1997 Minnesota Statutes

     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: 

    (1) the resident reimbursement classifications and 
 terminology established by rule under sections 256B.41 to 
 256B.48 are the basis for applying the level of care criteria 
 changes; 

    (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. 

    HIST: 1984 c 641 s 11; 1984 c 654 art 5 s 58; 1995 c 207 art 6 
 s 1,2; 1995 c 259 art 1 s 31; 1997 c 203 art 4 s 3