HF 90

6th Engrossment - 91st Legislature (2019 - 2020) Posted on 05/23/2019 09:53am

A bill for an act
relating to health; establishing consumer protections for residents of assisted living
establishments; prohibiting deceptive marketing and business practices; establishing
provisions for independent senior living facilities; establishing an assisted living
establishment license; changing the name for Board of Examiners for Nursing
Home Administrators; imposing fees; establishing a health services executive
license; making certain conforming changes; providing penalties; granting
rulemaking authority; requiring reports; appropriating money; amending Minnesota
Statutes 2018, sections 144.051, subdivisions 4, 5, 6; 144.057, subdivision 1;
144.122; 144A.04, subdivision 5; 144A.19, subdivision 1; 144A.20, subdivision
1, by adding subdivisions; 144A.21; 144A.23; 144A.24; 144A.251; 144A.2511;
144A.26; 144A.44, subdivision 1; 144A.471, subdivisions 7, 9; 144A.472,
subdivision 7; 144A.474, subdivisions 9, 11, by adding a subdivision; 144A.475,
subdivisions 3b, 5; 144A.476, subdivision 1; 144A.4799; 256.9741, subdivision
1; 256I.03, subdivision 15; 256I.04, subdivision 2a; 325F.72, subdivisions 1, 2;
626.5572, subdivision 6; proposing coding for new law in Minnesota Statutes,
chapters 144; 144G; 256M; 325F; proposing coding for new law as Minnesota
Statutes, chapter 144I; repealing Minnesota Statutes 2018, sections 144A.441;
144A.442; 144A.472, subdivision 4; 144D.01; 144D.015; 144D.02; 144D.025;
144D.03; 144D.04; 144D.045; 144D.05; 144D.06; 144D.065; 144D.066; 144D.07;
144D.08; 144D.09; 144D.10; 144D.11; 144G.01; 144G.02; 144G.03; 144G.04;
144G.05; 144G.06.

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

ARTICLE 1

ASSISTED LIVING LICENSURE

Section 1.

Minnesota Statutes 2018, section 144.122, is amended to read:

144.122 LICENSE, PERMIT, AND SURVEY FEES.

(a) The state commissioner of health, by rule, may prescribe procedures and fees for
filing with the commissioner as prescribed by statute and for the issuance of original and
renewal permits, licenses, registrations, and certifications issued under authority of the
commissioner. The expiration dates of the various licenses, permits, registrations, and
certifications as prescribed by the rules shall be plainly marked thereon. Fees may include
application and examination fees and a penalty fee for renewal applications submitted after
the expiration date of the previously issued permit, license, registration, and certification.
The commissioner may also prescribe, by rule, reduced fees for permits, licenses,
registrations, and certifications when the application therefor is submitted during the last
three months of the permit, license, registration, or certification period. Fees proposed to
be prescribed in the rules shall be first approved by the Department of Management and
Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
in an amount so that the total fees collected by the commissioner will, where practical,
approximate the cost to the commissioner in administering the program. All fees collected
shall be deposited in the state treasury and credited to the state government special revenue
fund unless otherwise specifically appropriated by law for specific purposes.

(b) The commissioner may charge a fee for voluntary certification of medical laboratories
and environmental laboratories, and for environmental and medical laboratory services
provided by the department, without complying with paragraph (a) or chapter 14. Fees
charged for environment and medical laboratory services provided by the department must
be approximately equal to the costs of providing the services.

(c) The commissioner may develop a schedule of fees for diagnostic evaluations
conducted at clinics held by the services for children with disabilities program. All receipts
generated by the program are annually appropriated to the commissioner for use in the
maternal and child health program.

(d) The commissioner shall set license fees for hospitals and nursing homes that are not
boarding care homes at the following levels:

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and American Osteopathic Association (AOA) hospitals	$7,655 plus $16 per bed
Non-JCAHO and non-AOA hospitals	$5,280 plus $250 per bed
Nursing home	$183 plus $91 per bed until June 30, 2018. $183 plus $100 per bed between July 1, 2018, and June 30, 2020. $183 plus $105 per bed beginning July 1, 2020.

The commissioner shall set license fees for outpatient surgical centers, boarding care
homes, deleted text begin and deleted text end supervised living facilities new text begin , assisted living facilities, and assisted living facilities
with dementia care new text end at the following levels:

Outpatient surgical centers	$3,712
Boarding care homes	$183 plus $91 per bed
Supervised living facilities	$183 plus $91 per bed.
new text begin Assisted living facilities with dementia care new text end	new text begin $3,000 plus $100 per resident. new text end
new text begin Assisted living facilities new text end	new text begin $2,000 plus $75 per resident. new text end

Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if
received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017,
or later.

(e) Unless prohibited by federal law, the commissioner of health shall charge applicants
the following fees to cover the cost of any initial certification surveys required to determine
a provider's eligibility to participate in the Medicare or Medicaid program:

Prospective payment surveys for hospitals	$	900
Swing bed surveys for nursing homes	$	1,200
Psychiatric hospitals	$	1,400
Rural health facilities	$	1,100
Portable x-ray providers	$	500
Home health agencies	$	1,800
Outpatient therapy agencies	$	800
End stage renal dialysis providers	$	2,100
Independent therapists	$	800
Comprehensive rehabilitation outpatient facilities	$	1,200
Hospice providers	$	1,700
Ambulatory surgical providers	$	1,800
Hospitals	$	4,200
Other provider categories or additional resurveys required to complete initial certification	Actual surveyor costs: average surveyor cost x number of hours for the survey process.

These fees shall be submitted at the time of the application for federal certification and
shall not be refunded. All fees collected after the date that the imposition of fees is not
prohibited by federal law shall be deposited in the state treasury and credited to the state
government special revenue fund.

new text begin (f) Notwithstanding section 16A.1283, the commissioner may adjust the fees assessed
on assisted living facilities and assisted living facilities with dementia care under paragraph
(d), in a revenue-neutral manner in accordance with the requirements of this paragraph:
new text end

new text begin (1) a facility seeking to renew a license shall pay a renewal fee in an amount that is up
to ten percent lower than the applicable fee in paragraph (d) if residents who receive home
and community-based waiver services under sections 256B.0915 and 256B.49 comprise
more than 50 percent of the facility's capacity in the calendar year prior to the year in which
the renewal application is submitted; and
new text end

new text begin (2) a facility seeking to renew a license shall pay a renewal fee in an amount that is up
to ten percent higher than the applicable fee in paragraph (d) if residents who receive home
and community-based waiver services under sections 256B.0915 and 256B.49 comprise
less than 50 percent of the facility's capacity during the calendar year prior to the year in
which the renewal application is submitted.
new text end

new text begin The commissioner may annually adjust the percentages in clauses (1) and (2), to ensure this
paragraph is implemented in a revenue-neutral manner. The commissioner shall develop a
method for determining capacity thresholds in this paragraph in consultation with the
commissioner of human services and must coordinate the administration of this paragraph
with the commissioner of human services for purposes of verification.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 2.

new text begin [144I.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

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

new text begin Subd. 2. new text end

new text begin Adult. new text end

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

new text begin Subd. 3. new text end

new text begin Advanced practice registered nurse. new text end

new text begin "Advanced practice registered nurse"
has the meaning given in section 148.171, subdivision 3.
new text end

new text begin Subd. 4. new text end

new text begin Applicant. new text end

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

new text begin Subd. 5. new text end

new text begin Assisted living contract. new text end

new text begin "Assisted living contract" means the legal agreement
between a resident and an assisted living facility for housing and, if applicable, assisted
living services.
new text end

new text begin Subd. 6. new text end

new text begin Assisted living director. new text end

new text begin "Assisted living director" means a person who
administers, manages, supervises, or is in general administrative charge of an assisted living
facility, whether or not the individual has an ownership interest in the facility, and whether
or not the person's functions or duties are shared with one or more individuals and who is
licensed by the Board of Executives for Long Term Services and Supports pursuant to
section 144A.20.
new text end

new text begin Subd. 7. new text end

new text begin Assisted living facility. new text end

new text begin "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:
new text end

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

new text begin (2) a nursing home licensed under chapter 144A;
new text end

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

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

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

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

new text begin (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;
new text end

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

new text begin (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;
new text end

new text begin (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;
new text end

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

new text begin (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;
new text end

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

new text begin (14) an independent senior living facility governed by chapter 144K.
new text end

new text begin Subd. 8. new text end

new text begin Assisted living facility with dementia care. new text end

new text begin "Assisted living facility with
dementia care" means a licensed assisted living facility that is advertised, marketed, or
otherwise promoted as providing specialized care for individuals with Alzheimer's disease
or other dementias. An assisted living facility with a secured dementia care unit must be
licensed as an assisted living facility with dementia care.
new text end

new text begin Subd. 9. new text end

new text begin Assisted living services. new text end

new text begin "Assisted living services" includes one or more of
the following:
new text end

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

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

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

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

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

new text begin (6) 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;
new text end

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

new text begin (8) medication management services;
new text end

new text begin (9) hands-on assistance with transfers and mobility;
new text end

new text begin (10) treatment and therapies;
new text end

new text begin (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;
new text end

new text begin (12) providing other complex or specialty health care services; and
new text end

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

new text begin Subd. 10. new text end

new text begin Authority having jurisdiction. new text end

new text begin "Authority having jurisdiction" means an
organization, office, or individual responsible for enforcing the requirements of a code or
standard, or for approving equipment, materials, an installation, or a procedure.
new text end

new text begin Subd. 11. new text end

new text begin Authorized agent. new text end

new text begin "Authorized agent" means the person who is authorized
to accept service of notices and orders on behalf of the licensee.
new text end

new text begin Subd. 12. new text end

new text begin Change of ownership. new text end

new text begin "Change of ownership" means a change in the licensee
that is responsible for the management, control, and operation of a facility.
new text end

new text begin Subd. 13. new text end

new text begin Commissioner. new text end

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

new text begin Subd. 14. new text end

new text begin Controlled substance. new text end

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

new text begin Subd. 15. new text end

new text begin Controlling individual. new text end

new text begin (a) "Controlling individual" means an owner and the
following individuals and entities, if applicable:
new text end

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

new text begin (2) each managerial official; and
new text end

new text begin (3) any entity with at least a five percent mortgage, deed of trust, or other security interest
in the facility.
new text end

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

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

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

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

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

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

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

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

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

new text begin Subd. 16. new text end

new text begin Dementia. new text end

new text begin "Dementia" means the loss of cognitive function, including the
ability to think, remember, problem solve, or reason, of sufficient severity to interfere with
an individual's daily functioning. Dementia is caused by different diseases and conditions,
including but not limited to Alzheimer's disease, vascular dementia, neurodegenerative
conditions, Creutzfeldt-Jakob disease, and Huntington's disease.
new text end

new text begin Subd. 17. new text end

new text begin Dementia care services. new text end

new text begin "Dementia care services" means ongoing care for
behavioral and psychological symptoms of dementia, including planned group and individual
programming and person-centered care practices provided according to section 144I.40 to
support activities of daily living for people living with dementia.
new text end

new text begin Subd. 18. new text end

new text begin Dementia-trained staff. new text end

new text begin "Dementia-trained staff" means any employee who
has completed the minimum training required under sections 144I.21 and 144I.39 and has
demonstrated knowledge and the ability to support individuals with dementia.
new text end

new text begin Subd. 19. new text end

new text begin Designated representative. new text end

new text begin "Designated representative" means a person
designated under section 144I.25.
new text end

new text begin Subd. 20. new text end

new text begin Dietary supplement. new text end

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

new text begin Subd. 21. new text end

new text begin Dietitian. new text end

new text begin "Dietitian" means a person licensed as a dietitian under section
148.624.
new text end

new text begin Subd. 22. new text end

new text begin Direct contact. new text end

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

new text begin Subd. 23. new text end

new text begin Direct ownership interest. new text end

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

new text begin Subd. 24. new text end

new text begin Facility. new text end

new text begin "Facility" means an assisted living facility.
new text end

new text begin Subd. 25. new text end

new text begin Hands-on assistance. new text end

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

new text begin Subd. 26. new text end

new text begin "I'm okay" check services. new text end

new text begin ""I'm okay" check services" means having,
maintaining documenting a system to, by any means, check on the safety of a resident a
minimum of once daily or more frequently according to the assisted living contract.
new text end

new text begin Subd. 27. new text end

new text begin Indirect ownership interest. new text end

new text begin "Indirect ownership interest" means an individual
or legal entity with a direct ownership interest in an entity that has a direct or indirect
ownership interest of at least five percent in an entity that is a licensee.
new text end

new text begin Subd. 28. new text end

new text begin Legal representative. new text end

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

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

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

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

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

new text begin Subd. 29. new text end

new text begin Licensed health professional. new text end

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

new text begin Subd. 30. new text end

new text begin Licensed practical nurse. new text end

new text begin "Licensed practical nurse" has the meaning given
in section 148.171, subdivision 8.
new text end

new text begin Subd. 31. new text end

new text begin Licensed resident capacity. new text end

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

new text begin Subd. 32. new text end

new text begin Licensee. new text end

new text begin "Licensee" means a person or legal entity to whom the commissioner
issues a license for an assisted living facility and who is responsible for the management,
control, and operation of a facility.
new text end

new text begin Subd. 33. new text end

new text begin Maltreatment. new text end

new text begin "Maltreatment" means conduct described in section 626.5572,
subdivision 15.
new text end

new text begin Subd. 34. new text end

new text begin Management agreement. new text end

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

new text begin Subd. 35. new text end

new text begin Manager. new text end

new text begin "Manager" means an individual or legal entity designated by the
licensee through a management agreement to act on behalf of the licensee in the on-site
management of the assisted living facility.
new text end

new text begin Subd. 36. new text end

new text begin Managerial official. new text end

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

new text begin Subd. 37. new text end

new text begin Medication. new text end

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

new text begin Subd. 38. new text end

new text begin Medication administration. new text end

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

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

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

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

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

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

new text begin Subd. 39. new text end

new text begin Medication management. new text end

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

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

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

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

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

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

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

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

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

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

new text begin Subd. 40. new text end

new text begin Medication reconciliation. new text end

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

new text begin Subd. 41. new text end

new text begin Medication setup. new text end

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

new text begin Subd. 42. new text end

new text begin New construction. new text end

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

new text begin Subd. 43. new text end

new text begin Nurse. new text end

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

new text begin Subd. 44. new text end

new text begin Nutritionist. new text end

new text begin "Nutritionist" means a person licensed as a nutritionist under
section 148.624.
new text end

new text begin Subd. 45. new text end

new text begin Occupational therapist. new text end

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

new text begin Subd. 46. new text end

new text begin Ombudsman. new text end

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

new text begin Subd. 47. new text end

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

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

new text begin Subd. 48. new text end

new text begin Owner. new text end

new text begin "Owner" means an individual or legal entity that has a direct or indirect
ownership interest of five percent or more in a licensee. For purposes of this chapter, "owner
of a nonprofit corporation" means the president and treasurer of the board of directors or,
for an entity owned by an employee stock ownership plan, means the president and treasurer
of the entity. A government entity that is issued a license under this chapter shall be
designated the owner.
new text end

new text begin Subd. 49. new text end

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

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

new text begin Subd. 50. new text end

new text begin Pharmacist. new text end

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

new text begin Subd. 51. new text end

new text begin Physical therapist. new text end

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

new text begin Subd. 52. new text end

new text begin Physician. new text end

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

new text begin Subd. 53. new text end

new text begin Prescriber. new text end

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

new text begin Subd. 54. new text end

new text begin Prescription. new text end

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

new text begin Subd. 55. new text end

new text begin Provisional license. new text end

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

new text begin Subd. 56. new text end

new text begin Regularly scheduled. new text end

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

new text begin Subd. 57. new text end

new text begin Reminder. new text end

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

new text begin Subd. 58. new text end

new text begin Repeat violation. new text end

new text begin "Repeat violation" means the issuance of two or more
correction orders within a 12-month period for a violation of the same provision of a statute
or rule.
new text end

new text begin Subd. 59. new text end

new text begin Resident. new text end

new text begin "Resident" means a person living in an assisted living facility who
has executed an assisted living contract.
new text end

new text begin Subd. 60. new text end

new text begin Resident record. new text end

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

new text begin Subd. 61. new text end

new text begin Respiratory therapist. new text end

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

new text begin Subd. 62. new text end

new text begin Secured dementia care unit. new text end

new text begin "Secured dementia care unit" means a designated
area or setting designed for individuals with dementia that is locked or secured to prevent
a resident from exiting, or to limit a resident's ability to exit, the secured area or setting. A
secured dementia care unit is not solely an individual resident's living area.
new text end

new text begin Subd. 63. new text end

new text begin Service plan. new text end

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

new text begin Subd. 64. new text end

new text begin Social worker. new text end

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

new text begin Subd. 65. new text end

new text begin Speech-language pathologist. new text end

new text begin "Speech-language pathologist" has the meaning
given in section 148.512, subdivision 17.
new text end

new text begin Subd. 66. new text end

new text begin Standby assistance. new text end

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

new text begin Subd. 67. new text end

new text begin Substantial compliance. new text end

new text begin "Substantial compliance" means complying with
the requirements in this chapter sufficiently to prevent unacceptable health or safety risks
to residents.
new text end

new text begin Subd. 68. new text end

new text begin Supportive services. new text end

new text begin "Supportive services" means:
new text end

new text begin (1) assistance with laundry, shopping, and household chores;
new text end

new text begin (2) housekeeping services;
new text end

new text begin (3) provision or assistance with meals or food preparation;
new text end

new text begin (4) help with arranging for, or arranging transportation to, medical, social, recreational,
personal, or social services appointments;
new text end

new text begin (5) provision of social or recreational services; or
new text end

new text begin (6) "I'm okay" check services.
new text end

new text begin Arranging for services does not include making referrals, or contacting a service provider
in an emergency.
new text end

new text begin Subd. 69. new text end

new text begin Survey. new text end

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

new text begin Subd. 70. new text end

new text begin Surveyor. new text end

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

new text begin Subd. 71. new text end

new text begin Treatment or therapy. new text end

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

new text begin Subd. 72. new text end

new text begin Unit of government. new text end

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

new text begin Subd. 73. new text end

new text begin Unlicensed personnel. new text end

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

new text begin Subd. 74. new text end

new text begin Verbal. new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 3.

new text begin [144I.02] ASSISTED LIVING FACILITY LICENSE.
new text end

new text begin Subdivision 1. new text end

new text begin License required. new text end

new text begin Beginning August 1, 2021, no assisted living facility
may operate in Minnesota unless it is licensed under this chapter. The licensee is legally
responsible for the management, control, and operation of the facility, regardless of the
existence of a management agreement or subcontract. Nothing in this chapter shall in any
way affect the rights and remedies available under other law.
new text end

new text begin Subd. 2. new text end

new text begin Licensure categories. new text end

new text begin (a) The categories in this subdivision are established for
assisted living facility licensure.
new text end

new text begin (b) The assisted living facility category is for assisted living facilities that only provide
assisted living services.
new text end

new text begin (c) The assisted living facility with dementia care category is for assisted living facilities
that provide assisted living services and dementia care services. An assisted living facility
with dementia care may also provide dementia care services in a secured dementia care
unit.
new text end

new text begin (d) An assisted living facility that has a secured dementia care unit must be licensed as
an assisted living facility with dementia care.
new text end

new text begin Subd. 3. new text end

new text begin Licensure under other law. new text end

new text begin An assisted living facility licensed under this
chapter is not required to also be licensed as a boarding establishment, food and beverage
service establishment, hotel, motel, lodging establishment, resort, or restaurant under chapter
157.
new text end

new text begin Subd. 4. new text end

new text begin Violations; penalty. new text end

new text begin (a) Operating an assisted living facility without a license
is a misdemeanor, and the commissioner may also impose a fine.
new text end

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 4.

new text begin [144I.03] PROVISIONAL LICENSE.
new text end

new text begin Subdivision 1. new text end

new text begin Provisional license. new text end

new text begin Beginning August 1, 2021, for new assisted living
facility license applicants, the commissioner shall issue a provisional license from one of
the licensure categories specified in section 144I.02, subdivision 2. A provisional license
is effective for up to one year from the initial effective date of the license, except that a
provisional license may be extended according to subdivision 2, paragraphs (c) and (d).
new text end

new text begin Subd. 2. new text end

new text begin Initial survey; licensure. new text end

new text begin (a) During the provisional license period, the
commissioner shall survey the provisional licensee after the commissioner is notified or
has evidence that the provisional licensee is providing assisted living services to at least
one resident.
new text end

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

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

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

new text begin Subd. 3. new text end

new text begin Reconsideration. new text end

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

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

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

new text begin Subd. 4. new text end

new text begin Continued operation. new text end

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

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

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

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

new text begin Subd. 5. new text end

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

new text begin A provisional licensee whose license
is denied must comply with the requirements for notification and the coordinated move of
residents in sections 144I.26 and 144I.263.
new text end

new text begin Subd. 6. new text end

new text begin Fines. new text end

new text begin The fee for failure to comply with the notification requirements in section
144I.26, subdivision 7, is $1,000.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 5.

new text begin [144I.04] APPLICATION FOR LICENSURE.
new text end

new text begin Subdivision 1. new text end

new text begin License applications. new text end

new text begin (a) Each application for an assisted living facility
license, including provisional and renewal applications, must include information sufficient
to show that the applicant meets the requirements of licensure, including:
new text end

new text begin (1) the business name and legal entity name of the licensee, and the street address and
mailing address of the facility;
new text end

new text begin (2) the names, e-mail addresses, telephone numbers, and mailing addresses of all owners,
controlling individuals, managerial officials, and the assisted living director;
new text end

new text begin (3) the name and e-mail address of the managing agent and manager, if applicable;
new text end

new text begin (4) the licensed resident capacity and the license category;
new text end

new text begin (5) the license fee in the amount specified in section 144.122;
new text end

new text begin (6) documentation of compliance with the background study requirements in section
144I.06 for the owner, controlling individuals, and managerial officials. Each application
for a new license must include documentation for the applicant and for each individual with
five percent or more direct or indirect ownership in the applicant;
new text end

new text begin (7) evidence of workers' compensation coverage as required by sections 176.181 and
176.182;
new text end

new text begin (8) documentation that the facility has liability coverage;
new text end

new text begin (9) a copy of the executed lease agreement between the landlord and the licensee, if
applicable;
new text end

new text begin (10) a copy of the management agreement, if applicable;
new text end

new text begin (11) a copy of the operations transfer agreement or similar agreement, if applicable;
new text end

new text begin (12) an organizational chart that identifies all organizations and individuals with an
ownership interest in the licensee of five percent or greater and that specifies their relationship
with the licensee and with each other;
new text end

new text begin (13) whether the applicant, owner, controlling individual, managerial official, or assisted
living director of the facility has ever been convicted of:
new text end

new text begin (i) a crime or found civilly liable for a federal or state felony level offense that was
detrimental to the best interests of the facility and its resident within the last ten years
preceding submission of the license application. Offenses include: felony crimes against
persons and other similar crimes for which the individual was convicted, including guilty
pleas and adjudicated pretrial diversions; financial crimes such as extortion, embezzlement,
income tax evasion,, insurance fraud, and other similar crimes for which the individual was
convicted, including guilty pleas and adjudicated pretrial diversions; any felonies involving
malpractice that resulted in a conviction of criminal neglect or misconduct; and any felonies
that would result in a mandatory exclusion under section 1128(a) of the Social Security
Act;.
new text end

new text begin (ii) any misdemeanor conviction, under federal or state law, related to: the delivery of
an item or service under Medicaid or a state health care program, or the abuse or neglect of
a patient in connection with the delivery of a health care item or service;
new text end

new text begin (iii) any misdemeanor conviction, under federal or state law, related to theft, fraud,
embezzlement, breach of fiduciary duty, or other financial misconduct in connection with
the delivery of a health care item or service;
new text end

new text begin (iv) any felony or misdemeanor conviction, under federal or state law, relating to the
interference with or obstruction of any investigation into any criminal offense described in
Code of Federal Regulations, title 42, section 1001.101 or 1001.201;
new text end

new text begin (v) any felony or misdemeanor conviction, under federal or state law, relating to the
unlawful manufacture, distribution, prescription, or dispensing of a controlled substance;
new text end

new text begin (vi) any felony or gross misdemeanor that relates to the operation of a nursing home or
assisted living facility or directly affects resident safety or care during that period;
new text end

new text begin (vii) any revocation or suspension of a license to provide health care by any state licensing
authority. This includes the surrender of such a license while a formal disciplinary proceeding
was pending before a state licensing authority;
new text end

new text begin (viii) any revocation or suspension of accreditation; or
new text end

new text begin (ix) any suspension or exclusion from participation in, or any sanction imposed by, a
federal or state health care program, or any debarment from participation in any federal
executive branch procurement or non-procurement program;
new text end

new text begin (14) whether, in the preceding three years, the applicant or any owner, controlling
individual, managerial official, or assisted living director of the facility has a record of
defaulting in the payment of money collected for others, including the discharge of debts
through bankruptcy proceedings;
new text end

new text begin (15) the signature of the owner of the licensee, or an authorized agent of the licensee;
new text end

new text begin (16) identification of all states where the applicant or individual having a five percent
or more ownership, currently or previously has been licensed as an owner or operator of a
long-term care, community-based, or health care facility or agency where its license or
federal certification has been denied, suspended, restricted, conditioned, refused, not renewed,
or revoked under a private or state-controlled receivership, or where these same actions are
pending under the laws of any state or federal authority;
new text end

new text begin (17) statistical information required by the commissioner; and
new text end

new text begin (18) any other information required by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Authorized agents. new text end

new text begin (a) An application for an assisted living facility license or
for renewal of a facility license must specify one or more owners, controlling individuals,
or employees as authorized agents who can accept service on behalf of the licensee in
proceedings under this chapter.
new text end

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

new text begin Subd. 3. new text end

new text begin Fees. new text end

new text begin (a) An initial applicant, renewal applicant, or applicant filing a change
of ownership for assisted living facility licensure must submit the application fee required
in section 144.122 to the commissioner along with a completed application.
new text end

new text begin (b) The penalty for late submission of the renewal application less than 30 days before
the expiration date of the license or after expiration of the license is $200. The penalty for
operating a facility after expiration of the license and before a renewal license is issued, is
$250 each day after expiration of the license until the renewal license issuance date. The
facility is still subject to the misdemeanor penalties for operating after license expiration.
new text end

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

new text begin (d) Fines collected under this subdivision shall be deposited in a dedicated special revenue
account. On an annual basis, the balance in the special revenue account shall be appropriated
to the commissioner to implement the recommendations of the advisory council established
in section 144A.4799.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 6.

new text begin [144I.05] TRANSFER OF LICENSE PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Transfers prohibited. new text end

new text begin An assisted living facility license may not be
transferred to another party.
new text end

new text begin Subd. 2. new text end

new text begin New license required. new text end

new text begin (a) A prospective licensee must apply for a license prior
to operating a currently licensed assisted living facility. The new license, if issued, shall
not be a provisional license. The licensee must change whenever one of the following events
occur:
new text end

new text begin (1) the form of the licensee's legal entity structure is converted or changed to a different
type of legal entity structure;
new text end

new text begin (2) the licensee dissolves, consolidates, or merges with another legal organization and
the licensee's legal organization does not survive;
new text end

new text begin (3) within the previous 24 months, 50 percent or more of the licensee is transferred,
whether by a single transaction or multiple transactions, to:
new text end

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

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

new text begin (4) any other event or combination of events that results in a substitution, elimination,
or withdrawal of the licensee's responsibility for the facility.
new text end

new text begin (b) The prospective licensee must provide written notice to the department at least 60
calendar days prior to the anticipated date of the change of licensee.
new text end

new text begin Subd. 3. new text end

new text begin Survey required. new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 7.

new text begin [144I.06] BACKGROUND STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Background studies required. new text end

new text begin (a) Before the commissioner issues a
provisional license, issues a license as a result of an approved change of ownership, or
renews a license, a managerial official or a natural person who is an owner with direct
ownership interest is required to undergo a background study under section 144.057. No
person may be involved in the management, operation, or control of an assisted living facility
if the person has been disqualified under chapter 245C. For the purposes of this section,
managerial officials subject to the background study requirement are individuals who provide
direct contact.
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) Employees, contractors, and regularly-scheduled volunteers of the facility are subject
to the background study required by section 144.057 and may be disqualified under chapter
245C. Nothing in this section shall be construed to prohibit the facility from requiring
self-disclosure of criminal conviction information.
new text end

new text begin Subd. 2. new text end

new text begin Reconsideration. new text end

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

new text begin Subd. 3. new text end

new text begin Data classification. new text end

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

new text begin Subd. 4. new text end

new text begin Termination in good faith. new text end

new text begin Termination of an employee in good faith reliance
on information or records obtained under this section regarding a confirmed conviction does
not subject the assisted living facility to civil liability or liability for unemployment benefits.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 8.

new text begin [144I.07] LICENSE RENEWAL.
new text end

new text begin A license that is not a provisional license may be renewed for a period of up to one year
if the licensee:
new text end

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

new text begin (2) submits the renewal fee under section 144I.04, subdivision 3;
new text end

new text begin (3) submits the late fee under section 144I.04, subdivision 3, if the renewal application
is received less than 30 days before the expiration date of the license or after the expiration
of the license;
new text end

new text begin (4) provides information sufficient to show that the applicant meets the requirements of
licensure, including items required under section 144I.04, subdivision 1; and
new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 9.

new text begin [144I.08] NOTIFICATION OF CHANGES IN INFORMATION.
new text end

new text begin A provisional licensee or licensee shall notify the commissioner in writing prior to a
change in the manager or authorized agent and within 60 calendar days after any change in
the information required in section 144I.04, subdivision 1, paragraph (a), clause (1), (3),
(4), (17), or (18).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 10.

new text begin [144I.09] CONSIDERATION OF APPLICATIONS.
new text end

new text begin (a) Before issuing a provisional license or license or renewing a license, the commissioner
shall consider an applicant's compliance history in providing care in a facility that provides
care to children, the elderly, ill individuals, or individuals with disabilities.
new text end

new text begin (b) The applicant's compliance history shall include repeat violation, rule violations, and
any license or certification involuntarily suspended or terminated during an enforcement
process.
new text end

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

new text begin (1) the applicant fails to provide complete and accurate information on the application
and the commissioner concludes that the missing or corrected information is needed to
determine if a license shall be granted;
new text end

new text begin (2) the applicant, knowingly or with reason to know, made a false statement of a material
fact in an application for the license or any data attached to the application or in any matter
under investigation by the department;
new text end

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

new text begin (4) the applicant willfully prevented, interfered with, or attempted to impede in any way:
(i) the work of any authorized representative of the commissioner, the ombudsman for
long-term care, or the ombudsman for mental health and developmental disabilities; or (ii)
the duties of the commissioner, local law enforcement, city or county attorneys, adult
protection, county case managers, or other local government personnel;
new text end

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

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

new text begin (d) If a license is denied, the applicant has the reconsideration rights available under
section 144I.03, subdivision 3.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 11.

new text begin [144I.10] MINIMUM ASSISTED LIVING FACILITY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Minimum requirements. new text end

new text begin (a) All assisted living facilities shall:
new text end

new text begin (1) distribute to residents the assisted living bill of rights;
new text end

new text begin (2) provide services in a manner that complies with the Nurse Practice Act in sections
148.171 to 148.285;
new text end

new text begin (3) utilize a person-centered planning and service delivery process;
new text end

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

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

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

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

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

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

new text begin (10) notify the resident of the resident's right to have and use a lockable door to the
resident's unit. The licensee shall provide the locks on the unit. Only a staff member with
a specific need to enter the unit shall have keys, and advance notice must be given to the
resident before entrance, when possible. An assisted living facility must not lock a resident
in the resident's unit;
new text end

new text begin (11) develop and implement a staffing plan for determining its staffing level that:
new text end

new text begin (i) includes an evaluation, to be conducted at least twice a year, of the appropriateness
of staffing levels in the facility;
new text end

new text begin (ii) ensures sufficient staffing at all times to meet the scheduled and reasonably
foreseeable unscheduled needs of each resident as required by the residents' assessments
and service plans on a 24-hour per day basis; and
new text end

new text begin (iii) ensures that the facility can respond promptly and effectively to individual resident
emergencies and to emergency, life safety, and disaster situations affecting staff or residents
in the facility;
new text end

new text begin (12) ensures that one or more persons are available 24 hours per day, seven days per
week, who are responsible for responding to the requests of residents for assistance with
health or safety needs. Such persons must be:
new text end

new text begin (i) awake;
new text end

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

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

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

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

new text begin (vi) for an assisted living facility with dementia care providing services in a secured
dementia care unit, an awake person must be physically present in the secured dementia
care unit; and
new text end

new text begin (13) offer to provide or make available at least the following services to residents:
new text end

