees may satisfy the initial training requirements by producing written
proof of previously completed required training within the past 18 months.
new text end

new text begin (b) Areas of required training include:
new text end

new text begin (1) an explanation of Alzheimer's disease and related disorders;
new text end

new text begin (2) assistance with activities of daily living;
new text end

new text begin (3) problem solving with challenging behaviors; and
new text end

new text begin (4) communication skills.
new text end

new text begin (c) The facility shall provide to consumers in written or electronic form a description of
the training program, the categories of employees trained, the frequency of training, and
the basic topics covered.
new text end

new text begin Subd. 2. new text end

new text begin Basic care facility dementia training requirements. new text end

new text begin (a) Basic care facilities
must meet the following training requirements:
new text end

new text begin (1) supervisors of direct-care staff must have at least four hours of initial training on
topics specified under paragraph (b) within 120 working hours of the employment start
date, and must have at least two hours of training on topics related to dementia care for each
12 months of employment thereafter;
new text end

new text begin (2) direct-care employees must have completed at least four hours of initial training on
topics specified under paragraph (b) within 160 working hours of the employment start
date. Until this initial training is complete, an employee must not provide direct care unless
there is another employee on site who has completed the initial four hours of training on
topics related to dementia care and who can act as a resource and assist if issues arise. A
trainer of the requirements under paragraph (b) or a supervisor meeting the requirements
under clause (1) must be available for consultation with the new employee until the training
requirement is complete. Direct-care employees must have at least two hours of training on
topics related to dementia for each 12 months of employment thereafter;
new text end

new text begin (4) new employees may satisfy the initial training requirements by producing written
proof of previously completed required training within the past 18 months.
new text end

new text begin (b) Areas of required training include:
new text end

new text begin (1) an explanation of Alzheimer's disease and related disorders;
new text end

new text begin (2) assistance with activities of daily living;
new text end

new text begin (3) problem solving with challenging behaviors; and
new text end

new text begin (4) communication skills.
new text end

ARTICLE 6

SERVICES

Section 1.

new text begin [144G.60] ACCEPTANCE OF RESIDENTS.
new text end

new text begin A facility may not accept a person as a resident unless the facility has staff, sufficient
in qualifications, competency, and numbers, to adequately provide the services agreed to
in the service agreement and that are within the facility's scope of practice.
new text end

Sec. 2.

new text begin [144G.61] REFERRALS TO ANOTHER PROVIDER.
new text end

new text begin If a facility reasonably believes that a resident is in need of another medical or health
service, including a licensed health professional, or social service provider, the facility shall:
new text end

new text begin (1) determine the resident's preferences with respect to obtaining the service; and
new text end

new text begin (2) inform the resident of the resources available, if known, to assist the resident in
obtaining services.
new text end

Sec. 3.

new text begin [144G.62] INITIATION OF SERVICES.
new text end

new text begin When a facility initiates services and the individualized review or assessment required
under section 144G.63 has not been completed, the facility must complete a temporary plan
and agreement with the resident for services.
new text end

Sec. 4.

new text begin [144G.63] INITIAL REVIEWS; ASSESSMENTS; MONITORING.
new text end

new text begin (a) A basic care facility shall complete an individualized initial review of the resident's
needs and preferences. The initial review must be completed within 30 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 days from the date of the last review.
new text end

new text begin (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 agreement 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. The nursing assessment must be
completed within five days of the start of services.
new text end

new text begin (c) Resident reassessment and monitoring must be conducted no more than 14 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 days from the
last date of the assessment.
new text end

new text begin (d) Residents who are not receiving any services shall not be required to undergo an
initial review or nursing assessment.
new text end

new text begin (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.
new text end

Sec. 5.

new text begin [144G.64] SERVICE AGREEMENTS.
new text end

new text begin (a) No later than 14 days after the date that services are first provided, a facility shall
finalize a current written service agreement.
new text end

new text begin (b) The service agreement and any revisions must include a signature or other
authentication by the facility and by the resident or the designated representative documenting
agreement on the services to be provided. The service agreement must be revised, if needed,
based on resident review or reassessment under section 144G.63. 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 Care.
new text end

new text begin (c) The facility must implement and provide all services required by the current service
agreement.
new text end

new text begin (d) The service agreement and the revised service agreement must be entered into the
resident's record, including notice of a change in a resident's fees when applicable.
new text end

new text begin (e) Staff providing services must be informed of the current written service agreement.
new text end

new text begin (f) The service agreement must include:
new text end

new text begin (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 review or assessment and resident
preferences;
new text end

new text begin (2) the identification of staff or categories of staff who will provide the services;
new text end

new text begin (3) the schedule and methods of monitoring reviews or assessments of the resident;
new text end

new text begin (4) the schedule and methods of monitoring staff providing services; and
new text end

new text begin (5) a contingency plan that includes:
new text end

new text begin (i) the action to be taken by the facility and by the resident and the designated
representative if the scheduled service cannot be provided;
new text end

new text begin (ii) information and a method for a resident and the designated representative to contact
the facility;
new text end

new text begin (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
new text end

new text begin (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.
new text end

Sec. 6.

new text begin [144G.65] MEDICATION MANAGEMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Medication management services. new text end

new text begin (a) This section applies only to
assisted living facilities that provide comprehensive assisted living services. Medication
management services shall not be provided by a basic care facility.
new text end

new text begin (b) An assisted living facility that provides medication management services must
develop, implement, and maintain current written medication management policies and
procedures. The policies and procedures must be developed under the supervision and
direction of a registered nurse, licensed health professional, or pharmacist consistent with
current practice standards and guidelines.
new text end

new text begin (c) The written policies and procedures must address requesting and receiving
prescriptions for medications; preparing and giving medications; verifying that prescription
drugs are administered as prescribed; documenting medication management activities;
controlling and storing medications; monitoring and evaluating medication use; resolving
medication errors; communicating with the prescriber, pharmacist, and resident and
designated representative, if any; disposing of unused medications; and educating residents
and designated representatives about medications. When controlled substances are being
managed, the policies and procedures must also identify how the provider will ensure security
and accountability for the overall management, control, and disposition of those substances
in compliance with state and federal regulations and with subdivision 23.
new text end

new text begin Subd. 2. new text end

new text begin Provision of medication management services. new text end

new text begin (a) For each resident who
requests medication management services, the assisted living facility shall, prior to providing
medication management services, have a registered nurse, licensed health professional, or
authorized prescriber under section 151.37 conduct an assessment to determine what
medication management services will be provided and how the services will be provided.
This assessment must be conducted face-to-face with the resident. The assessment must
include an identification and review of all medications the resident is known to be taking.
The review and identification must include indications for medications, side effects,
contraindications, allergic or adverse reactions, and actions to address these issues.
new text end

new text begin (b) The assessment must identify interventions needed in management of medications
to prevent diversion of medication by the resident or others who may have access to the
medications. "Diversion of medications" means the misuse, theft, or illegal or improper
disposition of medications and to provide instructions to the resident and designated
representative on interventions to manage the resident's medications and prevent diversion
of medications.
new text end

new text begin Subd. 3. new text end

new text begin Individualized medication monitoring and reassessment. new text end

new text begin The assisted living
facility must monitor and reassess the resident's medication management services as needed
under subdivision 2 when the resident presents with symptoms or other issues that may be
medication-related and, at a minimum, annually.
new text end

new text begin Subd. 4. new text end

new text begin Resident refusal. new text end

new text begin The assisted living facility must document in the resident's
record any refusal for an assessment for medication management by the resident. The assisted
living facility must discuss with the resident the possible consequences of the resident's
refusal and document the discussion in the resident's record.
new text end

new text begin Subd. 5. new text end

new text begin Individualized medication management plan. new text end

new text begin (a) For each resident receiving
medication management services, the assisted living facility must prepare and include in
the service agreement a written statement of the medication management services that will
be provided to the resident. The assisted living facility must develop and maintain a current
individualized medication management record for each resident based on the resident's
assessment that must contain the following:
new text end

new text begin (1) a statement describing the medication management services that will be provided;
new text end

new text begin (2) a description of storage of medications based on the resident's needs and preferences,
risk of diversion, and consistent with the manufacturer's directions;
new text end

new text begin (3) documentation of specific resident instructions relating to the administration of
medications;
new text end

new text begin (4) identification of persons responsible for monitoring medication supplies and ensuring
that medication refills are ordered on a timely basis;
new text end

new text begin (5) identification of medication management tasks that may be delegated to unlicensed
personnel;
new text end

new text begin (6) procedures for staff notifying a registered nurse or appropriate licensed health
professional when a problem arises with medication management services; and
new text end

new text begin (7) any resident-specific requirements relating to documenting medication administration,
verifications that all medications are administered as prescribed, and monitoring of
medication use to prevent possible complications or adverse reactions.
new text end

new text begin (b) The medication management record must be current and updated when there are any
changes.
new text end

new text begin (c) Medication reconciliation must be completed when a licensed nurse, licensed health
professional, or authorized prescriber is providing medication management.
new text end

new text begin Subd. 6. new text end

new text begin Administration of medication. new text end

new text begin Medications may be administered by a nurse,
physician, or other licensed health practitioner authorized to administer medications or by
unlicensed personnel who have been delegated medication administration tasks by a
registered nurse.
new text end

new text begin Subd. 7. new text end

new text begin Delegation of medication administration. new text end

new text begin When administration of medications
is delegated to unlicensed personnel, the assisted living facility must ensure that the registered
nurse has:
new text end

new text begin (1) instructed the unlicensed personnel in the proper methods to administer the
medications, and the unlicensed personnel has demonstrated the ability to competently
follow the procedures;
new text end

new text begin (2) specified, in writing, specific instructions for each resident and documented those
instructions in the resident's records; and
new text end

new text begin (3) communicated with the unlicensed personnel about the individual needs of the
resident.
new text end

new text begin Subd. 8. new text end

new text begin Documentation of administration of medications. new text end

new text begin Each medication
administered by the assisted living facility staff must be documented in the resident's record.
The documentation must include the signature and title of the person who administered the
medication. The documentation must include the medication name, dosage, date and time
administered, and method and route of administration. The staff must document the reason
why medication administration was not completed as prescribed and document any follow-up
procedures that were provided to meet the resident's needs when medication was not
administered as prescribed and in compliance with the resident's medication management
plan.
new text end

new text begin Subd. 9. new text end

new text begin Documentation of medication setup. new text end

new text begin Documentation of dates of medication
setup, name of medication, quantity of dose, times to be administered, route of administration,
and name of person completing medication setup must be done at the time of setup.
new text end

new text begin Subd. 10. new text end

new text begin Medication management for residents who will be away from home. new text end

new text begin (a)
An assisted living facility that is providing medication management services to the resident
must develop and implement policies and procedures for giving accurate and current
medications to residents for planned or unplanned times away from home according to the
resident's individualized medication management plan. The policies and procedures must
state that:
new text end

new text begin (1) for planned time away, the medications must be obtained from the pharmacy or set
up by the licensed nurse according to appropriate state and federal laws and nursing standards
of practice;
new text end

new text begin (2) for unplanned time away, when the pharmacy is not able to provide the medications,
a licensed nurse or unlicensed personnel shall give the resident and designated representative
medications in amounts and dosages needed for the length of the anticipated absence, not
to exceed seven calendar days;
new text end

new text begin (3) the resident or designated representative must be provided written information on
medications, including any special instructions for administering or handling the medications,
including controlled substances;
new text end

new text begin (4) the medications must be placed in a medication container or containers appropriate
to the provider's medication system and must be labeled with the resident's name and the
dates and times that the medications are scheduled; and
new text end

new text begin (5) the resident and designated representative must be provided in writing the facility's
name and information on how to contact the facility.
new text end

new text begin (b) For unplanned time away when the licensed nurse is not available, the registered
nurse may delegate this task to unlicensed personnel if:
new text end

new text begin (1) the registered nurse has trained the unlicensed staff and determined the unlicensed
staff is competent to follow the procedures for giving medications to residents; and
new text end

new text begin (2) the registered nurse has developed written procedures for the unlicensed personnel,
including any special instructions or procedures regarding controlled substances that are
prescribed for the resident. The procedures must address:
new text end

new text begin (i) the type of container or containers to be used for the medications appropriate to the
provider's medication system;
new text end

new text begin (ii) how the container or containers must be labeled;
new text end

new text begin (iii) written information about the medications to be given to the resident or designated
representative;
new text end

new text begin (iv) how the unlicensed staff must document in the resident's record that medications
have been given to the resident and the designated representative, including documenting
the date the medications were given to the resident or the designated representative and who
received the medications, the person who gave the medications to the resident, the number
of medications that were given to the resident, and other required information;
new text end

new text begin (v) how the registered nurse shall be notified that medications have been given to the
resident or designated representative and whether the registered nurse needs to be contacted
before the medications are given to the resident or the designated representative;
new text end

new text begin (vi) a review by the registered nurse of the completion of this task to verify that this task
was completed accurately by the unlicensed personnel; and
new text end

new text begin (vii) how the unlicensed personnel must document in the resident's record any unused
medications that are returned to the facility, including the name of each medication and the
doses of each returned medication.
new text end

new text begin Subd. 11. new text end

new text begin Prescribed and nonprescribed medication. new text end

new text begin The assisted living facility must
determine whether the facility shall require a prescription for all medications the provider
manages. The assisted living facility must inform the resident or the designated representative
whether the facility requires a prescription for all over-the-counter and dietary supplements
before the facility agrees to manage those medications.
new text end

new text begin Subd. 12. new text end

new text begin Medications; over-the-counter; dietary supplements not prescribed. new text end

new text begin An
assisted living facility providing medication management services for over-the-counter
drugs or dietary supplements must retain those items in the original labeled container with
directions for use prior to setting up for immediate or later administration. The facility must
verify that the medications are up to date and stored as appropriate.
new text end

new text begin Subd. 13. new text end

new text begin Prescriptions. new text end

new text begin There must be a current written or electronically recorded
prescription as defined in section 151.01, subdivision 16a, for all prescribed medications
that the assisted living facility is managing for the resident.
new text end

new text begin Subd. 14. new text end

new text begin Renewal of prescriptions. new text end

new text begin Prescriptions must be renewed at least every 12
months or more frequently as indicated by the assessment in subdivision 2. Prescriptions
for controlled substances must comply with chapter 152.
new text end

new text begin Subd. 15. new text end

new text begin Verbal prescription orders. new text end

new text begin Verbal prescription orders from an authorized
prescriber must be received by a nurse or pharmacist. The order must be handled according
to Minnesota Rules, part 6800.6200.
new text end

new text begin Subd. 16. new text end

new text begin Written or electronic prescription. new text end

new text begin When a written or electronic prescription
is received, it must be communicated to the registered nurse in charge and recorded or placed
in the resident's record.
new text end

new text begin Subd. 17. new text end

new text begin Records confidential. new text end

new text begin A prescription or order received verbally, in writing,
or electronically must be kept confidential according to sections 144.291 to 144.298 and
144A.44.
new text end

new text begin Subd. 18. new text end

new text begin Medications provided by resident or family members. new text end

new text begin When the assisted
living facility is aware of any medications or dietary supplements that are being used by
the resident and are not included in the assessment for medication management services,
the staff must advise the registered nurse and document that in the resident's record.
new text end

new text begin Subd. 19. new text end

new text begin Storage of medications. new text end

new text begin An assisted living facility must store all prescription
medications in securely locked and substantially constructed compartments according to
the manufacturer's directions and permit only authorized personnel to have access.
new text end

new text begin Subd. 20. new text end

new text begin Prescription drugs. new text end

new text begin A prescription drug, prior to being set up for immediate
or later administration, must be kept in the original container in which it was dispensed by
the pharmacy bearing the original prescription label with legible information including the
expiration or beyond-use date of a time-dated drug.
new text end

new text begin Subd. 21. new text end

new text begin Prohibitions. new text end

new text begin No prescription drug supply for one resident may be used or
saved for use by anyone other than the resident.
new text end

new text begin Subd. 22. new text end

new text begin Disposition of medications. new text end

new text begin (a) Any current medications being managed by
the assisted living facility must be given to the resident or the designated representative
when the resident's service agreement ends or medication management services are no
longer part of the service agreement. Medications that have been stored in the resident's
home for a resident who is deceased or that have been discontinued or have expired may
be given to the resident or the designated representative for disposal.
new text end

new text begin (b) The assisted living facility shall dispose of any medications remaining with the
facility that are discontinued or expired or upon the termination of the service contract or
the resident's death according to state and federal regulations for disposition of medications
and controlled substances.
new text end

new text begin (c) Upon disposition, the facility must document in the resident's record the disposition
of the medication including the medication's name, strength, prescription number as
applicable, quantity, to whom the medications were given, date of disposition, and names
of staff and other individuals involved in the disposition.
new text end

new text begin Subd. 23. new text end

new text begin Loss or spillage. new text end

new text begin (a) Assisted living facilities providing medication
management must develop and implement procedures for loss or spillage of all controlled
substances defined in Minnesota Rules, part 6800.4220. These procedures must require that
when a spillage of a controlled substance occurs, a notation must be made in the resident's
record explaining the spillage and the actions taken. The notation must be signed by the
person responsible for the spillage and include verification that any contaminated substance
was disposed of according to state or federal regulations.
new text end

new text begin (b) The procedures must require that the facility providing medication management
investigate any known loss or unaccounted for prescription drugs and take appropriate action
required under state or federal regulations and document the investigation in required records.
new text end

Sec. 7.

new text begin [144G.66] TREATMENT AND THERAPY MANAGEMENT SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Treatment and therapy management services. new text end

new text begin This section applies
only to assisted living facilities that provide comprehensive assisted living services. Treatment
and therapy management services shall not be provided by a basic care facility.
new text end

new text begin Subd. 2. new text end

new text begin Policies and procedures. new text end

new text begin (a) An assisted living facility that provides treatment
and therapy management services must develop, implement, and maintain up-to-date written
treatment or therapy management policies and procedures. The policies and procedures
must be developed under the supervision and direction of a registered nurse or appropriate
licensed health professional consistent with current practice standards and guidelines.
new text end

new text begin (b) The written policies and procedures must address requesting and receiving orders
or prescriptions for treatments or therapies, providing the treatment or therapy, documenting
treatment or therapy activities, educating and communicating with residents about treatments
or therapies they are receiving, monitoring and evaluating the treatment or therapy, and
communicating with the prescriber.
new text end

new text begin Subd. 3. new text end

new text begin Individualized treatment or therapy management plan. new text end

new text begin For each resident
receiving management of ordered or prescribed treatments or therapy services, the assisted
living facility must prepare and include in the service agreement a written statement of the
treatment or therapy services that will be provided to the resident. The facility must also
develop and maintain a current individualized treatment and therapy management record
for each resident which must contain at least the following:
new text end

new text begin (1) a statement of the type of services that will be provided;
new text end

new text begin (2) documentation of specific resident instructions relating to the treatments or therapy
administration;
new text end

new text begin (3) identification of treatment or therapy tasks that will be delegated to unlicensed
personnel;
new text end

new text begin (4) procedures for notifying a registered nurse or appropriate licensed health professional
when a problem arises with treatments or therapy services; and
new text end

new text begin (5) any resident-specific requirements relating to documentation of treatment and therapy
received, verification that all treatment and therapy was administered as prescribed, and
monitoring of treatment or therapy to prevent possible complications or adverse reactions.
The treatment or therapy management record must be current and updated when there are
any changes.
new text end

new text begin Subd. 4. new text end

new text begin Administration of treatments and therapy. new text end

new text begin Ordered or prescribed treatments
or therapies must be administered by a nurse, physician, or other licensed health professional
authorized to perform the treatment or therapy, or may be delegated or assigned to unlicensed
personnel by the licensed health professional according to the appropriate practice standards
for delegation or assignment. When administration of a treatment or therapy is delegated
or assigned to unlicensed personnel, the facility must ensure that the registered nurse or
authorized licensed health professional has:
new text end

new text begin (1) instructed the unlicensed personnel in the proper methods with respect to each resident
and the unlicensed personnel has demonstrated the ability to competently follow the
procedures;
new text end

new text begin (2) specified, in writing, specific instructions for each resident and documented those
instructions in the resident's record; and
new text end

new text begin (3) communicated with the unlicensed personnel about the individual needs of the
resident.
new text end

new text begin Subd. 5. new text end

new text begin Documentation of administration of treatments and therapies. new text end

new text begin Each treatment
or therapy administered by an assisted living facility must be in the resident's record. The
documentation must include the signature and title of the person who administered the
treatment or therapy and must include the date and time of administration. When treatment
or therapies are not administered as ordered or prescribed, the provider must document the
reason why it was not administered and any follow-up procedures that were provided to
meet the resident's needs.
new text end

new text begin Subd. 6. new text end

new text begin Treatment and therapy orders. new text end

new text begin There must be an up-to-date written or
electronically recorded order from an authorized prescriber for all treatments and therapies.
The order must contain the name of the resident, a description of the treatment or therapy
to be provided, and the frequency, duration, and other information needed to administer the
treatment or therapy. Treatment and therapy orders must be renewed at least every 12
months.
new text end

new text begin Subd. 7. new text end

new text begin Right to outside service provider; other payors. new text end

new text begin Under section 144G.76, a
resident is free to retain therapy and treatment services from an off-site service provider.
Assisted living facilities must make every effort to assist residents in obtaining information
regarding whether the Medicare, medical assistance under chapter 256B, or another public
program will pay for any or all of the services.
new text end

ARTICLE 7

RESIDENT RIGHTS AND PROTECTIONS

Section 1.

new text begin [144G.70] REQUIRED NOTICES.
new text end

new text begin Subdivision 1. new text end

new text begin Notices in plain language; language accommodations. new text end

new text begin The facility
must provide all notices in plain language that residents can understand and make reasonable
accommodations for residents who have communication disabilities and those whose primary
language is a language other than English.
new text end

new text begin Subd. 2. new text end

new text begin Notice to residents; change in ownership or management. new text end

new text begin A facility must
provide prompt written notice to the resident or designated representative of any change of
legal name, telephone number, and physical mailing address, which may not be a public or
private post office box, of:
new text end

new text begin (1) the licensee of the facility;
new text end

new text begin (2) the manager of the facility, if applicable; and
new text end

new text begin (3) the agent authorized to accept legal process on behalf of the facility.
new text end

new text begin Subd. 3. new text end

new text begin Notice of services for dementia. new text end

new text begin The facility that provides services to residents
with dementia shall provide in written or electronic form, to residents and families or other
persons who request it, a description of the training program and related training it provides,
including the categories of employees trained, the frequency of training, and the basic topics
covered.
new text end

new text begin Subd. 4. new text end

new text begin Notice of bill of rights. new text end

new text begin (a) The facility shall provide the resident and the
designated representative a written notice of the rights under section 144G.76 before the
initiation of services to that resident. The facility shall make all reasonable efforts to provide
notice of the rights to the resident and the designated representative in a language the resident
and designated representative can understand.
new text end

new text begin (b) In addition to the text of the bill of rights in section 144G.76, the notice shall also
contain the following statement describing how to file a complaint.
new text end

new text begin "If you have a complaint about the facility or the person providing your services, you may
call the Minnesota Adult Abuse Reporting Center at 1-844-880-1574, or you may contact
the Office of Health Facility Complaints, Minnesota Department of Health. You may also
contact the Office of Ombudsman for Long-Term Care or the Office of Ombudsman for
Mental Health and Developmental Disabilities."
new text end

new text begin (c) The statement must include 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.
new text end

new text begin (d) The facility must obtain written acknowledgment of the resident's receipt of the bill
of rights or shall document why an acknowledgment cannot be obtained. The
acknowledgment may be obtained from the resident and the designated representative.
Acknowledgment of receipt shall be retained in the resident's record.
new text end

new text begin Subd. 5. new text end

new text begin Notice of available assistance . new text end

new text begin The facility shall provide each resident with
identifying and contact information about the persons who can assist with health care or
supportive services being provided. The facility shall keep each resident informed of changes
in the personnel referenced in this subdivision.
new text end

new text begin Subd. 6. new text end

new text begin Notice of complaint and investigation procedures. new text end

new text begin The facility shall provide
each resident a written notice that includes:
new text end

new text begin (1) the resident's right to complain to the facility about the services received;
new text end

new text begin (2) the name or title of the person or persons with the facility to contact with complaints;
new text end

new text begin (3) the method of submitting a complaint to the facility; and
new text end

new text begin (4) a statement that the provider is prohibited against retaliation according to section
144G.72.
new text end

Sec. 2.

