Minnesota Session Laws - 1991, Regular Session

  

                         Laws of Minnesota 1991 

                         CHAPTER 93-S.F.No. 885 
           An act relating to health; creating a limited 
          exception to the moratorium on licensure of new 
          nursing home beds; allowing a facility with an 
          addendum to its provider agreement to upgrade beds 
          from boarding care beds to nursing home beds; amending 
          Minnesota Statutes 1990, section 144A.071, subdivision 
          3.  
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1990, section 144A.071, 
subdivision 3, is amended to read: 
    Subd. 3.  [EXCEPTIONS.] The commissioner of health, in 
coordination with the commissioner of human services, may 
approve the addition of a new certified bed or the addition of a 
new licensed nursing home bed, under the following conditions:  
     (a) to replace a bed decertified after May 23, 1983, or to 
address an extreme hardship situation, in a particular county 
that, together with all contiguous Minnesota counties, has fewer 
nursing home beds per 1,000 elderly than the number that is ten 
percent higher than the national average of nursing home beds 
per 1,000 elderly individuals.  For the purposes of this 
section, the national average of nursing home beds shall be the 
most recent figure that can be supplied by the federal health 
care financing administration and the number of elderly in the 
county or the nation shall be determined by the most recent 
federal census or the most recent estimate of the state 
demographer as of July 1, of each year of persons age 65 and 
older, whichever is the most recent at the time of the request 
for replacement.  In allowing replacement of a decertified bed, 
the commissioners shall ensure that the number of added or 
recertified beds does not exceed the total number of decertified 
beds in the state in that level of care.  An extreme hardship 
situation can only be found after the county documents the 
existence of unmet medical needs that cannot be addressed by any 
other alternatives; 
       (b) to certify a new bed in a facility that commenced 
construction before May 23, 1983.  For the purposes of this 
section, "commenced construction" means that all of the 
following conditions were met:  the final working drawings and 
specifications were approved by the commissioner of health; the 
construction contracts were let; a timely construction schedule 
was developed, stipulating dates for beginning, achieving 
various stages, and completing construction; and all zoning and 
building permits were secured; 
       (c) to certify beds in a new nursing home that is needed in 
order to meet the special dietary needs of its residents, if: 
the nursing home proves to the commissioner's satisfaction that 
the needs of its residents cannot otherwise be met; elements of 
the special diet are not available through most food 
distributors; and proper preparation of the special diet 
requires incurring various operating expenses, including extra 
food preparation or serving items, not incurred to a similar 
extent by most nursing homes; 
       (d) to license a new nursing home bed in a facility that 
meets one of the exceptions contained in clauses (a) to (c); 
       (e) to license nursing home beds in a facility that has 
submitted either a completed licensure application or a written 
request for licensure to the commissioner before March 1, 1985, 
and has either commenced any required construction as defined in 
clause (b) before May 1, 1985, or has, before May 1, 1985, 
received from the commissioner approval of plans for phased-in 
construction and written authorization to begin construction on 
a phased-in basis.  For the purpose of this clause, 
"construction" means any erection, building, alteration, 
reconstruction, modernization, or improvement necessary to 
comply with the nursing home licensure rules; 
       (f) to certify or license new beds in a new facility that 
is to be operated by the commissioner of veterans' affairs or 
when the costs of constructing and operating the new beds are to 
be reimbursed by the commissioner of veterans' affairs or the 
United States Veterans Administration; 
       (g) to license or certify beds in a new facility 
constructed to replace a facility that was destroyed after June 
30, 1987, by fire, lightning, or other hazard provided:  
       (1) destruction was not caused by the intentional act of or 
at the direction of a controlling person of the facility; 
       (2) at the time the facility was destroyed the controlling 
persons of the facility maintained insurance coverage for the 
type of hazard that occurred in an amount that a reasonable 
person would conclude was adequate; 
       (3) the net proceeds from an insurance settlement for the 
damages caused by the hazard are applied to the cost of the new 
facility; 
       (4) the new facility is constructed on the same site as the 
destroyed facility or on another site subject to the 
restrictions in section 144A.073, subdivision 5; and 
       (5) the number of licensed and certified beds in the new 
facility does not exceed the number of licensed and certified 
beds in the destroyed facility; 
       (h) to license or certify beds that are moved from one 
location to another within a nursing home facility, provided the 
total costs of remodeling performed in conjunction with the 
relocation of beds does not exceed ten percent of the appraised 
value of the facility or $200,000, whichever is less, or to 
license or certify beds in a facility for which the total costs 
of remodeling or renovation exceed ten percent of the appraised 
value of the facility or $200,000, whichever is less, if the 
facility makes a written commitment to the commissioner of human 
services that it will not seek to receive an increase in its 
property-related payment rate by reason of the remodeling or 
renovation; 
       (i) to license or certify beds in a facility that has been 
involuntarily delicensed or decertified for participation in the 
medical assistance program, provided that an application for 
relicensure or recertification is submitted to the commissioner 
within 120 days after delicensure or decertification; 
