SF 4392

as introduced - 91st Legislature (2019 - 2020) Posted on 03/17/2020 01:56pm

A bill for an act
relating to health; changing assisted living provisions; amending Minnesota Statutes
2019 Supplement, sections 144.6512, by adding a subdivision; 144A.474,
subdivision 11; 144G.07, by adding a subdivision; 144G.08, subdivisions 7, 9, 23,
by adding a subdivision; 144G.30, subdivision 2; 144G.31, subdivisions 4, 5;
144G.40, subdivision 1; 144G.41, subdivisions 7, 8; 144G.42, subdivisions 8, 9,
10, by adding a subdivision; 144G.43, subdivision 1; 144G.45, subdivisions 1, 2,
5; 144G.50, subdivisions 1, 2; 144G.52, subdivisions 1, 3, 5, 7; 144G.54,
subdivisions 1, 2, 3, 4; 144G.55, subdivisions 1, 2, 3; 144G.57; 144G.64; 144G.70,
subdivision 2; 144G.80, subdivision 3; 144G.82, subdivision 3; 144G.83,
subdivision 2; 144G.90, subdivision 1; 144G.91, subdivisions 13, 21; 144G.92,
subdivision 5; 144G.93; 144G.95, subdivision 1; 144G.9999, subdivision 2;
proposing coding for new law in Minnesota Statutes, chapter 144G.

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

Section 1.

Minnesota Statutes 2019 Supplement, section 144.6512, is amended by adding
a subdivision to read:

new text begin Subd. 6. new text end

new text begin Other laws. new text end

new text begin Nothing in this section affects the rights and remedies available
under section 626.557, subdivisions 10, 17, and 20.
new text end

Sec. 2.

Minnesota Statutes 2019 Supplement, 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 (b) and new text begin may be new text end imposed
immediately with no opportunity to correct the violation first as follows new text begin prior to imposition new text end :

(1) Level 1, no fines or enforcement;

(2) Level 2, a fine of $500 per violation, in addition to any of the enforcement
mechanisms authorized in section 144A.475 for widespread violations;

(3) Level 3, a fine of $3,000 per incident, in addition to any of the enforcement
mechanisms authorized in section 144A.475;

(4) Level 4, a fine of $5,000 per incident, in addition to any of the enforcement
mechanisms authorized in section 144A.475;

(5) for maltreatment violations for which the licensee was determined to be responsible
for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000.
A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible
for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury;
and

(6) the fines in clauses (1) to (4) are increased and immediate fine imposition is authorized
for both surveys and investigations conducted.

When a fine is assessed against a facility for substantiated maltreatment, the commissioner
shall not also impose an immediate fine under this chapter for the same circumstance.

(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 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-mail to the applicant's or provider's last known
e-mail address. The noncompliance notice must list the violations not corrected.

(d) For every new text begin Level 3 and Level 4 new text end violation identified by the commissioner, the
commissioner deleted text begin shall deleted text end new text begin may new text end issue an immediate fine pursuant to paragraph (a), clause (6). The
license holder must still correct the violation in the time specified. The issuance of an
immediate fine can occur in addition to any enforcement mechanism authorized under
section 144A.475. The immediate fine may be appealed as allowed under this subdivision.

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

(f) A license holder 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 a
second fine. The commissioner shall notify the license holder by mail to the last known
address in the licensing record that a second fine has been assessed. The license holder may
appeal the second fine as provided under this subdivision.

(g) A home care provider that has been assessed a fine under this subdivision has a right
to a reconsideration or a hearing under this section and chapter 14.

(h) 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.

(i) 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.

(j) Fines collected under paragraph (a), clauses (1) to (4), 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.

(k) Fines collected under paragraph (a), clause (5), shall be deposited in a dedicated
special revenue account and appropriated to the commissioner to provide compensation
according to subdivision 14 to clients subject to maltreatment. A client may choose to receive
compensation from this fund, not to exceed $5,000 for each substantiated finding of
maltreatment, or take civil action. This paragraph expires July 31, 2021.

new text begin (l) The procedures in section 626.557, subdivision 21, must be followed when appealing
a fine issued as a result of a finding of substantiated maltreatment under section 144A.474,
subdivision 11, paragraph (a), clause (5).
new text end

Sec. 3.

Minnesota Statutes 2019 Supplement, section 144G.07, is amended by adding a
subdivision to read:

new text begin Subd. 6. new text end

new text begin Other laws. new text end

new text begin Nothing in this section affects the rights and remedies available
under section 626.557, subdivisions 10, 17, and 20.
new text end

Sec. 4.

Minnesota Statutes 2019 Supplement, section 144G.08, subdivision 7, is amended
to read:

Subd. 7.

Assisted living facility.

"Assisted living facility" means a licensed facility that
provides sleeping accommodations and assisted living services to one or more adults.
Assisted living facility includes assisted living facility with dementia care, and does not
include:

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

(2) a nursing home licensed under chapter 144A;

(3) a hospital, certified boarding care, or supervised living facility licensed under sections
144.50 to 144.56;

(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
9520.0500 to 9520.0670, or under chapter 245D or 245G;

(5) services and residential settings licensed under chapter 245A, including adult foster
care and services and settings governed under the standards in chapter 245D;

(6) a private home in which the residents are related by kinship, law, or affinity with the
provider of services;

(7) 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;

(8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;

(9) a setting offering services conducted by and for the adherents of any recognized
church or religious denomination for its members exclusively through spiritual means or
by prayer for healing;

(10) 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, except for those developments
that market or hold themselves out as assisted living facilities and provide assisted living
services;

(11) rental housing developed under United States Code, title 42, section 1437, or United
States Code, title 12, section 1701q;

(12) 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;

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

(14) a covered setting as defined in section 325F.721, subdivision 1, paragraph (b) deleted text begin . deleted text end new text begin ; or
new text end

new text begin (15) any establishment that exclusively or primarily serves as a shelter or temporary
shelter for victims of domestic or any other form of violence.
new text end

Sec. 5.

Minnesota Statutes 2019 Supplement, section 144G.08, is amended by adding a
subdivision to read:

new text begin Subd. 7a. new text end

new text begin Assisted living facility license. new text end

new text begin (a) "Assisted living facility license" means a
certificate issued by the commissioner under section 144G.10 that authorizes the licensee
to provide sleeping accommodations and assisted living services or assisted living services
with dementia care for a specified period of time and in accordance with the terms of the
license and the rules of the commissioner.
new text end

new text begin (b) A license must be issued for each assisted living facility located at a separate address,
except for a campus as defined in this section.
new text end

new text begin (c) For the purposes of this section, "campus" means two or more assisted living buildings,
as defined in this section, operated by the same licensee and located on the same property,
identified by a single Property Identification Number (PID). Assisted living buildings
operated by the same licensee, but identified by different PIDs may be considered a campus
when the building is located on an adjacent property to that of the facility's main building.
new text end

new text begin (d) For the purposes of this section, "assisted living building" means a building in which
sleeping accommodations and assisted living services are provided to one or more adults,
and to which an assisted living facility license has been issued.
new text end

new text begin (e) For the purposes of this section, "adjacent property" means when two properties
share a portion of a legal boundary.
new text end

new text begin (f) An assisted living license for a campus shall be issued to the address of the facility's
main assisted living building and shall identify the address of each additional assisted living
building located on the campus.
new text end

new text begin (g) When dementia care services are provided in any assisted living building identified
on the assisted living license for a campus, the licensee must obtain the assisted living with
dementia care level of licensure for that campus license.
new text end

new text begin (h) The licensed resident capacity shall be identified for each assisted living building
listed on the assisted living license.
new text end

Sec. 6.

