MN Assisted Living License Regulations

CARE PROVIDERS OF MINNESOTA

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Minnesota Assisted Living License Regulations

Patti Cullen President/CEO

August 2021

MN Licensed Assisted Living Statutes Table of Contents TOPIC

Assisted Living Bill of Rights Assisted Living Bill of Rights - Distributed to Residents Assisted Living Contracts - Arbitration Assisted Living Contracts - Availability of Long-Term Care Consultation Services Assisted Living Contracts - Consumer Advocacy and Legal Services Assisted Living Contracts - Contract Termination - Coordination of Move Assisted Living Contracts - Contract Termination - Emergency Relocation Assisted Living Contracts - Contract Termination - Notice Required Assisted Living Contracts - Contract Termination - Required Elements Assisted Living Contracts - Contract Termination - Resident Appeal Rights Assisted Living Contracts - Contract Termination - Resident Right to Return Assisted Living Contracts - Contract Termination - Safe Location Assisted Living Contracts - Contract Termination - Relocation Plan Assisted Living Contracts - Expedited Termination Requirements Assisted Living Contracts - Nonrenewal of Housing/Lease Assisted Living Contracts - Offer to Declare a Designated Representative Assisted Living Contracts - Prohibited Waivers of Liability Assisted Living Contracts - Required Elements Assisted Living Contracts - Retention of Contracts Assisted Living Contracts - Termination Requirements Assisted Living Requirements - Access to RN 24/7 Assisted Living Requirements - Assistance with Arranging Transportation Assisted Living Requirements - Assistance with Community Resources Assisted Living Requirements - Awake Staff 24/7 Assisted Living Requirements - Clinical Nurse Supervisor Assisted Living Requirements - Communicable Disease Reporting Assisted Living Requirements - Compliance with Nurse Practice Act Assisted Living Requirements - Delegating Services Assisted Living Requirements - Disaster and Emergency Plan Staff Training Assisted Living Requirements - Disaster Planning and Emergency Preparedness Plan Assisted Living Requirements - Employee Records - Required Elements Assisted Living Requirements - Family Council Required Assisted Living Requirements - Food Prepared According to MN Food Code Assisted Living Requirements - Handling of Resident Finances and Property Assisted Living Requirements - Have Available 3 Meals per Day Assisted Living Requirements - Individualized Abuse Prevention Plan Assisted Living Requirements - Infection Control Program Assisted Living Requirements - Meals Comply with USDA Recommendations Assisted Living Requirements - Medical Cannabis Assisted Living Requirements - Menus Prepared at Least One Week in Advance Assisted Living Requirements - Missing Resident Policy Assisted Living Requirements - Permit Resident Access to Food Any Time Assisted Living Requirements - Person Centered Planning and Service Assisted Living Requirements - Planned Closures Assisted Living Requirements - Posting, Exit Diagrams, Annual Resident Training Assisted Living Requirements - Prohibition Requiring Including and Paying for Meals Assisted Living Requirements - Protecting Resident Rights - Information Required Assisted Living Requirements - Provide Seasonal Fruits and Vegetables Assisted Living Requirements - Providing Culturally Sensitive Programs Assisted Living Requirements - Providing Social and Recreational Activities Assisted Living Requirements - Reporting Maltreatment Assisted Living Requirements - Reporting under the MN Vulnerable Adults Act Assisted Living Requirements - Required Minimum Policies and Procedures Assisted Living Requirements - Required Notices

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MN Licensed Assisted Living Statutes Table of Contents TOPIC PAGE Assisted Living Requirements - Required Quality Management Plan in Place 37 Assisted Living Requirements - Resident Access to Visitors 34 Assisted Living Requirements - Resident Council Required 36 Assisted Living Requirements - Resident Grievances 37 Assisted Living Requirements - Resident Involvement in Menu Planning 35 Assisted Living Requirements - Resident Request to Discontinue Life-Sustaining Treatment 66 Assisted Living Requirements - Resident Right to Choose Roommate 34 Assisted Living Requirements - Resident Right to Have Lockable Door 34 Assisted Living Requirements - Resident's Ability to Request Assistance 24/7 35 Assisted Living Requirements - Resident's Furnish and Decorate Unit 35 Assisted Living Requirements - Restrictions on Staff 38 Assisted Living Requirements - Services - Acceptance of Residents 64 Assisted Living Requirements - Services - Initial Nursing Assessments 64 Assisted Living Requirements - Services - Reassessments Based on Change in Condition 64 Assisted Living Requirements - Services - Scheduled Nursing Reassessments and Monitoring 64 Assisted Living Requirements - Services - Service Plan - Required Elements 65 Assisted Living Requirements - Services - Service Plan - Temporary Service Plan 65 Assisted Living Requirements - Transfer of Resident's within the Facility 55 Assisted Living Requirements - Tuberculosis Prevention and Control 39 Assisted Living Requirements - Weekly Housekeeping 35 Assisted Living Requirements - Weekly Laundry Services 35 Background Studies of Applicants Required 14 Definitions 1 Dementia Care Licensed Facilities - Additional Minimum Services Required Under Dementia License 76 Dementia Care Licensed Facilities - Awake Staff Requirement on Unit if Secured Unit 74 Dementia Care Licensed Facilities - Code Reference for New (non-conversion) Licenses 74 Dementia Care Licensed Facilities - Demonstrated Capacity in Dementia Care 72 Dementia Care Licensed Facilities - Fire Drills 74 Dementia Care Licensed Facilities - Fire Protection and Physical Environment 74 Dementia Care Licensed Facilities - Hazard Vulnerabilty Assessment Requirement 74 Dementia Care Licensed Facilities - Nighttime Staffing Based on Sleeping Patterns and Needs of Reside 76 Dementia Care Licensed Facilities - Only Dementia Trained Staff to be Used 76 Dementia Care Licensed Facilities - Pre-Service and In-Service Training 76 Dementia Care Licensed Facilities - Process When Dementia Trained Staff are not Available 76 Dementia Care Licensed Facilities - Qualifications of Staff Supervising Dementia Staff Training 76 Dementia Care Licensed Facilities - Relinquishing License Requirements 73 Dementia Care Licensed Facilities - Required Annual Dementia Training for Licensed Assisted Living Di 75 Dementia Care Licensed Facilities - Required Policies 75 Dementia Care Licensed Facilities - Staffing Requirements 76 Dementia Care Licensed Facilities - Staffing to Meet Scheduled and Unscheduled Needs of Residents 76 Innovation Variance 32 License - Application 12 License - Controlling Individual Restrictions 23 License - Enforcement 21 License - Fees 13 License - General 10 License - Immediate Temporary Suspension 22 License - Mandatory Revocation 22 License - Order for Stay, eRvocatoin Suspension, or Nonrenewal 24 License - Posting 37 License - Posting Information Regarding 911 in Common Areas 39 License - Posting Information Regarding MAARC 39 License - Posting Information Regarding Reporting Crime and Maltreatment 39 License - Provisional 15

MN Licensed Assisted Living Statutes Table of Contents TOPIC

License - Renewal License - Responsible for Housing and Services License - Transition Period Renewals Licensed Assisted Living Director (LALD) - CEUs Licensed Assisted Living Director (LALD) - Dementia Training Licensed Assisted Living Director (LALD) - General Medication Management Medication Management - Assessment Medication Management - Delegation Medication Management - Disposition of Medications Medication Management - Documentation Medication Management - Individualized Medication Plan Medication Management - Medication Record Medication Management - Missing, Loss, or Spillage of Medications Medication Management - OTC and Dietary Supplements Medication Management - Policies and Procedures Medication Management - Prescribed and Nonprescribed Medications Medication Management - Prescription Drug Containers and Labels Medication Management - Prescription Renewals Medication Management - Prescriptions Medication Management - Prohibition on Drugs Being Shared Medication Management - Residents on Planned Time Away Medication Management - Storage of Medications Medication Management - Verbal Prescription Orders Medication Management - Written or Electronic Prescriptions Minimum Assisted Living Facility Requirements Notification of Change of Information Physical Environment - Bathtup Required for New Licenses Physical Environment - Codes Required for New Licenses Physical Environment - Fire Protection Physical Environment - Fire Safety and Evacuation Plan Physical Environment - Fire Safety and Evacuation Plan Make Available Resident Training Physical Environment - Fire Safety and Evacuation Plan Required Staff Training Physical Environment - Fire/Evacuation Drills Required Physical Environment - Maintain in Good Repair Physical Environment - Maintainance Program Physical Environment - Minimum Requirements Physical Environment - Plan Reviews Physical Environment - Portable Fire Extingishers Physical Environment - Smoke Alarms Physical Environment - Variance or Waiver Requests Resident Records- Access Resident Records - Required Contents Resident Records - Requirements Resident Records - Security Resident Records - Transfer of Records Restrictions Under Home and Community-Based Waivers Retailiation Prohibited Secured Dementia Unit - ALDC License Required Staffing - Annual Training Required Staffing - Availabilty of RN Staffing - Current Professional Licenses Required Staffing - Delegation and Supervision Staffing - Delegation by RN to ULP

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MN Licensed Assisted Living Statutes Table of Contents TOPIC

Staffing - Dementia Training Required Staffing - NETStudy 2.0 Background Studies Required Staffing - Orientation - Not Transferrable Staffing - Orientation - Required Topics Staffing - Staff Training and Competencies of ULPs Staffing - Supervision of Staff Requirements Staffing - Temporary/Pool Staff Requirements Staffing - Unlicensed Personnel Requirements Staffing Plan Staffing Requirements Surveys - Additional Penalties Surveys - Conducted Every Two Years Surveys - Correction Orders Surveys - Fines for Maltreatment Surveys - Fines for Noncompliance Surveys - Follow-Up Surveys (resurveys) Surveys - Immediate Fines Surveys - Levels of Violations Surveys - Notice of Noncompliance Surveys - Payment and Deposit of Fines Surveys - Reconsiderations of Correction Orders and Fines Surveys - Reconsiderations Options Surveys - Required Follow-Up Surveys Surveys - Scope of Violations Transfer of License Limitations Treatments and Therapies - Administration of Treatments or Therapies Treatments and Therapies - Documentation of Treatments or Therapies Treatments and Therapies - Individualized Treatment or Therapy Management Plan Treatments and Therapies - Orders Treatments and Therapies - Oright to Use Outside Treatment or Therapy Provider Treatments and Therapies - Policies and Procedures Uniform Disclosure of Assisted Living Services and Amenities (UDALSA)

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Chapter 144G ASSISTED LIVING LICENSURE 144G.08 DEFINITIONS. Subdivision 1. Applicability. For the purposes of this chapter, the terms in this section have the meanings given.

Subd. 2. Adult. "Adult" means a natural person who has attained the age of 18 years.

Subd. 3. Advanced practice registered nurse. "Advanced practice registered nurse" has the meaning given in section 148.171, subdivision 3.

Subd. 4. Applicant. "Applicant" means an individual, legal entity, or other organization that has applied for licensure under this chapter.

Subd. 4a. Assisted Living Campus. “Assisted Living Campus” or “campus” means: (1) a single building having two or more addresses, located on the same property with a single property identification number; (2) two or more buildings, each with a separate address, located on the same property with a single property identification number; or (3) two or more buildings at different addresses, located on properties with different property identification numbers, that share a portion of a legal property boundary.

Subd. 5. Assisted living contract. "Assisted living contract" means the legal agreement between a resident and an assisted living facility for housing and, if applicable, assisted living services.

Subd. 6. Assisted living director. "Assisted living director" means a person who administers, manages, supervises, or is in general administrative charge of an assisted living facility, whether or not the individual has an ownership interest in the facility, and whether or not the person's functions or duties are shared with one or more individuals and who is licensed by the Board of Executives for Long Term Services and Supports pursuant to section 144A.20.

Subd. 7. Assisted living facility. "Assisted living facility" means a licensed facility that provides sleeping accommodations and assisted living services to one or more adults. Assisted living facility includes assisted living facility with dementia care, and does not include: (1) emergency shelter, transitional housing, or any other residential units serving exclusively or primarily homeless individuals, as defined under section 116L.361; (2) a nursing home licensed under chapter 144A; (3) a hospital, certified boarding care, or supervised living facility licensed under sections 144.50 to 144.56; (4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, or under chapter 245D or 245G; (5) services and residential settings licensed under chapter 245A, including adult foster care and services and settings governed under the standards in chapter 245D;

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(6) a private home in which the residents are related by kinship, law, or affinity with the provider of services; (7) a duly organized condominium, cooperative, and common interest community, or owners' association of the condominium, cooperative, and common interest community where at least 80 percent of the units that comprise the condominium, cooperative, or common interest community are occupied by individuals who are the owners, members, or shareholders of the units; (8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593; (9) a setting offering services conducted by and for the adherents of any recognized church or religious denomination for its members exclusively through spiritual means or by prayer for healing; (10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with low-income housing tax credits pursuant to United States Code, title 26, section 42, and units financed by the Minnesota Housing Finance Agency that are intended to serve individuals with disabilities or individuals who are homeless, except for those developments that market or hold themselves out as assisted living facilities and provide assisted living services; (11) rental housing developed under United States Code, title 42, section 1437, or United States Code, title 12, section 1701q; (12) rental housing designated for occupancy by only elderly or elderly and disabled residents under United States Code, title 42, section 1437e, or rental housing for qualifying families under Code of Federal Regulations, title 24, section 983.56; (13) rental housing funded under United States Code, title 42, chapter 89, or United States Code, title 42, section 8011; or (14) a covered setting as defined in section 325F.721, subdivision 1, paragraph (b); or (15) any establishment that exclusively or primarily serves as a shelter or temporary shelter for victims of domestic or any other form of violence.

Subd. 7a. Assisted Living Facility License. ”Assisted living facility license” or “license” means a certificate issued by the commissioner under section 144G.10 that authorizes the licensee to manage, control, and operate an assisted living facility for a specified period of time and in accordance with the terms of the license, this chapter, and the rules of the commissioner.

Subd. 8. Assisted living facility with dementia care. "Assisted living facility with dementia care" means a licensed assisted living facility that is advertised, marketed, or otherwise promoted as providing specialized care for individuals with Alzheimer's disease or other dementias. An assisted living facility with a secured dementia care unit must be licensed as an assisted living facility with dementia care.

Subd. 9. Assisted living services. "Assisted living services" includes one or more of the following: (1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, and bathing; (2) providing standby assistance; (3) providing verbal or visual reminders to the resident to take regularly scheduled medication, which includes bringing the resident previously set up medication, medication in original containers, or liquid or food to accompany the medication; (4) providing verbal or visual reminders to the resident to perform regularly scheduled treatments and exercises; (5) preparing specialized diets ordered by a licensed health professional; 2

(6) services of an advanced practice registered nurse, registered nurse, licensed practical nurse, physical therapist, respiratory therapist, occupational therapist, speech-language pathologist, dietitian or nutritionist, (7) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed health professional within the person's scope of practice; (8) medication management services; (9) hands-on assistance with transfers and mobility; (10) treatment and therapies; (11) assisting residents with eating when the residents have complicated eating problems as identified in the resident record or through an assessment such as difficulty swallowing, recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous instruments to be fed; (12) providing other complex or specialty health care services; and (13) supportive services in addition to the provision of at least one of the services listed in clauses (1) to (12).

Subd. 10. Authority having jurisdiction. "Authority having jurisdiction" means an organization, office, or individual responsible for enforcing the requirements of a code or standard, or for approving equipment, materials, an installation, or a procedure.

Subd. 11. Authorized agent. "Authorized agent" means the person who is authorized to accept service of notices and orders on behalf of the licensee.

Subd. 12. Change of ownership. "Change of ownership" means a change in the licensee that is responsible for the management, control, and operation of a facility.

Subd. 13. Commissioner. "Commissioner" means the commissioner of health.

Subd. 14. Controlled substance. "Controlled substance" has the meaning given in section 152.01, subdivision 4.

Subd. 15. Controlling individual. (a) "Controlling individual" means an owner and the following individuals and entities, if applicable: (1) each officer of the organization, including the chief executive officer and chief financial officer; (2) each managerial official; and (3) any entity with at least a five percent mortgage, deed of trust, or other security interest in the facility. (b) Controlling individual does not include: (1) a bank, savings bank, trust company, savings association, credit union, industrial loan and thrift company, investment banking firm, or insurance company unless the entity operates a program directly or through a subsidiary; (2) government and government-sponsored entities such as the U.S. Department of Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the Minnesota Housing Finance Agency which provide loans, financing, and insurance products for housing sites; (3) an individual who is a state or federal official, a state or federal employee, or a member or employee of the governing body of a political subdivision of the state or federal government that operates one or more

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facilities, unless the individual is also an officer, owner, or managerial official of the facility, receives remuneration from the facility, or owns any of the beneficial interests not excluded in this subdivision; (4) an individual who owns less than five percent of the outstanding common shares of a corporation: (i) whose securities are exempt under section 80A.45, clause (6); or (ii) whose transactions are exempt under section 80A.46, clause (2); (5) an individual who is a member of an organization exempt from taxation under section 290.05, unless the individual is also an officer, owner, or managerial official of the license or owns any of the beneficial interests not excluded in this subdivision. This clause does not exclude from the definition of controlling individual an organization that is exempt from taxation; or (6) an employee stock ownership plan trust, or a participant or board member of an employee stock ownership plan, unless the participant or board member is a controlling individual.

Subd. 16. Dementia. "Dementia" means the loss of cognitive function, including the ability to think, remember, problem solve, or reason, of sufficient severity to interfere with an individual's daily functioning.

Dementia is caused by different diseases and conditions, including but not limited to Alzheimer's disease, vascular dementia, neurodegenerative conditions, Creutzfeldt-Jakob disease, and Huntington's disease.

Subd. 17. Dementia care services. "Dementia care services" means ongoing care for behavioral and psychological symptoms of dementia, including planned group and individual programming and personcentered care practices provided according to section 144G.84 to support activities of daily living for people living with dementia.

Subd. 18. Dementia-trained staff. "Dementia-trained staff" means any employee who has completed the minimum training required under sections 144G.64 and 144G.83 and has demonstrated knowledge and the ability to support individuals with dementia.

Subd. 19. Designated representative. "Designated representative" means a person designated under section 144G.50.

Subd. 20. Dietary supplement. "Dietary supplement" means a product taken by mouth that contains a dietary ingredient intended to supplement the diet. Dietary ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissue, glandulars, or metabolites.

Subd. 21. Dietitian. "Dietitian" means a person licensed as a dietitian under section 148.624.

Subd. 22. Direct contact. "Direct contact" means providing face-to-face care, training, supervision, counseling, consultation, or medication assistance to residents of a facility.

Subd. 23. Direct ownership interest. "Direct ownership interest" means an individual or legal entity with the possession of at least five percent equity in capital, stock, or profits of the licensee, or who is a member of a limited liability company of the licensee.

Subd. 24. Facility. "Facility" means an assisted living facility.

Subd. 25. Hands-on assistance. "Hands-on assistance" means physical help by another person without which the resident is not able to perform the activity.

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Subd. 26. "I'm okay" check services. "'I'm okay' check services" means having, maintaining, and documenting a system to, by any means, check on the safety of a resident a minimum of once daily or more frequently according to the assisted living contract.

Subd. 27. Indirect ownership interest. "Indirect ownership interest" means an individual or legal entity with a direct ownership interest in an entity that has a direct or indirect ownership interest of at least five percent in an entity that is a licensee.

Subd. 28. Legal representative. "Legal representative" means one of the following in the order of priority listed, to the extent the person may reasonably be identified and located: (1) a court-appointed guardian acting in accordance with the powers granted to the guardian under chapter 524; (2) a conservator acting in accordance with the powers granted to the conservator under chapter 524; (3) a health care agent acting in accordance with the powers granted to the health care agent under chapter 145C; or (4) an attorney-in-fact acting in accordance with the powers granted to the attorney-in-fact by a written power of attorney under chapter 523.

Subd. 29. Licensed health professional. "Licensed health professional" means a person licensed in Minnesota to practice a profession described in section 214.01, subdivision 2.

Subd. 30. Licensed practical nurse. "Licensed practical nurse" has the meaning given in section 148.171, subdivision 8.

Subd. 31. Licensed resident capacity. "Licensed resident capacity" means the resident occupancy level requested by a licensee and approved by the commissioner.

Subd. 32. Licensee. "Licensee" means a person or legal entity to whom the commissioner issues a license for an assisted living facility and who is responsible for the management, control, and operation of a facility.

Subd. 33. Maltreatment. "Maltreatment" means conduct described in section 626.5572, subdivision 15.

Subd. 34. Management agreement. "Management agreement" means a written, executed agreement between a licensee and manager regarding the provision of certain services on behalf of the licensee.

Subd. 35. Manager. "Manager" means an individual or legal entity designated by the licensee through a management agreement to act on behalf of the licensee in the on-site management of the assisted living facility.

Subd. 36. Managerial official. "Managerial official" means an individual who has the decision-making authority related to the operation of the facility and the responsibility for the ongoing management or direction of the policies, services, or employees of the facility.

Subd. 37. Medication. "Medication" means a prescription or over-the-counter drug. For purposes of this chapter only, medication includes dietary supplements.

Subd. 38. Medication administration. "Medication administration" means performing a set of tasks that includes the following:

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(1) checking the resident's medication record; (2) preparing the medication as necessary; (3) administering the medication to the resident; (4) documenting the administration or reason for not administering the medication; and (5) reporting to a registered nurse or appropriate licensed health professional any concerns about the medication, the resident, or the resident's refusal to take the medication.

Subd. 39. Medication management. "Medication management" means the provision of any of the following medication-related services to a resident: (1) performing medication setup; (2) administering medications; (3) storing and securing medications; (4) documenting medication activities; (5) verifying and monitoring the effectiveness of systems to ensure safe handling and administration; (6) coordinating refills; (7) handling and implementing changes to prescriptions; (8) communicating with the pharmacy about the resident's medications; and (9) coordinating and communicating with the prescriber.

Subd. 40. Medication reconciliation. "Medication reconciliation" means the process of identifying the most accurate list of all medications the resident is taking, including the name, dosage, frequency, and route, by comparing the resident record to an external list of medications obtained from the resident, hospital, prescriber, or other provider.

Subd. 41. Medication setup. "Medication setup" means arranging medications by a nurse, pharmacy, or authorized prescriber for later administration by the resident or by facility staff.

Subd. 42. New construction. "New construction" means a new building, renovation, modification, reconstruction, physical changes altering the use of occupancy, or addition to a building.

Subd. 43. Nurse. "Nurse" means a person who is licensed under sections 148.171 to 148.285.

Subd. 44. Nutritionist. "Nutritionist" means a person licensed as a nutritionist under section 148.624.

Subd. 45. Occupational therapist. "Occupational therapist" means a person who is licensed under sections 148.6401 to 148.6449.

Subd. 46. Ombudsman. "Ombudsman" means the ombudsman for long-term care.

Subd. 47. Over-the-counter drug. "Over-the-counter drug" means a drug that is not required by federal law to bear the symbol "Rx only."

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Subd. 48. Owner. "Owner" means an individual or legal entity that has a direct or indirect ownership interest of five percent or more in a licensee. For purposes of this chapter, "owner of a nonprofit corporation" means the president and treasurer of the board of directors or, for an entity owned by an employee stock ownership plan, means the president and treasurer of the entity. A government entity that is issued a license under this chapter shall be designated the owner.

Subd. 49. Person-centered planning and service delivery. "Person-centered planning and service delivery" means services as defined in section 245D.07, subdivision 1a, paragraph (b).

Subd. 50. Pharmacist. "Pharmacist" has the meaning given in section 151.01, subdivision 3.

Subd. 51. Physical therapist. "Physical therapist" means a person who is licensed under sections 148.65 to 148.78.

Subd. 52. Physician. "Physician" means a person who is licensed under chapter 147.

Subd. 53. Prescriber. "Prescriber" means a person who is authorized by section 148.235; 151.01, subdivision 23; or 151.37 to prescribe prescription drugs.

Subd. 54. Prescription. "Prescription" has the meaning given in section 151.01, subdivision 16a.

Subd. 55. Provisional license. "Provisional license" means the initial license the commissioner issues after approval of a complete written application and before the commissioner completes the provisional license survey and determines that the provisional licensee is in substantial compliance.

Subd. 56. Regularly scheduled. "Regularly scheduled" means ordered or planned to be completed at predetermined times or according to a predetermined routine.

Subd. 57. Reminder. "Reminder" means providing a verbal or visual reminder to a resident.

Subd. 58. Repeat violation. "Repeat violation" means the issuance of two or more correction orders within a 12-month period for a violation of the same provision of a statute or rule.

Subd. 59. Resident. "Resident" means an adult living in an assisted living facility who has executed an assisted living contract.

Subd. 60. Resident record. "Resident record" means all records that document information about the services provided to the resident.

Subd. 61. Respiratory therapist. "Respiratory therapist" means a person who is licensed under chapter 147C. Subd. 62. Secured dementia care unit. "Secured dementia care unit" means a designated area or setting designed for individuals with dementia that is locked or secured to prevent a resident from exiting, or to limit a resident's ability to exit, the secured area or setting. A secured dementia care unit is not solely an individual resident's living area.

Subd. 63. Service plan. "Service plan" means the written plan between the resident and the provisional licensee or licensee about the services that will be provided to the resident.

Subd. 64. Social worker. "Social worker" means a person who is licensed under chapter 148D or 148E. Subd. 65. Speech-language pathologist. "Speech-language pathologist" has the meaning given in section 148.512, subdivision 17.

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Subd. 66. Standby assistance. "Standby assistance" means the presence of another person within arm's reach to minimize the risk of injury while performing daily activities through physical intervention or cueing to assist a resident with an assistive task by providing cues, oversight, and minimal physical assistance.

Subd. 67. Substantial compliance. "Substantial compliance" means complying with the requirements in this chapter sufficiently to prevent unacceptable health or safety risks to residents.

Subd. 68. Supportive services. "Supportive services" means: (1) assistance with laundry, shopping, and household chores; (2) housekeeping services; (3) provision or assistance with meals or food preparation; (4) help with arranging for, or arranging transportation to, medical, social, recreational, personal, or social services appointments; (5) provision of social or recreational services; or (6) "I'm okay" check services.

Arranging for services does not include making referrals, or contacting a service provider in an emergency.

Subd. 69. Survey. "Survey" means an inspection of a licensee or applicant for licensure for compliance with this chapter and applicable rules.

Subd. 70. Surveyor. "Surveyor" means a staff person of the department who is authorized to conduct surveys of assisted living facilities.

Subd. 71. Treatment or therapy. "Treatment" or "therapy" means the provision of care, other than medications, ordered or prescribed by a licensed health professional and provided to a resident to cure, rehabilitate, or ease symptoms.

Subd. 72. Unit of government. "Unit of government" means a city, county, town, school district, other political subdivision of the state, or agency of the state or federal government, that includes any instrumentality of a unit of government.

Subd. 73. Unlicensed personnel. "Unlicensed personnel" means individuals not otherwise licensed or certified by a governmental health board or agency who provide services to a resident.

Subd. 74. Verbal. "Verbal" means oral and not in writing.

History: 2019 c 60 art 1 s 2,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 2, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 2, the effective date.

144G.09 COMMISSIONER OVERSIGHT AND AUTHORITY OVER ASSISTED LIVING FACILITIES. Subdivision 1. Regulations. The commissioner shall regulate assisted living facilities pursuant to this chapter. The regulations shall include the following:

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(1) provisions to assure, to the extent possible, the health, safety, well-being, and appropriate treatment of residents while respecting individual autonomy and choice; (2) requirements that facilities furnish the commissioner with specified information necessary to implement this chapter; (3) standards of training of facility personnel; (4) standards for the provision of assisted living services; (5) standards for medication management; (6) standards for supervision of assisted living services; (7) standards for resident evaluation or assessment; (8) standards for treatments and therapies; (9) requirements for the involvement of a resident's health care provider, the documentation of the health care provider's orders, if required, and the resident's service plan; (10) standards for the maintenance of accurate, current resident records; (11) the establishment of levels of licenses based on services provided; and (12) provisions to enforce these regulations and the assisted living bill of rights.

[See Note.]

Subd. 2. Regulatory functions. (a) The commissioner shall: (1) license, survey, and monitor without advance notice assisted living facilities in accordance with this chapter and rules; (2) survey every provisional licensee within one year of the provisional license issuance date subject to the provisional licensee providing assisted living services to residents; (3) survey assisted living facility licensees at least once every two years; (4) investigate complaints of assisted living facilities; (5) issue correction orders and assess civil penalties under sections 144G.30 and 144G.31; (6) take action as authorized in section 144G.20; and (7) take other action reasonably required to accomplish the purposes of this chapter. (b) The commissioner shall review blueprints for all new facility construction and must approve the plans before construction may be commenced. (c) The commissioner shall provide on-site review of the construction to ensure that all physical environment standards are met before the facility license is complete.

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Subd. 3. Rulemaking authorized. (a) The commissioner shall adopt rules for all assisted living facilities that promote person-centered planning and service delivery and optimal quality of life, and that ensure resident rights are protected, resident choice is allowed, and public health and safety is ensured. (b) On July 1, 2019, the commissioner shall begin rulemaking. (c) The commissioner shall adopt rules that include but are not limited to the following: (1) staffing appropriate for each licensure category to best protect the health and safety of residents no matter their vulnerability; (2) training prerequisites and ongoing training, including dementia care training and standards for demonstrating competency; (3) procedures for discharge planning and ensuring resident appeal rights; (4) initial assessments, continuing assessments, and a uniform assessment tool; (5) emergency disaster and preparedness plans; (6) uniform checklist disclosure of services; (7) a definition of serious injury that results from maltreatment; (8) conditions and fine amounts for planned closures; (9) procedures and timelines for the commissioner regarding termination appeals between facilities and the Office of Administrative Hearings; (10) establishing base fees and per-resident fees for each category of licensure; (11) considering the establishment of a maximum amount for any one fee; (12) procedures for relinquishing an assisted living facility with dementia care license and fine amounts for noncompliance; and (13) procedures to efficiently transfer existing housing with services registrants and home care licensees to the new assisted living facility licensure structure. (d) The commissioner shall publish the proposed rules by December 31, 2019, and shall publish final rules by December 31, 2020.

History: 2019 c 60 art 1 s 34,41,47 NOTE: Subdivisions 1 and 2, as added by Laws 2019, chapter 60, article 1, section 34, are effective August 1, 2021. Laws 2019, chapter 60, article 1, section 34, the effective date.

144G.10 ASSISTED LIVING FACILITY LICENSE. Subdivision 1 License required. (a)(1) Beginning August 1, 2021, no assisted living facility may operate in Minnesota unless it is licensed under this chapter.

(2) No facility or building on a campus may provide assisted living services until obtaining the required license under paragraphs (c) to (e). (b) The licensee is legally responsible for the management, control, and operation of the facility, regardless of the existence of a management agreement or subcontract. Nothing in this chapter shall in any way affect the rights and remedies available under other law. (c) Upon approving an application for an assisted living facility license, the commissioner shall issue a single license for each building that is operated by the licensee as an assisted living facility and is located at a separate address, except as provided under paragraph (d) or (e).

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(d) Upon approving an application for an assisted living facility license, the commissioner may issue a single license for two or more buildings on a campus that are operated by the same licensee as an assisted living facility. An assisted living facility license for a campus must identify the address and licensed resident capacity of each building located on the campus in which assisted living services are provided. (e) Upon approving an application for an assisted living facility license, the commissioner may: (1) issue a single license for two or more buildings on a campus that are operated by the same licensee as an assisted living facility with dementia care, provided the assisted living facility for dementia care license for a campus identifies the buildings operating as assisted living facilities with dementia care; or (2) issue a separate assisted living facility with dementia care license for a building that is on a campus and that is operating as an assisted living facility with dementia care.

Subd. 1a. Assisted living director license required. Each assisted living facility must employ an assisted living director licensed or permitted by the Board of Executives for Long Term Services and Supports.

Subd. 2. Licensure categories. (a) The categories in this subdivision are established for assisted living facility licensure.

(1) The assisted living facility category is for assisted living facilities that only provide assisted living services.

(2) The assisted living facility with dementia care category is for assisted living facilities that provide assisted living services and dementia care services. An assisted living facility with dementia care may also provide dementia care services in a secured dementia care unit. (b) An assisted living facility that has a secured dementia care unit must be licensed as an assisted living facility with dementia care.

Subd. 3. Licensure under other law. An assisted living facility licensed under this chapter is not requiredto also be licensed as a boarding establishment, food and beverage service establishment, hotel, motel, lodging establishment, resort, or restaurant under chapter 157.

Subd. 4. Violations; penalty. (a) Operating an assisted living facility without a license is a misdemeanor, and the commissioner may also impose a fine. (b) A controlling individual of the facility in violation of this section is guilty of a misdemeanor. This paragraph shall not apply to any controlling individual who had no legal authority to affect or change decisions related to the operation of the facility. (c) The sanctions in this section do not restrict other available sanctions in law.

History: 2019 c 60 art 1 s 3,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 3, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 3, the effective date.

144G.11 APPLICABILITY OF OTHER LAWS. Assisted living facilities: (1) are subject to and must comply with chapter 504B; (2) must comply with section 325F.72; and (3) are not required to obtain a lodging license under chapter 157 and related rules.

History: 2019 c 60 art 1 s 44,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 44, is effective August 1, 11

2021. Laws 2019, chapter 60, article 1, section 44, the effective date.

144G.12 APPLICATION FOR LICENSURE. Subdivision 1. License applications. Each application for an assisted living facility license, including provisional and renewal applications, must include information sufficient to show that the applicant meets the requirements of licensure, including: (1) the business name and legal entity name of the licensee, and the street address and mailing address of the facility; (2) the names, e-mail addresses, telephone numbers, and mailing addresses of all owners, controlling individuals, managerial officials, and the assisted living director; (3) the name and e-mail address of the managing agent and manager, if applicable; (4) the licensed resident capacity and the license category; (5) the license fee in the amount specified in section 144.122; (6) documentation of compliance with the background study requirements in section 144G.13 for the owner, controlling individuals, and managerial officials. Each application for a new license must include documentation for the applicant and for each individual with five percent or more direct or indirect ownership in the applicant; (7) evidence of workers' compensation coverage as required by sections 176.181 and 176.182; (8) documentation that the facility has liability coverage; (9) a copy of the executed lease agreement between the landlord and the licensee, if applicable; (10) a copy of the management agreement, if applicable; (11) a copy of the operations transfer agreement or similar agreement, if applicable; (12) an organizational chart that identifies all organizations and individuals with an ownership interest in the licensee of five percent or greater and that specifies their relationship with the licensee and with each other; (13) whether the applicant, owner, controlling individual, managerial official, or assisted living director of the facility has ever been convicted of: (i) a crime or found civilly liable for a federal or state felony level offense that was detrimental to the best interests of the facility and its resident within the last ten years preceding submission of the license application. Offenses include: felony crimes against persons and other similar crimes for which the individual was convicted, including guilty pleas and adjudicated pretrial diversions; financial crimes such as extortion, embezzlement, income tax evasion, insurance fraud, and other similar crimes for which the individual was convicted, including guilty pleas and adjudicated pretrial diversions; any felonies involving malpractice that resulted in a conviction of criminal neglect or misconduct; and any felonies that would result in a mandatory exclusion under section 1128(a) of the Social Security Act; (ii) any misdemeanor conviction, under federal or state law, related to: the delivery of an item or service under Medicaid or a state health care program, or the abuse or neglect of a patient in connection with the delivery of a health care item or service; (iii) any misdemeanor conviction, under federal or state law, related to theft, fraud, embezzlement, breach of fiduciary duty, or other financial misconduct in connection with the delivery of a health care item or service; (iv) any felony or misdemeanor conviction, under federal or state law, relating to the interference with 12

or obstruction of any investigation into any criminal offense described in Code of Federal Regulations, title 42, section 1001.101 or 1001.201; (v) any felony or misdemeanor conviction, under federal or state law, relating to the unlawful manufacture, distribution, prescription, or dispensing of a controlled substance; (vi) any felony or gross misdemeanor that relates to the operation of a nursing home or assisted living facility or directly affects resident safety or care during that period; (vii) any revocation or suspension of a license to provide health care by any state licensing authority.

This includes the surrender of such a license while a formal disciplinary proceeding was pending before a state licensing authority; (viii) any revocation or suspension of accreditation; or (ix) any suspension or exclusion from participation in, or any sanction imposed by, a federal or state health care program, or any debarment from participation in any federal executive branch procurement or nonprocurement program; (14) whether, in the preceding three years, the applicant or any owner, controlling individual, managerial official, or assisted living director of the facility has a record of defaulting in the payment of money collected for others, including the discharge of debts through bankruptcy proceedings; (15) the signature of the owner of the licensee, or an authorized agent of the licensee; (16) identification of all states where the applicant or individual having a five percent or more ownership, currently or previously has been licensed as an owner or operator of a long-term care, community-based, or health care facility or agency where its license or federal certification has been denied, suspended, restricted, conditioned, refused, not renewed, or revoked under a private or state-controlled receivership, or where these same actions are pending under the laws of any state or federal authority; (17) statistical information required by the commissioner; and (18) any other information required by the commissioner.

Subd. 2. Authorized agents. (a) An application for an assisted living facility license or for renewal of a facility license must specify one or more owners, controlling individuals, or employees as authorized agents who can accept service on behalf of the licensee in proceedings under this chapter. (b) Notwithstanding any law to the contrary, personal service on the authorized agent named in the application is deemed to be service on all of the controlling individuals or managerial officials of the facility, and it is not a defense to any action arising under this chapter that personal service was not made on each controlling individual or managerial official of the facility. The designation of one or more controlling individuals or managerial officials under this subdivision shall not affect the legal responsibility of any other controlling individual or managerial official under this chapter.

Subd. 3. Fees. (a) An initial applicant, renewal applicant, or applicant filing a change of ownership for assisted living facility licensure must submit the application fee required in section 144.122 to the commissioner along with a completed application. (b) Fees collected under this section shall be deposited in the state treasury and credited to the state government special revenue fund. All fees are nonrefundable.

Subd. 4. Fines and penalties. (a) The penalty for late submission of the renewal application less than 13

30 days before the expiration date of the license or after expiration of the license is $200. The penalty for operating a facility after expiration of the license and before a renewal license is issued is $250 each day after expiration of the license until the renewal license issuance date. The facility is still subject to the misdemeanor penalties for operating after license expiration. (b) Fines and penalties collected under this subdivision shall be deposited in a dedicated special revenue account. On an annual basis, the balance in the special revenue account shall be appropriated to the commissioner to implement the recommendations of the advisory council established in section 144A.4799.

History: 2019 c 60 art 1 s 5,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 5, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 5, the effective date.

144G.13 BACKGROUND STUDIES OF LICENSE APPLICANTS. Subdivision 1. Background studies required. (a) Before the commissioner issues a provisional license, issues a license as a result of an approved change of ownership, or renews a license, a managerial official or a natural person who is an owner with direct ownership interest is required to undergo a background study under section 144.057. No person may be involved in the management, operation, or control of an assisted living facility if the person has been disqualified under chapter 245C. For the purposes of this section, managerial officials subject to the background study requirement are individuals who provide direct contact.

Nothing in this section shall be construed to prohibit the facility from requiring self-disclosure of criminal conviction information. (b) The commissioner shall not issue a license if any controlling individual, including a managerial official, has been unsuccessful in having a background study disqualification set aside under section 144.057 and chapter 245C. (c) Termination of an employee in good faith reliance on information or records obtained under this section regarding a confirmed conviction does not subject the assisted living facility to civil liability or liability for unemployment benefits.

Subd. 2. Reconsideration. (a) If the individual requests reconsideration of a disqualification under section 144.057 or chapter 245C and the commissioner sets aside or rescinds the disqualification, the individual is eligible to be involved in the management, operation, or control of the facility. (b) If an individual has a disqualification under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's disqualification is barred from a set aside, and the individual must not be involved in the management, operation, or control of the facility.

Subd. 3. Data classification. Data collected under this section shall be classified as private data on individuals under section 13.02, subdivision 12.

History: 2019 c 60 art 1 s 7,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 7, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 7, the effective date.

144G.15 CONSIDERATION OF APPLICATIONS. (a) Before issuing a provisional license or license or renewing a license, the commissioner shall consider an applicant's compliance history in providing care in a facility that provides care to children, the elderly, ill individuals, or individuals with disabilities. (b) The applicant's compliance history shall include repeat violation, rule violations, and any license or certification involuntarily suspended or terminated during an enforcement process.