new text begin [144G.71] RESIDENT AND FAMILY OR RESIDENT REPRESENTATIVE
COUNCILS.
new text end

new text begin (a) If a resident, family, or designated representative chooses to establish a council, the
licensee shall support the council's establishment. The facility must provide assistance and
space for meetings and afford privacy. Staff or visitors may attend meetings only upon the
council's invitation. A staff person must be designated the responsibility of providing this
assistance and responding to written requests that result from council meetings. Resident
council minutes are public data and shall be available to all residents in the facility. Family
or resident representatives may attend resident councils upon invitation by a resident on the
council.
new text end

new text begin (b) All assisted living facilities shall engage their residents and families or designated
representatives in the operation of their community and document the methods and results
of this engagement.
new text end

Sec. 3.

new text begin [144G.713] RESIDENT GRIEVANCES.
new text end

new text begin 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 Minnesota Adult Abuse Reporting Center, the common entry
point, and the state and applicable regional Office of Ombudsman for Long-Term Care.
new text end

Sec. 4.

new text begin [144G.716] CONSUMER ADVOCACY AND LEGAL SERVICES.
new text end

new text begin A facility shall ensure that every resident has access to consumer advocacy or legal
services by:
new text end

new text begin (1) providing names and contact information, including telephone numbers and e-mail
addresses of at least three individuals or organizations that provide advocacy or legal services
to residents;
new text end

new text begin (2) providing the name and contact information for the Minnesota Office of Ombudsman
for Long-Term Care, including both the state and regional contact information;
new text end

new text begin (3) assisting residents in obtaining information on whether Medicare or medical assistance
will pay for services;
new text end

new text begin (4) making reasonable accommodations for people who have communication disabilities
and those who speak a language other than English; and
new text end

new text begin (5) providing all information and notices in plain language and in terms the residents
can understand.
new text end

Sec. 5.

new text begin [144G.72] RETALIATION PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Retaliation prohibited. new text end

new text begin A facility or agent of the facility may not retaliate
against a resident or employee if the resident, employee, or any person on behalf of the
resident:
new text end

new text begin (1) files a complaint or grievance, makes an inquiry, or asserts any right;
new text end

new text begin (2) indicates an intention to file a complaint or grievance, make an inquiry, or assert any
right;
new text end

new text begin (3) files or indicates an intention to file a maltreatment report, whether mandatory or
voluntary, under section 626.557;
new text end

new text begin (4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
problems or concerns to the administrator or manager of the facility, the long-term care
ombudsman, a regulatory or other government agency, or a legal or advocacy organization;
new text end

new text begin (5) advocates or seeks advocacy assistance for necessary or improved care or services
or enforcement of rights under this section or other law;
new text end

new text begin (6) takes or indicates an intention to take civil action;
new text end

new text begin (7) participates or indicates an intention to participate in any investigation or
administrative or judicial proceeding; or
new text end

new text begin (8) contracts or indicates an intention to contract to receive services from a service
provider of the resident's choice other than the facility.
new text end

new text begin Subd. 2. new text end

new text begin Retaliation against a resident. new text end

new text begin For purposes of this section, to retaliate against
a resident includes but is not limited to any of the following actions taken or threatened by
a facility or an agent of the facility against a resident, or any person with a familial, personal,
legal, or professional relationship with the resident:
new text end

new text begin (1) the discharge, eviction, transfer, or termination of services;
new text end

new text begin (2) the imposition of discipline, punishment, or a sanction or penalty;
new text end

new text begin (3) any form of discrimination;
new text end

new text begin (4) restriction or prohibition of access:
new text end

new text begin (i) of the resident to the facility or visitors; or
new text end

new text begin (ii) to the resident of a family member or a person with a personal, legal, or professional
relationship with the resident;
new text end

new text begin (5) the imposition of involuntary seclusion or withholding food, care, or services;
new text end

new text begin (6) restriction of any of the rights granted to residents under state or federal law;
new text end

new text begin (7) restriction or reduction of access to or use of amenities, care, services, privileges, or
living arrangements;
new text end

new text begin (8) an arbitrary increase in charges or fees;
new text end

new text begin (9) removing, tampering with, or deprivation of technology, communication, or electronic
monitoring devices; or
new text end

new text begin (10) any oral or written communication of false information about a person advocating
on behalf of the resident.
new text end

new text begin Subd. 3. new text end

new text begin Retaliation against an employee. new text end

new text begin For purposes of this section, to retaliate
against an employee includes but is not limited to any of the following actions taken or
threatened by the assisted living facility or an agent of the facility against an employee:
new text end

new text begin (1) discharge or transfer;
new text end

new text begin (2) demotion or refusal to promote;
new text end

new text begin (3) reduction in compensation, benefits, or privileges;
new text end

new text begin (4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
new text end

new text begin (5) any form of discrimination.
new text end

new text begin Subd. 4. new text end

new text begin Rebuttable presumptions of retaliation. new text end

new text begin There is a rebuttable presumption
that any action described in subdivision 2 or 3 and taken within 90 days of an initial action
described in subdivision 1 is retaliatory. This presumption does not apply to a discharge,
eviction, transfer, or termination of services provided the facility complied with the applicable
requirements in section 144G.47 and allowed the resident and a designated representative
to exercise any rights in section 144G.48 for the discharge, eviction, transfer, or termination
of services. This presumption does not apply to actions described in subdivision 2, clause
(4), if a good faith report of maltreatment pursuant to section 626.557 is made by the facility
or agent of the facility against the visitor, family member, or other person with a personal,
legal, or professional relationship that is subject to the restrictions or prohibitions. This
presumption does not apply to any oral or written communication described in subdivision
2, clause (10), that is associated with a good faith report of maltreatment pursuant to section
626.557 made by the facility or agent of the facility against the person advocating on behalf
of the resident.
new text end

new text begin Subd. 5. new text end

new text begin Rights under the vulnerable adults act. new text end

new text begin Nothing in this section affects rights
available under section 626.557.
new text end

Sec. 6.

new text begin [144G.73] DECEPTIVE MARKETING AND BUSINESS PRACTICES
PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Deceptive marketing and business practices by facilities are
prohibited. new text end

new text begin No employee or agent of any facility may:
new text end

new text begin (1) make any false, fraudulent, deceptive, or misleading statements or representations
or material omissions in marketing, advertising, or any other description or representation
of care or services;
new text end

new text begin (2) fail to inform a resident in writing of any limitations to care services available prior
to executing a contract or service agreement; or
new text end

new text begin (3) advertise as having a Tier Three assisted living license until the applicant has obtained
a Tier Three assisted living license from the commissioner. A prospective applicant seeking
a Tier Three assisted living license may advertise that the applicant has submitted an
application for a license to the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Penalty. new text end

new text begin After August 1, 2021, it shall be a criminal gross misdemeanor to
open, operate, maintain, advertise, or hold oneself out as either a basic care facility or an
assisted living facility without the appropriate license. Failure to comply may result in a
civil penalty as outlined in section 609.0341, subdivision 1.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 7.

new text begin [144G.74] DISCRIMINATION BASED ON SOURCE OF PAYMENT
PROHIBITED.
new text end

new text begin All facilities must, regardless of the source of payment and for all persons seeking to
reside or residing in the facility:
new text end

new text begin (1) provide equal access to quality care; and
new text end

new text begin (2) establish, maintain, and implement identical policies and practices regarding residency,
transfer, and provision and termination of services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 8.

new text begin [144G.75] USE OF RESTRAINTS PROHIBITED.
new text end

new text begin Residents of assisted living facilities must be free from any physical or chemical restraints
imposed for purposes of discipline or convenience.
new text end

Sec. 9.

new text begin [144G.76] BASIC CARE FACILITY AND ASSISTED LIVING FACILITY
BILL OF RIGHTS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin All basic care facilities and assisted living facilities licensed
under this chapter must comply with this section and the commissioner shall enforce this
section against all facilities. A resident has these rights and no facility may require or request
a resident to waive any of the rights listed in this section at any time or for any reason,
including as a condition of initiating services or entering into a basic care facility and assisted
living facility contract.
new text end

new text begin Subd. 2. new text end

new text begin Legislative intent. new text end

new text begin It is the intent of the legislature to promote the interests and
well-being of residents. It is the intent of this section that every resident's civil and religious
liberties, including the right to independent personal decisions and knowledge of available
choices, shall not be infringed and that the facility must encourage and assist in the fullest
possible exercise of these rights. The rights established under this section for the benefit of
residents do not limit the rights residents have under other applicable law.
new text end

new text begin Subd. 3. new text end

new text begin Right to information about rights. new text end

new text begin (a) Before receiving services, residents
have the right to receive from the facility written information about rights under this section
in plain language and in terms residents can understand. The provider must make reasonable
accommodations for residents who have communication disabilities and those who speak
a language other than English. The information must include:
new text end

new text begin (1) what recourse residents have if their rights are violated;
new text end

new text begin (2) the name, address, telephone number, and e-mail contact information of organizations
that provide advocacy and legal services for residents to enforce their rights, including but
not limited to the designated protection and advocacy organization in Minnesota that provides
advice and representation to individuals with disabilities; and
new text end

new text begin (3) the name, address, telephone number, and e-mail contact information for government
agencies where the resident or private client may file a maltreatment report, complain, or
seek assistance, including the Office of Health Facility Complaints, the Minnesota Adult
Abuse Reporting Center (MAARC), the long-term care ombudsman, and state and county
agencies that regulate basic care facilities and assisted living facilities.
new text end

new text begin (b) Upon request, residents and their designated and resident representatives have the
right to current facility policies, inspection findings of state and local health authorities, and
further explanation of the rights provided under this section, consistent with chapter 13 and
section 626.557.
new text end

new text begin Subd. 4. new text end

new text begin Right to courteous treatment. new text end

new text begin Residents have the right to be treated with
courtesy and respect, and to have the resident's property treated with respect.
new text end

new text begin Subd. 5. new text end

new text begin Right to appropriate care and services. new text end

new text begin (a) Residents have the right to receive
care and services that are according to a suitable and up-to-date plan, and subject to accepted
health care, medical or nursing standards, and person-centered care to take an active part
in developing, modifying, and evaluating the plan and services. All plans for care and
services must be designed to enable residents to achieve their highest level of emotional,
psychological, physical, medical, and functional well-being and safety.
new text end

new text begin (b) Residents have the right to receive medical and personal care and services with
continuity by people who are properly trained and competent to perform their duties and in
sufficient numbers to adequately provide the services agreed to in the assisted living facility
or basic care facility contract, whichever is applicable.
new text end

new text begin Subd. 6. new text end

new text begin Right to information about individuals providing services. new text end

new text begin Residents have
the right to be told before receiving services the type and disciplines of staff who will be
providing the services, the frequency of visits proposed to be furnished, and other choices
that are available for addressing the resident's needs.
new text end

new text begin Subd. 7. new text end

new text begin Freedom from maltreatment. new text end

new text begin Residents have the right to be free from
maltreatment.
new text end

new text begin Subd. 8. new text end

new text begin Right to participate in care and service agreement; notice of
change. new text end

new text begin Residents have the right to actively participate in the planning, modification, and
evaluation of their care and services. This right includes:
new text end

new text begin (1) the opportunity to discuss care, services, treatment, and alternatives with the
appropriate caregivers;
new text end

new text begin (2) the opportunity to request and participate in formal care conferences;
new text end

new text begin (3) the right to include a family member or the resident's designated representative, or
both; and
new text end

new text begin (4) the right to be told in advance of, and take an active part in decisions regarding, any
recommended changes in the plan for care and services.
new text end

new text begin Subd. 9. new text end

new text begin Right to disclosure of contract services and right to purchase outside
services. new text end

new text begin (a) Residents have the right to be informed, prior to receiving care or services
from a facility, of:
new text end

new text begin (1) care and services that are included under the terms of the contract;
new text end

new text begin (2) information about care and other public services or private services that may be
available in the community at additional charges; and
new text end

new text begin (3) any limits to the services available from the facility.
new text end

new text begin (b) If the assisted living facility or basic care facility contract permits changes in services,
residents have the right to reasonable advance notice of any change.
new text end

new text begin (c) Residents have the right to purchase or rent goods or services not included in the
contract rate from a supplier of their choice unless otherwise provided by law. The supplier
must ensure that these purchases are sufficient to meet the medical or treatment needs of
the residents.
new text end

new text begin (d) Residents have the right to change services after services have begun, within the
limits of health insurance, long-term care insurance, medical assistance under chapter 256B,
and other health programs.
new text end

new text begin (e) Facilities must make every effort to assist residents in obtaining information regarding
whether the Medicare, medical assistance under chapter 256B, or other public program will
pay for any or all of the services.
new text end

new text begin Subd. 10. new text end

new text begin Right to information about charges. new text end

new text begin (a) Before services are initiated, residents
have the right to be notified:
new text end

new text begin (1) of charges for the services;
new text end

new text begin (2) as to what extent payment may be expected from health insurance, public programs,
or other sources, if known; and
new text end

new text begin (3) what charges the resident may be responsible for paying.
new text end

new text begin (b) If a contract permits changes in charges, residents have the right to reasonable advance
notice of any change.
new text end

new text begin Subd. 11. new text end

new text begin Right to information about health care treatment. new text end

new text begin Where applicable,
residents have the right to be given by their physicians complete and current information
concerning their diagnosis, cognitive functioning level, treatment, alternatives, risks, and
prognosis as required by the physician's legal duty to disclose. This information must be in
terms and language the residents can reasonably be expected to understand. This information
shall include the likely medical or major psychological results of the treatment and its
alternatives. Residents receiving services may be accompanied by a family member or other
designated representative, or both.
new text end

new text begin Subd. 12. new text end

new text begin Right to refuse services or care. new text end

new text begin (a) Residents have the right to refuse services
or care.
new text end

new text begin (b) The facility must document in the resident's record that the facility informed residents
who refuse care, services, treatment, medication, or dietary restrictions of the likely medical,
health-related, or psychological consequences of the refusal.
new text end

new text begin (c) In cases where a resident is incapable of understanding the circumstances but has
not been adjudicated incompetent, or when legal requirements limit the right to refuse
medical treatment, the conditions and circumstances must be fully documented by the
attending physician in the resident's record.
new text end

new text begin Subd. 13. new text end

new text begin Right to personal, treatment, and communication policy. new text end

new text begin (a) Residents
have the right to:
new text end

new text begin (1) every 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 where doing so is contrary to the resident's person-centered care plan;
new text end

new text begin (2) respectfulness and privacy as they relate to the resident's medical and personal care
program. 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;
new text end

new text begin (3) communicate privately with persons of their choice;
new text end

new text begin (4) enter and, unless residing in a secured assisted living facility and restrictions on the
ability to leave are indicated in the resident's person-centered care plan, leave the facility
as they choose;
new text end

new text begin (5) private communication with a representative of a protection and advocacy services
agency; and
new text end

new text begin (6) access Internet service at their expense, unless offered by the facility.
new text end

new text begin (b) Personal mail must be sent by the facility without interference and received unopened
unless medically or programmatically contraindicated and documented by the physician or
advanced practice registered nurse in the resident's record. Residents must be provided
access to a telephone to make and receive calls as well as speak privately. Facilities that are
unable to provide a private area must make reasonable arrangements to accommodate the
privacy of residents' calls.
new text end

new text begin Subd. 14. new text end

new text begin Right to confidentiality of records. new text end

new text begin Residents have the right to have personal,
financial, and medical information kept private, to approve or refuse release of information
to any outside party, and to be advised of the facility's policies and procedures regarding
disclosure of the information. Residents must be notified when personal records are requested
by any outside party.
new text end

new text begin Subd. 15. new text end

new text begin Right to visitors and social participation. new text end

new text begin (a) Residents have the right of
reasonable access at reasonable times, or any time when the resident's welfare is in immediate
jeopardy, to any available rights protection services and advocacy services.
new text end

new text begin (b) Residents have the right to meet with or receive visits at any time by the resident's
guardian, conservator, health care agent, family, attorney, advocate, religious or social work
counselor, or any person of the resident's choosing.
new text end

new text begin (c) Residents have the right to participate in commercial, religious, social, community,
and political activities without interference and at their discretion if the activities do not
infringe on the right to privacy of other residents.
new text end

new text begin Subd. 16. new text end

new text begin Right to designate representative. new text end

new text begin Residents have the right to name a
designated representative. Before or at the time of execution of an assisted living facility
or basic care facility contract, the facility must offer the resident the opportunity to identify
a designated representative in writing in the contract. Residents have the right at any time
at or after they enter into an assisted living contract to name a designated representative.
new text end

new text begin Subd. 17. new text end

new text begin Right to form family and advisory councils. new text end

new text begin Residents and their families
have the right to organize, maintain, and participate in resident family and advisory councils.
Facilities must provide assistance and space for meetings and afford privacy. Staff or visitors
may attend only upon the council's invitation. A staff person must be designated the
responsibility of providing this assistance and responding to written requests that result
from council meetings. Resident and family councils must be encouraged to make
recommendations regarding facility policies.
new text end

new text begin Subd. 18. new text end

new text begin Right to complain. new text end

new text begin Residents have the right to:
new text end

new text begin (1) complain or inquire about either care or services that are provided or not provided;
new text end

new text begin (2) complain about the lack of courtesy or respect to the resident or the resident's property;
new text end

new text begin (3) know how to contact the agent of the facility who is responsible for handling
complaints and inquiries;
new text end

new text begin (4) have the facility conduct an investigation, attempt to resolve, and provide a timely
response to the complaint or inquiry;
new text end

new text begin (5) recommend changes in policies and services to staff and others of their choice; and
new text end

new text begin (6) complain about any violation of the resident's rights.
new text end

new text begin Subd. 19. new text end

new text begin Right to assert rights. new text end

new text begin Residents, their designated representatives, or any
person or persons on behalf of the resident have the right to assert the rights granted to
residents under this section or any other section.
new text end

new text begin Subd. 20. new text end

new text begin Right to choose service provider. new text end

new text begin Residents are free to choose who provides
the services they receive and where they receive those services. Residents shall not be
coerced or forced to obtain services in a particular setting and may instead choose to go out
into the community for the same services within the limits of health insurance, long-term
care insurance, medical assistance, or other health programs or public programs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 10.

new text begin [144G.77] PROTECTION-RELATED RIGHTS.
new text end

new text begin (a) In addition to the rights required in the basic care and assisted living bill of rights
under section 144G.76, the following rights must be provided to all residents. The facility
must promote and protect these rights for each resident by making residents aware of these
rights and ensuring staff are trained to support these rights:
new text end

new text begin (1) the right to furnish and decorate the resident's unit within the terms of the lease;
new text end

new text begin (2) the right to access food at any time;
new text end

new text begin (3) the right to choose visitors and the times of visits;
new text end

new text begin (4) the right to choose a roommate if sharing a unit;
new text end

new text begin (5) the right to personal privacy including the right to have and use a lockable door on
the resident's unit. The facility shall provide the locks on the resident's unit. Only a staff
member with a specific need to enter the unit shall have keys, and advance notice must be
given to the resident before entrance, when possible;
new text end

new text begin (6) the right to engage in chosen activities;
new text end

new text begin (7) the right to engage in community life;
new text end

new text begin (8) the right to control personal resources; and
new text end

new text begin (9) the right to individual autonomy, initiative, and independence in making life choices
including a daily schedule and with whom to interact.
new text end

new text begin (b) The resident's rights in paragraph (a), clauses (2), (3), and (5), may be restricted for
an individual resident only if determined necessary for health and safety reasons identified
by the facility through an initial assessment or reassessment, as defined under section
144G.63 and documented in the written service agreement under section 144G.64. Any
restrictions of those rights for people served under sections 256B.0915 and 256B.49 must
be documented by the case manager in the resident's coordinated service and support plan
(CSSP), as defined in sections 256B.0915, subdivision 6, and 256B.49, subdivision 15.
new text end

Sec. 11.

new text begin [144G.78] REQUEST FOR DISCONTINUATION OF LIFE-SUSTAINING
TREATMENT.
new text end

new text begin (a) If a resident, family member, or other caregiver of the resident requests that an
employee or other agent of the facility discontinue a life-sustaining treatment, the employee
or agent receiving the request:
new text end

new text begin (1) shall take no action to discontinue the treatment; and
new text end

new text begin (2) shall promptly inform the supervisor or other agent of the facility of the resident's
request.
new text end

new text begin (b) Upon being informed of a request for termination of treatment, the facility shall
promptly:
new text end

new text begin (1) inform the resident that the request will be made known to the physician or advanced
practice registered nurse who ordered the resident's treatment;
new text end

new text begin (2) inform the physician or advanced practice registered nurse of the resident's request;
and
new text end

new text begin (3) work with the resident and the resident's physician or advanced practice registered
nurse to comply with the provisions of the Health Care Directive Act in chapter 145C.
new text end

new text begin (c) This section does not require the facility to discontinue treatment, except as may be
required by law or court order.
new text end

new text begin (d) This section does not diminish the rights of residents to control their treatments,
refuse services, or terminate their relationships with the facility.
new text end

new text begin (e) This section shall be construed in a manner consistent with chapter 145B or 145C,
whichever applies, and declarations made by residents under those chapters.
new text end

Sec. 12.

new text begin [144G.79] FORCED ARBITRATION; WAIVER OF RIGHTS.
new text end

new text begin Subdivision 1. new text end

new text begin Forced arbitration. new text end

new text begin A facility must affirmatively disclose to the resident
any forced arbitration provisions in any basic care facility or assisted living facility contract
that precludes, limits, or delays the ability of a resident to begin a civil action. For contracts
entered into on or after July 1, 2020, forced arbitration provisions must be conspicuously
disclosed in a contract.
new text end

new text begin Subd. 2. new text end

new text begin Waiver of rights is void. new text end

new text begin Any waiver by the resident of the rights in this chapter
is void.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

ARTICLE 8

PHYSICAL PLANT REQUIREMENTS

Section 1.