Minnesota Statutes 2019 Supplement, section 144G.08, subdivision 9, is amended
to read:

Subd. 9.

Assisted living services.

"Assisted living services" includes one or more of
the following:

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

(2) providing standby assistance;

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

(4) providing verbal or visual reminders to the resident to perform regularly scheduled
treatments and exercises;

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

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

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

(8) medication management services;

(9) hands-on assistance with transfers and mobility;

(10) treatment and therapies;

(11) assisting residents with eating when the residents 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;

(12) providing other complex or specialty health care services; and

(13) supportive services in addition to the provision of at least one of the services listed
in clauses (1) to (12).

Sec. 7.

Minnesota Statutes 2019 Supplement, section 144G.08, subdivision 23, is amended
to read:

Subd. 23.

Direct ownership interest.

"Direct ownership interest" means an individual
or deleted text begin organization deleted text end new text begin legal entity new text end with the possession of at least five percent equity in capital,
stock, or profits of the licensee, or who is a member of a limited liability company of the
licensee.

Sec. 8.

new text begin [144G.191] ASSISTED LIVING FACILITY LICENSING
IMPLEMENTATION; PROVISIONAL LICENSES; TRANSITION PERIOD FOR
CURRENT PROVIDERS.
new text end

new text begin Subdivision 1. new text end

new text begin Provisional licenses. new text end

new text begin (a) Beginning March 1, 2021, applications for
provisional assisted living facility licenses under section 144G.12 may be submitted. No
provisional or assisted living facility licenses under this chapter shall be effective prior to
August 1, 2021.
new text end

new text begin (b) Beginning June 1, 2021, no initial housing with services establishment registration
applications will be accepted under chapter 144D.
new text end

new text begin (c) Beginning June 1, 2021, no temporary comprehensive home care provider license
applications will be accepted for providers that do not intend to provide home care services
under sections 144A.43 to 144A.484 on or after August 1, 2021.
new text end

new text begin Subd. 2. new text end

new text begin New construction; building permit. new text end

new text begin (a) All prospective assisted living facility
license applicants under new construction as defined in section 144G.08, subdivision 42,
with a complete building permit application submitted on or before July 31, 2021, must
meet existing construction requirements. Assisted living applicants under new construction
with a complete building permit application submitted on or after August 1, 2021, must
meet the new construction requirements under section 144G.45.
new text end

new text begin (b) The building permit application must be complete and submitted to the appropriate
building code jurisdiction.
new text end

new text begin (c) In areas of jurisdiction where there is no building code authority, an application for
an electrical or plumbing permit is acceptable in lieu of the building permit application.
new text end

new text begin (d) In jurisdictions where building plan review applications are separated from building
permit applications, an application for plan review is acceptable in lieu of the building
permit application.
new text end

new text begin Subd. 3. new text end

new text begin New construction; plan review. new text end

new text begin Beginning March 1, 2021, prospective assisted
living facility license applicants under new construction as defined in section 144G.08,
subdivision 42, may submit for plan review of the new construction requirements under
section 144G.45.
new text end

new text begin Subd. 4. new text end

new text begin Current comprehensive home care providers; provision of assisted living
services. new text end

new text begin (a) Comprehensive home care providers that do not intend to provide home care
services under chapter 144A on or after August 1, 2021, shall be issued a prorated license
period upon renewal and is applicable to renewal effective dates beginning September 1,
2020. The prorated license period will be effective from the current comprehensive home
care license renewal date through July 31, 2021.
new text end

new text begin (b) Comprehensive home care providers with prorated license periods shall pay a prorated
fee based on the number of months the comprehensive home care license is in effect.
new text end

new text begin (c) As of August 1, 2021, comprehensive home care providers are prohibited from
providing assisted living services as defined in section 144G.08, subdivision 9.
new text end

new text begin Subd. 5. new text end

new text begin Current housing with services establishments; conversion to licensure. new text end

new text begin (a)
Beginning January 1, 2021, all current housing with services establishments registered under
chapter 144D and intending to provide assisted living services on or after August 1, 2021,
must apply for an assisted living facility license under this chapter. The licensee on the
assisted living facility application may but need not be the same as the current housing with
services establishment registrant.
new text end

new text begin (b) By August 1, 2021, all registered housing with services establishments providing
assisted living services must have an assisted living facility license under this chapter.
new text end

new text begin (c) As of August 1, 2021, any existing housing with services establishment registered
under chapter 144D that does not intend to convert their registration to an assisted living
facility license under this chapter is prohibited from providing assisted living services as
defined in section 144G.08, subdivision 9.
new text end

new text begin Subd. 6. new text end

new text begin Conversion to assisted living licensure; renewal periods; prorated
licenses. new text end

new text begin (a) Applicants converting from a housing with services establishment registration
under chapter 144D to an assisted living facility license under this chapter must be provided
a new renewal date upon application for an assisted living facility license. The commissioner
shall assign a new, randomly generated renewal date to evenly disperse assisted living
facility license renewal dates throughout a calendar year.
new text end

new text begin (b) Applicants for converting housing with services establishments that receive new
license renewal dates occurring in September 2020 or October 2020 shall receive one assisted
living facility license upon conversion that is effective from August 1, 2021, and prorated
for 13- or 14-month periods, respectively.
new text end

new text begin (c) Applicants for current housing with services establishments that receive new license
renewal dates occurring in November 2020 or December 2020 must choose one of two
options:
new text end

new text begin (1) receive one assisted living facility license upon conversion effective August 1, 2021,
and prorated for 15- or 16-month periods, respectively; or
new text end

new text begin (2) receive one assisted living facility license upon conversion, effective August 1, 2021,
prorated for three- or four-month periods, respectively.
new text end

new text begin (d) Applicants for current housing with services establishments that receive new license
renewal dates occurring in January 2021 through July 2021 shall receive one assisted living
facility license upon conversion effective August 1, 2021, and prorated for five- to 11-month
periods, respectively.
new text end

new text begin (e) Applicants for current housing with services establishments that receive a new license
renewal date occurring in August 2021 shall receive one assisted living facility license upon
conversation effective for a full 12-month period.
new text end

new text begin (f) Applicants for current housing with services establishments converting to an assisted
living facility license shall receive their first assisted living facility license renewal application
for a full 12-month effective period approximately 90 days prior to the expiration of the
facility's prorated license.
new text end

new text begin (g) Applicants for current housing with services establishments who intend to obtain
more than one assisted living facility license under this chapter may request that the
commissioner allow all applicable renewal dates to occur on the same date or may request
all applicable renewal dates to occur at different points throughout a calendar year.
new text end

new text begin (h) All prorated licensing fee amounts for applicants of converting housing with services
establishments will be determined by calculating the appropriate annual fee based on section
144.122, paragraph (d), and dividing the total annual fee amount by the number of months
the prorated license will be effective.
new text end

new text begin Subd. 7. new text end

new text begin Conversion to assisted living licensure; background studies. new text end

new text begin (a) Any new
individuals listed on the assisted living facility application who have a direct ownership
interest in the license, as defined in section 144G.08, subdivision 23, or who are managerial
officials as defined in section 144G.08, subdivision 36, are subject to the background study
requirements of section 144.057. No individual may be involved in the management,
operation, or control of an assisted living facility if the individual has been disqualified
under chapter 245C.
new text end

new text begin (b) The commissioner shall not issue a license if any controlling individual, including
a 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 (c) If the individual requests reconsideration of a disqualification under section 144.057
or chapter 245C and the commissioner sets aside or rescinds the disqualification, the
individual is eligible to be involved in the management, operation, or control of the assisted
living facility.
new text end

new text begin (d) 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 assisted
living facility.
new text end

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

new text begin Subd. 8. new text end

new text begin Changes of ownership; current housing with services establishment
registrations. new text end

new text begin (a) A change of ownership application for an assisted living facility registered
as a housing with services establishment under chapter 144D prior to August 1, 2021, and
that has an anticipated change of ownership transaction effective on or after August 1, 2021,
must be submitted: (1) with an assisted living facility license application provided by the
commissioner; (2) according to sections 144G.08 to 144G.9999; and (3) with the assisted
living licensure fees in section 144.122, paragraph (d).
new text end

new text begin (b) Applications for changes of ownership must be submitted to the commissioner at
least 60 calendar days prior to the anticipated effective date of the sale or transaction.
new text end

Sec. 9.