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(c) The commissioner may deny, revoke, suspend, restrict, or refuse to renew the license or impose conditions if: (1) the applicant fails to provide complete and accurate information on the application and the commissioner concludes that the missing or corrected information is needed to determine if a license shall be granted; (2) the applicant, knowingly or with reason to know, made a false statement of a material fact in an application for the license or any data attached to the application or in any matter under investigation by the department; (3) the applicant refused to allow agents of the commissioner to inspect its books, records, and files related to the license application, or any portion of the premises; (4) the applicant willfully prevented, interfered with, or attempted to impede in any way: (i) the work of any authorized representative of the commissioner, the ombudsman for long-term care, or the ombudsman for mental health and developmental disabilities; or (ii) the duties of the commissioner, local law enforcement, city or county attorneys, adult protection, county case managers, or other local government personnel; (5) the applicant has a history of noncompliance with federal or state regulations that were detrimental to the health, welfare, or safety of a resident or a client; or (6) the applicant violates any requirement in this chapter. (d) If a license is denied, the applicant has the reconsideration rights available under section 144G.16, subdivision 4.

History: 2019 c 60 art 1 s 10,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 10, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 10, the effective date.

144G.16 PROVISIONAL LICENSE. Subdivision 1. Provisional license. Beginning August 1, 2021, for new assisted living facility license applicants, the commissioner shall issue a provisional license from one of the licensure categories specified in section 144G.10, subdivision 2. A provisional license is effective for up to one year from the initial effective date of the license, except that a provisional license may be extended according to subdivisions 2, paragraph (d), and 3.

Subd. 2. Initial survey. (a) During the provisional license period, the commissioner shall survey the provisional licensee after the commissioner is notified or has evidence that the provisional licensee is providing assisted living services to at least one resident. (b) Within two days of beginning to provide assisted living services, the provisional licensee must provide notice to the commissioner that it is providing assisted living services by sending an e-mail to the e-mail address provided by the commissioner. (c) If the provisional licensee does not provide services during the provisional license period, the provisional license shall expire at the end of the period and the applicant must reapply. (d) If the provisional licensee notifies the commissioner that the licensee is providing assisted living services within 45 calendar days prior to expiration of the provisional license, the commissioner may extend

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the provisional license for up to 60 calendar days in order to allow the commissioner to complete the on-site survey required under this section and follow-up survey visits.

Subd. 3. Licensure; termination or extension of provisional licenses. (a) If the provisional licensee is in substantial compliance with the survey, the commissioner shall issue a facility license. (b) If the provisional licensee is not in substantial compliance with the initial survey, the commissioner shall either: (1) not issue the facility license and terminate the provisional license; or (2) extend the provisional license for a period not to exceed 90 calendar days and apply conditions necessary to bring the facility into substantial compliance. If the provisional licensee is not in substantial compliance with the survey within the time period of the extension or if the provisional licensee does not satisfy the license conditions, the commissioner may deny the license.

Subd. 4. Reconsideration. (a) If a provisional licensee whose assisted living facility license has been denied or extended with conditions disagrees with the conclusions of the commissioner, then the provisional licensee may request a reconsideration by the commissioner. The reconsideration request process must be conducted internally by the commissioner and chapter 14 does not apply. (b) The provisional licensee requesting the reconsideration must make the request in writing and must list and describe the reasons why the provisional licensee disagrees with the decision to deny the facility license or the decision to extend the provisional license with conditions. (c) The reconsideration request and supporting documentation must be received by the commissioner within 15 calendar days after the date the provisional licensee receives the denial or provisional license with conditions.

Subd. 5. Continued operation. A provisional licensee whose license is denied is permitted to continue operating during the period of time when: (1) a reconsideration is in process; (2) an extension of the provisional license and terms associated with it is in active negotiation between the commissioner and the licensee, and the commissioner confirms the negotiation is active; or (3) a transfer of residents to a new facility is underway and not all of the residents have relocated.

Subd. 6. Requirements for notice and transfer. A provisional licensee whose license is denied must comply with the requirements for notification and the coordinated move of residents in sections 144G.52 and 144G.55.

Subd. 7. Fines. The fee for failure to comply with the notification requirements in section 144G.52, subdivision 7, is $1,000.

History: 2019 c 60 art 1 s 4,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 4, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 4, the effective date.

144G.17 LICENSE RENEWAL. A license that is not a provisional license may be renewed for a period of up to one year if the licensee: (1) submits an application for renewal in the format provided by the commissioner at least 60 calendar days before expiration of the license;

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(2) submits the renewal fee under section 144G.12, subdivision 3; (3) submits the late fee under section 144G.12, subdivision 4, if the renewal application is received less than 30 days before the expiration date of the license or after the expiration of the license; (4) provides information sufficient to show that the applicant meets the requirements of licensure, including items required under section 144G.12, subdivision 1; and (5) provides any other information deemed necessary by the commissioner.

History: 2019 c 60 art 1 s 8,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 8, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 8, the effective date.

144G.18 NOTIFICATION OF CHANGES IN INFORMATION. A provisional licensee or licensee shall notify the commissioner in writing prior to a change in the manager or authorized agent and within 60 calendar days after any change in the information required in section 144G.12, subdivision 1, paragraph (a), clause (1), (3), (4), (17), or (18).

History: 2019 c 60 art 1 s 9,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 9, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 9, the effective date.

144G.19 TRANSFER OF LICENSE PROHIBITED. Subdivision 1. Transfers prohibited. An assisted living facility license may not be transferred to another party.

Subd. 2. New license required. (a) A prospective licensee must apply for a license prior to operating a currently licensed assisted living facility. The new license, if issued, shall not be a provisional license. The licensee must change whenever one of the following events occur: (1) the form of the licensee's legal entity structure is converted or changed to a different type of legal entity structure; (2) the licensee dissolves, consolidates, or merges with another legal organization and the licensee's legal organization does not survive; (3) within the previous 24 months, 50 percent or more of the licensee is transferred, whether by a single transaction or multiple transactions, to: (i) a different person; or (ii) a person who had less than a five percent ownership interest in the facility at the time of the first transaction; or (4) any other event or combination of events that results in a substitution, elimination, or withdrawal of the licensee's responsibility for the facility. (b) The prospective licensee must provide written notice to the department at least 60 calendar days prior to the anticipated date of the change of licensee.

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Subd. 3. Survey required. For all new licensees after a change of ownership, the commissioner shall complete a survey within six months after the new license is issued.

History: 2019 c 60 art 1 s 6,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 6, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 6, the effective date.

144G.191 ASSISTED LIVING FACILITY LICENSING IMPLEMENTATION; TRANSITION PERIOD FOR CURRENT PROVIDERS. Subdivision 1. Application limits. (a) Beginning June 1, 2021, no initial housing with services establishment registration applications shall be accepted under chapter 144D. (b) Beginning June 1, 2021, no temporary comprehensive home care provider license applications shall be accepted for providers that do not intend to provide home care services under sections 144A.43 to 144A.484 on or after August 1, 2021.

Subd. 2. New construction; building permit. (a) All prospective assisted living facility license applicants seeking a license and having new construction who have submitted a complete building permit application to the appropriate building code jurisdiction on or before July 31, 2021, may meet construction requirements in effect when the building permit application was submitted. (b) All prospective assisted living facility license applicants seeking a license for new construction who submit a complete building permit application to the appropriate building code jurisdiction on or after August 1, 2021, must meet the requirements of section 144G.45. (c) For the purposes of paragraph (a), in areas of jurisdiction where there is no building code authority, a complete application for an electrical or plumbing permit is acceptable in lieu of the building permit application. (d) For the purposes of paragraph (a), in jurisdictions where building plan review applications are separated from building permit applications, a submitted complete application for plan review is acceptable in lieu of the building permit application.

Subd. 3. Current comprehensive home care providers; provision of assisted living services. (a) Comprehensive home care providers that do not intend to provide home care services under chapter 144A on or after August 1, 2021, shall be issued a comprehensive home care license for a prorated license period upon renewal, effective for license renewals beginning on or after September 1, 2020. The prorated license period shall be effective from the provider's current comprehensive home care license renewal date through July 31, 2021. (b) Comprehensive home care providers with prorated license periods shall pay a prorated fee based on the number of months the comprehensive home care license is in effect. (c) A comprehensive home care provider using the prorated license period in paragraph (a), or who otherwise does not intend to provide home care services under chapter 144A on or after August 1, 2021, must notify the recipients of changes to their home care services in writing at least 60 days before the expiration of the provider's comprehensive home care license, or no later than May 31, 2021, whichever is earlier. The notice must: (1) state that the provider will no longer be providing home care services under chapter 144A; (2) include the date when the provider will no longer be providing these services; 18

(3) include the name, e-mail address, and phone number of the individual associated with the comprehensive home care provider that the recipient of home care services may contact to discuss the notice; (4) include the contact information consisting of the phone number, e-mail address, mailing address, and website for the Office of Ombudsman for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental Disabilities; and (5) for recipients of home care services who receive home and community-based waiver services under section 256B.49 and chapter 256S, also be provided to the resident's case manager at the same time that it is provided to the resident. (d) A comprehensive home care provider that obtains an assisted living facility license but does so under a different business name as a result of reincorporation, and continues to provide services to the recipient, is not subject to the 60-day notice required under paragraph (c). However, the provider must otherwise provide notice to the recipient as required under sections 144A.44, 144A.441, and 144A.442, as applicable, and section 144A.4791.

Subd. 4. Housing with services establishment registration; conversion to an assisted living facility license. (a) Housing with services establishments registered under chapter 144D, providing home care services according to chapter 144A to at least one resident, and intending to provide assisted living services on or after August 1, 2021, must submit an application for an assisted living facility license in accordance with section 144G.12 no later than June 1, 2021. The commissioner shall consider the application in accordance with section 144G.16. (b) Notwithstanding the housing with services contract requirements identified in section 144D.04, any existing housing with services establishment registered under chapter 144D that does not intend to convert its registration to an assisted living facility license under this chapter must provide written notice to its residents at least 60 days before the expiration of its registration, or no later than May 31, 2021, whichever is earlier. The notice must: (1) state that the housing with services establishment does not intend to convert to an assisted living facility; (2) include the date when the housing with services establishment will no longer provide housing with services; (3) include the name, e-mail address, and phone number of the individual associated with the housing with services establishment that the recipient of home care services may contact to discuss the notice; (4) include the contact information consisting of the phone number, e-mail address, mailing address, and website for the Office of Ombudsman for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental Disabilities; and (5) for residents who receive home and community-based waiver services under section 256B.49 and chapter 256S, also be provided to the resident's case manager at the same time that it is provided to the resident. (c) A housing with services registrant that obtains an assisted living facility license, but does so under a different business name as a result of reincorporation, and continues to provide services to the recipient, is not subject to the 60-day notice required under paragraph (b). However, the provider must otherwise provide notice to the recipient as required under sections 144D.04 and 144D.045, as applicable, and section 144D.09. (d) All registered housing with services establishments providing assisted living under sections 144G.01 to 144G.07 prior to August 1, 2021, must have an assisted living facility license under this chapter.

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(e) Effective August 1, 2021, any housing with services establishment registered under chapter 144D that has not converted its registration to an assisted living facility license under this chapter is prohibited from providing assisted living services.

Subd. 5. Conversion to assisted living licensure; renewal periods; prorated licenses. (a) All assisted living facility licenses and assisted living facility with dementia care licenses with an initial effective date in August 2021, shall be valid through July 31, 2022. These licenses must be initially renewed on August 1, 2022. (b) Notices for renewal shall be issued by the department to all licensees by May 1, 2022. The notice shall include: (1) instructions for how to complete the renewal process, including completion of the renewal application and payment of the annual license fee in accordance with section 144G.17; (2) a new randomly assigned license renewal period that will apply for all future license renewals; (3) instructions for licensees to request a change to the randomly assigned renewal period based on financial hardship; and (4) instructions for licensees with more than one assisted living facility license to request that all license renewal dates occur in the same month or in different months throughout a 12-month period. (c) License fees for the first license renewal shall be prorated based on the randomly assigned license renewal period starting from August 1, 2022, as follows:

Assigned renewal month, must be completed by the 1st of the month

The initial renewed license will issued for:

January February March April May June July August September October November December

5 months; ending December 31, 2022 6 months; ending January 31, 2023 7 months, ending February 28, 2023 8 months, ending March 31, 2023 9 months, ending April 30, 2023 10 months, ending May 31, 2023 11 months, ending June 30, 3023 12 months, ending July 31, 2023 13 months, ending August 31, 2023 14 months, ending September 30, 2023 15 months, ending October 31, 2023 16 months, ending November 30, 2023

(d) All prorated license fees shall be established by the commissioner based on the licensee's annual fee in the fees schedule in section 144.122, paragraph (d). (e) The amount of the annual fee shall be divided by 12 to establish the monthly equivalent of that fee, and that amount shall be multiplied by the number of months in the assigned prorated renewal period.

This amount must be paid by the date in the renewal instructions to the licensee in order to renew the license.

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ENFORCEMENT 144G.20 ENFORCEMENT. Subdivision 1. Conditions. (a) The commissioner may refuse to grant a provisional license, refuse to grant a license as a result of a change in ownership, refuse to renew a license, suspend or revoke a license, or impose a conditional license if the owner, controlling individual, or employee of an assisted living facility: (1) is in violation of, or during the term of the license has violated, any of the requirements in this chapter or adopted rules; (2) permits, aids, or abets the commission of any illegal act in the provision of assisted living services; (3) performs any act detrimental to the health, safety, and welfare of a resident; (4) obtains the license by fraud or misrepresentation; (5) knowingly makes a false statement of a material fact in the application for a license or in any other record or report required by this chapter; (6) denies representatives of the department access to any part of the facility's books, records, files, or employees; (7) interferes with or impedes a representative of the department in contacting the facility's residents; (8) interferes with or impedes ombudsman access according to section 256.9742, subdivision 4; (9) interferes with or impedes a representative of the department in the enforcement of this chapter or fails to fully cooperate with an inspection, survey, or investigation by the department; (10) destroys or makes unavailable any records or other evidence relating to the assisted living facility's compliance with this chapter; (11) refuses to initiate a background study under section 144.057 or 245A.04; (12) fails to timely pay any fines assessed by the commissioner; (13) violates any local, city, or township ordinance relating to housing or assisted living services; (14) has repeated incidents of personnel performing services beyond their competency level; or (15) has operated beyond the scope of the assisted living facility's license category. (b) A violation by a contractor providing the assisted living services of the facility is a violation by the facility.

Subd. 2. Terms to suspension or conditional license. (a) A suspension or conditional license designation may include terms that must be completed or met before a suspension or conditional license designation is lifted. A conditional license designation may include restrictions or conditions that are imposed on the assisted living facility. Terms for a suspension or conditional license may include one or more of the following and the scope of each will be determined by the commissioner: (1) requiring a consultant to review, evaluate, and make recommended changes to the facility's practices and submit reports to the commissioner at the cost of the facility; (2) requiring supervision of the facility or staff practices at the cost of the facility by an unrelated person who has sufficient knowledge and qualifications to oversee the practices and who will submit reports to the commissioner; (3) requiring the facility or employees to obtain training at the cost of the facility; 21

(4) requiring the facility to submit reports to the commissioner; (5) prohibiting the facility from admitting any new residents for a specified period of time; or (6) any other action reasonably required to accomplish the purpose of this subdivision and subdivision 1. (b) A facility subject to this subdivision may continue operating during the period of time residents are being transferred to another service provider.

Subd. 3. Immediate temporary suspension. (a) In addition to any other remedies provided by law, the commissioner may, without a prior contested case hearing, immediately temporarily suspend a license or prohibit delivery of housing or services by a facility for not more than 90 calendar days or issue a conditional license, if the commissioner determines that there are: (1) Level 4 violations; or (2) violations that pose an imminent risk of harm to the health or safety of residents. (b) For purposes of this subdivision, "Level 4" has the meaning given in section 144G.31. (c) A notice stating the reasons for the immediate temporary suspension or conditional license and informing the licensee of the right to an expedited hearing under subdivision 17 must be delivered by personal service to the address shown on the application or the last known address of the licensee. The licensee may appeal an order immediately temporarily suspending a license or issuing a conditional license. The appeal must be made in writing by certified mail or personal service. If mailed, the appeal must be postmarked and sent to the commissioner within five calendar days after the licensee receives notice. If an appeal is made by personal service, it must be received by the commissioner within five calendar days after the licensee received the order. (d) A licensee whose license is immediately temporarily suspended must comply with the requirements for notification and transfer of residents in subdivision 15. The requirements in subdivision 9 remain if an appeal is requested.

Subd. 4. Mandatory revocation. Notwithstanding the provisions of subdivision 13, paragraph (a), the commissioner must revoke a license if a controlling individual of the facility is convicted of a felony or gross misdemeanor that relates to operation of the facility or directly affects resident safety or care. The commissioner shall notify the facility and the Office of Ombudsman for Long-Term Care 30 calendar days in advance of the date of revocation.

Subd. 5. Owners and managerial officials; refusal to grant license. (a) The owners and managerial officials of a facility whose Minnesota license has not been renewed or whose Minnesota license has been revoked because of noncompliance with applicable laws or rules shall not be eligible to apply for nor will be granted an assisted living facility license under this chapter or a home care provider license under chapter 144A, or be given status as an enrolled personal care assistance provider agency or personal care assistant by the Department of Human Services under section 256B.0659, for five years following the effective date of the nonrenewal or revocation. If the owners or managerial officials already have enrollment status, the Department of Human Services shall terminate that enrollment. (b) The commissioner shall not issue a license to a facility for five years following the effective date of license nonrenewal or revocation if the owners or managerial officials, including any individual who was an owner or managerial official of another licensed provider, had a Minnesota license that was not renewed or was revoked as described in paragraph (a). (c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall suspend or revoke, the license of a facility that includes any individual as an owner or managerial official who was an owner or managerial official of a facility whose Minnesota license was not renewed or was revoked as described in 22

paragraph (a) for five years following the effective date of the nonrenewal or revocation. (d) The commissioner shall notify the facility 30 calendar days in advance of the date of nonrenewal, suspension, or revocation of the license.

Subd. 6. Requesting a stay of adverse actions required by owners and managerial officialsrestrictions.

Within ten business days after the receipt of the notification, the facility may request, in writing, that the commissioner stay the nonrenewal, revocation, or suspension of the license. The facility shall specify the reasons for requesting the stay; the steps that will be taken to attain or maintain compliance with the licensure laws and regulations; any limits on the authority or responsibility of the owners or managerial officials whose actions resulted in the notice of nonrenewal, revocation, or suspension; and any other information to establish that the continuing affiliation with these individuals will not jeopardize resident health, safety, or well-being.

Subd. 7. Granting a stay of adverse actions required by owners and managerial officials restrictions.

The commissioner shall determine whether the stay will be granted within 30 calendar days of receiving the facility's request. The commissioner may propose additional restrictions or limitations on the facility's license and require that granting the stay be contingent upon compliance with those provisions. The commissioner shall take into consideration the following factors when determining whether the stay should be granted: (1) the threat that continued involvement of the owners and managerial officials with the facility poses to resident health, safety, and well-being; (2) the compliance history of the facility; and (3) the appropriateness of any limits suggested by the facility.

If the commissioner grants the stay, the order shall include any restrictions or limitation on the provider's license. The failure of the facility to comply with any restrictions or limitations shall result in the immediate removal of the stay and the commissioner shall take immediate action to suspend, revoke, or not renew the license.

Subd. 8. Controlling individual restrictions. (a) The commissioner has discretion to bar any controlling individual of a facility if the person was a controlling individual of any other nursing home or assisted living facility in the previous two-year period and: (1) during that period of time the nursing home or assisted living facility incurred the following number of uncorrected or repeated violations: (i) two or more repeated violations that created an imminent risk to direct resident care or safety; or (ii) four or more uncorrected violations that created an imminent risk to direct resident care or safety; or (2) during that period of time, was convicted of a felony or gross misdemeanor that related to the operation of the nursing home or assisted living facility, or directly affected resident safety or care. (b) When the commissioner bars a controlling individual under this subdivision, the controlling individual may appeal the commissioner's decision under chapter 14.

Subd. 9. Exception to controlling individual restrictions. Subdivision 8 does not apply to any controlling individual of the facility who had no legal authority to affect or change decisions related to the operation of the nursing home or assisted living facility that incurred the uncorrected violations.

Subd. 10. Stay of adverse action required by controlling individual restrictions. (a) In lieu of revoking, suspending, or refusing to renew the license of a facility where a controlling individual was disqualified by subdivision 8, paragraph (a), clause (1), the commissioner may issue an order staying the revocation, suspension, or nonrenewal of the facility's license. The order may but need not be contingent 23

upon the facility's compliance with restrictions and conditions imposed on the license to ensure the proper operation of the facility and to protect the health, safety, comfort, treatment, and well-being of the residents in the facility. The decision to issue an order for a stay must be made within 90 calendar days of the commissioner's determination that a controlling individual of the facility is disqualified by subdivision 8, paragraph (a), clause (1), from operating a facility. (b) In determining whether to issue a stay and to impose conditions and restrictions, the commissioner must consider the following factors: (1) the ability of the controlling individual to operate other facilities in accordance with the licensure rules and laws; (2) the conditions in the nursing home or assisted living facility that received the number and type of uncorrected or repeated violations described in subdivision 8, paragraph (a), clause (1); and (3) the conditions and compliance history of each of the nursing homes and assisted living facilities owned or operated by the controlling individual. (c) The commissioner's decision to exercise the authority under this subdivision in lieu of revoking, suspending, or refusing to renew the license of the facility is not subject to administrative or judicial review. (d) The order for the stay of revocation, suspension, or nonrenewal of the facility license must include any conditions and restrictions on the license that the commissioner deems necessary based on the factors listed in paragraph (b). (e) Prior to issuing an order for stay of revocation, suspension, or nonrenewal, the commissioner shall inform the licensee and the controlling individual in writing of any conditions and restrictions that will be imposed. The controlling individual shall, within ten working days, notify the commissioner in writing of a decision to accept or reject the conditions and restrictions. If any of the conditions or restrictions are rejected, the commissioner must either modify the conditions and restrictions or take action to suspend, revoke, or not renew the facility's license. (f) Upon issuance of the order for a stay of revocation, suspension, or nonrenewal, the controlling individual shall be responsible for compliance with the conditions and restrictions. Any time after the conditions and restrictions have been in place for 180 days, the controlling individual may petition the commissioner for removal or modification of the conditions and restrictions. The commissioner must respond to the petition within 30 days of receipt of the written petition. If the commissioner denies the petition, the controlling individual may request a hearing under chapter 14. Any hearing shall be limited to a determination of whether the conditions and restrictions shall be modified or removed. At the hearing, the controlling individual bears the burden of proof. (g) The failure of the controlling individual to comply with the conditions and restrictions contained in the order for stay shall result in the immediate removal of the stay and the commissioner shall take action to suspend, revoke, or not renew the license. (h) The conditions and restrictions are effective for two years after the date they are imposed. (i) Nothing in this subdivision shall be construed to limit in any way the commissioner's ability to impose other sanctions against a licensee under the standards in state or federal law whether or not a stay of revocation, suspension, or nonrenewal is issued.

Subd. 11. Mandatory proceedings. (a) The commissioner must initiate proceedings within 60 calendar days of notification to suspend or revoke a facility's license or must refuse to renew a facility's license if within the preceding two years the facility has incurred the following number of uncorrected or repeated violations: (1) two or more uncorrected violations or one or more repeated violations that created an imminent risk to direct resident care or safety; or 24

(2) four or more uncorrected violations or two or more repeated violations of any nature for which the fines are in the four highest daily fine categories prescribed in rule. (b) Notwithstanding paragraph (a), the commissioner is not required to revoke, suspend, or refuse to renew a facility's license if the facility corrects the violation.

Subd. 12. Notice to residents. (a) Within five business days after proceedings are initiated by the commissioner to revoke or suspend a facility's license, or a decision by the commissioner not to renew a living facility's license, the controlling individual of the facility or a designee must provide to the commissioner and the ombudsman for long-term care the names of residents and the names and addresses of the residents' designated representatives and legal representatives, and family or other contacts listed in the assisted living contract. (b) The controlling individual or designees of the facility must provide updated information each month until the proceeding is concluded. If the controlling individual or designee of the facility fails to provide the information within this time, the facility is subject to the issuance of: (1) a correction order; and (2) a penalty assessment by the commissioner in rule. (c) Notwithstanding subdivisions 21 and 22, any correction order issued under this subdivision must require that the facility immediately comply with the request for information and that, as of the date of the issuance of the correction order, the facility shall forfeit to the state a $500 fine the first day of noncompliance and an increase in the $500 fine by $100 increments for each day the noncompliance continues. (d) Information provided under this subdivision may be used by the commissioner or the ombudsman for long-term care only for the purpose of providing affected consumers information about the status of the proceedings. (e) Within ten business days after the commissioner initiates proceedings to revoke, suspend, or not renew a facility license, the commissioner must send a written notice of the action and the process involved to each resident of the facility, legal representatives and designated representatives, and at the commissioner's discretion, additional resident contacts. (f) The commissioner shall provide the ombudsman for long-term care with monthly information on the department's actions and the status of the proceedings.

Subd. 13. Notice to facility. (a) Prior to any suspension, revocation, or refusal to renew a license, the facility shall be entitled to notice and a hearing as provided by sections 14.57 to 14.69. The hearing must commence within 60 calendar days after the proceedings are initiated. In addition to any other remedy provided by law, the commissioner may, without a prior contested case hearing, temporarily suspend a license or prohibit delivery of services by a provider for not more than 90 calendar days, or issue a conditional license if the commissioner determines that there are Level 3 violations that do not pose an imminent risk of harm to the health or safety of the facility residents, provided: (1) advance notice is given to the facility; (2) after notice, the facility fails to correct the problem; (3) the commissioner has reason to believe that other administrative remedies are not likely to be effective; and (4) there is an opportunity for a contested case hearing within 30 calendar days unless there is an extension granted by an administrative law judge. (b) If the commissioner determines there are Level 4 violations or violations that pose an imminent risk of harm to the health or safety of the facility residents, the commissioner may immediately temporarily 25

suspend a license, prohibit delivery of services by a facility, or issue a conditional license without meeting the requirements of paragraph (a), clauses (1) to (4).

For the purposes of this subdivision, "Level 3" and "Level 4" have the meanings given in section 144G.31.

Subd. 14. Request for hearing. A request for hearing must be in writing and must: (1) be mailed or delivered to the commissioner; (2) contain a brief and plain statement describing every matter or issue contested; and (3) contain a brief and plain statement of any new matter that the applicant or assisted living facility believes constitutes a defense or mitigating factor.

Subd. 15. Plan required. (a) The process of suspending, revoking, or refusing to renew a license must include a plan for transferring affected residents' cares to other providers by the facility. The commissioner shall monitor the transfer plan. Within three calendar days of being notified of the final revocation, refusal to renew, or suspension, the licensee shall provide the commissioner, the lead agencies as defined in section 256B.0911, county adult protection and case managers, and the ombudsman for long-term care with the following information: (1) a list of all residents, including full names and all contact information on file; (2) a list of the resident's legal representatives and designated representatives and family or other contacts listed in the assisted living contract, including full names and all contact information on file; (3) the location or current residence of each resident; (4) the payor sources for each resident, including payor source identification numbers; and (5) for each resident, a copy of the resident's service plan and a list of the types of services being provided. (b) The revocation, refusal to renew, or suspension notification requirement is satisfied by mailing the notice to the address in the license record. The licensee shall cooperate with the commissioner and the lead agencies, county adult protection and case managers, and the ombudsman for long-term care during the process of transferring care of residents to qualified providers. Within three calendar days of being notified of the final revocation, refusal to renew, or suspension action, the facility must notify and disclose to each of the residents, or the resident's legal and designated representatives or emergency contact persons, that the commissioner is taking action against the facility's license by providing a copy of the revocation, refusal to renew, or suspension notice issued by the commissioner. If the facility does not comply with the disclosure requirements in this section, the commissioner shall notify the residents, legal and designated representatives, or emergency contact persons about the actions being taken. Lead agencies, county adult protection and case managers, and the Office of Ombudsman for Long-Term Care may also provide this information. The revocation, refusal to renew, or suspension notice is public data except for any private data contained therein. (c) A facility subject to this subdivision may continue operating while residents are being transferred to other service providers.

Subd. 16. Hearing. Within 15 business days of receipt of the licensee's timely appeal of a sanction under this section, other than for a temporary suspension, the commissioner shall request assignment of an administrative law judge. The commissioner's request must include a proposed date, time, and place of hearing. A hearing must be conducted by an administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within 90 calendar days of the request for assignment, unless an extension is requested by either party and granted by the administrative law judge for good cause or for purposes of discussing settlement. In no case shall one or more extensions be granted for a total of more than 90 calendar days unless there is a criminal action pending against the licensee. If, while a licensee continues to operate pending an appeal of an order for revocation, suspension, or refusal to renew a license, the commissioner identifies one or more new violations of law that meet the requirements of Level 3 or Level 4 violations as 26

defined in section 144G.31, the commissioner shall act immediately to temporarily suspend the license.

Subd. 17. Expedited hearing. (a) Within five business days of receipt of the licensee's timely appeal of a temporary suspension or issuance of a conditional license, the commissioner shall request assignment of an administrative law judge. The request must include a proposed date, time, and place of a hearing. A hearing must be conducted by an administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within 30 calendar days of the request for assignment, unless an extension is requested by either party and granted by the administrative law judge for good cause. The commissioner shall issue a notice of hearing by certified mail or personal service at least ten business days before the hearing. Certified mail to the last known address is sufficient. The scope of the hearing shall be limited solely to the issue of whether the temporary suspension or issuance of a conditional license should remain in effect and whether there is sufficient evidence to conclude that the licensee's actions or failure to comply with applicable laws are Level 3 or Level 4 violations as defined in section 144G.31, or that there were violations that posed an imminent risk of harm to the resident's health and safety. (b) The administrative law judge shall issue findings of fact, conclusions, and a recommendation within ten business days from the date of hearing. The parties shall have ten calendar days to submit exceptions to the administrative law judge's report. The record shall close at the end of the ten-day period for submission of exceptions. The commissioner's final order shall be issued within ten business days from the close of the record. When an appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed, the commissioner shall issue a final order affirming the temporary immediate suspension or conditional license within ten calendar days of the commissioner's receipt of the withdrawal or dismissal. The licensee is prohibited from operation during the temporary suspension period. (c) When the final order under paragraph (b) affirms an immediate suspension, and a final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that sanction, the licensee is prohibited from operation pending a final commissioner's order after the contested case hearing conducted under chapter 14. (d) A licensee whose license is temporarily suspended must comply with the requirements for notification and transfer of residents under subdivision 15. These requirements remain if an appeal is requested.

Subd. 18. Time limits for appeals. To appeal the assessment of civil penalties under section 144G.31, and an action against a license under this section, a licensee must request a hearing no later than 15 business days after the licensee receives notice of the action.

Subd. 19. Relicensing. If a facility license is revoked, a new application for license may be considered by the commissioner when the conditions upon which the revocation was based have been corrected and satisfactory evidence of this fact has been furnished to the commissioner. A new license may be granted after an inspection has been made and the facility has complied with all provisions of this chapter and adopted rules.

Subd. 20. Informal conference. At any time, the commissioner and the applicant, licensee, manager if applicable, or facility may hold an informal conference to exchange information, clarify issues, or resolve issues.

Subd. 21. Injunctive relief. In addition to any other remedy provided by law, the commissioner may bring an action in district court to enjoin a person who is involved in the management, operation, or control of a facility or an employee of the facility from illegally engaging in activities regulated by this chapter. The commissioner may bring an action under this subdivision in the district court in Ramsey County or in the district in which the facility is located. The court may grant a temporary restraining order in the proceeding if continued activity by the person who is involved in the management, operation, or control of a facility, or by an employee of the facility, would create an imminent risk of harm to a resident.

Subd. 22. Subpoena. In matters pending before the commissioner under this chapter, the commissioner may issue subpoenas and compel the attendance of witnesses and the production of all necessary papers, 27

books, records, documents, and other evidentiary material. If a person fails or refuses to comply with a subpoena or order of the commissioner to appear or testify regarding any matter about which the person may be lawfully questioned or to produce any papers, books, records, documents, or evidentiary materials in the matter to be heard, the commissioner may apply to the district court in any district, and the court shall order the person to comply with the commissioner's order or subpoena. The commissioner may administer oaths to witnesses or take their affirmation. Depositions may be taken in or outside the state in the manner provided by law for taking depositions in civil actions. A subpoena or other process or paper may be served on a named person anywhere in the state by an officer authorized to serve subpoenas in civil actions, with the same fees and mileage and in the same manner as prescribed by law for a process issued out of a district court. A person subpoenaed under this subdivision shall receive the same fees, mileage, and other costs that are paid in proceedings in district court.

History: 2019 c 60 art 1 s 24,38,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, sections 24 and 38, is effective August 1, 2021. Laws 2019, chapter 60, article 1, sections 24 and 38, the effective dates.

SURVEYS, CORRECTION ORDERS, AND FINES 144G.30 SURVEYS AND INVESTIGATIONS. Subdivision 1. Regulatory powers. (a) The Department of Health is the exclusive state agency charged with the responsibility and duty of surveying and investigating all assisted living facilities required to be licensed under this chapter. The commissioner of health shall enforce all sections of this chapter and the rules adopted under this chapter. (b) The commissioner, upon request to the facility, must be given access to relevant information, records, incident reports, and other documents in the possession of the facility if the commissioner considers them necessary for the discharge of responsibilities. For purposes of surveys and investigations and securing information to determine compliance with licensure laws and rules, the commissioner need not present a release, waiver, or consent to the individual. The identities of residents must be kept private as defined in section 13.02, subdivision 12.

Subd. 2. Surveys. The commissioner shall conduct a survey of each assisted living facility on a frequency of at least once every two years. The commissioner may conduct surveys more frequently than every two years based on the license category, the facility's compliance history, the number of residents served, or other factors as determined by the commissioner deemed necessary to ensure the health, safety, and welfare of residents and compliance with the law.

Subd. 3. Scheduling surveys. Surveys and investigations shall be conducted without advance notice to the facilities. Surveyors may contact the facility on the day of a survey to arrange for someone to be available at the survey site. The contact does not constitute advance notice. The surveyor must provide presurvey notification to the Office of Ombudsman for Long-Term Care.

Subd. 4. Information provided by facility. (a) The assisted living facility shall provide accurate and truthful information to the department during a survey, investigation, or other licensing activities. (b) Upon request of a surveyor, assisted living facilities shall within a reasonable period of time provide a list of current and past residents and their legal representatives and designated representatives that includes addresses and telephone numbers and any other information requested about the services to residents.

Subd. 5. Correction orders. (a) A correction order may be issued whenever the commissioner finds upon survey or during a complaint investigation that a facility, a managerial official, or an employee of the facility is not in compliance with this chapter. The correction order shall cite the specific statute and document areas of noncompliance and the time allowed for correction.

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(b) The commissioner shall mail or e-mail copies of any correction order to the facility within 30 calendar days after the survey exit date. A copy of each correction order and copies of any documentation supplied to the commissioner shall be kept on file by the facility and public documents shall be made available for viewing by any person upon request. Copies may be kept electronically. (c) By the correction order date, the facility must document in the facility's records any action taken to comply with the correction order. The commissioner may request a copy of this documentation and the facility's action to respond to the correction order in future surveys, upon a complaint investigation, and as otherwise needed.

Subd. 6. Follow-up surveys. The commissioner may conduct follow-up surveys to determine if the facility has corrected deficient issues and systems identified during a survey or complaint investigation.

Follow-up surveys may be conducted via phone, e-mail, fax, mail, or on-site reviews. Follow-up surveys, other than complaint investigations, shall be concluded with an exit conference and written information provided on the process for requesting a reconsideration of the survey results.

Subd. 7. Required follow-up surveys. For assisted living facilities that have Level 3 or Level 4 violations under section 144G.31, the commissioner shall conduct a follow-up survey within 90 calendar days of the survey. When conducting a follow-up survey, the surveyor shall focus on whether the previous violations have been corrected and may also address any new violations that are observed while evaluating the corrections that have been made.

Subd. 8. Notice of noncompliance. If the commissioner finds that the applicant or a facility has not corrected violations by the date specified in the correction order or conditional license resulting from a survey or complaint investigation, the commissioner shall provide a notice of noncompliance with a correction order by e-mailing the notice of noncompliance to the facility. The noncompliance notice must list the violations not corrected.

History: 2019 c 60 art 1 s 35,36,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, sections 35 and 36, is effective August 1, 2021. Laws 2019, chapter 60, article 1, sections 35 and 36, the effective dates.

144G.31 VIOLATIONS AND FINES. Subdivision 1. Categories of violations. Correction orders for violations are categorized by both level and scope.

Subd. 2. Levels of violations. Correction orders for violations are categorized by level as follows: (1) Level 1 is a violation that has no potential to cause more than a minimal impact on the resident and does not affect health or safety; (2) Level 2 is a violation that did not harm a resident's health or safety but had the potential to have harmed a resident's health or safety, but was not likely to cause serious injury, impairment, or death; (3) Level 3 is a violation that harmed a resident's health or safety, not including serious injury, impairment, or death, or a violation that has the potential to lead to serious injury, impairment, or death; and (4) Level 4 is a violation that results in serious injury, impairment, or death.

Subd. 3. Scope of violations. Levels of violations are categorized by scope as follows:

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(1) isolated, when one or a limited number of residents are affected or one or a limited number of staff are involved or the situation has occurred only occasionally; (2) pattern, when more than a limited number of residents are affected, more than a limited number of staff are involved, or the situation has occurred repeatedly but is not found to be pervasive; and (3) widespread, when problems are pervasive or represent a systemic failure that has affected or has the potential to affect a large portion or all of the residents.

Subd. 4. Fine amounts. (a) Fines and enforcement actions under this subdivision may be assessed based on the level and scope of the violations described in subdivisions 2 and 3 as follows and may be imposed immediately with no opportunity to correct the violation prior to imposition: (1) Level 1, no fines or enforcement; (2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism authorized in section 144G.20 for widespread violations; (3) Level 3, a fine of $3,000 per violation per incident, in addition to any enforcement mechanism authorized in section 144G.20; (4) Level 4, a fine of $5,000 per incident, in addition to any enforcement mechanism authorized in section 144G.20; and (5) for maltreatment violations for which the licensee was determined to be responsible for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000. A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury. (b) When a fine is assessed against a facility for substantiated maltreatment, the commissioner shall not also impose an immediate fine under this chapter for the same circumstance.

Subd. 5. Immediate fine; payment. (a) For every Level 3 or Level 4 violation, the commissioner may issue an immediate fine. The licensee must still correct the violation in the time specified. The issuance of an immediate fine may occur in addition to any enforcement mechanism authorized under section 144G.20.

The immediate fine may be appealed as allowed under this chapter. (b) The licensee must pay the fines assessed on or before the payment date specified. If the licensee fails to fully comply with the order, the commissioner may issue a second fine or suspend the license until the licensee complies by paying the fine. A timely appeal shall stay payment of the fine until the commissioner issues a final order. (c) A licensee shall promptly notify the commissioner in writing when a violation specified in the order is corrected. If upon reinspection the commissioner determines that a violation has not been corrected as indicated by the order, the commissioner may issue an additional fine. The commissioner shall notify the licensee by mail to the last known address in the licensing record that a second fine has been assessed. The licensee may appeal the second fine as provided under this subdivision. (d) A facility that has been assessed a fine under this section has a right to a reconsideration or hearing under this chapter and chapter 14.

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Subd. 6. Payment of fines required. When a fine has been assessed, the licensee may not avoid payment by closing, selling, or otherwise transferring the license to a third party. In such an event, the licensee shall be liable for payment of the fine.

Subd. 7. Additional penalties. In addition to any fine imposed under this section, the commissioner may assess a penalty amount based on costs related to an investigation that results in a final order assessing a fine or other enforcement action authorized by this chapter.

Subd. 8. Deposit of fines. Fines collected under this section shall be deposited in a dedicated special revenue account. On an annual basis, the balance in the special revenue account shall be appropriated to the commissioner for special projects to improve home care in Minnesota as recommended by the advisory council established in section 144A.4799.

History: 2019 c 60 art 1 s 36,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 36, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 36, the effective date.

144G.32 RECONSIDERATION OF CORRECTION ORDERS AND FINES. Subdivision 1. Reconsideration process required. The commissioner shall make available to assisted living facilities a correction order reconsideration process. This process may be used to challenge the correction order issued, including the level and scope described in section 144G.31, and any fine assessed.