       (j) to license or certify beds in a project recommended for 
approval by the interagency board for quality assurance under 
section 144A.073; 
      (k) to license nursing home beds in a hospital facility 
that are relocated from a different hospital facility under 
common ownership or affiliation, provided:  (1) the nursing home 
beds are not certified for participation in the medical 
assistance program; and (2) the relocation of nursing home beds 
under this clause should not exceed a radius of six miles; 
       (1) to license or certify beds that are moved from one 
location to another within an existing identifiable complex of 
hospital buildings, from a hospital-attached nursing home to the 
hospital building, or from a separate nursing home to a building 
formerly used as a hospital, provided the original nursing home 
building will no longer be operated as a nursing home and the 
building to which the beds are moved will no longer be operated 
as a hospital.  As a condition of receiving a license or 
certification under this clause, the facility must make a 
written commitment to the commissioner of human services that it 
will not seek to receive an increase in its property-related 
payment rate as a result of the relocation.  At the time of the 
licensure and certification of the nursing home beds, the 
commissioner of health shall delicense the same number of acute 
care beds within the existing complex of hospital buildings or 
building.  Relocation of nursing home beds under this clause is 
subject to the limitations in section 144A.073, subdivision 5; 
       (m) to license or certify beds that are moved from an 
existing state nursing home to a different state facility, 
provided there is no net increase in the number of state nursing 
home beds; 
       (n) to license new nursing home beds in a continuing care 
retirement community affiliated with a national referral center 
engaged in substantial programs of patient care, medical 
research, and medical education meeting state and national needs 
that receives more than 40 percent of its residents from outside 
the state for the purpose of meeting contractual obligations to 
residents of the retirement community, provided the facility 
makes a written commitment to the commissioner of human services 
that it will not seek medical assistance certification for the 
new beds; 
       (o) to certify or license new beds in a new facility on the 
Red Lake Indian Reservation for which payments will be made 
under the Indian Health Care Improvement Act, Public Law Number 
94-437, at the rates specified in United States Code, title 42, 
section 1396d(b); 
    (p) to certify and license as nursing home beds boarding 
care beds in a certified boarding care facility if the beds meet 
the standards for nursing home licensure and if the cost of any 
remodeling of the facility does not exceed ten percent of the 
appraised value of the facility or $200,000, whichever is less; 
or to license as nursing home beds boarding care beds in a 
facility with an addendum to its provider agreement effective 
beginning July 1, 1983, if the boarding care beds to be upgraded 
meet the standards for nursing home licensure.  If boarding care 
beds are licensed as nursing home beds, the number of boarding 
care beds in the facility must not increase in the future.  The 
provisions contained in section 144A.073 regarding the upgrading 
of the facilities do not apply to facilities that satisfy these 
requirements; 
    (q) to license and certify up to 40 beds transferred from 
an existing facility owned and operated by the Amherst H. Wilder 
Foundation in the city of Saint Paul to a new unit at the same 
location as the existing facility that will serve persons with 
Alzheimer's disease and other related disorders.  The transfer 
of beds may occur gradually or in stages, provided the total 
number of beds transferred does not exceed 40.  At the time of 
licensure and certification of a bed or beds in the new unit, 
the commissioner of health shall delicense and decertify the 
same number of beds in the existing facility.  As a condition of 
receiving a license or certification under this clause, the 
facility must make a written commitment to the commissioner of 
human services that it will not seek to receive an increase in 
its property-related payment rate as a result of the transfers 
allowed under this clause; 
     (r) to license and certify nursing home beds to replace 
currently licensed and certified boarding care beds which may be 
located either in a remodeled or renovated boarding care or 
nursing home facility or in a remodeled, renovated, newly 
constructed, or replacement nursing home facility within the 
identifiable complex of health care facilities in which the 
currently licensed boarding care beds are presently located, 
provided that the number of boarding care beds in the facility 
or complex are decreased by the number to be licensed as nursing 
home beds and further provided that, if the total costs of new 
construction, replacement, remodeling, or renovation exceed ten 
percent of the appraised value of the facility or $200,000, 
whichever is less, the facility makes a written commitment to 
the commissioner of human services that it will not seek to 
receive an increase in its property-related payment rate by 
reason of the new construction, replacement, remodeling, or 
renovation.  The provisions contained in section 144A.073 
regarding the upgrading of facilities do not apply to facilities 
that satisfy these requirements; or 
     (s) to license or certify beds that are moved from a 
nursing home to a separate facility under common ownership or 
control that was formerly licensed as a hospital and is 
currently licensed as a nursing facility and that is located 
within eight miles of the original facility, provided the 
original nursing home building will no longer be operated as a 
nursing home.  As a condition of receiving a license or 
certification under this clause, the facility must make a 
written commitment to the commissioner of human services that it 
will not seek to receive an increase in its property-related 
payment rate as a result of the relocation. 
    Presented to the governor May 10, 1991 
    Signed by the governor May 14, 1991, 4:55 p.m.