Minnesota Statutes 2019 Supplement, section 144G.30, subdivision 2, is amended
to read:

Subd. 2.

Surveys.

The commissioner shall conduct a survey of each assisted living
facility on a frequency of at least once every deleted text begin two years deleted text end new text begin 24 months new text end . The commissioner may
conduct surveys more frequently than every deleted text begin two years deleted text end new text begin 24 months new text end based on the license
category, the new text begin assisted living new text end facility's compliance history, the number of residents served,
or other factors as determined by the commissioner deemed necessary to ensure the health,
safety, and welfare of residents and compliance with the law.

Sec. 10.

Minnesota Statutes 2019 Supplement, section 144G.31, subdivision 4, is amended
to read:

Subd. 4.

Fine amounts.

(a) Fines and enforcement actions under this subdivision may
be assessed based on the level and scope of the violations described in subdivisions 2 and
3 as follows and may be imposed immediately with no opportunity to correct the violation
prior to imposition:

(1) Level 1, no fines or enforcement;

(2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism
authorized in section 144G.20 for widespread violations;

(3) Level 3, a fine of $3,000 per violation per deleted text begin incident deleted text end new text begin violation new text end , in addition to any
enforcement mechanism authorized in section 144G.20;

(4) Level 4, a fine of $5,000 per deleted text begin incident deleted text end new text begin violation new text end , in addition to any enforcement
mechanism authorized in section 144G.20; and

(5) for maltreatment violations for which the licensee was determined to be responsible
for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000.
A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible
for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury.

(b) When a fine is assessed against deleted text begin a deleted text end new text begin an assisted living new text end facility for substantiated
maltreatment, the commissioner shall not also impose an immediate fine under this chapter
for the same circumstance.

Sec. 11.

Minnesota Statutes 2019 Supplement, section 144G.31, subdivision 5, is amended
to read:

Subd. 5.

Immediate fine; payment.

(a) For every Level 3 or Level 4 violation, the
commissioner may issue an immediate fine new text begin that may be imposed immediately with no
opportunity to correct the violation prior to imposition new text end . 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 section 144G.20. The immediate fine may
be appealed as allowed under this chapter.

(b) 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.

(c) A licensee shall promptly notify the commissioner in writing when a violation
specified in the order is corrected. If upon deleted text begin reinspection deleted text end new text begin a follow-up survey new text end 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 this subdivision.

(d) deleted text begin A deleted text end new text begin An assisted living new text end facility that has been assessed a fine under this section has a
right to a reconsideration or hearing under this chapter and chapter 14.

Sec. 12.

Minnesota Statutes 2019 Supplement, section 144G.40, subdivision 1, is amended
to read:

Subdivision 1.

Responsibility for housing and services.

The deleted text begin facility deleted text end new text begin licensee new text end 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 new text begin assisted living new text end
facility.

Sec. 13.

Minnesota Statutes 2019 Supplement, section 144G.41, subdivision 7, is amended
to read:

Subd. 7.

Resident grievances; reporting maltreatment.

All new text begin assisted living new text end facilities
must post in a conspicuous place information about the facilities' grievance procedure, and
the name, telephone number, and e-mail contact information for the individuals who are
responsible for handling resident grievances. The notice must also have the contact
information for the deleted text begin state and applicable regional deleted text end Office of Ombudsman for Long-Term Care
and the Office of Ombudsman for Mental Health and Developmental Disabilities, and must
have information for reporting suspected maltreatment to the Minnesota Adult Abuse
Reporting Center.

Sec. 14.

Minnesota Statutes 2019 Supplement, section 144G.41, subdivision 8, is amended
to read:

Subd. 8.

Protecting resident rights.

All new text begin assisted living new text end facilities shall ensure that every
resident has access to consumer advocacy or legal services by:

(1) providing names and contact information, including telephone numbers and e-mail
addresses of at least three organizations that provide advocacy or legal services to residents new text begin ,
one of which must include the designated protection and advocacy organization in Minnesota
that provides advice and representation to individuals with disabilities new text end ;

(2) providing the name and contact information new text begin , including the central office telephone
number and e-mail address, new text end for the Minnesota Office of Ombudsman for Long-Term Care
and new text begin , including telephone numbers and e-mail addresses of new text end the Office of Ombudsman for
Mental Health and Developmental Disabilities, including both the state and regional contact
information;

(3) assisting residents in obtaining information on whether Medicare or medical assistance
under chapter 256B will pay for services;

(4) making reasonable accommodations for people who have communication disabilities
and those who speak a language other than English; and

(5) providing all information and notices in plain language and in terms the residents
can understand.

Sec. 15.

Minnesota Statutes 2019 Supplement, section 144G.42, subdivision 8, is amended
to read:

Subd. 8.

deleted text begin Employee deleted text end new text begin Staff new text end records.

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

(1) evidence of current professional licensure, registration, or certification if licensure,
registration, or certification is required by this chapter or rules;

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

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

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

(5) for individuals providing assisted living services, verification that required health
screenings under subdivision 9 have taken place and the dates of those screenings; and

(6) documentation of the background study as required under section 144.057.

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

Sec. 16.

Minnesota Statutes 2019 Supplement, section 144G.42, subdivision 9, is amended
to read:

Subd. 9.

Tuberculosis prevention and control.

new text begin (a) new text end The new text begin assisted living new text end 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 deleted text begin (MMWR) deleted text end . The program
must include a tuberculosis infection control plan that covers all paid and unpaid deleted text begin employees deleted text end new text begin
staff new text end , contractors, students, and regularly scheduled volunteers. The commissioner shall
provide technical assistance regarding implementation of the guidelines.

new text begin (b) The assisted living facility must maintain written evidence of compliance with this
subdivision.
new text end

Sec. 17.

Minnesota Statutes 2019 Supplement, section 144G.42, is amended by adding a
subdivision to read:

new text begin Subd. 9a. new text end

new text begin Communicable diseases. new text end

new text begin An assisted living facility must follow current state
requirements for prevention, control, and reporting of communicable diseases as defined
in Minnesota Rules, parts 4605.7040, 4605.7044, 4605.7050, 4605.7075, 4605.7080, and
4605.7090.
new text end

Sec. 18.

Minnesota Statutes 2019 Supplement, section 144G.42, subdivision 10, is amended
to read:

Subd. 10.

Disaster planning and emergency preparedness plan.