When a licensee requests reconsideration of a correction order, the correction order is not stayed while it is under reconsideration. The commissioner shall post information on its website that the licensee requested reconsideration of the correction order and that the review is pending.

Subd. 2. Reconsideration process. An assisted living facility may request from the commissioner, in writing, a correction order reconsideration regarding any correction order issued to the facility. The written request for reconsideration must be received by the commissioner within 15 calendar days of the correction order receipt date. The correction order reconsideration shall not be reviewed by any surveyor, investigator, or supervisor that participated in writing or reviewing the correction order being disputed. The correction order reconsiderations may be conducted in person, by telephone, by another electronic form, or in writing, as determined by the commissioner. The commissioner shall respond in writing to the request from a facility for a correction order reconsideration within 60 days of the date the facility requests a reconsideration. The commissioner's response shall identify the commissioner's decision regarding each citation challenged by the facility.

Subd. 3. Findings. The findings of a correction order reconsideration process shall be one or more of the following: (1) supported in full: the correction order is supported in full, with no deletion of findings to the citation; (2) supported in substance: the correction order is supported, but one or more findings are deleted or modified without any change in the citation; (3) correction order cited an incorrect licensing requirement: the correction order is amended by changing the correction order to the appropriate statute or rule; (4) correction order was issued under an incorrect citation: the correction order is amended to be issued under the more appropriate correction order citation; (5) the correction order is rescinded;

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(6) fine is amended: it is determined that the fine assigned to the correction order was applied incorrectly; or (7) the level or scope of the citation is modified based on the reconsideration.

Subd. 4. Updating the correction order website. If the correction order findings are changed by the commissioner, the commissioner shall update the correction order website.

Subd. 5. Exception; provisional licensees. This section does not apply to provisional licensees.

History: 2019 c 60 art 1 s 37,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 37, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 37, the effective date.

144G.33 INNOVATION VARIANCE. Subdivision 1. Definition; granting variances. (a) For purposes of this section, "innovation variance" means a specified alternative to a requirement of this chapter. (b) An innovation variance may be granted to allow an assisted living facility to offer services of a type or in a manner that is innovative, will not impair the services provided, will not adversely affect the health, safety, or welfare of the residents, and is likely to improve the services provided. The innovative variance cannot change any of the resident's rights under the assisted living bill of rights.

Subd. 2. Conditions. The commissioner may impose conditions on granting an innovation variance that the commissioner considers necessary.

Subd. 3. Duration and renewal. The commissioner may limit the duration of any innovation variance and may renew a limited innovation variance.

Subd. 4. Applications; innovation variance. An application for innovation variance from the requirements of this chapter may be made at any time, must be made in writing to the commissioner, and must specify the following: (1) the statute or rule from which the innovation variance is requested; (2) the time period for which the innovation variance is requested; (3) the specific alternative action that the licensee proposes; (4) the reasons for the request; and (5) justification that an innovation variance will not impair the services provided, will not adversely affect the health, safety, or welfare of residents, and is likely to improve the services provided.

The commissioner may require additional information from the facility before acting on the request.

Subd. 5. Grants and denials. The commissioner shall grant or deny each request for an innovation variance in writing within 45 days of receipt of a complete request. Notice of a denial shall contain the reasons for the denial. The terms of a requested innovation variance may be modified upon agreement between the commissioner and the facility.

Subd. 6. Violation of innovation variances. A failure to comply with the terms of an innovation variance shall be deemed to be a violation of this chapter.

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Subd. 7. Revocation or denial of renewal. The commissioner shall revoke or deny renewal of an innovation variance if: (1) it is determined that the innovation variance is adversely affecting the health, safety, or welfare of the residents; (2) the facility has failed to comply with the terms of the innovation variance; (3) the facility notifies the commissioner in writing that it wishes to relinquish the innovation variance and be subject to the statute previously varied; or (4) the revocation or denial is required by a change in law.

History: 2019 c 60 art 1 s 39,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 39, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 39, the effective date.

OPERATIONS AND PHYSICAL PLANT REQUIREMENTS 144G.40 HOUSING AND SERVICES. Subdivision 1. Responsibility for housing and services. The facility is directly responsible to the resident for all housing and service-related matters provided, irrespective of a management contract. Housing and service-related matters include but are not limited to the handling of complaints, the provision of notices, and the initiation of any adverse action against the resident involving housing or services provided by the facility.

Subd. 2. Uniform checklist disclosure of services. (a) All assisted living facilities must provide to prospective residents: (1) a disclosure of the categories of assisted living licenses available and the category of license held by the facility; (2) a written checklist listing all services permitted under the facility's license, identifying all services the facility offers to provide under the assisted living facility contract, and identifying all services allowed under the license that the facility does not provide; and (3) an oral explanation of the services offered under the contract. (b) The requirements of paragraph (a) must be completed prior to the execution of the assisted living contract. (c) The commissioner must, in consultation with all interested stakeholders, design the uniform checklist disclosure form for use as provided under paragraph (a).

Subd. 3. Reservation of rights. Nothing in this chapter: (1) requires a resident to utilize any service provided by or through, or made available in, a facility; (2) prevents a facility from requiring, as a condition of the contract, that the resident pay for a package of services even if the resident does not choose to use all or some of the services in the package. For residents who are eligible for home and community-based waiver services under chapter 256S and section 256B.49, payment for services will follow the policies of those programs;

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(3) requires a facility to fundamentally alter the nature of the operations of the facility in order to accommodate a resident's request; or (4) affects the duty of a facility to grant a resident's request for reasonable accommodations.

History: 2019 c 54 art 1 s 33; 2019 c 60 art 1 s 13,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 13, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 13, the effective date.

144G.401 PAYMENT FOR SERVICES UNDER DISABILITY WAIVERS. For new assisted living facilities that did not operate as registered housing with services establishments prior to August 1, 2021, home and community-based services under section 256B.49 are not available when the new facility setting is adjoined to, or on the same property as, an institution as defined in Code of Federal Regulations, title 42, section 441.301(c).

History: 2019 c 60 art 1 s 11,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 11, subdivision 9, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 11, the effective date.

144G.41 MINIMUM ASSISTED LIVING FACILITY REQUIREMENTS. Subdivision 1. Minimum requirements. All assisted living facilities shall: (1) distribute to residents the assisted living bill of rights; (2) provide services in a manner that complies with the Nurse Practice Act in sections 148.171 to 148.285; (3) utilize a person-centered planning and service delivery process; (4) have and maintain a system for delegation of health care activities to unlicensed personnel by a registered nurse, including supervision and evaluation of the delegated activities as required by the Nurse Practice Act in sections 148.171 to 148.285; (5) provide a means for residents to request assistance for health and safety needs 24 hours per day, seven days per week; (6) allow residents the ability to furnish and decorate the resident's unit within the terms of the assisted living contract; (7) permit residents access to food at any time; (8) allow residents to choose the resident's visitors and times of visits; (9) allow the resident the right to choose a roommate if sharing a unit; (10) notify the resident of the resident's right to have and use a lockable door to the resident's unit. The licensee shall provide the locks on the unit. Only a staff member with a specific need to enter the unit shall have keys, and advance notice must be given to the resident before entrance, when possible. An assisted living facility must not lock a resident in the resident's unit; (11) develop and implement a staffing plan for determining its staffing level that: (i) includes an evaluation, to be conducted at least twice a year, of the appropriateness of staffing levels in the facility; (ii) ensures sufficient staffing at all times to meet the scheduled and reasonably foreseeable unscheduled 34

needs of each resident as required by the residents' assessments and service plans on a 24-hour per day basis; and (iii) ensures that the facility can respond promptly and effectively to individual resident emergencies and to emergency, life safety, and disaster situations affecting staff or residents in the facility; (12) ensure that one or more persons are available 24 hours per day, seven days per week, who are responsible for responding to the requests of residents for assistance with health or safety needs. Such persons must be: (i) awake; (ii) located in the same building, in an attached building, or on a contiguous campus with the facility in order to respond within a reasonable amount of time; (iii) capable of communicating with residents; (iv) capable of providing or summoning the appropriate assistance; and (v) capable of following directions; and (13) offer to provide or make available at least the following services to residents: (i) at least three nutritious meals daily with snacks available seven days per week, according to the recommended dietary allowances in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables. The following apply: (A) menus must be prepared at least one week in advance, and made available to all residents. The facility must encourage residents' involvement in menu planning. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes; (B) food must be prepared and served according to the Minnesota Food Code, Minnesota Rules, chapter 4626; and (C) the facility cannot require a resident to include and pay for meals in their contract; (ii) weekly housekeeping; (iii) weekly laundry service; (iv) upon the request of the resident, provide direct or reasonable assistance with arranging for transportation to medical and social services appointments, shopping, and other recreation, and provide the name of or other identifying information about the persons responsible for providing this assistance; (v) upon the request of the resident, provide reasonable assistance with accessing community resources and social services available in the community, and provide the name of or other identifying information about persons responsible for providing this assistance; (vi) provide culturally sensitive programs; (vii) have a daily program of social and recreational activities that are based upon individual and group interests, physical, mental, and psychosocial needs, and that creates opportunities for active participation in the community at large; and (14) provide staff access to an on-call registered nurse 24 hours per day, seven days per week.

Subd. 2. Policies and procedures. Each assisted living facility must have policies and procedures in place to address the following and keep them current: 35

(1) requirements in section 626.557, reporting of maltreatment of vulnerable adults; (2) conducting and handling background studies on employees; (3) orientation, training, and competency evaluations of staff, and a process for evaluating staff performance; (4) handling complaints regarding staff or services provided by staff; (5) conducting initial evaluations of residents' needs and the providers' ability to provide those services; (6) conducting initial and ongoing resident evaluations and assessments of resident needs, including assessments by a registered nurse or appropriate licensed health professional, and how changes in a resident's condition are identified, managed, and communicated to staff and other health care providers as appropriate; (7) orientation to and implementation of the assisted living bill of rights; (8) infection control practices; (9) reminders for medications, treatments, or exercises, if provided; (10) conducting appropriate screenings, or documentation of prior screenings, to show that staff are free of tuberculosis, consistent with current United States Centers for Disease Control and Prevention standards; (11) ensuring that nurses and licensed health professionals have current and valid licenses to practice; (12) medication and treatment management; (13) delegation of tasks by registered nurses or licensed health professionals; (14) supervision of registered nurses and licensed health professionals; and (15) supervision of unlicensed personnel performing delegated tasks.

Subd. 3. Infection control program. (a) All assisted living facilities must establish and maintain an infection control program that complies with accepted health care, medical, and nursing standards for infection control. (b) The facility's infection control program must be consistent with current guidelines from the national Centers for Disease Control and Prevention (CDC) for infection prevention and control in long-term care facilities and, as applicable, for infection prevention and control in assisted living facilities. (c) The facility must maintain written evidence of compliance with this subdivision.

Subd. 4. Clinical nurse supervision. All assisted living facilities must have a clinical nurse supervisor who is a registered nurse licensed in Minnesota.

Subd. 5. Resident councils. The facility must provide a resident council with space and privacy for meetings, where doing so is reasonably achievable. Staff, visitors, and other guests may attend a resident council meeting only at the council's invitation. The facility must designate a staff person who is approved by the resident council to be responsible for providing assistance and responding to written requests that result from meetings. The facility must consider the views of the resident council and must respond promptly to the grievances and recommendations of the council, but a facility is not required to implement as recommended every request of the council. The facility shall, with the approval of the resident council, take reasonably achievable steps to make residents aware of upcoming meetings in a timely manner.

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Subd. 6. Family councils. The facility must provide a family council with space and privacy for meetings, where doing so is reasonably achievable. The facility must designate a staff person who is approved by the family council to be responsible for providing assistance and responding to written requests that result from meetings. The facility must consider the views of the family council and must respond promptly to the grievances and recommendations of the council, but a facility is not required to implement as recommended every request of the council. The facility shall, with the approval of the family council, take reasonably achievable steps to make residents and family members aware of upcoming meetings in a timely manner.

Subd. 7. Resident grievances; reporting maltreatment. All facilities must post in a conspicuous place information about the facilities' grievance procedure, and the name, telephone number, and e-mail contact information for the individuals who are responsible for handling resident grievances. The notice must also have the contact information for the state and applicable regional Office of Ombudsman for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental Disabilities, and must have information for reporting suspected maltreatment to the Minnesota Adult Abuse Reporting Center.

Subd. 8. Protecting resident rights. All facilities shall ensure that every resident has access to consumer advocacy or legal services by: (1) providing names and contact information, including telephone numbers and e-mail addresses of at least three organizations that provide advocacy or legal services to residents; (2) providing the name and contact information for the Minnesota Office of Ombudsman for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental Disabilities, including both the state and regional contact information; (3) assisting residents in obtaining information on whether Medicare or medical assistance under chapter 256B will pay for services; (4) making reasonable accommodations for people who have communication disabilities and those who speak a language other than English; and (5) providing all information and notices in plain language and in terms the residents can understand.

History: 2019 c 60 art 1 s 11,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 11, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 11, the effective date.

144G.42 BUSINESS OPERATION. Subdivision 1. Display of license. The original current license must be displayed at the main entrance of each assisted living facility. The facility must provide a copy of the license to any person who requests it.

Subd. 2. Quality management. The facility shall engage in quality management appropriate to the size of the facility and relevant to the type of services provided. "Quality management activity" means evaluating the quality of care by periodically reviewing resident services, complaints made, and other issues that have occurred and determining whether changes in services, staffing, or other procedures need to be made in order to ensure safe and competent services to residents. Documentation about quality management activity must be available for two years. Information about quality management must be available to the commissioner at the time of the survey, investigation, or renewal.

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Subd. 3. Facility restrictions. (a) This subdivision does not apply to licensees that are Minnesota counties or other units of government. (b) A facility or staff person may not: (1) accept a power-of-attorney from residents for any purpose, and may not accept appointments as guardians or conservators of residents; or (2) borrow a resident's funds or personal or real property, nor in any way convert a resident's property to the possession of the facility or staff person. (c) A facility may not serve as a resident's legal, designated, or other representative. (d) Nothing in this subdivision precludes a facility or staff person from accepting gifts of minimal value or precludes acceptance of donations or bequests made to a facility that are exempt from section 501(c)(3) of the Internal Revenue Code.

Subd. 4. Handling residents' finances and property. (a) A facility may assist residents with household budgeting, including paying bills and purchasing household goods, but may not otherwise manage a resident's property. (b) Where funds are deposited with the facility by the resident, the licensee: (1) retains fiduciary and custodial responsibility for the funds; (2) is directly accountable to the resident for the funds; and (3) must maintain records of and provide a resident with receipts for all transactions and purchases made with the resident's funds. When receipts are not available, the transaction or purchase must be documented. (c) Subject to paragraph (d), if responsibilities for day-to-day management of the resident funds are delegated to the manager, the manager must: (1) provide the licensee with a monthly accounting of the resident funds; and (2) meet all legal requirements related to holding and accounting for resident funds. (d) The facility must ensure any party responsible for holding or managing residents' personal funds is bonded or obtains insurance in sufficient amounts to specifically cover losses of resident funds and provides proof of the bond or insurance.

Subd. 5. Final accounting; return of money and property. Within 30 days of the effective date of a facility-initiated or resident-initiated termination of housing or services or the death of the resident, the facility must: (1) provide to the resident, resident's legal representative, and resident's designated representative a final statement of account; (2) provide any refunds due; (3) return any money, property, or valuables held in trust or custody by the facility; and (4) as required under section 504B.178, refund the resident's security deposit unless it is applied to the first month's charges.

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Subd. 6. Compliance with requirements for reporting maltreatment of vulnerable adults; abuse prevention plan. (a) The assisted living facility must comply with the requirements for the reporting of maltreatment of vulnerable adults in section 626.557. The facility must establish and implement a written procedure to ensure that all cases of suspected maltreatment are reported. (b) The facility must develop and implement an individual abuse prevention plan for each vulnerable adult. The plan shall contain an individualized review or assessment of the person's susceptibility to abuse by another individual, including other vulnerable adults; the person's risk of abusing other vulnerable adults; and statements of the specific measures to be taken to minimize the risk of abuse to that person and other vulnerable adults. For purposes of the abuse prevention plan, abuse includes self-abuse.

Subd. 7. Posting information for reporting suspected crime and maltreatment. The facility shall support protection and safety through access to the state's systems for reporting suspected criminal activity and suspected vulnerable adult maltreatment by: (1) posting the 911 emergency number in common areas and near telephones provided by the assisted living facility; (2) posting information and the reporting number for the Minnesota Adult Abuse Reporting Center to report suspected maltreatment of a vulnerable adult under section 626.557; and (3) providing reasonable accommodations with information and notices in plain language.

Subd. 8. Employee records. (a) The facility must maintain current records of each paid employee, each regularly scheduled volunteer providing services, and each individual contractor providing services. The records must include the following information: (1) evidence of current professional licensure, registration, or certification if licensure, registration, or certification is required by this chapter or rules; (2) records of orientation, required annual training and infection control training, and competency evaluations; (3) current job description, including qualifications, responsibilities, and identification of staff persons providing supervision; (4) documentation of annual performance reviews that identify areas of improvement needed and training needs; (5) for individuals providing assisted living services, verification that required health screenings under subdivision 9 have taken place and the dates of those screenings; and (6) documentation of the background study as required under section 144.057. (b) Each employee record must be retained for at least three years after a paid employee, volunteer, or contractor ceases to be employed by, provide services at, or be under contract with the facility. If a facility ceases operation, employee records must be maintained for three years after facility operations cease.

Subd. 9. Tuberculosis prevention and control. (a) The facility must establish and maintain a comprehensive tuberculosis infection control program according to the most current tuberculosis infection control guidelines issued by the United States Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination, as published in the CDC's Morbidity and Mortality Weekly Report (MMWR). The program must include a tuberculosis infection control plan that covers all paid and unpaid employees, contractors,

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students, and regularly scheduled volunteers. The commissioner shall provide technical assistance regarding implementation of the guidelines. (b)The facility must maintain written evidence of compliance with this subdivision.

Subd. 9a. Communicable Diseases. A facility must follow current state requirements for prevention, control, and reporting of communicable diseases as defined in Minnesota Rules, parts 4605.7040, 4605.7044, 4605.7050, 4605.7075, 4605.7080, and 4605.7090.

Subd. 10. Disaster planning and emergency preparedness plan. (a) The facility must meet the following requirements: (1) have a written emergency disaster plan that contains a plan for evacuation, addresses elements of sheltering in place, identifies temporary relocation sites, and details staff assignments in the event of a disaster or an emergency; (2) post an emergency disaster plan prominently; (3) provide building emergency exit diagrams to all residents; (4) post emergency exit diagrams on each floor; and (5) have a written policy and procedure regarding missing tenant residents. (b) The facility must provide emergency and disaster training to all staff during the initial staff orientation and annually thereafter and must make emergency and disaster training annually available to all residents.

Staff who have not received emergency and disaster training are allowed to work only when trained staff are also working on site. (c) The facility must meet any additional requirements adopted in rule.

History: 2019 c 60 art 1 s 15,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 15, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 15, the effective date.

144G.43 RESIDENT RECORD REQUIREMENTS. Subdivision 1. Resident record. (a) Assisted living facilities must maintain records for each resident for whom it is providing services. Entries in the resident records must be current, legible, permanently recorded, dated, and authenticated with the name and title of the person making the entry. (b) Resident records, whether written or electronic, must be protected against loss, tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable relevant federal and state laws.

The facility shall establish and implement written procedures to control use, storage, and security of resident records and establish criteria for release of resident information. (c) The facility may not disclose to any other person any personal, financial, or medical information about the resident, except: (1) as may be required by law; (2) to employees or contractors of the facility, another facility, other health care practitioner or provider, or inpatient facility needing information in order to provide services to the resident, but only the information that is necessary for the provision of services; (3) to persons authorized in writing by the resident, including third-party payers; and 40

(4) to representatives of the commissioner authorized to survey or investigate facilities under this chapter or federal laws.

Subd. 2. Access to records. The facility must ensure that the appropriate records are readily available to employees and contractors authorized to access the records. Resident records must be maintained in a manner that allows for timely access, printing, or transmission of the records. The records must be made readily available to the commissioner upon request.

Subd. 3. Contents of resident record. Contents of a resident record include the following for each resident: (1) identifying information, including the resident's name, date of birth, address, and telephone number; (2) the name, address, and telephone number of the resident's emergency contact, legal representatives, and designated representative; (3) names, addresses, and telephone numbers of the resident's health and medical service providers, if known; (4) health information, including medical history, allergies, and when the provider is managing medications, treatments or therapies that require documentation, and other relevant health records; (5) the resident's advance directives, if any; (6) copies of any health care directives, guardianships, powers of attorney, or conservatorships; (7) the facility's current and previous assessments and service plans; (8) all records of communications pertinent to the resident's services; (9) documentation of significant changes in the resident's status and actions taken in response to the needs of the resident, including reporting to the appropriate supervisor or health care professional; (10) documentation of incidents involving the resident and actions taken in response to the needs of the resident, including reporting to the appropriate supervisor or health care professional; (11) documentation that services have been provided as identified in the service plan; (12) documentation that the resident has received and reviewed the assisted living bill of rights; (13) documentation of complaints received and any resolution; (14) a discharge summary, including service termination notice and related documentation, when applicable; and (15) other documentation required under this chapter and relevant to the resident's services or status.

Subd. 4. Transfer of resident records. With the resident's knowledge and consent, if a resident is relocated to another facility or to a nursing home, or if care is transferred to another service provider, the facility must timely convey to the new facility, nursing home, or provider: (1) the resident's full name, date of birth, and insurance information; (2) the name, telephone number, and address of the resident's designated representatives and legal representatives, if any; (3) the resident's current documented diagnoses that are relevant to the services being provided; (4) the resident's known allergies that are relevant to the services being provided;

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(5) the name and telephone number of the resident's physician, if known, and the current physician orders that are relevant to the services being provided; (6) all medication administration records that are relevant to the services being provided; (7) the most recent resident assessment, if relevant to the services being provided; and (8) copies of health care directives, "do not resuscitate" orders, and any guardianship orders or powers of attorney.

Subd. 5. Record retention. Following the resident's discharge or termination of services, an assisted living facility must retain a resident's record for at least five years or as otherwise required by state or federal regulations. Arrangements must be made for secure storage and retrieval of resident records if the facility ceases to operate.

History: 2019 c 60 art 1 s 21,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 21, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 21, the effective date.

144G.45 MINIMUM SITE, PHYSICAL ENVIRONMENT, AND FIRE SAFETY REQUIREMENTS. Subdivision 1. Requirements. The following are required for all assisted living facilities: (1) public utilities must be available, and working or inspected and approved water and septic systems must be in place; (2) the location must be publicly accessible to fire department services and emergency medical services; (3) the location's topography must provide sufficient natural drainage and is not subject to flooding; (4) all-weather roads and walks must be provided within the lot lines to the primary entrance and the service entrance, including employees' and visitors' parking at the site; and (5) the location must include space for outdoor activities for residents.

Subd. 2. Fire protection and physical environment. (a) Each assisted living facility must comply with the State Fire Code in Minnesota rules , chapter 7511, and: (i) provide smoke alarms in each room used for sleeping purposes; (ii) provide smoke alarms outside each separate sleeping area in the immediate vicinity of bedrooms; (iii) provide smoke alarms on each story within a dwelling unit, including basements, but not including crawl spaces and unoccupied attics; (iv) where more than one smoke alarm is required within an individual dwelling unit or sleeping unit, interconnect all smoke alarms so that actuation of one alarm causes all alarms in the individual dwelling unit or sleeping unit to operate; and (v) ensure the power supply for existing smoke alarms complies with the State Fire Code, except that newly introduced smoke alarms in existing buildings may be battery operated; (2) install and maintain portable fire extinguishers in accordance with the State Fire Code; (3) install portable fire extinguishers having a minimum 2-A:10-B:C rating within Group R-3 occupancies, as defined by the State Fire Code, located so that the travel distance to the nearest fire extinguisher does not exceed 75 feet, and maintained in accordance with the State Fire Code; and

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(4) keep the physical environment, including walls, floors, ceiling, all furnishings, grounds, systems, and equipment a continuous state of good repair and operation with regard to the health, safety, comfort, and well-being of the residents in accordance with a maintenance and repair program. (b) Each assisted living facility shall develop and maintain fire safety and evacuation plans. The plans shall include but are not limited to: (1) location and number of resident sleeping rooms; (2) employee actions to be taken in the event of a fire or similar emergency; (3) fire protection procedures necessary for residents; and (4) procedures for resident movement, evacuation, or relocation during a fire or similar emergency including the identification of unique or unusual resident needs for movement or evacuation. (c) Employees of assisted living facilities shall receive training on the fire safety and evacuation plans upon hiring and at least twice per year thereafter. (d) Fire safety and evacuation plans shall be readily available at all times within the facility. (e) Residents who are capable of assisting in their own evacuation shall be trained on the proper actions to take in the event of a fire to include movement, evacuation, or relocation. The training shall be made available to residents at least once per year. (f) Evacuation drills are required for employees twice per year per shift with at least one evacuation drill every other month. Evacuation of the residents is not required. Fire alarm system activation is not required to initiate the evacuation drill. (g) Existing construction or elements, including assisted living facilities that were registered as housing with services establishments under chapter 144D prior to August 1, 2021, shall be permitted to continue in use provided such use does not constitute a distinct hazard to life. Any existing elements that an authority having jurisdiction deems a distinct hazard to life must be corrected. The facility must document in the facility's records any actions taken to comply with a correction order, and must submit to the commissioner for review and approval prior to correction.

Subd. 3. Local laws apply. Assisted living facilities shall comply with all applicable state and local governing laws, regulations, standards, ordinances, and codes for fire safety, building, and zoning requirements.

Subd. 4. Design requirements. (a) All assisted living facilities with six or more residents must meet the provisions relevant to assisted living facilities in the 2018 edition of the Facility Guidelines Institute "Guidelines for Design and Construction of Residential Health, Care and Support Facilities" and of adopted rules. This minimum design standard must be met for all new licenses, or new construction. In addition to the guidelines, assisted living facilities shall provide the option of a bath in addition to a shower for all residents. (b) If the commissioner decides to update the edition of the guidelines specified in paragraph (a) for purposes of this subdivision, the commissioner must notify the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over health care and public safety of the planned update by January 15 of the year in which the new edition will become effective. Following notice from the commissioner, the new edition shall become effective for assisted living facilities beginning August 1 of that year, unless provided otherwise in law. The commissioner shall, by publication in the State Register, specify a date by which facilities must comply with the updated edition. The date by which facilities must comply shall not be sooner than six months after publication of the commissioner's notice in the State Register.

Subd. 5. Assisted living facilities; Life Safety Code. (a) All assisted living facilities with six or more residents must meet the applicable provisions of the most current edition of the NFPA Standard 101, Life Safety Code, Residential Board and Care Occupancies chapter. The minimum design standard shall be met 43

for all new licenses, new construction, modifications, renovations, alterations, changes of use, or additions. (b) If the commissioner decides to update the Life Safety Code for purposes of this subdivision, the commissioner must notify the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over health care and public safety of the planned update by January 15 of the year in which the new Life Safety Code will become effective. Following notice from the commissioner, the new edition shall become effective for assisted living facilities beginning August 1 of that year, unless provided otherwise in law. The commissioner shall, by publication in the State Register, specify a date by which facilities must comply with the updated Life Safety Code. The date by which facilities must comply shall not be sooner than six months after publication of the commissioner's notice in the State Register.

Subd. 6. New construction; plans. (a) For all new licensure and construction beginning on or after August 1, 2021, the following must be provided to the commissioner: (1) architectural and engineering plans and specifications for new construction must be prepared and signed by architects and engineers who are registered in Minnesota. Final working drawings and specifications for proposed construction must be submitted to the commissioner for review and approval; (2) final architectural plans and specifications must include elevations and sections through the building showing types of construction, and must indicate dimensions and assignments of rooms and areas, room finishes, door types and hardware, elevations and details of nurses' work areas, utility rooms, toilet and bathing areas, and large-scale layouts of dietary and laundry areas. Plans must show the location of fixed equipment and sections and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions must be indicated. The roof plan must show all mechanical installations. The site plan must indicate the proposed and existing buildings, topography, roadways, walks and utility service lines; and (3) final mechanical and electrical plans and specifications must address the complete layout and type of all installations, systems, and equipment to be provided. Heating plans must include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers, boilers, breeching, and accessories. Ventilation plans must include room air quantities, ducts, fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing plans must include the fixtures and equipment fixture schedule; water supply and circulating piping, pumps, tanks, riser diagrams, and building drains; the size, location, and elevation of water and sewer services; and the building fire protection systems. Electrical plans must include fixtures and equipment, receptacles, switches, power outlets, circuits, power and light panels, transformers, and service feeders. Plans must show location of nurse call signals, cable lines, fire alarm stations, and fire detectors and emergency lighting. (b) Unless construction is begun within one year after approval of the final working drawing and specifications, the drawings must be resubmitted for review and approval. (c) The commissioner must be notified within 30 days before completion of construction so that the commissioner can make arrangements for a final inspection by the commissioner. (d) At least one set of complete life safety plans, including changes resulting from remodeling or alterations, must be kept on file in the facility.

Subd. 7. Variance or waiver. (a) A facility may request that the commissioner grant a variance or waiver from the provisions of this section or section 144G.81, subdivision 5. A request for a waiver must be submitted to the commissioner in writing. Each request must contain: (1) the specific requirement for which the variance or waiver is requested; (2) the reasons for the request; (3) the alternative measures that will be taken if a variance or waiver is granted; (4) the length of time for which the variance or waiver is requested; and 44

(5) other relevant information deemed necessary by the commissioner to properly evaluate the request for the waiver. (b) The decision to grant or deny a variance or waiver must be based on the commissioner's evaluation of the following criteria: (1) whether the waiver will adversely affect the health, treatment, comfort, safety, or well-being of a resident; (2) whether the alternative measures to be taken, if any, are equivalent to or superior to those permitted under section 144G.81, subdivision 5; and (3) whether compliance with the requirements would impose an undue burden on the facility. (c) The commissioner must notify the facility in writing of the decision. If a variance or waiver is granted, the notification must specify the period of time for which the variance or waiver is effective and the alternative measures or conditions, if any, to be met by the facility. (d) Alternative measures or conditions attached to a variance or waiver have the force and effect of this chapter and are subject to the issuance of correction orders and fines in accordance with sections 144G.30, subdivision 7, and 144G.31. The amount of fines for a violation of this subdivision is that specified for the specific requirement for which the variance or waiver was requested. (e) A request for renewal of a variance or waiver must be submitted in writing at least 45 days before its expiration date. Renewal requests must contain the information specified in paragraph (b). A variance or waiver must be renewed by the commissioner if the facility continues to satisfy the criteria in paragraph (a) and demonstrates compliance with the alternative measures or conditions imposed at the time the original variance or waiver was granted. (f) The commissioner must deny, revoke, or refuse to renew a variance or waiver if it is determined that the criteria in paragraph (a) are not met. The facility must be notified in writing of the reasons for the decision and informed of the right to appeal the decision. (g) A facility may contest the denial, revocation, or refusal to renew a variance or waiver by requesting a contested case hearing under chapter 14. The facility must submit, within 15 days of the receipt of the commissioner's decision, a written request for a hearing. The request for hearing must set forth in detail the reasons why the facility contends the decision of the commissioner should be reversed or modified. At the hearing, the facility has the burden of proving by a preponderance of the evidence that the facility satisfied the criteria specified in paragraph (b), except in a proceeding challenging the revocation of a variance or waiver.

History: 2019 c 60 art 1 s 25,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 25, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 25, the effective date.

CONTRACTS, TERMINATIONS, AND RELOCATIONS 144G.50 ASSISTED LIVING CONTRACT REQUIREMENTS. Subdivision 1. Contract required. (a) An assisted living facility may not offer or provide housing or assisted living services to any individual unless it has executed a written contract. (b) The contract must contain all the terms concerning the provision of: (1) housing; (2) assisted living services, whether provided directly by the facility or by management agreement or 45

other agreement; and (3) the resident's service plan, if applicable. (c) A facility must: (1) offer to prospective residents and provide to the Office of Ombudsman for Long-Term Care a complete unsigned copy of its contract; and (2) give a complete copy of any signed contract and any addendums, and all supporting documents and attachments, to the resident promptly after a contract and any addendum has been signed. (d) A contract under this section is a consumer contract under sections 325G.29 to 325G.37. (e) Before or at the time of execution of the contract, the facility must offer the resident the opportunity to identify a designated representative according to subdivision 3. (f) The resident must agree in writing to any additions or amendments to the contract. Upon agreement between the resident and the facility, a new contract or an addendum to the existing contract must be executed and signed.

Subd. 2. Contract information. (a) The contract must include in a conspicuous place and manner onthe contract the legal name and the license number of the facility. (b) The contract must include the name, telephone number, and physical mailing address, which may not be a public or private post office box, of: (1) the facility and contracted service provider when applicable; (2) the licensee of the facility; (3) the managing agent of the facility, if applicable; and (4) the authorized agent for the facility. (c) The contract must include: (1) a disclosure of the category of assisted living facility license held by the facility and, if the facility is not an assisted living facility with dementia care, a disclosure that it does not hold an assisted living facility with dementia care license; (2) a description of all the terms and conditions of the contract, including a description of and any limitations to the housing or assisted living services to be provided for the contracted amount; (3) a delineation of the cost and nature of any other services to be provided for an additional fee; (4) a delineation and description of any additional fees the resident may be required to pay if the resident's condition changes during the term of the contract; (5) a delineation of the grounds under which the resident may be discharged, evicted, or transferred or have services terminated; (6) billing and payment procedures and requirements; and (7) disclosure of the facility's ability to provide specialized diets. (d) The contract must include a description of the facility's complaint resolution process available to residents, including the name and contact information of the person representing the facility who is designated to handle and resolve complaints.

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(e) The contract must include a clear and conspicuous notice of: (1) the right under section 144G.54 to appeal the termination of an assisted living contract; (2) the facility's policy regarding transfer of residents within the facility, under what circumstances a transfer may occur, and the circumstances under which resident consent is required for a transfer; (3) contact information for the Office of Ombudsman for Long-Term Care, the Ombudsman for Mental Health and Developmental Disabilities, and the Office of Health Facility Complaints; (4) the resident's right to obtain services from an unaffiliated service provider; (5) a description of the facility's policies related to medical assistance waivers under chapter 256S and section 256B.49 and the housing support program under chapter 256I, including: (i) whether the facility is enrolled with the commissioner of human services to provide customized living services under medical assistance waivers; (ii) whether the facility has an agreement to provide housing support under section 256I.04, subdivision 2, paragraph (b); (iii) whether there is a limit on the number of people residing at the facility who can receive customized living services or participate in the housing support program at any point in time. If so, the limit must be provided; (iv) whether the facility requires a resident to pay privately for a period of time prior to accepting payment under medical assistance waivers or the housing support program, and if so, the length of time that private payment is required; (v) a statement that medical assistance waivers provide payment for services, but do not cover the cost of rent; (vi) a statement that residents may be eligible for assistance with rent through the housing support program; and (vii) a description of the rent requirements for people who are eligible for medical assistance waivers but who are not eligible for assistance through the housing support program; (6) the contact information to obtain long-term care consulting services under section 256B.0911; and (7) the toll-free phone number for the Minnesota Adult Abuse Reporting Center.

Subd. 3. Designation of representative. (a) Before or at the time of execution of an assisted living contract, an assisted living facility must offer the resident the opportunity to identify a designated representative in writing in the contract and must provide the following verbatim notice on a document separate from the contract: "RIGHT TO DESIGNATE A REPRESENTATIVE FOR CERTAIN PURPOSES. You have the right to name anyone as your "Designated Representative." A Designated Representative can assist you, receive certain information and notices about you, including some information related to your health care, and advocate on your behalf. A Designated Representative does not take the place of your guardian, conservator, power of attorney ("attorney-in-fact"), or health care power of attorney ("health care agent"), if applicable." (b) The contract must contain a page or space for the name and contact information of the designated representative and a box the resident must initial if the resident declines to name a designated representative.

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Notwithstanding subdivision 1, paragraph (f), the resident has the right at any time to add, remove, or change the name and contact information of the designated representative.

Subd. 4. Filing. The contract and related documents must be maintained by the facility in files from the date of execution until five years after the contract is terminated or expires. The contracts and all associated documents must be available for on-site inspection by the commissioner at any time. The documents shall be available for viewing or copies shall be made available to the resident and the legal or designated representative at any time.

Subd. 5. Waivers of liability prohibited. The contract must not include a waiver of facility liability for the health and safety or personal property of a resident. The contract must not include any provision that the facility knows or should know to be deceptive, unlawful, or unenforceable under state or federal law, nor include any provision that requires or implies a lesser standard of care or responsibility than is required by law.

History: 2019 c 54 art 1 s 33; 2019 c 60 art 1 s 26,47; 2020 c 83 art 1 s 36 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 26, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 26, the effective date.

144G.51 ARBITRATION. (a) An assisted living facility must clearly and conspicuously disclose, in writing in an assisted living contract, any arbitration provision in the contract that precludes, limits, or delays the ability of a resident from taking a civil action. (b) An arbitration requirement must not include a choice of law or choice of venue provision. Assisted living contracts must adhere to Minnesota law and any other applicable federal or local law.

History: 2019 c 60 art 1 s 31,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 31, is effective August 1, 2021, for contracts entered into on or after that date. Laws 2019, chapter 60, article 1, section 31, the effective date.

144G.52 ASSISTED LIVING CONTRACT TERMINATIONS. Subdivision 1. Definition. For purposes of sections 144G.52 to 144G.55, "termination" means: (1) a facility-initiated termination of housing provided to the resident under the contract; or (2) a facility-initiated termination or nonrenewal of all assisted living services the resident receives from the facility under the contract.

Subd. 2. Prerequisite to termination of a contract. (a) Before issuing a notice of termination of an assisted living contract, a facility must schedule and participate in a meeting with the resident and the resident's legal representative and designated representative. The purposes of the meeting are to: (1) explain in detail the reasons for the proposed termination; and (2) identify and offer reasonable accommodations or modifications, interventions, or alternatives to avoid the termination or enable the resident to remain in the facility, including but not limited to securing services from another provider of the resident's choosing that may allow the resident to avoid the termination.

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A facility is not required to offer accommodations, modifications, interventions, or alternatives that fundamentally alter the nature of the operation of the facility. (b) The meeting must be scheduled to take place at least seven days before a notice of termination is issued. The facility must make reasonable efforts to ensure that the resident, legal representative, and designated representative are able to attend the meeting. (c) The facility must notify the resident that the resident may invite family members, relevant health professionals, a representative of the Office of Ombudsman for Long-Term Care, or other persons of the resident's choosing to participate in the meeting. For residents who receive home and community-based waiver services under chapter 256S and section 256B.49, the facility must notify the resident's case manager of the meeting. (d) In the event of an emergency relocation under subdivision 9, where the facility intends to issue a notice of termination and an in-person meeting is impractical or impossible, the facility may attempt to schedule and participate in a meeting under this subdivision via telephone, video, or other means.

Subd. 3. Termination for nonpayment. (a) A facility may initiate a termination of housing because of nonpayment of rent or a termination of services because of nonpayment for services. Upon issuance of a notice of termination for nonpayment, the facility must inform the resident that public benefits may be available and must provide contact information for the Senior LinkAge Line under section 256.975, subdivision 7. (b) An interruption to a resident's public benefits that lasts for no more than 60 days does not constitute nonpayment.

Subd. 4. Termination for violation of the assisted living contract. A facility may initiate a termination of the assisted living contract if the resident violates a lawful provision of the contract and the resident does not cure the violation within a reasonable amount of time after the facility provides written notice of the ability to cure to the resident. Written notice of the ability to cure may be provided in person or by first class mail. A facility is not required to provide a resident with written notice of the ability to cure for a violation that threatens the health or safety of the resident or another individual in the facility, or for a violation that constitutes illegal conduct.

