2006 Minnesota Statutes

144A.161 NURSING HOME AND BOARDING CARE HOME RESIDENT RELOCATION.
    Subdivision 1. Definitions. The definitions in this subdivision apply to subdivisions 2 to 10.
(a) "Closure" means the cessation of operations of a facility and the delicensure and
decertification of all beds within the facility.
(b) "Curtailment," "reduction," or "change" refers to any change in operations which would
result in or encourage the relocation of residents.
(c) "Facility" means a nursing home licensed pursuant to this chapter, or a certified boarding
care home licensed pursuant to sections 144.50 to 144.56.
(d) "Licensee" means the owner of the facility or the owner's designee or the commissioner
of health for a facility in receivership.
(e) "County social services agency" means the county or multicounty social service agency
authorized under sections 393.01 and 393.07, as the agency responsible for providing social
services for the county in which the nursing home is located.
(f) "Plan" means a process developed under subdivision 3, paragraph (b), for the closure,
curtailment, reduction, or change in operations in a facility and the subsequent relocation of
residents.
(g) "Relocation" means the discharge of a resident and movement of the resident to another
facility or living arrangement as a result of the closing, curtailment, reduction, or change in
operations of a nursing home or boarding care home.
    Subd. 1a. Scope. Where a facility is undertaking closure, curtailment, reduction, or change in
operations, the facility and the county social services agency must comply with the requirements
of this section.
    Subd. 2. Initial notice from licensee. (a) A licensee shall notify the following parties in
writing when there is an intent to close or curtail, reduce, or change operations which would result
in or encourage the relocation of residents:
(1) the commissioner of health;
(2) the commissioner of human services;
(3) the county social services agency;
(4) the Office of the Ombudsman for Older Minnesotans; and
(5) the Office of the Ombudsman for Mental Health and Developmental Disabilities.
(b) The written notice shall include the names, telephone numbers, facsimile numbers,
and e-mail addresses of the persons in the facility responsible for coordinating the licensee's
efforts in the planning process, and the number of residents potentially affected by the closure or
curtailment, reduction, or change in operations.
(c) After providing written notice under this section, and prior to admission, the facility must
fully inform prospective residents and their families of the intent to close or curtail, reduce, or
change operations, and of the relocation plan.
    Subd. 3. Planning process. (a) The county social services agency shall, within five working
days of receiving initial notice of the licensee's intent to close or curtail, reduce, or change
operations, provide the licensee and all parties identified in subdivision 2, paragraph (a), with the
names, telephone numbers, facsimile numbers, and e-mail addresses of those persons responsible
for coordinating county social services agency efforts in the planning process.
(b) Within ten working days of receipt of the notice under paragraph (a), the county social
services agency and licensee shall meet to develop the relocation plan. The county social
services agency shall inform the Departments of Health and Human Services, the Office of
the Ombudsman for Older Minnesotans, and the Office of the Ombudsman for Mental Health
and Developmental Disabilities of the date, time, and location of the meeting so that their
representatives may attend. The relocation plan must be completed within 45 days of receipt of
the initial notice. However, the plan may be finalized on an earlier schedule agreed to by all
parties. To the extent practicable, consistent with requirements to protect the safety and health of
residents, the commissioner may authorize the planning process under this subdivision to occur
concurrent with the 60-day notice required under subdivision 5a. The plan shall:
(1) identify the expected date of closure, curtailment, reduction, or change in operations;
(2) outline the process for public notification of the closure, curtailment, reduction, or
change in operations;
(3) identify efforts that will be made to include other stakeholders in the relocation process;
(4) outline the process to ensure 60-day advance written notice to residents, family members,
and designated representatives;
(5) present an aggregate description of the resident population remaining to be relocated
and the population's needs;
(6) outline the individual resident assessment process to be utilized;
(7) identify an inventory of available relocation options, including home and
community-based services;
(8) identify a timeline for submission of the list identified in subdivision 5c, paragraph (b);
(9) identify a schedule for the timely completion of each element of the plan; and
(10) identify the steps the licensee and the county social services agency will take to address
the relocation needs of individual residents who may be difficult to place due to specialized
care needs such as behavioral health problems.
(c) All parties to the plan shall refrain from any public notification of the intent to close or
curtail, reduce, or change operations until a relocation plan has been established. If the planning
process occurs concurrently with the 60-day notice period, this requirement does not apply once
60-day notice is given.