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

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

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

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

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

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

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

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

new text begin (vi) provide culturally sensitive programs; and
new text end

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

new text begin (b) The resident's rights in section 144I.101, subdivisions 12, 13, and 18, may be restricted
for an individual resident only if determined necessary for health and safety reasons identified
by the facility through an initial assessment or reassessment under section 144I.16,
subdivision 2, and documented in the written service plan under section 144I.16, subdivision
4. Any restrictions of those rights for people served under sections 256B.0915 and 256B.49
must be documented by the case manager in the resident's coordinated service and support
plan (CSSP), as defined in sections 256B.0915, subdivision 6, and 256B.49, subdivision
15. Nothing in this section affects other laws applicable to or prohibiting restrictions on the
resident's rights in section 144I.101, subdivisions 12, 13, and 18.
new text end

new text begin Subd. 2. new text end

new text begin Policies and procedures. new text end

new text begin (a) Each assisted living facility must have policies
and procedures in place to address the following and keep them current:
new text end

new text begin (1) requirements in section 626.557, reporting of maltreatment of vulnerable adults;
new text end

new text begin (2) conducting and handling background studies on employees;
new text end

new text begin (3) orientation, training, and competency evaluations of staff, and a process for evaluating
staff performance;
new text end

new text begin (4) handling complaints regarding staff or services provided by staff;
new text end

new text begin (5) conducting initial evaluations of residents' needs and the providers' ability to provide
those services;
new text end

new text begin (6) conducting initial and ongoing resident evaluations and assessments of resident
needs, including assessments by a registered nurse or appropriate licensed health professional,
and how changes in a resident's condition are identified, managed, and communicated to
staff and other health care providers as appropriate;
new text end

new text begin (7) orientation to and implementation of the assisted living bill of rights;
new text end

new text begin (8) infection control practices;
new text end

new text begin (9) reminders for medications, treatments, or exercises, if provided;
new text end

new text begin (10) conducting appropriate screenings, or documentation of prior screenings, to show
that staff are free of tuberculosis, consistent with current United States Centers for Disease
Control and Prevention standards;
new text end

new text begin (11) ensuring that nurses and licensed health professionals have current and valid licenses
to practice;
new text end

new text begin (12) medication and treatment management;
new text end

new text begin (13) delegation of tasks by registered nurses or licensed health professionals;
new text end

new text begin (14) supervision of registered nurses and licensed health professionals; and
new text end

new text begin (15) supervision of unlicensed personnel performing delegated tasks.
new text end

new text begin Subd. 3. new text end

new text begin Infection control program. new text end

new text begin All assisted living facilities must establish and
maintain an infection control program.
new text end

new text begin Subd. 4. new text end

new text begin Clinical nurse supervision. new text end

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

new text begin Subd. 5. new text end

new text begin Resident councils. new text end

new text begin The facility must provide a resident council with space and
privacy for meetings, where doing so is reasonably achievable. Staff, visitors, and other
guests may attend a resident council meeting only at the council's invitation. The facility
must designate a staff person who is approved by the resident council to be responsible for
providing assistance and responding to written requests that result from meetings. The
facility must consider the views of the resident council and must respond promptly to the
grievances and recommendations of the council, but a facility is not required to implement
as recommended every request of the council. The facility shall, with the approval of the
resident council, take reasonably achievable steps to make residents aware of upcoming
meetings in a timely manner.
new text end

new text begin Subd. 6. new text end

new text begin Family councils. new text end

new text begin The facility must provide a family council with space and
privacy for meetings, where doing so is reasonably achievable. The facility must designate
a staff person who is approved by the family council to be responsible for providing
assistance and responding to written requests that result from meetings. The facility must
consider the views of the family council and must respond promptly to the grievances and
recommendations of the council, but a facility is not required to implement as recommended
every request of the council. The facility shall, with the approval of the family council, take
reasonably achievable steps to make residents and family members aware of upcoming
meetings in a timely manner.
new text end

new text begin Subd. 7. new text end

new text begin Resident grievances; reporting maltreatment. new text end

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

new text begin Subd. 8. new text end

new text begin Protecting resident rights. new text end

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

new text begin (1) providing names and contact information, including telephone numbers and e-mail
addresses of at least three organizations that provide advocacy or legal services to residents;
new text end

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

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

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

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

new text begin Subd. 9. new text end

new text begin Payment for services under disability waivers. new text end

new text begin For new assisted living
facilities that did not operate as registered housing with services establishments prior to
August 1, 2021, home and community-based services under section 256B.49 are not available
when the new facility setting is adjoined to, or on the same property as, an institution as
defined in Code of Federal Regulations, title 42, section 441.301(c).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 12.

new text begin [144I.101] ASSISTED LIVING BILL OF RIGHTS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin This section applies to residents living in assisted living
facilities.
new text end

new text begin Subd. 2. new text end

new text begin Legislative intent. new text end

new text begin The rights established under this section for the benefit of
residents do not limit any other rights available under law. No facility may request or require
that any resident waive any of these rights at any time for any reason, including as a condition
of admission to the facility.
new text end

new text begin Subd. 3. new text end

new text begin Information about rights. new text end

new text begin Before receiving services, residents have the right
to be informed by the facility of the rights granted under this section and the recourse
residents have if rights are violated. The information must be in plain language and in terms
residents can understand. The facility must make reasonable accommodations for residents
who have communication disabilities and those who speak a language other than English.
new text end

new text begin Subd. 4. new text end

new text begin Appropriate care and services. new text end

new text begin (a) Residents have the right to care and assisted
living services that are appropriate based on the resident's needs and according to an
up-to-date service plan subject to accepted health care standards.
new text end

new text begin (b) Residents have the right to receive health care and other assisted living services with
continuity from people who are properly trained and competent to perform their duties and
in sufficient numbers to adequately provide the services agreed to in the assisted living
contract and the service plan.
new text end

new text begin Subd. 5. new text end

new text begin Refusal of care or services. new text end

new text begin Residents have the right to refuse care or assisted
living services and to be informed by the facility of the medical, health-related, or
psychological consequences of refusing care or services.
new text end

new text begin Subd. 6. new text end

new text begin Participation in care and service planning. new text end

new text begin Residents have the right to actively
participate in the planning, modification, and evaluation of their care and services. This
right includes:
new text end

new text begin (1) the opportunity to discuss care, services, treatment, and alternatives with the
appropriate caregivers;
new text end

new text begin (2) the right to include the resident's legal and designated representatives and persons
of the resident's choosing; and
new text end

new text begin (3) the right to be told in advance of, and take an active part in decisions regarding, any
recommended changes in the service plan.
new text end

new text begin Subd. 7. new text end

new text begin Courteous treatment. new text end

new text begin Residents have the right to be treated with courtesy and
respect, and to have the resident's property treated with respect.
new text end

new text begin Subd. 8. new text end

new text begin Freedom from maltreatment. new text end

new text begin Residents have the right to be free from physical,
sexual, and emotional abuse; neglect; financial exploitation; and all forms of maltreatment
covered under the Vulnerable Adults Act.
new text end

new text begin Subd. 9. new text end

new text begin Right to come and go freely. new text end

new text begin Residents have the right to enter and leave the
facility as they choose. This right may be restricted only as allowed by other law and
consistent with a resident's service plan.
new text end

new text begin Subd. 10. new text end

new text begin Individual autonomy. new text end

new text begin Residents have the right to individual autonomy,
initiative, and independence in making life choices, including establishing a daily schedule
and choosing with whom to interact.
new text end

new text begin Subd. 11. new text end

new text begin Right to control resources. new text end

new text begin Residents have the right to control personal
resources.
new text end

new text begin Subd. 12. new text end

new text begin Visitors and social participation. new text end

new text begin (a) Residents have the right to meet with
or receive visits at any time by the resident's family, guardian, conservator, health care
agent, attorney, advocate, or religious or social work counselor, or any person of the resident's
choosing. This right may be restricted in certain circumstances if necessary for the resident's
health and safety and if documented in the resident's service plan.
new text end

new text begin (b) Residents have the right to engage in community life and in activities of their choice.
This includes the right to participate in commercial, religious, social, community, and
political activities without interference and at their discretion if the activities do not infringe
on the rights of other residents.
new text end

new text begin Subd. 13. new text end

new text begin Personal and treatment privacy. new text end

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

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

new text begin (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.
new text end

new text begin Subd. 14. new text end

new text begin Communication privacy. new text end

new text begin (a) Residents have the right to communicate
privately with persons of their choice.
new text end

new text begin (b) If an assisted living facility is sending or receiving mail on behalf of residents, the
assisted living facility must do so without interference.
new text end

new text begin (c) Residents must be provided access to a telephone to make and receive calls.
new text end

new text begin Subd. 15. new text end

new text begin Confidentiality of records. new text end

new text begin (a) Residents have the right to have personal,
financial, health, and medical information kept private, to approve or refuse release of
information to any outside party, and to be advised of the assisted living facility's policies
and procedures regarding disclosure of the information. Residents must be notified when
personal records are requested by any outside party.
new text end

new text begin (b) Residents have the right to access their own records.
new text end

new text begin Subd. 16. new text end

new text begin Right to furnish and decorate. new text end

new text begin Residents have the right to furnish and decorate
the resident's unit within the terms of the assisted living contract.
new text end

new text begin Subd. 17. new text end

new text begin Right to choose roommate. new text end

new text begin Residents have the right to choose a roommate
if sharing a unit.
new text end

new text begin Subd. 18. new text end

new text begin Right to access food. new text end

new text begin Residents have the right to access food at any time.
This right may be restricted in certain circumstances if necessary for the resident's health
and safety and if documented in the resident's service plan.
new text end

new text begin Subd. 19. new text end

new text begin Access to technology. new text end

new text begin Residents have the right to access Internet service at
their expense.
new text end

new text begin Subd. 20. new text end

new text begin Grievances and inquiries. new text end

new text begin Residents have the right to make and receive a
timely response to a complaint or inquiry, without limitation. Residents have the right to
know and every facility must provide the name and contact information of the person
representing the facility who is designated to handle and resolve complaints and inquiries.
new text end

new text begin Subd. 21. new text end

new text begin Access to counsel and advocacy services. new text end

new text begin Residents have the right to the
immediate access by:
new text end

new text begin (1) the resident's legal counsel;
new text end

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

new text begin (3) any representative of the Office of Ombudsman for Long-Term Care.
new text end

new text begin Subd. 22. new text end

new text begin Information about charges. new text end

new text begin Before services are initiated, residents have the
right to be notified:
new text end

new text begin (1) of all charges for housing and assisted living services;
new text end

new text begin (2) of any limits on housing and assisted living services available;
new text end

new text begin (3) if known, whether and what amount of payment may be expected from health
insurance, public programs, or other sources; and
new text end

new text begin (4) what charges the resident may be responsible for paying.
new text end

new text begin Subd. 23. new text end

new text begin Information about individuals providing services. new text end

new text begin Before receiving services
identified in the service plan, residents have the right to be told the type and disciplines of
staff who will be providing the services, the frequency of visits proposed to be furnished,
and other choices that are available for addressing the resident's needs.
new text end

new text begin Subd. 24. new text end

new text begin Information about other providers and services. new text end

new text begin Residents have the right
to be informed by the assisted living facility, prior to executing an assisted living contract,
that other public and private services may be available and that the resident has the right to
purchase, contract for, or obtain services from a provider other than the assisted living
facility.
new text end

new text begin Subd. 25. new text end

new text begin Resident councils. new text end

new text begin Residents have the right to organize and participate in
resident councils as described in section 144I.10, subdivision 5.
new text end

new text begin Subd. 26. new text end

new text begin Family councils. new text end

new text begin Residents have the right to participate in family councils
formed by families or residents as described in section 144I.10, subdivision 6.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 13.

new text begin [144I.11] HOUSING AND SERVICES.
new text end

new text begin Subdivision 1. new text end

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

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

new text begin Subd. 2. new text end

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

new text begin (a) All assisted living facilities must
provide to prospective residents:
new text end

new text begin (1) a disclosure of the categories of assisted living licenses available and the category
of license held by the facility;
new text end

new text begin (2) a written checklist listing all services permitted under the facility's license, identifying
all services the facility offers to provide under the assisted living facility contract, and
identifying all services allowed under the license that the facility does not provide; and
new text end

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

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

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

new text begin Subd. 3. new text end

new text begin Reservation of rights. new text end

new text begin Nothing in this chapter:
new text end

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

new text begin (2) prevents a facility from requiring, as a condition of the contract, that the resident pay
for a package of services even if the resident does not choose to use all or some of the
services in the package. For residents who are eligible for home and community-based
waiver services under sections 256B.0915 and 256B.49, payment for services will follow
the policies of those programs;
new text end

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 14.

new text begin [144I.12] TRANSFER OF RESIDENTS WITHIN FACILITY.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For the purposes of this section, "transfer" means a move of
a resident within the facility to a different room or other private living unit.
new text end

new text begin Subd. 2. new text end

new text begin Orderly transfer. new text end

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

new text begin Subd. 3. new text end

new text begin Notice required. new text end

new text begin (a) A facility must provide at least 30 calendar days' advance
written notice to the resident and the resident's legal and designated representative of a
facility-initiated transfer. The notice must include:
new text end

new text begin (1) the effective date of the proposed transfer;
new text end

new text begin (2) the proposed transfer location;
new text end

new text begin (3) a statement that the resident may refuse the proposed transfer, and may discuss any
consequences of a refusal with staff of the facility;
new text end

new text begin (4) the name and contact information of a person employed by the facility with whom
the resident may discuss the notice of transfer; and
new text end

new text begin (5) contact information for the Office of Ombudsman for Long-Term Care.
new text end

new text begin (b) Notwithstanding paragraph (a), a facility may conduct a facility-initiated transfer of
a resident with less than 30 days' written notice if the transfer is necessary due to:
new text end

new text begin (1) conditions that render the resident's room or private living unit uninhabitable;
new text end

new text begin (2) the resident's urgent medical needs; or
new text end

new text begin (3) a risk to the health or safety of another resident of the facility.
new text end

new text begin Subd. 4. new text end

new text begin Consent required. new text end

new text begin The facility may not transfer a resident without first obtaining
the resident's consent to the transfer unless:
new text end

new text begin (1) there are conditions that render the resident's room or private living unit uninhabitable;
or
new text end

new text begin (2) there is a change in facility operations as described in subdivision 5.
new text end

new text begin Subd. 5. new text end

new text begin Changes in facility operations. new text end

new text begin (a) In situations where there is a curtailment,
reduction, or capital improvement within a facility necessitating transfers, the facility must:
new text end

new text begin (1) minimize the number of transfers it initiates to complete the project or change in
operations;
new text end

new text begin (2) consider individual resident needs and preferences;
new text end

new text begin (3) provide reasonable accommodations for individual resident requests regarding the
transfers; and
new text end

new text begin (4) in advance of any notice to any residents, legal representatives, or designated
representatives, provide notice to the Office of Ombudsman for Long-Term Care and, when
appropriate, the Office of Ombudsman for Mental Health and Developmental Disabilities
of the curtailment, reduction, or capital improvement and the corresponding needed transfers.
new text end

new text begin Subd. 6. new text end

new text begin Evaluation. new text end

new text begin If a resident consents to a transfer, reasonable modifications must
be made to the new room or private living unit that are necessary to accommodate the
resident's disabilities. The facility must evaluate the resident's individual needs before
deciding whether the room or unit to which the resident will be moved is appropriate to the
resident's psychological, cognitive, and health care needs, including the accessibility of the
bathroom.
new text end

new text begin Subd. 7. new text end

new text begin Disclosure. new text end

new text begin When entering into the assisted living contract, the facility must
provide a conspicuous notice of the circumstance under which the facility may require a
transfer, including any transfer that may be required if the resident will be receiving housing
support under section 256I.06.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 15.

new text begin [144I.13] BUSINESS OPERATION.
new text end

new text begin Subdivision 1. new text end

new text begin Display of license. new text end

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

new text begin Subd. 2. new text end

new text begin Quality management. new text end

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

new text begin Subd. 3. new text end

new text begin Facility restrictions. new text end

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

new text begin (b) A facility or staff person may not:
new text end

new text begin (1) accept a power-of-attorney from residents for any purpose, and may not accept
appointments as guardians or conservators of residents; or
new text end

new text begin (2) borrow a resident's funds or personal or real property, nor in any way convert a
resident's property to the possession of the facility or staff person.
new text end

new text begin (c) A facility may not serve as a resident's legal, designated, or other representative.
new text end

new text begin (d) Nothing in this subdivision precludes a facility or staff person from accepting gifts
of minimal value or precludes acceptance of donations or bequests made to a facility that
are exempt from section 501(c)(3) of the Internal Revenue Code.
new text end

new text begin Subd. 4. new text end

new text begin Handling residents' finances and property. new text end

new text begin (a) A facility may assist residents
with household budgeting, including paying bills and purchasing household goods, but may
not otherwise manage a resident's property.
new text end

new text begin (b) Where funds are deposited with the facility by the resident, the licensee:
new text end

new text begin (1) retains fiduciary and custodial responsibility for the funds;
new text end

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

new text begin (3) must maintain records of and provide a resident with receipts for all transactions and
purchases made with the resident's funds. When receipts are not available, the transaction
or purchase must be documented.
new text end

new text begin (c) Subject to paragraph (d), if responsibilities for day-to-day management of the resident
funds are delegated to the manager, the manager must:
new text end

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

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

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

new text begin Subd. 5. new text end

new text begin Final accounting; return of money and property. new text end

new text begin Within 30 days of the
effective date of a facility-initiated or resident-initiated termination of housing or services
or the death of the resident, the facility must:
new text end

new text begin (1) provide to the resident, resident's legal representative, and resident's designated
representative a final statement of account;
new text end

new text begin (2) provide any refunds due;
new text end

new text begin (3) return any money, property, or valuables held in trust or custody by the facility; and
new text end

new text begin (4) as required under section 504B.178, refund the resident's security deposit unless it
is applied to the first month's charges.
new text end

new text begin Subd. 6. new text end

new text begin Compliance with requirements for reporting maltreatment of vulnerable
adults; abuse prevention plan. new text end

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

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

new text begin Subd. 7. new text end

new text begin Posting information for reporting suspected crime and maltreatment. new text end

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

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

new text begin (2) posting information and the reporting number for the Minnesota Adult Abuse
Reporting Center to report suspected maltreatment of a vulnerable adult under section
626.557; and
new text end

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

new text begin Subd. 8. new text end

new text begin Employee records. new text end

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

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

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

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

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

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

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

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

new text begin Subd. 9. new text end

new text begin Tuberculosis prevention and control. new text end

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

new text begin Subd. 10. new text end

new text begin Disaster planning and emergency preparedness plan. new text end

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

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

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 16.

new text begin [144I.14] STAFFING AND SUPERVISORY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Qualifications, training, and competency. new text end

new text begin All staff persons providing
assisted living services must be trained and competent in the provision of services consistent
with current practice standards appropriate to the resident's needs, and promote and be
trained to support the assisted living bill of rights.
new text end

new text begin Subd. 2. new text end

new text begin Licensed health professionals and nurses. new text end

new text begin (a) Licensed health professionals
and nurses providing services as employees of a licensed facility must possess a current
Minnesota license or registration to practice.
new text end

new text begin (b) Licensed health professionals and registered nurses must be competent in assessing
resident needs, planning appropriate services to meet resident needs, implementing services,
and supervising staff if assigned.
new text end

new text begin (c) Nothing in this section limits or expands the rights of nurses or licensed health
professionals to provide services within the scope of their licenses or registrations, as
provided by law.
new text end

new text begin Subd. 3. new text end

new text begin Unlicensed personnel. new text end

new text begin (a) Unlicensed personnel providing assisted living
services must have:
new text end

new text begin (1) successfully completed a training and competency evaluation appropriate to the
services provided by the facility and the topics listed in subdivision 10, paragraph (b); or
new text end

new text begin (2) demonstrated competency by satisfactorily completing a written or oral test on the
tasks the unlicensed personnel will perform and on the topics listed in subdivision 10,
paragraph (b); and successfully demonstrated competency of topics in subdivision 10,
paragraph (b), clauses (5), (7), and (8), by a practical skills test.
new text end

new text begin Unlicensed personnel who only provide assisted living services listed in section 144I.01,
subdivision 9, clauses (1) to (5), shall not perform delegated nursing or therapy tasks.
new text end

new text begin (b) Unlicensed personnel performing delegated nursing tasks in an assisted living facility
must:
new text end

new text begin (1) have successfully completed training and demonstrated competency by successfully
completing a written or oral test of the topics in subdivision 10, paragraphs (b) and (c), and
a practical skills test on tasks listed in subdivision 10, paragraphs (b), clauses (5) and (7),
and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform;
new text end

new text begin (2) satisfy the current requirements of Medicare for training or competency of home
health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
section 483 or 484.36; or
new text end

new text begin (3) have, before April 19, 1993, completed a training course for nursing assistants that
was approved by the commissioner.
new text end

new text begin (c) Unlicensed personnel performing therapy or treatment tasks delegated or assigned
by a licensed health professional must meet the requirements for delegated tasks in
subdivision 7 and any other training or competency requirements within the licensed health
professional's scope of practice relating to delegation or assignment of tasks to unlicensed
personnel.
new text end

new text begin Subd. 4. new text end

new text begin Availability of contact person to staff. new text end

new text begin (a) Assisted living facilities must have
a registered nurse available for consultation by staff performing delegated nursing tasks
and must have an appropriate licensed health professional available if performing other
delegated services such as therapies.
new text end

new text begin (b) The appropriate contact person must be readily available either in person, by
telephone, or by other means to the staff at times when the staff is providing services.
new text end

new text begin Subd. 5. new text end

new text begin Supervision of staff. new text end

new text begin (a) Staff who only provide assisted living services specified
in section 144I.01, subdivision 9, clauses (1) to (5), must be supervised periodically where
the services are being provided to verify that the work is being performed competently and
to identify problems and solutions to address issues relating to the staff's ability to provide
the services. The supervision of the unlicensed personnel must be done by staff of the facility
having the authority, skills, and ability to provide the supervision of unlicensed personnel
and who can implement changes as needed, and train staff.
new text end

new text begin (b) Supervision includes direct observation of unlicensed personnel while the unlicensed
personnel are providing the services and may also include indirect methods of gaining input
such as gathering feedback from the resident. Supervisory review of staff must be provided
at a frequency based on the staff person's competency and performance.
new text end

new text begin Subd. 6. new text end

new text begin Supervision of staff providing delegated nursing or therapy tasks. new text end

new text begin (a) Staff
who perform delegated nursing or therapy tasks must be supervised by an appropriate
licensed health professional or a registered nurse according to the assisted living facility's
policy where the services are being provided to verify that the work is being performed
competently and to identify problems and solutions related to the staff person's ability to
perform the tasks. Supervision of staff performing medication or treatment administration
shall be provided by a registered nurse or appropriate licensed health professional and must
include observation of the staff administering the medication or treatment and the interaction
with the resident.
new text end

new text begin (b) The direct supervision of staff performing delegated tasks must be provided within
30 calendar days after the date on which the individual begins working for the facility and
first performs the delegated tasks for residents and thereafter as needed based on performance.
This requirement also applies to staff who have not performed delegated tasks for one year
or longer.
new text end

new text begin Subd. 7. new text end

new text begin Delegation of assisted living services. new text end

new text begin A registered nurse or licensed health
professional may delegate tasks only to staff who are competent and possess the knowledge
and skills consistent with the complexity of the tasks and according to the appropriate
Minnesota practice act. The assisted living facility must establish and implement a system
to communicate up-to-date information to the registered nurse or licensed health professional
regarding the current available staff and their competency so the registered nurse or licensed
health professional has sufficient information to determine the appropriateness of delegating
tasks to meet individual resident needs and preferences.
new text end

new text begin Subd. 8. new text end

new text begin Documentation. new text end

new text begin A facility must retain documentation of supervision activities
in the personnel records.
new text end

new text begin Subd. 9. new text end

new text begin Temporary staff. new text end

new text begin When a facility contracts with a temporary staffing agency,
those individuals must meet the same requirements required by this section for personnel
employed by the facility and shall be treated as if they are staff of the facility.
new text end

new text begin Subd. 10. new text end

new text begin Instructor and competency evaluation requirements; training for
unlicensed personnel. new text end

new text begin (a) Instructors and competency evaluators must meet the following
requirements:
new text end

new text begin (1) training and competency evaluations of unlicensed personnel who only provide
assisted living services specified in section 144I.01, subdivision 9, clauses (1) to (5), must
be conducted by individuals with work experience and training in providing these services;
and
new text end

new text begin (2) training and competency evaluations of unlicensed personnel providing assisted
living services must be conducted by a registered nurse, or another instructor may provide
training in conjunction with the registered nurse.
new text end

new text begin (b) Training and competency evaluations for all unlicensed personnel must include the
following:
new text end

new text begin (1) documentation requirements for all services provided;
new text end

new text begin (2) reports of changes in the resident's condition to the supervisor designated by the
facility;
new text end

new text begin (3) basic infection control, including blood-borne pathogens;
new text end

new text begin (4) maintenance of a clean and safe environment;
new text end

new text begin (5) appropriate and safe techniques in personal hygiene and grooming, including:
new text end

new text begin (i) hair care and bathing;
new text end

new text begin (ii) care of teeth, gums, and oral prosthetic devices;
new text end

new text begin (iii) care and use of hearing aids; and
new text end

new text begin (iv) dressing and assisting with toileting;
new text end

new text begin (6) training on the prevention of falls;
new text end

new text begin (7) standby assistance techniques and how to perform them;
new text end

new text begin (8) medication, exercise, and treatment reminders;
new text end

new text begin (9) basic nutrition, meal preparation, food safety, and assistance with eating;
new text end

new text begin (10) preparation of modified diets as ordered by a licensed health professional;
new text end

new text begin (11) communication skills that include preserving the dignity of the resident and showing
respect for the resident and the resident's preferences, cultural background, and family;
new text end

new text begin (12) awareness of confidentiality and privacy;
new text end

new text begin (13) understanding appropriate boundaries between staff and residents and the resident's
family;
new text end

new text begin (14) procedures to use in handling various emergency situations; and
new text end

new text begin (15) awareness of commonly used health technology equipment and assistive devices.
new text end

new text begin (c) In addition to paragraph (b), training and competency evaluation for unlicensed
personnel providing assisted living services must include:
new text end

new text begin (1) observing, reporting, and documenting resident status;
new text end

new text begin (2) basic knowledge of body functioning and changes in body functioning, injuries, or
other observed changes that must be reported to appropriate personnel;
new text end

new text begin (3) reading and recording temperature, pulse, and respirations of the resident;
new text end

new text begin (4) recognizing physical, emotional, cognitive, and developmental needs of the resident;
new text end

new text begin (5) safe transfer techniques and ambulation;
new text end

new text begin (6) range of motioning and positioning; and
new text end

new text begin (7) administering medications or treatments as required.
new text end

new text begin (d) When the registered nurse or licensed health professional delegates tasks, that person
must ensure that prior to the delegation the unlicensed personnel is trained in the proper
methods to perform the tasks or procedures for each resident and are able to demonstrate
the ability to competently follow the procedures and perform the tasks. If an unlicensed
personnel has not regularly performed the delegated assisted living task for a period of 24
consecutive months, the unlicensed personnel must demonstrate competency in the task to
the registered nurse or appropriate licensed health professional. The registered nurse or
licensed health professional must document instructions for the delegated tasks in the
resident's record.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 17.

new text begin [144I.15] REQUIRED NOTICES.
new text end

new text begin Subdivision 1. new text end

new text begin Assisted living bill of rights; notification to resident. new text end

new text begin (a) An assisted
living facility must provide the resident a written notice of the rights under section 144I.101
before the initiation of services to that resident. The facility shall make all reasonable efforts
to provide notice of the rights to the resident in a language the resident can understand.
new text end

new text begin (b) In addition to the text of the assisted living bill of rights in section 144I.101, the
notice shall also contain the following statement describing how to file a complaint or report
suspected abuse.
new text end

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

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

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

new text begin Subd. 2. new text end

new text begin Notices in plain language; language accommodations. new text end

new text begin A facility must provide
all notices in plain language that residents can understand and make reasonable
accommodations for residents who have communication disabilities and those whose primary
language is a language other than English.
new text end

new text begin Subd. 3. new text end

new text begin Notice of dementia training. new text end

new text begin An assisted living facility with dementia care
shall make available in written or electronic form, to residents and families or other persons
who request it, a description of the training program and related training it provides, including
the categories of employees trained, the frequency of training, and the basic topics covered.
A hard copy of this notice must be provided upon request.
new text end

new text begin Subd. 4. new text end

new text begin Notice of available assistance. new text end

new text begin A facility shall provide each resident with
identifying and contact information about the persons who can assist with health care or
supportive services being provided. A facility shall keep each resident informed of changes
in the personnel referenced in this subdivision.
new text end

new text begin Subd. 5. new text end

new text begin Notice to residents; change in ownership or management. new text end

new text begin (a) A facility must
provide written notice to the resident, legal representative, or designated representative of
a change of ownership within seven calendar days after the facility receives a new license.
new text end

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

new text begin (1) the manager of the facility, if applicable; and
new text end

new text begin (2) the authorized agent.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 18.

new text begin [144I.16] SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Acceptance of residents. new text end

new text begin An assisted living facility may not accept a
person as a resident unless the facility has staff, sufficient in qualifications, competency,
and numbers, to adequately provide the services agreed to in the assisted living contract.
new text end

new text begin Subd. 2. new text end

new text begin Initial reviews, assessments, and monitoring. new text end

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

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

new text begin (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.
new text end

new text begin (d) For residents only receiving assisted living services specified in section 144I.01,
subdivision 9, clauses (1) to (5), the facility shall complete an individualized initial review
of the resident's needs and preferences. The initial review must be completed within 30
calendar days of the start of services. Resident monitoring and review must be conducted
as needed based on changes in the needs of the resident and cannot exceed 90 calendar days
from the date of the last review.
new text end

new text begin (e) A facility must inform the prospective resident of the availability of and contact
information for long-term care consultation services under section 256B.0911, prior to the
date on which a prospective resident executes a contract with a facility or the date on which
a prospective resident moves in, whichever is earlier.
new text end

new text begin Subd. 3. new text end

new text begin Temporary service plan. new text end

new text begin When a facility initiates services and the
individualized assessment required in subdivision 2 has not been completed, the facility
must complete a temporary plan and agreement with the resident for services. A temporary
service plan shall not be effective for more than 72 hours.
new text end

new text begin Subd. 4. new text end

new text begin Service plan, implementation, and revisions to service plan. new text end

new text begin (a) No later
than 14 calendar days after the date that services are first provided, an assisted living facility
shall finalize a current written service plan.
new text end

new text begin (b) The service plan and any revisions must include a signature or other authentication
by the facility and by the resident documenting agreement on the services to be provided.
The service plan must be revised, if needed, based on resident reassessment under subdivision
2. The facility must provide information to the resident about changes to the facility's fee
for services and how to contact the Office of Ombudsman for Long-Term Care.
new text end

new text begin (c) The facility must implement and provide all services required by the current service
plan.
new text end

new text begin (d) The service plan and the revised service plan must be entered into the resident record,
including notice of a change in a resident's fees when applicable.
new text end

new text begin (e) Staff providing services must be informed of the current written service plan.
new text end

new text begin (f) The service plan must include:
new text end

new text begin (1) a description of the services to be provided, the fees for services, and the frequency
of each service, according to the resident's current assessment and resident preferences;
new text end

new text begin (2) the identification of staff or categories of staff who will provide the services;
new text end

new text begin (3) the schedule and methods of monitoring assessments of the resident;
new text end

new text begin (4) the schedule and methods of monitoring staff providing services; and
new text end

new text begin (5) a contingency plan that includes:
new text end

new text begin (i) the action to be taken if the scheduled service cannot be provided;
new text end

new text begin (ii) information and a method to contact the facility;
new text end

new text begin (iii) the names and contact information of persons the resident wishes to have notified
in an emergency or if there is a significant adverse change in the resident's condition,
including identification of and information as to who has authority to sign for the resident
in an emergency; and
new text end

new text begin (iv) the circumstances in which emergency medical services are not to be summoned
consistent with chapters 145B and 145C, and declarations made by the resident under those
chapters.
new text end

new text begin Subd. 5. new text end

new text begin Referrals. new text end

new text begin If a facility reasonably believes that a resident is in need of another
medical or health service, including a licensed health professional, or social service provider,
the facility shall:
new text end

new text begin (1) determine the resident's preferences with respect to obtaining the service; and
new text end

new text begin (2) inform the resident of the resources available, if known, to assist the resident in
obtaining services.
new text end

new text begin Subd. 6. new text end

new text begin Medical cannabis. new text end

new text begin Assisted living facilities may exercise the authority and are
subject to the protections in section 152.34.
new text end

new text begin Subd. 7. new text end

new text begin Request for discontinuation of life-sustaining treatment. new text end

new text begin (a) If a resident,
family member, or other caregiver of the resident requests that an employee or other agent
of the facility discontinue a life-sustaining treatment, the employee or agent receiving the
request:
new text end

new text begin (1) shall take no action to discontinue the treatment; and
new text end

new text begin (2) shall promptly inform the supervisor or other agent of the facility of the resident's
request.
new text end

new text begin (b) Upon being informed of a request for discontinuance of treatment, the facility shall
promptly:
new text end

new text begin (1) inform the resident that the request will be made known to the physician or advanced
practice registered nurse who ordered the resident's treatment;
new text end

new text begin (2) inform the physician or advanced practice registered nurse of the resident's request;
and
new text end

new text begin (3) work with the resident and the resident's physician or advanced practice registered
nurse to comply with chapter 145C.
new text end

new text begin (c) This section does not require the facility to discontinue treatment, except as may be
required by law or court order.
new text end

new text begin (d) This section does not diminish the rights of residents to control their treatments,
refuse services, or terminate their relationships with the facility.
new text end

new text begin (e) This section shall be construed in a manner consistent with chapter 145B or 145C,
whichever applies, and declarations made by residents under those chapters.
new text end

new text begin Subd. 8. new text end

new text begin Applicability of other law. new text end

new text begin Assisted living facilities are subject to and must
comply with chapter 504B.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 19.