Subd. 5. Expedited termination. (a) A facility may initiate an expedited termination of housing or services if: (1) the resident has engaged in conduct that substantially interferes with the rights, health, or safety of other residents; (2) the resident has engaged in conduct that substantially and intentionally interferes with the safety or physical health of facility staff; or (3) the resident has committed an act listed in section 504B.171 that substantially interferes with the rights, health, or safety of other residents. (b) A facility may initiate an expedited termination of services if: (1) the resident has engaged in conduct that substantially interferes with the resident's health or safety; (2) the resident's assessed needs exceed the scope of services agreed upon in the assisted living contract and are not included in the services the facility disclosed in the uniform checklist; or

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(3) extraordinary circumstances exist, causing the facility to be unable to provide the resident with the services disclosed in the uniform checklist that are necessary to meet the resident's needs.

Subd. 6. Right to use provider of resident's choosing. A facility may not terminate the assisted living contract if the underlying reason for termination may be resolved by the resident obtaining services from another provider of the resident's choosing and the resident obtains those services.

Subd. 7. Notice of contract termination required. (a) A facility terminating a contract must issue a written notice of termination according to this section. The facility must also send a copy of the termination notice to the Office of Ombudsman for Long-Term Care and, for residents who receive home and community-based waiver services under chapter 256S and section 256B.49, to the resident's case manager, as soon as practicable after providing notice to the resident. A facility may terminate an assisted living contract only as permitted under subdivisions 3, 4, and 5. (b) A facility terminating a contract under subdivision 3 or 4 must provide a written termination notice at least 30 days before the effective date of the termination to the resident, legal representative, and designated representative. (c) A facility terminating a contract under subdivision 5 must provide a written termination notice at least 15 days before the effective date of the termination to the resident, legal representative, and designated representative. (d) If a resident moves out of a facility or cancels services received from the facility, nothing in this section prohibits a facility from enforcing against the resident any notice periods with which the resident must comply under the assisted living contract.

Subd. 8. Content of notice of termination. The notice required under subdivision 7 must contain, at a minimum: (1) the effective date of the termination of the assisted living contract; (2) a detailed explanation of the basis for the termination, including the clinical or other supporting rationale; (3) a detailed explanation of the conditions under which a new or amended contract may be executed; (4) a statement that the resident has the right to appeal the termination by requesting a hearing, and information concerning the time frame within which the request must be submitted and the contact information for the agency to which the request must be submitted; (5) a statement that the facility must participate in a coordinated move to another provider or caregiver, as required under section 144G.55; (6) the name and contact information of the person employed by the facility with whom the resident may discuss the notice of termination; (7) information on how to contact the Office of Ombudsman for Long-Term Care to request an advocate to assist regarding the termination; (8) information on how to contact the Senior LinkAge Line under section 256.975, subdivision 7, and an explanation that the Senior LinkAge Line may provide information about other available housing or service options; and

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(9) if the termination is only for services, a statement that the resident may remain in the facility and may secure any necessary services from another provider of the resident's choosing.

Subd. 9. Emergency relocation. (a) A facility may remove a resident from the facility in an emergencyif necessary due to a resident's urgent medical needs or an imminent risk the resident poses to the health or safety of another facility resident or facility staff member. An emergency relocation is not a termination. (b) In the event of an emergency relocation, the facility must provide a written notice that contains, at a minimum: (1) the reason for the relocation; (2) the name and contact information for the location to which the resident has been relocated and any new service provider; (3) contact information for the Office of Ombudsman for Long-Term Care; (4) if known and applicable, the approximate date or range of dates within which the resident is expected to return to the facility, or a statement that a return date is not currently known; and (5) a statement that, if the facility refuses to provide housing or services after a relocation, the resident has the right to appeal under section 144G.54. The facility must provide contact information for the agency to which the resident may submit an appeal. (c) The notice required under paragraph (b) must be delivered as soon as practicable to: (1) the resident, legal representative, and designated representative; (2) for residents who receive home and community-based waiver services under chapter 256S and section 256B.49, the resident's case manager; and (3) the Office of Ombudsman for Long-Term Care if the resident has been relocated and has not returned to the facility within four days. (d) Following an emergency relocation, a facility's refusal to provide housing or services constitutes a termination and triggers the termination process in this section.

Subd. 10. Right to return. If a resident is absent from a facility for any reason, including an emergency relocation, the facility shall not refuse to allow a resident to return if a termination of housing has not been effectuated.

History: 2019 c 54 art 1 s 33; 2019 c 60 art 1 s 27,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 27, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 27, the effective date.

144G.53 NONRENEWAL OF HOUSING. (a) If a facility decides to not renew a resident's housing under a contract, the facility must either (1) provide the resident with 60 calendar days' notice of the nonrenewal and assistance with relocation planning, or (2) follow the termination procedure under section 144G.52. (b) The notice must include the reason for the nonrenewal and contact information of the Office of Ombudsman for Long-Term Care.

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(c) A facility must: (1) provide notice of the nonrenewal to the Office of Ombudsman for Long-Term Care; (2) for residents who receive home and community-based waiver services under chapter 256S and section 256B.49, provide notice to the resident's case manager; (3) ensure a coordinated move to a safe location, as defined in section 144G.55, subdivision 2, that is appropriate for the resident; (4) ensure a coordinated move to an appropriate service provider identified by the facility, if services are still needed and desired by the resident; (5) consult and cooperate with the resident, legal representative, designated representative, case manager for a resident who receives home and community-based waiver services under chapter 256S and section 256B.49, relevant health professionals, and any other persons of the resident's choosing to make arrangements to move the resident, including consideration of the resident's goals; and (6) prepare a written plan to prepare for the move. (d) A resident may decline to move to the location the facility identifies or to accept services from a service provider the facility identifies, and may instead choose to move to a location of the resident's choosing or receive services from a service provider of the resident's choosing within the timeline prescribed in the nonrenewal notice.

History: 2019 c 54 art 1 s 33; 2019 c 60 art 1 s 28,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 28, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 28, the effective date.

144G.54 APPEALS OF CONTRACT TERMINATIONS. Subdivision 1. Right to appeal. Residents have the right to appeal the termination of an assisted living contract.

Subd. 2. Permissible grounds to appeal termination. A resident may appeal a termination initiated under section 144G.52, subdivision 3, 4, or 5, on the ground that: (1) there is a factual dispute as to whether the facility had a permissible basis to initiate the termination; (2) the termination would result in great harm or the potential for great harm to the resident as determined by the totality of the circumstances, except in circumstances where there is a greater risk of harm to other residents or staff at the facility; (3) the resident has cured or demonstrated the ability to cure the reasons for the termination, or has identified a reasonable accommodation or modification, intervention, or alternative to the termination; or (4) the facility has terminated the contract in violation of state or federal law.

Subd. 3. Appeals process. (a) The Office of Administrative Hearings must conduct an expedited hearing as soon as practicable under this section, but in no event later than 14 calendar days after the office receives the request, unless the parties agree otherwise or the chief administrative law judge deems the timing to be unreasonable, given the complexity of the issues presented.

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(b) The hearing must be held at the facility where the resident lives, unless holding the hearing at that location is impractical, the parties agree to hold the hearing at a different location, or the chief administrative law judge grants a party's request to appear at another location or by telephone or interactive video. (c) The hearing is not a formal contested case proceeding, except when determined necessary by the chief administrative law judge. (d) Parties may but are not required to be represented by counsel. The appearance of a party without counsel does not constitute the unauthorized practice of law. (e) The hearing shall be limited to the amount of time necessary for the participants to expeditiously present the facts about the proposed termination. The administrative law judge shall issue a recommendation to the commissioner as soon as practicable, but in no event later than ten business days after the hearing.

Subd. 4. Burden of proof for appeals of termination. (a) The facility bears the burden of proof to establish by a preponderance of the evidence that the termination was permissible if the appeal is brought on the ground listed in subdivision 2, clause (1) or (4). (b) The resident bears the burden of proof to establish by a preponderance of the evidence that the termination was not permissible if the appeal is brought on the ground listed in subdivision 2, clause (2) or (3).

Subd. 5. Determination; content of order. (a) The resident's termination must be rescinded if the resident prevails in the appeal. (b) The order may contain any conditions that may be placed on the resident's continued residency or receipt of services, including but not limited to changes to the service plan or a required increase in services.

Subd. 6. Service provision while appeal pending. A termination of housing or services shall not occur while an appeal is pending. If additional services are needed to meet the health or safety needs of the resident while an appeal is pending, the resident is responsible for contracting for those additional services from the facility or another provider and for ensuring the costs for those additional services are covered.

Subd. 7. Application of chapter 504B to appeals of terminations. A resident may not bring an action under chapter 504B to challenge a termination that has occurred and been upheld under this section.

History: 2019 c 60 art 1 s 29,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 29, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 29, the effective date.

144G.55 COORDINATED MOVES. Subdivision 1. Duties of facility. (a) If a facility terminates an assisted living contract, reduces services to the extent that a resident needs to move, or conducts a planned closure under section 144G.57, the facility: (1) must ensure, subject to paragraph (c), a coordinated move to a safe location that is appropriate for the resident and that is identified by the facility prior to any hearing under section 144G.54; (2) must ensure a coordinated move of the resident to an appropriate service provider identified by the facility prior to any hearing under section 144G.54, provided services are still needed and desired by the resident; and (3) must consult and cooperate with the resident, legal representative, designated representative, case manager for a resident who receives home and community-based waiver services under chapter 256S and

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section 256B.49, relevant health professionals, and any other persons of the resident's choosing to make arrangements to move the resident, including consideration of the resident's goals. (b) A facility may satisfy the requirements of paragraph (a), clauses (1) and (2), by moving the resident to a different location within the same facility, if appropriate for the resident. (c) A resident may decline to move to the location the facility identifies or to accept services from a service provider the facility identifies, and may choose instead to move to a location of the resident's choosing or receive services from a service provider of the resident's choosing within the timeline prescribed in the termination notice. (d) Sixty days before the facility plans to reduce or eliminate one or more services for a particular resident, the facility must provide written notice of the reduction that includes: (1) a detailed explanation of the reasons for the reduction and the date of the reduction; (2) the contact information for the Office of Ombudsman for Long-Term Care and the name and contact information of the person employed by the facility with whom the resident may discuss the reduction of services; (3) a statement that if the services being reduced are still needed by the resident, the resident may remain in the facility and seek services from another provider; and (4) a statement that if the reduction makes the resident need to move, the facility must participate in a coordinated move of the resident to another provider or caregiver, as required under this section. (e) In the event of an unanticipated reduction in services caused by extraordinary circumstances, the facility must provide the notice required under paragraph (d) as soon as possible. (f) If the facility, a resident, a legal representative, or a designated representative determines that a reduction in services will make a resident need to move to a new location, the facility must ensure a coordinated move in accordance with this section, and must provide notice to the Office of Ombudsman for Long-Term Care. (g) Nothing in this section affects a resident's right to remain in the facility and seek services from another provider.

Subd. 2. Safe location. A safe location is not a private home where the occupant is unwilling or unable to care for the resident, a homeless shelter, a hotel, or a motel. A facility may not terminate a resident's housing or services if the resident will, as the result of the termination, become homeless, as that term is defined in section 116L.361, subdivision 5, or if an adequate and safe discharge location or adequate and needed service provider has not been identified. This subdivision does not preclude a resident from declining to move to the location the facility identifies.

Subd. 3. Relocation plan required. The facility must prepare a relocation plan to prepare for the moveto the new location or service provider.

Subd. 4. License restrictions. Unless otherwise ordered by the commissioner, if a facility's license is restricted by the commissioner under section 144G.20 such that a resident must move or obtain a new service provider, the facility must comply with this section.

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Subd. 5. No waiver. The rights established under this section for the benefit of residents do not limit any other rights available under other law. No facility may request or require that any resident waive the resident's rights at any time for any reason, including as a condition of admission to the facility.

History: 2019 c 54 art 1 s 33; 2019 c 60 art 1 s 30,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 30, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 30, the effective date.

144G.56 TRANSFER OF RESIDENTS WITHIN FACILITY. Subdivision 1. Definition. For the purposes of this section, "transfer" means a move of a resident within the facility to a different room or other private living unit.

Subd. 2. Orderly transfer. A facility must provide for the safe, orderly, coordinated, and appropriate transfer of residents within the facility.

Subd. 3. Notice required. (a) A facility must provide at least 30 calendar days' advance written notice to the resident and the resident's legal and designated representative of a facility-initiated transfer. The notice must include: (1) the effective date of the proposed transfer; (2) the proposed transfer location; (3) a statement that the resident may refuse the proposed transfer, and may discuss any consequences of a refusal with staff of the facility; (4) the name and contact information of a person employed by the facility with whom the resident may discuss the notice of transfer; and (5) contact information for the Office of Ombudsman for Long-Term Care. (b) Notwithstanding paragraph (a), a facility may conduct a facility-initiated transfer of a resident with less than 30 days' written notice if the transfer is necessary due to: (1) conditions that render the resident's room or private living unit uninhabitable; (2) the resident's urgent medical needs; or (3) a risk to the health or safety of another resident of the facility.

Subd. 4. Consent required. The facility may not transfer a resident without first obtaining the resident's consent to the transfer unless: (1) there are conditions that render the resident's room or private living unit uninhabitable; or (2) there is a change in facility operations as described in subdivision 5.

Subd. 5. Changes in facility operations. (a) In situations where there is a curtailment, reduction, or capital improvement within a facility necessitating transfers, the facility must: (1) minimize the number of transfers it initiates to complete the project or change in operations; (2) consider individual resident needs and preferences;

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(3) provide reasonable accommodations for individual resident requests regarding the transfers; and (4) in advance of any notice to any residents, legal representatives, or designated representatives, provide notice to the Office of Ombudsman for Long-Term Care and, when appropriate, the Office of Ombudsman for Mental Health and Developmental Disabilities of the curtailment, reduction, or capital improvement and the corresponding needed transfers.

Subd. 6. Evaluation. If a resident consents to a transfer, reasonable modifications must be made to the new room or private living unit that are necessary to accommodate the resident's disabilities. The facility must evaluate the resident's individual needs before deciding whether the room or unit to which the resident will be moved is appropriate to the resident's psychological, cognitive, and health care needs, including the accessibility of the bathroom.

Subd. 7. Disclosure. When entering into the assisted living contract, the facility must provide a conspicuous notice of the circumstance under which the facility may require a transfer, including any transfer that may be required if the resident will be receiving housing support under section 256I.06.

History: 2019 c 60 art 1 s 14,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 14, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 14, the effective date.

144G.57 PLANNED CLOSURES. Subdivision 1. Closure plan required. In the event that an assisted living facility elects to voluntarily close the facility, the facility must notify the commissioner and the Office of Ombudsman for Long-Term Care in writing by submitting a proposed closure plan.

Subd. 2. Content of closure plan. The facility's proposed closure plan must include: (1) the procedures and actions the facility will implement to notify residents of the closure, including a copy of the written notice to be given to residents, designated representatives, legal representatives, and family and other resident contacts; (2) the procedures and actions the facility will implement to ensure all residents receive appropriate termination planning in accordance with section 144G.55, and final accountings and returns under section 144G.42, subdivision 5; (3) assessments of the needs and preferences of individual residents; and (4) procedures and actions the facility will implement to maintain compliance with this chapter until all residents have relocated.

Subd. 3. Commissioner's approval required prior to implementation. (a) The plan shall be subject to the commissioner's approval and subdivision 6. The facility shall take no action to close the residence prior to the commissioner's approval of the plan. The commissioner shall approve or otherwise respond to the plan as soon as practicable. (b) The commissioner may require the facility to work with a transitional team comprised of department staff, staff of the Office of Ombudsman for Long-Term Care, and other professionals the commissioner deems necessary to assist in the proper relocation of residents.

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Subd. 4. Termination planning and final accounting requirements. Prior to termination, the facility must follow the termination planning requirements under section 144G.55, and final accounting and return requirements under section 144G.42, subdivision 5, for residents. The facility must implement the plan approved by the commissioner and ensure that arrangements for relocation and continued care that meet each resident's social, emotional, and health needs are effectuated prior to closure.

Subd. 5. Notice to residents. After the commissioner has approved the relocation plan and at least 60 calendar days before closing, except as provided under subdivision 6, the facility must notify residents, designated representatives, and legal representatives of the closure, the proposed date of closure, the contact information of the ombudsman for long-term care, and that the facility will follow the termination planning requirements under section 144G.55, and final accounting and return requirements under section 144G.42, subdivision 5. For residents who receive home and community-based waiver services under chapter 256S and section 256B.49, the facility must also provide this information to the resident's case manager.

Subd. 6. Emergency closures. (a) In the event the facility must close because the commissioner deems the facility can no longer remain open, the facility must meet all requirements in subdivisions 1 to 5, except for any requirements the commissioner finds would endanger the health and safety of residents. In the event the commissioner determines a closure must occur with less than 60 calendar days' notice, the facility shall provide notice to residents as soon as practicable or as directed by the commissioner. (b) Upon request from the commissioner, the facility must provide the commissioner with any documentation related to the appropriateness of its relocation plan, or to any assertion that the facility lacks the funds to comply with subdivisions 1 to 5, or that remaining open would otherwise endanger the health and safety of residents pursuant to paragraph (a).

Subd. 7. Other rights. Nothing in this section affects the rights and remedies available under chapter 504B. Subd. 8. Fine. The commissioner may impose a fine for failure to follow the requirements of this section.

History: 2019 c 54 art 1 s 33; 2019 c 60 art 1 s 33,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 33, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 33, the effective date.

STAFFING REQUIREMENTS 144G.60 STAFFING REQUIREMENTS. Subdivision 1. Background studies required. (a) Employees, contractors, and regularly scheduled volunteers of the facility are subject to the background study required by section 144.057 and may be disqualified under chapter 245C. Nothing in this subdivision shall be construed to prohibit the facility from requiring self-disclosure of criminal conviction information. (b) Data collected under this subdivision shall be classified as private data on individuals under section 13.02, subdivision 12. (c) Termination of an employee in good faith reliance on information or records obtained under this section regarding a confirmed conviction does not subject the assisted living facility to civil liability or liability for unemployment benefits.

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Subd. 2. Qualifications, training, and competency. All staff persons providing assisted living services must be trained and competent in the provision of services consistent with current practice standards appropriate to the resident's needs, and promote and be trained to support the assisted living bill of rights.

Subd. 3. Licensed health professionals and nurses. (a) Licensed health professionals and nurses providing services as employees of a licensed facility must possess a current Minnesota license or registration to practice. (b) Licensed health professionals and registered nurses must be competent in assessing resident needs, planning appropriate services to meet resident needs, implementing services, and supervising staff if assigned. (c) Nothing in this section limits or expands the rights of nurses or licensed health professionals to provide services within the scope of their licenses or registrations, as provided by law.

Subd. 4. Unlicensed personnel. (a) Unlicensed personnel providing assisted living services must have: (1) successfully completed a training and competency evaluation appropriate to the services provided by the facility and the topics listed in section 144G.61, subdivision 2, paragraph (a); or (2) demonstrated competency by satisfactorily completing a written or oral test on the tasks the unlicensed personnel will perform and on the topics listed in section 144G.61, subdivision 2, paragraph (a); and successfully demonstrated competency on topics in section 144G.61, subdivision 2, paragraph (a), clauses (5), (7), and (8), by a practical skills test.

Unlicensed personnel who only provide assisted living services listed in section 144G.08, subdivision 9, clauses (1) to (5), shall not perform delegated nursing or therapy tasks. (b) Unlicensed personnel performing delegated nursing tasks in an assisted living facility must: (1) have successfully completed training and demonstrated competency by successfully completing a written or oral test of the topics in section 144G.61, subdivision 2, paragraphs (a) and (b), and a practical skills test on tasks listed in section 144G.61, subdivision 2, paragraphs (a), clauses (5) and (7), and (b), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform; (2) satisfy the current requirements of Medicare for training or competency of home health aides or nursing assistants, as provided by Code of Federal Regulations, title 42, section 483 or 484.36; or (3) have, before April 19, 1993, completed a training course for nursing assistants that was approved by the commissioner. (c) Unlicensed personnel performing therapy or treatment tasks delegated or assigned by a licensed health professional must meet the requirements for delegated tasks in section 144G.62, subdivision 2, paragraph (a), and any other training or competency requirements within the licensed health professional's scope of practice relating to delegation or assignment of tasks to unlicensed personnel.

Subd. 5. Temporary staff. When a facility contracts with a temporary staffing agency, those individuals must meet the same requirements required by this section for personnel employed by the facility and shall be treated as if they are staff of the facility.

History: 2019 c 60 art 1 s 7,16,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, sections 7 and 16, is effective August 1, 2021. Laws 2019, chapter 60, article 1, sections 7 and 16, the effective dates.

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144G.61 STAFF COMPETENCY EVALUATIONS. Subdivision 1. Instructor and competency evaluation requirements. Instructors and competency evaluators must meet the following requirements: (1) training and competency evaluations of unlicensed personnel who only provide assisted living services specified in section 144G.08, subdivision 9, clauses (1) to (5), must be conducted by individuals with work experience and training in providing these services; and (2) training and competency evaluations of unlicensed personnel providing assisted living services must be conducted by a registered nurse, or another instructor may provide training in conjunction with the registered nurse.

Subd. 2. Training and evaluation of unlicensed personnel. (a) Training and competency evaluationsfor all unlicensed personnel must include the following: (1) documentation requirements for all services provided; (2) reports of changes in the resident's condition to the supervisor designated by the facility; (3) basic infection control, including blood-borne pathogens; (4) maintenance of a clean and safe environment; (5) appropriate and safe techniques in personal hygiene and grooming, including: (i) hair care and bathing; (ii) care of teeth, gums, and oral prosthetic devices; (iii) care and use of hearing aids; and (iv) dressing and assisting with toileting; (6) training on the prevention of falls; (7) standby assistance techniques and how to perform them; (8) medication, exercise, and treatment reminders; (9) basic nutrition, meal preparation, food safety, and assistance with eating; (10) preparation of modified diets as ordered by a licensed health professional; (11) communication skills that include preserving the dignity of the resident and showing respect for the resident and the resident's preferences, cultural background, and family; (12) awareness of confidentiality and privacy; (13) understanding appropriate boundaries between staff and residents and the resident's family; (14) procedures to use in handling various emergency situations; and (15) awareness of commonly used health technology equipment and assistive devices. (b) In addition to paragraph (a), training and competency evaluation for unlicensed personnel providing assisted living services must include:

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(1) observing, reporting, and documenting resident status; (2) basic knowledge of body functioning and changes in body functioning, injuries, or other observed changes that must be reported to appropriate personnel; (3) reading and recording temperature, pulse, and respirations of the resident; (4) recognizing physical, emotional, cognitive, and developmental needs of the resident; (5) safe transfer techniques and ambulation; (6) range of motioning and positioning; and (7) administering medications or treatments as required.

History: 2019 c 60 art 1 s 16,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 16, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 16, the effective date.

144G.62 DELEGATION AND SUPERVISION. Subdivision 1. Availability of contact person to staff. (a) Assisted living facilities must have a registered nurse available for consultation by staff performing delegated nursing tasks and must have an appropriate licensed health professional available if performing other delegated services such as therapies. (b) The appropriate contact person must be readily available either in person, by telephone, or by other means to the staff at times when the staff is providing services.

Subd. 2. Delegation of assisted living services. (a) A registered nurse or licensed health professional may delegate tasks only to staff who are competent and possess the knowledge and skills consistent with the complexity of the tasks and according to the appropriate Minnesota practice act. The assisted living facility must establish and implement a system to communicate up-to-date information to the registered nurse or licensed health professional regarding the current available staff and their competency so the registered nurse or licensed health professional has sufficient information to determine the appropriateness of delegating tasks to meet individual resident needs and preferences. (b) When the registered nurse or licensed health professional delegates tasks to unlicensed personnel, that person must ensure that prior to the delegation the unlicensed personnel is trained in the proper methods to perform the tasks or procedures for each resident and is able to demonstrate the ability to competently follow the procedures and perform the tasks. If an unlicensed personnel has not regularly performed the delegated assisted living task for a period of 24 consecutive months, the unlicensed personnel must demonstrate competency in the task to the registered nurse or appropriate licensed health professional. The registered nurse or licensed health professional must document instructions for the delegated tasks in the resident's record.

Subd. 3. Supervision of staff. (a) Staff who only provide assisted living services specified in section 144G.08, subdivision 9, clauses (1) to (5), must be supervised periodically where the services are being provided to verify that the work is being performed competently and to identify problems and solutions to address issues relating to the staff's ability to provide the services. The supervision of the unlicensed personnel must be done by staff of the facility having the authority, skills, and ability to provide the supervision of unlicensed personnel and who can implement changes as needed, and train staff.

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(b) Supervision includes direct observation of unlicensed personnel while the unlicensed personnel are providing the services and may also include indirect methods of gaining input such as gathering feedback from the resident. Supervisory review of staff must be provided at a frequency based on the staff person's competency and performance.

Subd. 4. Supervision of staff providing delegated nursing or therapy tasks. (a) Staff who perform delegated nursing or therapy tasks must be supervised by an appropriate licensed health professional or a registered nurse according to the assisted living facility's policy where the services are being provided to verify that the work is being performed competently and to identify problems and solutions related to the staff person's ability to perform the tasks. Supervision of staff performing medication or treatment administration shall be provided by a registered nurse or appropriate licensed health professional and must include observation of the staff administering the medication or treatment and the interaction with the resident. (b) The direct supervision of staff performing delegated tasks must be provided within 30 calendar days after the date on which the individual begins working for the facility and first performs the delegated tasks for residents and thereafter as needed based on performance. This requirement also applies to staff who have not performed delegated tasks for one year or longer.

Subd. 5. Documentation. A facility must retain documentation of supervision activities in the personnel records.

History: 2019 c 60 art 1 s 16,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 16, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 16, the effective date.

144G.63 ORIENTATION AND ANNUAL TRAINING REQUIREMENTS. Subdivision 1. Orientation of staff and supervisors. All staff providing and supervising direct services must complete an orientation to assisted living facility licensing requirements and regulations before providing assisted living services to residents. The orientation may be incorporated into the training required under subdivision 5. The orientation need only be completed once for each staff person and is not transferable to another facility.

Subd. 2. Content of required orientation. (a) The orientation must contain the following topics: (1) an overview of this chapter; (2) an introduction and review of the facility's policies and procedures related to the provision of assisted living services by the individual staff person; (3) handling of emergencies and use of emergency services; (4) compliance with and reporting of the maltreatment of vulnerable adults under section 626.557 to the Minnesota Adult Abuse Reporting Center (MAARC); (5) the assisted living bill of rights and staff responsibilities related to ensuring the exercise and protection of those rights; (6) the principles of person-centered planning and service delivery and how they apply to direct support services provided by the staff person;

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(7) handling of residents' complaints, reporting of complaints, and where to report complaints, including information on the Office of Health Facility Complaints; (8) consumer advocacy services of the Office of Ombudsman for Long-Term Care, Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care Ombudsman at the Department of Human Services, county-managed care advocates, or other relevant advocacy services; and (9) a review of the types of assisted living services the employee will be providing and the facility's category of licensure. (b) In addition to the topics in paragraph (a), orientation may also contain training on providing services to residents with hearing loss. Any training on hearing loss provided under this subdivision must be high quality and research based, may include online training, and must include training on one or more of the following topics: (1) an explanation of age-related hearing loss and how it manifests itself, its prevalence, and the challenges it poses to communication; (2) health impacts related to untreated age-related hearing loss, such as increased incidence of dementia, falls, hospitalizations, isolation, and depression; or (3) information about strategies and technology that may enhance communication and involvement, including communication strategies, assistive listening devices, hearing aids, visual and tactile alerting devices, communication access in real time, and closed captions.

Subd. 3. Orientation to resident. Staff providing assisted living services must be oriented specificallyto each individual resident and the services to be provided. This orientation may be provided in person, orally, in writing, or electronically.

Subd. 4. Training required relating to dementia. All direct care staff and supervisors providing direct services must demonstrate an understanding of the training specified in section 144G.64.

Subd. 5. Required annual training. (a) All staff that perform direct services must complete at least eight hours of annual training for each 12 months of employment. The training may be obtained from the facility or another source and must include topics relevant to the provision of assisted living services. The annual training must include: (1) training on reporting of maltreatment of vulnerable adults under section 626.557; (2) review of the assisted living bill of rights and staff responsibilities related to ensuring the exercise and protection of those rights; (3) review of infection control techniques used in the home and implementation of infection control standards including a review of hand washing techniques; the need for and use of protective gloves, gowns, and masks; appropriate disposal of contaminated materials and equipment, such as dressings, needles, syringes, and razor blades; disinfecting reusable equipment; disinfecting environmental surfaces; and reporting communicable diseases; (4) effective approaches to use to problem solve when working with a resident's challenging behaviors, and how to communicate with residents who have dementia, Alzheimer's disease, or related disorders; (5) review of the facility's policies and procedures relating to the provision of assisted living services and how to implement those policies and procedures; and

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(6) the principles of person-centered planning and service delivery and how they apply to direct support services provided by the staff person. (b) In addition to the topics in paragraph (a), annual training may also contain training on providing services to residents with hearing loss. Any training on hearing loss provided under this subdivision must be high quality and research based, may include online training, and must include training on one or more of the following topics: (1) an explanation of age-related hearing loss and how it manifests itself, its prevalence, and challenges it poses to communication; (2) the health impacts related to untreated age-related hearing loss, such as increased incidence of dementia, falls, hospitalizations, isolation, and depression; or (3) information about strategies and technology that may enhance communication and involvement, including communication strategies, assistive listening devices, hearing aids, visual and tactile alerting devices, communication access in real time, and closed captions.

Subd. 6. Implementation. The assisted living facility must implement all orientation and training topics covered in this section.

Subd. 7. Verification and documentation of orientation and training. The assisted living facility shall retain evidence in the employee record of each staff person having completed the orientation and training required by this section.

History: 2019 c 60 art 1 s 22,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 22, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 22, the effective date.

144G.64 TRAINING IN DEMENTIA CARE REQUIRED. (a) All assisted living facilities must meet the following training requirements: (1) supervisors of direct-care staff must have at least eight hours of initial training on topics specified under paragraph (b) within 120 working hours of the employment start date, and must have at least two hours of training on topics related to dementia care for each 12 months of employment thereafter; (2) direct-care employees must have completed at least eight hours of initial training on topics specified under paragraph (b) within 160 working hours of the employment start date. Until this initial training is complete, an employee must not provide direct care unless there is another employee on site who has completed the initial eight hours of training on topics related to dementia care and who can act as a resource and assist if issues arise. A trainer of the requirements under paragraph (b) or a supervisor meeting the requirements in clause (1) must be available for consultation with the new employee until the training requirement is complete. Direct-care employees must have at least two hours of training on topics related to dementia for each 12 months of employment thereafter; (3) for assisted living facilities with dementia care, direct-care employees must have completed at least eight hours of initial training on topics specified under paragraph (b) within 80 working hours of the employment start date. Until this initial training is complete, an employee must not provide direct care unless there is another employee on site who has completed the initial eight hours of training on topics related to dementia care and who can act as a resource and assist if issues arise. A trainer of the requirements under paragraph (b) or a supervisor meeting the requirements in clause (1) must be available for consultation with

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the new employee until the training requirement is complete. Direct-care employees must have at least two hours of training on topics related to dementia for each 12 months of employment thereafter; (4) staff who do not provide direct care, including maintenance, housekeeping, and food service staff, must have at least four hours of initial training on topics specified under paragraph (b) within 160 working hours of the employment start date, and must have at least two hours of training on topics related to dementia care for each 12 months of employment thereafter; and (5) new employees may satisfy the initial training requirements by producing written proof of previously completed required training within the past 18 months. (b) Areas of required training include: (1) an explanation of Alzheimer's disease and other dementias; (2) assistance with activities of daily living; (3) problem solving with challenging behaviors; (4) communication skills; and (5) person-centered planning and service delivery. (c) The facility shall provide to consumers in written or electronic form a description of the training program, the categories of employees trained, the frequency of training, and the basic topics covered.

History: 2019 c 60 art 1 s 23,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 23, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 23, the effective date.

SERVICES 144G.70 SERVICES. Subdivision 1. Acceptance of residents. An assisted living facility may not accept a person as a resident unless the facility has staff, sufficient in qualifications, competency, and numbers, to adequately provide the services agreed to in the assisted living contract.

Subd. 2. Initial reviews, assessments, and monitoring. (a) Residents who are not receiving any services shall not be required to undergo an initial nursing assessment. (b) An assisted living facility shall conduct a nursing assessment by a registered nurse of the physical and cognitive needs of the prospective resident and propose a temporary service plan prior to the date on which a prospective resident executes a contract with a facility or the date on which a prospective resident moves in, whichever is earlier. If necessitated by either the geographic distance between the prospective resident and the facility, or urgent or unexpected circumstances, the assessment may be conducted using telecommunication methods based on practice standards that meet the resident's needs and reflect personcentered planning and care delivery. (c) Resident reassessment and monitoring must be conducted no more than 14 calendar days after initiation of services. Ongoing resident reassessment and monitoring must be conducted as needed based

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on changes in the needs of the resident and cannot exceed 90 calendar days from the last date of the assessment. (d) For residents only receiving assisted living services specified in section 144G.08, subdivision 9, clauses (1) to (5), the facility shall complete an individualized initial review of the resident's needs and preferences. The initial review must be completed within 30 calendar days of the start of services. Resident monitoring and review must be conducted as needed based on changes in the needs of the resident and cannot exceed 90 calendar days from the date of the last review. (e) A facility must inform the prospective resident of the availability of and contact information for long-term care consultation services under section 256B.0911, prior to the date on which a prospective resident executes a contract with a facility or the date on which a prospective resident moves in, whichever is earlier.

Subd. 3. Temporary service plan. When a facility initiates services and the individualized assessment required in subdivision 2 has not been completed, the facility must complete a temporary plan and agreement with the resident for services. A temporary service plan shall not be effective for more than 72 hours.

Subd. 4. Service plan, implementation, and revisions to service plan. (a) No later than 14 calendar days after the date that services are first provided, an assisted living facility shall finalize a current written service plan. (b) The service plan and any revisions must include a signature or other authentication by the facility and by the resident documenting agreement on the services to be provided. The service plan must be revised, if needed, based on resident reassessment under subdivision 2. The facility must provide information to the resident about changes to the facility's fee for services and how to contact the Office of Ombudsman for Long-Term Care. (c) The facility must implement and provide all services required by the current service plan. (d) The service plan and the revised service plan must be entered into the resident record, including notice of a change in a resident's fees when applicable. (e) Staff providing services must be informed of the current written service plan. (f) The service plan must include: (1) a description of the services to be provided, the fees for services, and the frequency of each service, according to the resident's current assessment and resident preferences; (2) the identification of staff or categories of staff who will provide the services; (3) the schedule and methods of monitoring assessments of the resident; (4) the schedule and methods of monitoring staff providing services; and (5) a contingency plan that includes: (i) the action to be taken if the scheduled service cannot be provided; (ii) information and a method to contact the facility;

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(iii) the names and contact information of persons the resident wishes to have notified in an emergency or if there is a significant adverse change in the resident's condition, including identification of and information as to who has authority to sign for the resident in an emergency; and (iv) the circumstances in which emergency medical services are not to be summoned consistent with chapters 145B and 145C, and declarations made by the resident under those chapters.

Subd. 5. Referrals. If a facility reasonably believes that a resident is in need of another medical or health service, including a licensed health professional, or social service provider, the facility shall: (1) determine the resident's preferences with respect to obtaining the service; and (2) inform the resident of the resources available, if known, to assist the resident in obtaining services.

Subd. 6. Medical cannabis. Assisted living facilities may exercise the authority and are subject to the protections in section 152.34.

Subd. 7. Request for discontinuation of life-sustaining treatment. (a) If a resident, family member, or other caregiver of the resident requests that an employee or other agent of the facility discontinue a lifesustaining treatment, the employee or agent receiving the request: (1) shall take no action to discontinue the treatment; and (2) shall promptly inform the supervisor or other agent of the facility of the resident's request. (b) Upon being informed of a request for discontinuance of treatment, the facility shall promptly: (1) inform the resident that the request will be made known to the physician or advanced practice registered nurse who ordered the resident's treatment; (2) inform the physician or advanced practice registered nurse of the resident's request; and (3) work with the resident and the resident's physician or advanced practice registered nurse to comply with chapter 145C. (c) This section does not require the facility to discontinue treatment, except as may be required by law or court order. (d) This section does not diminish the rights of residents to control their treatments, refuse services, or terminate their relationships with the facility. (e) This section shall be construed in a manner consistent with chapter 145B or 145C, whichever applies, and declarations made by residents under those chapters.

History: 2019 c 60 art 1 s 18,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 18, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 18, the effective date.

144G.71 MEDICATION MANAGEMENT. Subdivision 1. Medication management services. (a) This section applies only to assisted living facilities that provide medication management services.

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(b) An assisted living facility that provides medication management services must develop, implement, and maintain current written medication management policies and procedures. The policies and procedures must be developed under the supervision and direction of a registered nurse, licensed health professional, or pharmacist consistent with current practice standards and guidelines. (c) The written policies and procedures must address requesting and receiving prescriptions for medications; preparing and giving medications; verifying that prescription drugs are administered as prescribed; documenting medication management activities; controlling and storing medications; monitoring and evaluating medication use; resolving medication errors; communicating with the prescriber, pharmacist, and resident and legal and designated representatives; disposing of unused medications; and educating residents and legal and designated representatives about medications. When controlled substances are being managed, the policies and procedures must also identify how the provider will ensure security and accountability for the overall management, control, and disposition of those substances in compliance with state and federal regulations and with subdivision 23.

Subd. 2. Provision of medication management services. (a) For each resident who requests medication management services, the facility shall, prior to providing medication management services, have a registered nurse, licensed health professional, or authorized prescriber under section 151.37 conduct an assessment to determine what medication management services will be provided and how the services will be provided.

This assessment must be conducted face-to-face with the resident. The assessment must include an identification and review of all medications the resident is known to be taking. The review and identification must include indications for medications, side effects, contraindications, allergic or adverse reactions, and actions to address these issues. (b) The assessment must identify interventions needed in management of medications to prevent diversion of medication by the resident or others who may have access to the medications and provide instructions to the resident and legal or designated representatives on interventions to manage the resident's medications and prevent diversion of medications. For purposes of this section, "diversion of medication" means misuse, theft, or illegal or improper disposition of medications.

Subd. 3. Individualized medication monitoring and reassessment. The assisted living facility must monitor and reassess the resident's medication management services as needed under subdivision 2 when the resident presents with symptoms or other issues that may be medication-related and, at a minimum, annually.

Subd. 4. Resident refusal. The assisted living facility must document in the resident's record any refusal for an assessment for medication management by the resident. The facility must discuss with the resident the possible consequences of the resident's refusal and document the discussion in the resident's record.

Subd. 5. Individualized medication management plan. (a) For each resident receiving medication management services, the assisted living facility must prepare and include in the service plan a written statement of the medication management services that will be provided to the resident. The facility must develop and maintain a current individualized medication management record for each resident based on the resident's assessment that must contain the following: (1) a statement describing the medication management services that will be provided; (2) a description of storage of medications based on the resident's needs and preferences, risk of diversion, and consistent with the manufacturer's directions; (3) documentation of specific resident instructions relating to the administration of medications;

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(4) identification of persons responsible for monitoring medication supplies and ensuring that medication refills are ordered on a timely basis; (5) identification of medication management tasks that may be delegated to unlicensed personnel; (6) procedures for staff notifying a registered nurse or appropriate licensed health professional when a problem arises with medication management services; and (7) any resident-specific requirements relating to documenting medication administration, verifications that all medications are administered as prescribed, and monitoring of medication use to prevent possible complications or adverse reactions. (b) The medication management record must be current and updated when there are any changes. (c) Medication reconciliation must be completed when a licensed nurse, licensed health professional, or authorized prescriber is providing medication management.

Subd. 6. Administration of medication. Medications may be administered by a nurse, physician, or other licensed health practitioner authorized to administer medications or by unlicensed personnel who have been delegated medication administration tasks by a registered nurse.

Subd. 7. Delegation of medication administration. When administration of medications is delegated to unlicensed personnel, the assisted living facility must ensure that the registered nurse has: (1) instructed the unlicensed personnel in the proper methods to administer the medications, and the unlicensed personnel has demonstrated the ability to competently follow the procedures; (2) specified, in writing, specific instructions for each resident and documented those instructions in the resident's records; and (3) communicated with the unlicensed personnel about the individual needs of the resident.

Subd. 8. Documentation of administration of medications. Each medication administered by the assisted living facility staff must be documented in the resident's record. The documentation must include the signature and title of the person who administered the medication. The documentation must include the medication name, dosage, date and time administered, and method and route of administration. The staff must document the reason why medication administration was not completed as prescribed and document any follow-up procedures that were provided to meet the resident's needs when medication was not administered as prescribed and in compliance with the resident's medication management plan.