new text begin [144G.80] MINIMUM SITE, PHYSICAL ENVIRONMENT AND FIRE
SAFETY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Requirements. new text end

new text begin (a) Effective August 1, 2021, the following are required
for all basic care facilities and assisted living facilities:
new text end

new text begin (1) public utilities must be available, and working or inspected and approved water and
septic systems are in place;
new text end

new text begin (2) the location is publicly accessible to fire department services and emergency medical
services;
new text end

new text begin (3) the location's topography provides sufficient natural drainage and is not subject to
flooding;
new text end

new text begin (4) all-weather roads and walks must be provided within the lot lines to the primary
entrance and the service entrance, including employees' and visitors' parking at the site; and
new text end

new text begin (5) the location must include space for outdoor activities for residents.
new text end

new text begin (b) A Tier Three assisted living facility must also meet the following requirements:
new text end

new text begin (1) a hazard vulnerability assessment or safety risk assessment shall be performed on
and around the property. The hazards indicated on the assessment must be assessed and
mitigated to protect the residents from harm; and
new text end

new text begin (2) the facility shall be protected throughout by an approved supervised automatic
sprinkler system by August 1, 2029.
new text end

new text begin Subd. 2. new text end

new text begin Fire protection and physical environment. new text end

new text begin (a) Effective December 31, 2029,
each basic care facility and assisted living facility must have a comprehensive fire protection
system that includes:
new text end

new text begin (1) protection throughout by an approved supervised automatic sprinkler system according
to building code requirements established in Minnesota Rules, part 1305.0903, or smoke
detectors in each occupied room installed and maintained in accordance with the National
Fire Protection Association (NFPA) Standard 72;
new text end

new text begin (2) portable fire extinguishers installed and tested in accordance with the NFPA Standard
10;
new text end

new text begin (3) beginning August 1, 2021, fire drills shall be conducted in accordance with the
residential board and care requirements in the Life Safety Code; and
new text end

new text begin (4) the physical environment, including walls, floors, ceiling, all furnishings, grounds,
systems, and equipment must be kept in a continuous state of good repair and operation
with regard to the health, safety, comfort, and well-being of the residents in accordance
with a maintenance and repair program.
new text end

new text begin Subd. 3. new text end

new text begin Local laws apply. new text end

new text begin Basic care facilities and assisted living facilities shall be in
compliance with all applicable state and local governing laws, regulations, standards,
ordinances, and codes for fire safety, building, and zoning requirements.
new text end

new text begin Subd. 4. new text end

new text begin Basic care facilities and assisted living facilities; design. new text end

new text begin (a) After July 31,
2021, all basic care facilities and assisted living facilities with six or more residents must
meet the provisions relevant to assisted living facilities of the most current edition of the
Facility Guidelines Institute "Guidelines for Design and Construction of Residential Health,
Care and Support Facilities" and of adopted rules. This minimum design standard shall be
met for all new licenses, new construction, modifications, renovations, alterations, change
of use, or additions. In addition to the guidelines, assisted living facilities shall provide the
option of a bath in addition to a shower for all residents.
new text end

new text begin (b) The commissioner shall establish an implementation timeline for mandatory usage
of the latest published guidelines. However, the commissioner shall not enforce the latest
published guidelines before six months after the date of publication.
new text end

new text begin Subd. 5. new text end

new text begin Basic care facilities and assisted living facilities; life safety code. new text end

new text begin (a) After
July 31, 2021, all basic care facilities and Tier Two assisted living facilities with six or more
residents shall meet the applicable provisions of the most current edition of the NFPA
Standard 101, Life Safety Code, Residential Board and Care Occupancies chapter. This
minimum design standard shall be met for all new licenses, new construction, modifications,
renovations, alterations, change of use, or additions.
new text end

new text begin (b) The commissioner shall establish an implementation timeline for mandatory usage
of the latest published Life Safety Code. However, the commissioner shall not enforce the
latest published guidelines before six months after the date of publication.
new text end

new text begin Subd. 6. new text end

new text begin Tier Three assisted living facilities; life safety code. new text end

new text begin (a) After July 31, 2021,
all Tier Three assisted living facilities shall meet the applicable provisions of the most
current edition of the NFPA Standard 101, Life Safety Code, Healthcare (limited care)
chapter. This minimum design standard shall be met for all new licenses, new construction,
modifications, renovations, alterations, change of use or additions.
new text end

new text begin (b) The commissioner shall establish an implementation timeline for mandatory usage
of the newest-published Life Safety Code. However, the commissioner shall not enforce
the newly-published guidelines before 6 months after the date of publication.
new text end

new text begin Subd. 7. new text end

new text begin New construction; plans. new text end

new text begin (a) For all new licensure and construction beginning
August 1, 2021, the following must be provided to the commissioner:
new text end

new text begin (1) architectural and engineering plans and specifications for new construction must be
prepared and signed by architects and engineers who are registered in Minnesota. Final
working drawings and specifications for proposed construction must be submitted to the
commissioner for review and approval;
new text end

new text begin (2) final architectural plans and specifications must include elevations and sections
through the building showing types of construction, and must indicate dimensions and
assignments of rooms and areas, room finishes, door types and hardware, elevations and
details of nurses' work areas, utility rooms, toilet and bathing areas, and large-scale layouts
of dietary and laundry areas. Plans must show the location of fixed equipment and sections
and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions
must be indicated. The roof plan must show all mechanical installations. The site plan must
indicate the proposed and existing buildings, topography, roadways, walks and utility service
lines;
new text end

new text begin (3) final mechanical and electrical plans and specifications must address the complete
layout and type of all installations, systems, and equipment to be provided. Heating plans
must include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers,
boilers, breeching and accessories. Ventilation plans must include room air quantities, ducts,
fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing plans
must include the fixtures and equipment fixture schedule; water supply and circulating
piping, pumps, tanks, riser diagrams, and building drains; the size, location, and elevation
of water and sewer services; and the building fire protection systems. Electrical plans must
include fixtures and equipment, receptacles, switches, power outlets, circuits, power and
light panels, transformers, and service feeders. Plans must show location of nurse call signals,
cable lines, fire alarm stations, and fire detectors and emergency lighting.
new text end

new text begin (b) Unless construction is begun within one year after approval of the final working
drawing and specifications, the drawings must be resubmitted for review and approval.
new text end

new text begin (c) The commissioner must be notified within 30 days before completion of construction
so that the commissioner can make arrangements for a final inspection by the commissioner.
new text end

new text begin (d) At least one set of complete life safety plans, including changes resulting from
remodeling or alterations, must be kept on file in the facility.
new text end

new text begin Subd. 8. new text end

new text begin Variances or waivers. new text end

new text begin (a) A facility may request that the commissioner grant
a variance or waiver from the provisions of this section. A request for a waiver must be
submitted to the commissioner in writing. Each request must contain:
new text end

new text begin (1) the specific requirement for which the variance or waiver is requested;
new text end

new text begin (2) the reasons for the request;
new text end

new text begin (3) the alternative measures that will be taken if a variance or waiver is granted;
new text end

new text begin (4) the length of time for which the variance or waiver is requested; and
new text end

new text begin (5) other relevant information deemed necessary by the commissioner to properly evaluate
the request for the waiver.
new text end

new text begin (b) The decision to grant or deny a variance or waiver must be based on the
commissioner's evaluation of the following criteria:
new text end

new text begin (1) whether the waiver will adversely affect the health, treatment, comfort, safety, or
well-being of a patient;
new text end

new text begin (2) whether the alternative measures to be taken, if any, are equivalent to or superior to
those prescribed in this section; and
new text end

new text begin (3) whether compliance with the requirements would impose an undue burden on the
applicant.
new text end

new text begin (c) The commissioner must notify the applicant in writing of the decision. If a variance
or waiver is granted, the notification must specify the period of time for which the variance
or waiver is effective and the alternative measures or conditions, if any, to be met by the
applicant.
new text end

new text begin (d) Alternative measures or conditions attached to a variance or waiver have the force
and effect of this chapter and are subject to the issuance of correction orders and fines in
accordance with sections 144G.34, subdivision 5, and 144G.35, subdivision 3. The amount
of fines for a violation of this section is that specified for the specific requirement for which
the variance or waiver was requested.
new text end

new text begin (e) A request for the renewal of a variance or waiver must be submitted in writing at
least 45 days before its expiration date. Renewal requests must contain the information
specified in paragraph (a). A variance or waiver must be renewed by the department if the
applicant continues to satisfy the criteria in paragraph (a) and demonstrates compliance
with the alternative measures or conditions imposed at the time the original variance or
waiver was granted.
new text end

new text begin (f) The department must deny, revoke, or refuse to renew a variance or waiver if it is
determined that the criteria in paragraph (a) are not met. The applicant must be notified in
writing of the reasons for the decision and informed of the right to appeal the decision.
new text end

new text begin (g) An applicant may contest the denial, revocation, or refusal to renew a variance or
waiver by requesting a contested case hearing under chapter 14. The applicant must submit,
within 15 days of the receipt of the department's decision, a written request for a hearing.
The request for hearing must set forth in detail the reasons why the applicant contends the
decision of the department should be reversed or modified. At the hearing, the applicant
has the burden of proving that the applicant satisfied the criteria specified in paragraph (b),
except in a proceeding challenging the revocation of a variance or waiver.
new text end

ARTICLE 9

TIER THREE ASSISTED LIVING LICENSURE

Section 1.

new text begin [144G.85] ADDITIONAL REQUIREMENTS FOR TIER THREE
ASSISTED LIVING LICENSURE.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin This section applies only to Tier Three assisted living
facilities.
new text end

new text begin Subd. 2. new text end

new text begin Demonstrated capacity. new text end

new text begin (a) The applicant 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:
new text end

new text begin (1) the experience of the applicant in managing residents with dementia or previous
long-term care experience; and
new text end

new text begin (2) the compliance history of the applicant in the operation of any care facility licensed,
certified, or registered under federal or state law.
new text end

new text begin (b) If the applicant does not have experience in managing residents with dementia, the
applicant must employ a consultant or management company for at least the first year of
operation. The consultant or management company must have experience in dementia care
operations and must be approved by the commissioner. The applicant must implement the
recommendations of the consultant or management company or present an acceptable plan
to the commissioner to address the consultant's identified concerns.
new text end

new text begin (c) The commissioner shall conduct an on-site inspection prior to the issuance of a Tier
Three assisted living facility license to ensure compliance with the physical environment
requirements.
new text end

new text begin (d) The label "Tier Three Assisted Living Facility" must be identified on the license.
new text end

new text begin Subd. 3. new text end

new text begin Relinquishing license. new text end

new text begin The licensee must notify the commissioner in writing
at least 60 days prior to the voluntary relinquishment of a Tier Three assisted living facility
license. For voluntary relinquishment, the facility must:
new text end

new text begin (1) give all residents and their designated representatives 45 days' notice. The notice
must include:
new text end

new text begin (i) the proposed effective date of the relinquishment;
new text end

new text begin (ii) changes in staffing;
new text end

new text begin (iii) changes in services including the elimination or addition of services; and
new text end

new text begin (iv) staff training that shall occur when the relinquishment becomes effective;
new text end

new text begin (2) submit a transitional plan to the commissioner demonstrating how the current residents
shall be evaluated and assessed to reside in other housing settings that are not a Tier Three
assisted living facility, that are physically unsecured, or that would require move-out or
transfer to other settings;
new text end

new text begin (3) change service or care plans as appropriate to address any needs the residents may
have with the transition;
new text end

new text begin (4) notify the commissioner when the relinquishment process has been completed; and
new text end

new text begin (5) revise advertising materials and disclosure information to remove any reference that
the facility is a Tier Three assisted living facility
new text end

Sec. 2.

new text begin [144G.86] RESPONSIBILITIES OF ADMINISTRATION FOR
COMPREHENSIVE PLUS LICENSEES.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin The licensee of a Tier Three assisted living facility is responsible
for the care and housing of the persons with dementia and the provision of person-centered
care that promotes each resident's dignity, independence, and comfort. This includes the
supervision, training, and overall conduct of the staff.
new text end

new text begin Subd. 2. new text end

new text begin Additional requirements. new text end

new text begin (a) The Tier Three licensee must follow the assisted
living license requirements and the criteria in this section.
new text end

new text begin (b) The administrator of a facility with a Tier Three assisted living facility license must
complete and document that at least ten hours of the required annual continuing educational
requirements relate to the care of individuals with dementia. Continuing education credits
must be obtained through commissioner-approved sources that may include college courses,
preceptor credits, self-directed activities, course instructor credits, corporate training,
in-service training, professional association training, web-based training, correspondence
courses, telecourses, seminars, and workshops.
new text end

new text begin Subd. 3. new text end

new text begin Policies. new text end

new text begin In addition to the policies and procedures required in the licensing of
assisted living facilities, the Tier Three assisted living facility licensee must develop and
implement policies and procedures that address the:
new text end

new text begin (1) philosophy of how services are provided based upon the assisted living licensee's
values, mission, and promotion of person-centered care and how the philosophy shall be
implemented;
new text end

new text begin (2) evaluation of behavioral symptoms and design of supports for intervention plans;
new text end

new text begin (3) wandering and egress prevention that provides detailed instructions to staff in the
event a resident elopes;
new text end

new text begin (4) assessment of residents for the use and effects of medications, including psychotropic
medications;
new text end

new text begin (5) use of supportive devices with restraining qualities;
new text end

new text begin (6) staffing plan to ensure that residents' needs are met including a quality control system
that periodically reviews how well the staffing plan is working;
new text end

new text begin (7) staff training specific to dementia care;
new text end

new text begin (8) description of life enrichment programs and how activities are implemented;
new text end

new text begin (9) description of family support programs and efforts to keep the family engaged;
new text end

new text begin (10) limiting the use of public address and intercom systems for emergencies and
evacuation drills only;
new text end

new text begin (11) transportation coordination and assistance to and from outside medical appointments;
and
new text end

new text begin (12) safekeeping of resident's possessions.
new text end

new text begin The policies and procedures must be provided to residents and the resident's representative
at the time of move-in.
new text end

Sec. 3.

new text begin [144G.87] STAFFING AND STAFF TRAINING.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin (a) A Tier Three assisted living facility must provide residents
with dementia-trained staff who have been instructed in the person-centered care approach.
All direct care and other community staff assigned to care for dementia residents must be
specially trained to work with residents with Alzheimer's disease and other dementias.
new text end

new text begin (b) Only staff trained as specified in subdivisions 2 and 3 shall be assigned to care for
dementia residents.
new text end

new text begin (c) Staffing levels must be sufficient to meet the scheduled and unscheduled needs of
residents. Staffing levels during nighttime hours shall be based on the sleep patterns and
needs of residents.
new text end

new text begin (d) In an emergency situation when trained staff are not available to provide services,
the facility may assign staff who have not completed the required training. The particular
emergency situation must be documented and must address:
new text end

new text begin (1) the nature of the emergency;
new text end

new text begin (2) how long the emergency lasted; and
new text end

new text begin (3) the names and positions of staff that provided coverage.
new text end

new text begin Subd. 2. new text end

new text begin Staffing requirements. new text end

new text begin (a) The licensee must ensure that staff who provide
support to residents with dementia have a basic understanding and fundamental knowledge
of the residents' emotional and unique health care needs using person-centered planning
delivery. Direct care dementia-trained staff and other staff must be trained on the topics
identified during the expedited rulemaking process. These requirements are in addition to
the licensing requirements for training.
new text end

new text begin (b) Failure to comply with paragraph (a) or subdivision 1 will result in a fine as defined
in section 144G.35, subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Supervising staff training. new text end

new text begin Persons providing or overseeing staff training must
have experience and knowledge in the care of individuals with dementia.
new text end

new text begin Subd. 4. new text end

new text begin Preservice and in-service training. new text end

new text begin Preservice and in-service training may
include various methods of instruction, such as classroom style, web-based training, video,
or one-to-one training. The licensee must have a method for determining and documenting
each staff person's knowledge and understanding of the training provided. All training must
be documented.
new text end

Sec. 4.

new text begin [144G.88] SERVICES FOR RESIDENTS WITH DEMENTIA.
new text end

new text begin Subdivision 1. new text end

new text begin Move-in assessment. new text end

new text begin (a) In addition to the minimum services required
of assisted living facilities, a Tier Three assisted living facility must also provide the
following services:
new text end

new text begin (1) assistance with activities of daily living that address the needs of each resident with
dementia due to cognitive or physical limitations. These services must meet or be in addition
to the requirements in the licensing rules for the facility. Services must be provided in a
person-centered manner that promotes resident choice, dignity, and sustains the resident's
abilities;
new text end

new text begin (2) health care services provided according to the licensing statutes and rules of the
facility;
new text end

new text begin (3) a daily meal program for nutrition and hydration must be provided and available
throughout each resident's waking hours. The individualized nutritional plan for each resident
must be documented in the resident's service or care plan. In addition, a Tier Three assisted
living facility must:
new text end

new text begin (i) provide visual contrast between plates, eating utensils, and the table to maximize the
independence of each resident; and
new text end

new text begin (ii) provide adaptive eating utensils for those residents who have been evaluated as
needing them to maintain their eating skills; and
new text end

new text begin (4) meaningful activities that promote or help sustain the physical and emotional
well-being of residents. The activities must be person-directed and available during residents'
waking hours.
new text end

new text begin (b) Each resident must be evaluated for activities according to the licensing rules of the
facility. In addition, the evaluation must address the following:
new text end

new text begin (1) past and current interests;
new text end

new text begin (2) current abilities and skills;
new text end

new text begin (3) emotional and social needs and patterns;
new text end

new text begin (4) physical abilities and limitations;
new text end

new text begin (5) adaptations necessary for the resident to participate; and
new text end

new text begin (6) identification of activities for behavioral interventions.
new text end

new text begin (c) An individualized activity plan must be developed for each resident based on their
activity evaluation. The plan must reflect the resident's activity preferences and needs.
new text end

new text begin (d) A selection of daily structured and non-structured activities must be provided and
included on the resident's activity service or care plan as appropriate. Daily activity options
based on resident evaluation may include but are not limited to:
new text end

new text begin (1) occupation or chore related tasks;
new text end

new text begin (2) scheduled and planned events such as entertainment or outings;
new text end

new text begin (3) spontaneous activities for enjoyment or those that may help defuse a behavior;
new text end

new text begin (4) one-to-one activities that encourage positive relationships between residents and
staff such as telling a life story, reminiscing, or playing music;
new text end

new text begin (5) spiritual, creative, and intellectual activities;
new text end

new text begin (6) sensory stimulation activities;
new text end

new text begin (7) physical activities that enhance or maintain a resident's ability to ambulate or move;
and
new text end

new text begin (8) outdoor activities.
new text end

new text begin (e) Behavioral symptoms that negatively impact the resident and others in the assisted
living facility must be evaluated and included on the service or care plan. The staff must
initiate and coordinate outside consultation or acute care when indicated.
new text end

new text begin (f) Support must be offered to family and other significant relationships on a regularly
scheduled basis but not less than quarterly. Examples in which support may be provided
include support groups, community gatherings, social events, or meetings that address the
needs of individual residents or their family or significant relationships.
new text end

new text begin (g) Access to secured outdoor space and walkways that allow residents to enter and
return without staff assistance must be provided.
new text end

Sec. 5.

new text begin [144G.991] RESIDENT QUALITY OF CARE AND OUTCOMES
IMPROVEMENT TASK FORCE.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner shall establish a resident quality of
care and outcomes improvement task force to examine and make recommendations, on an
ongoing basis, on how to apply proven safety and quality improvement practices and
infrastructure to settings and providers that provide long-term services and supports.
new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin The task force shall include representation from:
new text end

new text begin (1) nonprofit Minnesota-based organizations dedicated to patient safety or innovation
in health care safety and quality;
new text end

new text begin (2) Department of Health staff with expertise in issues related to safety and adverse
health events;
new text end

new text begin (3) consumer organizations;
new text end

new text begin (4) direct care providers or their representatives;
new text end

new text begin (5) organizations representing long-term care providers and home care providers in
Minnesota;
new text end

new text begin (6) national patient safety experts; and
new text end

new text begin (7) other experts in the safety and quality improvement field.
new text end

new text begin The task force shall have at least one public member who is or has been a resident in an
assisted living setting and one public member who has or had a family member living in
assisted living setting. The membership will be voluntary except that public members can
be reimbursed under the provisions of section 15.059, subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Recommendations. new text end

new text begin The task force shall periodically provide recommendations
to the commissioner and the legislature on changes needed to promote safety and quality
improvement practices in long-term care settings and with long-term care providers. The
task force shall meet no fewer than four times per year. The task force shall be established
by July 1, 2020.
new text end

Sec. 6. new text begin TRANSITION PERIOD.
new text end

new text begin (a) From July 1, 2019, to June 30, 2021, the commissioner shall engage in the rulemaking
process.
new text end

new text begin (b) From July 1, 2020, to July 31, 2021, the commissioner shall prepare for the new
basic care facility and assisted living facility licensure by hiring staff, developing forms,
and communicating with stakeholders about the new facility licensing.
new text end

new text begin (c) Effective August 1, 2021, all existing housing with services establishments providing
home care services under Minnesota Statutes, chapter 144A, must convert their registration
to licensure under Minnesota Statutes, chapter 144G.
new text end

new text begin (d) Effective August 1, 2021, all new basic care facilities and assisted living facilities
must be licensed by the commissioner.
new text end

new text begin (e) Effective August 1, 2021, all basic care facilities and assisted living facilities must
be licensed by the commissioner.
new text end

Sec. 7. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 144D.01; 144D.015; 144D.02; 144D.025; 144D.03;
144D.04; 144D.045; 144D.05; 144D.06; 144D.065; 144D.066; 144D.07; 144D.08; 144D.09;
144D.10; 144D.11; 144G.01; 144G.02; 144G.03; 144G.04; 144G.05; 144G.06; and 325F.72, new text end new text begin
are repealed effective August 1, 2021.
new text end

ARTICLE 10

BOARD OF EXECUTIVES FOR LONG TERM SERVICES AND SUPPORTS

Section 1.

Minnesota Statutes 2018, section 144A.04, subdivision 5, is amended to read:

Subd. 5.

Administrators.

deleted text begin (a)deleted text end Each nursing home must employ an administrator who
must be licensed or permitted as a nursing home administrator by the Board of deleted text begin Examiners
for Nursing Home Administratorsdeleted text end new text begin Executives for Long Term Services and Supportsnew text end . The
nursing home may share the services of a licensed administrator. The administrator must
maintain deleted text begin a sufficientdeleted text end new text begin annew text end on-site presence in the facility to effectively manage the facility in
compliance with applicable rules and regulations. The administrator must establish procedures
and delegate authority for on-site operations in the administrator's absence, but is ultimately
responsible for the management of the facility. Each nursing home must have posted at all
times the name of the administrator and the name of the person in charge on the premises
in the absence of the licensed administrator.

deleted text begin (b) Notwithstanding sections 144A.18 to 144A.27, a nursing home with a director of
nursing serving as an unlicensed nursing home administrator as of March 1, 2001, may
continue to have a director of nursing serve in that capacity, provided the director of nursing
has passed the state law and rules examination administered by the Board of Examiners for
Nursing Home Administrators and maintains evidence of completion of 20 hours of
continuing education each year on topics pertinent to nursing home administration.
deleted text end

Sec. 2.

Minnesota Statutes 2018, section 144A.20, subdivision 1, is amended to read:

Subdivision 1.

Criteria.

The Board of deleted text begin Examinersdeleted text end new text begin Executivesnew text end may issue licenses to
qualified persons as nursing home administrators, and shall establish qualification criteria
for nursing home administrators. No license shall be issued to a person as a nursing home
administrator unless that person:

(1) is at least 21 years of age deleted text begin and otherwise suitably qualifieddeleted text end ;

(2) has satisfactorily met standards set by the Board of deleted text begin Examinersdeleted text end new text begin Executivesnew text end , which
standards shall be designed to assure that nursing home administrators will be individuals
who, by training or experience are qualified to serve as nursing home administrators; and

(3) has passed an examination approved by the board and designed to test for competence
in the deleted text begin subject mattersdeleted text end new text begin standardsnew text end referred to in clause (2), or has been approved by the Board
of deleted text begin Examinersdeleted text end new text begin Executivesnew text end through the development and application of other appropriate
techniques.

Sec. 3.

Minnesota Statutes 2018, section 144A.24, is amended to read:

144A.24 DUTIES OF THE BOARD.

The Board of deleted text begin Examinersdeleted text end new text begin Executivesnew text end shall:

(1) develop and enforce standards for nursing home administrator licensing, which
standards shall be designed to assure that nursing home administrators will be individuals
of good character who, by training or experience, are suitably qualified to serve as nursing
home administrators;

(2) develop appropriate techniques, including examinations and investigations, for
determining whether applicants and licensees meet the board's standards;

(3) issue licenses and permits to those individuals who are found to meet the board's
standards;

(4) establish and implement procedures designed to assure that individuals licensed as
nursing home administrators will comply with the board's standards;

(5) receive and investigate complaints and take appropriate action consistent with chapter
214, to revoke or suspend the license or permit of a nursing home administrator or acting
administrator who fails to comply with sections 144A.18 to 144A.27 or the board's standards;

(6) conduct a continuing study and investigation of nursing homes, and the administrators
of nursing homes within the state, with a view to the improvement of the standards imposed
for the licensing of administrators and improvement of the procedures and methods used
for enforcement of the board's standards; and

(7) approve or conduct courses of instruction or training designed to prepare individuals
for licensing in accordance with the board's standards. deleted text begin Courses designed to meet license
renewal requirements shall be designed solely to improve professional skills and shall not
include classroom attendance requirements exceeding 50 hours per year.deleted text end The board may
approve courses conducted within or without this state.

Sec. 4.

Minnesota Statutes 2018, section 144A.26, is amended to read:

144A.26 RECIPROCITY WITH OTHER STATESnew text begin AND EQUIVALENCY OF
HEALTH SERVICES EXECUTIVEnew text end .

new text begin Subdivision 1. new text end

new text begin Reciprocity. new text end

The Board of Examiners may issue a nursing home
administrator's license, without examination, to any person who holds a current license as
a nursing home administrator from another jurisdiction if the board finds that the standards
for licensure in the other jurisdiction are at least the substantial equivalent of those prevailing
in this state and that the applicant is otherwise qualified.

new text begin Subd. 2. new text end

new text begin Health services executive license. new text end

new text begin The Board of Examiners may issue a health
services executive license to any person who (1) has been validated by the National
Association of Long Term Care Administrator Boards as a health services executive, and
(2) has met the education and practice requirements for the minimum qualifications of a
nursing home administrator, assisted living administrator, and home and community-based
service provider. Licensure decisions made by the board under this subdivision are final.
new text end

Sec. 5.

new text begin [144A.291] FEES.
new text end

new text begin Subdivision 1. new text end

new text begin Payment types and nonrefundability. new text end

new text begin The fees imposed in this section
shall be paid by cash, personal check, bank draft, cashier's check, or money order made
payable to the Board of Executives for Long Term Services and Supports. All fees are
nonrefundable.
new text end

new text begin Subd. 2. new text end

new text begin Amount. new text end

new text begin The amount of fees may be set by the Board of Executives with the
approval of Minnesota Management and Budget up to the limits provided in this section
depending upon the total amount required to sustain board operations under section
16A.1285, subdivision 2. Information about fees in effect at any time is available from the
board office. The maximum amounts of fees are:
new text end

new text begin (1) application for licensure, $150;
new text end

new text begin (2) for a prospective applicant for a review of education and experience advisory to the
license application, $50, to be applied to the fee for application for licensure if the latter is
submitted within one year of the request for review of education and experience;
new text end

new text begin (3) state examination, $75;
new text end

new text begin (4) licensed nursing home administrator initial license, $200 if issued between July 1
and December 31, $100 if issued between January 1 and June 30;
new text end

new text begin (5) acting administrator permit, $250;
new text end

new text begin (6) renewal license, $200;
new text end

new text begin (7) duplicate license, $10;
new text end

new text begin (8) fee to a sponsor for review of individual continuing education seminars, institutes,
workshops, or home study courses:
new text end

new text begin (i) for less than seven clock hours, $30; and
new text end

new text begin (ii) for seven or more clock hours, $50;
new text end

new text begin (9) fee to a licensee for review of continuing education seminars, institutes, workshops,
or home study courses not previously approved for a sponsor and submitted with an
application for license renewal:
new text end

new text begin (i) for less than seven clock hours total, $30; and
new text end

new text begin (ii) for seven or more clock hours total, $50;
new text end

new text begin (10) late renewal fee, $50;
new text end

new text begin (11) fee to a licensee for verification of licensure status and examination scores, $30;
new text end

new text begin (12) registration as a registered continuing education sponsor, $1,000; and
new text end

new text begin (13) health services executive initial license, $200 if issued between July 1 and December
31, $100 if issued between January 1 and June 30.
new text end

Sec. 6. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the phrases "Board of Examiners for Nursing Home
Administrators" to "Board of Executives for Long Term Services and Supports" and "Board
of Examiners" to "Board of Executives" wherever the phrases appear in Minnesota Statutes
and apply to the board established in Minnesota Statutes, section 144A.19.
new text end

Sec. 7. new text begin REPEALER.
new text end

new text begin Minnesota Rules, part 6400.6970, new text end new text begin is repealed.
new text end

ARTICLE 11

ASSISTED LIVING LICENSURE CONFORMING CHANGES

Section 1.