new text begin [144I.17] MEDICATION MANAGEMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Medication management services. new text end

new text begin (a) This section applies only to
assisted living facilities that provide medication management services.
new text end

new text begin (b) An assisted living facility that provides medication management services must
develop, implement, and maintain current written medication management policies and
procedures. The policies and procedures must be developed under the supervision and
direction of a registered nurse, licensed health professional, or pharmacist consistent with
current practice standards and guidelines.
new text end

new text begin (c) The written policies and procedures must address requesting and receiving
prescriptions for medications; preparing and giving medications; verifying that prescription
drugs are administered as prescribed; documenting medication management activities;
controlling and storing medications; monitoring and evaluating medication use; resolving
medication errors; communicating with the prescriber, pharmacist, and resident and legal
and designated representatives; disposing of unused medications; and educating residents
and legal and designated representatives about medications. When controlled substances
are being managed, the policies and procedures must also identify how the provider will
ensure security and accountability for the overall management, control, and disposition of
those substances in compliance with state and federal regulations and with subdivision 23.
new text end

new text begin Subd. 2. new text end

new text begin Provision of medication management services. new text end

new text begin (a) For each resident who
requests medication management services, the facility shall, prior to providing medication
management services, have a registered nurse, licensed health professional, or authorized
prescriber under section 151.37 conduct an assessment to determine what medication
management services will be provided and how the services will be provided. This assessment
must be conducted face-to-face with the resident. The assessment must include an
identification and review of all medications the resident is known to be taking. The review
and identification must include indications for medications, side effects, contraindications,
allergic or adverse reactions, and actions to address these issues.
new text end

new text begin (b) The assessment must identify interventions needed in management of medications
to prevent diversion of medication by the resident or others who may have access to the
medications and provide instructions to the resident and legal or designated representatives
on interventions to manage the resident's medications and prevent diversion of medications.
For purposes of this section, "diversion of medication" means misuse, theft, or illegal or
improper disposition of medications.
new text end

new text begin Subd. 3. new text end

new text begin Individualized medication monitoring and reassessment. new text end

new text begin The assisted living
facility must monitor and reassess the resident's medication management services as needed
under subdivision 2 when the resident presents with symptoms or other issues that may be
medication-related and, at a minimum, annually.
new text end

new text begin Subd. 4. new text end

new text begin Resident refusal. new text end

new text begin The assisted living facility must document in the resident's
record any refusal for an assessment for medication management by the resident. The facility
must discuss with the resident the possible consequences of the resident's refusal and
document the discussion in the resident's record.
new text end

new text begin Subd. 5. new text end

new text begin Individualized medication management plan. new text end

new text begin (a) For each resident receiving
medication management services, the assisted living facility must prepare and include in
the service plan a written statement of the medication management services that will be
provided to the resident. The facility must develop and maintain a current individualized
medication management record for each resident based on the resident's assessment that
must contain the following:
new text end

new text begin (1) a statement describing the medication management services that will be provided;
new text end

new text begin (2) a description of storage of medications based on the resident's needs and preferences,
risk of diversion, and consistent with the manufacturer's directions;
new text end

new text begin (3) documentation of specific resident instructions relating to the administration of
medications;
new text end

new text begin (4) identification of persons responsible for monitoring medication supplies and ensuring
that medication refills are ordered on a timely basis;
new text end

new text begin (5) identification of medication management tasks that may be delegated to unlicensed
personnel;
new text end

new text begin (6) procedures for staff notifying a registered nurse or appropriate licensed health
professional when a problem arises with medication management services; and
new text end

new text begin (7) any resident-specific requirements relating to documenting medication administration,
verifications that all medications are administered as prescribed, and monitoring of
medication use to prevent possible complications or adverse reactions.
new text end

new text begin (b) The medication management record must be current and updated when there are any
changes.
new text end

new text begin (c) Medication reconciliation must be completed when a licensed nurse, licensed health
professional, or authorized prescriber is providing medication management.
new text end

new text begin Subd. 6. new text end

new text begin Administration of medication. new text end

new text begin Medications may be administered by a nurse,
physician, or other licensed health practitioner authorized to administer medications or by
unlicensed personnel who have been delegated medication administration tasks by a
registered nurse.
new text end

new text begin Subd. 7. new text end

new text begin Delegation of medication administration. new text end

new text begin When administration of medications
is delegated to unlicensed personnel, the assisted living facility must ensure that the registered
nurse has:
new text end

new text begin (1) instructed the unlicensed personnel in the proper methods to administer the
medications, and the unlicensed personnel has demonstrated the ability to competently
follow the procedures;
new text end

new text begin (2) specified, in writing, specific instructions for each resident and documented those
instructions in the resident's records; and
new text end

new text begin (3) communicated with the unlicensed personnel about the individual needs of the
resident.
new text end

new text begin Subd. 8. new text end

new text begin Documentation of administration of medications. new text end

new text begin Each medication
administered by the assisted living facility staff must be documented in the resident's record.
The documentation must include the signature and title of the person who administered the
medication. The documentation must include the medication name, dosage, date and time
administered, and method and route of administration. The staff must document the reason
why medication administration was not completed as prescribed and document any follow-up
procedures that were provided to meet the resident's needs when medication was not
administered as prescribed and in compliance with the resident's medication management
plan.
new text end

new text begin Subd. 9. new text end

new text begin Documentation of medication setup. new text end

new text begin Documentation of dates of medication
setup, name of medication, quantity of dose, times to be administered, route of administration,
and name of person completing medication setup must be done at the time of setup.
new text end

new text begin Subd. 10. new text end

new text begin Medication management for residents who will be away from home. new text end

new text begin (a)
An assisted living facility that is providing medication management services to the resident
must develop and implement policies and procedures for giving accurate and current
medications to residents for planned or unplanned times away from home according to the
resident's individualized medication management plan. The policies and procedures must
state that:
new text end

new text begin (1) for planned time away, the medications must be obtained from the pharmacy or set
up by the licensed nurse according to appropriate state and federal laws and nursing standards
of practice;
new text end

new text begin (2) for unplanned time away, when the pharmacy is not able to provide the medications,
a licensed nurse or unlicensed personnel shall provide medications in amounts and dosages
needed for the length of the anticipated absence, not to exceed seven calendar days;
new text end

new text begin (3) the resident must be provided written information on medications, including any
special instructions for administering or handling the medications, including controlled
substances; and
new text end

new text begin (4) the medications must be placed in a medication container or containers appropriate
to the provider's medication system and must be labeled with the resident's name and the
dates and times that the medications are scheduled.
new text end

new text begin (b) For unplanned time away when the licensed nurse is not available, the registered
nurse may delegate this task to unlicensed personnel if:
new text end

new text begin (1) the registered nurse has trained the unlicensed staff and determined the unlicensed
staff is competent to follow the procedures for giving medications to residents; and
new text end

new text begin (2) the registered nurse has developed written procedures for the unlicensed personnel,
including any special instructions or procedures regarding controlled substances that are
prescribed for the resident. The procedures must address:
new text end

new text begin (i) the type of container or containers to be used for the medications appropriate to the
provider's medication system;
new text end

new text begin (ii) how the container or containers must be labeled;
new text end

new text begin (iii) written information about the medications to be provided;
new text end

new text begin (iv) how the unlicensed staff must document in the resident's record that medications
have been provided, including documenting the date the medications were provided and
who received the medications, the person who provided the medications to the resident, the
number of medications that were provided to the resident, and other required information;
new text end

new text begin (v) how the registered nurse shall be notified that medications have been provided and
whether the registered nurse needs to be contacted before the medications are given to the
resident or the designated representative;
new text end

new text begin (vi) a review by the registered nurse of the completion of this task to verify that this task
was completed accurately by the unlicensed personnel; and
new text end

new text begin (vii) how the unlicensed personnel must document in the resident's record any unused
medications that are returned to the facility, including the name of each medication and the
doses of each returned medication.
new text end

new text begin Subd. 11. new text end

new text begin Prescribed and nonprescribed medication. new text end

new text begin The assisted living facility must
determine whether the facility shall require a prescription for all medications the provider
manages. The facility must inform the resident whether the facility requires a prescription
for all over-the-counter and dietary supplements before the facility agrees to manage those
medications.
new text end

new text begin Subd. 12. new text end

new text begin Medications; over-the-counter drugs; dietary supplements not
prescribed. new text end

new text begin An assisted living facility providing medication management services for
over-the-counter drugs or dietary supplements must retain those items in the original labeled
container with directions for use prior to setting up for immediate or later administration.
The facility must verify that the medications are up to date and stored as appropriate.
new text end

new text begin Subd. 13. new text end

new text begin Prescriptions. new text end

new text begin There must be a current written or electronically recorded
prescription as defined in section 151.01, subdivision 16a, for all prescribed medications
that the assisted living facility is managing for the resident.
new text end

new text begin Subd. 14. new text end

new text begin Renewal of prescriptions. new text end

new text begin Prescriptions must be renewed at least every 12
months or more frequently as indicated by the assessment in subdivision 2. Prescriptions
for controlled substances must comply with chapter 152.
new text end

new text begin Subd. 15. new text end

new text begin Verbal prescription orders. new text end

new text begin Verbal prescription orders from an authorized
prescriber must be received by a nurse or pharmacist. The order must be handled according
to Minnesota Rules, part 6800.6200.
new text end

new text begin Subd. 16. new text end

new text begin Written or electronic prescription. new text end

new text begin When a written or electronic prescription
is received, it must be communicated to the registered nurse in charge and recorded or placed
in the resident's record.
new text end

new text begin Subd. 17. new text end

new text begin Records confidential. new text end

new text begin A prescription or order received verbally, in writing,
or electronically must be kept confidential according to sections 144.291 to 144.298 and
144A.44.
new text end

new text begin Subd. 18. new text end

new text begin Medications provided by resident or family members. new text end

new text begin When the assisted
living facility is aware of any medications or dietary supplements that are being used by
the resident and are not included in the assessment for medication management services,
the staff must advise the registered nurse and document that in the resident record.
new text end

new text begin Subd. 19. new text end

new text begin Storage of medications. new text end

new text begin An assisted living facility must store all prescription
medications in securely locked and substantially constructed compartments according to
the manufacturer's directions and permit only authorized personnel to have access.
new text end

new text begin Subd. 20. new text end

new text begin Prescription drugs. new text end

new text begin A prescription drug, prior to being set up for immediate
or later administration, must be kept in the original container in which it was dispensed by
the pharmacy bearing the original prescription label with legible information including the
expiration or beyond-use date of a time-dated drug.
new text end

new text begin Subd. 21. new text end

new text begin Prohibitions. new text end

new text begin No prescription drug supply for one resident may be used or
saved for use by anyone other than the resident.
new text end

new text begin Subd. 22. new text end

new text begin Disposition of medications. new text end

new text begin (a) Any current medications being managed by
the assisted living facility must be provided to the resident when the resident's service plan
ends or medication management services are no longer part of the service plan. Medications
for a resident who is deceased or that have been discontinued or have expired may be
provided for disposal.
new text end

new text begin (b) The facility shall dispose of any medications remaining with the facility that are
discontinued or expired or upon the termination of the service contract or the resident's
death according to state and federal regulations for disposition of medications and controlled
substances.
new text end

new text begin (c) Upon disposition, the facility must document in the resident's record the disposition
of the medication including the medication's name, strength, prescription number as
applicable, quantity, to whom the medications were given, date of disposition, and names
of staff and other individuals involved in the disposition.
new text end

new text begin Subd. 23. new text end

new text begin Loss or spillage. new text end

new text begin (a) Assisted living facilities providing medication
management must develop and implement procedures for loss or spillage of all controlled
substances defined in Minnesota Rules, part 6800.4220. These procedures must require that
when a spillage of a controlled substance occurs, a notation must be made in the resident's
record explaining the spillage and the actions taken. The notation must be signed by the
person responsible for the spillage and include verification that any contaminated substance
was disposed of according to state or federal regulations.
new text end

new text begin (b) The procedures must require that the facility providing medication management
investigate any known loss or unaccounted for prescription drugs and take appropriate action
required under state or federal regulations and document the investigation in required records.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 20.

new text begin [144I.18] TREATMENT AND THERAPY MANAGEMENT SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Treatment and therapy management services. new text end

new text begin This section applies
only to assisted living facilities that provide treatment and therapy management services.
new text end

new text begin Subd. 2. new text end

new text begin Policies and procedures. new text end

new text begin (a) An assisted living facility that provides treatment
and therapy management services must develop, implement, and maintain up-to-date written
treatment or therapy management policies and procedures. The policies and procedures
must be developed under the supervision and direction of a registered nurse or appropriate
licensed health professional consistent with current practice standards and guidelines.
new text end

new text begin (b) The written policies and procedures must address requesting and receiving orders
or prescriptions for treatments or therapies, providing the treatment or therapy, documenting
treatment or therapy activities, educating and communicating with residents about treatments
or therapies they are receiving, monitoring and evaluating the treatment or therapy, and
communicating with the prescriber.
new text end

new text begin Subd. 3. new text end

new text begin Individualized treatment or therapy management plan. new text end

new text begin For each resident
receiving management of ordered or prescribed treatments or therapy services, the assisted
living facility must prepare and include in the service plan a written statement of the treatment
or therapy services that will be provided to the resident. The facility must also develop and
maintain a current individualized treatment and therapy management record for each resident
which must contain at least the following:
new text end

new text begin (1) a statement of the type of services that will be provided;
new text end

new text begin (2) documentation of specific resident instructions relating to the treatments or therapy
administration;
new text end

new text begin (3) identification of treatment or therapy tasks that will be delegated to unlicensed
personnel;
new text end

new text begin (4) procedures for notifying a registered nurse or appropriate licensed health professional
when a problem arises with treatments or therapy services; and
new text end

new text begin (5) any resident-specific requirements relating to documentation of treatment and therapy
received, verification that all treatment and therapy was administered as prescribed, and
monitoring of treatment or therapy to prevent possible complications or adverse reactions.
The treatment or therapy management record must be current and updated when there are
any changes.
new text end

new text begin Subd. 4. new text end

new text begin Administration of treatments and therapy. new text end

new text begin Ordered or prescribed treatments
or therapies must be administered by a nurse, physician, or other licensed health professional
authorized to perform the treatment or therapy, or may be delegated or assigned to unlicensed
personnel by the licensed health professional according to the appropriate practice standards
for delegation or assignment. When administration of a treatment or therapy is delegated
or assigned to unlicensed personnel, the facility must ensure that the registered nurse or
authorized licensed health professional has:
new text end

new text begin (1) instructed the unlicensed personnel in the proper methods with respect to each resident
and the unlicensed personnel has demonstrated the ability to competently follow the
procedures;
new text end

new text begin (2) specified, in writing, specific instructions for each resident and documented those
instructions in the resident's record; and
new text end

new text begin (3) communicated with the unlicensed personnel about the individual needs of the
resident.
new text end

new text begin Subd. 5. new text end

new text begin Documentation of administration of treatments and therapies. new text end

new text begin Each treatment
or therapy administered by an assisted living facility must be in the resident record. The
documentation must include the signature and title of the person who administered the
treatment or therapy and must include the date and time of administration. When treatment
or therapies are not administered as ordered or prescribed, the provider must document the
reason why it was not administered and any follow-up procedures that were provided to
meet the resident's needs.
new text end

new text begin Subd. 6. new text end

new text begin Treatment and therapy orders. new text end

new text begin There must be an up-to-date written or
electronically recorded order from an authorized prescriber for all treatments and therapies.
The order must contain the name of the resident, a description of the treatment or therapy
to be provided, and the frequency, duration, and other information needed to administer the
treatment or therapy. Treatment and therapy orders must be renewed at least every 12
months.
new text end

new text begin Subd. 7. new text end

new text begin Right to outside service provider; other payors. new text end

new text begin Under section 144I.101, a
resident is free to retain therapy and treatment services from an off-site service provider.
Assisted living facilities must make every effort to assist residents in obtaining information
regarding whether the Medicare program, the medical assistance program under chapter
256B, or another public program will pay for any or all of the services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 21.

new text begin [144I.19] RESIDENT RECORD REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Resident record. new text end

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

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

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

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

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

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

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

new text begin Subd. 2. new text end

new text begin Access to records. new text end

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

new text begin Subd. 3. new text end

new text begin Contents of resident record. new text end

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

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

new text begin (2) the name, address, and telephone number of the resident's emergency contact, legal
representatives, and designated representative;
new text end

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

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

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

new text begin (6) copies of any health care directives, guardianships, powers of attorney, or
conservatorships;
new text end

new text begin (7) the facility's current and previous assessments and service plans;
new text end

new text begin (8) all records of communications pertinent to the resident's services;
new text end

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

new text begin (10) documentation of incidents involving the resident and actions taken in response to
the needs of the resident, including reporting to the appropriate supervisor or health care
professional;
new text end

new text begin (11) documentation that services have been provided as identified in the service plan;
new text end

new text begin (12) documentation that the resident has received and reviewed the assisted living bill
of rights;
new text end

new text begin (13) documentation of complaints received and any resolution;
new text end

new text begin (14) a discharge summary, including service termination notice and related
documentation, when applicable; and
new text end

new text begin (15) other documentation required under this chapter and relevant to the resident's
services or status.
new text end

new text begin Subd. 4. new text end

new text begin Transfer of resident records. new text end

new text begin With the resident's knowledge and consent, if
a resident is relocated to another facility or to a nursing home, or if care is transferred to
another service provider, the facility must timely convey to the new facility, nursing home,
or provider:
new text end

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

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

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

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

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

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

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

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

new text begin Subd. 5. new text end

new text begin Record retention. new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 22.

new text begin [144I.20] ORIENTATION AND ANNUAL TRAINING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Orientation of staff and supervisors. new text end

new text begin All staff providing and supervising
direct services must complete an orientation to assisted living facility licensing requirements
and regulations before providing assisted living services to residents. The orientation may
be incorporated into the training required under subdivision 6. The orientation need only
be completed once for each staff person and is not transferable to another facility.
new text end

new text begin Subd. 2. new text end

new text begin Content. new text end

new text begin (a) The orientation must contain the following topics:
new text end

new text begin (1) an overview of this chapter;
new text end

new text begin (2) an introduction and review of the facility's policies and procedures related to the
provision of assisted living services by the individual staff person;
new text end

new text begin (3) handling of emergencies and use of emergency services;
new text end

new text begin (4) compliance with and reporting of the maltreatment of vulnerable adults under section
626.557 to the Minnesota Adult Abuse Reporting Center (MAARC);
new text end

new text begin (5) the assisted living bill of rights and staff responsibilities related to ensuring the
exercise and protection of those rights;
new text end

new text begin (6) the principles of person-centered planning and service delivery and how they apply
to direct support services provided by the staff person;
new text end

new text begin (7) handling of residents' complaints, reporting of complaints, and where to report
complaints, including information on the Office of Health Facility Complaints;
new text end

new text begin (8) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
Ombudsman at the Department of Human Services, county-managed care advocates, or
other relevant advocacy services; and
new text end

new text begin (9) a review of the types of assisted living services the employee will be providing and
the facility's category of licensure.
new text end

new text begin (b) In addition to the topics in paragraph (a), orientation may also contain training on
providing services to residents with hearing loss. Any training on hearing loss provided
under this subdivision must be high quality and research based, may include online training,
and must include training on one or more of the following topics:
new text end

new text begin (1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and the challenges it poses to communication;
new text end

new text begin (2) health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or
new text end

new text begin (3) information about strategies and technology that may enhance communication and
involvement, including communication strategies, assistive listening devices, hearing aids,
visual and tactile alerting devices, communication access in real time, and closed captions.
new text end

new text begin Subd. 3. new text end

new text begin Verification and documentation of orientation and training. new text end

new text begin The assisted
living facility shall retain evidence in the employee record of each staff person having
completed the orientation and training required by this section.
new text end

new text begin Subd. 4. new text end

new text begin Orientation to resident. new text end

new text begin Staff providing assisted living services must be oriented
specifically to each individual resident and the services to be provided. This orientation
may be provided in person, orally, in writing, or electronically.
new text end

new text begin Subd. 5. new text end

new text begin Training required relating to dementia. new text end

new text begin All direct care staff and supervisors
providing direct services must demonstrate an understanding of the training specified in
section 144I.21.
new text end

new text begin Subd. 6. new text end

new text begin Required annual training. new text end

new text begin (a) All staff that perform direct services must
complete at least eight hours of annual training for each 12 months of employment. The
training may be obtained from the facility or another source and must include topics relevant
to the provision of assisted living services. The annual training must include:
new text end

new text begin (1) training on reporting of maltreatment of vulnerable adults under section 626.557;
new text end

new text begin (2) review of the assisted living bill of rights and staff responsibilities related to ensuring
the exercise and protection of those rights;
new text end

new text begin (3) review of infection control techniques used in the home and implementation of
infection control standards including a review of hand washing techniques; the need for and
use of protective gloves, gowns, and masks; appropriate disposal of contaminated materials
and equipment, such as dressings, needles, syringes, and razor blades; disinfecting reusable
equipment; disinfecting environmental surfaces; and reporting communicable diseases;
new text end

new text begin (4) effective approaches to use to problem solve when working with a resident's
challenging behaviors, and how to communicate with residents who have dementia,
Alzheimer's disease, or related disorders;
new text end

new text begin (5) review of the facility's policies and procedures relating to the provision of assisted
living services and how to implement those policies and procedures; and
new text end

new text begin (6) the principles of person-centered planning and service delivery and how they apply
to direct support services provided by the staff person.
new text end

new text begin (b) In addition to the topics in paragraph (a), annual training may also contain training
on providing services to residents with hearing loss. Any training on hearing loss provided
under this subdivision must be high quality and research based, may include online training,
and must include training on one or more of the following topics:
new text end

new text begin (1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and challenges it poses to communication;
new text end

new text begin (2) the health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or
new text end

new text begin (3) information about strategies and technology that may enhance communication and
involvement, including communication strategies, assistive listening devices, hearing aids,
visual and tactile alerting devices, communication access in real time, and closed captions.
new text end

new text begin Subd. 7. new text end

new text begin Implementation. new text end

new text begin The assisted living facility must implement all orientation
and training topics covered in this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 23.

new text begin [144I.21] TRAINING IN DEMENTIA CARE REQUIRED.
new text end

new text begin (a) All assisted living facilities must meet the following training requirements:
new text end

new text begin (1) supervisors of direct-care staff must have at least eight hours of initial training on
topics specified under paragraph (b) within 120 working hours of the employment start
date, and must have at least two hours of training on topics related to dementia care for each
12 months of employment thereafter;
new text end

new text begin (2) direct-care employees must have completed at least eight hours of initial training on
topics specified under paragraph (b) within 160 working hours of the employment start
date. Until this initial training is complete, an employee must not provide direct care unless
there is another employee on site who has completed the initial eight hours of training on
topics related to dementia care and who can act as a resource and assist if issues arise. A
trainer of the requirements under paragraph (b) or a supervisor meeting the requirements
in clause (1) must be available for consultation with the new employee until the training
requirement is complete. Direct-care employees must have at least two hours of training on
topics related to dementia for each 12 months of employment thereafter;
new text end

new text begin (3) for assisted living facilities with dementia care, direct care employees 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,
an employee must not provide direct care unless there is another employee on site who has
completed the initial eight hours of training on topics related to dementia care and who can
act as a resource and assist if issues arise. A trainer of the requirements under paragraph
(b) or a supervisor meeting the requirements in clause (1) must be available for consultation
with the new employee until the training requirement is complete. Direct-care employees
must have at least two hours of training on topics related to dementia for each 12 months
of employment thereafter;
new text end

new text begin (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
new text end

new text begin (5) new employees may satisfy the initial training requirements by producing written
proof of previously completed required training within the past 18 months.
new text end

new text begin (b) Areas of required training include:
new text end

new text begin (1) an explanation of Alzheimer's disease and other dementias;
new text end

new text begin (2) assistance with activities of daily living;
new text end

new text begin (3) problem solving with challenging behaviors;
new text end

new text begin (4) communication skills; and
new text end

new text begin (5) person-centered planning and service delivery.
new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 24.

new text begin [144I.22] CONTROLLING INDIVIDUAL RESTRICTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Restrictions. new text end

new text begin (a) The commissioner has discretion to bar any controlling
individual of a facility if the person was a controlling individual of any other nursing home
or assisted living facility in the previous two-year period and:
new text end

new text begin (1) during that period of time the nursing home or assisted living facility incurred the
following number of uncorrected or repeated violations:
new text end

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

new text begin (ii) four or more uncorrected violations that created an imminent risk to direct resident
care or safety; or
new text end

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

new text begin (b) When the commissioner bars a controlling individual under this subdivision, the
controlling individual may appeal the commissioner's decision under chapter 14.
new text end

new text begin Subd. 2. new text end

new text begin Exception. new text end

new text begin Subdivision 1 does not apply to any controlling individual of the
facility who had no legal authority to affect or change decisions related to the operation of
the nursing home or assisted living facility that incurred the uncorrected violations.
new text end

new text begin Subd. 3. new text end

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

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

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

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

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

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

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

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 25.

new text begin [144I.24] MINIMUM SITE, PHYSICAL ENVIRONMENT, AND FIRE
SAFETY REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Requirements. new text end

new text begin (a) The following are required for all assisted living
facilities:
new text end

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

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

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

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

new text begin (5) the location must include space for outdoor activities for residents.
new text end

new text begin (b) An assisted living facility with dementia care that has a secured dementia care unit
must also meet the following requirements:
new text end

new text begin (1) a hazard vulnerability assessment or safety risk must be performed on and around
the property. The hazards indicated on the assessment must be assessed and mitigated to
protect the residents from harm; and
new text end

new text begin (2) the facility shall be protected throughout by an approved supervised automatic
sprinkler system by August 1, 2029.
new text end

new text begin Subd. 2. new text end

new text begin Fire protection and physical environment. new text end

new text begin (a) Each assisted living facility
must have a comprehensive fire protection system that includes:
new text end

new text begin (1) protection throughout by an approved supervised automatic sprinkler system according
to building code requirements established in Minnesota Rules, part 1305.0903, or smoke
detectors in each occupied room installed and maintained in accordance with the National
Fire Protection Association (NFPA) Standard 72;
new text end

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

new text begin (3) the physical environment, including walls, floors, ceiling, all furnishings, grounds,
systems, and equipment that is kept in a continuous state of good repair and operation with
regard to the health, safety, comfort, and well-being of the residents in accordance with a
maintenance and repair program.
new text end

new text begin (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 the healthcare (limited
care) chapter of the Life Safety Code.
new text end

new text begin (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 be continued 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 facility must document in the 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 end

new text begin Subd. 3. new text end

new text begin Local laws apply. new text end

new text begin Assisted living facilities shall comply with all applicable
state and local governing laws, regulations, standards, ordinances, and codes for fire safety,
building, and zoning requirements.
new text end

new text begin Subd. 4. new text end

new text begin Design requirements. new text end

new text begin (a) All assisted living facilities with six or more residents
must meet the provisions relevant to assisted living facilities in the most current edition of
the Facility Guidelines Institute "Guidelines for Design and Construction of Residential
Health, Care and Support Facilities" and of adopted rules. This minimum design standard
must be met for all new licenses, new construction, modifications, renovations, alterations,
changes of use, or additions. In addition to the guidelines, assisted living facilities shall
provide the option of a bath in addition to a shower for all residents.
new text end

new text begin (b) If the commissioner decides to update the edition of the guidelines specified in
paragraph (a) 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 edition 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 facilities must comply with the updated edition. The date by which
facilities must comply shall not be sooner than six months after publication of the
commissioner's notice in the State Register.
new text end

new text begin Subd. 5. new text end

new text begin Assisted living facilities; life safety code. new text end

new text begin (a) All assisted living facilities with
six or more residents must meet the applicable provisions of the most current 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.
new text end

new text begin (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
facilities must comply with the updated Life Safety Code. The date by which facilities must
comply shall not be sooner than six months after publication of the commissioner's notice
in the State Register.
new text end

new text begin Subd. 6. new text end

new text begin Assisted living facilities with dementia care and secured dementia care
unit; Life Safety Code. new text end

new text begin (a) All assisted living facilities with dementia care and a secured
dementia care unit must meet the applicable provisions of the most current edition of the
NFPA Standard 101, Life Safety Code, Healthcare (limited care) chapter. The minimum
design standards shall be met for all new licenses, new construction, modifications,
renovations, alterations, changes of use, or additions.
new text end

new text begin (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 with dementia care and a secured dementia care unit 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 these facilities must comply with
the updated Life Safety Code. The date by which these facilities must comply shall not be
sooner than six months after publication of the commissioner's notice in the State Register.
new text end

new text begin Subd. 7. new text end

new text begin New construction; plans. new text end

new text begin (a) For all new licensure and construction beginning
on or after August 1, 2021, the following must be provided to the commissioner:
new text end

new text begin (1) architectural and engineering plans and specifications for new construction must be
prepared and signed by architects and engineers who are registered in Minnesota. Final
working drawings and specifications for proposed construction must be submitted to the
commissioner for review and approval;
new text end

new text begin (2) final architectural plans and specifications must include elevations and sections
through the building showing types of construction, and must indicate dimensions and
assignments of rooms and areas, room finishes, door types and hardware, elevations and
details of nurses' work areas, utility rooms, toilet and bathing areas, and large-scale layouts
of dietary and laundry areas. Plans must show the location of fixed equipment and sections
and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions
must be indicated. The roof plan must show all mechanical installations. The site plan must
indicate the proposed and existing buildings, topography, roadways, walks and utility service
lines; and
new text end

new text begin (3) final mechanical and electrical plans and specifications must address the complete
layout and type of all installations, systems, and equipment to be provided. Heating plans
must include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers,
boilers, breeching, and accessories. Ventilation plans must include room air quantities,
ducts, fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing
plans must include the fixtures and equipment fixture schedule; water supply and circulating
piping, pumps, tanks, riser diagrams, and building drains; the size, location, and elevation
of water and sewer services; and the building fire protection systems. Electrical plans must
include fixtures and equipment, receptacles, switches, power outlets, circuits, power and
light panels, transformers, and service feeders. Plans must show location of nurse call signals,
cable lines, fire alarm stations, and fire detectors and emergency lighting.
new text end

new text begin (b) Unless construction is begun within one year after approval of the final working
drawing and specifications, the drawings must be resubmitted for review and approval.
new text end

new text begin (c) The commissioner must be notified within 30 days before completion of construction
so that the commissioner can make arrangements for a final inspection by the commissioner.
new text end

new text begin (d) At least one set of complete life safety plans, including changes resulting from
remodeling or alterations, must be kept on file in the facility.
new text end

new text begin Subd. 8. new text end

new text begin Variances or waivers. new text end

new text begin (a) A facility may request that the commissioner grant
a variance or waiver from the provisions of this section. A request for a waiver must be
submitted to the commissioner in writing. Each request must contain:
new text end

new text begin (1) the specific requirement for which the variance or waiver is requested;
new text end

new text begin (2) the reasons for the request;
new text end

new text begin (3) the alternative measures that will be taken if a variance or waiver is granted;
new text end

new text begin (4) the length of time for which the variance or waiver is requested; and
new text end

new text begin (5) other relevant information deemed necessary by the commissioner to properly evaluate
the request for the waiver.
new text end

new text begin (b) The decision to grant or deny a variance or waiver must be based on the
commissioner's evaluation of the following criteria:
new text end

new text begin (1) whether the waiver will adversely affect the health, treatment, comfort, safety, or
well-being of a resident;
new text end

new text begin (2) whether the alternative measures to be taken, if any, are equivalent to or superior to
those prescribed in this section; and
new text end

new text begin (3) whether compliance with the requirements would impose an undue burden on the
facility.
new text end

new text begin (c) The commissioner must notify the facility in writing of the decision. If a variance or
waiver is granted, the notification must specify the period of time for which the variance
or waiver is effective and the alternative measures or conditions, if any, to be met by the
facility.
new text end

new text begin (d) Alternative measures or conditions attached to a variance or waiver have the force
and effect of this chapter and are subject to the issuance of correction orders and fines in
accordance with sections 144I.30, subdivision 7, and 144I.31. The amount of fines for a
violation of this subdivision is that specified for the specific requirement for which the
variance or waiver was requested.
new text end

new text begin (e) A request for renewal of a variance or waiver must be submitted in writing at least
45 days before its expiration date. Renewal requests must contain the information specified
in paragraph (b). A variance or waiver must be renewed by the commissioner if the facility
continues to satisfy the criteria in paragraph (a) and demonstrates compliance with the
alternative measures or conditions imposed at the time the original variance or waiver was
granted.
new text end

new text begin (f) The commissioner must deny, revoke, or refuse to renew a variance or waiver if it
is determined that the criteria in paragraph (a) are not met. The facility must be notified in
writing of the reasons for the decision and informed of the right to appeal the decision.
new text end

new text begin (g) A facility may contest the denial, revocation, or refusal to renew a variance or waiver
by requesting a contested case hearing under chapter 14. The facility must submit, within
15 days of the receipt of the commissioner's decision, a written request for a hearing. The
request for hearing must set forth in detail the reasons why the facility contends the decision
of the commissioner should be reversed or modified. At the hearing, the facility has the
burden of proving by a preponderance of the evidence that the facility satisfied the criteria
specified in paragraph (b), except in a proceeding challenging the revocation of a variance
or waiver.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 26.

new text begin [144I.25] ASSISTED LIVING CONTRACT REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Contract required. new text end