Subd. 9. Documentation of medication setup. Documentation of dates of medication setup, name of medication, quantity of dose, times to be administered, route of administration, and name of person completing medication setup must be done at the time of setup.

Subd. 10. Medication management for residents who will be away from home. (a) An assisted living facility that is providing medication management services to the resident must develop and implement policies and procedures for giving accurate and current medications to residents for planned or unplanned times away from home according to the resident's individualized medication management plan. The policies and procedures must state that: (1) for planned time away, the medications must be obtained from the pharmacy or set up by the licensed nurse according to appropriate state and federal laws and nursing standards of practice;

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(2) for unplanned time away, when the pharmacy is not able to provide the medications, a licensed nurse or unlicensed personnel shall provide medications in amounts and dosages needed for the length of the anticipated absence, not to exceed seven calendar days; (3) the resident must be provided written information on medications, including any special instructions for administering or handling the medications, including controlled substances; and (4) the medications must be placed in a medication container or containers appropriate to the provider's medication system and must be labeled with the resident's name and the dates and times that the medications are scheduled. (b) For unplanned time away when the licensed nurse is not available, the registered nurse may delegate this task to unlicensed personnel if: (1) the registered nurse has trained the unlicensed staff and determined the unlicensed staff is competent to follow the procedures for giving medications to residents; and (2) the registered nurse has developed written procedures for the unlicensed personnel, including any special instructions or procedures regarding controlled substances that are prescribed for the resident. The procedures must address: (i) the type of container or containers to be used for the medications appropriate to the provider's medication system; (ii) how the container or containers must be labeled; (iii) written information about the medications to be provided; (iv) how the unlicensed staff must document in the resident's record that medications have been provided, including documenting the date the medications were provided and who received the medications, the person who provided the medications to the resident, the number of medications that were provided to the resident, and other required information; (v) how the registered nurse shall be notified that medications have been provided and whether the registered nurse needs to be contacted before the medications are given to the resident or the designated representative; (vi) a review by the registered nurse of the completion of this task to verify that this task was completed accurately by the unlicensed personnel; and (vii) how the unlicensed personnel must document in the resident's record any unused medications that are returned to the facility, including the name of each medication and the doses of each returned medication.

Subd. 11. Prescribed and nonprescribed medication. The assisted living facility must determine whether the facility shall require a prescription for all medications the provider manages. The facility must inform the resident whether the facility requires a prescription for all over-the-counter and dietary supplements before the facility agrees to manage those medications.

Subd. 12. Medications; over-the-counter drugs; dietary supplements not prescribed. An assisted living facility providing medication management services for over-the-counter drugs or dietary supplements must retain those items in the original labeled container with directions for use prior to setting up for immediate or later administration. The facility must verify that the medications are up to date and stored as appropriate.

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Subd. 13. Prescriptions. There must be a current written or electronically recorded prescription as defined in section 151.01, subdivision 16a, for all prescribed medications that the assisted living facility is managing for the resident.

Subd. 14. Renewal of prescriptions. Prescriptions must be renewed at least every 12 months or more frequently as indicated by the assessment in subdivision 2. Prescriptions for controlled substances must comply with chapter 152.

Subd. 15. Verbal prescription orders. Verbal prescription orders from an authorized prescriber must be received by a nurse or pharmacist. The order must be handled according to Minnesota Rules, part 6800.6200.

Subd. 16. Written or electronic prescription. When a written or electronic prescription is received, it must be communicated to the registered nurse in charge and recorded or placed in the resident's record.

Subd. 17. Records confidential. A prescription or order received verbally, in writing, or electronically must be kept confidential according to sections 144.291 to 144.298 and 144A.44.

Subd. 18. Medications provided by resident or family members. When the assisted living facility is aware of any medications or dietary supplements that are being used by the resident and are not included in the assessment for medication management services, the staff must advise the registered nurse and document that in the resident record.

Subd. 19. Storage of medications. An assisted living facility must store all prescription medications in securely locked and substantially constructed compartments according to the manufacturer's directions and permit only authorized personnel to have access.

Subd. 20. Prescription drugs. A prescription drug, prior to being set up for immediate or later administration, must be kept in the original container in which it was dispensed by the pharmacy bearing the original prescription label with legible information including the expiration or beyond-use date of a time-dated drug.

Subd. 21. Prohibitions. No prescription drug supply for one resident may be used or saved for use by anyone other than the resident.

Subd. 22. Disposition of medications. (a) Any current medications being managed by the assisted living facility must be provided to the resident when the resident's service plan ends or medication management services are no longer part of the service plan. Medications for a resident who is deceased or that have been discontinued or have expired may be provided for disposal. (b) The facility shall dispose of any medications remaining with the facility that are discontinued or expired or upon the termination of the service contract or the resident's death according to state and federal regulations for disposition of medications and controlled substances. (c) Upon disposition, the facility must document in the resident's record the disposition of the medication including the medication's name, strength, prescription number as applicable, quantity, to whom the medications were given, date of disposition, and names of staff and other individuals involved in the disposition.

Subd. 23. Loss or spillage. (a) Assisted living facilities providing medication management must develop and implement procedures for loss or spillage of all controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must require that when a spillage of a controlled substance occurs, a notation

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must be made in the resident's record explaining the spillage and the actions taken. The notation must be signed by the person responsible for the spillage and include verification that any contaminated substance was disposed of according to state or federal regulations. (b) The procedures must require that the facility providing medication management investigate any known loss or unaccounted for prescription drugs and take appropriate action required under state or federal regulations and document the investigation in required records.

History: 2019 c 60 art 1 s 19,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 19, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 19, the effective date.

144G.72 TREATMENT AND THERAPY MANAGEMENT SERVICES. Subdivision 1. Treatment and therapy management services. This section applies only to assisted living facilities that provide treatment and therapy management services.

Subd. 2. Policies and procedures. (a) An assisted living facility that provides treatment and therapy management services must develop, implement, and maintain up-to-date written treatment or therapy management policies and procedures. The policies and procedures must be developed under the supervision and direction of a registered nurse or appropriate licensed health professional consistent with current practice standards and guidelines. (b) The written policies and procedures must address requesting and receiving orders or prescriptions for treatments or therapies, providing the treatment or therapy, documenting treatment or therapy activities, educating and communicating with residents about treatments or therapies they are receiving, monitoring and evaluating the treatment or therapy, and communicating with the prescriber.

Subd. 3. Individualized treatment or therapy management plan. For each resident receiving management of ordered or prescribed treatments or therapy services, the assisted living facility must prepare and include in the service plan a written statement of the treatment or therapy services that will be provided to the resident. The facility must also develop and maintain a current individualized treatment and therapy management record for each resident which must contain at least the following: (1) a statement of the type of services that will be provided; (2) documentation of specific resident instructions relating to the treatments or therapy administration; (3) identification of treatment or therapy tasks that will be delegated to unlicensed personnel; (4) procedures for notifying a registered nurse or appropriate licensed health professional when a problem arises with treatments or therapy services; and (5) any resident-specific requirements relating to documentation of treatment and therapy received, verification that all treatment and therapy was administered as prescribed, and monitoring of treatment or therapy to prevent possible complications or adverse reactions. The treatment or therapy management record must be current and updated when there are any changes.

Subd. 4. Administration of treatments and therapy. Ordered or prescribed treatments or therapies must be administered by a nurse, physician, or other licensed health professional authorized to perform the treatment or therapy, or may be delegated or assigned to unlicensed personnel by the licensed health professional according to the appropriate practice standards for delegation or assignment. When administration

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of a treatment or therapy is delegated or assigned to unlicensed personnel, the facility must ensure that the registered nurse or authorized licensed health professional has: (1) instructed the unlicensed personnel in the proper methods with respect to each resident and the unlicensed personnel has demonstrated the ability to competently follow the procedures; (2) specified, in writing, specific instructions for each resident and documented those instructions in the resident's record; and (3) communicated with the unlicensed personnel about the individual needs of the resident.

Subd. 5. Documentation of administration of treatments and therapies. Each treatment or therapy administered by an assisted living facility must be in the resident record. The documentation must include the signature and title of the person who administered the treatment or therapy and must include the date and time of administration. When treatment or therapies are not administered as ordered or prescribed, the provider must document the reason why it was not administered and any follow-up procedures that were provided to meet the resident's needs.

Subd. 6. Treatment and therapy orders. There must be an up-to-date written or electronically recorded order from an authorized prescriber for all treatments and therapies. The order must contain the name of the resident, a description of the treatment or therapy to be provided, and the frequency, duration, and other information needed to administer the treatment or therapy. Treatment and therapy orders must be renewed at least every 12 months.

Subd. 7. Right to outside service provider; other payors. Under section 144G.91, a resident is free to retain therapy and treatment services from an off-site service provider. Assisted living facilities must make every effort to assist residents in obtaining information regarding whether the Medicare program, the medical assistance program under chapter 256B, or another public program will pay for any or all of the services.

History: 2019 c 60 art 1 s 20,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 20, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 20, the effective date.

ASSISTED LIVING FACILITIES WITH DEMENTIA CARE 144G.80 ADDITIONAL LICENSING REQUIREMENTS FOR ASSISTED LIVING FACILITIES WITH DEMENTIA CARE. Subdivision 1. Applicability. This section applies only to assisted living facilities with dementia care.

Subd. 2. Demonstrated capacity. (a) An applicant for licensure as an assisted living facility with dementia care must have the ability to provide services in a manner that is consistent with the requirements in this section. The commissioner shall consider the following criteria, including, but not limited to: (1) the experience of the applicant in managing residents with dementia or previous long-term care experience; and (2) the compliance history of the applicant in the operation of any care facility licensed, certified, or registered under federal or state law.

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(b) If the applicant does not have experience in managing residents with dementia, the applicant must employ a consultant for at least the first six months of operation. The consultant must meet the requirements in paragraph (a), clause (1), and make recommendations on providing dementia care services consistent with the requirements of this chapter. The consultant must (1) have two years of work experience related to dementia, health care, gerontology, or a related field, and (2) have completed at least the minimum core training requirements in section 144G.64. The applicant must document an acceptable plan to address the consultant's identified concerns and must either implement the recommendations or document in the plan any consultant recommendations that the applicant chooses not to implement. The commissioner must review the applicant's plan upon request. (c) The commissioner shall conduct an on-site inspection prior to the issuance of an assisted living facility with dementia care license to ensure compliance with the physical environment requirements. (d) The label "Assisted Living Facility with Dementia Care" must be identified on the license.

Subd. 3. Relinquishing license. (a) The licensee must notify the commissioner and the Office of Ombudsman for Long-Term Care in writing at least 60 calendar days prior to the voluntary relinquishment of an assisted living facility with dementia care license. For voluntary relinquishment, the facility must at least: (1) give all residents and their designated and legal representatives 60 calendar days' notice. The notice must include at a minimum: (i) the proposed effective date of the relinquishment; (ii) changes in staffing; (iii) changes in services including the elimination or addition of services; (iv) staff training that shall occur when the relinquishment becomes effective; and (v) contact information for the Office of Ombudsman for Long-Term Care; (2) submit a transitional plan to the commissioner demonstrating how the current residents shall be evaluated and assessed to reside in other housing settings that are not an assisted living facility with dementia care, that are physically unsecured, or that would require move-out or transfer to other settings; (3) change service or care plans as appropriate to address any needs the residents may have with the transition; (4) notify the commissioner when the relinquishment process has been completed; and (5) revise advertising materials and disclosure information to remove any reference that the facility is an assisted living facility with dementia care. (b) Nothing in this section alters obligations under section 144G.57.

History: 2019 c 60 art 1 s 47; art 2 s 1 NOTE: This section, as added by Laws 2019, chapter 60, article 2, section 1, is effective August 1, 2021. Laws 2019, chapter 60, article 2, section 1, the effective date.

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144G.81 ADDITIONAL REQUIREMENTS FOR ASSISTED LIVING FACILITIES WITH SECURED DEMENTIA CARE UNITS. Subdivision 1. Fire protection and physical environment. An assisted living facility with dementia care that has a secured dementia care unit must meet the requirements of section 144G.45 and the following additional requirements: (1) a hazard vulnerability assessment or safety risk must be performed on and around the property. The hazards indicated on the assessment must be assessed and mitigated to protect the residents from harm; and (2) the facility shall be protected throughout by an approved supervised automatic sprinkler system by August 1, 2029.

Subd. 2. Fire drills. Fire drills in secured dementia care units in assisted living facilities with dementia care shall be conducted in accordance with the NFPA Standard 101, Life Safety Code, Healthcare (limited care) chapter.

Subd. 3. Assisted living facilities with dementia care and secured dementia care unit; Life Safety Code. (a) All assisted living facilities with dementia care and a secured dementia care unit must meet the applicable provisions of the 2018 edition of the NFPA Standard 101, Life Safety Code, Healthcare (limited care) chapter. The minimum design standards shall be met for all new licenses, or new construction. (b) If the commissioner decides to update the Life Safety Code for purposes of this subdivision, the commissioner must notify the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over health care and public safety of the planned update by January 15 of the year in which the new Life Safety Code will become effective. Following notice from the commissioner, the new edition shall become effective for assisted living facilities with dementia care and a secured dementia care unit beginning August 1 of that year, unless provided otherwise in law. The commissioner shall, by publication in the State Register, specify a date by which these facilities must comply with the updated Life Safety Code.

The date by which these facilities must comply shall not be sooner than six months after publication of the commissioner's notice in the State Register.

Subd. 4. Awake staff requirement. An assisted living facility with dementia care providing services in a secured dementia care unit must have an awake person who is physically present in the secured dementia care unit 24 hours per day, seven days per week, who is responsible for responding to the requests of residents for assistance with health and safety needs, and who meets the requirements of section 144G.41, subdivision 1, clause (12).

Subd. 5. Variance or waiver. A facility may request under section 144G.45, subdivision 7, that the commissioner grant a variance or waiver from the provisions of this section, except subdivision 4.

History: 2019 c 60 art 1 s 11,25,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, sections 11 and 25, is effective August 1, 2021. Laws 2019, chapter 60, article 1, sections 11 and 25, the effective dates.

144G.82 ADDITIONAL RESPONSIBILITIES OF ADMINISTRATION FOR ASSISTED LIVING FACILITIES WITH DEMENTIA CARE. Subdivision 1. General. The licensee of an assisted living facility with dementia care is responsible for the care and housing of the persons with dementia and the provision of person-centered care that promotes

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each resident's dignity, independence, and comfort. This includes the supervision, training, and overall conduct of the staff.

Subd. 2. Additional requirements. (a) The licensee must follow the assisted living license requirements and the criteria in this section. (b) The assisted living director of an assisted living facility with dementia care must complete and document that at least ten hours of the required annual continuing educational requirements relate to the care of individuals with dementia. The training must include medical management of dementia, creating and maintaining supportive and therapeutic environments for residents with dementia, and transitioning and coordinating services for residents with dementia. Continuing education credits may include college courses, preceptor credits, self-directed activities, course instructor credits, corporate training, in-service training, professional association training, web-based training, correspondence courses, telecourses, seminars, and workshops.

Subd. 3. Policies. (a) In addition to the policies and procedures required in the licensing of all facilities, the assisted living facility with dementia care licensee must develop and implement policies and procedures that address the: (1) philosophy of how services are provided based upon the assisted living facility licensee's values, mission, and promotion of person-centered care and how the philosophy shall be implemented; (2) evaluation of behavioral symptoms and design of supports for intervention plans, including nonpharmacological practices that are person-centered and evidence-informed; (3) wandering and egress prevention that provides detailed instructions to staff in the event a resident elopes; (4) medication management, including an assessment of residents for the use and effects of medications, including psychotropic medications; (5) staff training specific to dementia care; (6) description of life enrichment programs and how activities are implemented; (7) description of family support programs and efforts to keep the family engaged; (8) limiting the use of public address and intercom systems for emergencies and evacuation drills only; (9) transportation coordination and assistance to and from outside medical appointments; and (10) safekeeping of residents' possessions. (b) The policies and procedures must be provided to residents and the residents' legal and designated representatives at the time of move-in.

History: 2019 c 60 art 1 s 47; art 2 s 2 NOTE: This section, as added by Laws 2019, chapter 60, article 2, section 2, is effective August 1, 2021. Laws 2019, chapter 60, article 2, section 2, the effective date.

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144G.83 ADDITIONAL TRAINING REQUIREMENTS FOR ASSISTED LIVING FACILITIES WITH DEMENTIA CARE. Subdivision 1. General. (a) An assisted living facility with dementia care must provide residents with dementia-trained staff who have been instructed in the person-centered care approach. All direct care staff assigned to care for residents with dementia must be specially trained to work with residents with Alzheimer's disease and other dementias. (b) Only staff trained as specified in subdivisions 2 and 3 shall be assigned to care for dementia residents. (c) Staffing levels must be sufficient to meet the scheduled and unscheduled needs of residents. Staffing levels during nighttime hours shall be based on the sleep patterns and needs of residents. (d) In an emergency situation when trained staff are not available to provide services, the facility may assign staff who have not completed the required training. The particular emergency situation must be documented and must address: (1) the nature of the emergency; (2) how long the emergency lasted; and (3) the names and positions of staff that provided coverage.

Subd. 2. Staffing requirements. (a) The licensee must ensure that staff who provide support to residents with dementia can demonstrate a basic understanding and ability to apply dementia training to the residents' emotional and unique health care needs using person-centered planning delivery. Direct care dementia-trained staff and other staff must be trained on the topics identified during the expedited rulemaking process. These requirements are in addition to the licensing requirements for training. (b) Failure to comply with paragraph (a) or subdivision 1 shall result in a fine under section 144G.31.

Subd. 3. Supervising staff training. Persons providing or overseeing staff training must have experience and knowledge in the care of individuals with dementia, including: (1) two years of work experience related to Alzheimer's disease or other dementias, or in health care, gerontology, or another related field; and (2) completion of training equivalent to the requirements in this section and successfully passing a skills competency or knowledge test required by the commissioner.

Subd. 4. Preservice and in-service training. Preservice and in-service training may include various methods of instruction, such as classroom style, web-based training, video, or one-to-one training. The licensee must have a method for determining and documenting each staff person's knowledge and understanding of the training provided. All training must be documented.

History: 2019 c 60 art 1 s 47; art 2 s 3 NOTE: This section, as added by Laws 2019, chapter 60, article 2, section 3, is effective August 1, 2021. Laws 2019, chapter 60, article 2, section 3, the effective date.

144G.84 SERVICES FOR RESIDENTS WITH DEMENTIA. (a) In addition to the minimum services required in section 144G.41, an assisted living facility with dementia care must also provide the following services:

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(1) assistance with activities of daily living that address the needs of each resident with dementia due to cognitive or physical limitations. These services must meet or be in addition to the requirements in the licensing rules for the facility. Services must be provided in a person-centered manner that promotes resident choice, dignity, and sustains the resident's abilities; (2) nonpharmacological practices that are person-centered and evidence-informed; (3) services to prepare and educate persons living with dementia and their legal and designated representatives about transitions in care and ensuring complete, timely communication between, across, and within settings; and (4) services that provide residents with choices for meaningful engagement with other facility residents and the broader community. (b) Each resident must be evaluated for activities according to the licensing rules of the facility. In addition, the evaluation must address the following: (1) past and current interests; (2) current abilities and skills; (3) emotional and social needs and patterns; (4) physical abilities and limitations; (5) adaptations necessary for the resident to participate; and (6) identification of activities for behavioral interventions. (c) An individualized activity plan must be developed for each resident based on their activity evaluation.

The plan must reflect the resident's activity preferences and needs. (d) A selection of daily structured and non-structured activities must be provided and included on the resident's activity service or care plan as appropriate. Daily activity options based on resident evaluation may include but are not limited to: (1) occupation or chore related tasks; (2) scheduled and planned events such as entertainment or outings; (3) spontaneous activities for enjoyment or those that may help defuse a behavior; (4) one-to-one activities that encourage positive relationships between residents and staff such as telling a life story, reminiscing, or playing music; (5) spiritual, creative, and intellectual activities; (6) sensory stimulation activities; (7) physical activities that enhance or maintain a resident's ability to ambulate or move; and (8) a residents individualized activity plan for regular outdoor activity. (e) Behavioral symptoms that negatively impact the resident and others in the assisted living facility with dementia care must be evaluated and included on the service or care plan. The staff must initiate and coordinate outside consultation or acute care when indicated.

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(f) Support must be offered to family and other significant relationships on a regularly scheduled basis but not less than quarterly.

(g)Existing housing with services establishments registered under chapter 144D prior to August 1, 2021, that obtain an assisted living facility license must provide residents with regular access to outdoor space. A licensee with new construction on or after August 1, 2021, or a new licensee that was not previously registered under chapter 144D prior to August 1, 2021, must provide regular access to secured outdoor space on the premises of the facility. A resident's access to outdoor space must be in accordance with the resident's documented care plan.

History: 2019 c 60 art 1 s 47; art 2 s 4 NOTE: This section, as added by Laws 2019, chapter 60, article 2, section 4, is effective August 1, 2021. Laws 2019, chapter 60, article 2, section 4, the effective date.

RESIDENT RIGHTS AND PROTECTIONS 144G.90 REQUIRED NOTICES. Subdivision 1. Assisted living bill of rights; notification to resident. (a) An assisted living facility must provide the resident a written notice of the rights under section 144G.91 before the initiation of services to that resident. The facility shall make all reasonable efforts to provide notice of the rights to the resident in a language the resident can understand. (b) In addition to the text of the assisted living bill of rights in section 144G.91, the notice shall also contain the following statement describing how to file a complaint or report suspected abuse: "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.

You may also contact the Office of Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health and Developmental Disabilities." (c) The statement must include contact information for the Minnesota Adult Abuse Reporting Center and the telephone number, website address, e-mail address, mailing address, and street address of the Office of Health Facility Complaints at the Minnesota Department of Health, the Office of Ombudsman for Long-Term Care, and the Office of Ombudsman for Mental Health and Developmental Disabilities. The statement must include the facility's name, address, e-mail, telephone number, and name or title of the person at the facility to whom problems or complaints may be directed. It must also include a statement that the facility will not retaliate because of a complaint. (d) A facility must obtain written acknowledgment from the resident of the resident's receipt of the assisted living bill of rights or shall document why an acknowledgment cannot be obtained. Acknowledgment of receipt shall be retained in the resident's record.

Subd. 2. Notices in plain language; language accommodations. A facility must provide all notices in plain language that residents can understand and make reasonable accommodations for residents who have communication disabilities and those whose primary language is a language other than English.

Subd. 3. Notice of dementia training. An assisted living facility with dementia care shall make availablein 78

written or electronic form, to residents and families or other persons who request it, a description of the training program and related training it provides, including the categories of employees trained, the frequency of training, and the basic topics covered. A hard copy of this notice must be provided upon request.

Subd. 4. Notice of available assistance. A facility shall provide each resident with identifying and contact information about the persons who can assist with health care or supportive services being provided.

A facility shall keep each resident informed of changes in the personnel referenced in this subdivision.

Subd. 5. Notice to residents; change in ownership or management. (a) A facility must provide written notice to the resident, legal representative, or designated representative of a change of ownership within seven calendar days after the facility receives a new license. (b) A facility must provide prompt written notice to the resident, legal representative, or designated representative, of any change of legal name, telephone number, and physical mailing address, which may not be a public or private post office box, of: (1) the manager of the facility, if applicable; and (2) the authorized agent.

History: 2019 c 60 art 1 s 17,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 17, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 17, the effective date.

144G.91 ASSISTED LIVING BILL OF RIGHTS. Subdivision 1. Applicability. This section applies to residents living in assisted living facilities.

Subd. 2. Legislative intent. The rights established under this section for the benefit of residents do not limit any other rights available under law. No facility may request or require that any resident waive any of these rights at any time for any reason, including as a condition of admission to the facility.

Subd. 3. Information about rights. Before receiving services, residents have the right to be informed by the facility of the rights granted under this section and the recourse residents have if rights are violated.

The information must be in plain language and in terms residents can understand. The facility must make reasonable accommodations for residents who have communication disabilities and those who speak a language other than English.

Subd. 4. Appropriate care and services. (a) Residents have the right to care and assisted living services that are appropriate based on the resident's needs and according to an up-to-date service plan subject to accepted health care standards. (b) Residents have the right to receive health care and other assisted living services with continuity from people who are properly trained and competent to perform their duties and in sufficient numbers to adequately provide the services agreed to in the assisted living contract and the service plan.

Subd. 5. Refusal of care or services. Residents have the right to refuse care or assisted living services and to be informed by the facility of the medical, health-related, or psychological consequences of refusing care or services.

Subd. 6. Participation in care and service planning. Residents have the right to actively participate in the planning, modification, and evaluation of their care and services. This right includes: (1) the opportunity to discuss care, services, treatment, and alternatives with the appropriate caregivers; (2) the right to include the resident's legal and designated representatives and persons of the resident's choosing; and

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(3) the right to be told in advance of, and take an active part in decisions regarding, any recommended changes in the service plan.

Subd. 7. Courteous treatment. Residents have the right to be treated with courtesy and respect, and to have the resident's property treated with respect.

Subd. 8. Freedom from maltreatment. Residents have the right to be free from physical, sexual, and emotional abuse; neglect; financial exploitation; and all forms of maltreatment covered under the Vulnerable Adults Act. Subd. 9. Right to come and go freely. Residents have the right to enter and leave the facility as they choose. This right may be restricted only as allowed by other law and consistent with a resident's service plan.

Subd. 10. Individual autonomy. Residents have the right to individual autonomy, initiative, and independence in making life choices, including establishing a daily schedule and choosing with whom to interact.

Subd. 11. Right to control resources. Residents have the right to control personal resources.

Subd. 12. Visitors and social participation. (a) Residents have the right to meet with or receive visitsat any time by the resident's family, guardian, conservator, health care agent, attorney, advocate, or religiousor social work counselor, or any person of the resident's choosing. This right may be restricted in certain circumstances if necessary for the resident's health and safety and if documented in the resident's service plan. (b) Residents have the right to engage in community life and in activities of their choice. This includes the right to participate in commercial, religious, social, community, and political activities without interference and at their discretion if the activities do not infringe on the rights of other residents.

Subd. 13. Personal and treatment privacy. (a) 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. (b) Residents have the right to have and use a lockable door to the resident's unit. The facility shall provide locks on the resident's unit. Only a staff member with a specific need to enter the unit shall have keys. This right may be restricted in certain circumstances if necessary for a resident's health and safety and documented in the resident's service plan. (c) Residents have the right to respect and privacy regarding the resident's service plan. Case discussion, consultation, examination, and treatment are confidential and must be conducted discreetly. Privacy must be respected during toileting, bathing, and other activities of personal hygiene, except as needed for resident safety or assistance.

Subd. 14. Communication privacy. (a) Residents have the right to communicate privately with personsof their choice. (b) If an assisted living facility is sending or receiving mail on behalf of residents, the assisted living facility must do so without interference. (c) Residents must be provided access to a telephone to make and receive calls.

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Subd. 15. Confidentiality of records. (a) Residents have the right to have personal, financial, health, and medical information kept private, to approve or refuse release of information to any outside party, and to be advised of the assisted living facility's policies and procedures regarding disclosure of the information.

Residents must be notified when personal records are requested by any outside party. (b) Residents have the right to access their own records.

Subd. 16. Right to furnish and decorate. Residents have the right to furnish and decorate the resident's unit within the terms of the assisted living contract.

Subd. 17. Right to choose roommate. Residents have the right to choose a roommate if sharing a unit.

Subd. 18. Right to access food. Residents have the right to access food at any time. This right may be restricted in certain circumstances if necessary for the resident's health and safety and if documented in the resident's service plan.

Subd. 19. Access to technology. Residents have the right to access Internet service at their expense.

Subd. 20. Grievances and inquiries. Residents have the right to make and receive a timely response to a complaint or inquiry, without limitation. Residents have the right to know and every facility must provide the name and contact information of the person representing the facility who is designated to handle and resolve complaints and inquiries.

Subd. 21. Access to counsel and advocacy services. Residents have the right to the immediate access by: (1) the resident's legal counsel; (2) any representative of the protection and advocacy system designated by the state under Code of Federal Regulations, title 45, section 1326.21; or (3) any representative of the Office of Ombudsman for Long-Term Care.

Subd. 22. Information about charges. Before services are initiated, residents have the right to be notified: (1) of all charges for housing and assisted living services; (2) of any limits on housing and assisted living services available; (3) if known, whether and what amount of payment may be expected from health insurance, public programs, or other sources; and (4) what charges the resident may be responsible for paying.

Subd. 23. Information about individuals providing services. Before receiving services identified in the service plan, residents have the right to be told the type and disciplines of staff who will be providing the services, the frequency of visits proposed to be furnished, and other choices that are available for addressing the resident's needs.

Subd. 24. Information about other providers and services. Residents have the right to be informed by the assisted living facility, prior to executing an assisted living contract, that other public and private services may be available and that the resident has the right to purchase, contract for, or obtain services from a provider other than the assisted living facility.

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Subd. 25. Resident councils. Residents have the right to organize and participate in resident councils as described in section 144G.41, subdivision 5.

Subd. 26. Family councils. Residents have the right to participate in family councils formed by families or residents as described in section 144G.41, subdivision 6.

History: 2019 c 60 art 1 s 12,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 12, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 12, the effective date.

144G.911 RESTRICTIONS UNDER HOME AND COMMUNITY-BASED WAIVERS. The resident's rights in section 144G.91, subdivisions 12, 13, and 18, may be restricted for an individual resident only if determined necessary for health and safety reasons identified by the facility through an initial assessment or reassessment under section 144G.70, subdivision 2, and documented in the written service plan under section 144G.70, subdivision 4. Any restrictions of those rights for people served under chapter 256S and section 256B.49 must be documented by the case manager in the resident's coordinated service and support plan (CSSP), as defined in sections 256B.49, subdivision 15, and 256S.10. Nothing in this section affects other laws applicable to or prohibiting restrictions on the resident's rights in section 144G.91, subdivisions 12, 13, and 18.

History: 2019 c 54 art 1 s 33; 2019 c 60 art 1 s 11,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 11, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 11, the effective date.

144G.92 RETALIATION PROHIBITED. Subdivision 1. Retaliation prohibited. A facility or agent of a facility may not retaliate against a residentor employee if the resident, employee, or any person acting on behalf of the resident: (1) files a good faith complaint or grievance, makes a good faith inquiry, or asserts any right; (2) indicates a good faith intention to file a complaint or grievance, make an inquiry, or assert any right; (3) files, in good faith, or indicates an intention to file a maltreatment report, whether mandatory or voluntary, under section 626.557; (4) seeks assistance from or reports a reasonable suspicion of a crime or systemic problems or concerns to the director or manager of the facility, the Office of Ombudsman for Long-Term Care, a regulatory or other government agency, or a legal or advocacy organization; (5) advocates or seeks advocacy assistance for necessary or improved care or services or enforcement of rights under this section or other law; (6) takes or indicates an intention to take civil action; (7) participates or indicates an intention to participate in any investigation or administrative or judicial proceeding; (8) contracts or indicates an intention to contract to receive services from a service provider of the resident's choice other than the facility; or

82

(9) places or indicates an intention to place a camera or electronic monitoring device in the resident's private space as provided under section 144.6502.

Subd. 2. Retaliation against a resident. For purposes of this section, to retaliate against a resident includes but is not limited to any of the following actions taken or threatened by a facility or an agent of the facility against a resident, or any person with a familial, personal, legal, or professional relationship with the resident: (1) termination of a contract; (2) any form of discrimination; (3) restriction or prohibition of access: (i) of the resident to the facility or visitors; or (ii) of a family member or a person with a personal, legal, or professional relationship with the resident, to the resident, unless the restriction is the result of a court order; (4) the imposition of involuntary seclusion or the withholding of food, care, or services; (5) restriction of any of the rights granted to residents under state or federal law; (6) restriction or reduction of access to or use of amenities, care, services, privileges, or living arrangements; or (7) unauthorized removal, tampering with, or deprivation of technology, communication, or electronic monitoring devices.

Subd. 3. Retaliation against an employee. For purposes of this section, to retaliate against an employee means any of the following actions taken or threatened by the facility or an agent of the facility against an employee: (1) unwarranted discharge or transfer; (2) unwarranted demotion or refusal to promote; (3) unwarranted reduction in compensation, benefits, or privileges; (4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or (5) any form of unwarranted discrimination.

Subd. 4. Determination by commissioner. A resident may request that the commissioner determine whether the facility retaliated against a resident. If a resident demonstrates to the commissioner that the facility took any action described in subdivision 2 within 30 days of an initial action described in subdivision 1, the facility must present evidence to the commissioner of the nonretaliatory reason relied on by the facility for the facility action. Based on the evidence provided by both parties, the commissioner shall determine if retaliation occurred.

Subd. 5. Other laws. Nothing in this section affects the rights and remedies available under section 626.557, subdivisions 10, 17, and 20.

History: 2019 c 60 art 1 s 42,47

83

NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 42, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 42, the effective date.

144G.93 CONSUMER ADVOCACY AND LEGAL SERVICES. Upon execution of an assisted living contract, every facility must provide the resident with the names and contact information, including telephone numbers and e-mail addresses, of: (1) nonprofit organizations that provide advocacy or legal services to residents including but not limited to the designated protection and advocacy organization in Minnesota that provides advice and representation to individuals with disabilities; and (2) the Office of Ombudsman for Long-Term Care, including both the state and regional contact information.

History: 2019 c 60 art 1 s 43,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 43, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 43, the effective date.

144G.95 OFFICE OF OMBUDSMAN FOR LONG-TERM CARE. Subdivision 1. Immunity from liability. The Office of Ombudsman for Long-Term Care and representatives of the office are immune from liability for conduct described in section 256.9742, subdivision 2.

Subd. 2. Data classification. All forms and notices received by the Office of Ombudsman for Long-Term Care under this chapter are classified under section 256.9744.

History: 2019 c 60 art 1 s 32,47 NOTE: This section, as added by Laws 2019, chapter 60, article 1, section 32, is effective August 1, 2021. Laws 2019, chapter 60, article 1, section 32, the effective date.

144G.9999 RESIDENT QUALITY OF CARE AND OUTCOMES IMPROVEMENT TASK FORCE. Subdivision 1. Establishment. The commissioner shall establish a Resident Quality of Care and Outcomes Improvement Task Force to examine and make recommendations, on an ongoing basis, on how to apply proven safety and quality improvement practices and infrastructure to settings and providers that provide long-term services and supports.

Subd. 2. Membership. The task force shall include representation from: (1) nonprofit Minnesota-based organizations dedicated to patient safety or innovation in health care safety and quality; (2) Department of Health staff with expertise in issues related to safety and adverse health events; (3) consumer organizations; (4) direct care providers or their representatives; (5) organizations representing long-term care providers and home care providers in Minnesota; (6) the ombudsman for long-term care or a designee;

84

(7) national patient safety experts; and (8) other experts in the safety and quality improvement field.

The task force shall have at least one public member who either is or has been a resident in an assisted living setting and one public member who has or had a family member living in an assisted living setting. The membership shall be voluntary except that public members may be reimbursed under section 15.059, subdivision 3.

Subd. 3. Recommendations. The task force shall periodically provide recommendations to the commissioner and the legislature on changes needed to promote safety and quality improvement practices in long-term care settings and with long-term care providers. The task force shall meet no fewer than four times per year. The task force shall be established by July 1, 2020.

