144.0721 Assessments of care and services to nursing home residents.
Subdivision 1. Appropriateness and quality. The commissioner of health shall assess the appropriateness and quality of care and services furnished to private paying residents in nursing homes and boarding care homes that are certified for participation in the medical assistance program under United States Code, title 42, sections 1396-1396p. These assessments shall be conducted in accordance with section 144.072, with the exception of provisions requiring recommendations for changes in the level of care provided to the private paying residents.
Subd. 2. Access to data. With the exception of summary data, data on individuals that is collected, maintained, used, or disseminated by the commissioner of health under subdivision 1 is private data on individuals and shall not be disclosed to others except:
(1) under section 13.05;
(2) under a valid court order;
(3) to the nursing home or boarding care home in which the individual resided at the time the assessment was completed;
(4) to the commissioner of human services; or
(5) to county home care staff for the purpose of assisting the individual to be discharged from a nursing home or boarding care home and returned to the community.
Subd. 3. Level of care criteria; modifications. The commissioner shall seek appropriate federal waivers to implement this subdivision. Notwithstanding any laws or rules to the contrary, effective July 1, 1998, Minnesota's level of care criteria for admission of any person to a nursing facility licensed under chapter 144A, or a boarding care home licensed under sections 144.50 to 144.56, are modified as follows:
(2) an applicant to a certified nursing facility or certified boarding care home who is dependent in zero, one, or two case mix activities of daily living, is classified as a case mix A, and is independent in orientation and self-preservation, is reclassified as a high function class A person and is not eligible for admission to Minnesota certified nursing facilities or certified boarding care homes;
(3) applicants in clause (2) who are dependent in one or two case mix activities of daily living, who are eligible for assistance as determined under sections 256B.055 and 256B.056 or meet eligibility criteria for section 256B.0913 are eligible for a service allowance under section 256B.0913, subdivision 15, and are not eligible for services under sections 256B.0913, subdivisions 1 to 14, and 256B.0915. Applicants in clause (2) shall have the option of residing in community settings under sections 256I.01 to 256I.06, if otherwise eligible, or receiving the services allowance option under section 256B.0913, subdivision 15, but not both;
(4) residents of a certified nursing facility or certified boarding care home who were admitted before July 1, 1998, or individuals receiving services under section 256B.0913, subdivisions 1 to 14, or 256B.0915, before July 1, 1998, are not subject to the new level of care criteria unless the resident is discharged home or to another service setting other than a certified nursing facility or certified boarding care home and applies for admission to a certified nursing facility or certified boarding care home after June 30, 1998;
(5) the local screening teams under section 256B.0911 may determine the existence of extraordinary circumstances which render nonadmission to a certified nursing or certified boarding care home a serious threat to the health and safety of applicants in clause (2) and may authorize admission to a certified nursing facility or certified boarding care home in accordance with a treatment and discharge plan; and
(6) an individual deemed ineligible for admission to Minnesota certified nursing facilities is entitled to an appeal under section 256.045, subdivision 3.
If the commissioner determines upon appeal that an applicant in clause (2) presents extraordinary circumstances including but not limited to the absence or inaccessibility of suitable alternatives, contravening family circumstances, or protective service issues, the applicant may be eligible for admission to Minnesota certified nursing facilities or certified boarding care homes.
Subd. 3a. Exception. Subdivision 3 does not apply to a facility whose rates are subject to section 256I.05, subdivision 2.
Official Publication of the State of Minnesota
Revisor of Statutes