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

new text begin (b) The contract must contain all the terms concerning the provision of:
new text end

new text begin (1) housing;
new text end

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

new text begin (3) the resident's service plan, if applicable.
new text end

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

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

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

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

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

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

new text begin Subd. 2. new text end

new text begin Contents and contract; contact information. new text end

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

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

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

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

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

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

new text begin (c) The contract must include:
new text end

new text begin (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;
new text end

new text begin (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;
new text end

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

new text begin (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;
new text end

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

new text begin (6) billing and payment procedures and requirements; and
new text end

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

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

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

new text begin (1) the right under section 144I.262 to appeal the termination of an assisted living
contract;
new text end

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

new text begin (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;
new text end

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

new text begin (5) a description of the facility's policies related to medical assistance waivers under
sections 256B.0915 and 256B.49 and the housing support program under chapter 256I,
including:
new text end

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

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

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

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

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

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

new text begin (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;
new text end

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

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

new 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.
new text end

new text begin Subd. 3. new text end

new text begin Designation of representative. new text end

new text begin (a) Before or at the time of execution of an
assisted living contract, an assisted living facility must offer the resident the opportunity to
identify a designated representative in writing in the contract and must provide the following
verbatim notice on a document separate from the contract:
new text end

new text begin RIGHT TO DESIGNATE A REPRESENTATIVE FOR CERTAIN PURPOSES.
new text end

new text begin You have the right to name anyone as your "Designated Representative." A Designated
Representative can assist you, receive certain information and notices about you, including
some information related to your health care, and advocate on your behalf. A Designated
Representative does not take the place of your guardian, conservator, power of attorney
("attorney-in-fact"), or health care power of attorney ("health care agent"), if applicable.
new text end

new text begin (b) The contract must contain a page or space for the name and contact information of
the designated representative and a box the resident must initial if the resident declines to
name a designated representative. Notwithstanding subdivision 1, paragraph (f), the resident
has the right at any time to add, remove, or change the name and contact information of the
designated representative.
new text end

new text begin Subd. 4. new text end

new text begin Filing. new text end

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

new text begin Subd. 5. new text end

new text begin Waivers of liability prohibited. new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 27.

new text begin [144I.26] ASSISTED LIVING CONTRACT TERMINATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For purposes of sections 144I.26 to 144I.263, "termination"
means:
new text end

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

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

new text begin Subd. 2. new text end

new text begin Prerequisite to termination of a contract. new text end

new text begin (a) Before issuing a notice of
termination of an assisted living contract, a facility must schedule and participate in a meeting
with the resident and the resident's legal representative and designated representative. The
purposes of the meeting are to:
new text end

new text begin (1) explain in detail the reasons for the proposed termination; and
new text end

new text begin (2) identify and offer reasonable accommodations or modifications, interventions, or
alternatives to avoid the termination or enable the resident to remain in the facility, including
but not limited to securing services from another provider of the resident's choosing that
may allow the resident to avoid the termination. A facility is not required to offer
accommodations, modifications, interventions, or alternatives that fundamentally alter the
nature of the operation of the facility.
new text end

new text begin (b) The meeting must be scheduled to take place at least seven days before a notice of
termination is issued. The facility must make reasonable efforts to ensure that the resident,
legal representative, and designated representative are able to attend the meeting.
new text end

new text begin (c) The facility must notify the resident that the resident may invite family members,
relevant health professionals, a representative of the Office of Ombudsman for Long-Term
Care, or other persons of the resident's choosing to participate in the meeting. For residents
who receive home and community-based waiver services under sections 256B.0915 and
256B.49, the facility must notify the resident's case manager of the meeting.
new text end

new text begin (d) In the event of an emergency relocation under subdivision 9, where the facility intends
to issue a notice of termination and an in-person meeting is impractical or impossible, the
facility may attempt to schedule and participate in a meeting under this subdivision via
telephone, video, or other means.
new text end

new text begin Subd. 3. new text end

new text begin Termination for nonpayment. new text end

new text begin (a) A facility may initiate a termination of
housing because of nonpayment of rent or a termination of services because of nonpayment
for services. Upon issuance of a notice of termination for nonpayment, the 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.
new text end

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

new text begin Subd. 4. new text end

new text begin Termination for violation of the assisted living contract. new text end

new text begin A facility may
initiate a termination of the assisted living contract if the resident violates a lawful provision
of the contract and the resident does not cure the violation within a reasonable amount of
time after the facility provides written notice of the ability to cure to the resident. Written
notice of the ability to cure may be provided in person or by first class mail. A facility is
not required to provide a resident with written notice of the ability to cure for a violation
that threatens the health or safety of the resident or another individual in the facility, or for
a violation that constitutes illegal conduct.
new text end

new text begin Subd. 5. new text end

new text begin Expedited termination. new text end

new text begin (a) A facility may initiate an expedited termination
of housing or services if:
new text end

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

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

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

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

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

new text begin (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 facility disclosed in the uniform
checklist; or
new text end

new text begin (3) extraordinary circumstances exist, causing the 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.
new text end

new text begin Subd. 6. new text end

new text begin Right to use provider of resident's choosing. new text end

new text begin A facility may not terminate
the assisted living contract if the underlying reason for termination may be resolved by the
resident obtaining services from another provider of the resident's choosing and the resident
obtains those services.
new text end

new text begin Subd. 7. new text end

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

new text begin (a) A facility terminating a contract
must issue a written notice of termination according to this section. The 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 sections
256B.0915 and 256B.49, to the resident's case manager, as soon as practicable after providing
notice to the resident. A facility may terminate an assisted living contract only as permitted
under subdivisions 3, 4, and 5.
new text end

new text begin (b) A facility terminating a 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.
new text end

new text begin (c) A facility terminating a 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.
new text end

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

new text begin Subd. 8. new text end

new text begin Content of notice of termination. new text end

new text begin The notice required under subdivision 7
must contain, at a minimum:
new text end

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

new text begin (2) a detailed explanation of the basis for the termination, including the clinical or other
supporting rationale;
new text end

new text begin (3) a detailed explanation of the conditions under which a new or amended contract may
be executed;
new text end

new text begin (4) a statement that the resident has the right to appeal the termination by requesting a
hearing, and information concerning the timeframe within which the request must be
submitted and the contact information for the agency to which the request must be submitted;
new text end

new text begin (5) a statement that the facility must participate in a coordinated move to another provider
or caregiver, as required under section 144I.263;
new text end

new text begin (6) the name and contact information of the person employed by the facility with whom
the resident may discuss the notice of termination;
new text end

new text begin (7) information on how to contact the Office of Ombudsman for Long-Term Care to
request an advocate to assist regarding the termination;
new text end

new text begin (8) information on how to contact the Senior LinkAge Line under section 256.975,
subdivision 7, and an explanation that the Senior LinkAge Line may provide information
about other available housing or service options; and
new text end

new text begin (9) if the termination is only for services, a statement that the resident may remain in
the facility and may secure any necessary services from another provider of the resident's
choosing.
new text end

new text begin Subd. 9. new text end

new text begin Emergency relocation. new text end

new text begin (a) A facility may remove a resident from the facility
in an emergency if necessary due to a resident's urgent medical needs or an imminent risk
the resident poses to the health or safety of another facility resident or facility staff member.
An emergency relocation is not a termination.
new text end

new text begin (b) In the event of an emergency relocation, the facility must provide a written notice
that contains, at a minimum:
new text end

new text begin (1) the reason for the relocation;
new text end

new text begin (2) the name and contact information for the location to which the resident has been
relocated and any new service provider;
new text end

new text begin (3) contact information for the Office of Ombudsman for Long-Term Care;
new text end

new text begin (4) if known and applicable, the approximate date or range of dates within which the
resident is expected to return to the facility, or a statement that a return date is not currently
known; and
new text end

new text begin (5) a statement that, if the facility refuses to provide housing or services after a relocation,
the resident has the right to appeal under section 144I.262. The facility must provide contact
information for the agency to which the resident may submit an appeal.
new text end

new text begin (c) The notice required under paragraph (b) must be delivered as soon as practicable to:
new text end

new text begin (1) the resident, legal representative, and designated representative;
new text end

new text begin (2) for residents who receive home and community-based waiver services under sections
256B.0915 and 256B.49, the resident's case manager; and
new text end

new text begin (3) the Office of Ombudsman for Long-Term Care if the resident has been relocated
and has not returned to the facility within four days.
new text end

new text begin (d) Following an emergency relocation, a facility's refusal to provide housing or services
constitutes a termination and triggers the termination process in this section.
new text end

new text begin Subd. 10. new text end

new text begin Right to return. new text end

new text begin If a resident is absent from a facility for any reason, including
an emergency relocation, the facility shall not refuse to allow a resident to return if a
termination of housing has not been effectuated.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 28.

new text begin [144I.261] NONRENEWAL OF HOUSING.
new text end

new text begin (a) If a facility decides to not renew a resident's housing under a contract, the facility
must either (1) provide the resident with 60 calendar days' notice of the nonrenewal and
assistance with relocation planning, or (2) follow the termination procedure under section
144I.26.
new text end

new text begin (b) The notice must include the reason for the nonrenewal and contact information of
the Office of Ombudsman for Long-Term Care.
new text end

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

new text begin (1) provide notice of the nonrenewal to the Office of Ombudsman for Long-Term Care;
new text end

new text begin (2) for residents who receive home and community-based waiver services under sections
256B.0915 and 256B.49, provide notice to the resident's case manager;
new text end

new text begin (3) ensure a coordinated move to a safe location, as defined in section 144I.263,
subdivision 2, that is appropriate for the resident;
new text end

new text begin (4) ensure a coordinated move to an appropriate service provider identified by the facility,
if services are still needed and desired by the resident;
new text end

new text begin (5) consult and cooperate with the resident, legal representative, designated representative,
case manager for a resident who receives home and community-based waiver services under
sections 256B.0915 and 256B.49, relevant health professionals, and any other persons of
the resident's choosing to make arrangements to move the resident, including consideration
of the resident's goals; and
new text end

new text begin (6) prepare a written plan to prepare for the move.
new text end

new text begin (d) A resident may decline to move to the location the facility identifies or to accept
services from a service provider the facility identifies, and may instead choose to move to
a location of the resident's choosing or receive services from a service provider of the
resident's choosing within the timeline prescribed in the nonrenewal notice.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 29.

new text begin [144I.262] APPEALS.
new text end

new text begin Subdivision 1. new text end

new text begin Right to appeal. new text end

new text begin Residents have the right to appeal the termination of
an assisted living contract.
new text end

new text begin Subd. 2. new text end

new text begin Permissible grounds to appeal termination. new text end

new text begin A resident may appeal a
termination initiated under section 144I.26, subdivision 3, 4, or 5, on the ground that:
new text end

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

new text begin (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 facility;
new text end

new text begin (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
new text end

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

new text begin Subd. 3. new text end

new text begin Appeals process. new text end

new text begin (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.
new text end

new text begin (b) The hearing must be held at the 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.
new text end

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

new text begin (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.
new text end

new text begin (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 recommendation to the commissioner as soon as practicable, but in no event
later than ten business days after the hearing.
new text end

new text begin Subd. 4. new text end

new text begin Burden of proof for appeals of termination. new text end

new text begin (a) The 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 (4).
new text end

new text begin (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).
new text end

new text begin Subd. 5. new text end

new text begin Determination; appeal of determination. new text end

new text begin (a) The resident's termination must
be rescinded if the resident prevails in the appeal.
new text end

new text begin (b) The order may contain any conditions that may be placed on the resident's continued
residency or receipt of services, including but not limited to changes to the service plan or
a required increase in services.
new text end

new text begin Subd. 6. new text end

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

new text begin A termination of housing or services
shall not occur while an appeal is pending. If additional services are needed to meet the
health or safety needs of the resident while an appeal is pending, the resident is responsible
for contracting for those additional services from the facility or another provider and for
ensuring the costs for those additional services are covered.
new text end

new text begin Subd. 7. new text end

new text begin Application of chapter 504B to appeals of terminations. new text end

new text begin A resident may not
bring an action under chapter 504B to challenge a termination that has occurred and been
upheld under this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 30.

new text begin [144I.263] COORDINATED MOVES.
new text end

new text begin Subdivision 1. new text end

new text begin Duties of facility. new text end

new text begin (a) If a facility terminates an assisted living contract,
reduces services to the extent that a resident needs to move, or conducts a planned closure
under section 144I.27, the facility:
new text end

new text begin (1) must ensure, subject to paragraph (c), a coordinated move to a safe location that is
appropriate for the resident and that is identified by the facility prior to any hearing under
section 144I.262;
new text end

new text begin (2) must ensure a coordinated move of the resident to an appropriate service provider
identified by the facility prior to any hearing under section 144I.262, provided services are
still needed and desired by the resident; and
new text end

new text begin (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 sections 256B.0915 and 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.
new text end

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

new text begin (c) A resident may decline to move to the location the facility identifies or to accept
services from a service provider the facility identifies, and may choose instead to move to
a location of the resident's choosing or receive services from a service provider of the
resident's choosing within the timeline prescribed in the termination notice.
new text end

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

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

new text begin (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 facility with whom the resident
may discuss the reduction of services;
new text end

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

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

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

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

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

new text begin Subd. 2. new text end

new text begin Safe location. new text end

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

new text begin Subd. 3. new text end

new text begin Relocation plan required. new text end

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

new text begin Subd. 4. new text end

new text begin License restrictions. new text end

new text begin Unless otherwise ordered by the commissioner, if a
facility's license is restricted by the commissioner under section 144I.33 such that a resident
must move or obtain a new service provider, the facility must comply with this section.
new text end

new text begin Subd. 5. new text end

new text begin No waiver. new text end

new text begin The rights established under this section for the benefit of residents
do not limit any other rights available under other law. No facility may request or require
that any resident waive the resident's rights at any time for any reason, including as a
condition of admission to the facility.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 31.

new text begin [144I.264] ARBITRATION.
new text end

new text begin (a) An assisted living facility must clearly and conspicuously disclose, in writing in an
assisted living contract, any arbitration provision in the contract that precludes, limits, or
delays the ability of a resident from taking a civil action.
new text end

new text begin (b) An arbitration requirement must not include a choice of law or choice of venue
provision. Assisted living contracts must adhere to Minnesota law and any other applicable
federal or local law.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021, for contracts entered
into on or after that date.
new text end

Sec. 32.

new text begin [144I.265] OFFICE OF OMBUDSMAN FOR LONG-TERM CARE.
new text end

new text begin Subdivision 1. new text end

new text begin Immunity from liability. new text end

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

new text begin Subd. 2. new text end

new text begin Data classification. new text end

new text begin All forms and notices received by the Office of Ombudsman
for Long-Term Care under this chapter are classified under section 256.9744.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 33.

new text begin [144I.27] PLANNED CLOSURES.
new text end

new text begin Subdivision 1. new text end

new text begin Closure plan required. new text end

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

new text begin Subd. 2. new text end

new text begin Content of closure plan. new text end

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

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

new text begin (2) the procedures and actions the facility will implement to ensure all residents receive
appropriate termination planning in accordance with section 144I.263, and final accountings
and returns under section 144I.13, subdivision 5;
new text end

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

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

new text begin Subd. 3. new text end

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

new text begin (a) The plan
shall be subject to the commissioner's approval and subdivision 6. The facility shall take
no action to close the residence prior to the commissioner's approval of the plan. The
commissioner shall approve or otherwise respond to the plan as soon as practicable.
new text end

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

new text begin Subd. 4. new text end

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

new text begin Prior to
termination, the facility must follow the termination planning requirements under section
144I.263, and final accounting and return requirements under section 144I.13, subdivision
5, for residents. The facility must implement the plan approved by the commissioner and
ensure that arrangements for relocation and continued care that meet each resident's social,
emotional, and health needs are effectuated prior to closure.
new text end

new text begin Subd. 5. new text end

new text begin Notice to residents. new text end

new text begin After the commissioner has approved the relocation plan
and at least 60 calendar days before closing, except as provided under subdivision 6, the
facility must notify residents, designated representatives, and legal representatives of the
closure, the proposed date of closure, the contact information of the ombudsman for long-term
care, and that the facility will follow the termination planning requirements under section
144I.263, and final accounting and return requirements under section 144I.13, subdivision
5. For residents who receive home and community-based waiver services under sections
256B.0915 and 256B.49, the facility must also provide this information to the resident's
case manager.
new text end

new text begin Subd. 6. new text end

new text begin Emergency closures. new text end

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

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

new text begin Subd. 7. new text end

new text begin Other rights. new text end

new text begin Nothing in this section affects the rights and remedies available
under chapter 504B.
new text end

new text begin Subd. 8. new text end

new text begin Fine. new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 34.

new text begin [144I.29] COMMISSIONER OVERSIGHT AND AUTHORITY.
new text end

new text begin Subdivision 1. new text end

new text begin Regulations. new text end

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

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

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

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

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

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

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

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

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

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

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

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

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

new text begin Subd. 2. new text end

new text begin Regulatory functions. new text end

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

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

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

new text begin (3) survey assisted living facility licensees at least once every two years;
new text end

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

new text begin (5) issue correction orders and assess civil penalties under sections 144I.30 and 144I.31;
new text end

new text begin (6) take action as authorized in section 144I.33; and
new text end

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 35.

new text begin [144I.30] SURVEYS AND INVESTIGATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Regulatory powers. new text end

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

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

new text begin Subd. 2. new text end

new text begin Surveys. new text end

new text begin The commissioner shall conduct a survey of each assisted living
facility on a frequency of at least once every two years. The commissioner may conduct
surveys more frequently than every two years based on the license category, the 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.
new text end

new text begin Subd. 3. new text end

new text begin Follow-up surveys. new text end

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

new text begin Subd. 4. new text end

new text begin Scheduling surveys. new text end

new text begin Surveys and investigations shall be conducted without
advance notice to the facilities. Surveyors may contact the facility on the day of a survey
to arrange for someone to be available at the survey site. The contact does not constitute
advance notice. The surveyor must provide presurvey notification to the Office of
Ombudsman for Long-Term Care.
new text end

new text begin Subd. 5. new text end

new text begin Information provided by facility. new text end

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

new text begin Subd. 6. new text end

new text begin Providing resident records. new text end

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

new text begin Subd. 7. new text end

new text begin Correction orders. new text end

new text begin (a) A correction order may be issued whenever the
commissioner finds upon survey or during a complaint investigation that a facility, a
managerial official, or an employee of the facility is not in compliance with this chapter.
The correction order shall cite the specific statute and document areas of noncompliance
and the time allowed for correction.
new text end

new text begin (b) The commissioner shall mail or e-mail copies of any correction order to the facility
within 30 calendar days after the survey exit date. A copy of each correction order and
copies of any documentation supplied to the commissioner shall be kept on file by the
facility and public documents shall be made available for viewing by any person upon
request. Copies may be kept electronically.
new text end

new text begin (c) By the correction order date, the facility must document in the facility's records any
action taken to comply with the correction order. The commissioner may request a copy of
this documentation and the facility's action to respond to the correction order in future
surveys, upon a complaint investigation, and as otherwise needed.
new text end

new text begin Subd. 8. new text end

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

new text begin For assisted living facilities that have Level 3
or Level 4 violations under section 144I.31, the commissioner shall conduct a follow-up
survey within 90 calendar days of the survey. When conducting a follow-up survey, the
surveyor shall focus on whether the previous violations have been corrected and may also
address any new violations that are observed while evaluating the corrections that have been
made.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 36.

new text begin [144I.31] VIOLATIONS AND FINES.
new text end

new text begin Subdivision 1. new text end

new text begin Fine amounts. new text end

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

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

new text begin (2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism
authorized in section 144I.33 for widespread violations;
new text end

new text begin (3) Level 3, a fine of $3,000 per violation per incident, in addition to any enforcement
mechanism authorized in section 144I.33;
new text end

new text begin (4) Level 4, a fine of $5,000 per incident, in addition to any enforcement mechanism
authorized in section 144I.33; and
new text end

new text begin (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.
new text end

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

new text begin Subd. 2. new text end

new text begin Level and scope of violation. new text end

new text begin Correction orders for violations are categorized
by both level and scope:
new text end

new text begin (1) level of violation:
new text end

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

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

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

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

new text begin (2) scope of violation:
new text end

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

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

new text begin (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 residents.
new text end

new text begin Subd. 3. new text end

new text begin Notice of noncompliance. new text end

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

new text begin Subd. 4. new text end

new text begin Immediate fine; payment. new text end

new text begin (a) For every Level 3 or Level 4 violation, the
commissioner may issue an immediate fine. The licensee must still correct the violation in
the time specified. The issuance of an immediate fine may occur in addition to any
enforcement mechanism authorized under section 144I.33. The immediate fine may be
appealed as allowed under this section.
new text end

new text begin (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.
new text end

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

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

new text begin Subd. 5. new text end

new text begin Payment of fines required. new text end

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

new text begin Subd. 6. new text end

new text begin Additional penalties. new text end

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

new text begin Subd. 7. new text end

new text begin Deposit of fines. new text end

new text begin Fines collected under this section shall be deposited in a
dedicated special revenue account. On an annual basis, the balance in the special revenue
account shall be appropriated to the commissioner for special projects to improve home
care in Minnesota as recommended by the advisory council established in section 144A.4799.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 37.

new text begin [144I.32] RECONSIDERATION OF CORRECTION ORDERS AND FINES.
new text end

new text begin Subdivision 1. new text end

new text begin Reconsideration process required. new text end

new text begin The commissioner shall make
available to assisted living facilities a correction order reconsideration process. This process
may be used to challenge the correction order issued, including the level and scope described
in section 144I.31, and any fine assessed. When a licensee requests reconsideration of a
correction order, the correction order is not stayed while it is under reconsideration. The
commissioner shall post information on its website that the licensee requested reconsideration
of the correction order and that the review is pending.
new text end

new text begin Subd. 2. new text end

new text begin Reconsideration process. new text end

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

new text begin Subd. 3. new text end

new text begin Findings. new text end

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

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

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

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

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

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

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

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

new text begin Subd. 4. new text end

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

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

new text begin Subd. 5. new text end

new text begin Provisional licensees. new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 38.

new text begin [144I.33] ENFORCEMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Conditions. new text end

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

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

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

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

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

new text begin (5) knowingly makes a false statement of a material fact in the application for a license
or in any other record or report required by this chapter;
new text end

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

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

new text begin (8) interferes with or impedes ombudsman access according to section 256.9742,
subdivision 4;
new text end

new text begin (9) interferes with or impedes a representative of the department in the enforcement of
this chapter or fails to fully cooperate with an inspection, survey, or investigation by the
department;
new text end

new text begin (10) destroys or makes unavailable any records or other evidence relating to the assisted
living facility's compliance with this chapter;
new text end

new text begin (11) refuses to initiate a background study under section 144.057 or 245A.04;
new text end

new text begin (12) fails to timely pay any fines assessed by the commissioner;
new text end

new text begin (13) violates any local, city, or township ordinance relating to housing or assisted living
services;
new text end

new text begin (14) has repeated incidents of personnel performing services beyond their competency
level; or
new text end

new text begin (15) has operated beyond the scope of the assisted living facility's license category.
new text end

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

new text begin Subd. 2. new text end

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

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

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

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

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

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

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

new text begin (6) any other action reasonably required to accomplish the purpose of this subdivision
and subdivision 1.
new text end

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

new text begin Subd. 3. new text end

new text begin Immediate temporary suspension. new text end

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

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

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

new text begin (b) For purposes of this subdivision, "Level 4" has the meaning given in section 144I.31.
new text end

new text begin (c) A notice stating the reasons for the immediate temporary suspension or conditional
license and informing the licensee of the right to an expedited hearing under subdivision
11 must be delivered by personal service to the address shown on the application or the last
known address of the licensee. The licensee may appeal an order immediately temporarily
suspending a license or issuing a conditional license. The appeal must be made in writing
by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
the commissioner within five calendar days after the licensee receives notice. If an appeal
is made by personal service, it must be received by the commissioner within five calendar
days after the licensee received the order.
new text end

new text begin (d) A licensee whose license is immediately temporarily suspended must comply with
the requirements for notification and transfer of residents in subdivision 9. The requirements
in subdivision 9 remain if an appeal is requested.
new text end

new text begin Subd. 4. new text end

new text begin Mandatory revocation. new text end

new text begin Notwithstanding the provisions of subdivision 7,
paragraph (a), the commissioner must revoke a license if a controlling individual of the
facility is convicted of a felony or gross misdemeanor that relates to operation of the facility
or directly affects resident safety or care. The commissioner shall notify the facility and the
Office of Ombudsman for Long-Term Care 30 calendar days in advance of the date of
revocation.
new text end

new text begin Subd. 5. new text end

new text begin Mandatory proceedings. new text end

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

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

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

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

new text begin Subd. 6. new text end

new text begin Notice to residents. new text end

new text begin (a) Within five business days after proceedings are initiated
by the commissioner to revoke or suspend a facility's license, or a decision by the
commissioner not to renew a living facility's license, the controlling individual of the facility
or a designee must provide to the commissioner and the ombudsman for long-term care the
names of residents and the names and addresses of the residents' designated representatives
and legal representatives, and family or other contacts listed in the assisted living contract.
new text end

new text begin (b) The controlling individual or designees of the facility must provide updated
information each month until the proceeding is concluded. If the controlling individual or
designee of the facility fails to provide the information within this time, the facility is subject
to the issuance of:
new text end

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

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

new text begin (c) Notwithstanding subdivisions 16 and 17, any correction order issued under this
subdivision must require that the facility immediately comply with the request for information
and that, as of the date of the issuance of the correction order, the facility shall forfeit to the
state a $500 fine the first day of noncompliance and an increase in the $500 fine by $100
increments for each day the noncompliance continues.
new text end

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

new text begin (e) Within ten business days after the commissioner initiates proceedings to revoke,
suspend, or not renew a facility license, the commissioner must send a written notice of the
action and the process involved to each resident of the facility, legal representatives and
designated representatives, and at the commissioner's discretion, additional resident contacts.
new text end

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

new text begin Subd. 7. new text end

new text begin Notice to facility. new text end

new text begin (a) Prior to any suspension, revocation, or refusal to renew
a license, the facility shall be entitled to notice and a hearing as provided by sections 14.57
to 14.69. The hearing must commence within 60 calendar days after the proceedings are
initiated. In addition to any other remedy provided by law, the commissioner may, without
a prior contested case hearing, temporarily suspend a license or prohibit delivery of services
by a provider for not more than 90 calendar days, or issue a conditional license if the
commissioner determines that there are Level 3 violations that do not pose an imminent
risk of harm to the health or safety of the facility residents, provided:
new text end

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

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

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

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

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

new text begin For the purposes of this subdivision, "Level 3" and "Level 4" have the meanings given in
section 144I.31.
new text end

new text begin Subd. 8. new text end

new text begin Request for hearing. new text end

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

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

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

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

new text begin Subd. 9. new text end

new text begin Plan required. new text end

new text begin (a) The process of suspending, revoking, or refusing to renew
a license must include a plan for transferring affected residents' cares to other providers by
the facility. The commissioner shall monitor the transfer plan. Within three calendar days
of being notified of the final revocation, refusal to renew, or suspension, the licensee shall
provide the commissioner, the lead agencies as defined in section 256B.0911, county adult
protection and case managers, and the ombudsman for long-term care with the following
information:
new text end

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

new text begin (2) a list of the resident's legal representatives and designated representatives and family
or other contacts listed in the assisted living contract, including full names and all contact
information on file;
new text end

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

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

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

new text begin (b) The revocation, refusal to renew, or suspension notification requirement is satisfied
by mailing the notice to the address in the license record. The licensee shall cooperate with
the commissioner and the lead agencies, county adult protection and county managers, and
the ombudsman for long-term care during the process of transferring care of residents to
qualified providers. Within three calendar days of being notified of the final revocation,
refusal to renew, or suspension action, the facility must notify and disclose to each of the
residents, or the resident's legal and designated representatives or emergency contact persons,
that the commissioner is taking action against the facility's license by providing a copy of
the revocation, refusal to renew, or suspension notice issued by the commissioner. If the
facility does not comply with the disclosure requirements in this section, the commissioner
shall notify the residents, legal and designated representatives, or emergency contact persons
about the actions being taken. Lead agencies, county adult protection and county managers,
and the Office of Ombudsman for Long-Term Care may also provide this information. The
revocation, refusal to renew, or suspension notice is public data except for any private data
contained therein.
new text end

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

new text begin Subd. 10. new text end

new text begin Hearing. new text end

new text begin Within 15 business days of receipt of the licensee's timely appeal
of a sanction under this section, other than for a temporary suspension, the commissioner
shall request assignment of an administrative law judge. The commissioner's request must
include a proposed date, time, and place of hearing. A hearing must be conducted by an
administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
90 calendar days of the request for assignment, unless an extension is requested by either
party and granted by the administrative law judge for good cause or for purposes of discussing
settlement. In no case shall one or more extensions be granted for a total of more than 90
calendar days unless there is a criminal action pending against the licensee. If, while a
licensee continues to operate pending an appeal of an order for revocation, suspension, or
refusal to renew a license, the commissioner identifies one or more new violations of law
that meet the requirements of Level 3 or Level 4 violations as defined in section 144I.31,
the commissioner shall act immediately to temporarily suspend the license.
new text end

new text begin Subd. 11. new text end

new text begin Expedited hearing. new text end

new text begin (a) Within five business days of receipt of the licensee's
timely appeal of a temporary suspension or issuance of a conditional license, the
commissioner shall request assignment of an administrative law judge. The request must
include a proposed date, time, and place of a hearing. A hearing must be conducted by an
administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
30 calendar days of the request for assignment, unless an extension is requested by either
party and granted by the administrative law judge for good cause. The commissioner shall
issue a notice of hearing by certified mail or personal service at least ten business days
before the hearing. Certified mail to the last known address is sufficient. The scope of the
hearing shall be limited solely to the issue of whether the temporary suspension or issuance
of a conditional license should remain in effect and whether there is sufficient evidence to
conclude that the licensee's actions or failure to comply with applicable laws are Level 3
or Level 4 violations as defined in section 144I.31, or that there were violations that posed
an imminent risk of harm to the resident's health and safety.
new text end

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

new text begin (c) When the final order under paragraph (b) affirms an immediate suspension, and a
final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that
sanction, the licensee is prohibited from operation pending a final commissioner's order
after the contested case hearing conducted under chapter 14.
new text end

new text begin (d) A licensee whose license is temporarily suspended must comply with the requirements
for notification and transfer of residents under subdivision 9. These requirements remain if
an appeal is requested.
new text end

new text begin Subd. 12. new text end

new text begin Time limits for appeals. new text end

new text begin To appeal the assessment of civil penalties under
section 144I.31, and an action against a license under this section, a licensee must request
a hearing no later than 15 business days after the licensee receives notice of the action.
new text end

new text begin Subd. 13. new text end

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

new text begin (a) The owner
and managerial officials of a facility whose Minnesota license has not been renewed or
whose Minnesota license has been revoked because of noncompliance with applicable laws
or rules shall not be eligible to apply for nor will be granted an assisted living facility license
under this chapter or a home care provider license under chapter 144A, or be given status
as an enrolled personal care assistance provider agency or personal care assistant by the
Department of Human Services under section 256B.0659, for five years following the
effective date of the nonrenewal or revocation. If the owner or managerial officials already
have enrollment status, the Department of Human Services shall terminate that enrollment.
new text end

new text begin (b) The commissioner shall not issue a license to a facility for five years following the
effective date of license nonrenewal or revocation if the owner or managerial official,
including any individual who was an owner or managerial official of another licensed
provider, had a Minnesota license that was not renewed or was revoked as described in
paragraph (a).
new text end

new text begin (c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall suspend
or revoke, the license of a facility that includes any individual as an owner or managerial
official who was an owner or managerial official of a facility whose Minnesota license was
not renewed or was revoked as described in paragraph (a) for five years following the
effective date of the nonrenewal or revocation.
new text end

new text begin (d) The commissioner shall notify the facility 30 calendar days in advance of the date
of nonrenewal, suspension, or revocation of the license. Within ten business days after the
receipt of the notification, the facility may request, in writing, that the commissioner stay
the nonrenewal, revocation, or suspension of the license. The facility shall specify the
reasons for requesting the stay; the steps that will be taken to attain or maintain compliance
with the licensure laws and regulations; any limits on the authority or responsibility of the
owners or managerial officials whose actions resulted in the notice of nonrenewal, revocation,
or suspension; and any other information to establish that the continuing affiliation with
these individuals will not jeopardize resident health, safety, or well-being. The commissioner
shall determine whether the stay will be granted within 30 calendar days of receiving the
facility's request. The commissioner may propose additional restrictions or limitations on
the facility's license and require that granting the stay be contingent upon compliance with
those provisions. The commissioner shall take into consideration the following factors when
determining whether the stay should be granted:
new text end

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

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

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

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

new text begin Subd. 14. new text end

new text begin Relicensing. new text end

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

new text begin Subd. 15. new text end

new text begin Informal conference. new text end

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

new text begin Subd. 16. new text end

new text begin Injunctive relief. new text end

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

new text begin Subd. 17. new text end

new text begin Subpoena. new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 39.