History: 2019 c 60 art 1 s 40,47

85

1​

MINNESOTA RULES​ CHAPTER 4626​ DEPARTMENT OF HEALTH​ FOOD CODE; FOOD MANAGERS​

NOTE: In this chapter, the hyphenated numbers following the part headnotes correspond to section numbers in​ the U.S. FDA Food Code.​ FOOD CODE GENERALLY​ 4626.0010​

FOOD CODE. 1-101.10​

4626.0015​

FOOD SAFETY, ILLNESS PREVENTION, AND HONEST PRESENTATION. 1-102.10​

4626.0017​

SCOPE. 1-103.10​ DEFINITIONS​

4626.0020​

STATEMENT OF APPLICATION AND DEFINITIONS. 1-201.10​

4626.0024​

RESPONSIBILITY TO MEET STANDARDS.​ SUPERVISION​

4626.0025​

ASSIGNMENT OF PERSON IN CHARGE. 2-101.11​

4626.0030​

DEMONSTRATION OF KNOWLEDGE BY PERSON IN CHARGE. 2-102.11​

4626.0033​

CERTIFIED FOOD PROTECTION MANAGER (CFPM) REQUIREMENTS FOR FOOD​ ESTABLISHMENTS.​

4626.0035​

DUTIES OF PERSON IN CHARGE. 2-103.11​ EMPLOYEE HEALTH​

4626.0040​

RESPONSIBILITY OF LICENSEE; PERSON IN CHARGE; FOOD EMPLOYEES; AND​ CONDITIONAL EMPLOYEES. 2-201.11​

4626.0045​

EXCLUSIONS AND RESTRICTIONS. 2-201.12​

4626.0050​

REMOVAL, ADJUSTMENT, OR RETENTION OF EXCLUSIONS AND RESTRICTIONS. 2-201.13​ PERSONAL CLEANLINESS​

4626.0065​

CLEAN HANDS. 2-301.11​

4626.0070​

CLEANING PROCEDURE. 2-301.12​

4626.0075​

WHEN TO WASH HANDS. 2-301.14​

4626.0080​

WHERE TO WASH HANDS. 2-301.15​

4626.0085​

HAND ANTISEPTICS. 2-301.16​

4626.0090​

FINGERNAIL MAINTENANCE. 2-302.11​

4626.0095​

JEWELRY PROHIBITION. 2-303.11​

4626.0100​

CLOTHING; CLEAN CONDITION. 2-304.11​ HYGIENIC PRACTICES​

4626.0105​

EATING, DRINKING, OR USING TOBACCO. 2-401.11​

4626.0110​

DISCHARGES FROM EYES, NOSE, AND MOUTH. 2-401.12​

MINNESOTA RULES​ 4626.0115​

HAIR RESTRAINTS. 2-402.11​

4626.0120​

ANIMAL HANDLING PROHIBITION. 2-403.11​

4626.0123​

CLEANUP OF VOMITING AND DIARRHEAL EVENTS. 2-501.11​ FOOD CHARACTERISTICS​

4626.0125​

SAFE AND NOT ADULTERATED. 3-101.11​

4626.0130​

COMPLIANCE WITH FOOD LAW. 3-201.11​

4626.0135​

FOOD IN HERMETICALLY SEALED CONTAINER; SOURCES. 3-201.12​

4626.0140​

FLUID MILK AND MILK PRODUCTS; SOURCES. 3-201.13​

4626.0145​

FISH. 3-201.14​

4626.0150​

MOLLUSCAN SHELLFISH. 3-201.15​

4626.0155​

WILD MUSHROOMS. 3-201.16​

4626.0156​

CERTIFIED WILD MUSHROOM HARVESTER.​

4626.0160​

GAME ANIMALS. 3-201.17​

4626.0165​

FOOD TEMPERATURES; RECEIVING. 3-202.11​

4626.0170​

FOOD ADDITIVES. 3-202.12​

4626.0175​

EGGS. 3-202.13​

4626.0177​

EGG AND MILK PRODUCTS; PASTEURIZED. 3-202.14​

4626.0190​

PACKAGE INTEGRITY. 3-202.15​

4626.0195​

ICE. 3-202.16​

4626.0200​

SHUCKED SHELLFISH; PACKAGING AND IDENTIFICATION. 3-202.17​

4626.0202​

SHELLSTOCK IDENTIFICATION. 3-202.18​

4626.0210​

SHELLSTOCK; CONDITION. 3-202.19​

4626.0215​

MOLLUSCAN SHELLFISH AND SHELLSTOCK; ORIGINAL CONTAINER. 3-203.11​

4626.0220​

SHELLSTOCK; MAINTAINING IDENTIFICATION. 3-203.12​ PROTECTION FROM CONTAMINATION​

4626.0225​

PREVENTING CONTAMINATION FROM HANDS (ALSO SEE PART 4626.0070). 3-301.11​

4626.0230​

PREVENTING CONTAMINATION WHEN TASTING. 3-301.12​

4626.0235​

PREVENTING CROSS-CONTAMINATION. 3-302.11​

4626.0240​

FOOD STORAGE CONTAINERS IDENTIFIED WITH COMMON NAME OF FOOD. 3-302.12​

4626.0245​

PASTEURIZED EGGS; SUBSTITUTE FOR RAW EGGS. 3-302.13​

4626.0250​

PROTECTION FROM UNAPPROVED ADDITIVES. (SEE ALSO 4626.0170) 3-302.14​

4626.0255​

WASHING FRUITS AND VEGETABLES. 3-302.15​

4626.0260​

ICE USED AS EXTERIOR COOLANT; PROHIBITED AS INGREDIENT. 3-303.11​

4626.0265​

FOOD IN CONTACT WITH WATER OR ICE. 3-303.12​

4626.0270​

FOOD CONTACT WITH EQUIPMENT AND UTENSILS. 3-304.11​

4626.0275​

IN-USE UTENSILS; BETWEEN-USE STORAGE. 3-304.12​

4626.0280​

LINENS AND NAPKINS; USE LIMITATION. 3-304.13​

4626.0285​

WIPING CLOTHS; USE LIMITATION. 3-304.14​

2​

3​

MINNESOTA RULES​

4626.0287​

GLOVES; USE LIMITATION. 3-304.15​

4626.0290​

USING CLEAN TABLEWARE FOR SECOND PORTIONS AND REFILLS. 3-304.16​

4626.0295​

REFILLING RETURNABLES. 3-304.17​

4626.0300​

FOOD STORAGE. 3-305.11​

4626.0305​

FOOD STORAGE; PROHIBITED AREAS. 3-305.12​

4626.0310​

VENDED TCS FOOD; ORIGINAL CONTAINER. 3-305.13​

4626.0315​

UNPACKAGED FOOD; PROTECTION FROM CONTAMINATION. 3-305.14​

4626.0320​

FOOD DISPLAY; PROTECTION FROM CONTAMINATION. 3-306.11​

4626.0325​

CONDIMENTS; PROTECTION. 3-306.12​

4626.0330​

CONSUMER SELF-SERVICE OPERATIONS. 3-306.13​

4626.0335​

RETURNED FOOD; RE-SERVICE OF FOOD. 3-306.14​

4626.0337​

MISCELLANEOUS SOURCES OF CONTAMINATION. 3-307.11​ DESTROYING ORGANISMS​

4626.0340​

COOKING RAW ANIMAL FOODS. 3-401.11​

4626.0345​

MICROWAVE COOKING. 3-401.12​

4626.0347​

PLANT FOOD; COOKING FOR HOT HOLDING. 3-401.13​

4626.0349​

NONCONTINUOUS COOKING OF RAW ANIMAL FOODS. 3-401.14​

4626.0350​

PARASITE DESTRUCTION. 3-402.11​

4626.0355​

PARASITE DESTRUCTION; RECORDS. 3-402.12​

4626.0357​

FOODS PREPARED FOR IMMEDIATE SERVICE. 3-403.10​

4626.0360​

REHEATING FOR HOT HOLDING. 3-403.11​

4626.0367​

TREATING JUICE. 3-404.11​

4626.0368​

JUICE; TREATED. 3-202.110​

4626.0370​

FROZEN FOOD. 3-501.11​

4626.0375​

SLACKING TCS FOOD. 3-501.12​

4626.0380​

THAWING. 3-501.13​

4626.0385​

COOLING REQUIREMENTS. 3-501.14​

4626.0390​

COOLING METHODS. 3-501.15​

4626.0395​

TCS FOOD; HOT AND COLD HOLDING. 3-501.16​

4626.0400​

DATE MARKING; READY-TO-EAT TCS FOOD. 3-501.17​

4626.0405​

READY-TO-EAT, TCS FOOD; DISPOSITION. 3-501.18​

4626.0408​

TIME AS PUBLIC HEALTH CONTROL. 3-501.19​

4626.0415​

SPECIALIZED PROCESSING VARIANCE REQUIREMENTS. 3-502.11​

4626.0420​

REDUCED OXYGEN PACKAGING WITHOUT A VARIANCE; CRITERIA. 3-502.12​ FOOD IDENTITY​

4626.0425​

PACKAGED FOOD; STANDARDS OF IDENTITY. 3-601.11​

4626.0430​

FOOD HONESTLY PRESENTED. 3-601.12​

4626.0435​

FOOD LABELS. 3-602.11​

MINNESOTA RULES​ 4626.0440​

OTHER FORMS OF INFORMATION. 3-602.12​

4626.0442​

CONSUMER ADVISORY; DISCLOSURE. 3-603.11​

4​

CONTAMINATED FOOD​ 4626.0445​

UNSAFE, ADULTERATED, OR CONTAMINATED FOOD. 3-701.11​

4626.0447​

FOOD SERVED TO A HIGHLY SUSCEPTIBLE POPULATION. 3-801.11​ EQUIPMENT CONSTRUCTION MATERIALS​

4626.0450​

FOOD-CONTACT SURFACES; CHARACTERISTICS AND MATERIALS. 4-101.11​

4626.0455​

CAST IRON; USE LIMITATION. 4-101.12​

4626.0460​

LEAD; USE LIMITATION. 4-101.13​

4626.0465​

COPPER; USE LIMITATION. 4-101.14​

4626.0470​

GALVANIZED METAL; USE LIMITATION. 4-101.15​

4626.0475​

SPONGES; USE LIMITATION. 4-101.16​

4626.0490​

WOOD; USE LIMITATION. 4-101.17​

4626.0493​

NONSTICK COATINGS; USE LIMITATIONS. 4-101.18​

4626.0495​

NON-FOOD-CONTACT SURFACES; CHARACTERISTICS. 4-101.19​

4626.0500​

SINGLE-SERVICE AND SINGLE-USE ARTICLES; CHARACTERISTICS. 4-102.11​ EQUIPMENT DESIGN AND CONSTRUCTION​

4626.0505​

EQUIPMENT AND UTENSILS. 4-201.11​

4626.0506​

EQUIPMENT.​

4626.0510​

FOOD TEMPERATURE MEASURING DEVICES. 4-201.12​

4626.0515​

MULTIUSE FOOD-CONTACT SURFACES; CHARACTERISTICS. 4-202.11​

4626.0520​

CIP EQUIPMENT. 4-202.12​

4626.0525​

"V"-TYPE THREADS; USE LIMITATION. 4-202.13​

4626.0530​

HOT OIL FILTERING EQUIPMENT. 4-202.14​

4626.0535​

CAN OPENERS. 4-202.15​

4626.0540​

NON-FOOD-CONTACT SURFACES. 4-202.16​

4626.0545​

KICK PLATES, REMOVABLE; ENCLOSED HOLLOW BASES. 4-202.17​

4626.0550​

VENTILATION HOOD SYSTEMS; FILTERS. 4-202.18​

4626.0555​

TEMPERATURE MEASURING DEVICES; FOOD. 4-203.11​

4626.0560​

TEMPERATURE MEASURING DEVICES; AMBIENT AIR AND WATER. 4-203.12​

4626.0563​

PRESSURE MEASURING DEVICES; MECHANICAL WAREWASHING EQUIPMENT. 4-203.13​

4626.0565​

VENTILATION HOOD SYSTEMS, DRIP PREVENTION. 4-204.11​

4626.0570​

EQUIPMENT OPENINGS, CLOSURES, AND DEFLECTORS. 4-204.12​

4626.0575​

DISPENSING EQUIPMENT; PROTECTION OF EQUIPMENT AND FOOD. 4-204.13​

4626.0580​

VENDING MACHINE; VENDING STAGE CLOSURE. 4-204.14​

4626.0585​

BEARINGS AND GEAR BOXES; LEAKPROOF. 4-204.15​

4626.0590​

BEVERAGE TUBING; SEPARATION. 4-204.16​

5​

MINNESOTA RULES​

4626.0595​

ICE UNITS; SEPARATION OF DRAINS. 4-204.17​

4626.0600​

CONDENSER UNIT; SEPARATION. 4-204.18​

4626.0605​

CAN OPENERS ON VENDING MACHINES. 4-204.19​

4626.0610​

MOLLUSCAN SHELLFISH TANKS. 4-204.110​

4626.0615​

VENDING MACHINES; AUTOMATIC SHUTOFF. 4-204.111​

4626.0620​

AMBIENT AIR TEMPERATURE MEASURING DEVICES. 4-204.112​

4626.0625​

WAREWASHING MACHINES; DATA PLATE OPERATING SPECIFICATIONS. 4-204.113​

4626.0630​

WAREWASHING MACHINES; INTERNAL BAFFLES. 4-204.114​

4626.0635​

WAREWASHING MACHINES; TEMPERATURE MEASURING DEVICES. 4-204.115​

4626.0640​

MANUAL WAREWASHING EQUIPMENT; HEATERS AND BASKETS. 4-204.116​

4626.0643​

WAREWASHING MACHINES; AUTOMATIC DISPENSING OF DETERGENTS AND SANITIZERS.​ 4-204.117​

4626.0645​

WAREWASHING MACHINES; FLOW PRESSURE DEVICE. 4-204.118​

4626.0650​

WAREWASHING SINKS AND DRAINBOARDS; SELF-DRAINING. 4-204.119​

4626.0655​

EQUIPMENT; DRAINAGE. 4-204.120​

4626.0660​

VENDING MACHINES; LIQUID WASTE PRODUCTS. 4-204.121​

4626.0665​

CASE LOT HANDLING APPARATUSES; MOVEABILITY. 4-204.122​

4626.0670​

VENDING MACHINE DOORS AND OPENINGS. 4-204.123​ EQUIPMENT NUMBERS AND CAPACITIES​

4626.0675​

COOLING, HEATING, AND HOLDING CAPACITIES. 4-301.11​

4626.0680​

MANUAL WAREWASHING; SINK COMPARTMENT REQUIREMENTS. 4-301.12​

4626.0685​

DRAINBOARDS. 4-301.13​

4626.0690​

VENTILATION HOOD SYSTEMS; ADEQUACY. 4-301.14​

4626.0695​

CLOTHES WASHERS AND DRYERS. 4-301.15​

4626.0700​

UTENSILS; CONSUMER SELF-SERVICE. 4-302.11​

4626.0705​

FOOD TEMPERATURE MEASURING DEVICES REQUIRED. 4-302.12​

4626.0710​

TEMPERATURE MEASURING DEVICES; WAREWASHING. 4-302.13​

4626.0715​

SANITIZING SOLUTIONS; TESTING DEVICES. 4-302.14​ EQUIPMENT LOCATION AND INSTALLATION​

4626.0721​

CLEANING AGENTS AND SANITIZERS; AVAILABILITY. 4-303.11​

4626.0725​

FIXED EQUIPMENT; SPACING OR SEALING. 4-402.11​

4626.0730​

FIXED EQUIPMENT; ELEVATION OR SEALING. 4-402.12​ EQUIPMENT MAINTENANCE AND OPERATION​

4626.0735​

EQUIPMENT; GOOD REPAIR AND PROPER ADJUSTMENT. 4-501.11​

4626.0740​

CUTTING SURFACES. 4-501.12​

4626.0745​

MICROWAVE OVENS. 4-501.13​

4626.0750​

WAREWASHING EQUIPMENT AND FOOD PREPARATION SINKS; CLEANING FREQUENCY.​ 4-501.14​

MINNESOTA RULES​

6​

4626.0755​

WAREWASHING MACHINE; MANUFACTURER'S OPERATING INSTRUCTIONS. 4-501.15​

4626.0760​

WAREWASHING SINKS; USE LIMITATION. 4-501.16​

4626.0765​

WAREWASHING EQUIPMENT; CLEANING AGENTS. 4-501.17​

4626.0770​

WAREWASHING EQUIPMENT; CLEAN SOLUTIONS. 4-501.18​

4626.0775​

MANUAL WAREWASHING EQUIPMENT; WASH SOLUTION TEMPERATURE. 4-501.19​

4626.0780​

FOOD PREPARATION SINKS.​

4626.0785​

MECHANICAL WAREWASHING EQUIPMENT; WASH SOLUTION TEMPERATURE. 4-501.110​

4626.0790​

MANUAL WAREWASHING EQUIPMENT; HOT WATER SANITIZATION TEMPERATURES.​ 4-501.111​

4626.0795​

MECHANICAL WAREWASHING EQUIPMENT; HOT WATER SANITIZATION TEMPERATURES.​ 4-501.112​

4626.0800​

MECHANICAL WAREWASHING EQUIPMENT; SANITIZATION RINSE PRESSURE. 4-501.113​

4626.0805​

MANUAL AND MECHANICAL WAREWASHING EQUIPMENT; CHEMICAL SANITIZATION,​ TEMPERATURE, PH, CONCENTRATION, AND HARDNESS. 4-501.114​

4626.0810​

MANUAL WAREWASHING EQUIPMENT; CHEMICAL SANITIZATION USING​ DETERGENT-SANITIZERS. 4-501.115​

4626.0815​

WAREWASHING EQUIPMENT TEST KIT. 4-501.116​

4626.0820​

UTENSILS AND TEMPERATURE MEASURING DEVICES; GOOD REPAIR AND PROPER​ CALIBRATION. 4-502.11​

4626.0825​

SINGLE-SERVICE AND SINGLE-USE ARTICLES; REQUIRED USE. 4-502.12​

4626.0830​

SINGLE-SERVICE AND SINGLE-USE ARTICLES; RE-USE LIMITATION. 4-502.13​

4626.0833​

BULK MILK CONTAINERS.​

4626.0835​

SHELLS; USE LIMITATION. 4-502.14​ CLEANING EQUIPMENT AND UTENSILS​

4626.0840​

EQUIPMENT, FOOD-CONTACT SURFACES, NON-FOOD-CONTACT SURFACES, AND​ UTENSILS. 4-601.11​

4626.0845​

EQUIPMENT; FOOD-CONTACT SURFACES, AND UTENSILS. 4-602.11​

4626.0850​

COOKING AND BAKING EQUIPMENT. 4-602.12​

4626.0855​

NON-FOOD-CONTACT SURFACES; CLEANING FREQUENCY. 4-602.13​

4626.0860​

DRY CLEANING. 4-603.11​

4626.0865​

PRECLEANING. 4-603.12​

4626.0870​

LOADING OF SOILED ITEMS; WAREWASHING MACHINES. 4-603.13​

4626.0875​

WET CLEANING. 4-603.14​

4626.0880​

WASHING; PROCEDURES FOR ALTERNATIVE MANUAL WAREWASHING EQUIPMENT.​ 4-603.15​

4626.0885​

UTENSILS AND EQUIPMENT; RINSING PROCEDURES. 4-603.16​ SANITIZING EQUIPMENT AND UTENSILS​

4626.0900​

BEFORE USE AFTER CLEANING. 4-702.11​

4626.0905​

HOT WATER AND CHEMICAL SANITIZATION. 4-703.11​

7​

MINNESOTA RULES​ LAUNDERING​

4626.0910​

CLEAN LINENS. 4-801.11​

4626.0915​

LINENS, CLOTH GLOVES, AND WIPING CLOTHS; FREQUENCY OF LAUNDERING. 4-802.11​

4626.0920​

STORAGE OF SOILED LINENS. 4-803.11​

4626.0925​

LINENS; MECHANICAL WASHING. 4-803.12​

4626.0930​

LAUNDRY FACILITIES; USE LIMITATIONS. 4-803.13​ PROTECTING CLEAN ITEMS​

4626.0935​

EQUIPMENT AND UTENSILS; AIR-DRYING REQUIRED. 4-901.11​

4626.0940​

WIPING CLOTHS; AIR-DRYING LOCATIONS. 4-901.12​

4626.0945​

LUBRICANTS; FOOD-CONTACT SURFACES. 4-902.11​

4626.0950​

EQUIPMENT REASSEMBLY. 4-902.12​

4626.0955​

EQUIPMENT, UTENSILS, LINENS, AND SINGLE-SERVICE AND SINGLE-USE ARTICLES;​ STORAGE. 4-903.11​

4626.0960​

STORAGE PROHIBITIONS. 4-903.12​

4626.0965​

KITCHENWARE AND TABLEWARE. 4-904.11​

4626.0970​

SOILED TABLEWARE. 4-904.12​

4626.0975​

PRESET TABLEWARE. 4-904.13​

4626.0977​

RINSING EQUIPMENT AND UTENSILS AFTER CLEANING AND SANITIZING. 4-904.14​ WATER​

4626.0980​

DRINKING WATER APPROVED SOURCE. 5-101.11​

4626.0985​

DRINKING WATER SYSTEM FLUSHING AND DISINFECTION. 5-101.12​

4626.0990​

BOTTLED DRINKING WATER. 5-101.13​

4626.0995​

DRINKING WATER STANDARDS. 5-102.11​

4626.1000​

NONDRINKING WATER. 5-102.12​

4626.1005​

WATER SAMPLING. 5-102.13​

4626.1010​

WATER SAMPLE REPORT; NOTIFICATION AND RETENTION. 5-102.14​

4626.1015​

WATER SYSTEM CAPACITY. 5-103.11​

4626.1020​

WATER PRESSURE. 5-103.12​

4626.1030​

WATER SYSTEM. 5-104.11​

4626.1035​

ALTERNATIVE WATER SUPPLY. 5-104.12​ PLUMBING SYSTEM​

4626.1040​

PLUMBING SYSTEM; APPROVED MATERIALS, INSTALLATION, AND MAINTENANCE.​ 5-201.11​

4626.1050​

HANDWASHING SINK; INSTALLATION. 5-202.12​

4626.1065​

WATER CONDITIONING DEVICE; DESIGN. 5-202.15​

4626.1070​

HANDWASHING SINKS; NUMBERS AND CAPACITY. 5-203.11​

4626.1075​

TOILETS AND URINALS. 5-203.12​

MINNESOTA RULES​ 4626.1080​

SERVICE SINK. 5-203.13​

4626.1085​

BACKFLOW PREVENTION DEVICE; WHEN REQUIRED. 5-203.14​

4626.1095​

HANDWASHING SINKS. 5-204.11​

4626.1110​

USING HANDWASHING SINKS. 5-205.11​

4626.1115​

CROSS-CONNECTIONS PROHIBITED. 5-205.12​

4626.1120​

SCHEDULING INSPECTION AND SERVICE FOR A WATER SYSTEM DEVICE. 5-205.13​

4626.1125​

WATER RESERVOIR OF FOGGING DEVICES; CLEANING. 5-205.14​

8​

WATER TANKS​ 4626.1135​

WATER TANKS; APPROVED. 5-301.11​

4626.1140​

DRINKING WATER HOSE; CONSTRUCTION AND IDENTIFICATION. 5-302.16​

4626.1145​

FILTER; COMPRESSED AIR. 5-303.11​

4626.1150​

WATER INLET, OUTLET, AND HOSES; PROTECTIVE COVER OR DEVICE. 5-303.12​

4626.1155​

MOBILE FOOD ESTABLISHMENT WATER TANK INLET. 5-303.13​

4626.1160​

WATER SYSTEM FLUSHING AND SANITIZATION. 5-304.11​

4626.1165​

WATER TANK, PUMP, AND HOSE; BACKFLOW PREVENTION. 5-304.12​

4626.1175​

WATER TANK, PUMP, AND HOSE; DEDICATION. 5-304.14​ SEWAGE​

4626.1180​

SEWAGE HOLDING TANK CAPACITY AND DRAINAGE. 5-401.11​

4626.1190​

BACKFLOW PREVENTION. 5-402.11​

4626.1195​

GREASE TRAP. 5-402.12​

4626.1200​

CONVEYING SEWAGE. 5-402.13​

4626.1205​

REMOVING TEMPORARY FOOD ESTABLISHMENT WASTES. 5-402.14​

4626.1210​

FLUSHING WASTE RETENTION TANK. 5-402.15​

4626.1215​

APPROVED SEWAGE DISPOSAL SYSTEM. 5-403.11​

4626.1220​

OTHER LIQUID WASTES AND RAINWATER. 5-403.12​ REFUSE AND RECYCLABLES​

4626.1225​

REFUSE; INDOOR STORAGE AREA. 5-501.10​

4626.1230​

REFUSE; OUTDOOR STORAGE SURFACE. 5-501.11​

4626.1235​

REFUSE; OUTDOOR ENCLOSURE. 5-501.12​

4626.1240​

REFUSE; RECEPTACLES. 5-501.13​

4626.1245​

REFUSE; RECEPTACLES IN VENDING MACHINES. 5-501.14​

4626.1250​

REFUSE; OUTSIDE RECEPTACLES. 5-501.15​

4626.1255​

REFUSE; STORAGE AREAS, ROOMS, AND RECEPTACLES; CAPACITY AND AVAILABILITY.​ 5-501.16​

4626.1260​

REFUSE; TOILET ROOM RECEPTACLE; COVERED. 5-501.17​

4626.1265​

REFUSE; CLEANING IMPLEMENTS AND SUPPLIES. 5-501.18​

4626.1270​

REFUSE; STORAGE AREAS, REDEEMING MACHINES, EQUIPMENT, AND RECEPTACLES;​ LOCATION. 5-501.19​

9​

MINNESOTA RULES​

4626.1275​

STORING REFUSE, RECYCLABLES, AND RETURNABLES; INSECT AND RODENT CONTROL.​ 5-501.110​

4626.1280​

AREAS, ENCLOSURES, AND RECEPTACLES; GOOD REPAIR. 5-501.111​

4626.1285​

OUTSIDE STORAGE PROHIBITIONS. 5-501.112​

4626.1290​

COVERING RECEPTACLES. 5-501.113​

4626.1295​

USING DRAIN PLUGS. 5-501.114​

4626.1300​

MAINTAINING REFUSE AREAS AND ENCLOSURES. 5-501.115​

4626.1305​

CLEANING RECEPTACLES. 5-501.116​

4626.1310​

REFUSE, RECYCLABLES, AND RETURNABLES; REMOVAL FREQUENCY. 5-502.11​

4626.1315​

RECEPTACLES OR VEHICLES. 5-502.12​

4626.1320​

SOLID WASTE COMMUNITY OR INDIVIDUAL FACILITY. 5-503.11​ PHYSICAL FACILITY CONSTRUCTION MATERIALS​

4626.1325​

FLOORS, WALLS, AND CEILINGS; CHARACTERISTICS INDOOR AREAS AND MATERIALS.​ 6-101.11​

4626.1330​

OUTDOOR SURFACES; CHARACTERISTICS AND MATERIALS. 6-102.11​ PHYSICAL FACILITY DESIGN AND CONSTRUCTION​

4626.1335​

FLOORS, WALLS, AND CEILINGS; CLEANABILITY. 6-201.11​

4626.1340​

FLOORS, WALLS, AND CEILINGS; UTILITY LINES. 6-201.12​

4626.1345​

FLOOR AND WALL JUNCTURES; COVED AND ENCLOSED OR SEALED. 6-201.13​

4626.1350​

FLOOR CARPETING; RESTRICTIONS AND INSTALLATION. 6-201.14​

4626.1355​

FLOOR COVERING; MATS AND DUCKBOARDS. 6-201.15​

4626.1360​

WALL AND CEILING COVERINGS AND COATINGS. 6-201.16​

4626.1365​

WALLS AND CEILINGS; ATTACHMENTS. 6-201.17​

4626.1370​

WALLS AND CEILINGS; STUDS, JOISTS, AND RAFTERS. 6-201.18​

4626.1375​

LIGHT BULBS; PROTECTIVE SHIELDING. 6-202.11​

4626.1380​

HEATING, VENTILATING, AND AIR CONDITIONING SYSTEM VENTS. 6-202.12​

4626.1385​

INSECT CONTROL DEVICES; DESIGN AND INSTALLATION. 6-202.13​

4626.1390​

TOILET ROOMS; ENCLOSED. 6-202.14​

4626.1395​

OUTER OPENINGS; PROTECTED. 6-202.15​

4626.1400​

EXTERIOR WALLS AND ROOFS; PROTECTIVE BARRIER. 6-202.16​

4626.1405​

OUTDOOR FOOD VENDING AREAS; OVERHEAD PROTECTION. 6-202.17​

4626.1410​

OUTDOOR SERVICING AREAS; OVERHEAD PROTECTION. 6-202.18​

4626.1415​

OUTDOOR WALKING AND DRIVING SURFACES; GRADED TO DRAIN. 6-202.19​

4626.1420​

OUTDOOR REFUSE AREAS; CURBED AND GRADED TO DRAIN. 6-202.110​

4626.1425​

PRIVATE HOMES AND LIVING OR SLEEPING QUARTERS; USE PROHIBITION. 6-202.111​

4626.1430​

LIVING OR SLEEPING QUARTERS; SEPARATION. 6-202.112​ PHYSICAL FACILITY NUMBERS AND CAPACITIES​

4626.1440​

HANDWASHING SOAP; AVAILABILITY. 6-301.11​

MINNESOTA RULES​ 4626.1445​

HAND DRYING PROVISION. 6-301.12​

4626.1450​

DISPOSABLE TOWELS; WASTE RECEPTACLE. 6-301.20​

4626.1455​

HANDWASHING AIDS AND DEVICES; USE RESTRICTIONS. 6-301.13​

4626.1457​

HANDWASHING SIGNAGE. 6-301.14​

4626.1465​

TOILET TISSUE; AVAILABILITY. 6-302.11​

4626.1470​

LIGHTING INTENSITY. 6-303.11​

4626.1475​

VENTILATION; MECHANICAL. 6-304.11​

4626.1480​

DRESSING ROOMS AND LOCKERS; DESIGNATION. 6-305.11​

10​

PHYSICAL FACILITY PLACEMENT​ 4626.1495​

TOILET ROOMS; CONVENIENCE AND ACCESSIBILITY. 6-402.11​

4626.1500​

EMPLOYEE BREAK AREAS, LOCKERS; LOCATION. 6-403.11​

4626.1505​

RETURNED PRODUCTS; SEGREGATION AND LOCATION. 6-404.11​ PHYSICAL FACILITY MAINTENANCE AND OPERATION​

4626.1515​

PHYSICAL FACILITIES; GOOD REPAIR. 6-501.11​

4626.1520​

PHYSICAL FACILITIES; CLEANING FREQUENCY AND RESTRICTIONS. 6-501.12​

4626.1525​

CLEANING FLOORS; DUSTLESS METHODS. 6-501.13​

4626.1530​

CLEANING VENTILATION SYSTEMS; NUISANCE AND DISCHARGE PROHIBITION. 6-501.14​

4626.1535​

CLEANING MAINTENANCE TOOLS; PREVENTING CONTAMINATION. 6-501.15​

4626.1540​

DRYING MOPS. 6-501.16​

4626.1545​

ABSORBENT MATERIALS ON FLOORS; USE LIMITATION. 6-501.17​

4626.1550​

CLEANING OF PLUMBING FIXTURES. 6-501.18​

4626.1555​

CLOSING TOILET ROOM DOORS. 6-501.19​

4626.1560​

USING DRESSING ROOMS AND LOCKERS. 6-501.110​

4626.1565​

CONTROLLING PESTS. 6-501.111​

4626.1570​

REMOVING DEAD OR TRAPPED BIRDS, INSECTS, RODENTS, AND OTHER PESTS. 6-501.112​

4626.1575​

STORING MAINTENANCE TOOLS. 6-501.113​

4626.1580​

MAINTAINING PREMISES; UNNECESSARY ITEMS AND LITTER. 6-501.114​

4626.1585​

PROHIBITING ANIMALS. 6-501.115​ TOXIC LABELING​

4626.1590​

POISONOUS OR TOXIC MATERIALS; IDENTIFYING INFORMATION. 7-101.11​

4626.1595​

POISONOUS OR TOXIC MATERIALS; COMMON NAME. 7-102.11​ TOXIC SUPPLIES AND APPLICATIONS​

4626.1600​

POISONOUS OR TOXIC MATERIALS; STORAGE. 7-201.11​

4626.1605​

POISONOUS OR TOXIC MATERIALS; RESTRICTION. 7-202.11​

4626.1610​

POISONOUS OR TOXIC MATERIALS; CONDITIONS OF USE. 7-202.12​

4626.1615​

POISONOUS OR TOXIC MATERIAL CONTAINERS. 7-203.11​

4626.1620​

SANITIZERS; CRITERIA. 7-204.11​

11​

MINNESOTA RULES​

4626.1625​

CHEMICALS FOR WASHING, TREATMENT, STORAGE AND PROCESSING; FRUITS AND​ VEGETABLES; CRITERIA. 7-204.12​

4626.1630​

BOILER WATER ADDITIVES; CRITERIA. 7-204.13​

4626.1635​

DRYING AGENTS; CRITERIA. 7-204.14​

4626.1640​

LUBRICANTS; INCIDENTAL FOOD-CONTACT; CRITERIA. 7-205.11​

4626.1645​

RESTRICTED USE PESTICIDES; CRITERIA. 7-206.11​

4626.1650​

RODENT BAIT STATIONS. 7-206.12​

4626.1655​

TRACKING POWDERS; PEST CONTROL AND MONITORING. 7-206.13​

4626.1660​

EMPLOYEE MEDICINES; RESTRICTION AND STORAGE. 7-207.11​

4626.1665​

REFRIGERATED MEDICINES; STORAGE. 7-207.12​

4626.1670​

FIRST AID STORAGE. 7-208.11​

4626.1675​

PERSONAL CARE ITEMS; STORAGE. 7-209.11​ TOXIC RETAIL SALE​

4626.1680​

POISONOUS OR TOXIC MATERIALS; SEPARATION. 7-301.11​ CODE APPLICABILITY​

4626.1685​

PUBLIC HEALTH PROTECTION. 8-101.10​

4626.1690​

VARIANCE REQUEST; PROCEDURES. 8-103.11​

4626.1695​

VARIANCE REQUEST; CRITERIA FOR DECISION.​

4626.1700​

VARIANCE CONDITIONS; HACCP; NOTIFICATION OF DECISION. 8-103.12​

4626.1705​

VARIANCES; EFFECT OF ALTERNATIVE MEASURES OR CONDITIONS. 8-103.13​

4626.1710​

RENEWAL OF VARIANCE.​

4626.1715​

VARIANCE DENIAL, REVOCATION, OR REFUSAL TO RENEW; APPEALS.​ PLAN SUBMISSION AND APPROVAL​

4626.1720​

PLANS; REVIEW REQUIRED. 8-201.11​

4626.1725​

CONTENTS OF PLANS AND SPECIFICATIONS. 8-201.12​

4626.1730​

WHEN A HACCP PLAN IS REQUIRED. 8-201.13​

4626.1735​

CONTENTS OF HACCP PLAN. (SEE ALSO PART 4626.0420) 8-201.14​

4626.1740​

TRADE SECRETS. 8-202.10​

4626.1745​

PREOPERATIONAL INSPECTIONS. 8-203.10​

4626.1750​

NOTICE OF OPENING.​ LICENSE TO OPERATE​

4626.1755​

LICENSE REQUIRED. 8-301.11​

4626.1760​

LICENSE APPLICATION. 8-302.11​

4626.1770​

QUALIFICATIONS AND RESPONSIBILITIES OF APPLICANTS. 8-302.13​

4626.1777​

DENIAL OF APPLICATION FOR LICENSE; NOTICE. 8-303.30​ INSPECTION AND CORRECTION OF VIOLATIONS​

4626.1785​

INSPECTION. 8-401.10​

4626.0010​

MINNESOTA RULES​

4626.1787​

PERFORMANCE AND RISK-BASED INSPECTIONS. 8-401.20​

4626.1790​

ALLOWED AT REASONABLE TIMES AFTER DUE NOTICE. 8-402.11​

4626.1791​

DOCUMENTING INFORMATION AND OBSERVATIONS. 8-403.10​

4626.1792​

ISSUING A REPORT. 8-403.30​

4626.1795​

CEASING OPERATIONS AND EMERGENCY REPORTING. 8-404.11​

4626.1797​

RESUMPTION OF OPERATIONS. 8-404.12​

4626.1800​

FOOD SAMPLES.​

4626.1805​

EMBARGO.​

4626.1810​

CONDEMNATION.​

4626.1815​

TAG.​

12​

MISCELLANEOUS HEALTH AND SAFETY​ 4626.1820​

MINNESOTA CLEAN INDOOR AIR ACT.​ TEMPORARY AND PORTABLE FOOD ESTABLISHMENTS​

4626.1855​

SPECIAL EVENT FOOD STANDS.​

FOOD CODE GENERALLY​ 4626.0010

FOOD CODE. 1-101.10​

This chapter shall be known as the Food Code, hereinafter referred to as "this Code."​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 144.122; 157.011​ History: 23 SR 519; 24 SR 605; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0015 FOOD SAFETY, ILLNESS PREVENTION, AND HONEST PRESENTATION.​ 1-102.10​ The purpose of this Code is to safeguard public health and ensure that food is safe, unadulterated,​ and honestly presented.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0017 SCOPE. 1-103.10​ A. This Code establishes definitions; sets standards for management and personnel, food​ operations, and equipment and facilities; and provides for food establishment plan review, license​ issuance, inspection, employee restriction, and license suspension.​ B. References to federal law used in this Code shall incorporate future amendments to the​ law.​

13​

MINNESOTA RULES​

4626.0020​

C. This Code applies to food establishments licensed and inspected by the Department of​ Agriculture, Department of Health, or delegated regulatory authorities that conduct licensing and​ inspections of food establishments.​ D. This Code also applies to individuals applying for certification and certification renewal​ as a food protection manager, persons providing training for applicants for food protection manager​ certification, and for certified food protection managers, persons developing and publishing food​ protection manager certification examinations, and persons proctoring food protection manager​ certification examinations.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ DEFINITIONS​ 4626.0020

STATEMENT OF APPLICATION AND DEFINITIONS. 1-201.10​

Subpart 1. Applicability. The terms used in this chapter have the meanings given them in this​ part.​ Subp. 2. Additive.​ A. "Food additive" has the meaning given in the Federal Food, Drug, and Cosmetic Act,​ United States Code, title 21, section 321(s), and Code of Federal Regulations, title 21, section​ 170.3(e)(1).​ B. "Color additive" has the meaning given in the Federal Food, Drug, and Cosmetic Act,​ United States Code, title 21, section 321(t), and Code of Federal Regulations, title 21, section​ 70.3(f).​ Subp. 3. Adulterated. "Adulterated" has the meaning given in Minnesota Statutes, section​ 34A.02, and the Federal Food, Drug, and Cosmetic Act, United States Code, title 21, section 342.​ Subp. 4. Approved. "Approved" means acceptable to the regulatory authority based on a​ determination of conformity with principles, practices, and generally recognized standards that​ protect public health.​ Subp. 4a. Asymptomatic.​ A. "Asymptomatic" means without obvious symptoms or not showing or producing​ indications of a disease or other medical condition, such as an individual infected with a pathogen,​ but not exhibiting or producing any signs or symptoms of vomiting, diarrhea, or jaundice.​ B. Asymptomatic includes not showing symptoms because symptoms have resolved or​ subsided, or because symptoms were never manifested.​

​

4626.0020​

MINNESOTA RULES​

14​

Subp. 5. aw. "aw" means water activity that is a measure of the free moisture in a food, is the​ quotient of the water vapor pressure of the substance divided by the vapor pressure of the pure​ water at the same temperature, and is indicated by the symbol a w.​ Subp. 5a. Balut. "Balut" means an embryo inside a fertile egg that has been incubated until​ the embryo reaches a specific stage of development and is then removed from incubation before​ hatching.​ Subp. 6. Beverage. "Beverage" means a liquid for drinking, including water.​ Subp. 7. Bottled drinking water. "Bottled drinking water" means water that is sealed in​ bottles, packages, or other containers and offered for sale for human consumption, including bottled​ mineral water.​ Subp. 8. Bulk food. "Bulk food" has the meaning given in Minnesota Statutes, section 31.80,​ subdivision 2.​ Subp. 9. [Repealed, 43 SR 295]​ Subp. 10. Certification number. "Certification number" means a unique combination of​ letters and numbers assigned by a shellfish control authority to a molluscan shellfish dealer according​ to the National Shellfish Sanitation Program.​ Subp. 10a. Certified food protection manager or CFPM. "Certified food protection manager"​ or "CFPM" means an individual who has a valid Minnesota food protection manager's certification​ under part 4626.0033 or an individual who is certified under Minnesota Rules 2015, parts 4626.2005​ to 4626.2020.​ Subp. 11. CIP.​ A. "CIP" means cleaned in place.​ B. A CIP system circulates cleaning, rinsing, and sanitizing solutions through a fixed​ system.​ C. CIP does not include in-place, manual cleaning without the use of a CIP system for​ equipment such as band saws, slicers, or mixers.​ Subp. 11a. [Repealed, 43 SR 295]​ Subp. 12. [Repealed, 43 SR 295]​ Subp. 12a. Commingle. "Commingle" means:​ A. to combine shellstock harvested on different days or from different growing areas as​ identified on the tag or label; or​ B. to combine shucked shellfish from containers with different container codes or different​ shucking dates.​

​

15​

MINNESOTA RULES​

4626.0020​

Subp. 13. Comminuted.​ A. "Comminuted" means reduced in size by methods including chopping, flaking, grinding,​ or mincing.​ B. Comminuted products include fish or meat products that are reduced in size and​ restructured or reformulated such as gefilte fish, gyros, ground beef, or sausage; and a mixture of​ two or more types of meat that have been reduced in size and combined, such as sausages made​ from two or more meats.​ Subp. 13a. Commissioner. "Commissioner" means the commissioner of health.​ Subp. 14. [Repealed, 43 SR 295]​ Subp. 14a. Conditional employee. "Conditional employee" means a potential food employee​ to whom a job offer is made, conditional on responses to subsequent medical questions or​ examinations designed to identify potential food employees who may be suffering from a disease​ that can be transmitted through food and done in compliance with the Americans with Disabilities​ Act, United States Code, title 42, chapter 126.​ Subp. 15. Confirmed disease outbreak. "Confirmed disease outbreak" means a foodborne​ disease outbreak when laboratory analysis of appropriate specimens identifies a causative organism​ and epidemiological analysis implicates the food as the source of the illness.​ Subp. 16. Consumer. "Consumer" means a person who is a member of the public, takes​ possession of food, is not functioning in the capacity of an operator of a food establishment or food​ processing plant, and does not offer the food for resale.​ Subp. 17. [Repealed, 43 SR 295]​ Subp. 18. Corrosion-resistant material. "Corrosion-resistant material" means a material that​ maintains acceptable surface cleanability characteristics under prolonged influence of food contact,​ the normal use of cleaning compounds and sanitizing solutions, and other conditions of the use​ environment.​ Subp. 18a. Counter-mounted equipment. "Counter-mounted equipment" means equipment​ that is not portable and is designed to be mounted off the floor on a table, counter, or shelf.​ Subp. 19. Critical control point. "Critical control point" means a point or procedure in a​ specific food system where loss of control may result in an unacceptable health risk.​ Subp. 19a. Critical limit. "Critical limit" means the maximum or minimum value to which a​ physical, biological, or chemical parameter must be controlled at a critical control point to minimize​ the risk that the identified food safety hazard may occur.​ Subp. 19b. Cross-contamination. "Cross-contamination" is the movement or transfer of​ bacteria, microorganisms, or other harmful substances from one person, object, place, or food item​ to another.​ Subp. 20. [Repealed, 43 SR 295]​

4626.0020​

MINNESOTA RULES​

16​

Subp. 20a. Cut leafy greens or leafy greens. "Cut leafy greens" means fresh leafy greens​ whose leaves have been cut, shredded, sliced, chopped, or torn. "Leafy greens" includes iceberg​ lettuce; romaine lettuce; leaf lettuce; butter lettuce; baby leaf lettuce such as immature lettuce or​ leafy greens; escarole; endive; spring mix; spinach; cabbage; kale; arugula; and chard. Leafy greens​ does not include herbs such as cilantro or parsley.​ Subp. 20b. Dealer. "Dealer" means a person who is authorized by a shellfish control authority​ for the activities of shellstock shipper, shucker-packer, repacker, reshipper, or depuration processor​ of molluscan shellfish according to the provisions of the National Shellfish Sanitation Program.​ Subp. 20c. Disclosure. "Disclosure" means a written statement that clearly identifies the​ animal-derived foods or items containing ingredients that contain animal-derived foods that are,​ or can be ordered, raw, undercooked, or without otherwise being processed to eliminate pathogens.​ Subp. 21. Drinking water. "Drinking water" means water from a source that meets chapters​ 4720 and 4725 and Code of Federal Regulations, title 40, part 141.​ Drinking water includes the term water except the terms boiler water, mop water, rainwater,​ wastewater, nondrinking water, and other terms that connote that the water is not potable.​ Subp. 22. Dry storage area. "Dry storage area" means a room or area designated for the​ storage of packaged or containerized food that is not time/temperature control for safety food, and​ dry goods such as single-service items.​ Subp. 23. Easily cleanable. "Easily cleanable" means a characteristic of a surface that:​ A. allows effective removal of soil by normal cleaning methods; and​ B. is dependent on the material, design, construction, and installation of the surface.​ Subp. 24. Easily movable. "Easily movable" means:​ A. portable; mounted on casters, gliders, or rollers; or provided with a mechanical means​ to safely tilt a unit of equipment for cleaning; and​ B. having no utility connection, a utility connection that disconnects quickly, or a flexible​ utility connection line of sufficient length to allow the equipment to be moved for cleaning of the​ equipment and adjacent area.​ Subp. 24a. Egg.​ A. "Egg" means the shell egg of avian species such as chicken, duck, goose, guinea, quail,​ ratite, or turkey.​ B. Egg does not include:​ (1) a balut;​ (2) the egg of reptile species such as alligator; or​ (3) an egg product.​