(a) The new text begin assisted living new text end
facility must meet the following requirements:

(1) have a written emergency disaster plan that contains a plan for evacuation, addresses
elements of sheltering in place, identifies temporary relocation sites, and details staff
assignments in the event of a disaster or an emergency;

(2) post an emergency disaster plan prominently;

(3) provide building emergency exit diagrams to all residents;

(4) post emergency exit diagrams on each floor; and

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

(b) The new text begin assisted living new text end facility must provide emergency and disaster training to all staff
during the initial staff orientation and annually thereafter and must make emergency and
disaster training annually available to all residents. Staff who have not received emergency
and disaster training are allowed to work only when trained staff are also working on site.

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

Sec. 19.

Minnesota Statutes 2019 Supplement, section 144G.43, subdivision 1, is amended
to read:

Subdivision 1.

Resident record.

(a) Assisted living facilities must maintain records for
each resident for whom it is providing new text begin assisted living new text end 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.

(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 new text begin assisted living new text end facility shall establish and implement
written procedures to control use, storage, and security of resident records and establish
criteria for release of resident information.

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

(1) as may be required by law;

(2) to employees or contractors of the new text begin assisted living new text end 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;

(3) to persons authorized in writing by the resident, including third-party payers; and

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

Sec. 20.

Minnesota Statutes 2019 Supplement, section 144G.45, subdivision 1, is amended
to read:

Subdivision 1.

Requirements.

The following are required for all assisted living facilities:

(1) public utilities must be available, and working or inspected and approved water and
septic systems must be in place;

(2) the location must be publicly accessible to fire department services and emergency
medical services;

(3) the location's topography must provide sufficient natural drainage and is not subject
to flooding;

(4) all-weather roads and walks must be provided within the lot lines to the primary
entrance and the service entrance, including deleted text begin employees' deleted text end new text begin staff new text end and visitors' parking at the
site; and

(5) the location must include space for outdoor activities for residents.

Sec. 21.

Minnesota Statutes 2019 Supplement, section 144G.45, subdivision 2, is amended
to read:

Subd. 2.

Fire protection and physical environment.

(a) Each assisted living facility
must deleted text begin have a comprehensive fire protection system that includes deleted text end new text begin comply with the State Fire
Code in Minnesota Rules, chapter 7511, and the following new text end :

(1) deleted text begin 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 deleted text end new text begin smoke alarms provided within individual
dwelling units or sleeping units, as defined in the Minnesota State Fire Code, in accordance
with the following: (i) in each room used for sleeping purposes; (ii) outside of each separate
sleeping area in the immediate vicinity of bedrooms; (iii) on each story within a dwelling
unit, including basements, but not including crawl spaces and unoccupied attics; (iv) where
more than one smoke alarm is required within an individual dwelling unit or sleeping unit,
smoke alarms must be interconnected so that actuation of one causes all alarms in the
individual dwelling unit or sleeping unit to operate; and (v) the power supply for existing
smoke alarms must comply with the State Fire Code. Newly introduced smoke alarms in
existing buildings required under this clause may be battery operated new text end ;

(2) portable fire extinguishers installed and tested in accordance with the NFPA Standard
10; and

(3) the physical environment, including walls, floors, ceiling, all furnishings, grounds,
systems, and equipment deleted text begin that is deleted text end new text begin must be new text end 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.

(b) Fire drills in assisted living facilities shall be conducted in accordance with the
residential board and care requirements in the Life Safety Code, except that fire drills in
secured dementia care units shall be conducted in accordance with section 144G.81,
subdivision 2.

(c) Existing construction or elements, including assisted living facilities that were
registered as housing with services establishments under chapter 144D prior to August 1,
2021, shall be permitted to deleted text begin be continued deleted text end new text begin continue new text end in use provided such use does not constitute
a distinct hazard to life. Any existing elements that an authority having jurisdiction deems
a distinct hazard to life must be corrected. The new text begin assisted living new text end facility must document in the new text begin
assisted living new text end facility's records any actions taken to comply with a correction order, and
must submit to the commissioner for review and approval prior to correction.

new text begin (d) For the purposes of this subdivision: (i) "dwelling" means a building that contains
one or two dwelling units used, intended or designed to be used, rented, leased, let, or hired
out to be occupied for living purposes; (ii) "dwelling unit" means a single unit providing
complete, independent living facilities for one or more persons, including permanent
provisions for living, sleeping, eating, cooking, and sanitation; and (iii) "sleeping unit"
means a single unit providing rooms or spaces for one or more persons that includes
permanent provisions for sleeping and may include provisions for living, eating, and either
sanitation or kitchen facilities, but not both. Such rooms and spaces that are also part of a
dwelling unit are not sleeping units.
new text end

Sec. 22.

Minnesota Statutes 2019 Supplement, section 144G.45, subdivision 5, is amended
to read:

Subd. 5.

Assisted living facilities; Life Safety Code.

(a) All assisted living facilities
with six or more residents must meet the applicable provisions of the deleted text begin most current deleted text end new text begin 2018 new text end
edition of the NFPA Standard 101, Life Safety Code, Residential Board and Care
Occupancies chapter. The minimum design standard shall be met for all new licenses, new
construction, modifications, renovations, alterations, changes of use, or additions.

(b) If the commissioner decides to update the Life Safety Code for purposes of this
subdivision, the commissioner must notify the chairs and ranking minority members of the
legislative committees and divisions with jurisdiction over health care and public safety of
the planned update by January 15 of the year in which the new Life Safety Code will become
effective. Following notice from the commissioner, the new edition shall become effective
for assisted living facilities beginning August 1 of that year, unless provided otherwise in
law. The commissioner shall, by publication in the State Register, specify a date by which
new text begin assisted living new text end facilities must comply with the updated Life Safety Code. The date by which new text begin
assisted living new text end facilities must comply shall not be sooner than six months after publication
of the commissioner's notice in the State Register.

Sec. 23.

Minnesota Statutes 2019 Supplement, section 144G.50, subdivision 1, is amended
to read:

Subdivision 1.

Contract required.

(a) An assisted living facility may not offer or provide
housing or assisted living services to deleted text begin a resident deleted text end new text begin any individual new text end unless it has executed a
written new text begin assisted living new text end contract deleted text begin with the resident deleted text end .

(b) The contract must contain all the terms concerning the provision of:

(1) housing;

(2) assisted living services, whether provided directly by the new text begin assisted living new text end facility or
by management agreement or other agreement; and

(3) the resident's service plan, if applicable.

(c) deleted text begin A deleted text end new text begin An assisted living new text end facility must:

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

(2) give a complete copy of any signed contract and any addendums, and all supporting
documents and attachments, to the resident promptly after a contract and any addendum
has been signed.

(d) A contract under this section is a consumer contract under sections 325G.29 to
325G.37.

(e) Before or at the time of execution of the contract, the new text begin assisted living new text end facility must
offer the resident the opportunity to identify a designated representative according to
subdivision 3.

(f) The resident must agree in writing to any additions or amendments to the contract.
Upon agreement between the resident and the new text begin assisted living new text end facility, a new contract or an
addendum to the existing contract must be executed and signed.

Sec. 24.

Minnesota Statutes 2019 Supplement, section 144G.50, subdivision 2, is amended
to read:

Subd. 2.

Contract information.

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

(b) The contract must include the name, telephone number, and physical mailing address,
which may not be a public or private post office box, of:

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

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

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

(4) the authorized agent for the new text begin assisted living new text end facility.