new text begin [144I.34] INNOVATION VARIANCE.
new text end

new text begin Subdivision 1. new text end

new text begin Definition; granting variances. new text end

new text begin (a) For purposes of this section,
"innovation variance" means a specified alternative to a requirement of this chapter.
new text end

new text begin (b) An innovation variance may be granted to allow an assisted living facility to offer
services of a type or in a manner that is innovative, will not impair the services provided,
will not adversely affect the health, safety, or welfare of the residents, and is likely to improve
the services provided. The innovative variance cannot change any of the resident's rights
under the assisted living bill of rights.
new text end

new text begin Subd. 2. new text end

new text begin Conditions. new text end

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

new text begin Subd. 3. new text end

new text begin Duration and renewal. new text end

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

new text begin Subd. 4. new text end

new text begin Applications; innovation variance. new text end

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

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

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

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

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

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

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

new text begin Subd. 5. new text end

new text begin Grants and denials. new text end

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

new text begin Subd. 6. new text end

new text begin Violation of innovation variances. new text end

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

new text begin Subd. 7. new text end

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 40.

new text begin [144I.35] RESIDENT QUALITY OF CARE AND OUTCOMES
IMPROVEMENT TASK FORCE.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner shall establish a resident quality of
care and outcomes improvement task force to examine and make recommendations, on an
ongoing basis, on how to apply proven safety and quality improvement practices and
infrastructure to settings and providers that provide long-term services and supports.
new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin The task force shall include representation from:
new text end

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

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

new text begin (3) consumer organizations;
new text end

new text begin (4) direct care providers or their representatives;
new text end

new text begin (5) organizations representing long-term care providers and home care providers in
Minnesota;
new text end

new text begin (6) the ombudsman for long-term care or a designee;
new text end

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

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

new text begin The task force shall have at least one public member who 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.
new text end

new text begin Subd. 3. new text end

new text begin Recommendations. new text end

new text begin The task force shall periodically provide recommendations
to the commissioner and the legislature on changes needed to promote safety and quality
improvement practices in long-term care settings and with long-term care providers. The
task force shall meet no fewer than four times per year. The task force shall be established
by July 1, 2020.
new text end

Sec. 41.

new text begin [144I.36] RULEMAKING AUTHORIZED.
new text end

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

new text begin (b) On July 1, 2019, the commissioner shall begin rulemaking.
new text end

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

new text begin (1) staffing appropriate for each licensure category to best protect the health and safety
of residents no matter their vulnerability;
new text end

new text begin (2) training prerequisites and ongoing training, including dementia care training and
standards for demonstrating competency;
new text end

new text begin (3) procedures for discharge planning and ensuring resident appeal rights;
new text end

new text begin (4) initial assessments, continuing assessments, and a uniform assessment tool;
new text end

new text begin (5) emergency disaster and preparedness plans;
new text end

new text begin (6) uniform checklist disclosure of services;
new text end

new text begin (7) a definition of serious injury that results from maltreatment;
new text end

new text begin (8) conditions and fine amounts for planned closures;
new text end

new text begin (9) procedures and timelines for the commissioner regarding termination appeals between
facilities and the Office of Administrative Hearings;
new text end

new text begin (10) establishing base fees and per-resident fees for each category of licensure;
new text end

new text begin (11) considering the establishment of a maximum amount for any one fee;
new text end

new text begin (12) procedures for relinquishing an assisted living facility with dementia care license
and fine amounts for noncompliance; and
new text end

new text begin (13) procedures to efficiently transfer existing housing with services registrants and
home care licensees to the new assisted living facility licensure structure.
new text end

new text begin (d) The commissioner shall publish the proposed rules by December 31, 2019, and shall
publish final rules by December 31, 2020.
new text end

Sec. 42.

new text begin [144I.50] RETALIATION PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Retaliation prohibited. new text end

new text begin A facility or agent of a facility may not retaliate
against a resident or employee if the resident, employee, or any person acting on behalf of
the resident:
new text end

new text begin (1) files a good faith complaint or grievance, makes a good faith inquiry, or asserts any
right;
new text end

new text begin (2) indicates a good faith intention to file a complaint or grievance, make an inquiry, or
assert any right;
new text end

new text begin (3) files, in good faith, or indicates an intention to file a maltreatment report, whether
mandatory or voluntary, under section 626.557;
new text end

new text begin (4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
problems or concerns to the director or manager of the facility, the Office of Ombudsman
for Long-Term Care, a regulatory or other government agency, or a legal or advocacy
organization;
new text end

new text begin (5) advocates or seeks advocacy assistance for necessary or improved care or services
or enforcement of rights under this section or other law;
new text end

new text begin (6) takes or indicates an intention to take civil action;
new text end

new text begin (7) participates or indicates an intention to participate in any investigation or
administrative or judicial proceeding;
new text end

new text begin (8) contracts or indicates an intention to contract to receive services from a service
provider of the resident's choice other than the facility; or
new text end

new text begin (9) places or indicates an intention to place a camera or electronic monitoring device in
the resident's private space as provided under section 144.6502.
new text end

new text begin Subd. 2. new text end

new text begin Retaliation against a resident. new text end

new text begin For purposes of this section, to retaliate against
a resident includes but is not limited to any of the following actions taken or threatened by
a facility or an agent of the facility against a resident, or any person with a familial, personal,
legal, or professional relationship with the resident:
new text end

new text begin (1) termination of a contract;
new text end

new text begin (2) any form of discrimination;
new text end

new text begin (3) restriction or prohibition of access:
new text end

new text begin (i) of the resident to the facility or visitors; or
new text end

new text begin (ii) of a family member or a person with a personal, legal, or professional relationship
with the resident, to the resident, unless the restriction is the result of a court order;
new text end

new text begin (4) the imposition of involuntary seclusion or the withholding of food, care, or services;
new text end

new text begin (5) restriction of any of the rights granted to residents under state or federal law;
new text end

new text begin (6) restriction or reduction of access to or use of amenities, care, services, privileges, or
living arrangements; or
new text end

new text begin (7) unauthorized removal, tampering with, or deprivation of technology, communication,
or electronic monitoring devices.
new text end

new text begin Subd. 3. new text end

new text begin Retaliation against an employee. new text end

new text begin For purposes of this section, to retaliate
against an employee means any of the following actions taken or threatened by the facility
or an agent of the facility against an employee:
new text end

new text begin (1) unwarranted discharge or transfer;
new text end

new text begin (2) unwarranted demotion or refusal to promote;
new text end

new text begin (3) unwarranted reduction in compensation, benefits, or privileges;
new text end

new text begin (4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
new text end

new text begin (5) any form of unwarranted discrimination.
new text end

new text begin Subd. 4. new text end

new text begin Determination by commissioner. new text end

new text begin A resident may request that the commissioner
determine whether the facility retaliated against a resident. If a resident demonstrates to the
commissioner that the facility took any action described in subdivision 2 within 30 days of
an initial action described in subdivision 1, the facility must present evidence to the
commissioner of the nonretaliatory reason relied on by the facility for the facility action.
Based on the evidence provided by both parties, the commissioner shall determine if
retaliation occurred.
new text end

new text begin Subd. 5. new text end

new text begin Other laws. new text end

new text begin Nothing in this section affects the rights available to a resident
under section 626.557.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 43.

new text begin [144I.51] CONSUMER ADVOCACY AND LEGAL SERVICES.
new text end

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

new text begin (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
new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 44.

new text begin [144I.52] APPLICABILITY OF OTHER LAWS.
new text end

new text begin Assisted living facilities:
new text end

new text begin (1) are subject to and must comply with chapter 504B;
new text end

new text begin (2) must comply with section 325F.72; and
new text end

new text begin (3) are not required to obtain a lodging license under chapter 157 and related rules.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 45. new text begin TRANSITION PERIOD.
new text end

new text begin (a) The commissioner shall begin rulemaking on July 1, 2019.
new text end

new text begin (b) From July 1, 2020, to July 31, 2021, the commissioner shall prepare for the new
assisted living facility and assisted living facility with dementia care licensure by hiring
staff, developing forms, and communicating with stakeholders about the new facility
licensing.
new text end

new text begin (c) Effective August 1, 2021, all existing housing with services establishments providing
home care services under Minnesota Statutes, chapter 144A, must convert their registration
to licensure under Minnesota Statutes, chapter 144I.
new text end

new text begin (d) Effective August 1, 2021, all new assisted living facilities and assisted living facilities
with dementia care must be licensed by the commissioner.
new text end

Sec. 46. new text begin PRIORITIZATION OF ENFORCEMENT ACTIVITIES.
new text end

new text begin Within available appropriations to the commissioner of health for enforcement activities
for fiscal years 2020 and 2021, the commissioner of health shall prioritize enforcement
activities taken under Minnesota Statutes, section 144A.442.
new text end

Sec. 47. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes, in consultation with Senate Counsel, Research, and Fiscal
Analysis, House Research, and the commissioner of health, shall recodify Minnesota Statutes,
chapter 144I, in Minnesota Statutes, chapter 144G, prior to publication of the 2019
Supplement of Minnesota Statutes, and shall reorganize provisions in that chapter for greater
clarity and improved organization, without changing the meaning or effect of these
provisions.
new text end

Sec. 48. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 144D.01; 144D.015; 144D.02; 144D.025; 144D.03;
144D.04; 144D.045; 144D.05; 144D.06; 144D.065; 144D.066; 144D.07; 144D.08; 144D.09;
144D.10; 144D.11; 144G.01; 144G.02; 144G.03; 144G.04; 144G.05; and 144G.06, new text end new text begin are
repealed effective August 1, 2021.
new text end

ARTICLE 2

DEMENTIA CARE SERVICES FOR ASSISTED LIVING FACILITIES WITH
DEMENTIA CARE

Section 1.

new text begin [144I.37] ADDITIONAL REQUIREMENTS FOR ASSISTED LIVING
FACILITIES WITH DEMENTIA CARE.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin This section applies only to assisted living facilities with
dementia care.
new text end

new text begin Subd. 2. new text end

new text begin Demonstrated capacity. new text end

new text begin (a) An applicant for licensure as an assisted living
facility with dementia care must have the ability to provide services in a manner that is
consistent with the requirements in this section. The commissioner shall consider the
following criteria, including, but not limited to:
new text end

new text begin (1) the experience of the applicant in managing residents with dementia or previous
long-term care experience; and
new text end

new text begin (2) the compliance history of the applicant in the operation of any care facility licensed,
certified, or registered under federal or state law.
new text end

new text begin (b) If the applicant does not have experience in managing residents with dementia, the
applicant must employ a consultant for at least the first six months of operation. The
consultant must meet the requirements in paragraph (a), clause (1), and make
recommendations on providing dementia care services consistent with the requirements of
this chapter. The consultant must (1) have two years of work experience related to dementia,
health care, gerontology, or a related field, and (2) have completed at least the minimum
core training requirements in section 144I.21. The applicant must document an acceptable
plan to address the consultant's identified concerns and must either implement the
recommendations or document in the plan any consultant recommendations that the applicant
chooses not to implement. The commissioner must review the applicant's plan upon request.
new text end

new text begin (c) The commissioner shall conduct an on-site inspection prior to the issuance of an
assisted living facility with dementia care license to ensure compliance with the physical
environment requirements.
new text end

new text begin (d) The label "Assisted Living Facility with Dementia Care" must be identified on the
license.
new text end

new text begin Subd. 3. new text end

new text begin Relinquishing license. new text end

new text begin (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 facility must at least:
new text end

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

new text begin (i) the proposed effective date of the relinquishment;
new text end

new text begin (ii) changes in staffing;
new text end

new text begin (iii) changes in services including the elimination or addition of services;
new text end

new text begin (iv) staff training that shall occur when the relinquishment becomes effective; and
new text end

new text begin (v) contact information for the Office of Ombudsman for Long-Term Care;
new text end

new text begin (2) submit a transitional plan to the commissioner demonstrating how the current residents
shall be evaluated and assessed to reside in other housing settings that are not an assisted
living facility with dementia care, that are physically unsecured, or that would require
move-out or transfer to other settings;
new text end

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

new text begin (4) notify the commissioner when the relinquishment process has been completed; and
new text end

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

new text begin (b) Nothing in this section alters obligations under section 144I.27.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 2.

new text begin [144I.38] RESPONSIBILITIES OF ADMINISTRATION FOR ASSISTED
LIVING FACILITIES WITH DEMENTIA CARE.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin The licensee of an assisted living facility with dementia care
is responsible for the care and housing of the persons with dementia and the provision of
person-centered care that promotes each resident's dignity, independence, and comfort. This
includes the supervision, training, and overall conduct of the staff.
new text end

new text begin Subd. 2. new text end

new text begin Additional requirements. new text end

new text begin (a) The licensee must follow the assisted living
license requirements and the criteria in this section.
new text end

new text begin (b) The assisted living director of an assisted living facility with dementia care must
complete and document that at least ten hours of the required annual continuing educational
requirements relate to the care of individuals with dementia. The training must include
medical management of dementia, creating and maintaining supportive and therapeutic
environments for residents with dementia, and transitioning and coordinating services for
residents with dementia. Continuing education credits may include college courses, preceptor
credits, self-directed activities, course instructor credits, corporate training, in-service
training, professional association training, web-based training, correspondence courses,
telecourses, seminars, and workshops.
new text end

new text begin Subd. 3. new text end

new text begin Policies. new text end

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

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

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

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

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

new text begin (5) staff training specific to dementia care;
new text end

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

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

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

new text begin (9) transportation coordination and assistance to and from outside medical appointments;
and
new text end

new text begin (10) safekeeping of resident's possessions.
new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 3.

new text begin [144I.39] STAFFING AND STAFF TRAINING.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin (a) An assisted living facility with dementia care must provide
residents with dementia-trained staff who have been instructed in the person-centered care
approach. All direct care staff assigned to care for residents with dementia must be specially
trained to work with residents with Alzheimer's disease and other dementias.
new text end

new text begin (b) Only staff trained as specified in subdivisions 2 and 3 shall be assigned to care for
dementia residents.
new text end

new text begin (c) Staffing levels must be sufficient to meet the scheduled and unscheduled needs of
residents. Staffing levels during nighttime hours shall be based on the sleep patterns and
needs of residents.
new text end

new text begin (d) In an emergency situation when trained staff are not available to provide services,
the facility may assign staff who have not completed the required training. The particular
emergency situation must be documented and must address:
new text end

new text begin (1) the nature of the emergency;
new text end

new text begin (2) how long the emergency lasted; and
new text end

new text begin (3) the names and positions of staff that provided coverage.
new text end

new text begin Subd. 2. new text end

new text begin Staffing requirements. new text end

new text begin (a) The licensee must ensure that staff who provide
support to residents with dementia 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 expedited rulemaking process. These
requirements are in addition to the licensing requirements for training.
new text end

new text begin (b) Failure to comply with paragraph (a) or subdivision 1 shall result in a fine under
section 144I.31.
new text end

new text begin Subd. 3. new text end

new text begin Supervising staff training. new text end

new text begin Persons providing or overseeing staff training must
have experience and knowledge in the care of individuals with dementia, including:
new text end

new text begin (1) two years of work experience related to Alzheimer's disease or other dementias, or
in health care, gerontology, or another related field; and
new text end

new text begin (2) completion of training equivalent to the requirements in this section and successfully
passing a skills competency or knowledge test required by the commissioner.
new text end

new text begin Subd. 4. new text end

new text begin Preservice and in-service training. new text end

new text begin Preservice and in-service training may
include various methods of instruction, such as classroom style, web-based training, video,
or one-to-one training. The licensee must have a method for determining and documenting
each staff person's knowledge and understanding of the training provided. All training must
be documented.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 4.

new text begin [144I.40] SERVICES FOR RESIDENTS WITH DEMENTIA.
new text end

new text begin (a) In addition to the minimum services required in section 144I.10, an assisted living
facility with dementia care must also provide the following services:
new text end

new text begin (1) assistance with activities of daily living that address the needs of each resident with
dementia due to cognitive or physical limitations. These services must meet or be in addition
to the requirements in the licensing rules for the facility. Services must be provided in a
person-centered manner that promotes resident choice, dignity, and sustains the resident's
abilities;
new text end

new text begin (2) nonpharmacological practices that are person-centered and evidence-informed;
new text end

new text begin (3) services to prepare and educate persons living with dementia and their legal and
designated representatives about transitions in care and ensuring complete, timely
communication between, across, and within settings; and
new text end

new text begin (4) services that provide residents with choices for meaningful engagement with other
facility residents and the broader community.
new text end

new text begin (b) Each resident must be evaluated for activities according to the licensing rules of the
facility. In addition, the evaluation must address the following:
new text end

new text begin (1) past and current interests;
new text end

new text begin (2) current abilities and skills;
new text end

new text begin (3) emotional and social needs and patterns;
new text end

new text begin (4) physical abilities and limitations;
new text end

new text begin (5) adaptations necessary for the resident to participate; and
new text end

new text begin (6) identification of activities for behavioral interventions.
new text end

new text begin (c) An individualized activity plan must be developed for each resident based on their
activity evaluation. The plan must reflect the resident's activity preferences and needs.
new text end

new text begin (d) A selection of daily structured and non-structured activities must be provided and
included on the resident's activity service or care plan as appropriate. Daily activity options
based on resident evaluation may include but are not limited to:
new text end

new text begin (1) occupation or chore related tasks;
new text end

new text begin (2) scheduled and planned events such as entertainment or outings;
new text end

new text begin (3) spontaneous activities for enjoyment or those that may help defuse a behavior;
new text end

new text begin (4) one-to-one activities that encourage positive relationships between residents and
staff such as telling a life story, reminiscing, or playing music;
new text end

new text begin (5) spiritual, creative, and intellectual activities;
new text end

new text begin (6) sensory stimulation activities;
new text end

new text begin (7) physical activities that enhance or maintain a resident's ability to ambulate or move;
and
new text end

new text begin (8) outdoor activities.
new text end

new text begin (e) Behavioral symptoms that negatively impact the resident and others in the assisted
living facility with dementia care must be evaluated and included on the service or care
plan. The staff must initiate and coordinate outside consultation or acute care when indicated.
new text end

new text begin (f) Support must be offered to family and other significant relationships on a regularly
scheduled basis but not less than quarterly.
new text end

new text begin (g) Access to secured outdoor space and walkways that allow residents to enter and
return without staff assistance must be provided.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

ARTICLE 3

CONSUMER PROTECTIONS

Section 1.

new text begin [144.6502] ELECTRONIC MONITORING IN CERTAIN FACILITIES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.
new text end

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

new text begin (c) "Department" means the Department of Health.
new text end

new text begin (d) "Electronic monitoring" means the placement and use of an electronic monitoring
device by a resident in the resident's room or private living unit in accordance with this
section.
new text end

new text begin (e) "Electronic monitoring device" means a camera or other device that captures, records,
or broadcasts audio, video, or both, that is placed in a resident's room or private living unit
and is used to monitor the resident or activities in the room or private living unit.
new text end

new text begin (f) "Facility" means a facility that is:
new text end

new text begin (1) licensed as a nursing home under chapter 144A;
new text end

new text begin (2) licensed as a boarding care home under sections 144.50 to 144.56;
new text end

new text begin (3) until August 1, 2021, a housing with services establishment registered under chapter
144D that is either subject to chapter 144G or has a disclosed special unit under section
325F.72; or
new text end

new text begin (4) on or after August 1, 2021, an assisted living facility.
new text end

new text begin (g) "Resident" means a person 18 years of age or older residing in a facility.
new text end

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

new text begin (1) a court-appointed guardian;
new text end

new text begin (2) a health care agent as defined in section 145C.01, subdivision 2; or
new text end

new text begin (3) a person who is not an agent of a facility or of a home care provider designated in
writing by the resident and maintained in the resident's records on file with the facility.
new text end

new text begin Subd. 2. new text end

new text begin Electronic monitoring authorized. new text end

new text begin (a) A resident or a resident representative
may conduct electronic monitoring of the resident's room or private living unit through the
use of electronic monitoring devices placed in the resident's room or private living unit as
provided in this section.
new text end

new text begin (b) Nothing in this section precludes the use of electronic monitoring of health care
allowed under other law.
new text end

new text begin (c) Electronic monitoring authorized under this section is not a covered service under
home and community-based waivers under sections 256B.0913, 256B.0915, 256B.092, and
256B.49.
new text end

new text begin (d) This section does not apply to monitoring technology authorized as a home and
community-based service under section 256B.0913, 256B.0915, 256B.092, or 256B.49.
new text end

new text begin Subd. 3. new text end

new text begin Consent to electronic monitoring. new text end

new text begin (a) Except as otherwise provided in this
subdivision, a resident must consent to electronic monitoring in the resident's room or private
living unit in writing on a notification and consent form. If the resident has not affirmatively
objected to electronic monitoring and the resident's medical professional determines that
the resident currently lacks the ability to understand and appreciate the nature and
consequences of electronic monitoring, the resident representative may consent on behalf
of the resident. For purposes of this subdivision, a resident affirmatively objects when the
resident orally, visually, or through the use of auxiliary aids or services declines electronic
monitoring. The resident's response must be documented on the notification and consent
form.
new text end

new text begin (b) Prior to a resident representative consenting on behalf of a resident, the resident must
be asked if the resident wants electronic monitoring to be conducted. The resident
representative must explain to the resident:
new text end

new text begin (1) the type of electronic monitoring device to be used;
new text end

new text begin (2) the standard conditions that may be placed on the electronic monitoring device's use,
including those listed in subdivision 6;
new text end

new text begin (3) with whom the recording may be shared under subdivision 10 or 11; and
new text end

new text begin (4) the resident's ability to decline all recording.
new text end

new text begin (c) A resident, or resident representative when consenting on behalf of the resident, may
consent to electronic monitoring with any conditions of the resident's or resident
representative's choosing, including the list of standard conditions provided in subdivision
6. A resident, or resident representative when consenting on behalf of the resident, may
request that the electronic monitoring device be turned off or the visual or audio recording
component of the electronic monitoring device be blocked at any time.
new text end

new text begin (d) Prior to implementing electronic monitoring, a resident, or resident representative
when acting on behalf of the resident, must obtain the written consent on the notification
and consent form of any other resident residing in the shared room or shared private living
unit. A roommate's or roommate's resident representative's written consent must comply
with the requirements of paragraphs (a) to (c). Consent by a roommate or a roommate's
resident representative under this paragraph authorizes the resident's use of any recording
obtained under this section, as provided under subdivision 10 or 11.
new text end

new text begin (e) Any resident conducting electronic monitoring must immediately remove or disable
an electronic monitoring device prior to a new roommate moving into a shared room or
shared private living unit, unless the resident obtains the roommate's or roommate's resident
representative's written consent as provided under paragraph (d) prior to the roommate
moving into the shared room or shared private living unit. Upon obtaining the new
roommate's signed notification and consent form and submitting the form to the facility as
required under subdivision 5, the resident may resume electronic monitoring.
new text end

new text begin (f) The resident or roommate, or the resident representative or roommate's resident
representative if the representative is consenting on behalf of the resident or roommate, may
withdraw consent at any time and the withdrawal of consent must be documented on the
original consent form as provided under subdivision 5, paragraph (d).
new text end

new text begin Subd. 4. new text end

new text begin Refusal of roommate to consent. new text end

new text begin If a resident of a facility who is residing in
a shared room or shared living unit, or the resident representative of such a resident when
acting on behalf of the resident, wants to conduct electronic monitoring and another resident
living in or moving into the same shared room or shared living unit refuses to consent to
the use of an electronic monitoring device, the facility shall make a reasonable attempt to
accommodate the resident who wants to conduct electronic monitoring. A facility has met
the requirement to make a reasonable attempt to accommodate a resident or resident
representative who wants to conduct electronic monitoring when, upon notification that a
roommate has not consented to the use of an electronic monitoring device in the resident's
room, the facility offers to move the resident to another shared room or shared living unit
that is available at the time of the request. If a resident chooses to reside in a private room
or private living unit in a facility in order to accommodate the use of an electronic monitoring
device, the resident must pay either the private room rate in a nursing home setting, or the
applicable rent in a housing with services establishment or assisted living facility. If a facility
is unable to accommodate a resident due to lack of space, the facility must reevaluate the
request every two weeks until the request is fulfilled. A facility is not required to provide
a private room, a single-bed room, or a private living unit to a resident who is unable to
pay.
new text end

new text begin Subd. 5. new text end

new text begin Notice to facility; exceptions. new text end

new text begin (a) Electronic monitoring may begin only after
the resident or resident representative who intends to place an electronic monitoring device
and any roommate or roommate's resident representative completes the notification and
consent form and submits the form to the facility.
new text end

new text begin (b) Notwithstanding paragraph (a), the resident or resident representative who intends
to place an electronic monitoring device may do so without submitting a notification and
consent form to the facility for up to 14 days:
new text end

new text begin (1) if the resident or the resident representative reasonably fears retaliation against the
resident by the facility, timely submits the completed notification and consent form to the
Office of Ombudsman for Long-Term Care, and timely submits a Minnesota Adult Abuse
Reporting Center report or police report, or both, upon evidence from the electronic
monitoring device that suspected maltreatment has occurred;
new text end

new text begin (2) if there has not been a timely written response from the facility to a written
communication from the resident or resident representative expressing a concern prompting
the desire for placement of an electronic monitoring device and if the resident or a resident
representative timely submits a completed notification and consent form to the Office of
Ombudsman for Long-Term Care; or
new text end

new text begin (3) if the resident or resident representative has already submitted a Minnesota Adult
Abuse Reporting Center report or police report regarding the resident's concerns prompting
the desire for placement and if the resident or a resident representative timely submits a
completed notification and consent form to the Office of Ombudsman for Long-Term Care.
new text end

new text begin (c) Upon receipt of any completed notification and consent form, the facility must place
the original form in the resident's file or file the original form with the resident's housing
with services contract. The facility must provide a copy to the resident and the resident's
roommate, if applicable.
new text end

new text begin (d) If a resident is conducting electronic monitoring according to paragraph (b) and
obtains a signed notification and consent form from a roommate, the resident or resident
representative must submit the signed notification and consent form to the facility. In the
event that a resident or roommate, or the resident representative or roommate's resident
representative if the representative is consenting on behalf of the resident or roommate,
chooses to alter the conditions under which consent to electronic monitoring is given or
chooses to withdraw consent to electronic monitoring, the facility must make available the
original notification and consent form so that it may be updated. Upon receipt of the updated
form, the facility must place the updated form in the resident's file or file the original form
with the resident's signed housing with services contract. The facility must provide a copy
of the updated form to the resident and the resident's roommate, if applicable.
new text end

new text begin (e) If a new roommate, or the new roommate's resident representative when consenting
on behalf of the new roommate, does not submit to the facility a completed notification and
consent form and the resident conducting the electronic monitoring does not remove or
disable the electronic monitoring device, the facility must remove the electronic monitoring
device.
new text end

new text begin (f) If a roommate, or the roommate's resident representative when withdrawing consent
on behalf of the roommate, submits an updated notification and consent form withdrawing
consent and the resident conducting electronic monitoring does not remove or disable the
electronic monitoring device, the facility must remove the electronic monitoring device.
new text end

new text begin Subd. 6. new text end

new text begin Form requirements. new text end

new text begin (a) The notification and consent form completed by the
resident must include, at a minimum, the following information:
new text end

new text begin (1) the resident's signed consent to electronic monitoring or the signature of the resident
representative, if applicable. If a person other than the resident signs the consent form, the
form must document the following:
new text end

new text begin (i) the date the resident was asked if the resident wants electronic monitoring to be
conducted;
new text end

new text begin (ii) who was present when the resident was asked;
new text end

new text begin (iii) an acknowledgment that the resident did not affirmatively object; and
new text end

new text begin (iv) the source of authority allowing the resident representative to sign the notification
and consent form on the resident's behalf;
new text end

new text begin (2) the resident's roommate's signed consent or the signature of the roommate's resident
representative, if applicable. If a roommate's resident representative signs the consent form,
the form must document the following:
new text end

new text begin (i) the date the roommate was asked if the roommate wants electronic monitoring to be
conducted;
new text end

new text begin (ii) who was present when the roommate was asked;
new text end

new text begin (iii) an acknowledgment that the roommate did not affirmatively object; and
new text end

new text begin (iv) the source of authority allowing the resident representative to sign the notification
and consent form on the roommate's behalf;
new text end

new text begin (3) the type of electronic monitoring device to be used;
new text end

new text begin (4) a list of standard conditions or restrictions that the resident or a roommate may elect
to place on the use of the electronic monitoring device, including but not limited to:
new text end

new text begin (i) prohibiting audio recording;
new text end

new text begin (ii) prohibiting video recording;
new text end

new text begin (iii) prohibiting broadcasting of audio or video;
new text end

new text begin (iv) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device for the duration of an exam or procedure by
a health care professional;
new text end

new text begin (v) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device while dressing or bathing is performed; and
new text end

new text begin (vi) turning off the electronic monitoring device for the duration of a visit with a spiritual
adviser, ombudsman, attorney, financial planner, intimate partner, or other visitor;
new text end

new text begin (5) any other condition or restriction elected by the resident or roommate on the use of
an electronic monitoring device;
new text end

new text begin (6) a statement of the circumstances under which a recording may be disseminated under
subdivision 10;
new text end

new text begin (7) a signature box for documenting that the resident or roommate has withdrawn consent;
and
new text end

new text begin (8) an acknowledgment that the resident consents to the Office of Ombudsman for
Long-Term Care and its representatives disclosing information about the form. Disclosure
under this clause shall be limited to:
new text end

new text begin (i) the fact that the form was received from the resident or resident representative;
new text end

new text begin (ii) if signed by a resident representative, the name of the resident representative and
the source of authority allowing the resident representative to sign the notification and
consent form on the resident's behalf; and
new text end

new text begin (iii) the type of electronic monitoring device placed.
new text end

new text begin (b) Facilities must make the notification and consent form available to the residents and
inform residents of their option to conduct electronic monitoring of their rooms or private
living unit.
new text end

new text begin (c) Notification and consent forms received by the Office of Ombudsman for Long-Term
Care are classified under section 256.9744.
new text end

new text begin (d) A facility that contacts the Office of Ombudsman for Long-Term Care regarding an
electronic monitoring device presumably placed in accordance with subdivision 5, paragraph
(a) or (b), must provide the office with the type, make, and model number of the electronic
monitoring device discovered by the facility.
new text end

new text begin Subd. 7. new text end

new text begin Costs and installation. new text end

new text begin (a) A resident or resident representative choosing to
conduct electronic monitoring must do so at the resident's own expense, including paying
purchase, installation, maintenance, and removal costs.
new text end

new text begin (b) If a resident chooses to place an electronic monitoring device that uses Internet
technology for visual or audio monitoring, the resident may be responsible for contracting
with an Internet service provider.
new text end

new text begin (c) The facility shall make a reasonable attempt to accommodate the resident's installation
needs, including allowing access to the facility's public-use Internet or Wi-Fi systems when
available for other public uses. A facility has the burden of proving that a requested
accommodation is not reasonable.
new text end

new text begin (d) All electronic monitoring device installations and supporting services must be
UL-listed.
new text end

new text begin Subd. 8. new text end

new text begin Notice to visitors. new text end

new text begin (a) A facility must post a sign at each facility entrance
accessible to visitors that states: "Electronic monitoring devices, including security cameras
and audio devices, may be present to record persons and activities."
new text end

new text begin (b) The facility is responsible for installing and maintaining the signage required in this
subdivision.
new text end

new text begin Subd. 9. new text end

new text begin Obstruction of electronic monitoring devices. new text end

new text begin (a) A person must not knowingly
hamper, obstruct, tamper with, or destroy an electronic monitoring device placed in a
resident's room or private living unit without the permission of the resident or resident
representative. Checking the electronic monitoring device by facility staff for the make and
model number does not constitute tampering under this subdivision.
new text end

new text begin (b) It is not a violation of paragraph (a) if a person turns off the electronic monitoring
device or blocks the visual recording component of the electronic monitoring device at the
direction of the resident or resident representative, or if consent has been withdrawn.
new text end

new text begin Subd. 10. new text end

new text begin Dissemination of recordings. new text end

new text begin (a) No person may access any video or audio
recording created through authorized electronic monitoring without the written consent of
the resident or resident representative.
new text end

new text begin (b) Except as required under other law, a recording or copy of a recording made as
provided in this section may only be disseminated for the purpose of addressing health,
safety, or welfare concerns of one or more residents.
new text end

new text begin (c) A person disseminating a recording or copy of a recording made as provided in this
section in violation of paragraph (b) may be civilly or criminally liable.
new text end

new text begin Subd. 11. new text end

new text begin Admissibility of evidence. new text end

new text begin Subject to applicable rules of evidence and
procedure, any video or audio recording created through electronic monitoring under this
section may be admitted into evidence in a civil, criminal, or administrative proceeding.
new text end

new text begin Subd. 12. new text end

new text begin Liability. new text end

new text begin (a) For the purposes of state law, the mere presence of an electronic
monitoring device in a resident's room or private living unit is not a violation of the resident's
right to privacy under section 144.651 or 144A.44.
new text end

new text begin (b) For the purposes of state law, a facility or home care provider is not civilly or
criminally liable for the mere disclosure by a resident or a resident representative of a
recording.
new text end

new text begin Subd. 13. new text end

new text begin Immunity from liability. new text end

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

new text begin Subd. 14. new text end

new text begin Resident protections. new text end

new text begin (a) A facility must not:
new text end

new text begin (1) refuse to admit a potential resident or remove a resident because the facility disagrees
with the decision of the potential resident, the resident, or a resident representative acting
on behalf of the resident regarding electronic monitoring;
new text end

new text begin (2) retaliate or discriminate against any resident for consenting or refusing to consent
to electronic monitoring, as provided in section 144.6512, 144G.07, or 144I.50; or
new text end

new text begin (3) prevent the placement or use of an electronic monitoring device by a resident who
has provided the facility or the Office of Ombudsman for Long-Term Care with notice and
consent as required under this section.
new text end

new text begin (b) Any contractual provision prohibiting, limiting, or otherwise modifying the rights
and obligations in this section is contrary to public policy and is void and unenforceable.
new text end

new text begin Subd. 15. new text end

new text begin Employee discipline. new text end

new text begin (a) An employee of the facility or an employee of a
contractor providing services at the facility, including an arranged home care provider as
defined in section 144D.01, subdivision 2a, who is the subject of proposed disciplinary
action based upon evidence obtained by electronic monitoring must be given access to that
evidence for purposes of defending against the proposed action.
new text end

new text begin (b) An employee who obtains a recording or a copy of the recording must treat the
recording or copy confidentially and must not further disseminate it to any other person
except as required under law. Any copy of the recording must be returned to the facility or
resident who provided the copy when it is no longer needed for purposes of defending
against a proposed action.
new text end

new text begin Subd. 16. new text end

new text begin Penalties. new text end

new text begin (a) The commissioner may issue a correction order as provided
under section 144A.10, 144A.45, 144A.474, or 144I.30, upon a finding that the facility has
failed to comply with:
new text end

new text begin (1) subdivision 5, paragraphs (c) to (f);
new text end

new text begin (2) subdivision 6, paragraph (b);
new text end

new text begin (3) subdivision 7, paragraph (c); or
new text end

new text begin (4) subdivision 8, 9, 10, or 14.
new text end

new text begin (b) For each violation of this section, the commissioner may impose a fine of up to $500
upon a finding of noncompliance with a correction order issued under this subdivision.
new text end

new text begin (c) The commissioner may exercise the commissioner's authority under section 144D.05
to compel a housing with services establishment to meet the requirements of this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, and applies to all
agreements in effect, entered into, or renewed on or after that date.
new text end

