d. Licensed assisted living technical changes

Licensed assisted living technical changes

2022 Regular Session HF4065 Chapter 98, Article 1, Sections 21-60 Health & Human Services omnibus policy bill Effective: August 1, 2022

Short description

There were a number of technical changes made to licensed assisted living statutes this session—most brought forward by the Minnesota Department of Health. In general, these were issues that came to light during this first year of licensed assisted living.

Summary

Technical changes that passed during the session include the following: • Provides a definition to the term “serious injury”—which now has the meaning given in section 245.91 subdivision 6 • Includes a review of a provisional license applicants, owners, controlling individuals, managerial individuals, or assisted living directors’ compliance history in Minnesota and states other than Minnesota • Requires, for a license renewal, proof to show the facility cared for at least one resident at the assisted living facility listed on the license • Notwithstanding any other provision of law, a change of licensee does not require the facility to meet the design requirements of the FGI Institute, NFPA Life Safety Code, or new construction plans • Owners or managerial officials whose assisted living license have been revoked in Minnesota or any other state will not be able to hold an assisted living license in Minnesota for a period of five years • Expands the ability to bar any controlling individual, who had legal authority to affect or change decisions of an assisted living facility if the person also was a controlling individual in licensed home care, was a PCA, or a PCA provider who was convicted of a felony or gross misdemeanor related to the operation of such providers • Adds “an agent of the facility” to a facility, a managerial official, or an employee whose actions can support a correction order • Clarifies that correction order fines are issued based on per violation, not per incident • Clarifies that maltreatment fines are issued based on per incident • Directs fines collected from assisted living surveys to be deposited in a dedicated special revenue account, whose balance shall be annually appropriated to the commissioner for special projects to improve resident quality of care and outcomes in assisted living facilities • Removes the requirement in the posted grievance policy to post the contact information for regional ombudsman • Adds a requirement in the posted grievance policy to state that if an individual has a complaint about the facility or person providing services, the individual may contact the Office of Health Facility Complaints at the Minnesota Department of Health • Adds the Office of Ombudsman for Mental Health & Developmental Disabilities to the list of names and contact information to be provided to residents, and removes the regional ombudsman from that list of names that must be provided • Provides that for facilities constructed as of August 1, 2021, a variance to provide an option for a bath must be based on alterative measures taken, level of burden, and whether the variance will adversely affect the health, treatment, or safety of a resident • Drops the requirement that the assisted living contract must include the license number of the facility—replaces it with a requirement for assisted living contracts to include the licensed facility’s HFID number

o This change will no longer require updated contracts only as a result of a license renewal (which includes a new license number each time) • Clarifies that residents who do not receive any assisted living services are not required to undergo an initial nursing assessment • The assisted living contract must now include “a delineation of the grounds under which the resident may be discharged, evicted, or transferred or have housing or services terminated or be subject to an emergency relocation” • Facility responsibilities for coordinated moves (144G.55) now includes actions if the licensed facility obtains a new service provider or the facility has its license restricted, or the facility conducts a planned closure • Relocation plans—The facility must prepare a relocation plan to prepare for the move to the a new safe location or appropriate service provider • Clarifies the prior experience of an applicant for assisted living with dementia care’s assisted living’s director, managerial official, and clinical nurse supervisor will be considered when proving demonstrated capacity o The assisted living director and clinical nurse supervisors must have experience in managing residents with dementia to avoid the requirement to hire a consultant for sixmonths • Modifies the additional language that must be provided with the assisted living bill of rights:

If you want to report suspected abuse, neglect, or financial exploitation, you may contact the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about the facility or person providing your services, you may contact the Office of Health Facility Complaints, Minnesota Department of Health. If you would like to request advocacy services, you may also contact the Office of Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health and Developmental Disabilities.

• Adds a new required notice to be provided to residents:

For any notice to a resident, legal representative, or designated representative provided under this chapter or under Minnesota Rules, chapter 4659, that is required to include information regarding the Office of Ombudsman for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental Disabilities, the notice must contain the following language: "You may contact the Ombudsman for Long-Term Care for questions about your rights as an assisted living facility resident and to request advocacy services. As an assisted living facility resident, you may contact the Ombudsman for Mental Health and Developmental Disabilities to request advocacy regarding your rights, concerns, or questions on issues relating to services for mental health, developmental disabilities, or chemical dependency.

• Modifies the assisted living bill of rights regarding personal treatment and privacy by removing the phrase “where clearly inadvisable”:

Residents have the right to consideration of their privacy, individuality, and cultural identity as related to their social, religious, and psychological well-being. Staff must respect the privacy of a resident's space by knocking on the door and seeking consent before entering, except in an emergency or where clearly inadvisable or unless otherwise documented in the resident's service plan.

• Includes the Office of Ombudsman for Mental Health & Developmental Disabilities and representatives of the office from immunity from liability and includes them for classified data collection

• Changes the "long-term care consultation" to "long-term care options counseling for assisted living" and applies the requirement to assisted living facilities rather than housing with services establishments • Most areas of 144G that currently reference the Office of Ombudsman for Long-Term Care will now also be required to reference the Office of Ombudsman for Mental Health & Developmental

Disabilities: o Notice to residents (144G.20 Subd.12) o Resident transfer plans regarding final revocation, refusal to renew, or suspension of license (144G.20 Subd. 15) o Notice regarding a meeting to discuss a resident’s termination (144G.52 Subd.2) o Included as part of the content of notice of termination (144G.52 Subd.8) o Included as part of the content of emergency relocation (144G.52 Subd.9) o Included as part of the content of nonrenewal of housing (144G.53(b)) o Included as part of the content of a coordinate move (144G.55 Subd.1) o Included as part of the content of a transfer within the facility (144G.56 Subd.3) o Included as part of the content of a closure plan (144G.57 Subd.3) o Included as part of the resident notice regarding an approved closure plan (144G.57 subd.5) o Included as a required element of the service plan (144G.70 Subd.4) o Included in the updated assisted living bill of rights (144G.91 Subd.21) o Included as a reason to prohibit retaliation (contact with) regarding complaints (144G.92 Subd.1) o Included as information to be included with every assisted living contract (144g.93)

Implications

Numerous notices, postings, and policies will need to be updated. Contracts will need to be modified. New bill of rights will need to be provided.

Bill language:

Chapter 98, Article 1, Sections 21-60: https://www.revisor.mn.gov/laws/2022/0/Session+Law/Chapter/98/