(c) The contract must include:

(1) a disclosure of the category of assisted living facility license held by the facility and,
if the facility is not an assisted living facility with dementia care, a disclosure that it does
not hold an assisted living facility with dementia care license;

(2) a description of all the terms and conditions of the contract, including a description
of and any limitations to the housing or assisted living services to be provided for the
contracted amount;

(3) a delineation of the cost and nature of any other services to be provided for an
additional fee;

(4) a delineation and description of any additional fees the resident may be required to
pay if the resident's condition changes during the term of the contract;

(5) a delineation of the grounds under which the resident may be discharged, evicted,
or transferred or have services terminated;

(6) billing and payment procedures and requirements; and

(7) disclosure of the new text begin assisted living new text end facility's ability to provide specialized diets.

(d) The contract must include a description of the new text begin assisted living new text end facility's complaint
resolution process available to residents, including the name and contact information of the
person representing the new text begin assisted living new text end facility who is designated to handle and resolve
complaints.

(e) The contract must include a clear and conspicuous notice of:

(1) the right under section 144G.54 to appeal the termination of an assisted living contract;

(2) the new text begin assisted living new text end facility's policy regarding transfer of residents within the new text begin assisted
living new text end facility, under what circumstances a transfer may occur, and the circumstances under
which resident consent is required for a transfer;

(3) contact information for the Office of Ombudsman for Long-Term Care, the
Ombudsman for Mental Health and Developmental Disabilities, and the Office of Health
Facility Complaints;

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

(5) a description of the new text begin assisted living new text end facility's policies related to medical assistance
waivers under chapter 256S and section 256B.49 and the housing support program under
chapter 256I, including:

(i) whether the new text begin assisted living new text end facility is enrolled with the commissioner of human services
to provide customized living services under medical assistance waivers;

(ii) whether the new text begin assisted living new text end facility has an agreement to provide housing support
under section 256I.04, subdivision 2, paragraph (b);

(iii) whether there is a limit on the number of people residing at the new text begin assisted living new text end facility
who can receive customized living services or participate in the housing support program
at any point in time. If so, the limit must be provided;

(iv) whether the new text begin assisted living new text end facility requires a resident to pay privately for a period
of time prior to accepting payment under medical assistance waivers or the housing support
program, and if so, the length of time that private payment is required;

(v) a statement that medical assistance waivers provide payment for services, but do not
cover the cost of rent;

(vi) a statement that residents may be eligible for assistance with rent through the housing
support program; and

(vii) a description of the rent requirements for people who are eligible for medical
assistance waivers but who are not eligible for assistance through the housing support
program;

(6) the contact information to obtain long-term care consulting services under section
256B.0911; and

(7) the toll-free phone number for the Minnesota Adult Abuse Reporting Center.

deleted text begin (f) 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.
deleted text end

Sec. 25.

Minnesota Statutes 2019 Supplement, section 144G.52, subdivision 1, is amended
to read:

Subdivision 1.

Definition.

For purposes of sections 144G.52 to 144G.55, "termination new text begin
of an assisted living contract new text end " means:

(1) a facility-initiated termination of housing provided to the resident under the new text begin assisted
living new text end contract; or

(2) a facility-initiated termination or nonrenewal of all assisted living services the resident
receives from the new text begin assisted living new text end facility under the new text begin assisted living new text end contract.

Sec. 26.

Minnesota Statutes 2019 Supplement, section 144G.52, subdivision 3, is amended
to read:

Subd. 3.

Termination for nonpayment.

(a) deleted text begin A deleted text end new text begin An assisted living new text end facility may initiate a
termination of new text begin an assisted living contract for new text end housing because of nonpayment of rent or a
termination of services because of nonpayment for services. Upon issuance of a notice of
termination new text begin of an assisted living contract new text end for nonpayment, the new text begin assisted living new text end facility must
inform the resident that public benefits may be available and must provide contact
information for the Senior LinkAge Line under section 256.975, subdivision 7.

(b) An interruption to a resident's public benefits that lasts for no more than 60 days
does not constitute nonpayment.

Sec. 27.

Minnesota Statutes 2019 Supplement, section 144G.52, subdivision 5, is amended
to read:

Subd. 5.

Expedited termination.

(a) deleted text begin A deleted text end new text begin An assisted living new text end facility may initiate an
expedited termination of new text begin an assisted living contract for new text end housing or services if:

(1) the resident has engaged in conduct that substantially interferes with the rights, health,
or safety of other residents;

(2) the resident has engaged in conduct that substantially and intentionally interferes
with the safety or physical health of new text begin assisted living new text end facility staff; or

(3) the resident has committed an act listed in section 504B.171 that substantially
interferes with the rights, health, or safety of other residents.

(b) deleted text begin A deleted text end new text begin An assisted living new text end facility may initiate an expedited termination of services if:

(1) the resident has engaged in conduct that substantially interferes with the resident's
health or safety;

(2) the resident's assessed needs exceed the scope of services agreed upon in the assisted
living contract and are not included in the services the new text begin assisted living new text end facility disclosed in
the uniform checklist; or

(3) extraordinary circumstances exist, causing the new text begin assisted living new text end facility to be unable
to provide the resident with the services disclosed in the uniform checklist that are necessary
to meet the resident's needs.

Sec. 28.

Minnesota Statutes 2019 Supplement, section 144G.52, subdivision 7, is amended
to read:

Subd. 7.

Notice of contract termination required.

(a) deleted text begin A deleted text end new text begin An assisted living new text end facility
terminating deleted text begin a deleted text end new text begin an assisted living new text end contract must issue a written notice of termination according
to this section. The new text begin assisted living new text end facility must also send a copy of the termination notice
to the Office of Ombudsman for Long-Term Care and, for residents who receive home and
community-based waiver services under chapter 256S and section 256B.49, to the resident's
case manager, as soon as practicable after providing notice to the resident. deleted text begin A deleted text end new text begin An assisted
living new text end facility may terminate an assisted living contract only as permitted under subdivisions
3, 4, and 5.

(b) deleted text begin A deleted text end new text begin An assisted living new text end facility terminating deleted text begin a deleted text end new text begin an assisted living new text end contract under subdivision
3 or 4 must provide a written termination notice at least 30 days before the effective date
of the termination to the resident, legal representative, and designated representative.

(c) deleted text begin A deleted text end new text begin An assisted living new text end facility terminating deleted text begin a deleted text end new text begin an assisted living new text end contract under subdivision
5 must provide a written termination notice at least 15 days before the effective date of the
termination to the resident, legal representative, and designated representative.

(d) If a resident moves out of deleted text begin a deleted text end new text begin an assisted living new text end facility or cancels services received
from the new text begin assisted living new text end facility, nothing in this section prohibits deleted text begin a deleted text end new text begin an assisted living new text end facility
from enforcing against the resident any notice periods with which the resident must comply
under the assisted living contract.

Sec. 29.

Minnesota Statutes 2019 Supplement, section 144G.54, subdivision 1, is amended
to read:

Subdivision 1.

Right to appeal.

Residents new text begin or individuals acting on behalf of residents
new text end have the right to appeal the termination of an assisted living contract.

Sec. 30.

Minnesota Statutes 2019 Supplement, section 144G.54, subdivision 2, is amended
to read:

Subd. 2.

Permissible grounds to appeal termination.

A resident new text begin or an individual acting
on behalf of the resident new text end may appeal a termination initiated under section 144G.52,
subdivision 3, 4, or 5, on the ground that:

(1) there is a factual dispute as to whether the new text begin assisted living new text end facility had a permissible
basis to initiate the termination;

(2) the termination would result in great harm or the potential for great harm to the
resident as determined by the totality of the circumstances, except in circumstances where
there is a greater risk of harm to other residents or staff at the new text begin assisted living new text end facility;

(3) the resident has cured or demonstrated the ability to cure the reasons for the
termination, or has identified a reasonable accommodation or modification, intervention,
or alternative to the termination; or

(4) the new text begin assisted living new text end facility has terminated the contract in violation of state or federal
law.