Sec. 2.

new text begin [144.6512] RETALIATION IN NURSING HOMES PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section:
new text end

new text begin (1) "nursing home" means a facility licensed as a nursing home under chapter 144A;
and
new text end

new text begin (2) "resident" means a person residing in a nursing home.
new text end

new text begin Subd. 2. new text end

new text begin Retaliation prohibited. new text end

new text begin A nursing home or agent of a nursing home may not
retaliate against a resident or employee if the resident, employee, or any person acting on
behalf of the resident:
new text end

new text begin (1) files a good faith complaint or grievance, makes a good faith inquiry, or asserts any
right;
new text end

new text begin (2) indicates a good faith intention to file a complaint or grievance, make an inquiry, or
assert any right;
new text end

new text begin (3) files, in good faith, or indicates an intention to file a maltreatment report, whether
mandatory or voluntary, under section 626.557;
new text end

new text begin (4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
problems or concerns to the administrator or manager of the nursing home, the Office of
Ombudsman for Long-Term Care, a regulatory or other government agency, or a legal or
advocacy organization;
new text end

new text begin (5) advocates or seeks advocacy assistance for necessary or improved care or services
or enforcement of rights under this section or other law;
new text end

new text begin (6) takes or indicates an intention to take civil action;
new text end

new text begin (7) participates or indicates an intention to participate in any investigation or
administrative or judicial proceeding;
new text end

new text begin (8) contracts or indicates an intention to contract to receive services from a service
provider of the resident's choice other than the nursing home; or
new text end

new text begin (9) places or indicates an intention to place a camera or electronic monitoring device in
the resident's private space as provided under section 144.6502.
new text end

new text begin Subd. 3. new text end

new text begin Retaliation against a resident. new text end

new text begin For purposes of this section, to retaliate against
a resident includes but is not limited to any of the following actions taken or threatened by
a nursing home or an agent of the nursing home against a resident, or any person with a
familial, personal, legal, or professional relationship with the resident:
new text end

new text begin (1) a discharge or transfer;
new text end

new text begin (2) any form of discrimination;
new text end

new text begin (3) restriction or prohibition of access:
new text end

new text begin (i) of the resident to the nursing home or visitors; or
new text end

new text begin (ii) of a family member or a person with a personal, legal, or professional relationship
with the resident, to the resident, unless the restriction is the result of a court order;
new text end

new text begin (4) the imposition of involuntary seclusion or the withholding of food, care, or services;
new text end

new text begin (5) restriction of any of the rights granted to residents under state or federal law;
new text end

new text begin (6) restriction or reduction of access to or use of amenities, care, services, privileges, or
living arrangements; or
new text end

new text begin (7) unauthorized removal, tampering with, or deprivation of technology, communication,
or electronic monitoring devices.
new text end

new text begin Subd. 4. new text end

new text begin Retaliation against an employee. new text end

new text begin For purposes of this section, to retaliate
against an employee means any of the following actions taken by the nursing home or an
agent of the nursing home against an employee:
new text end

new text begin (1) unwarranted discharge or transfer;
new text end

new text begin (2) unwarranted demotion or refusal to promote;
new text end

new text begin (3) unwarranted reduction in compensation, benefits, or privileges;
new text end

new text begin (4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
new text end

new text begin (5) any form of unwarranted discrimination.
new text end

new text begin Subd. 5. new text end

new text begin Determination by commissioner. new text end

new text begin A resident may request that the commissioner
determine whether the facility retaliated against a resident. If a resident demonstrates to the
commissioner that the facility took any action described in subdivision 3 within 30 days of
an initial action described in subdivision 2, the facility must present evidence to the
commissioner of the nonretaliatory reason relied on by the facility for the facility action.
Based on the evidence provided by both parties, the commissioner shall determine if
retaliation occurred.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 3.

new text begin [144G.07] RETALIATION PROHIBITED.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section:
new text end

new text begin (1) "facility" means a housing with services establishment registered under section
144D.02 and operating under title protection under this chapter; and
new text end

new text begin (2) "resident" means a resident of a facility.
new text end

new text begin Subd. 2. new text end

new text begin Retaliation prohibited. new text end

new text begin A facility or agent of a facility may not retaliate against
a resident or employee if the resident, employee, or any person on behalf of the resident:
new text end

new text begin (1) files a good faith complaint or grievance, makes a good faith inquiry, or asserts any
right;
new text end

new text begin (2) indicates a good faith intention to file a complaint or grievance, make an inquiry, or
assert any right;
new text end

new text begin (3) files, in good faith, or indicates an intention to file a maltreatment report, whether
mandatory or voluntary, under section 626.557;
new text end

new text begin (4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
problems or concerns to the administrator or manager of the facility, the Office of
Ombudsman for Long-Term Care, a regulatory or other government agency, or a legal or
advocacy organization;
new text end

new text begin (5) advocates or seeks advocacy assistance for necessary or improved care or services
or enforcement of rights under this section or other law;
new text end

new text begin (6) takes or indicates an intention to take civil action;
new text end

new text begin (7) participates or indicates an intention to participate in any investigation or
administrative or judicial proceeding;
new text end

new text begin (8) contracts or indicates an intention to contract to receive services from a service
provider of the resident's choice other than the facility; or
new text end

new text begin (9) places or indicates an intention to place a camera or electronic monitoring device in
the resident's private space as provided under section 144.6502.
new text end

new text begin Subd. 3. new text end

new text begin Retaliation against a resident. new text end

new text begin For purposes of this section, to retaliate against
a resident includes but is not limited to any of the following actions taken or threatened by
a facility or an agent of the facility against a resident, or any person with a familial, personal,
legal, or professional relationship with the resident:
new text end

new text begin (1) termination of a contract;
new text end

new text begin (2) any form of discrimination;
new text end

new text begin (3) restriction or prohibition of access:
new text end

new text begin (i) of the resident to the facility or visitors; or
new text end

new text begin (ii) of a family member or a person with a personal, legal, or professional relationship
with the resident, to the resident, unless the restriction is the result of a court order;
new text end

new text begin (4) the imposition of involuntary seclusion or the withholding of food, care, or services;
new text end

new text begin (5) restriction of any of the rights granted to residents under state or federal law;
new text end

new text begin (6) restriction or reduction of access to or use of amenities, care, services, privileges, or
living arrangements;
new text end

new text begin (7) an arbitrary increase in charges or fees;
new text end

new text begin (8) unauthorized removal, tampering with, or deprivation of technology, communication,
or electronic monitoring devices; or
new text end

new text begin (9) any oral or written communication of false information about a person advocating
on behalf of the resident.
new text end

new text begin Subd. 4. new text end

new text begin Retaliation against an employee. new text end

new text begin For purposes of this section, to retaliate
against an employee means any of the following actions taken by the facility or an agent of
the facility against an employee:
new text end

new text begin (1) unwarranted discharge or transfer;
new text end

new text begin (2) unwarranted demotion or refusal to promote;
new text end

new text begin (3) unwarranted reduction in compensation, benefits, or privileges;
new text end

new text begin (4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
new text end

new text begin (5) any form of unwarranted discrimination.
new text end

new text begin Subd. 5. new text end

new text begin Determination by commissioner. new text end

new text begin A resident may request that the commissioner
determine whether the facility retaliated against a resident. If a resident demonstrates to the
commissioner that the facility took any action described in subdivision 3 within 30 days of
an initial action described in subdivision 2, the facility must present evidence to the
commissioner of the nonretaliatory reason relied on by the facility for the facility action.
Based on the evidence provided by both parties, the commissioner shall determine if
retaliation occurred.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019, and expires July 31,
2021.
new text end

Sec. 4.

new text begin [325F.721] PROVISION OF "I'M OKAY" CHECK SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the following terms have
the meanings given them.
new text end

new text begin (b) "Covered setting" means an unlicensed setting providing sleeping accommodations
to one or more adult residents, at least 80 percent of which are 55 years of age or older, and
offering or providing, for a fee, supportive services. For the purposes of this section, covered
setting does not mean:
new text end

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

new text begin (2) a nursing home licensed under chapter 144A;
new text end

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

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

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

new text begin (6) private homes in which the residents are related by kinship, law, or affinity with the
providers of services;
new text end

new text begin (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;
new text end

new text begin (8) temporary family health care dwellings as defined in sections 394.307 and 462.3593;
new text end

new text begin (9) settings 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;
new text end

new text begin (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;
new text end

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

new text begin (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;
new text end

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

new text begin (14) an assisted living facility licensed under chapter 144I.
new text end

new text begin (b) ""I'm okay" check services" means providing a service to, by any means, check on
the safety of a resident.
new text end

new text begin (c) "Resident" means a person entering into written contract for housing and services
with a covered setting.
new text end

new text begin (d) "Supportive services" means:
new text end

new text begin (1) assistance with laundry, shopping, and household chores;
new text end

new text begin (2) housekeeping services;
new text end

new text begin (3) provision of meals or assistance with meals or food preparation;
new text end

new text begin (4) help with arranging, or arranging transportation to, medical, social, recreational,
personal, or social services appointments; or
new text end

new text begin (5) provision of social or recreational services.
new text end

new text begin Arranging for services does not include making referrals or contacting a service provider
in an emergency.
new text end

new text begin Subd. 2. new text end

new text begin Disclosure of "I'm okay" check services. new text end

new text begin (a) A covered setting must
prominently disclose in a written contract whether or not the setting itself or through a
provider with which the setting has a business agreement offers "I'm okay" check services.
new text end

new text begin (b) If the resident contracts for "I'm okay" check services, the written contract must
detail the nature, extent, and frequency of the provision of these services.
new text end

new text begin (c) A covered setting must disclose to prospective residents that the facility is not licensed
as an assisted living facility under chapter 144I and, notwithstanding any contract for "I'm
okay" check services, is not permitted to provide assisted living services, as defined in
section 144I.01, subdivision 9, either directly or through a provider under a business
relationship or other affiliation with the covered setting.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for contracts entered into on or after
August 1, 2021.
new text end

ARTICLE 4

ASSISTED LIVING LICENSURE CONFORMING CHANGES; DIRECTOR
LICENSURE

Section 1.

Minnesota Statutes 2018, section 144.051, subdivision 4, is amended to read:

Subd. 4.

Data classification; public data.

For providers regulated pursuant to sections
144A.43 to 144A.482 new text begin and chapter 144I new text end , the following data collected, created, or maintained
by the commissioner are classified as public data as defined in section 13.02, subdivision
15:

(1) all application data on licensees, license numbers, and license status;

(2) licensing information about licenses previously held under this chapter;

(3) correction orders, including information about compliance with the order and whether
the fine was paid;

(4) final enforcement actions pursuant to chapter 14;

(5) orders for hearing, findings of fact, and conclusions of law; and

(6) when the licensee and department agree to resolve the matter without a hearing, the
agreement and specific reasons for the agreement are public data.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 2.

Minnesota Statutes 2018, section 144.051, subdivision 5, is amended to read:

Subd. 5.

Data classification; confidential data.

For providers regulated pursuant to
sections 144A.43 to 144A.482 new text begin and chapter 144I new text end , the following data collected, created, or
maintained by the Department of Health are classified as confidential data on individuals
as defined in section 13.02, subdivision 3: active investigative data relating to the
investigation of potential violations of law by a licensee including data from the survey
process before the correction order is issued by the department.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 3.

Minnesota Statutes 2018, section 144.051, subdivision 6, is amended to read:

Subd. 6.

Release of private or confidential data.

For providers regulated pursuant to
sections 144A.43 to 144A.482 new text begin and chapter 144I new text end , the department may release private or
confidential data, except Social Security numbers, to the appropriate state, federal, or local
agency and law enforcement office to enhance investigative or enforcement efforts or further
a public health protective process. Types of offices include Adult Protective Services, Office
of the Ombudsman for Long-Term Care and Office of the Ombudsman for Mental Health
and Developmental Disabilities, the health licensing boards, Department of Human Services,
county or city attorney's offices, police, and local or county public health offices.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 4.

Minnesota Statutes 2018, section 144.057, subdivision 1, is amended to read:

Subdivision 1.

Background studies required.

The commissioner of health shall contract
with the commissioner of human services to conduct background studies of:

(1) individuals providing services deleted text begin which deleted text end new text begin that new text end have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; deleted text begin residential care homes licensed under
chapter 144B, deleted text end new text begin assisted living facilities and assisted living facilities with dementia care
licensed under chapter 144I; new text end and board and lodging establishments that are registered to
provide supportive or health supervision services under section 157.17;

(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
services in a nursing home or a home care agency licensed under chapter 144A new text begin ; an assisted
living facility or assisted living facility with dementia care licensed under chapter 144I; new text end or
a boarding care home licensed under sections 144.50 to 144.58. If the individual under study
resides outside Minnesota, the study must include a check for substantiated findings of
maltreatment of adults and children in the individual's state of residence when the information
is made available by that state, and must include a check of the National Crime Information
Center database;

(3) deleted text begin beginning July 1, 1999, deleted text end all other employees in new text begin assisted living facilities or assisted
living facilities with dementia care licensed under chapter 144I, new text end nursing homes licensed
under chapter 144A, and boarding care homes licensed under sections 144.50 to 144.58. A
disqualification of an individual in this section shall disqualify the individual from positions
allowing direct contact or access to patients or residents receiving services. "Access" means
physical access to a client or the client's personal property without continuous, direct
supervision as defined in section 245C.02, subdivision 8, when the employee's employment
responsibilities do not include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; and

(5) controlling persons of a supplemental nursing services agency, as defined under
section 144A.70.

If a facility or program is licensed by the Department of Human Services and subject to
the background study provisions of chapter 245C and is also licensed by the Department
of Health, the Department of Human Services is solely responsible for the background
studies of individuals in the jointly licensed programs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 5.

Minnesota Statutes 2018, section 144A.04, subdivision 5, is amended to read:

Subd. 5.

Administrators.

deleted text begin (a) deleted text end Each nursing home must employ an administrator who
must be licensed or permitted as a nursing home administrator by the Board of deleted text begin Examiners
for Nursing Home Administrators deleted text end new text begin Executives for Long Term Services and Supports new text end . The
nursing home may share the services of a licensed administrator. The administrator must
maintain deleted text begin a sufficient deleted text end new text begin an new text end on-site presence in the facility to effectively manage the facility in
compliance with applicable rules and regulations. The administrator must establish procedures
and delegate authority for on-site operations in the administrator's absence, but is ultimately
responsible for the management of the facility. Each nursing home must have posted at all
times the name of the administrator and the name of the person in charge on the premises
in the absence of the licensed administrator.

deleted text begin (b) Notwithstanding sections 144A.18 to 144A.27, a nursing home with a director of
nursing serving as an unlicensed nursing home administrator as of March 1, 2001, may
continue to have a director of nursing serve in that capacity, provided the director of nursing
has passed the state law and rules examination administered by the Board of Examiners for
Nursing Home Administrators and maintains evidence of completion of 20 hours of
continuing education each year on topics pertinent to nursing home administration.
deleted text end

Sec. 6.

Minnesota Statutes 2018, section 144A.19, subdivision 1, is amended to read:

Subdivision 1.

Creation; membership.

There is hereby created the Board of deleted text begin Examiners
for Nursing Home Administrators deleted text end new text begin Executives for Long Term Services and Supports new text end which
shall consist of the following members:

(1) a designee of the commissioner of health who shall be a nonvoting member;

(2) a designee of the commissioner of human services who shall be a nonvoting member;
and

(3) the following members appointed by the governor:

(i) deleted text begin two members deleted text end new text begin one licensed nursing home administrator member new text end actively engaged in
the management, operation, or ownership of deleted text begin proprietary deleted text end nursing homes;

new text begin (ii) one licensed nursing home administrator or health services executive member actively
engaged in the management, operation, or ownership of proprietary nursing homes or assisted
living facilities;
new text end

deleted text begin (ii) two members deleted text end new text begin (iii) one licensed nursing home administrator or health services
executive member new text end actively engaged in the management or operation of nonprofit nursing
homes new text begin or assisted living facilities new text end ;

new text begin (iv) one licensed assisted living facility director member actively engaged in the
management, operation, or ownership of assisted living facilities;
new text end

deleted text begin (iii) deleted text end new text begin (v) new text end one member actively engaged in the practice of medicine;

deleted text begin (iv) one member deleted text end new text begin (vi) two members new text end actively engaged in the practice of professional
nursing new text begin , one practicing in nursing homes and one practicing in assisted living facilities new text end ; and

deleted text begin (v) deleted text end new text begin (vii) new text end three public members as defined in section 214.02. new text begin Public members may not
be current health-related license holders.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 7.

Minnesota Statutes 2018, section 144A.20, subdivision 1, is amended to read:

Subdivision 1.

Criteria.

The Board of deleted text begin Examiners deleted text end new text begin Executives new text end may issue licenses to
qualified persons as nursing home administrators new text begin or assisted living directors new text end , and shall
establish qualification criteria for nursing home administrators new text begin and assisted living directors new text end .
deleted text begin No license shall be issued to a person as a nursing home administrator unless that person:
deleted text end

deleted text begin (1) is at least 21 years of age and otherwise suitably qualified;
deleted text end

deleted text begin (2) has satisfactorily met standards set by the Board of Examiners, which standards shall
be designed to assure that nursing home administrators will be individuals who, by training
or experience are qualified to serve as nursing home administrators; and
deleted text end

deleted text begin (3) has passed an examination approved by the board and designed to test for competence
in the subject matters referred to in clause (2), or has been approved by the Board of
Examiners through the development and application of other appropriate techniques.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 8.

Minnesota Statutes 2018, section 144A.20, is amended by adding a subdivision to
read:

new text begin Subd. 3. new text end

new text begin Nursing home administrator qualifications. new text end

new text begin The Board of Executives may
issue licenses to qualified persons as a nursing home administrator and shall approve training
and examinations. No license shall be issued to a person as a nursing home administrator
unless that person:
new text end

new text begin (1) is at least 21 years of age and otherwise suitably qualified;
new text end

new text begin (2) has satisfactorily met standards set by the Board of Executives. The standards shall
be designed to assure that nursing home administrators are individuals who, by training or
experience, are qualified to serve as nursing home administrators; and
new text end

new text begin (3) has passed an examination approved by the board and designed to test for competence
in the subject matters referred to in clause (2), or has been approved by the Board of
Executives through the development and application of other appropriate techniques.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 9.

Minnesota Statutes 2018, section 144A.20, is amended by adding a subdivision to
read:

new text begin Subd. 4. new text end

new text begin Assisted living director qualifications; ongoing training. new text end

new text begin (a) The Board of
Executives may issue licenses to qualified persons as an assisted living director and shall
approve training and examinations. No license shall be issued to a person as an assisted
living director unless that person:
new text end

new text begin (1) is eligible for licensure;
new text end

new text begin (2) has applied for licensure under this subdivision within six months of hire; and
new text end

new text begin (3) has satisfactorily met standards set by the board or is scheduled to complete the
training in paragraph (b) within one year of hire. The standards shall be designed to assure
that assisted living directors are individuals who, by training or experience, are qualified to
serve as assisted living directors.
new text end

new text begin (b) In order to be qualified to serve as an assisted living director, an individual must:
new text end

new text begin (1) have completed an approved training course and passed an examination approved
by the board that is designed to test for competence and that includes assisted living facility
laws in Minnesota;
new text end

new text begin (2)(i) currently be licensed as a nursing home administrator or have been validated as a
qualified health services executive by the National Association of Long-Term Care
Administrator Boards; and
new text end

new text begin (ii) have core knowledge of assisted living facility laws; or
new text end

new text begin (3) apply for licensure by July 1, 2021, and satisfy one of the following:
new text end

new text begin (i) have a higher education degree in nursing, social services, or mental health, or another
professional degree with training specific to management and regulatory compliance;
new text end

new text begin (ii) have at least three years of supervisory, management, or operational experience and
higher education training applicable to an assisted living facility;
new text end

new text begin (iii) have completed at least 1,000 hours of an executive in training program provided
by an assisted living director licensed under this subdivision; or
new text end

new text begin (iv) have managed a housing with services establishment operating under assisted living
title protection for at least three years.
new text end

new text begin (c) An assisted living director must receive at least 30 hours of training every two years
on topics relevant to the operation of an assisted living facility and the needs of its residents.
An assisted living director must maintain records of the training required by this paragraph
for at least the most recent three-year period and must provide these records to Department
of Health surveyors upon request. Continuing education earned to maintain another
professional license, such as a nursing home administrator license, nursing license, social
worker license, mental health professional license, or real estate license, may be used to
satisfy this requirement when the continuing education is relevant to the assisted living
services offered and residents served at the assisted living facility.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 10.

Minnesota Statutes 2018, section 144A.21, is amended to read:

144A.21 ADMINISTRATOR LICENSES.

Subdivision 1.

Transferability.

A nursing home administrator's license shall not be
transferable. new text begin An assisted living director's license shall not be transferable.
new text end

Subd. 2.

Rules; renewal.

The Board of deleted text begin Examiners deleted text end new text begin Executives new text end by rule shall establish
forms and procedures for the processing of license renewals. A nursing home administrator's
license new text begin or an assisted living director's license new text end may be renewed only in accordance with the
standards adopted by the Board of deleted text begin Examiners deleted text end new text begin Executives new text end pursuant to section 144A.24.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 11.

Minnesota Statutes 2018, section 144A.23, is amended to read:

144A.23 JURISDICTION OF BOARD.

Except as provided in section 144A.04, subdivision 5, the Board of deleted text begin examiners deleted text end new text begin Executives new text end
shall have exclusive authority to determine the qualifications, skill and fitness required of
any person to serve as an administrator of a nursing home new text begin or an assisted living director of
an assisted living facility new text end . The holder of a license shall be deemed fully qualified to serve
as the administrator of a nursing home new text begin or director of an assisted living facility under chapter
144I new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 12.

Minnesota Statutes 2018, section 144A.24, is amended to read:

144A.24 DUTIES OF THE BOARD.

The Board of deleted text begin Examiners deleted text end new text begin Executives new text end shall:

(1) develop and enforce standards for new text begin licensing of new text end nursing home deleted text begin administrator licensing,
which deleted text end new text begin administrators and assisted living directors. The new text end standards shall be designed to assure
that nursing home administrators new text begin and assisted living directors new text end will be individuals of good
character who, by training or experience, are suitably qualified to serve as nursing home
administrators new text begin or assisted living directors new text end ;

(2) develop appropriate techniques, including examinations and investigations, for
determining whether applicants and licensees meet the board's standards;

(3) issue licenses and permits to those individuals who are found to meet the board's
standards;

(4) establish and implement procedures designed to assure that individuals licensed as
nursing home administrators new text begin and assisted living directors new text end will comply with the board's
standards;

(5) receive and investigate complaints and take appropriate action consistent with chapter
214, to revoke or suspend the license or permit of a nursing home administrator or acting
administrator new text begin or an assisted living director or acting director new text end who fails to comply with
sections 144A.18 to 144A.27 or the board's standards;

(6) conduct a continuing study and investigation of nursing homes new text begin and assisted living
facilities new text end , and the administrators of nursing homes new text begin and assisted living directors new text end within the
state, with a view to the improvement of the standards imposed for the licensing of
administrators new text begin and directors new text end and improvement of the procedures and methods used for
enforcement of the board's standards; and

(7) approve or conduct courses of instruction or training designed to prepare individuals
for licensing in accordance with the board's standards. deleted text begin Courses designed to meet license
renewal requirements shall be designed solely to improve professional skills and shall not
include classroom attendance requirements exceeding 50 hours per year. deleted text end The board may
approve courses conducted within or without this state.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 13.

Minnesota Statutes 2018, section 144A.251, is amended to read:

144A.251 MANDATORY PROCEEDINGS.

In addition to its discretionary authority to initiate proceedings under section 144A.24
and chapter 214, the Board of deleted text begin Examiners deleted text end new text begin Executives new text end shall initiate proceedings to suspend
or revoke a nursing home administrator new text begin or assisted living director new text end license or shall refuse to
renew a license if within the preceding two-year period the administrator new text begin or director new text end was
employed at a nursing home new text begin or assisted living facility new text end which during the period of employment
incurred the following number of uncorrected violations, which violations were in the
jurisdiction and control of the administrator new text begin or director new text end and for which a fine was assessed
and allowed to be recovered:

(1) two or more uncorrected violations which created an imminent risk of harm to a
nursing home new text begin or assisted living facility new text end resident; or

(2) ten or more uncorrected violations of any nature.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 14.

Minnesota Statutes 2018, section 144A.2511, is amended to read:

144A.2511 COSTS; PENALTIES.

If the Board of deleted text begin Examiners deleted text end new text begin Executives new text end has initiated proceedings under section 144A.24
or 144A.251 or chapter 214, and upon completion of the proceedings has found that a nursing
home administrator new text begin or assisted living director new text end has violated a provision or provisions of
sections 144A.18 to 144A.27, it may impose a civil penalty not exceeding $10,000 for each
separate violation, with all violations related to a single event or incident considered as one
violation. The amount of the civil penalty shall be fixed so as to deprive the nursing home
administrator new text begin or assisted living director new text end of any economic advantage gained by reason of the
violation charged or to reimburse the board for the cost of the investigation and proceeding.
For purposes of this section, the cost of the investigation and proceeding may include, but
is not limited to, fees paid for services provided by the Office of Administrative Hearings,
legal and investigative services provided by the Office of the Attorney General, court
reporters, witnesses, and reproduction of records.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 15.

Minnesota Statutes 2018, section 144A.26, is amended to read:

144A.26 RECIPROCITY WITH OTHER STATES new text begin AND EQUIVALENCY OF
HEALTH SERVICES EXECUTIVE new text end .

new text begin Subdivision 1. new text end

new text begin Reciprocity. new text end

The Board of deleted text begin Examiners deleted text end new text begin Executives new text end may issue a nursing
home administrator's license, without examination, to any person who holds a current license
as a nursing home administrator from another jurisdiction if the board finds that the standards
for licensure in the other jurisdiction are at least the substantial equivalent of those prevailing
in this state and that the applicant is otherwise qualified.

new text begin Subd. 2. new text end

new text begin Health services executive license. new text end

new text begin The Board of Executives may issue a health
services executive license to any person who (1) has been validated by the National
Association of Long Term Care Administrator Boards as a health services executive, and
(2) has met the education and practice requirements for the minimum qualifications of a
nursing home administrator, assisted living director, and home and community-based service
provider. Licensure decisions made by the board under this subdivision are final.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 16.

Minnesota Statutes 2018, section 144A.44, subdivision 1, is amended to read:

Subdivision 1.

Statement of rights.

new text begin (a) new text end A deleted text begin person deleted text end new text begin client new text end who receives home care services
new text begin in the community or in an assisted living facility licensed under chapter 144I new text end has these
rights:

(1) deleted text begin the right to deleted text end receive written information new text begin , in plain language, new text end about rights before
receiving services, including what to do if rights are violated;

(2) deleted text begin the right to deleted text end receive care and services according to a suitable and up-to-date plan, and
subject to accepted health care, medical or nursing standards new text begin and person-centered care new text end , to
take an active part in developing, modifying, and evaluating the plan and services;

(3) deleted text begin the right to deleted text end be told before receiving services the type and disciplines of staff who
will be providing the services, the frequency of visits proposed to be furnished, other choices
that are available for addressing home care needs, and the potential consequences of refusing
these services;

(4) deleted text begin the right to deleted text end be told in advance of any recommended changes by the provider in the
service plan and to take an active part in any decisions about changes to the service plan;

(5) deleted text begin the right to deleted text end refuse services or treatment;

(6) deleted text begin the right to deleted text end know, before receiving services or during the initial visit, any limits to
the services available from a home care provider;

(7) deleted text begin the right to deleted text end be told before services are initiated what the provider charges for the
services; to what extent payment may be expected from health insurance, public programs,
or other sources, if known; and what charges the client may be responsible for paying;

(8) deleted text begin the right to deleted text end know that there may be other services available in the community,
including other home care services and providers, and to know where to find information
about these services;

(9) deleted text begin the right to deleted text end choose freely among available providers and to change providers after
services have begun, within the limits of health insurance, long-term care insurance, medical
assistance, deleted text begin or deleted text end other health programs new text begin , or public programs new text end ;

(10) deleted text begin the right to deleted text end have personal, financial, and medical information kept private, and to
be advised of the provider's policies and procedures regarding disclosure of such information;

(11) deleted text begin the right to deleted text end access the client's own records and written information from those
records in accordance with sections 144.291 to 144.298;

(12) deleted text begin the right to deleted text end be served by people who are properly trained and competent to perform
their duties;

(13) deleted text begin the right to deleted text end be treated with courtesy and respect, and to have the client's property
treated with respect;

(14) deleted text begin the right to deleted text end be free from physical and verbal abuse, neglect, financial exploitation,
and all forms of maltreatment covered under the Vulnerable Adults Act and the Maltreatment
of Minors Act;

(15) deleted text begin the right to deleted text end reasonable, advance notice of changes in services or charges;

(16) deleted text begin the right to deleted text end know the provider's reason for termination of services;

(17) deleted text begin the right to deleted text end at least ten new text begin calendar new text end days' advance notice of the termination of a service
by a new text begin home care new text end provider, except new text begin at least 30 calendar days' advance notice of the service
termination shall be given by a home care provider for services provided to a client residing
in an assisted living facility as defined in section 144I.01, subdivision 7. This clause does
not apply new text end in cases where:

(i) the client engages in conduct that significantly alters the terms of the service plan
with the home care provider;

(ii) the client, person who lives with the client, or others create an abusive or unsafe
work environment for the person providing home care services; or

(iii) an emergency or a significant change in the client's condition has resulted in service
needs that exceed the current service plan and that cannot be safely met by the home care
provider;

(18) deleted text begin the right to deleted text end a coordinated transfer when there will be a change in the provider of
services;

(19) deleted text begin the right to deleted text end complain new text begin to staff and others of the client's choice new text end about services that
are provided, or fail to be provided, and the lack of courtesy or respect to the client or the
client's property new text begin and the right to recommend changes in policies and services, free from
retaliation including the threat of termination of services new text end ;

(20) deleted text begin the right to deleted text end know how to contact an individual associated with the home care provider
who is responsible for handling problems and to have the home care provider investigate
and attempt to resolve the grievance or complaint;

(21) deleted text begin the right to deleted text end know the name and address of the state or county agency to contact for
additional information or assistance; deleted text begin and
deleted text end

(22) deleted text begin the right to deleted text end assert these rights personally, or have them asserted by the client's
representative or by anyone on behalf of the client, without retaliation deleted text begin . deleted text end new text begin ; and
new text end

new text begin (23) place an electronic monitoring device in the client's or resident's space in compliance
with state requirements.
new text end

new text begin (b) When providers violate the rights in this section, they are subject to the fines and
license actions in sections 144A.474, subdivision 11, and 144A.475.
new text end

new text begin (c) Providers must do all of the following:
new text end

new text begin (1) encourage and assist in the fullest possible exercise of these rights;
new text end

new text begin (2) provide the names and telephone numbers of individuals and organizations that
provide advocacy and legal services for clients and residents seeking to assert their rights;
new text end

new text begin (3) make every effort to assist clients or residents in obtaining information regarding
whether Medicare, medical assistance, other health programs, or public programs will pay
for services;
new text end

new text begin (4) make reasonable accommodations for people who have communication disabilities,
or those who speak a language other than English; and
new text end

new text begin (5) provide all information and notices in plain language and in terms the client or
resident can understand.
new text end

new text begin (d) No provider may require or request a client or resident to waive any of the rights
listed in this section at any time or for any reasons, including as a condition of initiating
services or entering into an assisted living contract.
new text end

Sec. 17.

Minnesota Statutes 2018, section 144A.471, subdivision 7, is amended to read:

Subd. 7.

Comprehensive home care license provider.

Home care services that may
be provided with a comprehensive home care license include any of the basic home care
services listed in subdivision 6, and one or more of the following:

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

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

(3) medication management services;

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

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

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

deleted text begin (6) deleted text end new text begin (7) new text end providing other complex or specialty health care services.

