Minnesota Legislature
HF 2757
as introduced - 94th Legislature (2025 - 2026) Posted on 03/24/2025 03:04pm
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| Introduction | Posted on 03/24/2025 |
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A bill for an act
relating to health; updating assisted living provisions; amending Minnesota Statutes
2024, sections 144G.08, by adding subdivisions; 144G.10, subdivisions 1, 1a, 5;
144G.16, subdivision 3; 144G.81, subdivision 1; proposing coding for new law
in Minnesota Statutes, chapter 144G; repealing Minnesota Statutes 2024, section
144G.9999, subdivisions 1, 2, 3.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:
new text begin Subd. 12a. new text end
new text begin Chemical restraint. new text end
new text begin
"Chemical restraint" has the meaning given in section
245D.02, subdivision 3b.
new text end
Sec. 2.
Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to
read:
new text begin Subd. 36a. new text end
new text begin Manual restraint. new text end
new text begin
"Manual restraint" has the meaning given in section
245D.02, subdivision 15a.
new text end
Sec. 3.
Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to
read:
new text begin Subd. 36b. new text end
new text begin Mechanical restraint. new text end
new text begin
"Mechanical restraint" has the meaning given in
section 245D.02, subdivision 15b. Mechanical restraint includes use of an auxiliary device
to ensure a person does not unfasten a seat belt in a vehicle. Mechanical restraint does not
include:
new text end
new text begin
(1) use of a seat belt as required under section 169.686; or
new text end
new text begin
(2) use of a child passenger restraint system as required under section 245A.18,
subdivision 1.
new text end
Sec. 4.
Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to
read:
new text begin Subd. 61a. new text end
new text begin Restraint. new text end
new text begin
"Restraint" has the meaning given in section 245D.02, subdivision
28.
new text end
Sec. 5.
Minnesota Statutes 2024, section 144G.10, subdivision 1, is amended to read:
Subdivision 1.
License required.
(a)(1) Beginning August 1, 2021, no assisted living
facility may operate in Minnesota unless it is licensed under this chapter.
(2) No facility or building on a campus may provide assisted living services until
obtaining the required license under paragraphs (c) to (e).
(b) 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.
(c) Upon approving an application for an assisted living facility license, the commissioner
shall issue a single license for each building that is operated by the licensee as an assisted
living facility and is located at a separate address, except as provided under paragraph (d)
or (e).new text begin Each licensed assisted living facility building must have a two-hour fire barrier as
defined by NFPA 101 between any licensed and unlicensed areas of the building and between
any licensed areas subject to another license type not granted under chapter 144G.
new text end
(d) Upon approving an application for an assisted living facility license, the commissioner
may issue a single license for two or more buildings on a campus that are operated by the
same licensee as an assisted living facility. An assisted living facility license for a campus
must identify the address and licensed resident capacity of each building located on the
campus in which assisted living services are provided.
(e) Upon approving an application for an assisted living facility license, the commissioner
may:
(1) issue a single license for two or more buildings on a campus that are operated by the
same licensee as an assisted living facility with dementia care, provided the assisted living
facility for dementia care license for a campus identifies the buildings operating as assisted
living facilities with dementia care; or
(2) issue a separate assisted living facility with dementia care license for a building that
is on a campus and that is operating as an assisted living facility with dementia care.
Sec. 6.
Minnesota Statutes 2024, section 144G.10, subdivision 1a, is amended to read:
Subd. 1a.
Assisted living director license required.
Each assisted living facility must
employ an assisted living director licensed or permitted by the Board of Executives for
Long Term Services and Supportsnew text begin and be affiliated as the director of record with the boardnew text end .
Sec. 7.
Minnesota Statutes 2024, section 144G.10, subdivision 5, is amended to read:
Subd. 5.
Protected title; restriction on use.
(a) Effective January 1, 2026, 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 licensed assisted living facility that meets
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 that meets the requirements of
this chapter.
(b) Effective January 1, 2026, the licensee's name for deleted text begin a newdeleted text end new text begin annew text end assisted living facility
may not include the terms "home care" or "nursing home."
Sec. 8.
Minnesota Statutes 2024, section 144G.16, subdivision 3, is amended to read:
Subd. 3.
Licensure; termination or extension of provisional licenses.
(a) If the
provisional licensee is in substantial compliance with the survey, the commissioner shall
issue a facility license.
(b) 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 begin
(c) The owners and managerial officials of a provisional licensee whose license is denied
are ineligible to apply for an assisted living facility license under this chapter for one year
following the facility's closure date.
new text end
Sec. 9.
new text begin
[144G.65] TRAINING IN RESTRAINTS.
new text end
new text begin Subdivision 1. new text end
new text begin Training. new text end
new text begin
The licensee must ensure that staff who may apply an
emergency manual restraint complete a minimum of four hours of training from qualified
individuals prior to assuming these responsibilities. Training must include:
new text end
new text begin
(1) de-escalation techniques and their value;
new text end
new text begin
(2) principles of person-centered planning and service delivery as identified in section
245D.07, subdivision 1a;
new text end
new text begin
(3) what constitutes the use of a manual restraint;
new text end
new text begin
(4) staff responsibilities related to prohibited procedures under section 144G.85,
subdivision 4; why the procedures are not effective for reducing or eliminating symptoms
or interfering behavior; and why the procedures are not safe;
new text end
new text begin
(5) the situations when staff must contact 911 services in response to an imminent risk
of harm to the resident or others; and
new text end
new text begin
(6) cultural competence.