Sec. 31.

Minnesota Statutes 2019 Supplement, section 144G.54, subdivision 3, is amended
to read:

Subd. 3.

Appeals process.

(a) The Office of Administrative Hearings must conduct an
expedited hearing as soon as practicable under this section, but in no event later than 14
calendar days after the office receives the request, unless the parties agree otherwise or the
chief administrative law judge deems the timing to be unreasonable, given the complexity
of the issues presented.

(b) The hearing must be held at the new text begin assisted living new text end facility where the resident lives, unless
holding the hearing at that location is impractical, the parties agree to hold the hearing at a
different location, or the chief administrative law judge grants a party's request to appear
at another location or by telephone or interactive video.

(c) The hearing is not a formal contested case proceeding, except when determined
necessary by the chief administrative law judge.

(d) Parties may but are not required to be represented by counsel. The appearance of a
party without counsel does not constitute the unauthorized practice of law.

(e) The hearing shall be limited to the amount of time necessary for the participants to
expeditiously present the facts about the proposed termination. The administrative law judge
shall issue a deleted text begin recommendation deleted text end new text begin decision new text end to the commissioner as soon as practicable, but in
no event later than ten business days after the hearing.

Sec. 32.

Minnesota Statutes 2019 Supplement, section 144G.54, subdivision 4, is amended
to read:

Subd. 4.

Burden of proof for appeals of termination.

(a) The new text begin assisted living new text end facility
bears the burden of proof to establish by a preponderance of the evidence that the termination
was permissible if the appeal is brought on the ground listed in subdivision 2, clause new text begin (1) or
new text end (4).

(b) The resident bears the burden of proof to establish by a preponderance of the evidence
that the termination was permissible if the appeal is brought on the ground listed in
subdivision 2, clause (2) or (3).

Sec. 33.

Minnesota Statutes 2019 Supplement, section 144G.55, subdivision 1, is amended
to read:

Subdivision 1.

Duties of new text begin an assisted living new text end facility.

(a) If deleted text begin a deleted text end new text begin an assisted living new text end facility
terminates an assisted living contract, new text begin nonrenews housing under section 144G.53, new text end reduces new text begin
or eliminates new text end services to the extent that a resident needs to move, deleted text begin or deleted text end conducts a planned
closure under section 144G.57, new text begin or relinquishes an assisted living facility with dementia care
license under section 144G.80, new text end the new text begin assisted living new text end facility:

(1) must ensure, subject to paragraph (c), a coordinated move to a safe location that is
appropriate for the resident and that is identified by the new text begin assisted living new text end facility prior to any
hearing under section 144G.54;

(2) must ensure a coordinated move of the resident to an appropriate service provider
new text begin that is new text end identified by the new text begin assisted living new text end facility prior to any hearing under section 144G.54,
provided services are still needed and desired by the resident; and

(3) must consult and cooperate with the resident, legal representative, designated
representative, case manager for a resident who receives home and community-based waiver
services under chapter 256S and section 256B.49, relevant health professionals, and any
other persons of the resident's choosing to make arrangements to move the resident, including
consideration of the resident's goals.

(b) deleted text begin A deleted text end new text begin An assisted living new text end facility may satisfy the requirements of paragraph (a), clauses
(1) and (2), by moving the resident to a different location within the same new text begin assisted living new text end
facility, if appropriate for the resident.

(c) A resident may decline to move to the location the new text begin assisted living new text end facility identifies
or to accept services from a service provider the new text begin assisted living new text end facility identifies, and may
choose instead to move to a location of the resident's choosing or receive services from a
service provider of the resident's choosing within the timeline prescribed in the deleted text begin termination deleted text end new text begin
planned closure, service reduction or elimination under paragraph (d), nonrenewal of housing,
or license relinquishment new text end notice.

(d) Sixty new text begin calendar new text end days before the new text begin assisted living new text end facility plans to reduce or eliminate
one or more services for a particular resident, the deleted text begin facility deleted text end new text begin licensee new text end must provide written
notice of the reduction new text begin or elimination to the resident new text end that includes:

(1) a detailed explanation of the reasons for the reduction new text begin or elimination new text end and the date of
the reduction new text begin or elimination new text end ;

(2) the contact information for the Office of Ombudsman for Long-Term Care and the
name and contact information of the person employed by the new text begin assisted living new text end facility with
whom the resident may discuss the reduction new text begin or elimination new text end of services;

(3) a statement that if the services being reduced new text begin or eliminated new text end are still needed by the
resident, the resident may remain in the new text begin assisted living new text end facility and seek services from another
provider; and

(4) a statement that if the reduction new text begin or elimination new text end makes the resident need to move, the
new text begin assisted living new text end facility must participate in a coordinated move of the resident to another
provider or caregiver, as required under this section.

(e) In the event of an unanticipated reduction deleted text begin in deleted text end new text begin or elimination of new text end services caused by
extraordinary circumstances, the new text begin assisted living new text end facility must provide the notice required
under paragraph (d) as soon as possible.

(f) If the new text begin assisted living new text end facility, a resident, a legal representative, or a designated
representative determines that a reduction deleted text begin in deleted text end new text begin or elimination of new text end services will make a resident
need to move to a new location, the new text begin assisted living new text end facility must ensure a coordinated move
in accordance with this section, and must provide notice to the Office of Ombudsman for
Long-Term Care.

(g) Nothing in this section affects a resident's right to remain in the new text begin assisted living new text end facility
and seek services from another provider.

Sec. 34.

Minnesota Statutes 2019 Supplement, section 144G.55, subdivision 2, is amended
to read:

Subd. 2.

Safe location.

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. deleted text begin A deleted text end new text begin An
assisted living new text end facility may not terminate a resident's housing or services if the resident deleted text begin will deleted text end ,
as the result of the termination, deleted text begin become deleted text end new text begin planned closure under section 144G.57, service
reduction or elimination to the extent that a resident needs to move in subdivision 1,
paragraph (d), nonrenewal of housing under section 144G.53, or assisted living facility with
dementia care license relinquishment in section 144G.80, subdivision 3, becomes new text end 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. This subdivision
does not preclude a resident from declining to move to the location the new text begin assisted living new text end facility
identifies.

Sec. 35.

Minnesota Statutes 2019 Supplement, section 144G.55, subdivision 3, is amended
to read:

Subd. 3.

Relocation plan required.

The new text begin assisted living new text end facility must prepare a relocation
plan new text begin for the resident new text end to prepare for the move to the new location or service provider.

Sec. 36.

Minnesota Statutes 2019 Supplement, section 144G.57, is amended to read:

144G.57 PLANNED CLOSURES.

Subdivision 1.

Closure plan required.

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

Subd. 2.

Content of closure plan.

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

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

(2) the procedures and actions the new text begin assisted living new text end facility will implement to ensure all
residents receive appropriate deleted text begin termination deleted text end planning in accordance with section 144G.55, and
final accountings and returns under section 144G.42, subdivision 5;

(3) assessments of the needs and preferences of individual residents; and

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

Subd. 3.

Commissioner's approval required prior to implementation.

(a) The plan
shall be subject to the commissioner's approval and subdivision 6. The new text begin assisted living new text end 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 begin
The commissioner shall promptly send the approved closure plan to the Office of
Ombudsman for Long-Term Care.
new text end

(b) The commissioner may require the new text begin assisted living new text end 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.