    Subd. 4. Responsibilities of licensee for resident relocations. The licensee shall provide
for the safe, orderly, and appropriate relocation of residents. The licensee and facility staff shall
cooperate with representatives from the county social services agency, the Department of Health,
the Department of Human Services, the Office of Ombudsman for Older Minnesotans, and
Ombudsman for Mental Health and Developmental Disabilities in planning for and implementing
the relocation of residents.
    Subd. 5. Licensee responsibilities prior to relocation. (a) The licensee shall establish
an interdisciplinary team responsible for coordinating and implementing the plan. The
interdisciplinary team shall include representatives from the county social services agency, the
Office of Ombudsman for Older Minnesotans, facility staff that provide direct care services
to the residents, and facility administration.
(b) The licensee shall provide a summary document to the county social services agency that
includes the following information on each resident to be relocated:
(1) name;
(2) date of birth;
(3) Social Security number;
(4) payment source and medical assistance identification number, if applicable;
(5) county of financial responsibility;
(6) date of admission to the facility;
(7) all diagnoses;
(8) the name of and contact information for the resident's physician;
(9) the name and contact information for the resident's family or other designated
representative;
(10) the names of and contact information for any case managers, if known; and
(11) information on the resident's status related to commitment and probation.
(c) The licensee shall consult with the county social services agency on the availability and
development of available resources and on the resident relocation process.
    Subd. 5a. Licensee responsibilities to provide notice. At least 60 days before the proposed
date of closing, curtailment, reduction, or change in operations as agreed to in the plan, the
licensee shall send a written notice of closure or curtailment, reduction, or change in operations to
each resident being relocated, the resident's family member or designated representative, and the
resident's attending physician. The notice must include the following:
(1) the date of the proposed closure, curtailment, reduction, or change in operations;
(2) the name, address, telephone number, facsimile number, and e-mail address of the
individual or individuals in the facility responsible for providing assistance and information;
(3) notification of upcoming meetings for residents, families and designated representatives,
and resident and family councils to discuss the relocation of residents;
(4) the name, address, and telephone number of the county social services agency contact
person; and
(5) the name, address, and telephone number of the Office of Ombudsman for Older
Minnesotans and the Ombudsman for Mental Health and Developmental Disabilities.
The notice must comply with all applicable state and federal requirements for notice of
transfer or discharge of nursing home residents.
    Subd. 5b. Licensee responsibility regarding medical information. The licensee shall
request the attending physician provide or arrange for the release of medical information needed
to update resident medical records and prepare all required forms and discharge summaries.
    Subd. 5c. Licensee responsibility regarding placement information. (a) The licensee shall
provide sufficient preparation to residents to ensure safe, orderly, and appropriate discharge and
relocation. The licensee shall assist residents in finding placements that respond to personal
preferences, such as desired geographic location.
(b) The licensee shall prepare a resource list with several relocation options for each resident.
The list must contain the following information for each relocation option, when applicable:
(1) the name, address, and telephone and facsimile numbers of each facility with appropriate,
available beds or services;
(2) the certification level of the available beds;
(3) the types of services available; and
(4) the name, address, and telephone and facsimile numbers of appropriate available home
and community-based placements, services, and settings or other options for individuals with
special needs.
The list shall be made available to residents and their families or designated representatives, and
upon request to the Office of Ombudsman for Older Minnesotans, the Ombudsman for Mental
Health and Developmental Disabilities, and the county social services agency.
(c) The Senior LinkAge line may make available via a Web site the name, address, and
telephone and facsimile numbers of each facility with available beds, the certification level of
the available beds, the types of services available, and the number of beds that are available
as updated daily by the listed facilities. The licensee must provide residents, their families or
designated representatives, the Office of the Ombudsman for Older Minnesotans, the Office of the
Ombudsman for Mental Health and Developmental Disabilities, and the county social services
agency with the toll-free number and Web site address for the Senior LinkAge line.
    Subd. 5d. Licensee responsibility to meet with residents and families. Following the
establishment of the plan, the licensee shall conduct meetings with residents, families and
designated representatives, and resident and family councils to notify them of the process for
resident relocation. Representatives from the local county social services agency, the Office of
Ombudsman for Older Minnesotans, the Ombudsman for Mental Health and Developmental
Disabilities, the commissioner of health, and the commissioner of human services shall receive
advance notice of the meetings.