Minnesota Statutes 2018, section 144.051, subdivision 4, is amended to read:

Subd. 4.

Data classification; public data.

For providers regulated pursuant to sections
144A.43 to 144A.482new text begin and chapter 144Gnew text end , the following data collected, created, or maintained
by the commissioner are classified as public data as defined in section 13.02, subdivision
15:

(1) all application data on licensees, license numbers, and license status;

(2) licensing information about licenses previously held under this chapter;

(3) correction orders, including information about compliance with the order and whether
the fine was paid;

(4) final enforcement actions pursuant to chapter 14;

(5) orders for hearing, findings of fact, and conclusions of law; and

(6) when the licensee and department agree to resolve the matter without a hearing, the
agreement and specific reasons for the agreement are public data.

Sec. 2.

Minnesota Statutes 2018, section 144.051, subdivision 5, is amended to read:

Subd. 5.

Data classification; confidential data.

For providers regulated pursuant to
sections 144A.43 to 144A.482new text begin and chapter 144Gnew text end , the following data collected, created, or
maintained by the Department of Health are classified as confidential data on individuals
as defined in section 13.02, subdivision 3: active investigative data relating to the
investigation of potential violations of law by a licensee including data from the survey
process before the correction order is issued by the department.

Sec. 3.

Minnesota Statutes 2018, section 144.051, subdivision 6, is amended to read:

Subd. 6.

Release of private or confidential data.

For providers regulated pursuant to
sections 144A.43 to 144A.482new text begin and chapter 144Gnew text end , the department may release private or
confidential data, except Social Security numbers, to the appropriate state, federal, or local
agency and law enforcement office to enhance investigative or enforcement efforts or further
a public health protective process. Types of offices include Adult Protective Services, Office
of the Ombudsman for Long-Term Care and Office of the Ombudsman for Mental Health
and Developmental Disabilities, the health licensing boards, Department of Human Services,
county or city attorney's offices, police, and local or county public health offices.

Sec. 4.

Minnesota Statutes 2018, section 144.057, subdivision 1, is amended to read:

Subdivision 1.

Background studies required.

The commissioner of health shall contract
with the commissioner of human services to conduct background studies of:

(1) individuals providing services deleted text begin whichdeleted text end new text begin thatnew text end have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; residential care homes licensed under
chapter 144B,new text begin basic care facilities and assisted living facilities licensed under chapter 144G,new text end
and board and lodging establishments that are registered to provide supportive or health
supervision services under section 157.17;

(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
services in a nursing homenew text begin , basic care facilities and assisted living facilities licensed under
chapter 144G,new text end or a home care agency licensed under chapter 144A or a boarding care home
licensed under sections 144.50 to 144.58. If the individual under study resides outside
Minnesota, the study must include a check for substantiated findings of maltreatment of
adults and children in the individual's state of residence when the information is made
available by that state, and must include a check of the National Crime Information Center
database;

(3) beginning July 1, 1999, all other employees innew text begin basic care facilities and assisted living
facilities licensed under chapter 144G,new text end nursing homes licensed under chapter 144A, and
boarding care homes licensed under sections 144.50 to 144.58. A disqualification of an
individual in this section shall disqualify the individual from positions allowing direct
contact or access to patients or residents receiving services. "Access" means physical access
to a client or the client's personal property without continuous, direct supervision as defined
in section 245C.02, subdivision 8, when the employee's employment responsibilities do not
include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; and

(5) controlling persons of a supplemental nursing services agency, as defined under
section 144A.70.

If a facility or program is licensed by the Department of Human Services and subject to
the background study provisions of chapter 245C and is also licensed by the Department
of Health, the Department of Human Services is solely responsible for the background
studies of individuals in the jointly licensed programs.

Sec. 5.

Minnesota Statutes 2018, section 144.122, is amended to read:

144.122 LICENSE, PERMIT, AND SURVEY FEES.

(a) The state commissioner of health, by rule, may prescribe procedures and fees for
filing with the commissioner as prescribed by statute and for the issuance of original and
renewal permits, licenses, registrations, and certifications issued under authority of the
commissioner. The expiration dates of the various licenses, permits, registrations, and
certifications as prescribed by the rules shall be plainly marked thereon. Fees may include
application and examination fees and a penalty fee for renewal applications submitted after
the expiration date of the previously issued permit, license, registration, and certification.
The commissioner may also prescribe, by rule, reduced fees for permits, licenses,
registrations, and certifications when the application therefor is submitted during the last
three months of the permit, license, registration, or certification period. Fees proposed to
be prescribed in the rules shall be first approved by the Department of Management and
Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
in an amount so that the total fees collected by the commissioner will, where practical,
approximate the cost to the commissioner in administering the program. All fees collected
shall be deposited in the state treasury and credited to the state government special revenue
fund unless otherwise specifically appropriated by law for specific purposes.

(b) The commissioner may charge a fee for voluntary certification of medical laboratories
and environmental laboratories, and for environmental and medical laboratory services
provided by the department, without complying with paragraph (a) or chapter 14. Fees
charged for environment and medical laboratory services provided by the department must
be approximately equal to the costs of providing the services.

(c) The commissioner may develop a schedule of fees for diagnostic evaluations
conducted at clinics held by the services for children with disabilities program. All receipts
generated by the program are annually appropriated to the commissioner for use in the
maternal and child health program.

(d) The commissioner shall set license fees for hospitals and nursing homes that are not
boarding care homes at the following levels:

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and American Osteopathic Association (AOA) hospitals	$7,655 plus $16 per bed
Non-JCAHO and non-AOA hospitals	$5,280 plus $250 per bed
Nursing home	$183 plus $91 per bed until June 30, 2018. $183 plus $100 per bed between July 1, 2018, and June 30, 2020. $183 plus $105 per bed beginning July 1, 2020.

The commissioner shall set license fees for outpatient surgical centers, boarding care
homes, deleted text begin anddeleted text end supervised living facilitiesnew text begin , assisted living facilities, and basic care facilitiesnew text end at
the following levels:

Outpatient surgical centers	$3,712
Boarding care homes	$183 plus $91 per bed
Supervised living facilities	$183 plus $91 per bed.
new text begin Assisted living facilities - Tier Three new text end	new text begin $....... plus $....... per bed. new text end
new text begin Assisted living facilities - Tier Two new text end	new text begin $....... plus $....... per bed. new text end
new text begin Basic care facilities new text end	new text begin $....... plus $....... per bed. new text end

Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if
received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017,
or later.

(e) Unless prohibited by federal law, the commissioner of health shall charge applicants
the following fees to cover the cost of any initial certification surveys required to determine
a provider's eligibility to participate in the Medicare or Medicaid program:

Prospective payment surveys for hospitals	$	900
Swing bed surveys for nursing homes	$	1,200
Psychiatric hospitals	$	1,400
Rural health facilities	$	1,100
Portable x-ray providers	$	500
Home health agencies	$	1,800
Outpatient therapy agencies	$	800
End stage renal dialysis providers	$	2,100
Independent therapists	$	800
Comprehensive rehabilitation outpatient facilities	$	1,200
Hospice providers	$	1,700
Ambulatory surgical providers	$	1,800
Hospitals	$	4,200
Other provider categories or additional resurveys required to complete initial certification	Actual surveyor costs: average surveyor cost x number of hours for the survey process.

These fees shall be submitted at the time of the application for federal certification and
shall not be refunded. All fees collected after the date that the imposition of fees is not
prohibited by federal law shall be deposited in the state treasury and credited to the state
government special revenue fund.

Sec. 6.

Minnesota Statutes 2018, section 144A.43, subdivision 6, is amended to read:

Subd. 6.

License.

"License" means a basic or comprehensive home care license issued
by the commissioner to a home care providernew text begin and effective July 1, 2021, providing services
outside of assisted living settings licensed under chapter 144Gnew text end .

Sec. 7.

Minnesota Statutes 2018, section 144A.44, subdivision 1, is amended to read:

Subdivision 1.

Statement of rights.

new text begin (a) new text end A deleted text begin persondeleted text end new text begin client or residentnew text end who receives home
care services new text begin in the community or in an assisted living facility licensed under chapter 144G
new text end has these rights:

(1) deleted text begin the right todeleted text end receive written informationnew text begin , in plain language,new text end about rights before
receiving services, including what to do if rights are violated;

(2) deleted text begin the right todeleted text end receive care and services according to a suitable and up-to-date plan, and
subject to accepted health care, medical or nursing standardsnew text begin and person-centered carenew text end , to
take an active part in developing, modifying, and evaluating the plan and services;

(3) deleted text begin the right todeleted text end be told before receiving services the type and disciplines of staff who
will be providing the services, the frequency of visits proposed to be furnished, other choices
that are available for addressing home care needs, and the potential consequences of refusing
these services;

(4) deleted text begin the right todeleted text end be told in advance of any recommended changes by the provider in the
service deleted text begin plandeleted text end new text begin agreementnew text end and to take an active part in any decisions about changes to the
service deleted text begin plandeleted text end new text begin agreementnew text end ;

(5) deleted text begin the right todeleted text end refuse services or treatment;

(6) deleted text begin the right todeleted text end know, before receiving services or during the initial visit, any limits to
the services available from a home care provider;

(7) deleted text begin the right todeleted text end be told before services are initiated what the provider charges for the
services; to what extent payment may be expected from health insurance, public programs,
or other sources, if known; and what charges the client may be responsible for paying;

(8) deleted text begin the right todeleted text end know that there may be other services available in the community,
including other home care services and providers, and to know where to find information
about these services;

(9) deleted text begin the right todeleted text end choose freely among available providers and to change providers after
services have begun, within the limits of health insurance, long-term care insurance, medical
assistance, deleted text begin ordeleted text end other health programsnew text begin , or public programsnew text end ;

(10) deleted text begin the right todeleted text end have personal, financial, and medical information kept private, and to
be advised of the provider's policies and procedures regarding disclosure of such information;

(11) deleted text begin the right todeleted text end access the client's own records and written information from those
records in accordance with sections 144.291 to 144.298;

(12) deleted text begin the right todeleted text end be served by people who are properly trained and competent to perform
their duties;

(13) deleted text begin the right todeleted text end be treated with courtesy and respect, and to have the client's property
treated with respect;

(14) deleted text begin the right todeleted text end be free from physical and verbal abuse, neglect, financial exploitation,
and all forms of maltreatment covered under the Vulnerable Adults Act and the Maltreatment
of Minors Act;

(15) deleted text begin the right todeleted text end reasonable, advance notice of changes in services or charges;

(16) deleted text begin the right todeleted text end know the provider's reason for termination of services;

(17) deleted text begin the right todeleted text end at least deleted text begin tendeleted text end new text begin 30new text end days' advance notice of the termination of a service new text begin or
housing new text end by a provider, except in cases where:

(i) the client engages in conduct that significantly alters the terms of the service deleted text begin plandeleted text end new text begin
agreementnew text end with the home care provider;

(ii) the client, person who lives with the client, or others create an abusive or unsafe
work environment for the person providing home care services; or

(iii) an emergency or a significant change in the client's condition has resulted in service
needs that exceed the current service deleted text begin plandeleted text end new text begin agreementnew text end and that cannot be safely met by the
home care provider;

(18) deleted text begin the right todeleted text end a coordinated transfer when there will be a change in the provider of
services;

(19) deleted text begin the right todeleted text end complain new text begin to staff and others of the client's choice new text end about services that
are provided, or fail to be provided, and the lack of courtesy or respect to the client or the
client's propertynew text begin and the right to recommend changes in policies and services, free from
retaliation including the threat of termination of servicesnew text end ;

(20) deleted text begin the right todeleted text end know how to contact an individual associated with the home care provider
who is responsible for handling problems and to have the home care provider investigate
and attempt to resolve the grievance or complaint;

(21) deleted text begin the right todeleted text end know the name and address of the state or county agency to contact for
additional information or assistance; deleted text begin and
deleted text end

(22) deleted text begin the right todeleted text end assert these rights personally, or have them asserted by the client's
representative or by anyone on behalf of the client, without retaliationdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (23) place an electronic monitoring device in the client's or resident's space in compliance
with state requirements.
new text end

new text begin (b) When providers violate the rights in this section, they are subject to the fines and
license actions in sections 144A.474, subdivision 11, and 144A.475.
new text end

new text begin (c) Providers must do all of the following:
new text end

new text begin (1) encourage and assist in the fullest possible exercise of these rights;
new text end

new text begin (2) provide the names and telephone numbers of individuals and organizations that
provide advocacy and legal services for clients and residents seeking to assert their rights;
new text end

new text begin (3) make every effort to assist clients or residents in obtaining information regarding
whether Medicare, medical assistance, other health programs, or public programs will pay
for services;
new text end

new text begin (4) make reasonable accommodations for people who have communication disabilities,
or those who speak a language other than English; and
new text end

new text begin (5) provide all information and notices in plain language and in terms the client or
resident can understand.
new text end

new text begin (d) No provider may require or request a client or resident to waive any of the rights
listed in this section at any time or for any reasons, including as a condition of initiating
services or entering into an assisted living facility and basic care facility contract.
new text end

Sec. 8.

Minnesota Statutes 2018, section 144A.441, is amended to read:

144A.441 ASSISTED LIVING BILL OF RIGHTS ADDENDUM.

Assisted living deleted text begin clientsdeleted text end new text begin residentsnew text end , as defined in section deleted text begin 144G.01, subdivision 3deleted text end new text begin 144G.01,
subdivision 10new text end , shall be provided with the home care bill of rights required by section
144A.44, except that the home care bill of rights provided to these deleted text begin clientsdeleted text end new text begin residentsnew text end must
include the following provision in place of the provision in section 144A.44, subdivision
1,new text begin paragraph (a),new text end clause (17):

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

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

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

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

Sec. 9.

Minnesota Statutes 2018, section 144A.442, is amended to read:

144A.442 ASSISTED LIVING deleted text begin CLIENTSdeleted text end new text begin RESIDENTSnew text end ; SERVICE
TERMINATION.

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

(1) the effective date of termination;

(2) the reason for termination;

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

(4) contact information for a reasonable number of other home care providers in the
geographic area of the assisted living client, as required by section 144A.4791, subdivision
10;

(5) a statement that the provider will participate in a coordinated transfer of the care of
the deleted text begin clientdeleted text end new text begin residentnew text end to another provider or caregiver, as required by section 144A.44,
subdivision 1, clause (18);

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

(7) a copy of the home care bill of rights; and

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

new text begin (b) Effective August 1, 2021, all assisted living settings must comply with the provisions
in chapter 144G relating to termination of services and housing.
new text end

Sec. 10.

Minnesota Statutes 2018, section 144A.471, subdivision 7, is amended to read:

Subd. 7.

Comprehensive home care license provider.

Home care services that may
be provided with a comprehensive home care license include any of the basic home care
services listed in subdivision 6, and one or more of the following:

(1) services of an advanced practice nurse, registered nurse, licensed practical nurse,
physical therapist, respiratory therapist, occupational therapist, speech-language pathologist,
dietitian or nutritionist, or social worker;

(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed
health professional within the person's scope of practice;

(3) medication management services;

(4) hands-on assistance with transfers and mobility;

(5) new text begin treatment and therapies;
new text end

new text begin (6) new text end assisting clients with eating when the clients have complicating eating problems as
identified in the client record or through an assessment such as difficulty swallowing,
recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
instruments to be fed; or

deleted text begin (6)deleted text end new text begin (7)new text end providing other complex or specialty health care services.

Sec. 11.

Minnesota Statutes 2018, section 144A.471, subdivision 9, is amended to read:

Subd. 9.

Exclusions from home care licensure.

The following are excluded from home
care licensure and are not required to provide the home care bill of rights:

(1) an individual or business entity providing only coordination of home care that includes
one or more of the following:

(i) determination of whether a client needs home care services, or assisting a client in
determining what services are needed;

(ii) referral of clients to a home care provider;

(iii) administration of payments for home care services; or

(iv) administration of a health care home established under section 256B.0751;

(2) an individual who is not an employee of a licensed home care provider if the
individual:

(i) only provides services as an independent contractor to one or more licensed home
care providers;

(ii) provides no services under direct agreements or contracts with clients; and

(iii) is contractually bound to perform services in compliance with the contracting home
care provider's policies and service deleted text begin plansdeleted text end new text begin agreementsnew text end ;

(3) a business that provides staff to home care providers, such as a temporary employment
agency, if the business:

(i) only provides staff under contract to licensed or exempt providers;

(ii) provides no services under direct agreements with clients; and

(iii) is contractually bound to perform services under the contracting home care provider's
direction and supervision;

(4) any home care services conducted by and for the adherents of any recognized church
or religious denomination for its members through spiritual means, or by prayer for healing;

(5) an individual who only provides home care services to a relative;

(6) an individual not connected with a home care provider that provides assistance with
basic home care needs if the assistance is provided primarily as a contribution and not as a
business;

(7) an individual not connected with a home care provider that shares housing with and
provides primarily housekeeping or homemaking services to an elderly or disabled person
in return for free or reduced-cost housing;

(8) an individual or provider providing home-delivered meal services;

(9) an individual providing senior companion services and other older American volunteer
programs (OAVP) established under the Domestic Volunteer Service Act of 1973, United
States Code, title 42, chapter 66;

deleted text begin (10) an employee of a nursing home or home care provider licensed under this chapter
or an employee of a boarding care home licensed under sections 144.50 to 144.56 when
responding to occasional emergency calls from individuals residing in a residential setting
that is attached to or located on property contiguous to the nursing home, boarding care
home, or location where home care services are also provided;
deleted text end

deleted text begin (11) an employee of a nursing home or home care provider licensed under this chapter
or an employee of a boarding care home licensed under sections 144.50 to 144.56 when
providing occasional minor services free of charge to individuals residing in a residential
setting that is attached to or located on property contiguous to the nursing home, boarding
care home, or location where home care services are also provided;
deleted text end

(12) a member of a professional corporation organized under chapter 319B that does
not regularly offer or provide home care services as defined in section 144A.43, subdivision
3;

(13) the following organizations established to provide medical or surgical services that
do not regularly offer or provide home care services as defined in section 144A.43,
subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit
corporation organized under chapter 317A, a partnership organized under chapter 323, or
any other entity determined by the commissioner;

(14) an individual or agency that provides medical supplies or durable medical equipment,
except when the provision of supplies or equipment is accompanied by a home care service;

(15) a physician licensed under chapter 147;

(16) an individual who provides home care services to a person with a developmental
disability who lives in a place of residence with a family, foster family, or primary caregiver;

(17) a business that only provides services that are primarily instructional and not medical
services or health-related support services;

(18) an individual who performs basic home care services for no more than 14 hours
each calendar week to no more than one client;

(19) an individual or business licensed as hospice as defined in sections 144A.75 to
144A.755 who is not providing home care services independent of hospice service;

(20) activities conducted by the commissioner of health or a community health board
as defined in section 145A.02, subdivision 5, including communicable disease investigations
or testing; or

(21) administering or monitoring a prescribed therapy necessary to control or prevent a
communicable disease, or the monitoring of an individual's compliance with a health directive
as defined in section 144.4172, subdivision 6.

new text begin EFFECTIVE DATE. new text end

new text begin The amendments to clauses (10) and (11) are effective July 1,
2021.
new text end

Sec. 12.

Minnesota Statutes 2018, section 144A.472, subdivision 7, is amended to read:

Subd. 7.

Fees; application, change of ownership, deleted text begin anddeleted text end renewalnew text begin , and failure to
notifynew text end .

(a) An initial applicant seeking temporary home care licensure must submit the
following application fee to the commissioner along with a completed application:

(1) for a basic home care provider, $2,100; or

(2) for a comprehensive home care provider, $4,200.

(b) A home care provider who is filing a change of ownership as required under
subdivision 5 must submit the following application fee to the commissioner, along with
the documentation required for the change of ownership:

(1) for a basic home care provider, $2,100; or

(2) for a comprehensive home care provider, $4,200.

(c) For the period ending June 30, 2018, a home care provider who is seeking to renew
the provider's license shall pay a fee to the commissioner based on revenues derived from
the provision of home care services during the calendar year prior to the year in which the
application is submitted, according to the following schedule:

License Renewal Fee

Provider Annual Revenue	Fee
greater than $1,500,000	$6,625
greater than $1,275,000 and no more than $1,500,000	$5,797
greater than $1,100,000 and no more than $1,275,000	$4,969
greater than $950,000 and no more than $1,100,000	$4,141
greater than $850,000 and no more than $950,000	$3,727
greater than $750,000 and no more than $850,000	$3,313
greater than $650,000 and no more than $750,000	$2,898
greater than $550,000 and no more than $650,000	$2,485
greater than $450,000 and no more than $550,000	$2,070
greater than $350,000 and no more than $450,000	$1,656
greater than $250,000 and no more than $350,000	$1,242
greater than $100,000 and no more than $250,000	$828
greater than $50,000 and no more than $100,000	$500
greater than $25,000 and no more than $50,000	$400
no more than $25,000	$200

(d) For the period between July 1, 2018, and June 30, 2020, a home care provider who
is seeking to renew the provider's license shall pay a fee to the commissioner in an amount
that is ten percent higher than the applicable fee in paragraph (c). A home care provider's
fee shall be based on revenues derived from the provision of home care services during the
calendar year prior to the year in which the application is submitted.

(e) Beginning July 1, 2020, a home care provider who is seeking to renew the provider's
license shall pay a fee to the commissioner based on revenues derived from the provision
of home care services during the calendar year prior to the year in which the application is
submitted, according to the following schedule:

License Renewal Fee

Provider Annual Revenue	Fee
greater than $1,500,000	$7,651
greater than $1,275,000 and no more than $1,500,000	$6,695
greater than $1,100,000 and no more than $1,275,000	$5,739
greater than $950,000 and no more than $1,100,000	$4,783
greater than $850,000 and no more than $950,000	$4,304
greater than $750,000 and no more than $850,000	$3,826
greater than $650,000 and no more than $750,000	$3,347
greater than $550,000 and no more than $650,000	$2,870
greater than $450,000 and no more than $550,000	$2,391
greater than $350,000 and no more than $450,000	$1,913
greater than $250,000 and no more than $350,000	$1,434
greater than $100,000 and no more than $250,000	$957
greater than $50,000 and no more than $100,000	$577
greater than $25,000 and no more than $50,000	$462
no more than $25,000	$231

(f) If requested, the home care provider shall provide the commissioner information to
verify the provider's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.

(g) At each annual renewal, a home care provider may elect to pay the highest renewal
fee for its license category, and not provide annual revenue information to the commissioner.

(h) A temporary license or license applicant, or temporary licensee or licensee that
knowingly provides the commissioner incorrect revenue amounts for the purpose of paying
a lower license fee, shall be subject to a civil penalty in the amount of double the fee the
provider should have paid.

new text begin (i) The fee for failure to comply with the notification requirements in section 144A.473,
subdivision 2, paragraph (c), is $1,000.
new text end

deleted text begin (i)deleted text end new text begin (j)new text end Fees deleted text begin and penaltiesdeleted text end collected under this section shall be deposited in the state
treasury and credited to the state government special revenue fund. All fees are
nonrefundable. Fees collected under paragraphs (c), (d), and (e) are nonrefundable even if
received before July 1, 2017, for temporary licenses or licenses being issued effective July
1, 2017, or later.

new text begin (k) Fines collected under this subdivision shall be deposited in a dedicated special revenue
account. On an annual basis, the balance in the special revenue account will be appropriated
to the commissioner to implement the recommendations of the advisory council established
in section 144A.4799.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2018, section 144A.475, subdivision 3b, is amended to read:

Subd. 3b.