17​

MINNESOTA RULES​

4626.0020​

Subp. 24b. Egg product.​ A. "Egg product" means all, or a portion of, the contents found inside eggs separated from​ the shell in a food processing plant, and processed to be free of viable Salmonella microorganisms.​ B. Egg product does not include food that contains eggs only in a relatively small proportion​ such as cake mixes.​ Subp. 25. Employee. "Employee" means a licensee, person in charge, food employee, person​ having supervisory or management duties, person on the payroll, family member, volunteer, person​ performing work under contractual agreement, or other person working in a food establishment.​ Subp. 26. Equipment.​ A. "Equipment" means an article that is used in the operation of a food establishment such​ as a freezer, grinder, hood, ice maker, mixer, oven, reach-in refrigerator, sink, slicer, stove, table,​ vending machine, warewashing machine, grill, and fryer.​ B. Equipment does not include apparatuses used for handling or storing large quantities of​ packaged foods that are received from a supplier in a cased or overwrapped lot, such as hand trucks,​ forklifts, dollies, pallets, racks, and skids.​ Subp. 26a. Exclude. "Exclude" means to prevent a person from working as an employee in a​ food establishment or entering a food establishment as an employee.​ Subp. 27. [Repealed, 43 SR 295]​ Subp. 28. [Repealed, 43 SR 295]​ Subp. 28a. FDA. "FDA" means the U.S. Food and Drug Administration.​ Subp. 29. Fish.​ A. "Fish" means fresh or saltwater finfish, crustaceans, and other forms of aquatic animal​ life other than birds or mammals, including alligator, frog, aquatic turtle, jellyfish, sea cucumber,​ and sea urchin, and the roe of such animals, if the animal life is intended for human consumption.​ B. Fish includes an edible human food product derived in whole or in part from fish,​ including fish that have been processed in any manner.​ Subp. 30. Food. "Food" means a raw, cooked, or processed edible substance, ice, beverage,​ or ingredient used or intended for use or for sale in whole or in part for human consumption, or​ chewing gum.​ Subp. 31. Foodborne disease outbreak.​ A. "Foodborne disease outbreak" means an incident, except as specified in item B, when:​ (1) two or more persons experience a similar illness after ingestion of a common food;​ and​

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(2) epidemiological analysis implicates the food as the source of the illness.​ B. Foodborne disease outbreak includes a single case of illness from botulism or chemical​ poisoning.​ Subp. 32. Food cart. "Food cart" has the meaning given in Minnesota Statutes, section 157.15,​ subdivision 6. A food cart must be a single self-contained unit.​ Subp. 32a. Food catering. "Food catering" means food that is prepared for service in support​ of an event with a predetermined guest list such as a reception, party, luncheon, conference,​ ceremony, or trade show. A food establishment doing catering is responsible for maintaining control​ of and ensuring the safety of the food from preparation to service to the consumer.​ Subp. 33. Food-contact surface. "Food-contact surface" means:​ A. a surface of equipment or a utensil with which food normally comes into contact; or​ B. a surface of equipment or a utensil from which food may drain, drip, or splash:​ (1) into a food; or​ (2) onto a surface normally in contact with food.​ Subp. 34. Food employee. "Food employee" means an individual working with unpackaged​ food, food equipment or utensils, or food-contact surfaces.​ Subp. 35. Food establishment.​ A. "Food establishment" means an operation that stores, prepares, packages, serves, vends,​ caters, delivers, or otherwise provides food for human consumption, where consumption is on or​ off the premises and regardless of whether there is a charge for the food, and relinquishes possession​ either directly or indirectly to a consumer.​ Food establishment includes:​ (1) an element of an operation such as a transportation vehicle or central preparation​ facility that supplies a vending location or satellite feeding location unless the vending or feeding​ location is licensed by the regulatory authority; or​ (2) retail operations located within the following establishments:​ (a) wholesale food processors, wholesale food handlers, food manufacturers, or​ food brokers as classified in Minnesota Statutes, section 28A.05, paragraphs (b), (c), and (d);​ (b) custom processors as defined in Minnesota Statutes, section 28A.03, subdivision​ 8, or custom processing as defined in Minnesota Statutes, section 31A.02, subdivision 5; or​ (c) animal food manufacturers as defined in Minnesota Statutes, section 31A.02,​ subdivision 8; and​

​

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(d) those food service operations within a hospital, nursing home, or boarding care​ home licensed under Minnesota Statutes, sections 144.50 to 144.56, that are not limited to patient​ or resident care.​ B. Food establishment does not include:​ (1) an establishment excluded from licensure under Minnesota Statutes, sections 28A.15,​ 28A.151, and 28A.152, or 31.56;​ (2) an establishment exempted under Minnesota Statutes, section 157.22;​ (3) a private home or other location that receives catered or home-delivered food when​ only invited guests are present; or​ (4) a food service limited to patient or resident care within a hospital, nursing home,​ boarding care home, or supervised living facility licensed under Minnesota Statutes, sections 144.50​ to 144.56, except for those operations subject to the rules and laws administered by the Minnesota​ Department of Agriculture.​ Subp. 36. Food processing plant. "Food processing plant" means a commercial operation​ that manufactures, packages, labels, or stores food for human consumption and provides food for​ sale or distribution only to other business entities such as food processing plants or food​ establishments.​ Subp. 37. Game animal.​ A. "Game animal" means an animal, the products of which are food.​ B. Game animals include (1) big and small game as defined in Minnesota Statutes, section​ 97A.015, subdivisions 3 and 45; and (2) game birds as defined in Minnesota Statutes, section​ 97A.015, subdivision 24.​ C. Game animal does not include animals classified as livestock in Code of Federal​ Regulations, title 9, section 301.2, or as animals as defined in Minnesota Statutes, section 31A.02,​ subdivision 4, or poultry or fish; or animals raised as livestock, Cervidae, Ratitae, or llama as​ defined in Minnesota Statutes, sections 17.452, 17.453, and 17.455.​ Subp. 38. General use pesticide. "General use pesticide" means a pesticide that is not classified​ by the U.S. Environmental Protection Agency for restricted use as specified in Code of Federal​ Regulations, title 40, section 152.175.​ Subp. 38a. Grade A standards. "Grade A standards" means the requirements found in "Grade​ A Pasteurized Milk Ordinance" produced with guidance from the U.S. Public Health Service and​ the FDA, and with which certain fluid and dry milk and milk products must comply. This publication​ is incorporated by reference, is subject to frequent change, and is available through the FDA website​ at www.fda.gov/downloads/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation​ /Milk/UCM513508.pdf.​ Subp. 39. [Repealed, 43 SR 295]​

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Subp. 40. HACCP plan. "HACCP plan" means a written document that delineates the formal​ procedures for following the hazard analysis and critical control point principles developed by the​ National Advisory Committee on Microbiological Criteria for Foods. This publication is incorporated​ by reference, is subject to infrequent change, and is available at www.fsis.usda.gov.​ Subp. 40a. Handwashing sink.​ A. "Handwashing sink" means a lavatory, a basin, or a vessel for washing; a wash basin;​ or a plumbing fixture dedicated to handwashing.​ B. Handwashing sink includes an automatic handwashing facility.​ Subp. 41. Hazard. "Hazard" means a biological, chemical, or physical property that may cause​ an unacceptable consumer health risk.​ Subp. 42. Hermetically sealed container. "Hermetically sealed container" means a container​ that is designed and intended to be secure against the entry of microorganisms and, in the case of​ low acid canned foods, to maintain the commercial sterility of its contents after processing.​ Subp. 42a. Highly susceptible population. "Highly susceptible population" means persons​ who are more likely than others in the general population to experience foodborne disease because​ they are immunocompromised, preschool-age children, or older adults and they are obtaining food​ at a facility that provides services such as custodial care, health care, or nutritional or socialization​ services.​ Subp. 43. Imminent health hazard. "Imminent health hazard" means a significant threat or​ danger to health that exists when there is evidence sufficient to show that a product, practice,​ circumstance, or event creates a situation that requires immediate correction or cessation of operation​ to prevent injury based on:​ A. the number of potential injuries; and​ B. the nature, severity, and duration of the anticipated injury.​ Subp. 44. Injected. "Injected" means manipulating meat by introducing a solution into its​ interior by processes referred to as "injecting," "pump marinating," or "stitch pumping."​ Subp. 44a. Juice.​ A. "Juice" means the aqueous liquid expressed or extracted from one or more fruits or​ vegetables, purees of the edible portions of one or more fruits or vegetables, or any concentrates​ of the liquid or puree.​ B. For purposes of HACCP, juice does not include liquids, purees, or concentrates that are​ not used as beverages or ingredients of beverages.​ Subp. 45. Kitchenware. "Kitchenware" means food preparation and storage utensils.​ Subp. 46. License. "License" means the authorization issued by the regulatory authority to a​ person to operate a food establishment.​

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Subp. 47. Licensee. "Licensee" means the person licensed by the regulatory authority who:​ A. is the owner, the owner's agent, or other person legally responsible for the operation of​ the food establishment; and​ B. possesses a valid license to operate a food establishment according to Minnesota Statutes,​ chapter 28A or 157.​ Subp. 48. Linens. "Linens" means fabric items such as cloth hampers, cloth napkins, tablecloths,​ wiping cloths, cloth gloves, and other work garments.​ Subp. 48a. Major food allergen.​ A. "Major food allergen" means:​ (1) milk; egg; fish, such as bass, flounder, or cod; crustacean shellfish, including crab,​ lobster, or shrimp; tree nuts, such as almonds, pecans, or walnuts; wheat; peanuts; and soybeans;​ or​ (2) a food ingredient that contains protein derived from a food, as specified in subitem​ (1).​ B. Major food allergen does not include:​ (1) any highly refined oil derived from a food specified in item A, subitem (1), and any​ ingredient derived from the oil; or​ (2) any ingredient that is exempt under the petition or notification process specified in​ the Food Allergen Labeling and Consumer Protection Act of 2004, Public Law 108-282.​ Subp. 49. [Repealed, 43 SR 295]​ Subp. 50. Meat.​ A. "Meat" means the flesh of animals used as food including the dressed flesh of cattle,​ swine, sheep, or goats and other edible animals.​ B. Meat does not include fish, poultry, and wild animals as defined in Minnesota Statutes,​ section 97A.015, subdivision 55, and as specified in part 4626.0160, item C.​ Subp. 50a. Mechanically tenderized.​ A. "Mechanically tenderized" means manipulating meat with deep penetration by processes​ such as blade tenderizing, jaccarding, pinning, needling, or using blades, pins, needles, or any​ mechanical device.​ B. Mechanically tenderized does not include processes by which solutions are injected into​ meat.​ Subp. 51. mg/L. "mg/L" means milligrams per liter, which is the metric equivalent of parts​ per million (ppm).​

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Subp. 52. Molluscan shellfish. "Molluscan shellfish" means an edible species of fresh or​ frozen oysters, clams, mussels, and scallops or edible portions thereof, except when the scallop​ product consists only of the shucked adductor muscle.​ Subp. 52a. [Repealed, 43 SR 295]​ Subp. 52b. Mushrooms.​ A. "Mushrooms, wild" means edible species of mushrooms that have been harvested from​ their naturally occurring environment where no human intervention occurred to support their growth.​ B. "Mushrooms, cultivated" means edible species of mushrooms that have been grown by​ a person or persons under controlled conditions, outdoors or indoors, on natural or artificial substrate.​ Subp. 52c. Neighborhood kitchen. "Neighborhood kitchen" means a satellite or auxiliary​ kitchen in residential buildings for adults age 55 or older that is secondary to the primary approved​ commercial kitchen where most of the food is received, stored, and prepared.​ Subp. 52d. Noncontinuous cooking.​ A. "Noncontinuous cooking" means the cooking of food in a food establishment using a​ process in which the initial heating of the food is intentionally halted so that it may be cooled and​ held for complete cooking at a later time prior to sale or service.​ B. Noncontinuous cooking does not include cooking procedures that only involve​ temporarily interrupting or slowing an otherwise continuous cooking process.​ Subp. 52e. Nonpublic water system. "Nonpublic water system" means any water system that​ does not meet the definition of a public water system as defined in subpart 66.​ Subp. 53. Packaged.​ A. "Packaged" means bottled, canned, cartoned, bagged, or wrapped, whether packaged in​ a food establishment or a food processing plant.​ B. Packaged does not include food delivered to a consumer by a food employee, upon​ consumer request, that is wrapped or placed in a carry-out container to protect the food during​ delivery to the consumer.​ Subp. 54. Person. "Person" means an association, corporation, individual, partnership,​ government, or governmental subdivision or agency.​ Subp. 55. Person in charge. "Person in charge" means the individual present at a food​ establishment who is responsible for the operation at the time of inspection.​ Subp. 56. Personal care item. "Personal care item" means an item or substance that may be​ poisonous, toxic, or a source of contamination and is used to maintain or enhance a person's health,​ hygiene, or appearance.​ Subp. 57. pH. "pH" is the symbol for the negative logarithm of the hydrogen ion concentration,​ which is a measure of the degree of acidity or alkalinity of a solution.​

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Subp. 58. Physical facility. "Physical facility" means the structure and interior surfaces of a​ food establishment including accessories such as soap and towel dispensers, and attachments such​ as light fixtures and heating or air conditioning system vents.​ Subp. 59. Plumbing fixture. "Plumbing fixture" means a receptacle or device that:​ A. is permanently or temporarily connected to the water distribution system of the premises​ and demands a supply of water from the system; or​ B. discharges used water, waste materials, or sewage directly or indirectly to the drainage​ system of the premises.​ Subp. 60. Plumbing system. "Plumbing system" means the water supply and distribution​ pipes; plumbing fixtures and traps; soil, waste, and vent pipes; sanitary and storm sewers and​ building drains, including their respective connections, devices, and appurtenances within the​ premises; and water-treating equipment.​ Subp. 61. Poisonous or toxic material. "Poisonous or toxic material" means a substance that​ is not intended for ingestion and is included in one of the following 4 categories:​ A. cleaners and sanitizers, such as cleaning and sanitizing agents and other chemicals such​ as caustics, acids, drying agents, and polishes;​ B. pesticides, except sanitizers, including substances such as insecticides and rodenticides;​ C. substances necessary for the operation and maintenance of the establishment, such as​ non-food-grade lubricants and personal care items that may be deleterious to health; or​ D. substances that are not necessary for the operation and maintenance of the establishment​ and are on the premises for retail sale, such as petroleum products and paints.​ Subp. 62. Potentially hazardous food.​ A. "Potentially hazardous food" means a food that is natural or synthetic and is in a form​ capable of supporting:​ (1) the rapid and progressive growth of infectious or toxigenic microorganisms;​ (2) the growth and toxic production of Clostridium botulinum; or​ (3) in raw shell eggs, the growth of Salmonella enteritidis.​ B. Potentially hazardous food includes a food of animal origin that is raw or heat-treated,​ a food of plant origin that is heat-treated or consists of raw seed sprouts, cut melons, and garlic and​ oil mixtures that are not acidified or otherwise modified at a food processing plant in a way that​ results in mixtures that do not support growth as specified in item A.​ C. Potentially hazardous food does not include:​ (1) an air-cooled hard-boiled egg with shell intact;​

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(2) a food with an aw value of 0.85 or less;​ (3) a food with a pH level of 4.6 or below when measured at 24 degrees C (75 degrees​ F);​ (4) a food, in an unopened hermetically sealed container, that is commercially processed​ to achieve and maintain commercial sterility under conditions of nonrefrigerated storage and​ distribution;​ (5) a food for which laboratory evidence demonstrates that the rapid and progressive​ growth of infectious and toxigenic microorganisms or the growth of Salmonella enteritidis in eggs​ or Clostridium botulinum cannot occur, including a food that has an aw and a pH that are above the​ levels specified in subitem (2) or (3) and that may contain a preservative, other barrier to the growth​ of microorganisms, or a combination of barriers that inhibit the growth of microorganisms; or​ (6) a food that may contain an infectious or toxigenic microorganism or chemical or​ physical contaminant at a level sufficient to cause illness, but that does not support the growth of​ microorganisms as specified in item A.​ Subp. 63. Poultry. "Poultry" means:​ A. any domesticated bird, such as chickens, turkeys, ducks, geese, guineas, ratites, or​ squabs, whether live or dead, as defined in Code of Federal Regulations, title 9, part 381.1; and​ B. any migratory waterfowl or game bird, whether live or dead, as defined in Code of​ Federal Regulations, title 9, part 362.1, including pheasant, partridge, quail, grouse, or pigeon.​ Subp. 64. Premises. "Premises" means:​ A. the physical facility, its contents, and the contiguous land or property under the control​ of the licensee; or​ B. the physical facility, its contents, and the land or property not described in item A, if its​ facilities and contents that are under the control of the licensee and may impact food establishment​ personnel, facilities, or operations, and a food establishment is only 1 component of a larger operation​ such as a health care facility, hotel, motel, school, recreational camp, or prison.​ Subp. 64a. Prepare. "Prepare" means to process food by means such as heating, cooking,​ canning, extracting, fermenting, distilling, pickling, freezing, baking, drying, smoking, grinding,​ cutting, mixing, coating, stuffing, packing, bottling, packaging, or any other treatment or preservation​ process.​ Subp. 65. Primal cut. "Primal cut" means a basic major cut into which carcasses and sides of​ meat are separated, such as a beef round, pork loin, lamb flank, or veal breast.​ Subp. 65a. Priority 1 item or P1.​ A. "Priority 1 item" or "P1" means a provision in this Code whose application contributes​ directly to the elimination, prevention, or reduction to an acceptable level of hazards associated​

25​

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4626.0020​

with foodborne illness or injury, and there is no other provision that more directly controls the​ hazard. This is the same as the FDA's "priority designation."​ B. A priority 1 item includes an item with a quantifiable measure to show control of hazards​ such as cooking, reheating, cooling, and handwashing.​ Subp. 65b. Priority 2 item or P2.​ A. "Priority 2 item" or "P2" means a provision in this Code whose application supports,​ facilitates, or enables one or more priority 1 items. This is the same as the FDA's "priority foundation​ designation."​ B. A priority 2 item includes an item that requires the purposeful incorporation of specific​ actions, equipment, or procedures by industry management to attain control of risk factors that​ contribute to foodborne illness or injury such as personnel training, infrastructure or necessary​ equipment, HACCP plans, documentation or record keeping, and labeling.​ Subp. 65c. Priority 3 item.​ A. "Priority 3 item" means a provision in this Code that is not designated as a priority 1​ item or a priority 2 item. This is the same as the FDA's "core designation."​ B. A priority 3 item includes an item that usually relates to general sanitation, operational​ controls, sanitation standard operating procedures (SSOPs), facilities or structures, equipment​ design, or general maintenance.​ C. Items not designated with a P1 or P2 are priority 3 items.​ Subp. 66. Public water system. "Public water system" has the meaning given in Code of​ Federal Regulations, title 40, part 141.2.​ Subp. 66a. Ratite. "Ratite" or "Ratitae" means a flightless bird such as an emu, ostrich, or​ rhea.​ Subp. 67. Ready-to-eat food.​ A. "Ready-to-eat food" means food that:​ (1) is in a form that is edible without additional preparation to achieve food safety as​ specified in part 4626.0340 or 4626.0350;​ (2) is a raw or partially cooked animal food and the consumer is advised as specified​ in part 4626.0340, item D, subitem (3); or​ (3) is prepared according to a variance that is granted under part 4626.0340, item D,​ subitem (4); and​ (4) may receive additional preparation for palatability or aesthetic, epicurean,​ gastronomic, or culinary purposes.​ B. Ready-to-eat food includes:​

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(1) raw animal food that is cooked as specified under part 4626.0340 or 4626.0345, or​ frozen as specified under part 4626.0350;​ (2) raw fruits and vegetables that are washed as specified under part 4626.0255;​ (3) fruits and vegetables that are cooked for hot holding, as specified in part 4626.0347;​ (4) plant food for which further washing, cooking, or other processing is not required​ for food safety, and from which rinds, peels, husks, or shells, if naturally present, are removed;​ (5) all TCS food as defined in subpart 90a that is cooked to the temperature and time​ required for the specific food under parts 4626.0340 to 4626.0349 and cooled as specified in part​ 4626.0385;​ (6) substances derived from plants such as spices, seasonings, and sugar;​ (7) bakery items such as bread, cakes, pies, fillings, or icing for which further cooking​ is not required for food safety;​ (8) products that are produced according to USDA guidelines and have received a​ lethality treatment for pathogens; and​ (9) food manufactured as specified in Code of Federal Regulations, title 21, part 113.​ Subp. 68. Reduced oxygen packaging.​ A. "Reduced oxygen packaging" means:​ (1) the reduction of the amount of oxygen in a package by removing oxygen, displacing​ oxygen and replacing it with another gas or combination of gases, or otherwise controlling the​ oxygen content to a level below that normally found in the atmosphere, which is approximately 21​ percent at sea level; and​ (2) the process in subitem (1) that involves a food for which the hazards Clostridium​ botulinum or Listeria monocytogenes require control in the final packaged form.​ B. Reduced oxygen packaging includes:​ (1) vacuum packaging in which air is removed from a package of food and the package​ is hermetically sealed so that a vacuum remains inside the package;​ (2) modified atmosphere packaging in which the atmosphere of a package of food is​ modified so that its composition is different from air but the atmosphere may change over time due​ to the permeability of the packaging material or the respiration of the food. Modified atmosphere​ packaging includes reduction in the proportion of oxygen, total replacement of oxygen, or an​ increase in the proportion of other gases such as carbon dioxide or nitrogen;​ (3) controlled atmosphere packaging in which the atmosphere of a package of food is​ modified so that until the package is opened, its composition is different from air, and continuous​ control of that atmosphere is maintained, such as by using oxygen scavengers or a combination of​ total replacement of oxygen, nonrespiring food, and impermeable packaging material;​

​

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(4) cook-chill packaging in which cooked food is hot filled into impermeable bags that​ have the air expelled and are then sealed or crimped closed. The bagged food is rapidly chilled and​ refrigerated at temperatures that inhibit the growth of psychotropic pathogens; or​ (5) sous-vide packaging in which raw or partially cooked food is vacuum packaged in​ an impermeable bag, cooked in the bag, rapidly chilled, and refrigerated at temperatures that inhibit​ the growth of psychotropic pathogens.​ Subp. 69. Refuse. "Refuse" means solid waste not carried by water through the sewage system.​ Subp. 70. Regulatory authority. "Regulatory authority" means the local, state, or federal​ enforcement body or authorized representative having jurisdiction over the food establishment.​ Subp. 70a. Reminder. "Reminder" means a written statement concerning the health risk of​ consuming animal foods raw, undercooked, or without otherwise being processed to eliminate​ pathogens.​ Subp. 70b. Re-service. "Re-service" means food that is served or sold to a consumer who then​ returns the unused food, which is then transferred by means of serving or selling to another person.​ Subp. 70c. Restrict. "Restrict" means to limit the activities of a food employee so that there​ is no risk of transmitting a disease that is transmissible through food and the food employee does​ not work with exposed food or handle clean equipment, utensils, linens, or unwrapped single-service​ or single-use articles.​ Subp. 70d. Restricted egg. "Restricted egg" means any egg as defined in Code of Federal​ Regulations, title 9, section 590.5, that is a check, incubator reject, inedible, leaker, loss, or dirty​ egg.​ Subp. 71. Restricted use pesticide. "Restricted use pesticide" means a pesticide product that​ contains the active ingredients specified in Code of Federal Regulations, title 40, section 152.175,​ and that is limited to use by a licensed applicator.​ Subp. 72. [Repealed, 43 SR 295]​ Subp. 73. Retail food vehicle, portable structure, or cart. "Retail food vehicle, portable​ structure, or cart" means a food establishment licensed under Minnesota Statutes, sections 28A.06​ and 28A.07, that is a motor vehicle, portable structure, or nonmotorized cart where food and food​ products are:​ A. offered to the consumer;​ B. intended for off-premises consumption; and​ C. not subject to on-site preparation.​ Subp. 73a. Risk. "Risk" means the likelihood that an adverse health effect will occur within​ a population as a result of a hazard in a food.​ Subp. 74. Safe material. "Safe material" means:​

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A. an article manufactured from or composed of materials that may not reasonably be​ expected to result directly or indirectly in their becoming a component or otherwise affecting the​ characteristics of any food;​ B. an additive that is used as specified in the Federal Food, Drug, and Cosmetic Act, United​ States Code, title 21, section 348 or 379e; or​ C. any other material that is not an additive and that is used in conformity with applicable​ regulations of the Food and Drug Administration.​ Subp. 75. Sanitization. "Sanitization" means the application of cumulative heat or chemicals​ on cleaned food-contact surfaces that, when evaluated for efficacy, yields within 1 minute a reduction​ of 5 logs, which is equal to a 99.999 percent reduction, of representative disease microorganisms​ of public health importance.​ Subp. 76. Sealed. "Sealed" means free of cracks or other openings that allow the entry or​ passage of moisture.​ Subp. 76a. Service animal. "Service animal" means an animal such as a guide dog, signal​ dog, or other animal individually trained to provide assistance to a person with a disability.​ Subp. 77. Servicing area. "Servicing area" means an operating base location to which a food​ cart, special event food stand, temporary food establishment, retail food vehicle, portable structure,​ cart, or transportation vehicle returns regularly for such things as vehicle and equipment cleaning,​ discharging liquid or solid wastes or refilling water tanks and ice bins, and loading food.​ Subp. 78. Sewage. "Sewage" means liquid waste containing animal or vegetable matter in​ suspension or solution and may include liquids containing chemicals in solution.​ Subp. 78a. [Repealed, 43 SR 295]​ Subp. 78b. Shellfish control authority. "Shellfish control authority" means a state, federal,​ foreign, tribal, or other government entity legally responsible for administering a program that​ includes certification of molluscan shellfish harvesters and dealers for interstate commerce.​ Subp. 79. Shellstock. "Shellstock" means raw, in-shell molluscan shellfish.​ Subp. 79a. Shiga toxin-producing Escherichia coli or STEC. "Shiga toxin-producing​ Escherichia coli " or "STEC" means any E. coli capable of producing Shiga toxins, also called​ verocytotoxins or Shiga-like toxins. Examples of serotypes of STEC include both O157 and​ non-O157 E. coli.​ Subp. 80. Shucked shellfish. "Shucked shellfish" means molluscan shellfish that have 1 or​ both shells removed.​ Subp. 81. Single-service articles. "Single-service articles " means tableware, carry-out utensils,​ and other items such as bags, containers, placemats, stirrers, straws, toothpicks, and wrappers, that​ are designed and constructed to be used 1 time by 1 person, after which they are intended to be​ discarded.​

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Subp. 82. Single-use article.​ A. "Single-use article" means a utensil or bulk food container designed and constructed to​ be used once and discarded.​ B. Single-use article includes items such as wax paper, butcher paper, plastic wrap, formed​ aluminum food containers, jars, plastic tubs or buckets, bread wrappers, pickle barrels, ketchup​ bottles, number 10 cans, and other items that do not meet the materials, durability, strength, and​ cleanability specifications contained in parts 4626.0450, 4626.0505, and 4626.0515 for multiuse​ utensils.​ Subp. 83. Slacking. "Slacking" means the process of moderating the temperature of a food,​ such as allowing a food to gradually increase from a temperature of -10 degrees F (-23 degrees C)​ to 25 degrees F (-4 degrees C) in preparation for deep-fat frying or for even heat penetration during​ the cooking of previously block-frozen food such as shrimp.​ Subp. 84. Smooth. "Smooth" means:​ A. a food-contact surface, free of pits and inclusions with a cleanability equal to or exceeding​ that of number 3 (100 grit) stainless steel;​ B. a non-food-contact surface of equipment having a surface equal to that of commercial​ grade hot-rolled steel free of visible scale; or​ C. a floor, wall, or ceiling having an even or level surface with no roughness or projections​ that render the surface difficult to clean.​ Subp. 85. Special event food stand. "Special event food stand" has the meaning given in​ Minnesota Statutes, section 157.15, subdivision 14.​ Subp. 86. [Repealed, 43 SR 295]​ Subp. 87. [Repealed, 43 SR 295]​ Subp. 88. [Repealed, 43 SR 295]​ Subp. 89. Temperature measuring device. "Temperature measuring device" means a​ thermometer, thermocouple, thermistor, or other device that indicates the temperature of food, air,​ or water.​ Subp. 90. Temporary food establishment. "Temporary food establishment" means a food​ establishment that is a mobile food unit, seasonal permanent food stand, or seasonal temporary​ food stand, as those terms are defined in Minnesota Statutes, section 157.15, subdivisions 9, 12a,​ and 13.​ Subp. 90a. Time/temperature control for safety food (TCS).​ A. "Time/temperature control for safety food (TCS)" means a food that requires​ time/temperature control for safety to limit pathogenic microorganism growth or toxin formation.​ B. TCS includes:​

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(1) an animal food that is raw or heat-treated; a plant food that is heat-treated or consists​ of raw seed sprouts, cut melons, cut leafy greens, cut tomatoes, or mixtures of cut tomatoes that​ are not modified in a way so that they are unable to support pathogenic microorganism growth or​ toxin formation, or garlic-in-oil mixtures that are not modified in a way so that they are unable to​ support pathogenic microorganism growth or toxin formation; and​ (2) except as specified in item C, subitem (4), a food that because of the interaction of​ its aw and pH values is designated as product assessment (PA) required in Table A or B:​ TABLE A. Interaction of pH and awfor control of spores in food heat-treated to destroy vegetative​ cells and subsequently packaged​ pH values​

aw values​ 4.6 or less​

> 4.6 up to 5.6​

> 5.6​

≤ 0.92​

non-TCS FOOD*​

non-TCS FOOD​

non-TCS FOOD​

> 0.92 up to​ 0.95​

non-TCS FOOD​

non-TCS FOOD​

PA**​

> 0.95​

non-TCS FOOD​

PA​

PA​

* TCS FOOD means TIME/TEMPERATURE CONTROL FOR SAFETY FOOD​ ** PA means Product Assessment required​ TABLE B. Interaction of pH and aw for control of vegetative cells and spores in food not heat-treated​ or heat-treated but not packaged​ aw values​

pH values​ < 4.2​

4.2 - 4.6​

> 4.6 - 5.0​

> 5.0​

< 0.88​

non-TCS food*​

non-TCS food​

non-TCS food​

non-TCS food​

0.88 - 0.90​

non-TCS food​

non-TCS food​

non-TCS food​

PA**​

> 0.90 - 0.92​

non-TCS food​

non-TCS food​

PA​

PA​

> 0.92​

non-TCS food​

PA​

PA​

PA​

* TCS FOOD means TIME/TEMPERATURE CONTROL FOR SAFETY FOOD​ ** PA means Product Assessment required​ C. TCS does not include:​ (1) an air-cooled hard-boiled egg with shell intact, or an egg with shell intact that is not​ hard-boiled but has been pasteurized to destroy all viable Salmonellae;​

31​

MINNESOTA RULES​

4626.0020​

(2) a food in an unopened, hermetically sealed container that is commercially processed​ to achieve and maintain commercial sterility under conditions of nonrefrigerated storage and​ distribution;​ (3) a food that because of its pH or aw value, or interaction of aw and pH values, is​ designated as a non-TCS food in item B, Table A or B;​ (4) a food that is designated as product assessment (PA) required in item B, Table A​ or B, and has undergone a product assessment showing that the growth or toxin formation of​ pathogenic microorganisms that are reasonably likely to occur in that food is precluded due to:​ (a) intrinsic factors including added or natural characteristics of the food such as​ preservatives, antimicrobials, humectants, acidulants, or nutrients;​ (b) extrinsic factors including environmental or operational factors that affect the​ food such as packaging, modified atmosphere such as reduced oxygen packaging, shelf life and​ use, or temperature range of storage and use; or​ (c) a combination of intrinsic and extrinsic factors; or​ (5) a food that does not support the growth or toxin formation of pathogenic​ microorganisms according to subitems (1) to (4) even though the food may contain a pathogenic​ microorganism or chemical or physical contaminant at a level sufficient to cause illness or injury.​ Subp. 90b. USDA. "USDA" means the U.S. Department of Agriculture.​ Subp. 91. Utensil. "Utensil" means a food-contact implement or container used in the storage,​ preparation, transportation, dispensing, sale, or service of food, including kitchenware or tableware​ that is multiuse, single-service, or single-use; gloves used in contact with food; temperature-sensing​ probes of food temperature measuring devices; and probe-type price or identification tags used in​ contact with food.​ Subp. 92. Vending machine. "Vending machine" means a self-service device that, upon​ insertion of a coin, paper currency, token, card, or key, or by optional manual operation, dispenses​ unit servings of food in bulk or in packages without the necessity of replenishing the device between​ each vending operation.​ Subp. 93. Vending machine location. "Vending machine location" means the room, enclosure,​ space, or area where one or more vending machines are installed and operated and includes the​ storage areas and areas on the premises that are used to service and maintain the vending machines.​ Subp. 94. Warewashing. "Warewashing" means the cleaning and sanitizing of utensils and​ food-contact surfaces of equipment.​ Subp. 94a. Whole-muscle, intact beef. "Whole-muscle, intact beef" means whole muscle​ beef that is not injected, mechanically tenderized, reconstructed, or scored and marinated, from​ which beef steaks may be cut.​ Subp. 95. [Repealed, 43 SR 295]​

4626.0020​

MINNESOTA RULES​

32​

Subp. 96. [Repealed, 43 SR 295]​ Subp. 97. [Repealed, 43 SR 295]​ Subp. 98. [Repealed, 43 SR 295]​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; L 2005 1Sp1 art 1 s 97; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0024 RESPONSIBILITY TO MEET STANDARDS.​ The licensee shall meet the standards that this Code prescribes, by carrying out its requirements​ directly or ensuring that other entities subject to the licensee's control or direction do so. The licensee​ bears the responsibility for complying and for acts and omissions of its employees, vendors, and​ subcontractors with respect to this Code.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ SUPERVISION​ 4626.0025

ASSIGNMENT OF PERSON IN CHARGE. 2-101.11​

The licensee shall be the person in charge or shall designate a person in charge and shall ensure​ that a person in charge is present at the food establishment during all hours of operation.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0030

DEMONSTRATION OF KNOWLEDGE BY PERSON IN CHARGE. 2-102.11​

Based on the risks inherent to the food operation, during inspections and upon request by the​ regulatory authority, the person in charge shall demonstrate knowledge of foodborne disease​ prevention, application of the hazard analysis critical control point principles, and the requirements​ of this Code. The person in charge shall demonstrate this knowledge by responding correctly to​ the inspector's questions as they relate to the specific food operation. The areas of knowledge​ include:​ A. describing the relationship between the prevention of foodborne disease and the personal​ hygiene of a food employee;P2​ B. explaining the responsibility of the person in charge for preventing the transmission of​ foodborne disease by a food employee who has a disease or medical condition that may cause​ foodborne disease;P2​

​

33​

MINNESOTA RULES​

4626.0030​

C. describing the symptoms associated with diseases that are transmissible through food;P2​ D. explaining the significance of the relationship between maintaining the time and​ temperature of TCS food and the prevention of foodborne illness;P2​ E. explaining the hazards involved in the consumption of raw or undercooked meat, poultry,​ eggs, and fish;P2​ F. stating the required food temperatures and times for safe cooking of TCS food including​ meat, poultry, eggs, and fish;P2​ G. stating the required temperatures and times for the safe refrigerated storage, hot holding,​ cooling, and reheating of TCS food;P2​ H. describing the relationship between the prevention of foodborne illness and the​ management and control of the following:​ (1) cross-contamination;P2​ (2) hand contact with ready-to-eat foods;P2​ (3) handwashing;P2 and​ (4) maintaining the food establishment in a clean condition and in good repair;P2​ I. describing foods identified as major food allergens and the symptoms that a major food​ allergen could cause in a sensitive individual who has an allergic reaction;P2​ J. explaining the relationship between food safety and providing equipment that is:​ (1) sufficient in number and capacity;P2 and​ (2) properly designed, constructed, located, installed, operated, maintained, and​ cleaned;P2​ K. explaining correct procedures for cleaning and sanitizing utensils and food-contact​ surfaces of equipment;P2​ L. identifying the source of water used and measures taken to ensure that the water source​ remains protected from contamination such as providing protection from backflow and precluding​ the creation of cross connections;P2​ M. identifying poisonous or toxic materials in the food establishment and the procedures​ necessary to ensure that they are safely stored, dispensed, used, and disposed of according to​ Minnesota Statutes, chapter 18B;P2​ N. identifying critical control points in the operation from purchasing through sale or service​ that when not controlled may contribute to the transmission of foodborne illness, and by explaining​ the steps to be taken to ensure that the points are controlled according to this Code;P2​

​

4626.0030​

MINNESOTA RULES​

34​

O. explaining the details of how the person in charge and food employees comply with the​ HACCP plan if a plan is required;P2​ P. explaining the responsibilities, rights, and authorities assigned by this Code to the:​ (1) food employee;P2​ (2) conditional employee;P2​ (3) person in charge;P2 and​ (4) regulatory authority;P2 and​ Q. explaining how the person in charge, food employees, and conditional employees comply​ with reporting requirements and explaining the exclusion or restriction of a food employee who​ has a disease or medical condition that may cause foodborne disease.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0033 CERTIFIED FOOD PROTECTION MANAGER (CFPM) REQUIREMENTS​ FOR FOOD ESTABLISHMENTS.​ A. A food establishment licensee shall employ a certified food protection manager (CFPM)​ for each establishment including a food establishment that reheats ready-to-eat TCS foods for hot​ holding, except as provided in item B.​ B. A food establishment does not need to employ a CFPM:​ (1) where the method of food preparation meets the definition of a low-risk food​ establishment in Minnesota Statutes, section 157.20;​ (2) where the food establishment is licensed as a special event food stand;​ (3) where the establishment operates as a retail food vehicle, portable structure, or cart​ as defined in part 4626.0020, subpart 73; or​ (4) where food preparation activities are solely limited to one or more of the following:​ (a) preparing or packaging non-TCS foods that are made from ingredients that are​ not TCS;​ (b) processing raw meat, poultry, fish, or game animals intended for cooking by​ the consumer; or​ (c) heating or serving precooked hot dog or sausage products, popcorn, nachos,​ pretzels, or frozen pizza.​ C. Only upon opening or reopening a food establishment, a licensee may employ 1 full-time​ employee who:​

​

35​

MINNESOTA RULES​

4626.0033​

(1) at the time of opening or reopening meets the requirements in item G, subitem (1);​ and​ (2) within 60 days of opening or reopening meets the requirements in item A.​ D. A food establishment licensee required to employ a CFPM shall display a current original​ CFPM certificate or a current duplicate CFPM certificate in the establishment.​ E. A food establishment licensee that ceases to employ a CFPM shall employ a new CFPM​ within 60 days.​ F. A food establishment licensee through the CFPM is responsible for:​ (1) identifying hazards in the day-to-day operation of the food establishment;​ (2) developing or implementing specific policies, procedures, or standards to prevent​ foodborne illness in the food establishment;​ (3) coordinating training, supervising or directing food preparation activities, and taking​ corrective action as needed in the food establishment to protect the health of the consumer; and​ (4) completing in-house self-inspections of daily operations in the food establishment​ at a frequency that ensures food safety policies and procedures are followed.​ G. The requirements for CFPM initial certification are as specified in this item.​ (1) An applicant for initial certification as a CFPM shall complete a training course and​ pass an examination that is accepted under item H on the date taken. The examination must have​ been taken within 6 months directly preceding the application for certification under subitem (2).​ (2) An applicant for initial certification as a CFPM shall submit to the commissioner:​ (a) a completed application on a form provided by the commissioner containing the​ name; telephone number; mailing address, including county; e-mail address, if applicable; and​ Social Security number of the applicant;​ (b) documentation of the applicant's qualifications under this subitem and subitem​ (1); and​ (c) the fee specified in Minnesota Statutes, section 157.16, subdivision 2a.​ H. The commissioner shall accept only examinations that are evaluated and listed by a​ Conference for Food Protection recognized accrediting agency as conforming to the Conference​ for Food Protection Standards for Accreditation of Food Protection Manager Certification Programs.​ I. The requirements for CFPM renewal certification are as specified in this item.​ (1) An applicant for renewal as a CFPM shall successfully complete at least 4 contact​ hours of continuing education within the effective dates of the valid certificate. The continuing​ education must meet the requirements of item K.​