    Subd. 5e. Licensee responsibility for site visits. The licensee shall assist residents desiring
to make site visits to facilities with available beds or other appropriate living options to which
the resident may relocate, unless it is medically inadvisable, as documented by the attending
physician in the resident's care record. The licensee shall provide or arrange transportation for
site visits to facilities or other living options within a 50-mile radius to which the resident may
relocate, or within a larger radius if no suitable options are available within 50 miles. The licensee
shall provide available written materials to residents on a potential new facility or living option.
    Subd. 5f. Licensee responsible for resident property, funds, and telephone service. (a)
The licensee shall complete an inventory of resident personal possessions and provide a copy of
the final inventory to the resident and the resident's designated representative prior to relocation.
The licensee shall be responsible for the transfer of the resident's possessions for all relocations
within a 50-mile radius of the facility, or within a larger radius if no suitable options are available
within 50 miles. The licensee shall complete the transfer of resident possessions in a timely
manner, but no later than the date of the actual physical relocation of the resident.
(b) The licensee shall complete a final accounting of personal funds held in trust by the
facility and provide a copy of this accounting to the resident and the resident's family or the
resident's designated representative. The licensee shall be responsible for the transfer of all
personal funds held in trust by the facility. The licensee shall complete the transfer of all personal
funds in a timely manner.
(c) The licensee shall assist residents with the transfer and reconnection of service for
telephones or, for residents who are deaf or blind, other personal communication devices or
services. The licensee shall pay the costs associated with reestablishing service for telephones
or other personal communication devices or services, such as connection fees or other one-time
charges. The transfer or reconnection of personal communication devices or services shall be
completed in a timely manner.
    Subd. 5g. Licensee responsibilities for final notice and records transfer. (a) The licensee
shall provide the resident, the resident's family or designated representative, and the resident's
attending physician final written notice prior to the relocation of the resident. The notice must:
(1) be provided seven days prior to the actual relocation, unless the resident agrees to waive
the right to advance notice; and
(2) identify the date of the anticipated relocation and the destination to which the resident is
being relocated.
(b) The licensee shall provide the receiving facility or other health, housing, or care
entity with complete and accurate resident records including information on family members,
designated representatives, guardians, social service caseworkers, or other contact information.
These records must also include all information necessary to provide appropriate medical care and
social services. This includes, but is not limited to, information on preadmission screening, Level
I and Level II screening, minimum data set (MDS), and all other assessments, resident diagnoses,
social, behavioral, and medication information.
(c) For residents with special care needs, the licensee shall consult with the receiving facility
or other placement entity and provide staff training or other preparation as needed to assist in
providing for the special needs.
    Subd. 6. Responsibilities of the licensee during relocation. (a) The licensee shall make
arrangements or provide for the transportation of residents to the new facility or placement within
a 50-mile radius, or within a larger radius if no suitable options are available within 50 miles. The
licensee shall provide a staff person to accompany the resident during transportation, upon request
of the resident, the resident's family, or designated representative. The discharge and relocation of
residents must comply with all applicable state and federal requirements and must be conducted
in a safe, orderly, and appropriate manner. The licensee must ensure that there is no disruption in
providing meals, medications, or treatments of a resident during the relocation process.
(b) Beginning the week following development of the initial relocation plan, the licensee
shall submit weekly status reports to the commissioners of health and human services or their
designees and to the county social services agency. The initial status report must identify:
(1) the relocation plan developed;
(2) the interdisciplinary team members; and
(3) the number of residents to be relocated.
(c) Subsequent status reports must identify:
(1) any modifications to the plan;
(2) any change of interdisciplinary team members;
(3) the number of residents relocated;
(4) the destination to which residents have been relocated;
(5) the number of residents remaining to be relocated; and
(6) issues or problems encountered during the process and resolution of these issues.
    Subd. 7. Responsibilities of the licensee following relocation. The licensee shall retain or
make arrangements for the retention of all remaining resident records for the period required by
law. The licensee shall provide the Department of Health access to these records. The licensee
shall notify the Department of Health of the location of any resident records that have not been
transferred to the new facility or other health care entity.