Expedited hearing.

(a) Within five business days of receipt of the license
holder's timely appeal of a temporary suspension or issuance of a conditional license, the
commissioner shall request assignment of an administrative law judge. The request must
include a proposed date, time, and place of a hearing. A hearing must be conducted by an
administrative law judgenew text begin pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612,new text end within
30 calendar days of the request for assignment, unless an extension is requested by either
party and granted by the administrative law judge for good cause. The commissioner shall
issue a notice of hearing by certified mail or personal service at least ten business days
before the hearing. Certified mail to the last known address is sufficient. The scope of the
hearing shall be limited solely to the issue of whether the temporary suspension or issuance
of a conditional license should remain in effect and whether there is sufficient evidence to
conclude that the licensee's actions or failure to comply with applicable laws are level 3 or
4 violations as defined in section 144A.474, subdivision 11, paragraph (b), or that there
were violations that posed an imminent risk of harm to the health and safety of persons in
the provider's care.

(b) The administrative law judge shall issue findings of fact, conclusions, and a
recommendation within ten business days from the date of hearing. The parties shall have
ten calendar days to submit exceptions to the administrative law judge's report. The record
shall close at the end of the ten-day period for submission of exceptions. The commissioner's
final order shall be issued within ten business days from the close of the record. When an
appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed,
the commissioner shall issue a final order affirming the temporary immediate suspension
or conditional license within ten calendar days of the commissioner's receipt of the
withdrawal or dismissal. The license holder is prohibited from operation during the temporary
suspension period.

(c) When the final order under paragraph (b) affirms an immediate suspension, and a
final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that
sanction, the licensee is prohibited from operation pending a final commissioner's order
after the contested case hearing conducted under chapter 14.

(d) A licensee whose license is temporarily suspended must comply with the requirements
for notification and transfer of clients in subdivision 5. These requirements remain if an
appeal is requested.

Sec. 14.

Minnesota Statutes 2018, section 144A.475, subdivision 5, is amended to read:

Subd. 5.

Plan required.

(a) The process of suspending deleted text begin ordeleted text end new text begin ,new text end revokingnew text begin , or refusing to renewnew text end
a license must include a plan for transferring affected deleted text begin clientsdeleted text end new text begin clients' carenew text end to other providers
by the home care provider, which will be monitored by the commissioner. Within three
deleted text begin businessdeleted text end new text begin calendarnew text end days of being notified of the deleted text begin finaldeleted text end revocationnew text begin , refusal to renew,new text end or
suspension deleted text begin actiondeleted text end , the home care provider shall provide the commissioner, the lead agencies
as defined in section 256B.0911, new text begin county adult protection and case managers, new text end and the
ombudsman for long-term care with the following information:

(1) a list of all clients, including full names and all contact information on file;

(2) a list of each client's representative or emergency contact person, including full names
and all contact information on file;

(3) the location or current residence of each client;

(4) the payor sources for each client, including payor source identification numbers; and

(5) for each client, a copy of the client's service deleted text begin plandeleted text end new text begin agreementnew text end , and a list of the types
of services being provided.

(b) The revocationnew text begin , refusal to renew,new text end or suspension notification requirement is satisfied
by mailing the notice to the address in the license record. The home care provider shall
cooperate with the commissioner and the lead agenciesnew text begin , county adult protection and county
managers, and the ombudsman for long term carenew text end during the process of transferring care of
clients to qualified providers. Within three deleted text begin businessdeleted text end new text begin calendarnew text end days of being notified of the
final revocationnew text begin , refusal to renew,new text end or suspension action, the home care provider must notify
and disclose to each of the home care provider's clients, or the client's representative or
emergency contact persons, that the commissioner is taking action against the home care
provider's license by providing a copy of the revocationnew text begin , refusal to renew,new text end or suspension
notice issued by the commissioner.new text begin If the provider does not comply with the disclosure
requirements in this section, the commissioner, lead agencies, county adult protection and
county managers and ombudsman for long-term care shall notify the clients, client
representatives, or emergency contact persons, about the action being taken. The revocation,
refusal to renew, or suspension notice is public data except for any private data contained
therein.
new text end

new text begin (c) A home care provider subject to this subdivision may continue operating during the
period of time home care clients are being transferred to other providers.
new text end

Sec. 15.

Minnesota Statutes 2018, section 144A.476, subdivision 1, is amended to read:

Subdivision 1.

Prior criminal convictions; owner and managerial officials.

(a) Before
the commissioner issues a temporary licensenew text begin , issues a license as a result of an approved
change in ownership,new text end or renews a license, an owner or managerial official is required to
complete a background study under section 144.057. No person may be involved in the
management, operation, or control of a home care provider if the person has been disqualified
under chapter 245C. If an individual is disqualified under section 144.057 or chapter 245C,
the individual may request reconsideration of the disqualification. If the individual requests
reconsideration and the commissioner sets aside or rescinds the disqualification, the individual
is eligible to be involved in the management, operation, or control of the provider. If an
individual has a disqualification under section 245C.15, subdivision 1, and the disqualification
is affirmed, the individual's disqualification is barred from a set aside, and the individual
must not be involved in the management, operation, or control of the provider.

(b) For purposes of this section, owners of a home care provider subject to the background
check requirement are those individuals whose ownership interest provides sufficient
authority or control to affect or change decisions related to the operation of the home care
provider. An owner includes a sole proprietor, a general partner, or any other individual
whose individual ownership interest can affect the management and direction of the policies
of the home care provider.

(c) For the purposes of this section, managerial officials subject to the background check
requirement are individuals who provide direct contact as defined in section 245C.02,
subdivision 11, or individuals who have the responsibility for the ongoing management or
direction of the policies, services, or employees of the home care provider. Data collected
under this subdivision shall be classified as private data on individuals under section 13.02,
subdivision 12.

(d) The department shall not issue any license if the applicant or owner or managerial
official has been unsuccessful in having a background study disqualification set aside under
section 144.057 and chapter 245C; if the owner or managerial official, as an owner or
managerial official of another home care provider, was substantially responsible for the
other home care provider's failure to substantially comply with sections 144A.43 to
144A.482; or if an owner that has ceased doing business, either individually or as an owner
of a home care provider, was issued a correction order for failing to assist clients in violation
of this chapter.

Sec. 16.

Minnesota Statutes 2018, section 144A.4791, subdivision 10, is amended to read:

Subd. 10.

Termination of service deleted text begin plandeleted text end new text begin agreementnew text end .

(a) If a home care provider terminates
a service deleted text begin plandeleted text end new text begin agreementnew text end with a client, and the client continues to need home care services,
the home care provider shall provide the client and the client's representative, if any, with
a new text begin 30-day new text end written notice of termination which includes the following information:

(1) the effective date of termination;

(2) the reason for termination;

(3) a list of known licensed home care providers in the client's immediate geographic
area;

(4) a statement that the home care provider will participate in a coordinated transfer of
care of the client to another home care provider, health care provider, or caregiver, as
required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);

(5) the name and contact information of a person employed by the home care provider
with whom the client may discuss the notice of termination; and

(6) if applicable, a statement that the notice of termination of home care services does
not constitute notice of termination of the housing with services contract with a housing
with services establishment.

(b) When the home care provider voluntarily discontinues services to all clients, the
home care provider must notify the commissioner, lead agencies, and ombudsman for
long-term care about its clients and comply with the requirements in this subdivision.

Sec. 17.

Minnesota Statutes 2018, section 144A.4799, is amended to read:

144A.4799 DEPARTMENT OF HEALTH LICENSED HOME CARE PROVIDER
ADVISORY COUNCIL.

Subdivision 1.

Membership.

The commissioner of health shall appoint eight persons
to a home care and assisted living program advisory council consisting of the following:

(1) three public members as defined in section 214.02 who shall be deleted text begin eitherdeleted text end persons who
are currently receiving home care services deleted text begin ordeleted text end new text begin , persons who have received home care within
five years of the application date, persons whonew text end 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) three 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; deleted text begin and
deleted text end

(4) one member representing the new text begin office of new text end ombudsman for long-term caredeleted text begin .deleted text end new text begin ; and
new text end

new text begin (5) beginning July 1, 2021, a member of a county health and human services or county
adult protection office.
new text end

Subd. 2.

Organizations and meetings.

The advisory council shall be organized and
administered under section 15.059 with per diems and costs paid within the limits of available
appropriations. Meetings will be held quarterly and hosted by the department. Subcommittees
may be developed as necessary by the commissioner. Advisory council meetings are subject
to the Open Meeting Law under chapter 13D.

Subd. 3.

Duties.

(a) At the commissioner's request, the advisory council shall provide
advice regarding regulations of Department of Health licensed 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;

(4) training standards;

(5) identifying emerging issues and opportunities in deleted text begin thedeleted text end home care deleted text begin field, includingdeleted text end new text begin ;
new text end

new text begin (6)new text end new text begin identifyingnew text end the use of technology in home and telehealth capabilities;

deleted text begin (6)deleted text end new text begin (7)new text end 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

deleted text begin (7)deleted text end new text begin (8)new text end 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 deleted text begin review the balance of the account in the state
government special revenue fund described in section 144A.474, subdivision 11, paragraph
(i), anddeleted text end make deleted text begin annualdeleted text end recommendationsdeleted text begin by January 15 directly to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services regarding appropriationsdeleted text end to the commissioner for the purposes in section 144A.474,
subdivision 11, paragraph (i).new text begin 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, 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.
new text end

Sec. 18.

Minnesota Statutes 2018, section 256I.03, subdivision 15, is amended to read:

Subd. 15.

Supportive housing.

"Supportive housing" means housing deleted text begin with support
services according to the continuum of care coordinated assessment system established
under Code of Federal Regulations, title 24, section 578.3deleted text end new text begin that is not time-limited and
provides or coordinates services necessary for a resident to maintain housing stabilitynew text end .

Sec. 19.

Minnesota Statutes 2018, section 256I.04, subdivision 2a, is amended to read:

Subd. 2a.

License required; staffing qualifications.

(a) Except as provided in paragraph
(b), an agency may not enter into an agreement with an establishment to provide housing
support unless:

(1) the establishment is licensed by the Department of Health as a hotel and restaurant;
a board and lodging establishment; a boarding care home before March 1, 1985; or a
supervised living facility, and the service provider for residents of the facility is licensed
under chapter 245A. However, an establishment licensed by the Department of Health to
provide lodging need not also be licensed to provide board if meals are being supplied to
residents under a contract with a food vendor who is licensed by the Department of Health;

(2) the residence is: (i) licensed by the commissioner of human services under Minnesota
Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior
to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265;
(iii) licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120,
with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02,
subdivision 4a, as a community residential setting by the commissioner of human services;
or

(3) the deleted text begin establishmentdeleted text end new text begin facilitynew text end is deleted text begin registereddeleted text end new text begin licensednew text end under deleted text begin chapter 144Ddeleted text end new text begin chapter 144Gnew text end
and provides three meals a day.

(b) The requirements under paragraph (a) do not apply to establishments exempt from
state licensure because they are:

(1) located on Indian reservations and subject to tribal health and safety requirements;
or

(2) deleted text begin a supportive housing establishment that has an approved habitability inspection and
an individual lease agreement and that serves people who have experienced long-term
homelessness and were referred through a coordinated assessment in section 256I.03,
subdivision 15deleted text end new text begin supportive housing establishments where an individual has an approved
habitability inspection and an individual lease agreementnew text end .

(c) Supportive housing establishmentsnew text begin that serve individuals who have experienced
long-term homelessnessnew text end and emergency shelters must participate in the homeless management
information systemnew text begin and a coordinated assessment system as defined by the commissionernew text end .

(d) Effective July 1, 2016, an agency shall not have an agreement with a provider of
housing support unless all staff members who have direct contact with recipients:

(1) have skills and knowledge acquired through one or more of the following:

(i) a course of study in a health- or human services-related field leading to a bachelor
of arts, bachelor of science, or associate's degree;

(ii) one year of experience with the target population served;

(iii) experience as a mental health certified peer specialist according to section 256B.0615;
or

(iv) meeting the requirements for unlicensed personnel under sections 144A.43 to
144A.483;

(2) hold a current driver's license appropriate to the vehicle driven if transporting
recipients;

(3) complete training on vulnerable adults mandated reporting and child maltreatment
mandated reporting, where applicable; and

(4) complete housing support orientation training offered by the commissioner.

Sec. 20.

Minnesota Statutes 2018, section 626.5572, subdivision 6, is amended to read:

Subd. 6.

Facility.

(a) "Facility" means a hospital or other entity required to be licensed
under sections 144.50 to 144.58; a nursing home required to be licensed to serve adults
under section 144A.02; a facility or service required to be licensed under chapter 245A;new text begin an
assisted living facility or basic care facility required to be licensed under chapter 144G;new text end a
home care provider licensed or required to be licensed under sections 144A.43 to 144A.482;
a hospice provider licensed under sections 144A.75 to 144A.755; or a person or organization
that offers, provides, or arranges for personal care assistance services under the medical
assistance program as authorized under sections 256B.0625, subdivision 19a, 256B.0651
to 256B.0654, 256B.0659, or 256B.85.

(b) For services identified in paragraph (a) that are provided in the vulnerable adult's
own home or in another unlicensed location, the term "facility" refers to the provider, person,
or organization that offers, provides, or arranges for personal care services, and does not
refer to the vulnerable adult's home or other location at which services are rendered.

Sec. 21.

Minnesota Statutes 2018, section 626.5572, subdivision 21, is amended to read:

Subd. 21.

Vulnerable adult.

(a) "Vulnerable adult" means any person 18 years of age
or older who:

(1) is a resident or inpatient of a facility;

(2) receives services required to be licensed under chapter 245A, except that a person
receiving outpatient services for treatment of chemical dependency or mental illness, or one
who is served in the Minnesota sex offender program on a court-hold order for commitment,
or is committed as a sexual psychopathic personality or as a sexually dangerous person
under chapter 253B, is not considered a vulnerable adult unless the person meets the
requirements of clause (4);

new text begin (3) is a resident of an assisted living facility or basic care facility required to be licensed
under chapter 144G;
new text end

deleted text begin (3)deleted text end new text begin (4)new text end receives services from a home care provider required to be licensed under sections
144A.43 to 144A.482; or from a person or organization that offers, provides, or arranges
for personal care assistance services under the medical assistance program as authorized
under section 256B.0625, subdivision 19a, 256B.0651, 256B.0653, 256B.0654, 256B.0659,
or 256B.85; or

deleted text begin (4)deleted text end new text begin (5)new text end regardless of residence or whether any type of service is received, possesses a
physical or mental infirmity or other physical, mental, or emotional dysfunction:

(i) that impairs the individual's ability to provide adequately for the individual's own
care without assistance, including the provision of food, shelter, clothing, health care, or
supervision; and

(ii) because of the dysfunction or infirmity and the need for care or services, the individual
has an impaired ability to protect the individual's self from maltreatment.

(b) For purposes of this subdivision, "care or services" means care or services for the
health, safety, welfare, or maintenance of an individual.

Sec. 22. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, section 144A.472, subdivision 4, new text end new text begin is repealed.
new text end

ARTICLE 12

ELECTRONIC MONITORING

Section 1.

new text begin [144.6502] ELECTRONIC MONITORING IN CERTAIN HEALTH CARE
FACILITIES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.
new text end

new text begin (b) "Electronic monitoring" means the placement and use of an electronic monitoring
device by a resident in the resident's room or private living unit in accordance with this
section.
new text end

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

new text begin (d) "Department" means the Department of Health.
new text end

new text begin (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.
new text end

new text begin (f) "Facility" means a nursing home licensed under chapter 144A, a boarding care home
licensed under sections 144.50 to 144.56, or 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.
new text end

new text begin (g) "Resident" means a person 18 years of age or older residing in a facility.
new text end

new text begin (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:
new text end

new text begin (1) a court-appointed guardian;
new text end

new text begin (2) a health care agent under section 145C.01, subdivision 2; or
new text end

new text begin (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 or
with the resident's executed housing with services contract.
new text end

new text begin Subd. 2. new text end

new text begin Electronic monitoring. new text end

new text begin (a) A resident or a resident representative may conduct
electronic monitoring of the resident's room or private living unit through the use of electronic
monitoring devices placed in the resident's room or private living unit as provided in this
section.
new text end

new text begin (b) Nothing in this section precludes the use of electronic monitoring of health care
allowed under other law.
new text end

new text begin (c) Electronic monitoring authorized under this section is not a covered service under
home and community-based waivers under sections 256B.0913, 256B.0915, 256B.092, and
256B.49.
new text end

new text begin (d) This section does not apply to monitoring technology authorized as a home and
community-based service under section 256B.0913, 256B.0915, 256B.092, or 256B.49.
new text end

new text begin Subd. 3. new text end

new text begin Consent to electronic monitoring. new text end

new text begin (a) Except as otherwise provided in this
subdivision, a resident must consent to electronic monitoring in the resident's room or private
living unit in writing on a notification and consent form. If the resident has not affirmatively
objected to electronic monitoring and the resident's medical professional determines that
the resident currently lacks the ability to understand and appreciate the nature and
consequences of electronic monitoring, the resident representative may consent on behalf
of the resident. For purposes of this subdivision, a resident affirmatively objects when the
resident orally, visually, or through the use of auxiliary aids or services declines electronic
monitoring. The resident's response must be documented on the notification and consent
form.
new text end

new text begin (b) Prior to a resident representative consenting on behalf of a resident, the resident must
be asked if the resident wants electronic monitoring to be conducted. The resident
representative must explain to the resident:
new text end

new text begin (1) the type of electronic monitoring device to be used;
new text end

new text begin (2) the standard conditions that may be placed on the electronic monitoring device's use,
including those listed in subdivision 6;
new text end

new text begin (3) with whom the recording may be shared under subdivision 10 or 11; and
new text end

new text begin (4) the resident's ability to decline all recording.
new text end

new text begin (c) A resident, or resident representative when consenting on behalf of the resident, may
consent to electronic monitoring with any conditions of the resident's or resident
representative's choosing, including the list of standard conditions provided in subdivision
6. A resident, or resident representative when consenting on behalf of the resident, may
request that the electronic monitoring device be turned off or the visual or audio recording
component of the electronic monitoring device be blocked at any time.
new text end

new text begin (d) Prior to implementing electronic monitoring, a resident, or resident representative
when acting on behalf of the resident, must obtain the written consent on the notification
and consent form of any other resident residing in the shared room or shared private living
unit. A roommate's or roommate's resident representative's written consent must comply
with the requirements of paragraphs (a) to (c). Consent by a roommate or a roommate's
resident representative under this paragraph authorizes the resident's use of any recording
obtained under this section, as provided under subdivision 10 or 11.
new text end

new text begin (e) Any resident conducting electronic monitoring must immediately remove or disable
an electronic monitoring device prior to a new roommate moving into a shared room or
shared private living unit, unless the resident obtains the roommate's or roommate's resident
representative's written consent as provided under paragraph (d) prior to the roommate
moving into the shared room or shared private living unit. Upon obtaining the new
roommate's signed notification and consent form and submitting the form to the facility as
required under subdivision 5, the resident may resume electronic monitoring.
new text end

new text begin (f) The resident or roommate, or the resident representative or roommate's resident
representative if the representative is consenting on behalf of the resident or roommate, may
withdraw consent at any time and the withdrawal of consent must be documented on the
original consent form as provided under subdivision 5, paragraph (c).
new text end

new text begin Subd. 4. new text end

new text begin Refusal of roommate to consent. new text end

new text begin If a resident of a facility who is residing in
a shared room or shared living unit, or the resident representative of such a resident when
acting on behalf of the resident, wants to conduct electronic monitoring and another resident
living in or moving into the same shared room or shared living unit refuses to consent to
the use of an electronic monitoring device, the facility shall make a reasonable attempt to
accommodate the resident who wants to conduct electronic monitoring. A facility has met
the requirement to make a reasonable attempt to accommodate a resident or resident
representative who wants to conduct electronic monitoring when, upon notification that a
roommate has not consented to the use of an electronic monitoring device in the resident's
room, the facility offers to move the resident to another shared room or shared living unit
that is available at the time of the request. If a resident chooses to reside in a private room
or private living unit in a facility in order to accommodate the use of an electronic monitoring
device, the resident must pay either the private room rate in a nursing home setting, or the
applicable rent in a housing with services establishment. If a facility is unable to
accommodate a resident due to lack of space, the facility must reevaluate the request every
two weeks until the request is fulfilled. A facility is not required to provide a private room,
a single-bed room, or a private living unit to a resident who is unable to pay.
new text end

new text begin Subd. 5. new text end

new text begin Notice to facility. new text end

new text begin (a) Electronic monitoring may begin only after the resident
or resident representative who intends to place an electronic monitoring device and any
roommate or roommate's resident representative completes the notification and consent
form and submits the form to the facility.
new text end

new text begin (b) Upon receipt of any completed notification and consent form, the facility must place
the original form in the resident's file or file the original form with the resident's housing
with services contract. The facility must provide a copy to the resident and the resident's
roommate, if applicable.
new text end

new text begin (c) In the event that a resident or roommate, or the resident representative or roommate's
resident representative if the representative is consenting on behalf of the resident or
roommate, chooses to alter the conditions under which consent to electronic monitoring is
given or chooses to withdraw consent to electronic monitoring, the facility must make
available the original notification and consent form so that it may be updated. Upon receipt
of the updated form, the facility must place the updated form in the resident's file or file the
original form with the resident's signed housing with services contract. The facility must
provide a copy of the updated form to the resident and the resident's roommate, if applicable.
new text end

new text begin (d) If a new roommate, or the new roommate's resident representative when consenting
on behalf of the new roommate, does not submit to the facility a completed notification and
consent form and the resident conducting the electronic monitoring does not remove or
disable the electronic monitoring device, the facility must remove the electronic monitoring
device.
new text end

new text begin (e) If a roommate, or the roommate's resident representative when withdrawing consent
on behalf of the roommate, submits an updated notification and consent form withdrawing
consent and the resident conducting electronic monitoring does not remove or disable the
electronic monitoring device, the facility must remove the electronic monitoring device.
new text end

new text begin (f) Notwithstanding paragraph (a), the resident or resident representative who intends
to place an electronic monitoring device may do so without submitting a notification and
consent form to the facility, provided that:
new text end

new text begin (1) the resident or resident representative reasonably fears retaliation by the facility;
new text end

new text begin (2) the resident does not have a roommate;
new text end

new text begin (3) the resident or resident representative submits the completed notification and consent
form to the Office of the Ombudsman for Long-Term Care;
new text end

new text begin (4) the resident or resident representative submits the notification and consent form to
the facility within 14 calendar days of placing the electronic monitoring device; and
new text end

new text begin (5) the resident or resident representative immediately submits a Minnesota Adult Abuse
Reporting Center report or police report upon evidence from the electronic monitoring
device that suspected maltreatment has occurred between the time the electronic monitoring
device is placed under this paragraph and the time the resident or resident representative
submits the completed notification and consent form to the facility.
new text end

new text begin Subd. 6. new text end

new text begin Form requirements. new text end

new text begin (a) The notification and consent form completed by the
resident must include, at a minimum, the following information:
new text end

new text begin (1) the resident's signed consent to electronic monitoring or the signature of the resident
representative, if applicable. If a person other than the resident signs the consent form, the
form must document the following:
new text end

new text begin (i) the date the resident was asked if the resident wants electronic monitoring to be
conducted;
new text end

new text begin (ii) who was present when the resident was asked;
new text end

new text begin (iii) an acknowledgment that the resident did not affirmatively object; and
new text end

new text begin (iv) the source of authority allowing the resident representative to sign the notification
and consent form on the resident's behalf;
new text end

new text begin (2) the resident's roommate's signed consent or the signature of the roommate's resident
representative, if applicable. If a roommate's resident representative signs the consent form,
the form must document the following:
new text end

new text begin (i) the date the roommate was asked if the roommate wants electronic monitoring to be
conducted;
new text end

new text begin (ii) who was present when the roommate was asked;
new text end

new text begin (iii) an acknowledgment that the roommate did not affirmatively object; and
new text end

new text begin (iv) the source of authority allowing the resident representative to sign the notification
and consent form on the resident's behalf;
new text end

new text begin (3) the type of electronic monitoring device to be used;
new text end

new text begin (4) a list of standard conditions or restrictions that the resident or a roommate may elect
to place on the use of the electronic monitoring device, including but not limited to:
new text end

