Skip to main content Skip to office menu Skip to footer
Minnesota Legislature

Office of the Revisor of Statutes

144.6501 NURSING HOME ADMISSION CONTRACTS.
    Subdivision 1. Definitions. For purposes of this section, the following terms have the
meanings given them.
(a) "Facility" means a nursing home licensed under chapter 144A or a boarding care facility
licensed under sections 144.50 to 144.58.
(b) "Contract of admission," "admission contract," or "admission agreement," includes, but
is not limited to, all documents that a resident or resident's representative must sign at the time of,
or as a condition of, admission to the facility. Oral representations and statements between the
facility and the resident or resident's representative are not part of the contract of admission unless
expressly contained in writing in those documents. The contract of admission must specify the
obligations of the resident or the responsible party.
(c) "Legal representative" means an attorney-in-fact under a valid power of attorney executed
by the prospective resident, or a conservator or guardian appointed for the prospective resident, or
a representative payee appointed for the prospective resident, or other agent of limited powers.
(d) "Responsible party" means a person who has access to the resident's income and assets
and who agrees to apply the resident's income and assets to pay for the resident's care or who
agrees to make and complete an application for medical assistance on behalf of the resident.
    Subd. 2. Waivers of liability prohibited. An admission contract must not include a waiver
of facility liability for the health and safety or personal property of a resident while the resident
is under the facility's supervision. An admission contract must not include a provision that the
facility knows or should know to be deceptive, unlawful, or unenforceable under state or federal
law, nor any provision that requires or implies a lesser standard of care or responsibility than is
required by law.
    Subd. 3. Contracts of admission. (a) A facility shall make complete unsigned copies of
its admission contract available to potential applicants and to the state or local long-term care
ombudsman immediately upon request.
(b) A facility shall post conspicuously within the facility, in a location accessible to public
view, either a complete copy of its admission contract or notice of its availability from the facility.
(c) An admission contract must be printed in black type of at least ten-point type size. The
facility shall give a complete copy of the admission contract to the resident or the resident's legal
representative promptly after it has been signed by the resident or legal representative.
(d) An admission contract is a consumer contract under sections 325G.29 to 325G.37.
(e) All admission contracts must state in bold capital letters the following notice to applicants
for admission: "NOTICE TO APPLICANTS FOR ADMISSION. READ YOUR ADMISSION
CONTRACT. ORAL STATEMENTS OR COMMENTS MADE BY THE FACILITY OR YOU
OR YOUR REPRESENTATIVE ARE NOT PART OF YOUR ADMISSION CONTRACT
UNLESS THEY ARE ALSO IN WRITING. DO NOT RELY ON ORAL STATEMENTS OR
COMMENTS THAT ARE NOT INCLUDED IN THE WRITTEN ADMISSION CONTRACT."
    Subd. 4. Resident and facility obligations. (a) Before or at the time of admission, the
facility shall make reasonable efforts to communicate the content of the admission contract to,
and obtain on the admission contract the signature of, the person who is to be admitted to the
facility and the responsible party. The admission contract must be signed by the prospective
resident unless the resident is legally incompetent or cannot understand or sign the admission
contract because of the resident's medical condition.
(b) If the resident cannot sign the admission contract, the reason must be documented in the
resident's medical record by the admitting physician.
(c) If the determination under paragraph (b) has been made, the facility may request the
signature of another person on behalf of the applicant, subject to the provisions of paragraph
(d). The facility must not require the person to disclose any information regarding the person's
personal financial assets, liabilities, or income, unless the person voluntarily chooses to become
financially responsible for the resident's care. The facility must issue timely billing, respond to
questions, and monitor timely payment.
(d) A person who desires to assume financial responsibility for the resident's care may
contract with the facility to do so. A person other than the resident or a financially responsible
spouse who signs an admission contract must not be required by the facility to assume personal
financial liability for the resident's care. However, if the responsible party has signed the
admission contract and fails to make timely payment of the facility obligation, or knowingly fails
to spend down the resident's assets appropriately for the purpose of obtaining medical assistance,
then the responsible party shall be liable to the facility for the resident's costs of care which are
not paid for by medical assistance. A responsible party shall be personally liable only to the extent
the resident's income or assets were misapplied.
(e) The admission contract must include written notice in the signature block, in bold capital
letters, that a person other than the resident or financially responsible spouse may not be required
by the facility to assume personal financial liability for the resident's care.
(f) This subdivision does not preclude the facility from obtaining the signature of a legal
representative, if applicable.
    Subd. 5. Public benefits eligibility. An admission contract must clearly and explicitly state
whether the facility participates in the Medicare, medical assistance, or Veterans Administration
programs. If the facility's participation in any of those programs is limited for any reason, the
admission contract must clearly state the limitation and whether the facility is eligible to receive
payment from the program for the person who is considering admission or who has been admitted
to the facility.
    Subd. 6. Medical assistance payment. (a) An admission contract for a facility that is
certified for participation in the medical assistance program must state that neither the prospective
resident, nor anyone on the resident's behalf, is required to pay privately any amount for which the
resident's care at the facility has been approved for payment by medical assistance or to make any
kind of donation, voluntary or otherwise. Except as permitted under section 6015 of the Deficit
Reduction Act of 2005, Public Law 109-171, an admission contract must state that the facility does
not require as a condition of admission, either in its admission contract or by oral promise before
signing the admission contract, that residents remain in private pay status for any period of time.
(b) The admission contract must state that upon presentation of proof of eligibility, the
facility will submit a medical assistance claim for reimbursement and will return any and all
payments made by the resident, or by any person on the resident's behalf, for services covered by
medical assistance, upon receipt of medical assistance payment.
(c) A facility that participates in the medical assistance program shall not charge for the day
of the resident's discharge from the facility or subsequent days.
(d) If a facility's charges incurred by the resident are delinquent for 30 days, and no person
has agreed to apply for medical assistance for the resident, the facility may petition the court
under chapter 525 to appoint a representative for the resident in order to apply for medical
assistance for the resident.
(e) The remedy provided in this subdivision does not preclude a facility from seeking any
other remedy available under other laws of this state.
    Subd. 7. Consent to treatment. An admission contract must not include a clause requiring a
resident to sign a consent to all treatment ordered by any physician. An admission contract may
require consent only for routine nursing care or emergency care. An admission contract must
contain a clause that informs the resident of the right to refuse treatment.
    Subd. 8. Written acknowledgment. An admission contract must contain a written
acknowledgment that the resident has been informed of the patient's bill of rights, as required in
section 144.652.
    Subd. 9. Violations; penalties. (a) Violation of this section is grounds for issuance of a
correction order, and if uncorrected, a penalty assessment issued by the commissioner of health,
under section 144A.10. The civil fine for noncompliance with a correction order issued under
this section is $250 per day.
(b) Unless otherwise expressly provided, the remedies or penalties provided by this
subdivision do not preclude a resident from seeking any other remedy and penalty available
under other laws of this state.
    Subd. 10. Applicability. This section applies to new admissions to facilities on and after
October 1, 1989. This section does not require the execution of a new admission contract for a
resident who was residing in a facility before June 1, 1989. However, provisions of the admission
contract that are inconsistent with or in conflict with this section are voidable at the sole option of
the resident. Residents must be given notice of the changes in admission contracts according to
this section and must be given the opportunity to execute a new admission contract that conforms
to this section.
History: 1989 c 285 s 2; 1990 c 426 art 1 s 19; 1995 c 136 s 1,2; 2005 c 10 art 4 s 1;
2006 c 282 art 17 s 23