Subd. 4.

deleted text begin Termination deleted text end new text begin Coordinated move new text end planning and final accounting
requirements.

Prior to deleted text begin termination deleted text end new text begin closure new text end , the new text begin assisted living new text end facility must follow the
deleted text begin termination deleted text end planning requirements under section 144G.55, and final accounting and return
requirements under section 144G.42, subdivision 5, for residents. The new text begin assisted living new text end 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.

Subd. 5.

Notice to residents.

After the commissioner has approved the relocation plan
and at least 60 calendar days before closing, except as provided under subdivision 6, the
new text begin assisted living new text end facility must notify residents, designated representatives, and legal
representatives of the closure, the deleted text begin proposed deleted text end date of closure, the contact information of the
ombudsman for long-term care, and that the deleted text begin facility deleted text end new text begin licensee new text end will follow the deleted text begin termination deleted text end
planning requirements under section 144G.55, and final accounting and return requirements
under section 144G.42, subdivision 5. For residents who receive home and community-based
waiver services under chapter 256S and section 256B.49, the new text begin assisted living new text end facility must
also provide this information to the resident's case manager.

Subd. 6.

Emergency closures.

(a) In the event the new text begin assisted living new text end facility must close
because the commissioner deems the new text begin assisted living new text end facility can no longer remain open, the new text begin
assisted living new text end facility must meet all requirements in subdivisions 1 to 5, 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 calendar days'
notice, the new text begin assisted living new text end facility shall provide notice to residents as soon as practicable or
as directed by the commissioner.

(b) Upon request from the commissioner, the deleted text begin facility deleted text end new text begin licensee new text end must provide the
commissioner with any documentation related to the appropriateness of its relocation plan,
or to any assertion that the new text begin assisted living new text end facility lacks the funds to comply with subdivisions
1 to 5, or that remaining open would otherwise endanger the health and safety of residents
pursuant to paragraph (a).

Subd. 7.

Other rights.

Nothing in this section affects the rights and remedies available
under chapter 504B.

Subd. 8.

Fine.

The commissioner may impose a fine for failure to follow the requirements
of this section.

Sec. 37.

Minnesota Statutes 2019 Supplement, section 144G.64, is amended to read:

144G.64 TRAINING IN DEMENTIA CARE REQUIRED.

(a) All assisted living facilities 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 deleted text begin employees deleted text end new text begin staff new text end 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, deleted text begin an employee deleted text end new text begin a staff person new text end must not provide
direct care unless there is another deleted text begin employee deleted text end new text begin staff person new text end 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
deleted text begin employee deleted text end new text begin staff person new text end until the training requirement is complete. Direct-care deleted text begin employees deleted text end new text begin
staff new text end must have at least two hours of training on topics related to dementia for each 12
months of employment thereafter;

(3) for assisted living facilities with dementia care, direct-care deleted text begin employees deleted text end new text begin staff new text end must
have completed at least eight hours of initial training on topics specified under paragraph
(b) within 80 working hours of the employment start date. Until this initial training is
complete, deleted text begin an employee deleted text end new text begin a staff person new text end must not provide direct care unless there is another
deleted text begin employee deleted text end new text begin staff person new text end 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 deleted text begin employee deleted text end new text begin staff person new text end until the training
requirement is complete. Direct-care deleted text begin employees deleted text end new text begin staff new text end must have at least two hours of training
on topics related to dementia for each 12 months of employment thereafter;

(4) 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

(5) new deleted text begin employees deleted text end new text begin staff new text end 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 other dementias;

(2) assistance with activities of daily living;

(3) problem solving with challenging behaviors;

(4) communication skills; and

(5) person-centered planning and service delivery.

(c) The new text begin assisted living new text end facility shall provide to consumers in written or electronic form
a description of the training program, the categories of deleted text begin employees deleted text end new text begin staff new text end trained, the frequency
of training, and the basic topics covered.

Sec. 38.

Minnesota Statutes 2019 Supplement, section 144G.70, subdivision 2, is amended
to read:

Subd. 2.

Initial reviews, assessments, and monitoring.

(a) Residents who are not
receiving deleted text begin any deleted text end new text begin assisted living new text end services shall not be required to undergo an initial nursing
assessment.

(b) An assisted living facility shall conduct a nursing assessment by a registered nurse
of the physical and cognitive needs of the prospective resident and propose a temporary
service plan prior to the date on which a prospective resident executes a contract with deleted text begin a deleted text end new text begin an
assisted living new text end 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 new text begin assisted living new text end facility, or urgent or unexpected circumstances, the assessment may
be conducted using telecommunication methods based on practice standards that meet the
resident's needs and reflect person-centered planning and care delivery.

(c) Resident reassessment and monitoring must be conducted no more than 14 calendar
days after initiation of services. Ongoing resident reassessment and monitoring must be
conducted as needed based on changes in the needs of the resident and cannot exceed 90
calendar days from the last date of the assessment.

(d) For residents only receiving assisted living services specified in section 144G.08,
subdivision 9, clauses (1) to (5), the new text begin assisted living new text end facility shall complete an individualized
initial review of the resident's needs and preferences. The initial review must be completed
within 30 calendar days of the start of services. Resident monitoring and review must be
conducted as needed based on changes in the needs of the resident and cannot exceed 90
calendar days from the date of the last review.

(e) deleted text begin A deleted text end new text begin An assisted living new text end 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 deleted text begin a deleted text end new text begin an assisted living new text end
facility or the date on which a prospective resident moves in, whichever is earlier.

Sec. 39.

Minnesota Statutes 2019 Supplement, section 144G.80, subdivision 3, is amended
to read:

Subd. 3.

Relinquishing license.

(a) The licensee must notify the commissioner and the
Office of Ombudsman for Long-Term Care in writing at least 60 calendar days prior to the
voluntary relinquishment of an assisted living facility with dementia care license. For
voluntary relinquishment, the deleted text begin facility deleted text end new text begin licensee new text end must at least:

(1) give all residents and their designated and legal representatives new text begin at least new text end 60 calendar
days' notice. The notice must include at a minimum:

(i) the proposed effective date of the relinquishment;

(ii) changes in staffing;

(iii) changes in services including the elimination or addition of services;

(iv) staff training that shall occur when the relinquishment becomes effective; and

(v) contact information for the Office of Ombudsman for Long-Term Care;

(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 an assisted
living facility with dementia care, that are physically unsecured, or that would require
move-out or transfer to other settings;

(3) change service or care plans as appropriate to address any needs the residents may
have with the transition;

(4) notify the commissioner when the relinquishment process has been completed; and

(5) revise advertising materials and disclosure information to remove any reference that
the new text begin assisted living new text end facility is an assisted living facility with dementia care.

(b) Nothing in this section alters obligations under section 144G.57.

Sec. 40.

Minnesota Statutes 2019 Supplement, section 144G.82, subdivision 3, is amended
to read:

Subd. 3.

Policies.

(a) In addition to the policies and procedures required in the licensing
of all new text begin assisted living new text end facilities, the assisted living facility with dementia care licensee must
develop and implement policies and procedures that address deleted text begin the deleted text end :

(1) new text begin the new text end philosophy of how services are provided based upon the assisted living facility
licensee's values, mission, and promotion of person-centered care and how the philosophy
shall be implemented;

(2) new text begin the new text end evaluation of behavioral symptoms and design of supports for intervention plans,
including nonpharmacological practices that are person-centered and evidence-informed;

(3) wandering and egress prevention that provides detailed instructions to staff in the
event a resident elopes;

(4) medication management, including an assessment of residents for the use and effects
of medications, including psychotropic medications;

(5) staff training specific to dementia care;

(6) deleted text begin description of deleted text end life enrichment programs and how activities are implemented;

(7) deleted text begin description of deleted text end family support programs and efforts to keep the family engaged;

(8) limiting the use of public address and intercom systems for emergencies and
evacuation drills only;

(9) transportation coordination and assistance to and from outside medical appointments;
and

(10) new text begin the new text end safekeeping of residents' possessions.