new text begin (i) prohibiting audio recording;
new text end

new text begin (ii) prohibiting video recording;
new text end

new text begin (iii) prohibiting broadcasting of audio or video;
new text end

new text begin (iv) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device for the duration of an exam or procedure by
a health care professional;
new text end

new text begin (v) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device while dressing or bathing is performed; and
new text end

new text begin (vi) turning off the electronic monitoring device for the duration of a visit with a spiritual
adviser, ombudsman, attorney, financial planner, intimate partner, or other visitor;
new text end

new text begin (5) any other condition or restriction elected by the resident or roommate on the use of
an electronic monitoring device;
new text end

new text begin (6) a statement of the circumstances under which a recording may be disseminated under
subdivision 10;
new text end

new text begin (7) a signature box for documenting that the resident or roommate has withdrawn consent;
and
new text end

new text begin (8) an acknowledgment that the resident, in accordance with subdivision 3, consents,
authorizes, and allows the Office of Ombudsman for Long-Term Care and representatives
of its office to disclose information about the form limited to:
new text end

new text begin (i) the fact that the form was received from the resident or resident representative;
new text end

new text begin (ii) if signed by a resident representative, the name of the resident representative and
the source of authority allowing the resident representative to sign the notification and
consent form on the resident's behalf; and
new text end

new text begin (iii) the type of electronic monitoring device placed.
new text end

new text begin (b) Facilities must make the notification and consent form available to the residents and
inform residents of their option to conduct electronic monitoring of their rooms or private
living unit.
new text end

new text begin (c) Notification and consent forms received by the Office of Ombudsman for Long-Term
Care are data protected under section 256.9744.
new text end

new text begin Subd. 7. new text end

new text begin Cost and installation. new text end

new text begin (a) A resident choosing to conduct electronic monitoring
must do so at the resident's own expense, including paying purchase, installation,
maintenance, and removal costs.
new text end

new text begin (b) If a resident chooses to place an electronic monitoring device that uses Internet
technology for visual or audio monitoring, the resident may be responsible for contracting
with an Internet service provider.
new text end

new text begin (c) The facility shall make a reasonable attempt to accommodate the resident's installation
needs, including allowing access to the facility's public-use Internet or Wi-Fi systems when
available for other public uses.
new text end

new text begin (d) All electronic monitoring device installations and supporting services must be
UL-listed.
new text end

new text begin Subd. 8. new text end

new text begin Notice to visitors. new text end

new text begin (a) A facility shall post a sign at each facility entrance
accessible to visitors that states "Security cameras and audio devices may be present to
record persons and activities."
new text end

new text begin (b) The facility is responsible for installing and maintaining the signage required in this
subdivision.
new text end

new text begin Subd. 9. new text end

new text begin Obstruction of electronic monitoring devices. new text end

new text begin (a) A person must not knowingly
hamper, obstruct, tamper with, or destroy an electronic monitoring device placed in a
resident's room or private living unit without the permission of the resident or resident
representative.
new text end

new text begin (b) It is not a violation of paragraph (a) if a person turns off the electronic monitoring
device or blocks the visual recording component of the electronic monitoring device at the
direction of the resident or resident representative, or if consent has been withdrawn.
new text end

new text begin Subd. 10. new text end

new text begin Dissemination of recordings. new text end

new text begin (a) No person may access any video or audio
recording created through authorized electronic monitoring without the written consent of
the resident or resident representative.
new text end

new text begin (b) Except as required under other law, a recording or copy of a recording made as
provided in this section may only be disseminated for the purpose of addressing health,
safety, or welfare concerns of a resident or residents.
new text end

new text begin (c) A person disseminating a recording or copy of a recording made as provided in this
section in violation of paragraph (b) may be civilly or criminally liable.
new text end

new text begin Subd. 11. new text end

new text begin Admissibility of evidence. new text end

new text begin Subject to applicable rules of evidence and
procedure, any video or audio recording created through electronic monitoring under this
section may be admitted into evidence in a civil, criminal, or administrative proceeding.
new text end

new text begin Subd. 12. new text end

new text begin Liability. new text end

new text begin (a) For the purposes of state law, the mere presence of an electronic
monitoring device in a resident's room or private living unit is not a violation of the resident's
right to privacy under section 144.651 or 144A.44.
new text end

new text begin (b) For the purposes of state law, a facility or home care provider is not civilly or
criminally liable for the mere disclosure by a resident or a resident representative of a
recording.
new text end

new text begin Subd. 13. new text end

new text begin Immunity from liability. new text end

new text begin The Office of Ombudsman for Long-Term Care
and representatives of the office are immune from liability as provided under section
256.9742, subdivision 2.
new text end

new text begin Subd. 14. new text end

new text begin Resident protections. new text end

new text begin (a) A facility must not:
new text end

new text begin (1) refuse to admit a potential resident or remove a resident because the facility disagrees
with the potential resident's or the resident's decisions regarding electronic monitoring,
including when the decision is made by a resident representative acting on behalf of the
resident;
new text end

new text begin (2) retaliate or discriminate against any resident for consenting or refusing to consent
to electronic monitoring; or
new text end

new text begin (3) prevent the placement or use of an electronic monitoring device by a resident who
has provided the facility or the Office of the Ombudsman for Long-Term Care with notice
and consent as required under this section.
new text end

new text begin (b) Any contractual provision prohibiting, limiting, or otherwise modifying the rights
and obligations in this section is contrary to public policy and is void and unenforceable.
new text end

new text begin Subd. 15. new text end

new text begin Employee discipline. new text end

new text begin An employee of the facility or of a contractor providing
services at the facility, including an arranged home care provider as defined in section
144D.01, subdivision 2a, who is the subject of proposed corrective or disciplinary action
based upon evidence obtained by electronic monitoring must be given access to that evidence
for purposes of defending against the proposed action. The recording or a copy of the
recording must be treated confidentially by the employee and must not be further
disseminated to any other person except as required under law. Any copy of the recording
must be returned to the facility or resident who provided the copy when it is no longer
needed for purposes of defending against a proposed action.
new text end

new text begin Subd. 16. new text end

new text begin Penalties. new text end

new text begin (a) The commissioner may issue a correction order as provided
under section 144A.10, 144A.45, or 144A.474, upon a finding that the facility has failed to
comply with subdivision 5, paragraphs (b) to (e); 6, paragraph (b); 7, paragraph (c); 8; 9;
10; or 14. For each violation of this section, the commissioner may impose a fine up to $500
upon a finding of noncompliance with a correction order issued according to this subdivision.
new text end

new text begin (b) The commissioner may exercise the commissioner's authority provided under section
144D.05 to compel a housing with services establishment to meet the requirements of this
section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, and applies to all
agreements in effect, entered into, or renewed on or after that date.
new text end

Sec. 2. new text begin TRANSITION TO AUTHORIZED ELECTRONIC MONITORING IN
CERTAIN HEALTH CARE FACILITIES.
new text end

new text begin Any resident, resident representative, or other person conducting electronic monitoring
in a resident's room or private living unit prior to January 1, 2020, must comply with the
requirements of Minnesota Statutes, section 144.6502, by January 1, 2020.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 3. new text begin DIRECTION TO THE COMMISSIONER OF HEALTH.
new text end

new text begin The commissioner of health shall prescribe the notification and consent form described
in Minnesota Statutes, section 144.6502, subdivision 6, no later than January 1, 2020. The
commissioner shall make the form available on the department's website.
new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 13

OFFICE OF HEALTH FACILITY COMPLAINTS; MINNESOTA VULNERABLE
ADULTS ACT

Section 1.

Minnesota Statutes 2018, section 144A.53, subdivision 1, is amended to read:

Subdivision 1.

Powers.

The director may:

(1) promulgate by rule, pursuant to chapter 14, and within the limits set forth in
subdivision 2, the methods by which complaints against health facilities, health care
providers, home care providers, deleted text begin or residential care homes,deleted text end or administrative agencies are
to be made, reviewed, investigated, and acted upon; provided, however, that a fee may not
be charged for filing a complaint;

(2) recommend legislation and changes in rules to the state commissioner of health,
governor, administrative agencies or the federal government;

(3) investigate, upon a complaint or upon initiative of the director, any action or failure
to act by a health care provider, home care provider, deleted text begin residential care home,deleted text end or a health
facility;

(4) request and receive access to relevant information, records, incident reports, or
documents in the possession of an administrative agency, a health care provider, a home
care provider, deleted text begin a residential care home,deleted text end or a health facility, and issue investigative subpoenas
to individuals and facilities for oral information and written information, including privileged
information which the director deems necessary for the discharge of responsibilities. For
purposes of investigation and securing information to determine violations, the director
need not present a release, waiver, or consent of an individual. The identities of patients or
residents must be kept private as defined by section 13.02, subdivision 12;

(5) enter and inspect, at any time, a health facility deleted text begin or residential care homedeleted text end and be
permitted to interview staff; provided that the director shall not unduly interfere with or
disturb the provision of care and services within the facility deleted text begin or homedeleted text end or the activities of a
patient or resident unless the patient or resident consents;

(6) issue correction orders and assess civil fines deleted text begin pursuant to sectiondeleted text end new text begin for violations of
sections 144.651,new text end 144.653new text begin , 144A.10, 144A.45, and 626.557, Minnesota Rules, chapters
4655, 4658, 4664, and 4665,new text end or any other law deleted text begin whichdeleted text end new text begin thatnew text end provides for the issuance of
correction orders to health facilities or home care provider, or under section 144A.45.new text begin The
director may use the authority in section 144A.474, subdivision 11, to calculate the fine
amount.new text end A facility's or home's refusal to cooperate in providing lawfully requested
informationnew text begin within the requested time periodnew text end may also be grounds for a correction ordernew text begin or
fine at a Level 2 fine pursuant to section 144A.474, subdivision 11new text end ;

(7) recommend the certification or decertification of health facilities pursuant to Title
XVIII or XIX of the United States Social Security Act;

(8) assist patients or residents of health facilities deleted text begin or residential care homesdeleted text end in the
enforcement of their rights under Minnesota law; and

(9) work with administrative agencies, health facilities, home care providers, residential
care homes, and health care providers and organizations representing consumers on programs
designed to provide information about health facilities to the public and to health facility
residents.

Sec. 2.

Minnesota Statutes 2018, section 144A.53, is amended by adding a subdivision to
read:

new text begin Subd. 5. new text end

new text begin Safety and quality improvement technical panel. new text end

new text begin The director shall establish
an expert technical panel to examine and make recommendations, on an ongoing basis, on
how to apply proven safety and quality improvement practices and infrastructure to settings
and providers that provide long-term services and supports. The technical panel must include
representation from nonprofit Minnesota-based organizations dedicated to patient safety or
innovation in health care safety and quality, Department of Health staff with expertise in
issues related to adverse health events, the University of Minnesota, organizations
representing long-term care providers and home care providers in Minnesota, national patient
safety experts, and other experts in the safety and quality improvement field. The technical
panel shall periodically provide recommendations to the legislature on legislative changes
needed to promote safety and quality improvement practices in long-term care settings and
with long-term care providers.
new text end

Sec. 3.

Minnesota Statutes 2018, section 144A.53, is amended by adding a subdivision to
read:

new text begin Subd. 6. new text end

new text begin Training and operations panel. new text end

new text begin (a) The director shall establish a training and
operations panel within the Office of Health Facility Complaints to examine and make
recommendations, on an ongoing basis, on continual improvements to the operation of the
office. The training and operations panel shall be composed of office staff, including
investigators and intake and triage staff; one or more representatives of the commissioner's
office; and employees from any other divisions in the Department of Health with relevant
knowledge or expertise. The training and operations panel may also consult with employees
from other agencies in state government with relevant knowledge or expertise.
new text end

new text begin (b) The training and operations panel shall examine and make recommendations to the
director and the commissioner regarding introducing or refining office systems, procedures,
and staff training in order to improve office and staff efficiency; enhance communications
between the office, health care facilities, home care providers, and residents or clients; and
provide for appropriate, effective protection for vulnerable adults through rigorous
investigations and enforcement of laws. Panel duties include but are not limited to:
new text end

new text begin (1) developing the office's training processes to adequately prepare and support
investigators in performing their duties;
new text end

new text begin (2) developing clear, consistent internal policies for conducting investigations as required
by federal law, including policies to ensure staff meet the deadlines in state and federal laws
for triaging, investigating, and making final dispositions of cases involving maltreatment,
and procedures for notifying the vulnerable adult, reporter, and facility of any delays in
investigations; communicating these policies to staff in a clear, timely manner; and
developing procedures to evaluate and modify these internal policies on an ongoing basis;
new text end

new text begin (3) developing and refining quality control measures for the intake and triage processes,
through such practices as reviewing a random sample of the triage decisions made in case
reports or auditing a random sample of the case files to ensure the proper information is
being collected, the files are being properly maintained, and consistent triage and
investigations determinations are being made;
new text end

new text begin (4) developing and maintaining systems and procedures to accurately determine the
situations in which the office has jurisdiction over a maltreatment allegation;
new text end

new text begin (5) developing and maintaining audit procedures for investigations to ensure investigators
obtain and document information necessary to support decisions;
new text end

new text begin (6) following a maltreatment determination, developing and maintaining procedures to
clearly communicate the appeal or review rights of all parties upon final disposition; and
new text end

new text begin (7) continuously upgrading the information on and utility of the office's website through
such steps as providing clear, detailed information about the appeal or review rights of
vulnerable adults, alleged perpetrators, and providers and facilities.
new text end

Sec. 4.

Minnesota Statutes 2018, section 144A.53, is amended by adding a subdivision to
read:

new text begin Subd. 7. new text end

new text begin Posting maltreatment reports. new text end

new text begin (a) The director shall post on the Department
of Health website the following information for the most recent five-year period:
new text end

new text begin (1) the public portions of all substantiated reports of maltreatment of a vulnerable adult
at a facility or by a provider for which the Department of Health is the lead investigative
agency under section 626.557; and
new text end

new text begin (2) whether the facility or provider has requested reconsideration or initiated any type
of dispute resolution or appeal of a substantiated maltreatment report.
new text end

new text begin (b) Following a reconsideration, dispute resolution, or appeal, the director must update
the information posted under this subdivision to reflect the results of the reconsideration,
dispute resolution, or appeal.
new text end

new text begin (c) The information posted under this subdivision must be posted in coordination with
other divisions or sections at the Department of Health and in a manner that does not duplicate
information already published by the Department of Health, and must be posted in a format
that allows consumers to search the information by facility or provider name and by the
physical address of the facility or the local business address of the provider.
new text end

Sec. 5.

Minnesota Statutes 2018, section 626.557, subdivision 4, is amended to read:

Subd. 4.

Reporting.

(a) Except as provided in paragraph (b), a mandated reporter shall
immediately make an oral report to the common entry point. The common entry point may
accept electronic reports submitted through a web-based reporting system established by
the commissioner. Use of a telecommunications device for the deaf or other similar device
shall be considered an oral report. The common entry point may not require written reports.
To the extent possible, the report must be of sufficient content to identify the vulnerable
adult, the caregiver, the nature and extent of the suspected maltreatment, any evidence of
previous maltreatment, the name and address of the reporter, the time, date, and location of
the incident, and any other information that the reporter believes might be helpful in
investigating the suspected maltreatment. new text begin The common entry point must provide a way to
record that the reporter has electronic evidence to submit. new text end A mandated reporter may disclose
not public data, as defined in section 13.02, and medical records under sections 144.291 to
144.298, to the extent necessary to comply with this subdivision.

(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified
under Title 19 of the Social Security Act, a nursing home that is licensed under section
144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital
that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code
of Federal Regulations, title 42, section 482.66, may submit a report electronically to the
common entry point instead of submitting an oral report. The report may be a duplicate of
the initial report the facility submits electronically to the commissioner of health to comply
with the reporting requirements under Code of Federal Regulations, title 42, section 483.13.
The commissioner of health may modify these reporting requirements to include items
required under paragraph (a) that are not currently included in the electronic reporting form.

Sec. 6.

Minnesota Statutes 2018, section 626.557, subdivision 9c, is amended to read:

Subd. 9c.

Lead investigative agency; notifications, dispositions, determinations.

(a)
deleted text begin Upon request of the reporter,deleted text end The lead investigative agency shall notify the reporter that it
has received the report, and provide information on the initial disposition of the report within
five business days of receipt of the report, provided that the notification will not endanger
the vulnerable adult or hamper the investigation.

(b) new text begin Except to the extent prohibited by federal law, when the Department of Health is the
lead investigative agency, the agency must provide the following information to the
vulnerable adult or the vulnerable adult's guardian or health care agent, if known, within
five days after the initiation of an investigation, provided that the provision of the information
will not hamper the investigation or harm the vulnerable adult:
new text end

new text begin (1) the maltreatment allegations by types: abuse, neglect, financial exploitation, and
drug diversion;
new text end

new text begin (2) the name of the facility or other location at which alleged maltreatment occurred;
new text end

new text begin (3) the dates of the alleged maltreatment if identified in the report at the time of the lead
investigative agency disclosure;
new text end

new text begin (4) the name and contact information for the investigator or other information as requested
and allowed under law; and
new text end

new text begin (5) confirmation of whether the lead investigative agency is investigating the matter
and, if so:
new text end

new text begin (i) an explanation of the process;
new text end

new text begin (ii) an estimated timeline for the investigation;
new text end

new text begin (iii) a notification that the vulnerable adult or the vulnerable adult's guardian or health
care agent may electronically submit evidence to support the maltreatment report, including
but not limited to photographs, videos, and documents; and
new text end

new text begin (iv) a statement that the lead investigative agency will provide an update on the
investigation upon request by the vulnerable adult or the vulnerable adult's guardian or
health care agent and a report when the investigation is concluded.
new text end

new text begin (c) If the Department of Health is the lead investigative agency, the Department of Health
shall provide maltreatment information, to the extent allowed under state and federal law,
including any reports, upon request of the vulnerable adult that is the subject of a
maltreatment report or upon request of that vulnerable adult's guardian or health care agent.
new text end

new text begin (d) If the common entry point data indicates that the reporter has electronic evidence,
the lead investigative agency shall seek to receive such evidence prior to making a
determination that the lead investigative agency will not investigate the matter. Nothing in
this paragraph requires the lead investigative agency to stop investigating prior to receipt
of the electronic evidence nor prevents the lead investigative agency from closing the
investigation prior to receipt of the electronic evidence if, in the opinion of the investigator,
the evidence is not necessary to the determination.
new text end

new text begin (e) The lead investigative agency may assign multiple reports of maltreatment for the
same or separate incidences related to the same vulnerable adult to the same investigator,
as deemed appropriate.
new text end

new text begin (f) Reports related to the same vulnerable adult, the same incident, or the same alleged
perpetrator, facility, or licensee must be cross-referenced.
new text end

new text begin (g) new text end Upon conclusion of every investigation it conducts, the lead investigative agency
shall make a final disposition as defined in section 626.5572, subdivision 8.

deleted text begin (c)deleted text end new text begin (h)new text end When determining whether the facility or individual is the responsible party for
substantiated maltreatment or whether both the facility and the individual are responsible
for substantiated maltreatment, the lead investigative agency shall consider at least the
following mitigating factors:

(1) whether the actions of the facility or the individual caregivers were in accordance
with, and followed the terms of, an erroneous physician order, prescription, resident care
plan, or directive. This is not a mitigating factor when the facility or caregiver is responsible
for the issuance of the erroneous order, prescription, plan, or directive or knows or should
have known of the errors and took no reasonable measures to correct the defect before
administering care;

(2) the comparative responsibility between the facility, other caregivers, and requirements
placed upon the employee, including but not limited to, the facility's compliance with related
regulatory standards and factors such as the adequacy of facility policies and procedures,
the adequacy of facility training, the adequacy of an individual's participation in the training,
the adequacy of caregiver supervision, the adequacy of facility staffing levels, and a
consideration of the scope of the individual employee's authority; and

(3) whether the facility or individual followed professional standards in exercising
professional judgment.

deleted text begin (d)deleted text end new text begin (i)new text end When substantiated maltreatment is determined to have been committed by an
individual who is also the facility license holder, both the individual and the facility must
be determined responsible for the maltreatment, and both the background study
disqualification standards under section 245C.15, subdivision 4, and the licensing actions
under section 245A.06 or 245A.07 apply.

deleted text begin (e)deleted text end new text begin (j)new text end The lead investigative agency shall complete its final disposition within 60 calendar
days. If the lead investigative agency is unable to complete its final disposition within 60
calendar days, the lead investigative agency shall notify the following persons provided
that the notification will not endanger the vulnerable adult or hamper the investigation: (1)
the vulnerable adult or the vulnerable adult's guardian or health care agent, when known,
if the lead investigative agency knows them to be aware of the investigation; and (2) the
facility, where applicable. The notice shall contain the reason for the delay and the projected
completion date. If the lead investigative agency is unable to complete its final disposition
by a subsequent projected completion date, the lead investigative agency shall again notify
the vulnerable adult or the vulnerable adult's guardian or health care agent, when known if
the lead investigative agency knows them to be aware of the investigation, and the facility,
where applicable, of the reason for the delay and the revised projected completion date
provided that the notification will not endanger the vulnerable adult or hamper the
investigation. The lead investigative agency must notify the health care agent of the
vulnerable adult only if the health care agent's authority to make health care decisions for
the vulnerable adult is currently effective deleted text begin under section 145C.06deleted text end and not suspended under
section 524.5-310 deleted text begin and the investigation relates to a duty assigned to the health care agent
by the principaldeleted text end . A lead investigative agency's inability to complete the final disposition
within 60 calendar days or by any projected completion date does not invalidate the final
disposition.

deleted text begin (f)deleted text end new text begin (k)new text end Within ten calendar days of completing the final disposition, the lead investigative
agency shall provide a copy of the public investigation memorandum under subdivision
12b, paragraph deleted text begin (b), clause (1)deleted text end new text begin (d)new text end , when required to be completed under this section, to the
following persons:

(1) the vulnerable adult, or the vulnerable adult's guardian or health care agent, if known,
unless the lead investigative agency knows that the notification would endanger the
well-being of the vulnerable adult;

(2) the reporter, deleted text begin ifdeleted text end new text begin unless new text end the reporter requested deleted text begin notificationdeleted text end new text begin otherwise new text end when making the
report, provided this notification would not endanger the well-being of the vulnerable adult;

(3) the alleged perpetrator, if known;

(4) the facility; deleted text begin and
deleted text end

(5) the ombudsman for long-term care, or the ombudsman for mental health and
developmental disabilities, as appropriatenew text begin ;
new text end

new text begin (6) law enforcement; and
new text end

new text begin (7) the county attorney, as appropriatenew text end .

deleted text begin (g)deleted text end new text begin (l)new text end If, as a result of a reconsideration, review, or hearing, the lead investigative agency
changes the final disposition, or if a final disposition is changed on appeal, the lead
investigative agency shall notify the parties specified in paragraph deleted text begin (f)deleted text end new text begin (k)new text end .

deleted text begin (h)deleted text end new text begin (m)new text end The lead investigative agency shall notify the vulnerable adult who is the subject
of the report or the vulnerable adult's guardian or health care agent, if known, and any person
or facility determined to have maltreated a vulnerable adult, of their appeal or review rights
under this section or section 256.021.

deleted text begin (i)deleted text end new text begin (n)new text end The lead investigative agency shall routinely provide investigation memoranda
for substantiated reports to the appropriate licensing boards. These reports must include the
names of substantiated perpetrators. The lead investigative agency may not provide
investigative memoranda for inconclusive or false reports to the appropriate licensing boards
unless the lead investigative agency's investigation gives reason to believe that there may
have been a violation of the applicable professional practice laws. If the investigation
memorandum is provided to a licensing board, the subject of the investigation memorandum
shall be notified and receive a summary of the investigative findings.

deleted text begin (j)deleted text end new text begin (o)new text end In order to avoid duplication, licensing boards shall consider the findings of the
lead investigative agency in their investigations if they choose to investigate. This does not
preclude licensing boards from considering other information.

deleted text begin (k)deleted text end new text begin (p)new text end The lead investigative agency must provide to the commissioner of human services
its final dispositions, including the names of all substantiated perpetrators. The commissioner
of human services shall establish records to retain the names of substantiated perpetrators.

Sec. 7.

Minnesota Statutes 2018, section 626.557, subdivision 12b, is amended to read:

Subd. 12b.

Data management.