Sec. 18.

Minnesota Statutes 2018, section 144A.471, subdivision 9, is amended to read:

Subd. 9.

Exclusions from home care licensure.

The following are excluded from home
care licensure and are not required to provide the home care bill of rights:

(1) an individual or business entity providing only coordination of home care that includes
one or more of the following:

(i) determination of whether a client needs home care services, or assisting a client in
determining what services are needed;

(ii) referral of clients to a home care provider;

(iii) administration of payments for home care services; or

(iv) administration of a health care home established under section 256B.0751;

(2) an individual who is not an employee of a licensed home care provider if the
individual:

(i) only provides services as an independent contractor to one or more licensed home
care providers;

(ii) provides no services under direct agreements or contracts with clients; and

(iii) is contractually bound to perform services in compliance with the contracting home
care provider's policies and service plans;

(3) a business that provides staff to home care providers, such as a temporary employment
agency, if the business:

(i) only provides staff under contract to licensed or exempt providers;

(ii) provides no services under direct agreements with clients; and

(iii) is contractually bound to perform services under the contracting home care provider's
direction and supervision;

(4) any home care services conducted by and for the adherents of any recognized church
or religious denomination for its members through spiritual means, or by prayer for healing;

(5) an individual who only provides home care services to a relative;

(6) an individual not connected with a home care provider that provides assistance with
basic home care needs if the assistance is provided primarily as a contribution and not as a
business;

(7) an individual not connected with a home care provider that shares housing with and
provides primarily housekeeping or homemaking services to an elderly or disabled person
in return for free or reduced-cost housing;

(8) an individual or provider providing home-delivered meal services;

(9) an individual providing senior companion services and other older American volunteer
programs (OAVP) established under the Domestic Volunteer Service Act of 1973, United
States Code, title 42, chapter 66;

deleted text begin (10) an employee of a nursing home or home care provider licensed under this chapter
or an employee of a boarding care home licensed under sections 144.50 to 144.56 when
responding to occasional emergency calls from individuals residing in a residential setting
that is attached to or located on property contiguous to the nursing home, boarding care
home, or location where home care services are also provided;
deleted text end

deleted text begin (11) an employee of a nursing home or home care provider licensed under this chapter
or an employee of a boarding care home licensed under sections 144.50 to 144.56 when
providing occasional minor services free of charge to individuals residing in a residential
setting that is attached to or located on property contiguous to the nursing home, boarding
care home, or location where home care services are also provided;
deleted text end

(12) a member of a professional corporation organized under chapter 319B that does
not regularly offer or provide home care services as defined in section 144A.43, subdivision
3;

(13) the following organizations established to provide medical or surgical services that
do not regularly offer or provide home care services as defined in section 144A.43,
subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit
corporation organized under chapter 317A, a partnership organized under chapter 323, or
any other entity determined by the commissioner;

(14) an individual or agency that provides medical supplies or durable medical equipment,
except when the provision of supplies or equipment is accompanied by a home care service;

(15) a physician licensed under chapter 147;

(16) an individual who provides home care services to a person with a developmental
disability who lives in a place of residence with a family, foster family, or primary caregiver;

(17) a business that only provides services that are primarily instructional and not medical
services or health-related support services;

(18) an individual who performs basic home care services for no more than 14 hours
each calendar week to no more than one client;

(19) an individual or business licensed as hospice as defined in sections 144A.75 to
144A.755 who is not providing home care services independent of hospice service;

(20) activities conducted by the commissioner of health or a community health board
as defined in section 145A.02, subdivision 5, including communicable disease investigations
or testing; or

(21) administering or monitoring a prescribed therapy necessary to control or prevent a
communicable disease, or the monitoring of an individual's compliance with a health directive
as defined in section 144.4172, subdivision 6.

new text begin EFFECTIVE DATE. new text end

new text begin The amendments to clauses (10) and (11) are effective July 1,
2021.
new text end

Sec. 19.

Minnesota Statutes 2018, section 144A.472, subdivision 7, is amended to read:

Subd. 7.

Fees; application, change of ownership, deleted text begin and deleted text end renewal new text begin , and failure to
notify new text end .

(a) An initial applicant seeking temporary home care licensure must submit the
following application fee to the commissioner along with a completed application:

(1) for a basic home care provider, $2,100; or

(2) for a comprehensive home care provider, $4,200.

(b) A home care provider who is filing a change of ownership as required under
subdivision 5 must submit the following application fee to the commissioner, along with
the documentation required for the change of ownership:

(1) for a basic home care provider, $2,100; or

(2) for a comprehensive home care provider, $4,200.

(c) For the period ending June 30, 2018, a home care provider who is seeking to renew
the provider's license shall pay a fee to the commissioner based on revenues derived from
the provision of home care services during the calendar year prior to the year in which the
application is submitted, according to the following schedule:

License Renewal Fee

Provider Annual Revenue	Fee
greater than $1,500,000	$6,625
greater than $1,275,000 and no more than $1,500,000	$5,797
greater than $1,100,000 and no more than $1,275,000	$4,969
greater than $950,000 and no more than $1,100,000	$4,141
greater than $850,000 and no more than $950,000	$3,727
greater than $750,000 and no more than $850,000	$3,313
greater than $650,000 and no more than $750,000	$2,898
greater than $550,000 and no more than $650,000	$2,485
greater than $450,000 and no more than $550,000	$2,070
greater than $350,000 and no more than $450,000	$1,656
greater than $250,000 and no more than $350,000	$1,242
greater than $100,000 and no more than $250,000	$828
greater than $50,000 and no more than $100,000	$500
greater than $25,000 and no more than $50,000	$400
no more than $25,000	$200

(d) For the period between July 1, 2018, and June 30, 2020, a home care provider who
is seeking to renew the provider's license shall pay a fee to the commissioner in an amount
that is ten percent higher than the applicable fee in paragraph (c). A home care provider's
fee shall be based on revenues derived from the provision of home care services during the
calendar year prior to the year in which the application is submitted.

(e) Beginning July 1, 2020, a home care provider who is seeking to renew the provider's
license shall pay a fee to the commissioner based on revenues derived from the provision
of home care services during the calendar year prior to the year in which the application is
submitted, according to the following schedule:

License Renewal Fee

Provider Annual Revenue	Fee
greater than $1,500,000	$7,651
greater than $1,275,000 and no more than $1,500,000	$6,695
greater than $1,100,000 and no more than $1,275,000	$5,739
greater than $950,000 and no more than $1,100,000	$4,783
greater than $850,000 and no more than $950,000	$4,304
greater than $750,000 and no more than $850,000	$3,826
greater than $650,000 and no more than $750,000	$3,347
greater than $550,000 and no more than $650,000	$2,870
greater than $450,000 and no more than $550,000	$2,391
greater than $350,000 and no more than $450,000	$1,913
greater than $250,000 and no more than $350,000	$1,434
greater than $100,000 and no more than $250,000	$957
greater than $50,000 and no more than $100,000	$577
greater than $25,000 and no more than $50,000	$462
no more than $25,000	$231

(f) If requested, the home care provider shall provide the commissioner information to
verify the provider's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.

(g) At each annual renewal, a home care provider may elect to pay the highest renewal
fee for its license category, and not provide annual revenue information to the commissioner.

(h) A temporary license or license applicant, or temporary licensee or licensee that
knowingly provides the commissioner incorrect revenue amounts for the purpose of paying
a lower license fee, shall be subject to a civil penalty in the amount of double the fee the
provider should have paid.

new text begin (i) The fine for failure to comply with the notification requirements in section 144A.473,
subdivision 2, paragraph (c), is $1,000.
new text end

deleted text begin (i) deleted text end new text begin (j) new text end Fees deleted text begin and penalties deleted text end collected under this section shall be deposited in the state
treasury and credited to the state government special revenue fund. All fees are
nonrefundable. Fees collected under paragraphs (c), (d), and (e) are nonrefundable even if
received before July 1, 2017, for temporary licenses or licenses being issued effective July
1, 2017, or later.

new text begin (k) Fines and civil penalties collected under this subdivision shall be deposited in a
dedicated special revenue account. On an annual basis, the balance in the special revenue
account shall be appropriated to the commissioner to implement the recommendations of
the advisory council established in section 144A.4799.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 20.

Minnesota Statutes 2018, section 144A.474, subdivision 9, is amended to read:

Subd. 9.

Follow-up surveys.

For providers that have Level 3 or Level 4 violations under
subdivision 11, or any violations determined to be widespread, the department shall conduct
a follow-up survey within 90 calendar days of the survey. When conducting a follow-up
survey, the surveyor will focus on whether the previous violations have been corrected and
may also address any new violations that are observed while evaluating the corrections that
have been made. deleted text begin If a new violation is identified on a follow-up survey, no fine will be
imposed unless it is not corrected on the next follow-up survey.
deleted text end

Sec. 21.

Minnesota Statutes 2018, section 144A.474, subdivision 11, is amended to read:

Subd. 11.

Fines.

(a) Fines and enforcement actions under this subdivision may be assessed
based on the level and scope of the violations described in paragraph deleted text begin (c) deleted text end new text begin (b) and imposed
immediately with no opportunity to correct the violation first new text end as follows:

(1) Level 1, no fines or enforcement;

(2) Level 2, deleted text begin fines ranging from $0 to deleted text end new text begin a fine of new text end $500 new text begin per violation new text end , in addition to any of
the enforcement mechanisms authorized in section 144A.475 for widespread violations;

(3) Level 3, deleted text begin fines ranging from $500 to $1,000 deleted text end new text begin a fine of $3,000 per incident new text end , in addition
to any of the enforcement mechanisms authorized in section 144A.475; deleted text begin and
deleted text end

(4) Level 4, deleted text begin fines ranging from $1,000 to deleted text end new text begin a fine of new text end $5,000 new text begin per incident new text end , in addition to
any of the enforcement mechanisms authorized in section 144A.475 deleted text begin . deleted text end new text begin ;
new text end

new text begin (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
new text end

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

new text begin 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.
new text end

(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 deleted text begin required to be
licensed under sections 144A.43 to 144A.482 deleted text end has not corrected violations by the date
specified in the correction order or conditional license resulting from a survey or complaint
investigation, the commissioner deleted text begin may impose a fine. A deleted text end new text begin shall provide a new text end notice of
noncompliance with a correction order deleted text begin must be mailed deleted text end new text begin by e-mail new text end to the applicant's or
provider's last known new text begin e-mail new text end address. The noncompliance notice must list the violations not
corrected.

new text begin (d) For every violation identified by the commissioner, the commissioner shall 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.
new text end

deleted text begin (d) deleted text end new text begin (e) new text end 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.

deleted text begin (e) deleted text end new text begin (f) new text end 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.

deleted text begin (f) deleted text end new text begin (g) new text end 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.

deleted text begin (g) deleted text end new text begin (h) new text end 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.

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

deleted text begin (i) deleted text end new text begin (j) new text end Fines collected under deleted text begin this subdivision deleted text end new text begin paragraph (a), clauses (1) to (4) new text end shall be
deposited in deleted text begin the state government deleted text end new text begin a dedicated new text end special revenue deleted text begin fund and credited to an account
separate from the revenue collected under section 144A.472. Subject to an appropriation
by the legislature, the revenue from the fines collected must be used by the commissioner
for special projects to improve home care in Minnesota as recommended by deleted text end new text begin account. On
an annual basis, the balance in the special revenue account shall be appropriated to the
commissioner to implement the recommendations of new text end the advisory council established in
section 144A.4799.

new text begin (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 end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2019.
new text end

Sec. 22.

Minnesota Statutes 2018, section 144A.474, is amended by adding a subdivision
to read:

new text begin Subd. 14. new text end

new text begin Maltreatment compensation fund. new text end

new text begin (a) Once a finding of maltreatment for
which the licensee is determined to be responsible is substantiated and any request for
reconsideration, if applicable, is completed, the commissioner shall pay the fine assessed
under subdivision 11, paragraph (a), clause (5), as compensation to the client who was
subject to the maltreatment, if:
new text end

new text begin (1) the client chooses to receive a compensation payment of either $1,000 or $5,000 as
determined by the fine assessed under subdivision 11, paragraph (a), clause (5), depending
on the level of maltreatment; and
new text end

new text begin (2) the client accepts payment of compensation under this subdivision as payment in
full and agrees to waive any civil claims, including claims under section 626.557, subdivision
20, arising from the specific maltreatment incident that resulted in the fine.
new text end

new text begin (b) The commissioner shall notify the client that the client may reject a compensation
payment under this subdivision and instead pursue any civil claims.
new text end

new text begin (c) Except as provided in paragraph (a), Nothing in this subdivision affects the rights
available to clients under section 626.557 or prevents a client from filing a maltreatment
report in the future.
new text end

new text begin (d) This subdivision expires July 31, 2021.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2019.
new text end

Sec. 23.

Minnesota Statutes 2018, section 144A.475, subdivision 3b, is amended to read:

Subd. 3b.

Expedited hearing.

(a) Within five business days of receipt of the license
holder's timely appeal of a temporary suspension or issuance of a conditional license, the
commissioner shall request assignment of an administrative law judge. The request must
include a proposed date, time, and place of a hearing. A hearing must be conducted by an
administrative law judge new text begin pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, new text end within
30 calendar days of the request for assignment, unless an extension is requested by either
party and granted by the administrative law judge for good cause. The commissioner shall
issue a notice of hearing by certified mail or personal service at least ten business days
before the hearing. Certified mail to the last known address is sufficient. The scope of the
hearing shall be limited solely to the issue of whether the temporary suspension or issuance
of a conditional license should remain in effect and whether there is sufficient evidence to
conclude that the licensee's actions or failure to comply with applicable laws are level 3 or
4 violations as defined in section 144A.474, subdivision 11, paragraph (b), or that there
were violations that posed an imminent risk of harm to the health and safety of persons in
the provider's care.

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

(c) When the final order under paragraph (b) affirms an immediate suspension, and a
final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that
sanction, the licensee is prohibited from operation pending a final commissioner's order
after the contested case hearing conducted under chapter 14.

(d) A licensee whose license is temporarily suspended must comply with the requirements
for notification and transfer of clients in subdivision 5. These requirements remain if an
appeal is requested.

Sec. 24.

Minnesota Statutes 2018, section 144A.475, subdivision 5, is amended to read:

Subd. 5.

Plan required.

(a) The process of suspending deleted text begin or deleted text end new text begin , new text end revoking new text begin , or refusing to renew new text end
a license must include a plan for transferring affected deleted text begin clients deleted text end new text begin clients' care new text end to other providers
by the home care provider, which will be monitored by the commissioner. Within three
deleted text begin business deleted text end new text begin calendar new text end days of being notified of the deleted text begin final deleted text end revocation new text begin , refusal to renew, new text end or
suspension deleted text begin action deleted text end , the home care provider shall provide the commissioner, the lead agencies
as defined in section 256B.0911, new text begin county adult protection and case managers, new text end and the
ombudsman for long-term care with the following information:

(1) a list of all clients, including full names and all contact information on file;

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

(3) the location or current residence of each client;

(4) the payor sources for each client, including payor source identification numbers; and

(5) for each client, a copy of the client's service plan, and a list of the types of services
being provided.

(b) The revocation new text begin , refusal to renew, new text end or suspension notification requirement is satisfied
by mailing the notice to the address in the license record. The home care provider shall
cooperate with the commissioner and the lead agencies new text begin , county adult protection and county
managers, and the ombudsman for long term care new text end during the process of transferring care of
clients to qualified providers. Within three deleted text begin business deleted text end new text begin calendar new text end days of being notified of the
final revocation new text begin , refusal to renew, new text end or suspension action, the home care provider must notify
and disclose to each of the home care provider's clients, or the client's representative or
emergency contact persons, that the commissioner is taking action against the home care
provider's license by providing a copy of the revocation new text begin , refusal to renew, new text end or suspension
notice issued by the commissioner. new text begin If the provider does not comply with the disclosure
requirements in this section, the commissioner shall notify the clients, client representatives,
or emergency contact persons, about the action being taken. Lead agencies, county adult
protection and county managers, and the Office of Ombudsman for Long-Term Care may
also provide this information. The revocation, refusal to renew, or suspension notice is
public data except for any private data contained therein.
new text end

new text begin (c) A home care provider subject to this subdivision may continue operating during the
period of time home care clients are being transferred to other providers.
new text end

Sec. 25.

Minnesota Statutes 2018, section 144A.476, subdivision 1, is amended to read:

Subdivision 1.

Prior criminal convictions; owner and managerial officials.

(a) Before
the commissioner issues a temporary license new text begin , issues a license as a result of an approved
change in ownership, new text end or renews a license, an owner or managerial official is required to
complete a background study under section 144.057. No person may be involved in the
management, operation, or control of a home care provider if the person has been disqualified
under chapter 245C. If an individual is disqualified under section 144.057 or chapter 245C,
the individual may request reconsideration of the disqualification. If the individual requests
reconsideration and the commissioner sets aside or rescinds the disqualification, the individual
is eligible to be involved in the management, operation, or control of the provider. If an
individual has a disqualification under section 245C.15, subdivision 1, and the disqualification
is affirmed, the individual's disqualification is barred from a set aside, and the individual
must not be involved in the management, operation, or control of the provider.

(b) For purposes of this section, owners of a home care provider subject to the background
check requirement are those individuals whose ownership interest provides sufficient
authority or control to affect or change decisions related to the operation of the home care
provider. An owner includes a sole proprietor, a general partner, or any other individual
whose individual ownership interest can affect the management and direction of the policies
of the home care provider.

(c) For the purposes of this section, managerial officials subject to the background check
requirement are individuals who provide direct contact as defined in section 245C.02,
subdivision 11, or individuals who have the responsibility for the ongoing management or
direction of the policies, services, or employees of the home care provider. Data collected
under this subdivision shall be classified as private data on individuals under section 13.02,
subdivision 12.

(d) The department shall not issue any license if the applicant or owner or managerial
official has been unsuccessful in having a background study disqualification set aside under
section 144.057 and chapter 245C; if the owner or managerial official, as an owner or
managerial official of another home care provider, was substantially responsible for the
other home care provider's failure to substantially comply with sections 144A.43 to
144A.482; or if an owner that has ceased doing business, either individually or as an owner
of a home care provider, was issued a correction order for failing to assist clients in violation
of this chapter.

Sec. 26.

Minnesota Statutes 2018, section 144A.4799, is amended to read:

144A.4799 DEPARTMENT OF HEALTH LICENSED HOME CARE PROVIDER
ADVISORY COUNCIL.

Subdivision 1.

Membership.

The commissioner of health shall appoint eight persons
to a home care and assisted living program advisory council consisting of the following:

(1) three public members as defined in section 214.02 who shall be deleted text begin either deleted text end persons who
are currently receiving home care services deleted text begin or deleted text end new text begin , persons who have received home care services
within five years of the application date, persons who new text end have family members receiving home
care services, or persons who have family members who have received home care services
within five years of the application date;

(2) three Minnesota home care licensees representing basic and comprehensive levels
of licensure who may be a managerial official, an administrator, a supervising registered
nurse, or an unlicensed personnel performing home care tasks;

(3) one member representing the Minnesota Board of Nursing; deleted text begin and
deleted text end

(4) one member representing the new text begin office of new text end ombudsman for long-term care deleted text begin . deleted text end new text begin ; and
new text end

new text begin (5) beginning July 1, 2021, one member of a county health and human services or county
adult protection office.
new text end

Subd. 2.

Organizations and meetings.

The advisory council shall be organized and
administered under section 15.059 with per diems and costs paid within the limits of available
appropriations. Meetings will be held quarterly and hosted by the department. Subcommittees
may be developed as necessary by the commissioner. Advisory council meetings are subject
to the Open Meeting Law under chapter 13D.

Subd. 3.

Duties.

(a) At the commissioner's request, the advisory council shall provide
advice regarding regulations of Department of Health licensed home care providers in this
chapter, including advice on the following:

(1) community standards for home care practices;

(2) enforcement of licensing standards and whether certain disciplinary actions are
appropriate;

(3) ways of distributing information to licensees and consumers of home care;

(4) training standards;

(5) identifying emerging issues and opportunities in deleted text begin the deleted text end home care deleted text begin field, including deleted text end new text begin ;
new text end

new text begin (6) new text end new text begin identifying new text end the use of technology in home and telehealth capabilities;

deleted text begin (6) deleted text end new text begin (7) new text end allowable home care licensing modifications and exemptions, including a method
for an integrated license with an existing license for rural licensed nursing homes to provide
limited home care services in an adjacent independent living apartment building owned by
the licensed nursing home; and

deleted text begin (7) deleted text end new text begin (8) new text end recommendations for studies using the data in section 62U.04, subdivision 4,
including but not limited to studies concerning costs related to dementia and chronic disease
among an elderly population over 60 and additional long-term care costs, as described in
section 62U.10, subdivision 6.

(b) The advisory council shall perform other duties as directed by the commissioner.

(c) The advisory council shall annually deleted text begin review the balance of the account in the state
government special revenue fund described in section 144A.474, subdivision 11, paragraph
(i), and deleted text end make deleted text begin annual deleted text end recommendations deleted text begin by January 15 directly to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services regarding appropriations deleted text end to the commissioner for the purposes in section 144A.474,
subdivision 11, paragraph (i). new text begin The recommendations shall address ways the commissioner
may improve protection of the public under existing statutes and laws and include but are
not limited to projects that create and administer training of licensees and their employees
to improve residents lives, supporting ways that licensees can improve and enhance quality
care, ways to provide technical assistance to licensees to improve compliance; information
technology and data projects that analyze and communicate information about trends of
violations or lead to ways of improving client care; communications strategies to licensees
and the public; and other projects or pilots that benefit clients, families, and the public.
new text end

Sec. 27.

Minnesota Statutes 2018, section 256.9741, subdivision 1, is amended to read:

Subdivision 1.

Long-term care facility.

"Long-term care facility" means a nursing home
licensed under sections 144A.02 to 144A.10; a boarding care home licensed under sections
144.50 to 144.56; new text begin an assisted living facility or an assisted living facility with dementia care
licensed under chapter 144I; new text end or a licensed or registered residential setting that provides or
arranges for the provision of home care services.

Sec. 28.

Minnesota Statutes 2018, section 256I.03, subdivision 15, is amended to read:

Subd. 15.

Supportive housing.

"Supportive housing" means housing deleted text begin with support
services according to the continuum of care coordinated assessment system established
under Code of Federal Regulations, title 24, section 578.3 deleted text end new text begin that is not time-limited and
provides or coordinates services necessary for a resident to maintain housing stability new text end .

Sec. 29.

Minnesota Statutes 2018, section 256I.04, subdivision 2a, is amended to read:

Subd. 2a.

License required; staffing qualifications.

(a) Except as provided in paragraph
(b), an agency may not enter into an agreement with an establishment to provide housing
support unless:

(1) the establishment is licensed by the Department of Health as a hotel and restaurant;
a board and lodging establishment; a boarding care home before March 1, 1985; or a
supervised living facility, and the service provider for residents of the facility is licensed
under chapter 245A. However, an establishment licensed by the Department of Health to
provide lodging need not also be licensed to provide board if meals are being supplied to
residents under a contract with a food vendor who is licensed by the Department of Health;

(2) the residence is: (i) licensed by the commissioner of human services under Minnesota
Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior
to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265;
(iii) licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120,
with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02,
subdivision 4a, as a community residential setting by the commissioner of human services;
or

(3) the deleted text begin establishment deleted text end new text begin facility new text end is registered under chapter 144D new text begin or licensed under chapter
144I new text end and provides three meals a day.

(b) The requirements under paragraph (a) do not apply to establishments exempt from
state licensure because they are:

(1) located on Indian reservations and subject to tribal health and safety requirements;
or

(2) deleted text begin a supportive housing establishment that has an approved habitability inspection and
an individual lease agreement and that serves people who have experienced long-term
homelessness and were referred through a coordinated assessment in section 256I.03,
subdivision 15 deleted text end new text begin supportive housing establishments where an individual has an approved
habitability inspection and an individual lease agreement new text end .

(c) Supportive housing establishments new text begin that serve individuals who have experienced
long-term homelessness new text end and emergency shelters must participate in the homeless management
information system new text begin and a coordinated assessment system as defined by the commissioner new text end .

(d) Effective July 1, 2016, an agency shall not have an agreement with a provider of
housing support unless all staff members who have direct contact with recipients:

(1) have skills and knowledge acquired through one or more of the following:

(i) a course of study in a health- or human services-related field leading to a bachelor
of arts, bachelor of science, or associate's degree;

(ii) one year of experience with the target population served;

(iii) experience as a mental health certified peer specialist according to section 256B.0615;
or

(iv) meeting the requirements for unlicensed personnel under sections 144A.43 to
144A.483;

(2) hold a current driver's license appropriate to the vehicle driven if transporting
recipients;

(3) complete training on vulnerable adults mandated reporting and child maltreatment
mandated reporting, where applicable; and

(4) complete housing support orientation training offered by the commissioner.

Sec. 30.

new text begin [256M.42] ADULT PROTECTION GRANT ALLOCATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Formula. new text end

new text begin (a) The commissioner shall allocate state money appropriated
under this section to each county board and tribal government approved by the commissioner
to assume county agency duties for adult protective services or as a lead investigative agency
under section 626.557 on an annual basis in an amount determined according to the following
formula:
new text end

new text begin (1) 25 percent must be allocated on the basis of the number of reports of suspected
vulnerable adult maltreatment under sections 626.557 and 626.5572, when the county or
tribe is responsible as determined by the most recent data of the commissioner; and
new text end

new text begin (2) 75 percent must be allocated on the basis of the number of screened-in reports for
adult protective services or vulnerable adult maltreatment investigations under sections
626.557 and 626.5572, when the county or tribe is responsible as determined by the most
recent data of the commissioner.
new text end

new text begin (b) The commissioner is precluded from changing the formula under this subdivision
or recommending a change to the legislature without public review and input.
new text end

new text begin Subd. 2. new text end

new text begin Payment. new text end

new text begin The commissioner shall make allocations for the state fiscal year
starting July 1, 2019, and to each county board or tribal government on or before October
10, 2019. The commissioner shall make allocations under subdivision 1 to each county
board or tribal government each year thereafter on or before July 10.
new text end

new text begin Subd. 3. new text end

new text begin Prohibition on supplanting existing money. new text end

new text begin Money received under this section
must be used for staffing for protection of vulnerable adults or to expand adult protective
services. Money must not be used to supplant current county or tribe expenditures for these
purposes.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2019.
new text end

Sec. 31.

Minnesota Statutes 2018, section 325F.72, subdivision 1, is amended to read:

Subdivision 1.

Persons to whom disclosure is required.

deleted text begin Housing with services
establishments, as defined in sections 144D.01 to 144D.07, that secure, segregate, or provide
a special program or special unit for residents with a diagnosis of probable Alzheimer's
disease or a related disorder or that advertise, market, or otherwise promote the establishment
as providing specialized care for Alzheimer's disease or a related disorder are considered a
"special care unit." All special care units deleted text end new text begin Only assisted living facilities with dementia care
licenses under chapter 144I may advertise, market, or otherwise promote the facility as
providing specialized care for dementia or related disorders. All assisted living facilities
with dementia care licenses new text end shall provide a written disclosure to the following:

(1) the commissioner of health, if requested;

(2) the Office of Ombudsman for Long-Term Care; and

(3) each person seeking placement within a residence, or the person's deleted text begin authorized
representative deleted text end new text begin legal and designated representatives, as those terms are defined in section
144I.01 new text end , before an agreement to provide the care is entered into.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 32.

Minnesota Statutes 2018, section 325F.72, subdivision 2, is amended to read:

Subd. 2.

Content.

Written disclosure shall include, but is not limited to, the following:

(1) a statement of the overall philosophy and how it reflects the special needs of residents
with Alzheimer's disease or other dementias;

(2) the criteria for determining who may reside in the deleted text begin special care deleted text end new text begin secured dementia care new text end
unit new text begin as defined in section 144I.01, subdivision 62 new text end ;

(3) the process used for assessment and establishment of the service plan deleted text begin or agreement deleted text end ,
including how the plan is responsive to changes in the resident's condition;

(4) staffing credentials, job descriptions, and staff duties and availability, including any
training specific to dementia;

(5) physical environment as well as design and security features that specifically address
the needs of residents with Alzheimer's disease or other dementias;

(6) frequency and type of programs and activities for residents of the deleted text begin special care unit deleted text end new text begin
assisted living facility with dementia care new text end ;

(7) involvement of families in resident care and availability of family support programs;

(8) fee schedules for additional services to the residents of the deleted text begin special deleted text end new text begin secured dementia new text end
care unit; and

(9) a statement that residents will be given a written notice 30 new text begin calendar new text end days prior to
changes in the fee schedule.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 33.

Minnesota Statutes 2018, section 626.5572, subdivision 6, is amended to read:

Subd. 6.

Facility.

(a) "Facility" means a hospital or other entity required to be licensed
under sections 144.50 to 144.58; a nursing home required to be licensed to serve adults
under section 144A.02; a facility or service required to be licensed under chapter 245A; new text begin an
assisted living facility required to be licensed under chapter 144I; new text end a home care provider
licensed or required to be licensed under sections 144A.43 to 144A.482; a hospice provider
licensed under sections 144A.75 to 144A.755; or a person or organization that offers,
provides, or arranges for personal care assistance services under the medical assistance
program as authorized under sections 256B.0625, subdivision 19a, 256B.0651 to 256B.0654,
256B.0659, or 256B.85.

(b) For services identified in paragraph (a) that are provided in the vulnerable adult's
own home or in another unlicensed location, the term "facility" refers to the provider, person,
or organization that offers, provides, or arranges for personal care services, and does not
refer to the vulnerable adult's home or other location at which services are rendered.

Sec. 34. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the phrases "Board of Examiners for Nursing Home
Administrators" to "Board of Executives for Long Term Services and Supports" and "Board
of Examiners" to "Board of Executives" wherever the phrases appear in Minnesota Statutes
and apply to the board established in Minnesota Statutes, section 144A.19.
new text end

Sec. 35. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2018, section 144A.472, subdivision 4, new text end new text begin is repealed July 1, 2019.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2018, sections 144A.441; and 144A.442, new text end new text begin are repealed August 1,
2021.
new text end

ARTICLE 5

APPROPRIATIONS

Section 1. new text begin COMMISSIONER OF HUMAN SERVICES.
new text end

new text begin (a) $7,687,000 in fiscal year 2020 and $6,860,000 in fiscal year 2021 are appropriated
from the general fund to the commissioner of human services to implement administrative
and regulatory activities relating to vulnerable adults and assisted living licensure.
new text end

new text begin (b) Of the amount in paragraph (a), $1,456,000 in fiscal year 2020 and $2,023,000 in
fiscal year 2021 are for additional staff and support activities for the ombudsman for
long-term care. The base for this appropriation is $2,512,000 in fiscal year 2022 and
$2,512,000 in fiscal year 2023.
new text end

new text begin (c) Of the amount in paragraph (a), $1,456,000 in fiscal year 2020 and $635,000 in fiscal
year 2021 are for administrative and information technology costs to implement 24/7 capacity
for Minnesota Adult Abuse Reporting Center. The base for this appropriation is $472,000
in fiscal year 2022 and $472,000 in fiscal year 2023.
new text end

new text begin (d) Of the amount in paragraph (a), $1,000,000 in fiscal year 2020 and $1,500,000 in
fiscal year 2021 are for grants for adult abuse maltreatment investigations and adult protective
services to counties and tribes under Minnesota Statutes, section 256M.42. The base for
this appropriation is $2,050,000 in fiscal year 2022 and $2,655,000 in fiscal year 2023.
new text end

new text begin (e) Of the amount in paragraph (a), $2,682,000 in fiscal year 2020 and $2,702,000 in
fiscal year 2021 are for development and administration of a resident experience survey
and family survey for all housing with services establishments and assisted living facilities.
The base for this appropriation is $2,593,000 in fiscal year 2022 and $2,593,000 in fiscal
year 2023. These appropriations are available in either year of the biennium.
new text end

new text begin (f) Of the amount in paragraph (a), $1,093,000 in fiscal year 2020 is for improvements
to the current operations of regulatory activities related to vulnerable adults. The base for
this appropriation is $218,000 in fiscal year 2022 and $218,000 in fiscal year 2023.
new text end

Sec. 2. new text begin COMMISSIONER OF HEALTH.
new text end

new text begin Subdivision 1. new text end

new text begin General fund appropriation. new text end

new text begin (a) $9,656,000 in fiscal year 2020 and
$9,416,000 in fiscal year 2021 are appropriated from the general fund to the commissioner
of health to implement regulatory activities relating to vulnerable adults and assisted living
licensure.
new text end

new text begin (b) Of the amount in paragraph (a), $7,438,000 in fiscal year 2020 and $4,302,000 in
fiscal year 2021 are for improvements to the current regulatory activities, systems, analysis,
reporting, and communications relating to regulation of vulnerable adults. The base for this
appropriation is $5,800,000 in fiscal year 2022 and $5,369,000 in fiscal year 2023.
new text end

new text begin (c) Of the amount in paragraph (a), $2,218,000 in fiscal year 2020 and $5,114,000 in
fiscal year 2021 are to establish assisted living licensure under Minnesota Statutes, section
144I.01. This is a onetime appropriation.
new text end

new text begin Subd. 2. new text end

new text begin State government special revenue fund appropriation. new text end

new text begin $1,103,000 in fiscal
year 2020 and $1,103,000 in fiscal year 2021 are appropriated from the state government
special revenue fund to improve the frequency of home care provider inspections and to
implement assisted living licensure activities under Minnesota Statutes, section 144I.01.
The base for this appropriation is $8,131,000 in fiscal year 2022 and $8,339,000 in fiscal
year 2023.
new text end

new text begin Subd. 3. new text end

new text begin Transfer. new text end

new text begin The commissioner shall transfer fine revenue previously deposited
to the state government special revenue fund under Minnesota Statutes, section 144A.474,
subdivision 11, estimated to be $632,000 to a dedicated special revenue account in the state
treasury established for the purposes of implementing the recommendations of the Home
Care Advisory Council under Minnesota Statutes, section 144A.4799.
new text end

APPENDIX

Repealed Minnesota Statutes: H0090-6

144A.441 ASSISTED LIVING BILL OF RIGHTS ADDENDUM.