new text end
new text begin Subd. 2. new text end
new text begin Annual refresher training. new text end
new text begin
The licensee must ensure that staff complete two
hours of refresher training on an annual basis covering each of the training areas in
subdivision 1.
new text end
new text begin Subd. 3. new text end
new text begin Implementation. new text end
new text begin
The assisted living facility must implement all orientation
and training topics in this section.
new text end
new text begin Subd. 4. new text end
new text begin Verification; documentation; orientation and training. new text end
new text begin
The assisted living
facility must document in each employee's record completion of the orientation and training
required in this section.
new text end
Sec. 10.
Minnesota Statutes 2024, section 144G.81, subdivision 1, is amended to read:
Subdivision 1.
Fire protection and physical environment.
An assisted living facility
with new text begin a new text end dementia care deleted text begin that has a secured dementia care unitdeleted text end new text begin licensenew text end must meet the requirements
of section 144G.45 and the following additional requirements:
(1) deleted text begin a hazard vulnerabilitydeleted text end new text begin annew text end assessment deleted text begin ordeleted text end new text begin ofnew text end safety deleted text begin riskdeleted text end new text begin risksnew text end must be performed on
and around the property. The deleted text begin hazards indicateddeleted text end new text begin safety risks identified by the facilitynew text end on the
assessment must be deleted text begin assessed anddeleted text end mitigated to protect the residents from harmnew text begin . The mitigation
efforts must be documented in the facility's recordsnew text end ; and
(2) the facility shall be protected throughout by an approved supervised automatic
sprinkler system by August 1, 2029.
Sec. 11.
new text begin
[144G.85] USE OF RESTRAINTS.
new text end
new text begin Subdivision 1. new text end
new text begin Restraints. new text end
new text begin
Residents must be free from any chemical, manual, and
mechanical restraints imposed for purposes of discipline or caregiver convenience, and that
are not required to treat the resident's medical symptoms.
new text end
new text begin Subd. 2. new text end
new text begin Protective measures. new text end
new text begin
(a) If a resident exhibits behavior which becomes a threat
to the health or safety of the resident or others, the nurse or person in charge, if other than
a nurse, must take temporary, emergency measures to protect the resident and other persons
in the facility. Emergency use of a manual restraint is permitted only when immediate
intervention is needed to protect the resident or others from imminent risk of physical harm
and it is the least restrictive intervention to address the immediate risk of harm. The restraint
must be removed when there is no longer imminent risk of physical harm to the resident or
other persons in the facility.
new text end
new text begin
(b) The resident's legal representative or interested family member must be notified
when temporary emergency measures are taken. Notification and the temporary emergency
measures must be documented. The advanced practice registered nurse, physician, or
physician assistant must be notified within 12 hours.
new text end
new text begin Subd. 3. new text end
new text begin Procedures prohibited. new text end
new text begin
The licensee is prohibited from using chemical
restraints, manual restraints, mechanical restraints, time out, seclusion, or any other aversive
or deprivation procedure as a substitute for adequate staffing, as punishment, or for staff
convenience.
new text end
new text begin Subd. 4. new text end
new text begin Ordered treatment. new text end
new text begin
Any use of restraints, other than an emergency use to
address an imminent risk, must comply with the requirements of section 144G.72 for an
ordered treatment.
new text end
new text begin Subd. 5. new text end
new text begin Permitted application. new text end
new text begin
The use of restraints must:
new text end
new text begin
(1) protect the rights, health, and welfare of the resident;
new text end
new text begin
(2) not apply back or chest pressure while a resident is in a prone, supine, or side-lying
position;
new text end
new text begin
(3) allow residents to be free from "prone restraint," meaning the use of manual restraint
that places a resident in a face-down position. Prone restraint does not include brief physical
holding of a resident who, during an emergency use of manual restraint, rolls into a prone
position, if the resident is restored to a standing, sitting, or side-lying position as quickly as
possible.
new text end
Sec. 12. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 144G.9999, subdivisions 1, 2, and 3,
new text end
new text begin
are repealed.
new text end
APPENDIX
Repealed Minnesota Statutes: 25-00308
144G.9999 RESIDENT QUALITY OF CARE AND OUTCOMES IMPROVEMENT TASK FORCE.
Subdivision 1.
Establishment.
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.
Subd. 2.
Membership.
The task force shall include representation from:
(1) nonprofit Minnesota-based organizations dedicated to patient safety or innovation in health care safety and quality;
(2) Department of Health staff with expertise in issues related to safety and adverse health events;
(3) consumer organizations;
(4) direct care providers or their representatives;
(5) organizations representing long-term care providers and home care providers in Minnesota;
(6) the ombudsman for long-term care or a designee;
(7) national patient safety experts; and
(8) other experts in the safety and quality improvement field.
The task force shall have at least one public member who either is or has been a resident in an assisted living setting and one public member who has or had a family member living in an assisted living setting. The membership shall be voluntary except that public members may be reimbursed under section 15.059, subdivision 3.
Subd. 3.
Recommendations.
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.