(a) In performing any of the duties of this section as a
lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this section are welfare
data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data
under this paragraph that are inactive investigative data on an individual who is a vendor
of services are private data on individuals, as defined in section 13.02. The identity of the
reporter may only be disclosed as provided in paragraph deleted text begin (c)deleted text end new text begin (g)new text end .

new text begin (b) new text end Data maintained by the common entry point are deleted text begin confidentialdeleted text end new text begin privatenew text end data on
individuals or deleted text begin protecteddeleted text end nonpublic data as defined in section 13.02new text begin , provided that the name
of the reporter is confidential data on individualsnew text end . Notwithstanding section 138.163, the
common entry point shall maintain data for three calendar years after date of receipt and
then destroy the data unless otherwise directed by federal requirements.

deleted text begin (b)deleted text end new text begin (c)new text end The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section. County
social service agencies must maintain private data on individuals but are not required to
prepare an investigation memorandum. During an investigation by the commissioner of
health or the commissioner of human services, data collected under this section are
confidential data on individuals or protected nonpublic data as defined in section 13.02new text begin ,
provided that data, other than data on the reporter, may be shared with the vulnerable adult
or guardian or health care agent if the lead investigative agency determines that sharing of
the data is needed to protect the vulnerable adultnew text end . Upon completion of the investigation, the
data are classified as provided in deleted text begin clauses (1) to (3) and paragraph (c)deleted text end new text begin paragraphs (d) to (g)new text end .

deleted text begin (1)deleted text end new text begin (d) new text end The investigation memorandum must contain the following data, which are public:

deleted text begin (i)deleted text end new text begin (1)new text end the name of the facility investigated;

deleted text begin (ii)deleted text end new text begin (2)new text end a statement of the nature of the alleged maltreatment;

deleted text begin (iii)deleted text end new text begin (3)new text end pertinent information obtained from medical or other records reviewed;

deleted text begin (iv)deleted text end new text begin (4)new text end the identity of the investigator;

deleted text begin (v)deleted text end new text begin (5)new text end a summary of the investigation's findings;

deleted text begin (vi)deleted text end new text begin (6)new text end statement of whether the report was found to be substantiated, inconclusive,
false, or that no determination will be made;

deleted text begin (vii)deleted text end new text begin (7)new text end a statement of any action taken by the facility;

deleted text begin (viii)deleted text end new text begin (8)new text end a statement of any action taken by the lead investigative agency; and

deleted text begin (ix)deleted text end new text begin (9)new text end when a lead investigative agency's determination has substantiated maltreatment,
a statement of whether an individual, individuals, or a facility were responsible for the
substantiated maltreatment, if known.

The investigation memorandum must be written in a manner which protects the identity
of the reporter and of the vulnerable adult and may not contain the names or, to the extent
possible, data on individuals or private data new text begin on individuals new text end listed in deleted text begin clause (2)deleted text end new text begin paragraph
(e)new text end .

deleted text begin (2)deleted text end new text begin (e)new text end Data on individuals collected and maintained in the investigation memorandum
are private datanew text begin on individualsnew text end , including:

deleted text begin (i)deleted text end new text begin (1)new text end the name of the vulnerable adult;

deleted text begin (ii)deleted text end new text begin (2)new text end the identity of the individual alleged to be the perpetrator;

deleted text begin (iii)deleted text end new text begin (3) new text end the identity of the individual substantiated as the perpetrator; and

deleted text begin (iv)deleted text end new text begin (4)new text end the identity of all individuals interviewed as part of the investigation.

deleted text begin (3)deleted text end new text begin (f)new text end Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.

deleted text begin (c)deleted text end new text begin (g) new text end After the assessment or investigation is completed, the name of the reporter must
be confidentialdeleted text begin .deleted text end new text begin , except:
new text end

new text begin (1) new text end the subject of the report may compel disclosure of the name of the reporter only with
the consent of the reporternew text begin ;new text end or

new text begin (2) new text end upon a written finding by a court that the report was false and there is evidence that
the report was made in bad faith.

This subdivision does not alter disclosure responsibilities or obligations under the Rules
of Criminal Procedure, except that where the identity of the reporter is relevant to a criminal
prosecution, the district court shall do an in-camera review prior to determining whether to
order disclosure of the identity of the reporter.

deleted text begin (d)deleted text end new text begin (h)new text end Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:

(1) data from reports determined to be false, maintained for three years after the finding
was made;

(2) data from reports determined to be inconclusive, maintained for four years after the
finding was made;

(3) data from reports determined to be substantiated, maintained for seven years after
the finding was made; and

(4) data from reports which were not investigated by a lead investigative agency and for
which there is no final disposition, maintained for three years from the date of the report.

deleted text begin (e)deleted text end new text begin (i)new text end The commissioners of health and human services shall annually publish on their
websites the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigation under this section,
and the resolution of those investigations. On a biennial basis, the commissioners of health
and human services shall jointly report the following information to the legislature and the
governor:

(1) the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigations under this section,
the resolution of those investigations, and which of the two lead agencies was responsible;

(2) trends about types of substantiated maltreatment found in the reporting period;

(3) deleted text begin if there are upward trends for types of maltreatment substantiated,deleted text end recommendations
fornew text begin preventing,new text end addressingnew text begin ,new text end and responding to deleted text begin themdeleted text end new text begin substantiated maltreatmentnew text end ;

(4) efforts undertaken or recommended to improve the protection of vulnerable adults;

(5) whether and where backlogs of cases result in a failure to conform with statutory
time frames and recommendations for reducing backlogs if applicable;

(6) recommended changes to statutes affecting the protection of vulnerable adults; and

(7) any other information that is relevant to the report trends and findings.

deleted text begin (f)deleted text end new text begin (j)new text end Each lead investigative agency must have a record retention policy.

deleted text begin (g)deleted text end new text begin (k)new text end Lead investigative agencies, prosecuting authorities, and law enforcement agencies
may exchange not public data, as defined in section 13.02, if the agency or authority
requesting the data determines that the data are pertinent and necessary to the requesting
agency in initiating, furthering, or completing an investigation under this section. Data
collected under this section must be made available to prosecuting authorities and law
enforcement officials, local county agencies, and licensing agencies investigating the alleged
maltreatment under this section. The lead investigative agency shall exchange not public
data with the vulnerable adult maltreatment review panel established in section 256.021 if
the data are pertinent and necessary for a review requested under that section.
Notwithstanding section 138.17, upon completion of the review, not public data received
by the review panel must be destroyed.

deleted text begin (h)deleted text end new text begin (l)new text end Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.

deleted text begin (i)deleted text end new text begin (m) Notwithstanding paragraph (a) or (b),new text end a lead investigative agency may new text begin share
common entry point or investigative data and may new text end notify other affected partiesnew text begin , including
the vulnerable adultnew text end and their authorized representativenew text begin ,new text end if the lead investigative agency has
reason to believe maltreatment has occurred and determines the information will safeguard
the well-being of the affected parties or dispel widespread rumor or unrest in the affected
facility.

deleted text begin (j)deleted text end new text begin (n)new text end Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.

Sec. 8. new text begin DIRECTION TO COMMISSIONER OF HEALTH; PROGRESS IN
IMPLEMENTING RECOMMENDATIONS OF LEGISLATIVE AUDITOR.
new text end

new text begin By March 1, 2020, the commissioner of health must submit a report to the chairs and
ranking minority members of the legislative committees with jurisdiction over health, human
services, or aging on the progress toward implementing each recommendation of the Office
of the Legislative Auditor with which the commissioner agreed in the commissioner's letter
to the legislative auditor dated March 1, 2018. The commissioner shall include in the report
existing data collected in the course of the commissioner's continuing oversight of the Office
of Health Facility Complaints sufficient to demonstrate the implementation of the
recommendations with which the commissioner agreed.
new text end

Sec. 9. new text begin REPORTS; OFFICE OF HEALTH FACILITY COMPLAINTS' RESPONSE
TO VULNERABLE ADULT MALTREATMENT ALLEGATIONS.
new text end

new text begin (a) On a quarterly basis until January 2021, and annually thereafter, the commissioner
of health must publish on the Department of Health website a report on the Office of Health
Facility Complaints' response to allegations of maltreatment of vulnerable adults. The report
must include:
new text end

new text begin (1) a description and assessment of the office's efforts to improve its internal processes
and compliance with federal and state requirements concerning allegations of maltreatment
of vulnerable adults, including any relevant timelines;
new text end

new text begin (2)(i) the number of reports received by type of reporter;
new text end

new text begin (ii) the number of reports investigated;
new text end

new text begin (iii) the percentage and number of reported cases awaiting triage;
new text end

new text begin (iv) the number and percentage of open investigations;
new text end

new text begin (v) the number and percentage of reports that have failed to meet state or federal timelines
for triaging, investigating, or making a final disposition of an investigation by cause of
delay; and
new text end

new text begin (vi) processes the office will implement to bring the office into compliance with state
and federal timelines for triaging, investigating, and making final dispositions of
investigations;
new text end

new text begin (3) a trend analysis of internal audits conducted by the office; and
new text end

new text begin (4) trends and patterns in maltreatment of vulnerable adults, licensing violations by
facilities or providers serving vulnerable adults, and other metrics as determined by the
commissioner.
new text end

new text begin (b) The commissioner shall maintain on the Department of Health website reports
published under this section for at least the past three years.
new text end

Sec. 10. new text begin REPORT; SAFETY AND QUALITY IMPROVEMENT PRACTICES.
new text end

new text begin By January 15, 2020, the safety and quality improvement technical panel established
under Minnesota Statutes, section 144A.53, subdivision 5, shall provide recommendations
to the legislature on legislative changes needed to promote safety and quality improvement
practices in long-term care settings and with long-term care providers. The recommendations
must address:
new text end

new text begin (1) how to implement a system for adverse health events reporting, learning, and
prevention in long-term care settings and with long-term care providers; and
new text end

new text begin (2) interim actions to improve systems for the timely analysis of reports and complaints
submitted to the Office of Health Facility Complaints to identify common themes and key
prevention opportunities, and to disseminate key findings to providers across the state for
the purposes of shared learning and prevention.
new text end

ARTICLE 14

MISCELLANEOUS

Section 1.

Minnesota Statutes 2018, section 144.1503, is amended to read:

144.1503 HOME AND COMMUNITY-BASED SERVICES EMPLOYEE
SCHOLARSHIP new text begin AND LOAN FORGIVENESS new text end PROGRAM.

Subdivision 1.

Creation.

The home and community-based services employee scholarship
new text begin and loan forgiveness new text end grant program is established for the purpose of assisting qualified
provider applicants to fund employee scholarships for education in nursing and other health
care fieldsnew text begin and to repay qualified educational loansnew text end new text begin secured by employees for education in
nursing and other health care fieldsnew text end .

new text begin Subd. 1a. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "qualified educational loan" means
a government, commercial, or foundation loan secured by an employee of a qualified provider
of older adult services, for actual costs paid for tuition, reasonable education expenses, and
reasonable living expenses related to the employee's graduate or undergraduate education.
new text end

Subd. 2.

Provision of grants.

The commissioner shall make grants available to qualified
providers of older adult services. Grants must be used by home and community-based service
providers to recruit and train staff through the establishment of an employee scholarship
new text begin and loan forgiveness new text end fund.

Subd. 3.

Eligibility.

(a) Eligible providers must primarily provide services to individuals
who are 65 years of age and older in home and community-based settings, including housing
with services establishments as defined in section 144D.01, subdivision 4; new text begin a facility licensed
under chapter 144G; new text end adult day care as defined in section 245A.02, subdivision 2a; and home
care services as defined in section 144A.43, subdivision 3.

(b) Qualifying providers must establish a home and community-based services employee
scholarship new text begin and loan forgiveness new text end program, as specified in subdivision 4. Providers that
receive funding under this section must use the funds to award scholarships tonew text begin , and to repay
qualified educational loans of,new text end employees who work an average of at least 16 hours per
week for the provider.

Subd. 4.

Home and community-based services employee scholarship program.

Each
qualifying provider under this section must propose a home and community-based services
employee scholarship new text begin and loan forgiveness new text end program. Providers must establish criteria by
which funds are to be distributed among employees. At a minimum, the scholarship new text begin and
loan forgiveness new text end program must cover employee costsnew text begin , and repay qualified educational loans
of employees,new text end related to a course of study that is expected to lead to career advancement
with the provider or in the field of long-term care, including home care, care of persons
with disabilities, or nursing.

Subd. 5.

Participating providers.

The commissioner shall publish a request for proposals
in the State Register, specifying provider eligibility requirements, criteria for a qualifying
employee scholarship new text begin and loan forgiveness new text end program, provider selection criteria,
documentation required for program participation, maximum award amount, and methods
of evaluation. The commissioner must publish additional requests for proposals each year
in which funding is available for this purpose.

Subd. 6.

Application requirements.

Eligible providers seeking a grant shall submit an
application to the commissioner. Applications must contain a complete description of the
employee scholarship new text begin and loan forgiveness new text end program being proposed by the applicant,
including the need for the organization to enhance the education of its workforce, the process
for determining which employees will be eligible for scholarshipsnew text begin or loan repaymentnew text end , any
other sources of funding for scholarshipsnew text begin or loan repaymentnew text end , the expected degrees or
credentials eligible for scholarshipsnew text begin or loan repaymentnew text end , the amount of funding sought for
the scholarship new text begin and loan forgiveness new text end program, a proposed budget detailing how funds will
be spent, and plans for retaining eligible employees after completion of their scholarshipnew text begin
or repayment of their loannew text end .

Subd. 7.

Selection process.

The commissioner shall determine a maximum award for
grants and make grant selections based on the information provided in the grant application,
including the demonstrated need for an applicant provider to enhance the education of its
workforce, the proposed employee scholarship new text begin and loan forgiveness new text end selection process, the
applicant's proposed budget, and other criteria as determined by the commissioner.
Notwithstanding any law or rule to the contrary, funds awarded to grantees in a grant
agreement do not lapse until the grant agreement expires.

Subd. 8.

Reporting requirements.

Participating providers shall submit an invoice for
reimbursement and a report to the commissioner on a schedule determined by the
commissioner and on a form supplied by the commissioner. The report shall include the
amount spent on scholarshipsnew text begin and loan repaymentnew text end ; the number of employees who received
scholarshipsnew text begin and the number of employees for whom loans were repaidnew text end ; and, for each
scholarship new text begin or loan forgiveness new text end recipient, the name of the recipient, the current position of
the recipient, the amount awardednew text begin or loan amount repaidnew text end , the educational institution attended,
the nature of the educational program, and the expected or actual program completion date.
During the grant period, the commissioner may require and collect from grant recipients
other information necessary to evaluate the program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 2.

Minnesota Statutes 2018, section 144A.10, subdivision 1, is amended to read:

Subdivision 1.

Enforcement authority.

The commissioner of health is the exclusive
state agency charged with the responsibility and duty of inspecting all facilities required to
be licensed under section 144A.02new text begin , and issuing correction orders and imposing fines as
provided in this section, Minnesota Rules, chapter 4658, or any other applicable lawnew text end . The
commissioner of health shall enforce the rules established pursuant to sections 144A.01 to
144A.155, subject only to the authority of the Department of Public Safety respecting the
enforcement of fire and safety standards in nursing homes and the responsibility of the
commissioner of human services under sections 245A.01 to 245A.16 or 252.28.

The commissioner may request and must be given access to relevant information, records,
incident reports, or other documents in the possession of a licensed facility if the
commissioner considers them necessary for the discharge of responsibilities. For the purposes
of inspections and securing information to determine compliance with the licensure laws
and rules, the commissioner need not present a release, waiver, or consent of the individual.
new text begin A nursing home's refusal to cooperate in providing lawfully requested information is grounds
for a correction order, a fine according to Minnesota Rules, part 4658.0190, item EE, or
both. new text end The identities of patients or residents must be kept private as defined by section 13.02,
subdivision 12.

Sec. 3.

Minnesota Statutes 2018, section 144A.45, subdivision 1, is amended to read:

Subdivision 1.

Regulations.

The commissioner shall regulate home care providers
pursuant to sections 144A.43 to 144A.482. The regulations shall include the following:

(1) provisions to assure, to the extent possible, the health, safety, well-being, and
appropriate treatment of persons who receive home care services while respecting a client's
autonomy and choice;

(2) requirements that home care providers furnish the commissioner with specified
information necessary to implement sections 144A.43 to 144A.482;

(3) standards of training of home care provider personnel;

(4) standards for provision of home care services;

(5) standards for medication management;

(6) standards for supervision of home care services;

(7) standards for client evaluation or assessment;

(8) requirements for the involvement of a client's health care provider, the documentation
of health care providers' orders, if required, and the client's service deleted text begin plandeleted text end new text begin agreementnew text end ;

(9) new text begin standards for new text end the maintenance of accurate, current client records;

(10) the establishment of basic and comprehensive levels of licenses based on services
provided; and

(11) provisions to enforce these regulations and the home care bill of rightsnew text begin , including
provisions for issuing penalties and fines according to section 144A.474, subdivision 11,
for violations of sections 144A.43 to 144A.482new text end .

Sec. 4.

Minnesota Statutes 2018, section 144A.45, subdivision 2, is amended to read:

Subd. 2.

Regulatory functions.

The commissioner shall:

(1) license, survey, and monitor without advance notice, home care providers in
accordance with sections 144A.43 to 144A.482;

(2) survey every temporary licensee within one year of the temporary license issuance
date subject to the temporary licensee providing home care services to a client or clients;

(3) survey all licensed home care providers on an interval that will promote the health
and safety of clients;

(4) with the consent of the client, visit the home where services are being provided;

(5) issue correction orders and assess civil penalties in accordance with deleted text begin sectiondeleted text end new text begin sectionsnew text end
144.653, subdivisions 5 to 8new text begin , 144A.474, and 144A.475new text end , for violations of sections 144A.43
to 144A.482;

(6) take action as authorized in section 144A.475; and

(7) take other action reasonably required to accomplish the purposes of sections 144A.43
to 144A.482.

Sec. 5.

Minnesota Statutes 2018, section 144A.474, subdivision 8, is amended to read:

Subd. 8.

Correction orders.

(a) A correction order may be issued whenever the
commissioner finds upon survey or during a complaint investigation that a home care
provider, a managerial official, or an employee of the provider is not in compliance with
sections 144A.43 to 144A.482. The correction order shall cite the specific statute and
document areas of noncompliance and the time allowed for correction.new text begin In addition to issuing
a correction order, the commissioner may impose an immediate fine as provided in
subdivision 11.
new text end

(b) The commissioner shall mail copies of any correction order to the last known address
of the home care provider, or electronically scan the correction order and e-mail it to the
last known home care provider e-mail address, within 30 calendar days after the survey exit
date. A copy of each correction ordernew text begin , the amount of any immediate fine issued, the correction
plan,new text end and copies of any documentation supplied to the commissioner shall be kept on file
by the home care provider, 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 home care provider must document in the provider's
records any action taken to comply with the correction order. The commissioner may request
a copy of this documentation and the home care provider's action to respond to the correction
order in future surveys, upon a complaint investigation, and as otherwise needed.

Sec. 6.

Minnesota Statutes 2018, section 144A.474, subdivision 9, is amended to read:

Subd. 9.

Follow-up surveys.

For providers that have Level 3 or Level 4 violations under
subdivision 11, or any violations determined to be widespread, the department shall conduct
a follow-up survey within 90 calendar days of the survey. When conducting a follow-up
survey, the surveyor will focus on whether the previous violations have been corrected and
may also address any new violations that are observed while evaluating the corrections that
have been made. If a new violation is identified on a follow-up survey, deleted text begin no fine will be
imposed unless it is not corrected on the next follow-up surveydeleted text end new text begin the surveyor shall issue a
correction order for the new violation and may impose an immediate fine for the new
violationnew text end .

Sec. 7.

Minnesota Statutes 2018, section 144A.474, subdivision 11, is amended to read:

Subd. 11.

Fines.

(a) Fines and enforcement actions under this subdivision may be assessed
based on the level and scope of the violations described in paragraph (c) as follows:

(1) Level 1, no fines or enforcement;

(2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement
mechanisms authorized in section 144A.475 for widespread violations;

(3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement
mechanisms authorized in section 144A.475; and

(4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the enforcement
mechanisms authorized in section 144A.475.

(b) Correction orders for violations are categorized by both level and scope and fines
shall be assessed as follows:

(1) level of violation:

(i) Level 1 is a violation that has no potential to cause more than a minimal impact on
the client and does not affect health or safety;

(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
to have harmed a client's health or safety, but was not likely to cause serious injury,
impairment, or death;

(iii) Level 3 is a violation that harmed a client's health or safety, not including serious
injury, impairment, or death, or a violation that has the potential to lead to serious injury,
impairment, or death; and

(iv) Level 4 is a violation that results in serious injury, impairment, or death;

(2) scope of violation:

(i) isolated, when one or a limited number of clients are affected or one or a limited
number of staff are involved or the situation has occurred only occasionally;

(ii) pattern, when more than a limited number of clients are affected, more than a limited
number of staff are involved, or the situation has occurred repeatedly but is not found to be
pervasive; and

(iii) widespread, when problems are pervasive or represent a systemic failure that has
affected or has the potential to affect a large portion or all of the clients.

(c) If the commissioner finds that the applicant or a home care provider required to be
licensed under sections 144A.43 to 144A.482 has not corrected violations by the date
specified in the correction order or conditional license resulting from a survey or complaint
investigation, the commissioner may impose deleted text begin adeleted text end new text begin an additionalnew text end finenew text begin for noncompliance with
a correction ordernew text end . A notice of noncompliance with a correction order must be mailed to
the applicant's or provider's last known address. The deleted text begin noncompliancedeleted text end notice new text begin of noncompliance
with a correction order new text end must list the violations not correctednew text begin and any fines imposednew text end .

(d) The license holder must pay the fines assessed on or before the payment date specifiednew text begin
on a correction order or on a notice of noncompliance with a correction ordernew text end . If the license
holder fails to deleted text begin fully comply with the orderdeleted text end new text begin pay a fine by the specified datenew text end , the commissioner
may issue a deleted text begin seconddeleted text end new text begin late payment new text end fine or suspend the license until the license holder deleted text begin complies
by paying the finedeleted text end new text begin pays all outstanding finesnew text end . A timely appeal shall stay payment of the new text begin late
payment new text end fine until the commissioner issues a final order.

(e) A license holder shall promptly notify the commissioner in writing when a violation
specified in deleted text begin the orderdeleted text end new text begin a notice of noncompliance with a correction ordernew text end is corrected. If upon
reinspection the commissioner determines that a violation has not been corrected as indicated
by the deleted text begin orderdeleted text end new text begin notice of noncompliance with a correction ordernew text end , the commissioner may issue
deleted text begin a seconddeleted text end new text begin an additionalnew text end finenew text begin for noncompliance with a notice of noncompliance with a
correction ordernew text end . The commissioner shall notify the license holder by mail to the last known
address in the licensing record that deleted text begin a seconddeleted text end new text begin an additional new text end fine has been assessed. The license
holder may appeal the deleted text begin seconddeleted text end new text begin additionalnew text end fine as provided under this subdivision.

(f) A home care provider that has been assessed a fine under this subdivision new text begin or
subdivision 8 new text end has a right to a reconsideration or a hearing under this section and chapter 14.

(g) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder shall be liable for payment of the fine.

(h) In addition to any fine imposed under this section, the commissioner may assess
costs related to an investigation that results in a final order assessing a fine or other
enforcement action authorized by this chapter.

(i) Fines collected under this subdivision shall be deposited in the state government
special revenue fund and credited to an account separate from the revenue collected under
section 144A.472. Subject to an appropriation by the legislature, the revenue from the fines
collected must be used by the commissioner for special projects to improve home care in
Minnesota as recommended by the advisory council established in section 144A.4799.

Sec. 8.

Minnesota Statutes 2018, section 611A.033, is amended to read:

611A.033 SPEEDY TRIAL; NOTICE OF SCHEDULE CHANGE.

(a) A victim has the right to request that the prosecutor make a demand under rule 11.09
of the Rules of Criminal Procedure that the trial be commenced within 60 days of the demand.
The prosecutor shall make reasonable efforts to comply with the victim's request.

(b) A prosecutor shall make reasonable efforts to provide advance notice of any change
in the schedule of the court proceedings to a victim who has been subpoenaed or requested
to testify.

(c) In a criminal proceeding in which a vulnerable adult, as defined in section 609.232,
subdivision 11, is a victim, the state maynew text begin , and, if requested to do so by the victim, the state
shall,new text end move the court for a speedy trial. The courtdeleted text begin , after consideration ofdeleted text end new text begin shall grant the
motion if it determines that new text end the age and health of the victimdeleted text begin , may grant a speedy trialdeleted text end new text begin justifies
doing sonew text end . The motion may be filed and served with the complaint or any time after the
complaint is filed and served.