    Subd. 8. Responsibilities of county social services agency. (a) The county social services
agency shall participate in the meeting as outlined in subdivision 3, paragraph (b), to develop a
relocation plan.
(b) The county social services agency shall designate a representative to the interdisciplinary
team established by the licensee responsible for coordinating the relocation efforts.
(c) The county social services agency shall serve as a resource in the relocation process.
(d) Concurrent with the notice sent to residents from the licensee as provided in subdivision
5a, the county social services agency shall provide written notice to residents, family, or
designated representatives describing:
(1) the county's role in the relocation process and in the follow-up to relocations;
(2) a county social services agency contact name, address, and telephone number; and
(3) the name, address, and telephone number of the Office of Ombudsman for Older
Minnesotans and the Ombudsman for Mental Health and Developmental Disabilities.
(e) The county social services agency designee shall meet with appropriate facility staff to
coordinate any assistance in the relocation process. This coordination shall include participating
in group meetings with residents, families, and designated representatives to explain the
relocation process.
(f) The county social services agency shall monitor compliance with all components of the
plan. If the licensee is not in compliance, the county social services agency shall notify the
commissioners of the Departments of Health and Human Services.
(g) Except as requested by the resident, family member, or designated representative and
within the parameters of the Vulnerable Adults Act, the county social services agency may halt
a relocation that it deems inappropriate or dangerous to the health or safety of a resident. The
county social services agency shall pursue remedies to protect the resident during the relocation
process, including, but not limited to, assisting the resident with filing an appeal of transfer
or discharge, notification of all appropriate licensing boards and agencies, and other remedies
available to the county under section 626.557, subdivision 10.
(h) A member of the county social services agency staff shall visit residents relocated within
100 miles of the county within 30 days after the relocation. This requirement does not apply to
changes in operation where the facility moved to a new location and residents chose to move to
that new location. The requirement also does not apply to residents admitted after the notice of
closure and discharged prior to the actual closure. County social services agency staff shall
interview the resident and family or designated representative, observe the resident on site, and
review and discuss pertinent medical or social records with appropriate facility staff to:
(1) assess the adjustment of the resident to the new placement;
(2) recommend services or methods to meet any special needs of the resident; and
(3) identify residents at risk.
(i) The county social services agency may conduct subsequent follow-up visits in cases
where the adjustment of the resident to the new placement is in question.
(j) Within 60 days of the completion of the follow-up visits, the county social services
agency shall submit a written summary of the follow-up work to the Departments of Health and
Human Services in a manner approved by the commissioners.
(k) The county social services agency shall submit to the Departments of Health and Human
Services a report of any issues that may require further review or monitoring.
(l) The county social services agency shall be responsible for the safe and orderly relocation
of residents in cases where an emergent need arises or when the licensee has abrogated its
responsibilities under the plan.
    Subd. 9. Penalties. Upon the recommendation of the commissioner of health, the
commissioner of human services may eliminate a closure rate adjustment under subdivision 10
for violations of this section.
    Subd. 10. Facility closure rate adjustment. Upon the request of a closing facility, the
commissioner of human services must allow the facility a closure rate adjustment equal to a 50
percent payment rate increase to reimburse relocation costs or other costs related to facility
closure. This rate increase is effective on the date the facility's occupancy decreases to 90 percent
of capacity days after the written notice of closure is distributed under subdivision 5 and shall
remain in effect for a period of up to 60 days. The commissioner shall delay the implementation
of rate adjustments under section 256B.437, subdivisions 3, paragraph (b), and 6, paragraph
(a), to offset the cost of this rate adjustment.
    Subd. 11. County costs. The commissioner of human services shall allocate up to $450
in total state and federal funds per nursing facility bed that is closing, within the limits of the
appropriation specified for this purpose, to be used for relocation costs incurred by counties for
resident relocation under this section or planned closures under section 256B.437. To be eligible
for this allocation, a county in which a nursing facility closes must provide to the commissioner a
detailed statement in a form provided by the commissioner of additional costs, not to exceed $450
in total state and federal funds per bed closed, that are directly incurred related to the county's role
in the relocation process.
History: 1Sp2001 c 9 art 5 s 9; 2002 c 379 art 1 s 113; 2005 c 56 s 1; 2006 c 282 art 20 s 7-16