Minnesota Session Laws - 1999, Regular Session

                             CHAPTER 83-H.F.No. 40 
                  An act relating to health; allowing a nursing home 
                  resident to request and consent to the use of a 
                  physical restraint; requiring certain actions by the 
                  commissioner of health with respect to immediate 
                  jeopardy citations; amending Minnesota Statutes 1998, 
                  sections 144.651, by adding a subdivision; and 
                  144A.10, by adding a subdivision. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  Minnesota Statutes 1998, section 144.651, is 
        amended by adding a subdivision to read: 
           Subd. 33.  [RESTRAINTS.] (a) Competent nursing home 
        residents, family members of residents who are not competent, 
        and legally appointed conservators, guardians, and health care 
        agents as defined under section 145C.01, have the right to 
        request and consent to the use of a physical restraint in order 
        to treat the medical symptoms of the resident. 
           (b) Upon receiving a request for a physical restraint, a 
        nursing home shall inform the resident, family member, or legal 
        representative of alternatives to and the risks involved with 
        physical restraint use.  The nursing home shall provide a 
        physical restraint to a resident only upon receipt of a signed 
        consent form authorizing restraint use and a written order from 
        the attending physician that contains statements and 
        determinations regarding medical symptoms and specifies the 
        circumstances under which restraints are to be used. 
           (c) A nursing home providing a restraint under paragraph 
        (b) must: 
           (1) document that the procedures outlined in that paragraph 
        have been followed; 
           (2) monitor the use of the restraint by the resident; and 
           (3) periodically, in consultation with the resident, the 
        family, and the attending physician, reevaluate the resident's 
        need for the restraint. 
           (d) A nursing home shall not be subject to fines, civil 
        money penalties, or other state or federal survey enforcement 
        remedies solely as the result of allowing the use of a physical 
        restraint as authorized in this subdivision.  Nothing in this 
        subdivision shall preclude the commissioner from taking action 
        to protect the health and safety of a resident if: 
           (1) the use of the restraint has jeopardized the health and 
        safety of the resident; and 
           (2) the nursing home failed to take reasonable measures to 
        protect the health and safety of the resident. 
           (e) For purposes of this subdivision, "medical symptoms" 
        include: 
           (1) a concern for the physical safety of the resident; and 
           (2) physical or psychological needs expressed by a 
        resident.  A resident's fear of falling may be the basis of a 
        medical symptom. 
        A written order from the attending physician that contains 
        statements and determinations regarding medical symptoms is 
        sufficient evidence of the medical necessity of the physical 
        restraint. 
           (f) When determining nursing facility compliance with state 
        and federal standards for the use of physical restraints, the 
        commissioner of health is bound by the statements and 
        determinations contained in the attending physician's order 
        regarding medical symptoms.  For purposes of this order, 
        "medical symptoms" include the request by a competent resident, 
        family member of a resident who is not competent, or legally 
        appointed conservator, guardian, or health care agent as defined 
        under section 145C.01, that the facility provide a physical 
        restraint in order to enhance the physical safety of the 
        resident. 
           Sec. 2.  Minnesota Statutes 1998, section 144A.10, is 
        amended by adding a subdivision to read: 
           Subd. 11.  [FACILITIES CITED FOR IMMEDIATE JEOPARDY.] (a) 
        The provisions of this subdivision apply to Minnesota nursing 
        facilities: 
           (1) that received immediate jeopardy citations between 
        April 1, 1998, and January 13, 1999, for violations of 
        regulations governing the use of physical restraints; and 
           (2) on whose behalf the commissioner recommended to the 
        federal government that fines for these citations not be imposed 
        or be rescinded.  
           (b) The commissioner: 
           (1) shall grant all possible waivers for the continuation 
        of an approved nurse aide training program, an approved 
        competency evaluation program, or an approved nurse aide 
        training and competency evaluation program conducted by or on 
        the site of a facility referred to in this subdivision; and 
           (2) shall notify the board of nursing home administrators 
        by June 1, 1999, that the commissioner has recommended to the 
        federal government that fines not be imposed on the facilities 
        referred to in this subdivision or that any fines imposed on 
        these facilities for violations of regulations governing use of 
        physical restraints be rescinded. 
           Sec. 3.  [EFFECTIVE DATE.] 
           Sections 1 and 2 are effective the day following final 
        enactment. 
           Presented to the governor April 19, 1999 
           Signed by the governor April 22, 1999, 9:20 a.m.