(b) The policies and procedures must be provided to residents and the residents' legal
and designated representatives at the time of move-in.

Sec. 41.

Minnesota Statutes 2019 Supplement, section 144G.83, subdivision 2, is amended
to read:

Subd. 2.

Staffing requirements.

(a) The licensee must ensure that staff who provide
support to residents with dementia can demonstrate a basic understanding and ability to
apply dementia training to 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 deleted text begin expedited deleted text end rulemaking process. These
requirements are in addition to the licensing requirements for training.

(b) Failure to comply with paragraph (a) or subdivision 1 shall result in a fine under
section 144G.31.

Sec. 42.

Minnesota Statutes 2019 Supplement, section 144G.90, subdivision 1, is amended
to read:

Subdivision 1.

Assisted living bill of rights; notification to resident.

(a) An assisted
living facility must provide the resident a written notice of the rights under section 144G.91
before the initiation of services to that resident. The new text begin assisted living new text end facility shall make all
reasonable efforts to provide notice of the rights to the resident in a language the resident
can understand.

(b) In addition to the text of the assisted living bill of rights in section 144G.91, the
notice shall also contain the following statement describing how to file a complaint or report
suspected abuse:

"If you want to report suspected abuse, neglect, or financial exploitation, you may contact
the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about
the new text begin assisted living new text end facility or person providing your services, you may contact the Office of
Health Facility Complaints, Minnesota Department of Health. new text begin If you would like to request
advocacy services, new text end you may also contact the Office of Ombudsman for Long-Term Care or
the Office of Ombudsman for Mental Health and Developmental Disabilities."

(c) The statement must include contact information for the Minnesota Adult Abuse
Reporting Center and the telephone number, website address, e-mail address, mailing
address, and street address of the Office of Health Facility Complaints at the Minnesota
Department of Health, the Office of Ombudsman for Long-Term Care, and the Office of
Ombudsman for Mental Health and Developmental Disabilities. The statement must include
the new text begin assisted living new text end facility's name, address, e-mail, telephone number, and name or title of
the person at the new text begin assisted living new text end facility to whom problems or complaints may be directed.
It must also include a statement that the new text begin assisted living new text end facility will not retaliate because of
a complaint.

(d) deleted text begin A deleted text end new text begin An assisted living new text end facility must obtain written acknowledgment from the resident
of the resident's receipt of the assisted living bill of rights or shall document why an
acknowledgment cannot be obtained. Acknowledgment of receipt shall be retained in the
resident's record.

Sec. 43.

Minnesota Statutes 2019 Supplement, section 144G.91, subdivision 13, is amended
to read:

Subd. 13.

Personal and treatment privacy.

(a) Residents have the right to consideration
of their privacy, individuality, and cultural identity as related to their social, religious, and
psychological well-being. Staff must respect the privacy of a resident's space by knocking
on the door and seeking consent before entering, except in an emergency deleted text begin or where clearly
inadvisable deleted text end or unless otherwise documented in the resident's service plan.

(b) Residents have the right to have and use a lockable door to the resident's unit. The
new text begin assisted living new text end facility shall provide locks on the resident's unit. Only a staff member with
a specific need to enter the unit shall have keys. This right may be restricted in certain
circumstances if necessary for a resident's health and safety and documented in the resident's
service plan.

(c) Residents have the right to respect and privacy regarding the resident's service plan.
Case discussion, consultation, examination, and treatment are confidential and must be
conducted discreetly. Privacy must be respected during toileting, bathing, and other activities
of personal hygiene, except as needed for resident safety or assistance.

Sec. 44.

Minnesota Statutes 2019 Supplement, section 144G.91, subdivision 21, is amended
to read:

Subd. 21.

Access to counsel and advocacy services.

Residents have the right to the
immediate access by:

(1) the resident's legal counsel;

(2) any representative of the protection and advocacy system designated by the state
under Code of Federal Regulations, title 45, section 1326.21; or

(3) any representative of the Office of Ombudsman for Long-Term Care new text begin or the Office
of Ombudsman for Mental Health and Developmental Disabilities new text end .

Sec. 45.

Minnesota Statutes 2019 Supplement, section 144G.92, subdivision 5, is amended
to read:

Subd. 5.

Other laws.

Nothing in this section affects the rights new text begin and remedies new text end available
deleted text begin to a resident deleted text end under section 626.557 new text begin , subdivisions 10, 17, and 20 new text end .

Sec. 46.

Minnesota Statutes 2019 Supplement, section 144G.93, is amended to read:

144G.93 CONSUMER ADVOCACY AND LEGAL SERVICES.

Upon execution of an assisted living contract, every new text begin assisted living new text end facility must provide
the resident with the names and contact information, including telephone numbers and
e-mail addresses, of:

(1) nonprofit organizations that provide advocacy or legal services to residents including
but not limited to the designated protection and advocacy organization in Minnesota that
provides advice and representation to individuals with disabilities; and

(2) the Office of Ombudsman for Long-Term Care deleted text begin , including both the state and regional
contact information deleted text end new text begin and the Office of Ombudsman for Mental Health and Developmental
Disabilities new text end .

Sec. 47.

Minnesota Statutes 2019 Supplement, section 144G.95, subdivision 1, is amended
to read:

Subdivision 1.

Immunity from liability.

new text begin (a) new text end The Office of Ombudsman for Long-Term
Care and representatives of the office are immune from liability for conduct described in
section 256.9742, subdivision 2.

new text begin (b) The Office of Ombudsman for Mental Health and Developmental Disabilities and
representatives of the office are immune from liability for conduct described in section
245.96.
new text end

Sec. 48.

Minnesota Statutes 2019 Supplement, section 144G.9999, subdivision 2, is
amended to read:

Subd. 2.

Membership.

The task force shall include representation from:

(1) nonprofit Minnesota-based organizations dedicated to patient safety or innovation
in health care safety and quality;

(2) Department of Health staff with expertise in issues related to safety and adverse
health events;

(3) consumer organizations;

(4) direct care providers or their representatives;

(5) organizations representing long-term care providers and home care providers in
Minnesota;

(6) the ombudsman for long-term care or a designee;

new text begin (7) the ombudsman for mental health and developmental disabilities or a designee;
new text end

deleted text begin (7) deleted text end new text begin (8) new text end national patient safety experts; and

deleted text begin (8) deleted text end new text begin (9) new text end other experts in the safety and quality improvement field.

The task force shall have at least one public member who either is or has been a resident in
an assisted living setting and one public member who has or had a family member living
in an assisted living setting. The membership shall be voluntary except that public members
may be reimbursed under section 15.059, subdivision 3.

Sec. 49. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes, in consultation with the House Research Department; Office of
Senate Counsel, Research and Fiscal Analysis; and the Department of Health shall prepare
legislation for the Department of Health to introduce during the 2021 legislative session to
make necessary cross-reference changes and remove statutory cross-references in Minnesota
Statutes and Minnesota Rules to conform with the passage of Minnesota Laws 2019, chapter
60.
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