Assisted living clients, as defined in section 144G.01, subdivision 3, shall be provided with the home care bill of rights required by section 144A.44, except that the home care bill of rights provided to these clients must include the following provision in place of the provision in section 144A.44, subdivision 1, clause (17):

"(17) the right to reasonable, advance notice of changes in services or charges, including at least 30 days' advance notice of the termination of a service by a provider, except in cases where:

(i) the recipient of services engages in conduct that alters the conditions of employment as specified in the employment contract between the home care provider and the individual providing home care services, or creates an abusive or unsafe work environment for the individual providing home care services;

(ii) an emergency for the informal caregiver or a significant change in the recipient's condition has resulted in service needs that exceed the current service provider agreement and that cannot be safely met by the home care provider; or

(iii) the provider has not received payment for services, for which at least ten days' advance notice of the termination of a service shall be provided."

144A.442 ASSISTED LIVING CLIENTS; SERVICE TERMINATION.

If an arranged home care provider, as defined in section 144D.01, subdivision 2a, who is not also Medicare certified terminates a service agreement or service plan with an assisted living client, as defined in section 144G.01, subdivision 3, the home care provider shall provide the assisted living client and the legal or designated representatives of the client, if any, with a written notice of termination which includes the following information:

(1) the effective date of termination;

(2) the reason for termination;

(3) without extending the termination notice period, an affirmative offer to meet with the assisted living client or client representatives within no more than five business days of the date of the termination notice to discuss the termination;

(4) contact information for a reasonable number of other home care providers in the geographic area of the assisted living client, as required by section 144A.4791, subdivision 10;

(5) a statement that the provider will participate in a coordinated transfer of the care of the client to another provider or caregiver, as required by section 144A.44, subdivision 1, clause (18);

(6) the name and contact information of a representative of the home care provider with whom the client may discuss the notice of termination;

(7) a copy of the home care bill of rights; and

(8) a statement that the notice of termination of home care services by the home care provider does not constitute notice of termination of the housing with services contract with a housing with services establishment.

144A.472 HOME CARE PROVIDER LICENSE; APPLICATION AND RENEWAL.

Subd. 4.

Multiple units.

Multiple units or branches of a licensee must be separately licensed if the commissioner determines that the units cannot adequately share supervision and administration of services from the main office.

144D.01 DEFINITIONS.

Subdivision 1.

Scope.

As used in sections 144D.01 to 144D.06, the following terms have the meanings given them.

Subd. 2.

Adult.

"Adult" means a natural person who has attained the age of 18 years.

Subd. 2a.

Arranged home care provider.

"Arranged home care provider" means a home care provider licensed under chapter 144A that provides services to some or all of the residents of a housing with services establishment and that is either the establishment itself or another entity with which the establishment has an arrangement.

Subd. 3.

Commissioner.

"Commissioner" means the commissioner of health or the commissioner's designee.

Subd. 3a.

Direct-care staff.

"Direct-care staff" means staff and employees who provide home care services listed in section 144A.471, subdivisions 6 and 7.

Subd. 4.

Housing with services establishment or establishment.

(a) "Housing with services establishment" or "establishment" means:

(1) an establishment providing sleeping accommodations to one or more adult residents, at least 80 percent of which are 55 years of age or older, and offering or providing, for a fee, one or more regularly scheduled health-related services or two or more regularly scheduled supportive services, whether offered or provided directly by the establishment or by another entity arranged for by the establishment; or

(2) an establishment that registers under section 144D.025.

(b) Housing with services establishment does not include:

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

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

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

(4) a board and lodging establishment which serves as a shelter for battered women or other similar purpose;

(5) a family adult foster care home licensed by the Department of Human Services;

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

(7) residential settings for persons with developmental disabilities in which the services are licensed under chapter 245D;

(8) a home-sharing arrangement such as when an elderly or disabled person or single-parent family makes lodging in a private residence available to another person in exchange for services or rent, or both;

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

(10) services for persons with developmental disabilities that are provided under a license under chapter 245D; or

(11) a temporary family health care dwelling as defined in sections 394.307 and 462.3593.

Subd. 5.

Supportive services.

"Supportive services" means help with personal laundry, handling or assisting with personal funds of residents, or arranging for medical services, health-related services, social services, or transportation to medical or social services appointments. Arranging for services does not include making referrals, assisting a resident in contacting a service provider of the resident's choice, or contacting a service provider in an emergency.

Subd. 6.

Health-related services.

"Health-related services" include professional nursing services, home health aide tasks, or the central storage of medication for residents.

Subd. 7.

Family adult foster care home.

"Family adult foster care home" means an adult foster care home that is licensed by the Department of Human Services, that is the primary residence of the license holder, and in which the license holder is the primary caregiver.

144D.015 DEFINITION FOR PURPOSES OF LONG-TERM CARE INSURANCE.

For purposes of consistency with terminology commonly used in long-term care insurance policies and notwithstanding chapter 144G, a housing with services establishment that is registered under section 144D.03 and that holds, or makes arrangements with an individual or entity that holds any type of home care license and all other licenses, permits, registrations, or other governmental approvals legally required for delivery of the services the establishment offers or provides to its residents, constitutes an "assisted living facility" or "assisted living residence."

144D.02 REGISTRATION REQUIRED.

No entity may establish, operate, conduct, or maintain a housing with services establishment in this state without registering and operating as required in sections 144D.01 to 144D.06.

144D.025 OPTIONAL REGISTRATION.

An establishment that meets all the requirements of this chapter except that fewer than 80 percent of the adult residents are age 55 or older, or a supportive housing establishment developed and funded in whole or in part with funds provided specifically as part of the plan to end long-term homelessness required under Laws 2003, chapter 128, article 15, section 9, may, at its option, register as a housing with services establishment.

144D.03 REGISTRATION.

Subdivision 1.

Registration procedures.

The commissioner shall establish forms and procedures for annual registration of housing with services establishments. The commissioner shall charge an annual registration fee of $155. No fee shall be refunded. A registered establishment shall notify the commissioner within 30 days of the date it is no longer required to be registered under this chapter or of any change in the business name or address of the establishment, the name or mailing address of the owner or owners, or the name or mailing address of the managing agent. There shall be no fee for submission of the notice.

Subd. 1a.

Surcharge for injunctive relief actions.

The commissioner shall assess each housing with services establishment that offers or provides assisted living under chapter 144G a surcharge on the annual registration fee paid under subdivision 1, to pay for the commissioner's costs related to bringing actions for injunctive relief under section 144G.02, subdivision 2, paragraph (b), on or after July 1, 2007. The commissioner shall assess surcharges using a sliding scale under which the surcharge amount increases with the client capacity of an establishment. The commissioner shall adjust the surcharge as necessary to recover the projected costs of bringing actions for injunctive relief. The commissioner shall adjust the surcharge in accordance with section 16A.1285.

Subd. 2.

Registration information.

The establishment shall provide the following information to the commissioner in order to be registered:

(1) the business name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if the owner or owners are not natural persons, identification of the type of business entity of the owner or owners, and the names and addresses of the officers and members of the governing body, or comparable persons for partnerships, limited liability corporations, or other types of business organizations of the owner or owners;

(3) the name and mailing address of the managing agent, whether through management agreement or lease agreement, of the establishment, if different from the owner or owners, and the name of the on-site manager, if any;

(4) verification that the establishment has entered into a housing with services contract, as required in section 144D.04, with each resident or resident's representative;

(5) verification that the establishment is complying with the requirements of section 325F.72, if applicable;

(6) the name and address of at least one natural person who shall be responsible for dealing with the commissioner on all matters provided for in sections 144D.01 to 144D.06, and on whom personal service of all notices and orders shall be made, and who shall be authorized to accept service on behalf of the owner or owners and the managing agent, if any;

(7) the signature of the authorized representative of the owner or owners or, if the owner or owners are not natural persons, signatures of at least two authorized representatives of each owner, one of which shall be an officer of the owner; and

(8) whether services are included in the base rate to be paid by the resident.

Personal service on the person identified under clause (6) by the owner or owners in the registration shall be considered service on the owner or owners, and it shall not be a defense to any action that personal service was not made on each individual or entity. The designation of one or more individuals under this subdivision shall not affect the legal responsibility of the owner or owners under sections 144D.01 to 144D.06.

144D.04 HOUSING WITH SERVICES CONTRACTS.

Subdivision 1.

Contract required.

No housing with services establishment may operate in this state unless a written housing with services contract, as defined in subdivision 2, is executed between the establishment and each resident or resident's representative and unless the establishment operates in accordance with the terms of the contract. The resident or the resident's representative shall be given a complete copy of the contract and all supporting documents and attachments and any changes whenever changes are made.

Subd. 2.

Contents of contract.

A housing with services contract, which need not be entitled as such to comply with this section, shall include at least the following elements in itself or through supporting documents or attachments:

(1) the name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if the owner or owners is not a natural person, identification of the type of business entity of the owner or owners;

(3) the name and mailing address of the managing agent, through management agreement or lease agreement, of the establishment, if different from the owner or owners;

(4) the name and address of at least one natural person who is authorized to accept service of process on behalf of the owner or owners and managing agent;

(5) a statement describing the registration and licensure status of the establishment and any provider providing health-related or supportive services under an arrangement with the establishment;

(6) the term of the contract;

(7) a description of the services to be provided to the resident in the base rate to be paid by the resident, including a delineation of the portion of the base rate that constitutes rent and a delineation of charges for each service included in the base rate;

(8) a description of any additional services, including home care services, available for an additional fee from the establishment directly or through arrangements with the establishment, and a schedule of fees charged for these services;

(9) a conspicuous notice informing the tenant of the policy concerning the conditions under which and the process through which the contract may be modified, amended, or terminated, including whether a move to a different room or sharing a room would be required in the event that the tenant can no longer pay the current rent;

(10) a description of the establishment's complaint resolution process available to residents including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;

(11) the resident's designated representative, if any;

(12) the establishment's referral procedures if the contract is terminated;

(13) requirements of residency used by the establishment to determine who may reside or continue to reside in the housing with services establishment;

(14) billing and payment procedures and requirements;

(15) a statement regarding the ability of a resident to receive services from service providers with whom the establishment does not have an arrangement;

(16) a statement regarding the availability of public funds for payment for residence or services in the establishment; and

(17) a statement regarding the availability of and contact information for long-term care consultation services under section 256B.0911 in the county in which the establishment is located.

Subd. 2a.

Additional contract requirements.

(a) For a resident receiving one or more health-related services from the establishment's arranged home care provider, as defined in section 144D.01, subdivision 6, the contract must include the requirements in paragraph (b). A restriction of a resident's rights under this subdivision is allowed only if determined necessary for health and safety reasons identified by the home care provider's registered nurse in an initial assessment or reassessment, as defined under section 144A.4791, subdivision 8, and documented in the written service plan under section 144A.4791, subdivision 9. Any restrictions of those rights for people served under sections 256B.0915 and 256B.49 must be documented in the resident's coordinated service and support plan (CSSP), as defined under sections 256B.0915, subdivision 6 and 256B.49, subdivision 15.

(b) The contract must include a statement:

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

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

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

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

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

Subd. 3.

Contracts in permanent files.

Housing with services contracts and related documents executed by each resident or resident's representative shall be maintained by the establishment in files from the date of execution until three years after the contract is terminated. The contracts and the written disclosures required under section 325F.72, if applicable, shall be made available for on-site inspection by the commissioner upon request at any time.

144D.045 INFORMATION CONCERNING ARRANGED HOME CARE PROVIDERS.

If a housing with services establishment has one or more arranged home care providers, the establishment shall arrange to have that arranged home care provider deliver the following information in writing to a prospective resident, prior to the date on which the prospective resident executes a contract with the establishment or the prospective resident's move-in date, whichever is earlier:

(1) the name, mailing address, and telephone number of the arranged home care provider;

(2) the name and mailing address of at least one natural person who is authorized to accept service of process on behalf of the entity described in clause (1);

(3) a description of the process through which a home care service agreement or service plan between a resident and the arranged home care provider, if any, may be modified, amended, or terminated;

(4) the arranged home care provider's billing and payment procedures and requirements; and

(5) any limits to the services available from the arranged provider.

144D.05 AUTHORITY OF COMMISSIONER.

The commissioner shall, upon receipt of information which may indicate the failure of the housing with services establishment, a resident, a resident's representative, or a service provider to comply with a legal requirement to which one or more of them may be subject, make appropriate referrals to other governmental agencies and entities having jurisdiction over the subject matter. The commissioner may also make referrals to any public or private agency the commissioner considers available for appropriate assistance to those involved.

The commissioner shall have standing to bring an action for injunctive relief in the district court in the district in which an establishment is located to compel the housing with services establishment to meet the requirements of this chapter or other requirements of the state or of any county or local governmental unit to which the establishment is otherwise subject. Proceedings for securing an injunction may be brought by the commissioner through the attorney general or through the appropriate county attorney. The sanctions in this section do not restrict the availability of other sanctions.

144D.06 OTHER LAWS.

In addition to registration under this chapter, a housing with services establishment must comply with chapter 504B and the provisions of section 325F.72, and shall obtain and maintain all other licenses, permits, registrations, or other governmental approvals required of it. A housing with services establishment is not required to obtain a lodging license under chapter 157 and related rules.

144D.065 TRAINING IN DEMENTIA CARE REQUIRED.

(a) If a housing with services establishment registered under this chapter has a special program or special care unit for residents with Alzheimer's disease or other dementias or advertises, markets, or otherwise promotes the establishment as providing services for persons with Alzheimer's disease or other dementias, whether in a segregated or general unit, employees of the establishment and of the establishment's arranged home care provider must meet the following training requirements:

(1) supervisors of direct-care staff must have at least eight hours of initial training on topics specified under paragraph (b) within 120 working hours of the employment start date, and must have at least two hours of training on topics related to dementia care for each 12 months of employment thereafter;

(2) direct-care employees must have completed at least eight hours of initial training on topics specified under paragraph (b) within 160 working hours of the employment start date. Until this initial training is complete, an employee must not provide direct care unless there is another employee on site who has completed the initial eight hours of training on topics related to dementia care and who can act as a resource and assist if issues arise. A trainer of the requirements under paragraph (b), or a supervisor meeting the requirements in clause (1), must be available for consultation with the new employee until the training requirement is complete. Direct-care employees must have at least two hours of training on topics related to dementia for each 12 months of employment thereafter;

(3) staff who do not provide direct care, including maintenance, housekeeping, and food service staff, must have at least four hours of initial training on topics specified under paragraph (b) within 160 working hours of the employment start date, and must have at least two hours of training on topics related to dementia care for each 12 months of employment thereafter; and

(4) new employees may satisfy the initial training requirements by producing written proof of previously completed required training within the past 18 months.

(b) Areas of required training include:

(1) an explanation of Alzheimer's disease and related disorders;

(2) assistance with activities of daily living;

(3) problem solving with challenging behaviors; and

(4) communication skills.

(c) The establishment shall provide to consumers in written or electronic form a description of the training program, the categories of employees trained, the frequency of training, and the basic topics covered. This information satisfies the disclosure requirements of section 325F.72, subdivision 2, clause (4).

(d) Housing with services establishments not included in paragraph (a) that provide assisted living services under chapter 144G must meet the following training requirements:

(1) supervisors of direct-care staff must have at least four hours of initial training on topics specified under paragraph (b) within 120 working hours of the employment start date, and must have at least two hours of training on topics related to dementia care for each 12 months of employment thereafter;

(2) direct-care employees must have completed at least four hours of initial training on topics specified under paragraph (b) within 160 working hours of the employment start date. Until this initial training is complete, an employee must not provide direct care unless there is another employee on site who has completed the initial four hours of training on topics related to dementia care and who can act as a resource and assist if issues arise. A trainer of the requirements under paragraph (b) or supervisor meeting the requirements under paragraph (a), clause (1), must be available for consultation with the new employee until the training requirement is complete. Direct-care employees must have at least two hours of training on topics related to dementia for each 12 months of employment thereafter;

(3) staff who do not provide direct care, including maintenance, housekeeping, and food service staff, must have at least four hours of initial training on topics specified under paragraph (b) within 160 working hours of the employment start date, and must have at least two hours of training on topics related to dementia care for each 12 months of employment thereafter; and

(4) new employees may satisfy the initial training requirements by producing written proof of previously completed required training within the past 18 months.

144D.066 ENFORCEMENT OF DEMENTIA CARE TRAINING REQUIREMENTS.

Subdivision 1.

Enforcement.

(a) The commissioner shall enforce the dementia care training standards for staff working in housing with services settings and for housing managers according to clauses (1) to (3):

(1) for dementia care training requirements in section 144D.065, the commissioner shall review training records as part of the home care provider survey process for direct care staff and supervisors of direct care staff, in accordance with section 144A.474. The commissioner may also request and review training records at any time during the year;

(2) for dementia care training standards in section 144D.065, the commissioner shall review training records for maintenance, housekeeping, and food service staff and other staff not providing direct care working in housing with services settings as part of the housing with services registration application and renewal application process in accordance with section 144D.03. The commissioner may also request and review training records at any time during the year; and

(3) for housing managers, the commissioner shall review the statement verifying compliance with the required training described in section 144D.10, paragraph (d), through the housing with services registration application and renewal application process in accordance with section 144D.03. The commissioner may also request and review training records at any time during the year.

(b) The commissioner shall specify the required forms and what constitutes sufficient training records for the items listed in paragraph (a), clauses (1) to (3).

Subd. 2.

Fines for noncompliance.

(a) Beginning January 1, 2017, the commissioner may impose a $200 fine for every staff person required to obtain dementia care training who does not have training records to show compliance. For violations of subdivision 1, paragraph (a), clause (1), the fine will be imposed upon the home care provider, and may be appealed under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. For violations of subdivision 1, paragraph (a), clauses (2) and (3), the fine will be imposed on the housing with services registrant and may be appealed under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. Prior to imposing the fine, the commissioner must allow two weeks for staff to complete the required training. Fines collected under this section shall be deposited in the state treasury and credited to the state government special revenue fund.

(b) The housing with services registrant and home care provider must allow for the required training as part of employee and staff duties. Imposition of a fine by the commissioner does not negate the need for the required training. Continued noncompliance with the requirements of sections 144D.065 and 144D.10 may result in revocation or nonrenewal of the housing with services registration or home care license. The commissioner shall make public the list of all housing with services establishments that have complied with the training requirements.

Subd. 3.

Technical assistance.

From January 1, 2016, to December 31, 2016, the commissioner shall provide technical assistance instead of imposing fines for noncompliance with the training requirements. During the year of technical assistance, the commissioner shall review the training records to determine if the records meet the requirements and inform the home care provider. The commissioner shall also provide information about available training resources.

144D.07 RESTRAINTS.

Residents must be free from any physical or chemical restraints imposed for purposes of discipline or convenience.

144D.08 UNIFORM CONSUMER INFORMATION GUIDE.

All housing with services establishments shall make available to all prospective and current residents information consistent with the uniform format and the required components adopted by the commissioner under section 144G.06. This section does not apply to an establishment registered under section 144D.025 serving the homeless.

144D.09 TERMINATION OF LEASE.

The housing with services establishment shall include with notice of termination of lease information about how to contact the ombudsman for long-term care, including the address and telephone number along with a statement of how to request problem-solving assistance.

144D.10 MANAGER REQUIREMENTS.

(a) The person primarily responsible for oversight and management of a housing with services establishment, as designated by the owner of the housing with services establishment, must obtain at least 30 hours of continuing education every two years of employment as the manager in topics relevant to the operations of the housing with services establishment and the needs of its tenants. Continuing education earned to maintain a professional license, such as nursing home administrator license, nursing license, social worker license, and real estate license, can be used to complete this requirement.

(b) For managers of establishments identified in section 325F.72, this continuing education must include at least eight hours of documented training on the topics identified in section 144D.065, paragraph (b), within 160 working hours of hire, and two hours of training on these topics for each 12 months of employment thereafter.

(c) For managers of establishments not covered by section 325F.72, but who provide assisted living services under chapter 144G, this continuing education must include at least four hours of documented training on the topics identified in section 144D.065, paragraph (b), within 160 working hours of hire, and two hours of training on these topics for each 12 months of employment thereafter.

(d) A statement verifying compliance with the continuing education requirement must be included in the housing with services establishment's annual registration to the commissioner of health. The establishment must maintain records for at least three years demonstrating that the person primarily responsible for oversight and management of the establishment has attended educational programs as required by this section.

(e) New managers may satisfy the initial dementia training requirements by producing written proof of previously completed required training within the past 18 months.

(f) This section does not apply to an establishment registered under section 144D.025 serving the homeless.

144D.11 EMERGENCY PLANNING.

(a) Each registered housing with services establishment must meet the following requirements:

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

(2) post an emergency disaster plan prominently;

(3) provide building emergency exit diagrams to all tenants upon signing a lease;

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

(5) have a written policy and procedure regarding missing tenants.

(b) Each registered housing with services establishment must provide emergency and disaster training to all staff during the initial staff orientation and annually thereafter and must make emergency and disaster training available to all tenants annually. Staff who have not received emergency and disaster training are allowed to work only when trained staff are also working on site.

(c) Each registered housing with services location must conduct and document a fire drill or other emergency drill at least every six months. To the extent possible, drills must be coordinated with local fire departments or other community emergency resources.

144G.01 DEFINITIONS.

Subdivision 1.

Scope; other definitions.

For purposes of sections 144G.01 to 144G.05, the following definitions apply. In addition, the definitions provided in section 144D.01 also apply to sections 144G.01 to 144G.05.

Subd. 2.

Assisted living.

"Assisted living" means a service or package of services advertised, marketed, or otherwise described, offered, or promoted using the phrase "assisted living" either alone or in combination with other words, whether orally or in writing, and which is subject to the requirements of this chapter.

Subd. 3.

Assisted living client; client.

"Assisted living client" or "client" means a housing with services resident who receives assisted living that is subject to the requirements of this chapter.

Subd. 4.

Commissioner.

"Commissioner" means the commissioner of health.

144G.02 ASSISTED LIVING; PROTECTED TITLE; REGULATORY FUNCTION.

Subdivision 1.

Protected title; restriction on use.

No person or entity may use the phrase "assisted living," whether alone or in combination with other words and whether orally or in writing, to advertise, market, or otherwise describe, offer, or promote itself, or any housing, service, service package, or program that it provides within this state, unless the person or entity is a housing with services establishment that meets the requirements of this chapter, or is a person or entity that provides some or all components of assisted living that meet the requirements of this chapter. A person or entity entitled to use the phrase "assisted living" shall use the phrase only in the context of its participation in assisted living that meets the requirements of this chapter. A housing with services establishment offering or providing assisted living that is not made available to residents in all of its housing units shall identify the number or location of the units in which assisted living is available, and may not use the term "assisted living" in the name of the establishment registered with the commissioner under chapter 144D, or in the name the establishment uses to identify itself to residents or the public.

Subd. 2.

Authority of commissioner.

(a) The commissioner, upon receipt of information that may indicate the failure of a housing with services establishment, the arranged home care provider, an assisted living client, or an assisted living client's representative to comply with a legal requirement to which one or more of the entities may be subject, shall make appropriate referrals to other governmental agencies and entities having jurisdiction over the subject matter. The commissioner may also make referrals to any public or private agency the commissioner considers available for appropriate assistance to those involved.

(b) In addition to the authority with respect to licensed home care providers under section 144A.45 and with respect to housing with services establishments under chapter 144D, the commissioner shall have standing to bring an action for injunctive relief in the district court in the district in which a housing with services establishment is located to compel the housing with services establishment or the arranged home care provider to meet the requirements of this chapter or other requirements of the state or of any county or local governmental unit to which the establishment or arranged home care provider is otherwise subject. Proceedings for securing an injunction may be brought by the commissioner through the attorney general or through the appropriate county attorney. The sanctions in this section do not restrict the availability of other sanctions.

144G.03 ASSISTED LIVING REQUIREMENTS.

Subdivision 1.

Verification in annual registration.

A registered housing with services establishment using the phrase "assisted living," pursuant to section 144G.02, subdivision 1, shall verify to the commissioner in its annual registration pursuant to chapter 144D that the establishment is complying with sections 144G.01 to 144G.05, as applicable.

Subd. 2.

Minimum requirements for assisted living.

(a) Assisted living shall be provided or made available only to individuals residing in a registered housing with services establishment. Except as expressly stated in this chapter, a person or entity offering assisted living may define the available services and may offer assisted living to all or some of the residents of a housing with services establishment. The services that comprise assisted living may be provided or made available directly by a housing with services establishment or by persons or entities with which the housing with services establishment has made arrangements.

(b) A person or entity entitled to use the phrase "assisted living," according to section 144G.02, subdivision 1, shall do so only with respect to a housing with services establishment, or a service, service package, or program available within a housing with services establishment that, at a minimum:

(1) provides or makes available health-related services under a home care license. At a minimum, health-related services must include:

(i) assistance with self-administration of medication, medication management, or medication administration as defined in section 144A.43; and

(ii) assistance with at least three of the following seven activities of daily living: bathing, dressing, grooming, eating, transferring, continence care, and toileting.

All health-related services shall be provided in a manner that complies with applicable home care licensure requirements in chapter 144A and sections 148.171 to 148.285;

(2) provides necessary assessments of the physical and cognitive needs of assisted living clients by a registered nurse, as required by applicable home care licensure requirements in chapter 144A and sections 148.171 to 148.285;

(3) has and maintains a system for delegation of health care activities to unlicensed personnel by a registered nurse, including supervision and evaluation of the delegated activities as required by applicable home care licensure requirements in chapter 144A and sections 148.171 to 148.285;

(4) provides staff access to an on-call registered nurse 24 hours per day, seven days per week;

(5) has and maintains a system to check on each assisted living client at least daily;

(6) provides a means for assisted living clients to request assistance for health and safety needs 24 hours per day, seven days per week, from the establishment or a person or entity with which the establishment has made arrangements;

(7) has a person or persons available 24 hours per day, seven days per week, who is responsible for responding to the requests of assisted living clients for assistance with health or safety needs, who shall be:

(i) awake;

(ii) located in the same building, in an attached building, or on a contiguous campus with the housing with services establishment in order to respond within a reasonable amount of time;

(iii) capable of communicating with assisted living clients;

(iv) capable of recognizing the need for assistance;

(v) capable of providing either the assistance required or summoning the appropriate assistance; and

(vi) capable of following directions;

(8) offers to provide or make available at least the following supportive services to assisted living clients:

(i) two meals per day;

(ii) weekly housekeeping;

(iii) weekly laundry service;

(iv) upon the request of the client, reasonable assistance with arranging for transportation to medical and social services appointments, and the name of or other identifying information about the person or persons responsible for providing this assistance;

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

(vi) periodic opportunities for socialization; and

(9) makes available to all prospective and current assisted living clients information consistent with the uniform format and the required components adopted by the commissioner under section 144G.06. This information must be made available beginning no later than six months after the commissioner makes the uniform format and required components available to providers according to section 144G.06.

Subd. 3.

Exemption from awake-staff requirement.

A housing with services establishment that offers or provides assisted living is exempt from the requirement in subdivision 2, paragraph (b), clause (7), item (i), that the person or persons available and responsible for responding to requests for assistance must be awake, if the establishment meets the following requirements:

(1) the establishment has a maximum capacity to serve 12 or fewer assisted living clients;

(2) the person or persons available and responsible for responding to requests for assistance are physically present within the housing with services establishment in which the assisted living clients reside;

(3) the establishment has a system in place that is compatible with the health, safety, and welfare of the establishment's assisted living clients;

(4) the establishment's housing with services contract, as required by section 144D.04, includes a statement disclosing the establishment's qualification for, and intention to rely upon, this exemption;

(5) the establishment files with the commissioner, for purposes of public information but not review or approval by the commissioner, a statement describing how the establishment meets the conditions in clauses (1) to (4), and makes a copy of this statement available to actual and prospective assisted living clients; and

(6) the establishment indicates on its housing with services registration, under section 144D.02 or 144D.03, as applicable, that it qualifies for and intends to rely upon the exemption under this subdivision.

Subd. 4.

Nursing assessment.

(a) A housing with services establishment offering or providing assisted living shall:

(1) offer to have the arranged home care provider conduct a nursing assessment by a registered nurse of the physical and cognitive needs of the prospective resident and propose a service plan prior to the date on which a prospective resident executes a contract with a housing with services establishment or the date on which a prospective resident moves in, whichever is earlier; and

(2) inform the prospective resident of the availability of and contact information for long-term care consultation services under section 256B.0911, prior to the date on which a prospective resident executes a contract with a housing with services establishment or the date on which a prospective resident moves in, whichever is earlier.

(b) An arranged home care provider is not obligated to conduct a nursing assessment by a registered nurse when requested by a prospective resident if either the geographic distance between the prospective resident and the provider, or urgent or unexpected circumstances, do not permit the assessment to be conducted prior to the date on which the prospective resident executes a contract or moves in, whichever is earlier. When such circumstances occur, the arranged home care provider shall offer to conduct a telephone conference whenever reasonably possible.

(c) The arranged home care provider shall comply with applicable home care licensure requirements in chapter 144A and sections 148.171 to 148.285, with respect to the provision of a nursing assessment prior to the delivery of nursing services and the execution of a home care service plan or service agreement.

Subd. 5.

Assistance with arranged home care provider.

The housing with services establishment shall provide each assisted living client with identifying information about a person or persons reasonably available to assist the client with concerns the client may have with respect to the services provided by the arranged home care provider. The establishment shall keep each assisted living client reasonably informed of any changes in the personnel referenced in this subdivision. Upon request of the assisted living client, such personnel or designee shall provide reasonable assistance to the assisted living client in addressing concerns regarding services provided by the arranged home care provider.

Subd. 6.

Termination of housing with services contract.

If a housing with services establishment terminates a housing with services contract with an assisted living client, the establishment shall provide the assisted living client, and the legal or designated representative of the assisted living client, if any, with a written notice of termination which includes the following information:

(1) the effective date of termination;

(2) the section of the contract that authorizes the termination;

(3) without extending the termination notice period, an affirmative offer to meet with the assisted living client and, if applicable, client representatives, within no more than five business days of the date of the termination notice to discuss the termination;

(4) an explanation that:

(i) the assisted living client must vacate the apartment, along with all personal possessions, on or before the effective date of termination;

(ii) failure to vacate the apartment by the date of termination may result in the filing of an eviction action in court by the establishment, and that the assisted living client may present a defense, if any, to the court at that time; and

(iii) the assisted living client may seek legal counsel in connection with the notice of termination;

(5) a statement that, with respect to the notice of termination, reasonable accommodation is available for the disability of the assisted living client, if any; and

(6) the name and contact information of the representative of the establishment with whom the assisted living client or client representatives may discuss the notice of termination.

144G.04 RESERVATION OF RIGHTS.

Subdivision 1.

Use of services.

Nothing in this chapter requires an assisted living client to utilize any service provided or made available in assisted living.

Subd. 2.

Housing with services contracts.

Nothing in this chapter requires a housing with services establishment to execute or refrain from terminating a housing with services contract with a prospective or current resident who is unable or unwilling to meet the requirements of residency, with or without assistance.

Subd. 3.

Provision of services.

Nothing in this chapter requires the arranged home care provider to offer or continue to provide services under a service agreement or service plan to a prospective or current resident of the establishment whose needs cannot be met by the arranged home care provider.

Subd. 4.

Altering operations; service packages.

Nothing in this chapter requires a housing with services establishment or arranged home care provider offering assisted living to fundamentally alter the nature of the operations of the establishment or the provider in order to accommodate the request or need for facilities or services by any assisted living client, or to refrain from requiring, as a condition of residency, that an assisted living client pay for a package of assisted living services even if the client does not choose to utilize all or some of the services in the package.

144G.05 REIMBURSEMENT UNDER ASSISTED LIVING SERVICE PACKAGES.

Notwithstanding the provisions of this chapter, the requirements for the elderly waiver program's assisted living payment rates under section 256B.0915, subdivision 3e, shall continue to be effective and providers who do not meet the requirements of this chapter may continue to receive payment under section 256B.0915, subdivision 3e, as long as they continue to meet the definitions and standards for assisted living and assisted living plus set forth in the federally approved Elderly Home and Community Based Services Waiver Program (Control Number 0025.91). Providers of assisted living for the community access for disability inclusion (CADI) and Brain Injury (BI) waivers shall continue to receive payment as long as they continue to meet the definitions and standards for assisted living and assisted living plus set forth in the federally approved CADI and BI waiver plans.

144G.06 UNIFORM CONSUMER INFORMATION GUIDE.

The commissioner shall adopt a uniform format for the guide to be used by individual providers, and the required components of materials to be used by providers to inform assisted living clients of their legal rights, and shall make the uniform format and the required components available to assisted living providers.