Sec. 9.

new text begin [630.38] VULNERABLE ADULT VICTIM; MOTION FOR DEPOSITION.
new text end

new text begin In a criminal proceeding in which a vulnerable adult, as defined in section 609.232,
subdivision 11, is a victim, the state may, and, if requested to do so by the victim, the state
shall, make a motion to depose the victim under Minnesota Rules of Criminal Procedure,
rule 21. The court shall grant the motion if it determines that the age and health of the victim
justifies doing so or if other criteria in the rule are met. If the motion is granted, the court
shall ensure that the deposition takes place as soon as is practicable.
new text end

ARTICLE 15

APPROPRIATIONS

Section 1. new text begin APPROPRIATION; OFFICE OF OMBUDSMAN FOR LONG-TERM
CARE.
new text end

new text begin (a) $2,150,000 in fiscal year 2020 and $3,577,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of human services for 25 additional regional
ombudsmen in the Office of Ombudsman for Long-Term Care, to perform the duties in
Minnesota Statutes, section 256.9742.
new text end

new text begin (b) $510,000 in fiscal year 2020 and $977,000 in fiscal year 2021 are appropriated from
the general fund to the commissioner of human services for six additional staff in the Office
of Ombudsman for Long-Term Care to perform at least the following functions: supervision,
policy activities, consumer intake, and data management.
new text end

APPENDIX

Repealed Minnesota Statutes: 19-4863

144A.472 HOME CARE PROVIDER LICENSE; APPLICATION AND RENEWAL.

Subd. 4.

Multiple units.

Multiple units or branches of a licensee must be separately licensed if the commissioner determines that the units cannot adequately share supervision and administration of services from the main office.

144D.01 DEFINITIONS.

Subdivision 1.

Scope.

As used in sections 144D.01 to 144D.06, the following terms have the meanings given them.

Subd. 2.

Adult.

"Adult" means a natural person who has attained the age of 18 years.

Subd. 2a.

Arranged home care provider.

"Arranged home care provider" means a home care provider licensed under chapter 144A that provides services to some or all of the residents of a housing with services establishment and that is either the establishment itself or another entity with which the establishment has an arrangement.

Subd. 3.

Commissioner.

"Commissioner" means the commissioner of health or the commissioner's designee.

Subd. 3a.

Direct-care staff.

"Direct-care staff" means staff and employees who provide home care services listed in section 144A.471, subdivisions 6 and 7.

Subd. 4.

Housing with services establishment or establishment.

(a) "Housing with services establishment" or "establishment" means:

(1) an establishment providing sleeping accommodations to one or more adult residents, at least 80 percent of which are 55 years of age or older, and offering or providing, for a fee, one or more regularly scheduled health-related services or two or more regularly scheduled supportive services, whether offered or provided directly by the establishment or by another entity arranged for by the establishment; or

(2) an establishment that registers under section 144D.025.

(b) Housing with services establishment does not include:

(1) a nursing home licensed under chapter 144A;

(2) a hospital, certified boarding care home, or supervised living facility licensed under sections 144.50 to 144.56;

(3) a board and lodging establishment licensed under chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, or under chapter 245D or 245G;

(4) a board and lodging establishment which serves as a shelter for battered women or other similar purpose;

(5) a family adult foster care home licensed by the Department of Human Services;

(6) private homes in which the residents are related by kinship, law, or affinity with the providers of services;

(7) residential settings for persons with developmental disabilities in which the services are licensed under chapter 245D;

(8) a home-sharing arrangement such as when an elderly or disabled person or single-parent family makes lodging in a private residence available to another person in exchange for services or rent, or both;

(9) a duly organized condominium, cooperative, common interest community, or owners' association of the foregoing where at least 80 percent of the units that comprise the condominium, cooperative, or common interest community are occupied by individuals who are the owners, members, or shareholders of the units;

(10) services for persons with developmental disabilities that are provided under a license under chapter 245D; or

(11) a temporary family health care dwelling as defined in sections 394.307 and 462.3593.

Subd. 5.

Supportive services.

"Supportive services" means help with personal laundry, handling or assisting with personal funds of residents, or arranging for medical services, health-related services, social services, or transportation to medical or social services appointments. Arranging for services does not include making referrals, assisting a resident in contacting a service provider of the resident's choice, or contacting a service provider in an emergency.

Subd. 6.

Health-related services.

"Health-related services" include professional nursing services, home health aide tasks, or the central storage of medication for residents.

Subd. 7.

Family adult foster care home.

"Family adult foster care home" means an adult foster care home that is licensed by the Department of Human Services, that is the primary residence of the license holder, and in which the license holder is the primary caregiver.

144D.015 DEFINITION FOR PURPOSES OF LONG-TERM CARE INSURANCE.

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

144D.02 REGISTRATION REQUIRED.

No entity may establish, operate, conduct, or maintain a housing with services establishment in this state without registering and operating as required in sections 144D.01 to 144D.06.

144D.025 OPTIONAL REGISTRATION.

An establishment that meets all the requirements of this chapter except that fewer than 80 percent of the adult residents are age 55 or older, or a supportive housing establishment developed and funded in whole or in part with funds provided specifically as part of the plan to end long-term homelessness required under Laws 2003, chapter 128, article 15, section 9, may, at its option, register as a housing with services establishment.

144D.03 REGISTRATION.

Subdivision 1.

Registration procedures.

The commissioner shall establish forms and procedures for annual registration of housing with services establishments. The commissioner shall charge an annual registration fee of $155. No fee shall be refunded. A registered establishment shall notify the commissioner within 30 days of the date it is no longer required to be registered under this chapter or of any change in the business name or address of the establishment, the name or mailing address of the owner or owners, or the name or mailing address of the managing agent. There shall be no fee for submission of the notice.

Subd. 1a.

Surcharge for injunctive relief actions.

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

Subd. 2.

Registration information.

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

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

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

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

(4) verification that the establishment has entered into a housing with services contract, as required in section 144D.04, with each resident or resident's representative;

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

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

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

(8) whether services are included in the base rate to be paid by the resident.

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

144D.04 HOUSING WITH SERVICES CONTRACTS.

Subdivision 1.

Contract required.

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

Subd. 2.

Contents of contract.

A housing with services contract, which need not be entitled as such to comply with this section, shall include at least the following elements in itself or through supporting documents or attachments:

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

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

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

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

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

(6) the term of the contract;

(7) a description of the services to be provided to the resident in the base rate to be paid by the resident, including a delineation of the portion of the base rate that constitutes rent and a delineation of charges for each service included in the base rate;

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

(9) a conspicuous notice informing the tenant of the policy concerning the conditions under which and the process through which the contract may be modified, amended, or terminated, including whether a move to a different room or sharing a room would be required in the event that the tenant can no longer pay the current rent;

(10) a description of the establishment's complaint resolution process available to residents including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;

(11) the resident's designated representative, if any;

(12) the establishment's referral procedures if the contract is terminated;

(13) requirements of residency used by the establishment to determine who may reside or continue to reside in the housing with services establishment;

(14) billing and payment procedures and requirements;

(15) a statement regarding the ability of a resident to receive services from service providers with whom the establishment does not have an arrangement;

(16) a statement regarding the availability of public funds for payment for residence or services in the establishment; and

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

Subd. 2a.

Additional contract requirements.

(a) For a resident receiving one or more health-related services from the establishment's arranged home care provider, as defined in section 144D.01, subdivision 6, the contract must include the requirements in paragraph (b). A restriction of a resident's rights under this subdivision is allowed only if determined necessary for health and safety reasons identified by the home care provider's registered nurse in an initial assessment or reassessment, as defined under section 144A.4791, subdivision 8, and documented in the written service plan under section 144A.4791, subdivision 9. Any restrictions of those rights for people served under sections 256B.0915 and 256B.49 must be documented in the resident's coordinated service and support plan (CSSP), as defined under sections 256B.0915, subdivision 6 and 256B.49, subdivision 15.

(b) The contract must include a statement:

(1) regarding the ability of a resident to furnish and decorate the resident's unit within the terms of the lease;

(2) regarding the resident's right to access food at any time;

(3) regarding a resident's right to choose the resident's visitors and times of visits;

(4) regarding the resident's right to choose a roommate if sharing a unit; and

(5) notifying the resident of the resident's right to have and use a lockable door to the resident's unit. The landlord shall provide the locks on the unit. Only a staff member with a specific need to enter the unit shall have keys, and advance notice must be given to the resident before entrance, when possible.

Subd. 3.

Contracts in permanent files.

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

144D.045 INFORMATION CONCERNING ARRANGED HOME CARE PROVIDERS.

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

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

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

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

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

(5) any limits to the services available from the arranged provider.

144D.05 AUTHORITY OF COMMISSIONER.

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

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

144D.06 OTHER LAWS.

In addition to registration under this chapter, a housing with services establishment must comply with chapter 504B and the provisions of section 325F.72, and shall obtain and maintain all other licenses, permits, registrations, or other governmental approvals required of it. A housing with services establishment is not required to obtain a lodging license under chapter 157 and related rules.

144D.065 TRAINING IN DEMENTIA CARE REQUIRED.

(a) If a housing with services establishment registered under this chapter has a special program or special care unit for residents with Alzheimer's disease or other dementias or advertises, markets, or otherwise promotes the establishment as providing services for persons with Alzheimer's disease or other dementias, whether in a segregated or general unit, employees of the establishment and of the establishment's arranged home care provider must meet the following training requirements:

(1) supervisors of direct-care staff must have at least eight hours of initial training on topics specified under paragraph (b) within 120 working hours of the employment start date, and must have at least two hours of training on topics related to dementia care for each 12 months of employment thereafter;

(2) direct-care employees must have completed at least eight hours of initial training on topics specified under paragraph (b) within 160 working hours of the employment start date. Until this initial training is complete, an employee must not provide direct care unless there is another employee on site who has completed the initial eight hours of training on topics related to dementia care and who can act as a resource and assist if issues arise. A trainer of the requirements under paragraph (b), or a supervisor meeting the requirements in clause (1), must be available for consultation with the new employee until the training requirement is complete. Direct-care employees must have at least two hours of training on topics related to dementia for each 12 months of employment thereafter;

(3) staff who do not provide direct care, including maintenance, housekeeping, and food service staff, must have at least four hours of initial training on topics specified under paragraph (b) within 160 working hours of the employment start date, and must have at least two hours of training on topics related to dementia care for each 12 months of employment thereafter; and

(4) new employees may satisfy the initial training requirements by producing written proof of previously completed required training within the past 18 months.

(b) Areas of required training include:

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

(2) assistance with activities of daily living;

(3) problem solving with challenging behaviors; and

(4) communication skills.

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

(d) Housing with services establishments not included in paragraph (a) that provide assisted living services under chapter 144G must meet the following training requirements:

(1) supervisors of direct-care staff must have at least four hours of initial training on topics specified under paragraph (b) within 120 working hours of the employment start date, and must have at least two hours of training on topics related to dementia care for each 12 months of employment thereafter;

(2) direct-care employees must have completed at least four hours of initial training on topics specified under paragraph (b) within 160 working hours of the employment start date. Until this initial training is complete, an employee must not provide direct care unless there is another employee on site who has completed the initial four hours of training on topics related to dementia care and who can act as a resource and assist if issues arise. A trainer of the requirements under paragraph (b) or supervisor meeting the requirements under paragraph (a), clause (1), must be available for consultation with the new employee until the training requirement is complete. Direct-care employees must have at least two hours of training on topics related to dementia for each 12 months of employment thereafter;

(4) new employees may satisfy the initial training requirements by producing written proof of previously completed required training within the past 18 months.

144D.066 ENFORCEMENT OF DEMENTIA CARE TRAINING REQUIREMENTS.

Subdivision 1.

Enforcement.

(a) The commissioner shall enforce the dementia care training standards for staff working in housing with services settings and for housing managers according to clauses (1) to (3):

(1) for dementia care training requirements in section 144D.065, the commissioner shall review training records as part of the home care provider survey process for direct care staff and supervisors of direct care staff, in accordance with section 144A.474. The commissioner may also request and review training records at any time during the year;

(2) for dementia care training standards in section 144D.065, the commissioner shall review training records for maintenance, housekeeping, and food service staff and other staff not providing direct care working in housing with services settings as part of the housing with services registration application and renewal application process in accordance with section 144D.03. The commissioner may also request and review training records at any time during the year; and

(3) for housing managers, the commissioner shall review the statement verifying compliance with the required training described in section 144D.10, paragraph (d), through the housing with services registration application and renewal application process in accordance with section 144D.03. The commissioner may also request and review training records at any time during the year.

(b) The commissioner shall specify the required forms and what constitutes sufficient training records for the items listed in paragraph (a), clauses (1) to (3).

Subd. 2.

Fines for noncompliance.

(a) Beginning January 1, 2017, the commissioner may impose a $200 fine for every staff person required to obtain dementia care training who does not have training records to show compliance. For violations of subdivision 1, paragraph (a), clause (1), the fine will be imposed upon the home care provider, and may be appealed under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. For violations of subdivision 1, paragraph (a), clauses (2) and (3), the fine will be imposed on the housing with services registrant and may be appealed under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. Prior to imposing the fine, the commissioner must allow two weeks for staff to complete the required training. Fines collected under this section shall be deposited in the state treasury and credited to the state government special revenue fund.

(b) The housing with services registrant and home care provider must allow for the required training as part of employee and staff duties. Imposition of a fine by the commissioner does not negate the need for the required training. Continued noncompliance with the requirements of sections 144D.065 and 144D.10 may result in revocation or nonrenewal of the housing with services registration or home care license. The commissioner shall make public the list of all housing with services establishments that have complied with the training requirements.

Subd. 3.

Technical assistance.

From January 1, 2016, to December 31, 2016, the commissioner shall provide technical assistance instead of imposing fines for noncompliance with the training requirements. During the year of technical assistance, the commissioner shall review the training records to determine if the records meet the requirements and inform the home care provider. The commissioner shall also provide information about available training resources.

144D.07 RESTRAINTS.

Residents must be free from any physical or chemical restraints imposed for purposes of discipline or convenience.

144D.08 UNIFORM CONSUMER INFORMATION GUIDE.

All housing with services establishments shall make available to all prospective and current residents information consistent with the uniform format and the required components adopted by the commissioner under section 144G.06. This section does not apply to an establishment registered under section 144D.025 serving the homeless.

144D.09 TERMINATION OF LEASE.

The housing with services establishment shall include with notice of termination of lease information about how to contact the ombudsman for long-term care, including the address and telephone number along with a statement of how to request problem-solving assistance.

144D.10 MANAGER REQUIREMENTS.

(a) The person primarily responsible for oversight and management of a housing with services establishment, as designated by the owner of the housing with services establishment, must obtain at least 30 hours of continuing education every two years of employment as the manager in topics relevant to the operations of the housing with services establishment and the needs of its tenants. Continuing education earned to maintain a professional license, such as nursing home administrator license, nursing license, social worker license, and real estate license, can be used to complete this requirement.

(b) For managers of establishments identified in section 325F.72, this continuing education must include at least eight hours of documented training on the topics identified in section 144D.065, paragraph (b), within 160 working hours of hire, and two hours of training on these topics for each 12 months of employment thereafter.

(c) For managers of establishments not covered by section 325F.72, but who provide assisted living services under chapter 144G, this continuing education must include at least four hours of documented training on the topics identified in section 144D.065, paragraph (b), within 160 working hours of hire, and two hours of training on these topics for each 12 months of employment thereafter.

(d) A statement verifying compliance with the continuing education requirement must be included in the housing with services establishment's annual registration to the commissioner of health. The establishment must maintain records for at least three years demonstrating that the person primarily responsible for oversight and management of the establishment has attended educational programs as required by this section.

(e) New managers may satisfy the initial dementia training requirements by producing written proof of previously completed required training within the past 18 months.

(f) This section does not apply to an establishment registered under section 144D.025 serving the homeless.

144D.11 EMERGENCY PLANNING.

(a) Each registered housing with services establishment 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 tenants upon signing a lease;

(4) post emergency exit diagrams on each floor; and

(5) have a written policy and procedure regarding missing tenants.

(b) Each registered housing with services establishment must provide emergency and disaster training to all staff during the initial staff orientation and annually thereafter and must make emergency and disaster training available to all tenants annually. Staff who have not received emergency and disaster training are allowed to work only when trained staff are also working on site.

(c) Each registered housing with services location must conduct and document a fire drill or other emergency drill at least every six months. To the extent possible, drills must be coordinated with local fire departments or other community emergency resources.

144G.01 DEFINITIONS.

Subdivision 1.

Scope; other definitions.

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

Subd. 2.

Assisted living.

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

Subd. 3.

Assisted living client; client.

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

Subd. 4.

Commissioner.

"Commissioner" means the commissioner of health.

144G.02 ASSISTED LIVING; PROTECTED TITLE; REGULATORY FUNCTION.

Subdivision 1.

Protected title; restriction on use.

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

Subd. 2.

Authority of commissioner.

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

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

144G.03 ASSISTED LIVING REQUIREMENTS.

Subdivision 1.

Verification in annual registration.

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

Subd. 2.

Minimum requirements for assisted living.

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

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

(1) provides or makes available health-related services under a home care license. At a minimum, health-related services must include:

(i) assistance with self-administration of medication, medication management, or medication administration as defined in section 144A.43; and

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

All health-related services shall be provided in a manner that complies with applicable home care licensure requirements in chapter 144A and sections 148.171 to 148.285;

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

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

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

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

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

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

(i) awake;

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

(iii) capable of communicating with assisted living clients;

(iv) capable of recognizing the need for assistance;

(v) capable of providing either the assistance required or summoning the appropriate assistance; and

(vi) capable of following directions;

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

(i) two meals per day;

(ii) weekly housekeeping;

(iii) weekly laundry service;

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

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

(vi) periodic opportunities for socialization; and

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

Subd. 3.

Exemption from awake-staff requirement.

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

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

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

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

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

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

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

Subd. 4.

Nursing assessment.

(a) A housing with services establishment offering or providing assisted living shall:

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

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

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

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

Subd. 5.

Assistance with arranged home care provider.

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

Subd. 6.

Termination of housing with services contract.

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

(1) the effective date of termination;

(2) the section of the contract that authorizes the termination;

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

(4) an explanation that:

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

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

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

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

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

144G.04 RESERVATION OF RIGHTS.

Subdivision 1.

Use of services.

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

Subd. 2.

Housing with services contracts.

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

Subd. 3.

Provision of services.

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

Subd. 4.

Altering operations; service packages.

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

144G.05 REIMBURSEMENT UNDER ASSISTED LIVING SERVICE PACKAGES.

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

144G.06 UNIFORM CONSUMER INFORMATION GUIDE.

The commissioner shall adopt a uniform format for the guide to be used by individual providers, and the required components of materials to be used by providers to inform assisted living clients of their legal rights, and shall make the uniform format and the required components available to assisted living providers.

325F.72 DISCLOSURE OF SPECIAL CARE STATUS REQUIRED.

Subdivision 1.

Persons to whom disclosure is required.

Housing with services establishments, as defined in sections 144D.01 to 144D.07, that secure, segregate, or provide a special program or special unit for residents with a diagnosis of probable Alzheimer's disease or a related disorder or that advertise, market, or otherwise promote the establishment as providing specialized care for Alzheimer's disease or a related disorder are considered a "special care unit." All special care units shall provide a written disclosure to the following:

(1) the commissioner of health, if requested;

(2) the Office of Ombudsman for Long-Term Care; and

(3) each person seeking placement within a residence, or the person's authorized representative, before an agreement to provide the care is entered into.

Subd. 2.

Content.

Written disclosure shall include, but is not limited to, the following:

(1) a statement of the overall philosophy and how it reflects the special needs of residents with Alzheimer's disease or other dementias;

(2) the criteria for determining who may reside in the special care unit;

(3) the process used for assessment and establishment of the service plan or agreement, including how the plan is responsive to changes in the resident's condition;

(4) staffing credentials, job descriptions, and staff duties and availability, including any training specific to dementia;

(5) physical environment as well as design and security features that specifically address the needs of residents with Alzheimer's disease or other dementias;

(6) frequency and type of programs and activities for residents of the special care unit;

(7) involvement of families in resident care and availability of family support programs;

(8) fee schedules for additional services to the residents of the special care unit; and

(9) a statement that residents will be given a written notice 30 days prior to changes in the fee schedule.

Subd. 3.

Duty to update.

Substantial changes to disclosures must be reported to the parties listed in subdivision 1 at the time the change is made.

Subd. 4.

Remedy.

The attorney general may seek the remedies set forth in section 8.31 for repeated and intentional violations of this section. However, no private right of action may be maintained as provided under section 8.31, subdivision 3a.

Repealed Minnesota Rule: 19-4863

6400.6970 FEES.

Subpart 1.

Payment types and nonrefundability.

The fees imposed in this part shall be paid by cash, personal check, bank draft, cashier's check, or money order made payable to the Board of Examiners for Nursing Home Administrators. All fees are nonrefundable.

Subp. 2.

Amounts.

The amount of fees may be set by the board with the approval of the Department of Management and Budget up to the limits provided in this part depending upon the total amount required to sustain board operations under Minnesota Statutes, section 16A.1285, subdivision 2. Information about fees in effect at any time is available from the board office. The maximum amounts of fees are:

A.

application for licensure, $150;

B.

for a prospective applicant for a review of education and experience advisory to the license application, $50, to be applied to the fee for application for licensure if the latter is submitted within one year of the request for review of education and experience;

C.

state examination, $75;

D.

initial license, $200 if issued between July 1 and December 31, $100 if issued between January 1 and June 30;

E.

acting administrator permit, $250;

F.

renewal license, $200;

G.

duplicate license, $10;

H.

fee to a sponsor for review of individual continuing education seminars, institutes, workshops, or home study courses:

(1)

for less than seven clock hours, $30; and

(2)

for seven or more clock hours, $50;

I.

fee to a licensee for review of continuing education seminars, institutes, workshops, or home study courses not previously approved for a sponsor and submitted with an application for license renewal:

(1)

for less than seven clock hours total, $30; and

(2)

for seven or more clock hours total, $50;

J.

late renewal fee, $50;

K.

fee to a licensee for verification of licensure status and examination scores, $30; and

L.

registration as a registered continuing education sponsor, $1,000.

SF 2686

Bill Text Versions

Current Version - as introduced

ARTICLE 1

ASSISTED LIVING LICENSURE

Section 1.

new text begin [144G.10] DEFINITIONS. new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin Subd. 2. new text end

new text begin Activities of daily living. new text end

new text begin Subd. 3. new text end

new text begin Adult. new text end

new text begin Subd. 4. new text end

new text begin Agent. new text end

new text begin Subd. 5. new text end

new text begin Alzheimer's disease. new text end

new text begin Subd. 6. new text end

new text begin Applicant. new text end

new text begin Subd. 7. new text end

new text begin Assisted living administrator. new text end

new text begin Subd. 8. new text end

new text begin Assisted living facility. new text end

new text begin Subd. 9. new text end

new text begin Assisted living facility and base care facility contract. new text end

new text begin Subd. 10. new text end

new text begin Assisted living resident or resident. new text end

new text begin Subd. 11. new text end

new text begin Assisted living services. new text end

new text begin Subd. 12. new text end

new text begin Basic care facility. new text end

new text begin Subd. 13. new text end

new text begin Basic care services. new text end

new text begin Subd. 14. new text end

new text begin Change of ownership. new text end

new text begin Subd. 15. new text end

new text begin Commissioner. new text end

new text begin Subd. 16. new text end

new text begin Compliance officer. new text end

new text begin Subd. 17. new text end

new text begin Comprehensive assisted living services. new text end

new text begin Subd. 18. new text end

new text begin Control. new text end

new text begin Subd. 19. new text end

new text begin Controlled substance. new text end

new text begin Subd. 20. new text end

new text begin Controlling individual. new text end

new text begin Subd. 21. new text end

new text begin Commissioner. new text end

new text begin Subd. 22. new text end

new text begin Dementia. new text end

new text begin Subd. 23. new text end

new text begin Dementia care unit. new text end

new text begin Subd. 24. new text end

new text begin Dementia-trained staff. new text end

new text begin Subd. 25. new text end

new text begin Designated representative. new text end

new text begin Subd. 26. new text end

new text begin Dietary supplement. new text end

new text begin Subd. 27. new text end

new text begin Direct contact. new text end

new text begin Subd. 28. new text end

new text begin Direct ownership interest. new text end

new text begin Subd. 29. new text end

new text begin Facility. new text end

new text begin Subd. 30. new text end

new text begin Hands-on assistance. new text end

new text begin Subd. 31. new text end

new text begin Indirect ownership interest. new text end

new text begin Subd. 32. new text end

new text begin Licensed health professional. new text end

new text begin Subd. 33. new text end

new text begin Licensed resident bed capacity. new text end

new text begin Subd. 34. new text end

new text begin Licensee. new text end

new text begin Subd. 35. new text end

new text begin Maltreatment. new text end

new text begin Subd. 36. new text end

new text begin Management agreement. new text end

new text begin Subd. 37. new text end

new text begin [144G.10] DEFINITIONS.
new text end