4626.0033​

MINNESOTA RULES​

36​

(2) An applicant for renewal as a CFPM shall submit to the commissioner:​ (a) a completed application on a form provided by the commissioner containing the​ name; telephone number; mailing address, including county; e-mail address, if applicable; and​ Social Security number of the applicant;​ (b) documentation of the applicant's qualifications specified in item J; and​ (c) the fee specified in Minnesota Statutes, section 157.16, subdivision 2a.​ (3) An applicant for renewal whose certification expires before the effective date of​ this rule shall meet the requirements in part 4626.2015, subpart 8. An applicant for renewal whose​ certification expires after the effective date of this rule shall meet the requirements in subitem (2)​ no more than 6 months following the expiration date of the certificate. If more than 6 months has​ elapsed since the expiration date, an applicant for renewal shall meet the requirements listed under​ item G.​ J. Documentation of a continuing education course must include:​ (1) the applicant's name;​ (2) the title of the approved course;​ (3) the number of approved contact hours;​ (4) the course date;​ (5) the instructor's name; and​ (6) the instructor's telephone number or e-mail address.​ K. A continuing education course:​ (1) must address food safety and sanitation topics included in this Code;​ (2) must be submitted to and approved by the commissioner before the course is offered​ and when changes to an approved course are proposed;​ (3) must be taught in an interactive format approved by the commissioner to ensure​ competency and use an assessment, such as a quiz, test, demonstration, or other mechanism, approved​ by the commissioner to evaluate learning;​ (4) must be a minimum of 1 hour;​ (5) is subject to periodic review by the commissioner of health; and​ (6) is subject to audit at no cost to the commissioner to verify that instructor​ qualifications, course content, and course length are being met.​ L. A continuing education course instructor shall:​ (1) be a Minnesota CFPM;​

37​

MINNESOTA RULES​

4626.0035​

(2) review developments in topics included in approved courses at least every 2 years;​ and​ (3) maintain course records, including attendance records, for 5 years.​ M. Upon review and verification, as needed, of the documents submitted under this part,​ the commissioner shall issue a certificate or a letter of denial within 45 days of receiving the​ application. Grounds for the commissioner to deny an application are provided in Minnesota Statutes,​ section 144.99, subdivision 8, paragraphs (a) and (b).​ N. CFPM certificate effective dates and transferability are as specified in this item.​ (1) A certificate issued under this section is valid statewide for 3 years from the effective​ date printed on the certificate.​ (2) The effective date of the initial CFPM certificate is the date the applicant passed an​ approved examination.​ (3) The effective date of the renewal CFPM certificate is 1 day after the expiration date​ of the previous certificate.​ (4) A CFPM certificate is not transferable to another person.​ O. The commissioner shall issue a duplicate certificate to replace a lost, destroyed, or​ damaged certificate if the applicant submits a completed application on a form provided by the​ commissioner for a duplicate certificate and pays the fee specified in Minnesota Statutes, section​ 157.16, subdivision 2a.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0035 DUTIES OF PERSON IN CHARGE. 2-103.11​ The person in charge shall:​ A. ensure food establishment operations are not conducted in a private home or in a room​ used as living or sleeping quarters as specified in part 4626.1425;P2​ B. ensure persons unnecessary to the food establishment operation are not allowed in the​ food preparation, food storage, or warewashing areas, except that brief visits and tours may be​ authorized by the person in charge if steps are taken to ensure that exposed food; clean equipment,​ utensils, and linens; and unwrapped single-service and single-use articles are protected from​ contamination;P2​ C. ensure employees and other persons, such as delivery and maintenance persons and​ pesticide applicators, entering the food preparation, food storage, and warewashing areas comply​ with this Code;P2​

​

4626.0035​

MINNESOTA RULES​

38​

D. ensure employees are effectively cleaning their hands, by routinely monitoring the​ employees' handwashing;P2​ E. ensure employees are visibly observing foods as they are received to determine that they​ are from approved sources, delivered at the required temperatures, protected from contamination,​ unadulterated, and accurately presented, by routinely monitoring the employees' observations and​ periodically evaluating foods upon their receipt;P2​ F. ensure employees are verifying that foods delivered to the food establishment during​ nonoperating hours are from approved sources and are placed into appropriate storage locations so​ that they are maintained at the required temperatures, protected from contamination, unadulterated,​ and accurately presented;P2​ G. ensure employees are properly cooking TCS food, such as through the daily oversight​ of the employees' routine monitoring of the cooking temperatures using appropriate temperature​ measuring devices properly scaled and calibrated as specified in parts 4626.0555 and 4626.0820,​ item B;P2​ H. ensure employees are using proper methods to rapidly cool TCS foods that are not held​ hot or are not for consumption within 4 hours, through daily oversight of the employees' routine​ monitoring of food temperatures during cooling;P2​ I. ensure employees are properly maintaining the temperatures of TCS foods during hot​ and cold holding through daily oversight of the employees' routine monitoring of food temperatures;P2​ J. ensure consumers who order raw or partially cooked ready-to-eat food of animal origin​ are informed as specified in part 4626.0442 that the food is not cooked sufficiently to ensure its​ safety;P2​ K. ensure employees are properly sanitizing cleaned multiuse equipment and utensils before​ they are reused, through routine monitoring of solution temperature and exposure time for hot water​ sanitizing, and chemical concentration, pH, temperature, and exposure time for chemical sanitizing;P2​ L. ensure consumers are notified that clean tableware is to be used when they return to​ self-service areas such as salad bars and buffets as specified in part 4626.0290, item B;P2​ M. ensure employees are preventing cross-contamination of ready-to-eat food with bare​ hands by properly using suitable utensils such as deli tissue, spatulas, tongs, single-use gloves, or​ dispensing equipment, except as specified in part 4626.0225, item D;P2​ N. ensure employees are properly trained in food safety, including food allergy awareness,​ as it relates to their assigned duties;P2​ O. ensure food employees and conditional employees are informed of their responsibility​ to report, to the person in charge, information about their health and activities as they relate to​ diseases that are transmissible through food, as specified in part 4626.0040, item A;P2 and​ P. ensure written procedures and plans, where specified by this Code and as developed by​ the food establishment, are maintained and implemented as required.P2​

​

39​

MINNESOTA RULES​

4626.0040​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ EMPLOYEE HEALTH​ 4626.0040

RESPONSIBILITY OF LICENSEE; PERSON IN CHARGE; FOOD​ EMPLOYEES; AND CONDITIONAL EMPLOYEES. 2-201.11​

A. The licensee shall require food employees and conditional employees to report to the​ person in charge information about their health and activities as they relate to diseases transmissible​ through food. A food employee or conditional employee shall report the information in a manner​ that allows the person in charge to reduce the risk of foodborne disease transmission, including​ providing necessary additional information, such as the date of onset of symptoms and an illness,​ or of a diagnosis without symptoms, if the food employee or conditional employee:​ (1) has any of the following symptoms:​ (a) vomiting;P1​ (b) diarrhea;P1​ (c) jaundice;P1​ (d) sore throat with fever;P1 or​ (e) a lesion containing pus such as a boil or infected wound that is open or draining​ and is:​ i. on the hands or wrists, unless an impermeable cover such as a finger cot or​ bandage protects the lesion and a single-use glove is worn over the impermeable cover;P1​ ii. on exposed portions of the arms, unless the lesion is protected by an​ impermeable cover;P1 or​ iii. on other parts of the body, unless the lesion is covered by a dry, durable,​ tight-fitting bandage;P1​ (2) has an illness diagnosed by a health practitioner due to, or is known to be infected​ with:​ (a) norovirus;P1​ (b) hepatitis A virus;P1​ (c) Salmonella spp.;P1​ (d) Shigella spp.;P1​ (e) Shiga toxin-producing Escherichia coli;P1 or​

4626.0040​

MINNESOTA RULES​

40​

(f) other enteric bacterial, viral, or parasitic pathogens;P1 or​ (3) has been exposed to, or is the suspected source of, a probable or confirmed disease​ outbreak within the last 30 days.P1​ B. The person in charge shall notify the regulatory authority of a food employee known to​ be infected with:​ (1) norovirus;P1​ (2) hepatitis A virus;P1​ (3) Salmonella spp.;P1​ (4) Shigella spp.;P1​ (5) Shiga toxin-producing Escherichia coli;P1 or​ (6) other enteric bacterial, viral, or parasitic pathogens.P1​ C. The person in charge shall record all reports of diarrhea or vomiting made by food​ employees and report those illnesses to the regulatory authority at the specific request of the​ regulatory authority.P1​ D. The person in charge shall notify the regulatory authority of any complaint from a​ consumer having or suspected of having:​ (1) diarrhea or vomiting;P1​ (2) norovirus;P1​ (3) hepatitis A virus;P1​ (4) Salmonella spp.;P1​ (5) Shigella spp.;P1​ (6) Shiga toxin-producing Escherichia coli;P1 or​ (7) other enteric bacterial, viral, or parasitic pathogens.P1​ E. A food employee or conditional food employee shall:​ (1) report to the person in charge the information specified in item A;P1 and​ (2) comply with exclusions and restrictions specified in part 4626.0045.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

41​

MINNESOTA RULES​

4626.0045

4626.0065​

EXCLUSIONS AND RESTRICTIONS. 2-201.12​

The person in charge shall:​ A. exclude a food employee from a food establishment if the food employee is ill with​ vomiting or diarrhea;P1​ B. exclude a food employee from working with exposed food, clean equipment, and clean​ utensils in a food establishment if the food employee has an enteric bacterial, viral, or parasitic​ pathogen capable of being transmitted by food, such as norovirus, Salmonella spp., Shigella spp.,​ hepatitis A, or Shiga toxin-producing E. coli;P1​ C. restrict an employee if the results of an epidemiological investigation by the commissioner​ of health under Minnesota Statutes, section 31.171, determines that a food employee or conditional​ employee presents a risk for transmission of foodborne disease;P1and​ D. restrict an employee if the employee is infected with a skin lesion containing pus such​ as a boil or infected wound that is open or draining and not properly covered as specified in part​ 4626.0040, item A, subitem (1), unit (e).P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0050

REMOVAL, ADJUSTMENT, OR RETENTION OF EXCLUSIONS AND​ RESTRICTIONS. 2-201.13​

The exclusion specified in part 4626.0045, item A, may be removed by the person in charge​ after the food employee has been asymptomatic for at least 24 hours. The exclusion and restriction​ specified in part 4626.0045, items B and C, must remain in effect for a food employee until the​ commissioner and the regulatory authority determine that the risk of foodborne disease transmission​ has been adequately mitigated.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0055 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0060 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ PERSONAL CLEANLINESS​ 4626.0065

CLEAN HANDS. 2-301.11​

A food employee shall keep hands and exposed portions of arms clean.P1​

4626.0065​

MINNESOTA RULES​

42​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0070

CLEANING PROCEDURE. 2-301.12​

A. Except as specified in item D, food employees shall clean their hands and exposed​ portions of their arms, including surrogate prosthetic devices for hands or arms for at least 20​ seconds, using soap in a handwashing sink that is equipped as specified in parts 4626.1050 and​ 4626.1440 to 4626.1457.P1​ B. Food employees shall use the following cleaning procedure in the order stated to clean​ their hands and exposed portions of their arms, including surrogate prosthetic devices for hands​ and arms:​ (1) rinse under clean, running warm water;P1​ (2) apply an amount of soap recommended by the soap manufacturer;P1​ (3) rub together vigorously for at least 10 to 15 seconds while:​ (a) paying particular attention to removing soil from underneath the fingernails​ during the cleaning procedure;P1 and​ (b) creating friction on the surfaces of the hands and arms or surrogate prosthetic​ devices for hands and arms, fingertips, and areas between the fingers;P1​ (4) thoroughly rinse under clean, running warm water;P1 and​ (5) immediately follow the cleaning procedure with thorough drying using a method​ as specified in part 4626.1445.P1​ C. To avoid recontaminating hands or surrogate prosthetic devices, food employees shall​ use disposable paper towels or similar clean barriers when touching surfaces such as manually​ operated faucet handles on a handwashing sink or the handle of a restroom door.​ D. An automatic handwashing device may be used by a food employee to clean hands or​ surrogate prosthetic devices if it is approved by the regulatory authority and is capable of removing​ the types of soils encountered in the food operations involved.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0075

WHEN TO WASH HANDS. 2-301.14​

A food employee shall clean the hands and exposed portions of the arms or surrogate prosthetic​ devices as specified in part 4626.0070 at the following times:​

​

43​

MINNESOTA RULES​

4626.0085​

A. immediately before:​ (1) engaging in food preparation including working with exposed food;P1​ (2) touching clean equipment and utensils;P1 and​ (3) touching unwrapped single-service and single-use articles;P1​ B. after touching bare human body parts other than clean hands and clean, exposed portions​ of arms or surrogate prosthetic devices;P1​ C. after using the toilet;P1​ D. after caring for or handling service animals or fish in an aquarium or molluscan shellfish​ or crustacea in display tanks as specified in part 4626.0120, item B;P1​ E. except as specified in part 4626.0105, item B, after coughing, sneezing, using a​ handkerchief or disposable tissue, using tobacco, eating, or drinking;P1​ F. after handling soiled equipment or utensils;P1​ G. during food preparation, as often as necessary to remove soil and contamination and to​ prevent cross-contamination when changing tasks;P1​ H. when switching between working with raw food and working with ready-to-eat food;P1​ I. before donning gloves for working with food;P1 and​ J. after engaging in other activities that contaminate the hands.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0080

WHERE TO WASH HANDS. 2-301.15​

Food employees shall clean their hands in a handwashing sink or approved automatic​ handwashing facility and shall not clean their hands in a sink used for food preparation or​ warewashing or in a service sink or a curbed cleaning facility used for the disposal of mop water​ or similar liquid waste.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0085

HAND ANTISEPTICS. 2-301.16​

A. A hand antiseptic used as a topical application, a hand antiseptic solution used as a hand​ dip, or a hand antiseptic soap must:​

​

4626.0085​

MINNESOTA RULES​

44​

(1) comply with 1 of the following requirements:​ (a) be an approved drug that is listed in the FDA publication Approved Drug​ Products with Therapeutic Equivalence Evaluations as an approved drug based on safety and​ effectiveness. This publication is incorporated by reference, is subject to frequent change, and can​ be found at www.fda.gov/Drugs/InformationOnDrugs/ucm129662.htm;P2or​ (b) have active antimicrobial ingredients that are listed in the FDA monograph for​ OTC Health-Care Antiseptic Drug Products as an antiseptic handwash;P2​ (2) consist only of components that the intended use of each complies with one of the​ following:​ (a) a threshold of regulation exemption under Code of Federal Regulations, title​ 21, section 170.39;P2​ (b) Code of Federal Regulations, title 21, section 178, as regulated for use as a food​ additive with conditions of safe use;P2​ (c) a determination of generally recognized as safe (GRAS). Partial listings of​ substances with food uses that are GRAS may be found in Code of Federal Regulations, title 21,​ sections 182, 184, and 186, and in the FDA's inventory of GRAS notices;P2​ (d) a prior sanction listed under Code of Federal Regulations, title 21, section 181;P2​ or​ (e) a food-contact notification that is effective;P2 and​ (3) be applied only to hands that are cleaned as specified in part 4626.0070.P2​ B. If a hand antiseptic or a hand antiseptic solution used as a hand dip does not meet the​ criteria under item A, subitem (2), use must be:​ (1) followed by thorough hand rinsing in clean water before hand contact with food or​ by the use of gloves;P2 or​ (2) limited to situations that involve no direct contact with food by the bare hands.P2​ C. A hand antiseptic solution used as a hand dip must be maintained clean and at a strength​ equivalent to at least 100 mg/L of chlorine.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0090

FINGERNAIL MAINTENANCE. 2-302.11​

A. Food employees shall keep their fingernails trimmed, filed, and maintained so the edges​ and surfaces are cleanable and not rough.P2​

​

45​

MINNESOTA RULES​

4626.0105​

B. Unless wearing intact gloves in good repair, food employees shall not wear fingernail​ polish or artificial fingernails when working with exposed food.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0095

JEWELRY PROHIBITION. 2-303.11​

Food employees shall not wear jewelry, including medical information jewelry, on their arms​ and hands while preparing food, except for a plain ring such as a flat, smooth band.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0100

CLOTHING; CLEAN CONDITION. 2-304.11​

A food employee shall wear clean outer clothing to prevent contamination of food, equipment,​ utensils, linens, and single-service and single-use articles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ HYGIENIC PRACTICES​ 4626.0105

EATING, DRINKING, OR USING TOBACCO. 2-401.11​

A. Except as specified in item B, an employee shall eat, drink, or use any form of tobacco​ only in designated areas where the contamination of exposed food; clean equipment, utensils, and​ linens; unwrapped single-service and single-use articles; or other items needing protection cannot​ result.​ B. A food employee may drink from a closed beverage container if the container is handled​ to prevent contamination of:​ (1) the employee's hands;​ (2) the container; and​ (3) exposed food; clean equipment, utensils, and linens; and unwrapped single-service​ and single-use articles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.0110​ 4626.0110

MINNESOTA RULES​

46​

DISCHARGES FROM EYES, NOSE, AND MOUTH. 2-401.12​

A food employee experiencing persistent sneezing, coughing, or a runny nose that causes​ discharges from the eyes, nose, or mouth shall not work with exposed food; clean equipment,​ utensils, and linens; or unwrapped single-service or single-use articles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0115

HAIR RESTRAINTS. 2-402.11​

A. Except as provided in item B, a food employee shall wear hair restraints, such as a hat,​ hair covering, or net, a beard restraint, and clothing that covers body hair. Hair restraints must be​ designed and worn to effectively keep hair from contacting exposed food; clean equipment, utensils,​ and linens; and unwrapped single-service and single-use articles.​ B. This part does not apply to food employees such as counter staff who only serve beverages​ and wrapped or packaged foods, hostesses, or wait staff, if they present a minimal risk of​ contaminating exposed food; clean equipment, utensils, and linens; and unwrapped single-service​ and single-use articles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0120

ANIMAL HANDLING PROHIBITION. 2-403.11​

A. Except as specified in item B, a food employee shall not care for or handle animals that​ may be present such as patrol dogs, service animals, or animals that are allowed under part​ 4626.1585, item B, subitems (2) to (5).P2​ B. A food employee with a service animal may handle or care for the service animal and​ a food employee may handle or care for fish in an aquarium or molluscan shellfish or crustacea in​ display tanks if the food employee's hands are washed as specified in part 4626.0070.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0123 CLEANUP OF VOMITING AND DIARRHEAL EVENTS. 2-501.11​ A food establishment must have procedures for employees to follow when responding to events​ that involve the discharge of vomitus or fecal matter onto surfaces in the food establishment. The​ procedures must address the specific actions employees shall take to minimize the spread of​ contamination and the exposure of employees, consumers, food, and surfaces to vomitus or fecal​ matter.P2​

​

47​

MINNESOTA RULES​

4626.0130​

Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ FOOD CHARACTERISTICS​ 4626.0125 SAFE AND NOT ADULTERATED. 3-101.11​ Food must be safe and not adulterated, as specified in Minnesota Statutes, section 34A.02.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0130

COMPLIANCE WITH FOOD LAW. 3-201.11​

A. Food must be obtained from sources that comply with Minnesota Statutes, Minnesota​ Rules, and United States Code and Code of Federal Regulations.P1​ B. Food prepared or stored in a private home must not be used or offered for human​ consumption in a food establishment, except as allowed by Minnesota Statutes, sections 28A.15​ and 157.22, clauses (6) and (7).P1​ C. Packaged food must be labeled as specified in Minnesota Statutes and Minnesota Rules,​ including parts 4626.0200, 4626.0202, and 4626.0435.P2​ D. Fish, other than molluscan shellfish, that are intended for consumption in raw or​ undercooked form and allowed as specified in part 4626.0340, item D, may be offered for sale or​ service if they are obtained from a supplier that freezes the fish as specified in part 4626.0350; or​ frozen on the premises as specified in part 4626.0350 and records must be retained as specified in​ part 4626.0355.​ E. Whole-muscle, intact beef steaks that are intended for consumption in an undercooked​ form without a consumer advisory as specified in part 4626.0340, item C, must be:​ (1) obtained from a food processing plant that, upon request by the purchaser, packages​ the steaks and labels them, to indicate that the steaks meet the definition of whole-muscle, intact​ beef;P2 or​ (2) deemed acceptable by the regulatory authority based on other evidence, such as​ written buyer specifications or invoices, that indicates that the steaks meet the definition of​ whole-muscle, intact beef;P2 and​ (3) if individually cut in a food establishment:​ (a) cut from whole-muscle, intact beef that is labeled by a food processing plant as​ specified in subitem (1) or identified as specified in subitem (2);P2​

4626.0130​

MINNESOTA RULES​

48​

(b) prepared so they remain intact;P2 and​ (c) if packaged for undercooking in a food establishment, labeled as specified in​ subitem (1) or identified as specified in subitem (2).P2​ F. Meat and poultry that is not a ready-to-eat food and is in a packaged form when it is​ offered for sale or otherwise offered for consumption must be labeled to include safe handling​ instructions as specified in law, including Code of Federal Regulations.​ G. Eggs that have not been specifically treated to destroy all viable Salmonellae must be​ labeled to include safe handling instructions as specified in law, including Code of Federal​ Regulations.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0135

FOOD IN HERMETICALLY SEALED CONTAINER; SOURCES. 3-201.12​

Food in a hermetically sealed container must be obtained from a food processing plant that is​ regulated by the food regulatory agency that has jurisdiction over the plant.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0140

FLUID MILK AND MILK PRODUCTS; SOURCES. 3-201.13​

Fluid milk and fluid milk products must be obtained from sources that comply with Grade A​ standards specified in Minnesota Statutes, chapter 32D.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0145

FISH. 3-201.14​

A. Fish that are received for sale or service must be:​ (1) commercially and legally caught or harvested as prescribed in chapters 1545 and​ 6200, Minnesota Statutes, section 31.11 and chapters 97A and 97C, and Code of Federal Regulations,​ title 21, section 123;P1 or​ (2) approved for sale or service.P1​ B. Molluscan shellfish that are recreationally caught must not be received for sale or​ service.P1​

49​

MINNESOTA RULES​

4626.0155​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0150

MOLLUSCAN SHELLFISH. 3-201.15​

A. Molluscan shellfish must be obtained from sources according to Code of Federal​ Regulations, title 21, section 123, and the requirements specified in the U.S. Department of Health​ and Human Services, Public Health Service, Food and Drug Administration, National Shellfish​ Sanitation Program Guide for the Control of Molluscan Shellfish. The guide is incorporated by​ reference and is available through the FDA website at​ www.fda.gov/downloads/Food/GuidanceRegulation/FederalStateFoodPrograms/UCM350004.pdf.​ The guide is not subject to frequent change.P1​ B. Molluscan shellfish received in interstate commerce must be from sources listed in the​ Interstate Certified Shellfish Shippers List. The list is incorporated by reference and is available​ t h r o u g h t h e F D A w e b s i t e a t ​ www.fda.gov/downloads/Food/GuidanceRegulation/FederalStateFoodPrograms/UCM2006753.htm.​ The list is subject to frequent change.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0155

WILD MUSHROOMS. 3-201.16​

A. All wild mushroom species served in a retail food establishment must be obtained from​ sources where each mushroom is individually inspected and found to be safe by a certified mushroom​ harvester, except as specified in item E.P1​ B. All wild mushroom species served in a retail food establishment must have a written​ buyer specification, except as specified in item E. The buyer shall retain the written buyer​ specification for 90 days from the date of sale or service. The written buyer specification must​ include all of the following information:​ (1) identification of each mushroom species by the scientific and common or usual​ name;P2​ (2) date of sale;P2​ (3) quantity by weight, fresh or dried, of each species sold;P2​ (4) a statement indicating that each mushroom was identified in its fresh state;P2​ (5) the name, address, and telephone number of the mushroom harvester;P2 and​ (6) verification that the seller is listed on the Minnesota Department of Agriculture's​ registry of wild mushroom harvesters.P2​

4626.0155​

MINNESOTA RULES​

50​

C. The mushroom harvester shall retain for 90 days all records of wild mushrooms sold to​ any retail food establishments. These records must include all of the following information:​ (1) identification of the mushrooms by the scientific and common name;P2​ (2) the country, state, and county location of harvest;P2​ (3) the date of harvest;P2​ (4) the names of the retail food establishments where wild mushrooms were sold;P2​ (5) the dates of sale;P2 and​ (6) the quantities by weight, fresh or dried, of each species sold.P2​ D. Except as specified in item E, any retail food establishment serving wild mushrooms​ must inform consumers of the risk of consuming wild mushrooms by way of a disclosure using​ brochures, deli case or menu advisories, table tents, placards, or other written means. A disclosure​ must include the statement: "Wild mushrooms are not an inspected product and are harvested from​ a noninspected site."P2​ E. This part does not apply to:​ (1) cultivated mushroom species that are grown, harvested, and processed in an operation​ that is licensed and inspected by a food regulatory agency; and​ (2) wild mushrooms that are packaged and are the product of a processing plant that is​ licensed and inspected by a food regulatory agency.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0156 CERTIFIED WILD MUSHROOM HARVESTER.​ A. A certified wild mushroom harvester shall have successfully completed a wild mushroom​ identification training program provided by an accredited college or university or state mycological​ society. The training program must include a component of actual identification of physical​ specimens of mushroom species.​ B. A document must be issued by an accredited college or accredited university or​ mycological society certifying the mushroom harvester's successful completion of the wild mushroom​ identification course and specifying the species of wild mushroom the harvester is qualified to​ identify.​ C. The mushroom harvester shall submit the document identified in item B to the Department​ of Agriculture.​

​

51​

MINNESOTA RULES​

4626.0160​

D. A wild mushroom harvester's certification documents will be verified by the Minnesota​ Department of Agriculture. The Minnesota Department of Agriculture shall maintain these documents​ on file and maintain a registry of all wild mushroom harvesters.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0160

GAME ANIMALS. 3-201.17​

A. Game animals commercially raised for food must be raised, slaughtered, and processed​ under an inspection program that is conducted by the USDA under Code of Federal Regulations,​ title 9, part 352, or the Minnesota Department of Agriculture under Minnesota Statutes, section​ 17.452, subdivision 8.P1​ B. Exotic species of animals, including animals raised for exhibition purposes in a zoo or​ circus, must:​ (1) comply with item A, or receive antemortem and postmortem examination by a​ veterinarian or a veterinarian's designee, approved by the regulatory authority;P1 and​ (2) be slaughtered and processed according to Minnesota Statutes, chapters 31 and 31A,​ and rules adopted thereunder governing meat and poultry as determined by the USDA as specified​ in Code of Federal Regulations, title 9, or under laws and rules of another state that are equivalent​ to the Minnesota laws and rules specified in this part.P1​ C. Wild animals lawfully taken and donated according to part 6230.1500 and Minnesota​ Statutes, section 97A.505, and donated to a charitable organization registered under Minnesota​ Statutes, chapter 309, are approved if:​ (1) only pure wild animals are donated;P1​ (2) the intact animal is properly cleaned, stored, and processed in an establishment that​ complies with chapters 1540 and 1545, and Minnesota Statutes, chapters 28A, 31, 31A, and 157,​ as those rules and laws relate to the licensing, processing, and storage of food;P1​ (3) evisceration was accomplished within 2 hours after harvest;P1 and​ (4) a written sanitation standard operating procedure that includes the entire process​ used to eliminate the possibility of cross-contamination from wild animal processing to retail​ products is implemented and available for inspection.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.0165​ 4626.0165

MINNESOTA RULES​

52​

FOOD TEMPERATURES; RECEIVING. 3-202.11​

A. Except as specified in items B and C, refrigerated TCS food must be at a temperature​ of 41 degrees F (5 degrees C) or below when received.P1​ B. If a temperature other than 41 degrees F (5 degrees C) for a TCS food is specified in​ law governing its distribution, such as laws governing milk and molluscan shellfish, the food may​ be received at the specified temperature.​ C. Raw eggs must be received in refrigerated equipment that maintains an ambient air​ temperature of 45 degrees F (7 degrees C) or less.P1​ D. TCS food that has been cooked to a temperature and for a time specified in parts​ 4626.0340 and 4626.0347 and received hot must be at a temperature of 135 degrees F (57 degrees​ C) or above.P1​ E. A food that is labeled frozen and shipped frozen by a food processing plant must be​ received frozen.P2​ F. Upon receipt, TCS food must be free of evidence of previous temperature abuse.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0170

FOOD ADDITIVES. 3-202.12​

Food must not contain:​ A. unapproved food additives or additives that exceed amounts specified in Code of Federal​ Regulations, title 21, parts 170 to 180;​ B. generally recognized as safe or prior sanctioned substances that exceed amounts specified​ in Code of Federal Regulations, title 21, parts 181 to 186;​ C. substances that exceed amounts specified in Code of Federal Regulations, title 9, subpart​ C, section 424.21 (b); or​ D. pesticide residues that exceed provisions specified in Code of Federal Regulations, title​ 40, part 180.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0175

EGGS. 3-202.13​

Eggs must be received clean and sound and:​

53​

MINNESOTA RULES​

4626.0190​

A. must not exceed the restricted egg tolerances for U.S. Consumer Grade B specified in​ U.S. Standards, Grades, and Weight Classes for Shell Eggs, AMS 56.200 et seq., maintained by​ the Agricultural Marketing Service (AMS) of the USDA, which is incorporated by reference, is​ not subject to frequent change, and is available through the AMS, USDA at​ www.ams.usda.gov/sites/default/files/media/Shell_Egg_Standard[1].pdf;P1and​ B. comply with parts 1520.1200 to 1520.2000 and Minnesota Statutes, chapter 29.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0177 EGG AND MILK PRODUCTS; PASTEURIZED. 3-202.14​ A. Egg products must be obtained pasteurized.P1​ B. Fluid and dry milk and milk products must be obtained pasteurized as specified in​ Minnesota Statutes, chapter 32D, and comply with standards as specified in Minnesota Statutes,​ chapter 32D.P1​ C. Frozen milk products, such as ice cream, must be obtained pasteurized as specified in​ Code of Federal Regulations, title 21, part 135, and must comply with Minnesota Statutes, chapter​ 32D.P1​ D. Cheese must be obtained pasteurized unless alternative procedures to pasteurization are​ specified in Code of Federal Regulations, title 21, part 133, and Minnesota Statutes, section 32D.22.P1​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0180 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0185 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0190

PACKAGE INTEGRITY. 3-202.15​

Food packages must be in good condition and protect the integrity of the contents so that the​ food is not exposed to adulteration or potential contaminants.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.0195​ 4626.0195

MINNESOTA RULES​

54​

ICE. 3-202.16​

Ice for use as a food or a cooling medium must be made from drinking water.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0200

SHUCKED SHELLFISH; PACKAGING AND IDENTIFICATION. 3-202.17​

A. Raw shucked shellfish must be obtained in nonreturnable packages that bear a legible​ label that identifies:P2​ (1) the name, address, and certification number of the shucker-packer or repacker of​ the molluscan shellfish;P2 and​ (2) the "sell by" or "best if used by" date for packages with a capacity of less than 1/2​ gallon (1.89 liter) or the date shucked for packages with a capacity of 1/2 gallon (1.89 liter) or​ more.P2​ B. A package of raw shucked shellfish that does not bear a label or that bears a label that​ does not contain all the information specified in item A must be subject to a hold order as allowed​

by Minnesota Statutes, section 34A.11, or seizure and destruction according to Code of Federal​ Regulations, title 21, subpart D, section 1240.60, paragraph (d).​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0202 SHELLSTOCK IDENTIFICATION. 3-202.18​ A. Shellstock must be obtained in containers bearing legible source identification tags or​ labels that are affixed by the harvester or dealer that depurates, ships, or reships the shellstock, as​ specified in the National Shellfish Sanitation Program Guide for the Control of Molluscan Shellfish​ which is incorporated by reference, is subject to frequent change, and can be found at​ www.fda.gov/Food/GuidanceRegulation/FederalStateFoodPrograms/​ ucm2006754.htm, and that list:P2​ (1) except as specified in item C, on the harvester's tag or label, the following information​ in the following order:P2​ (a) the harvester's identification number that is assigned by the shellfish control​ authority;P2​ (b) the date of harvesting;P2​ (c) the most precise identification of the harvest location or aquaculture site that is​ practicable based on the system of harvest area designations that is in use by the shellfish control​

55​

MINNESOTA RULES​

4626.0210​

authority and including the abbreviation of the name of the state or country in which the shellfish​ are harvested;P2​ (d) the type and quantity of shellfish;P2 and​ (e) the following statement in bold, capitalized type: "THIS TAG OR LABEL IS​ REQUIRED TO BE ATTACHED UNTIL CONTAINER IS EMPTY OR RETAGGED OR​ RELABELED AND THEREAFTER KEPT ON FILE FOR 90 DAYS.";P2and​ (2) except as specified in item D, on each dealer's tag or label, the following information​ in the following order:P2​ (a) the dealer's name and address and the certification number assigned by the​ shellfish control authority;P2​ (b) the original shipper's certification number including the abbreviation of the​ name of the state or country in which the shellfish are harvested;P2​ (c) the same information as specified for a harvester's tag under subitem (1), units​ (b) to (d);P2 and​ (d) the following statement in bold, capitalized type: "THIS TAG OR LABEL IS​ REQUIRED TO BE ATTACHED UNTIL CONTAINER IS EMPTY AND THEREAFTER KEPT​ ON FILE FOR 90 DAYS."P2​ B. A container of shellstock that does not bear a tag or label or that bears a tag or label that​ does not contain all the information specified in item A must be subject to a hold order as allowed​

by Minnesota Statutes, section 34A.11, or seizure and destruction according to Code of Federal​ Regulations, title 21, subpart D, section 1240.60, paragraph (d).​ C. If a place is provided on the harvester's tag or label for a dealer's name, address, and​ certification number, the dealer's information must be listed first.​ D. If the harvester's tag or label is designed to accommodate each dealer's identification as​ specified in item A, subitem (2), units (a) and (b), individual dealer tags or labels need not be​ provided.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0205 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0210

SHELLSTOCK; CONDITION. 3-202.19​

When received by a food establishment, shellstock must be reasonably free of mud, dead​ shellfish, and shellfish with broken shells. Dead shellfish or shellstock with badly broken shells​ must be discarded.​

​

4626.0210​

MINNESOTA RULES​

56​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0215 MOLLUSCAN SHELLFISH AND SHELLSTOCK; ORIGINAL CONTAINER.​ 3-203.11​ A. Except as specified in items B to D, molluscan shellfish must not be removed from the​ container in which they were received other than immediately before sale or preparation for service.​ B. For display purposes, shellstock may be removed from the container in which they were​ received, displayed on drained ice, or held in a display container, and a quantity specified by a​ consumer may be removed from the display or display container and provided to the consumer if:​ (1) the source of the shellstock on display is identified as specified in part 4626.0202​ and recorded as specified in part 4626.0220; and​ (2) the shellstock are protected from contamination.​ C. Shucked shellfish may be removed from the container in which they were received and​ held in a display container from which individual servings are dispensed upon a consumer's request​ if:​ (1) the labeling information for the shellfish on display specified in part 4626.0200 is​ retained and correlated to the date when, or dates during which, the shellfish are sold or served;​ and​ (2) the shellfish are protected from contamination.​ D. Shucked shellfish may be removed from the container in which they were received and​ repacked in consumer self-service containers where allowed by law if:​ (1) the labeling information for the shellfish is on each consumer self-service container​ as specified in parts 4626.0200 and 4626.0435, items A and B, subitems (1) to (5);​ (2) the labeling information specified in part 4626.0200 is retained and correlated with​ the date when, or dates during which, the shellfish are sold or served;​ (3) the labeling information and dates specified in subitem (2) are maintained for 90​ days; and​ (4) the shellfish are protected from contamination.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

57​

MINNESOTA RULES​

4626.0220

4626.0225​

SHELLSTOCK; MAINTAINING IDENTIFICATION. 3-203.12​

A. Except as specified in item C, subitem (3), shellstock tags or labels must remain attached​ to the container in which the shellstock are received until the container is empty.P2​ B. The date when the last shellstock from the container is sold or served must be recorded​ on the tag or label.P2​ C. The identity of the source of shellstock that are sold or served must be maintained:​ (1) by retaining shellstock tags or labels for 90 calendar days from the date that is​ recorded on the tag or label as specified in item B;P2​ (2) using a record-keeping system that keeps the tags or labels in chronological order​ correlated to the date that is recorded on the tag or label as specified in item B;P2and​ (3) if shellstock are removed from their tagged or labeled container:​ (a) preserving source identification by using a record-keeping system specified in​ subitem (1);P2 and​ (b) ensuring that shellstock from 1 tagged or labeled container are not commingled​ with shellstock from another container with different certification numbers, different harvest dates,​ or different growing areas identified on the tag or label before being ordered by the consumer.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ PROTECTION FROM CONTAMINATION​ 4626.0225

PREVENTING CONTAMINATION FROM HANDS (ALSO SEE PART​ 4626.0070). 3-301.11​

A. Except when washing fruits and vegetables as specified in items C and D or part​ 4626.0255, food employees shall not contact exposed, ready-to-eat food with their bare hands and​ shall use suitable utensils such as deli tissue, spatulas, tongs, single-use gloves, or dispensing​ equipment as specified in part 4626.0255, items C and D.P1​ B. Food employees shall minimize bare hand and arm contact with exposed food that is​ not in a ready-to-eat form.P2​ C. Item A does not apply to a food employee who contacts exposed, ready-to-eat food with​ bare hands at the time the ready-to-eat food is being added as an ingredient to a food that:​ (1) contains a raw animal food and is to be cooked in the food establishment to heat all​ parts of the food to the minimum temperatures and times specified in part 4626.0340, items A and​ B, or 4626.0345; or​

​

4626.0225​

MINNESOTA RULES​

58​

(2) does not contain a raw animal food but is to be cooked in the food establishment to​ heat all parts of the food to a temperature of at least 145 degrees F (63 degrees C).​ D. Food employees not serving a highly susceptible population may contact exposed,​ ready-to-eat food with their bare hands if written procedures are maintained in the food establishment​ and made available to the regulatory authority upon request that include:​ (1) for each bare hand food-contact procedure, a listing of the specific ready-to-eat​ foods that are touched by bare hands;​ (2) a written employee health policy that details how the food establishment complies​ with parts 4626.0040, 4626.0045, and 4626.0050 including:​ (a) documentation that food employees and conditional employees acknowledge​ that they are informed to report information about their health and activities as they relate to​ gastrointestinal symptoms and diseases that are transmittable through food as specified under part​ 4626.0040, item A;​ (b) documentation that food employees and conditional employees acknowledge​ their responsibilities to comply with exclusion and restriction as specified under part 4626.0040,​ item E; and​ (c) documentation that the person in charge acknowledges the responsibilities as​ specified under parts 4626.0040, items B, C, and D; 4626.0045; and 4626.0050;​ (3) documentation that food employees acknowledge that they have received training​ in:​ (a) the risks to the consumer that are created when employees contact ready-to-eat​ foods with bare hands;​ (b) proper handwashing as specified under part 4626.0070;​ (c) when to wash their hands as specified under part 4626.0075;​ (d) where to wash their hands as specified under part 4626.0080;​ (e) proper fingernail maintenance as specified under part 4626.0090;​ (f) prohibition of jewelry as specified under part 4626.0095; and​ (g) good hygienic practices as specified under parts 4626.0105 and 4626.0110;​ (4) documentation that food employees contacting ready-to-eat food with bare hands​ use two or more of the following control measures to provide additional safeguards to hazards​ associated with bare hand contact:​ (a) double handwashing;​ (b) nail brushes;​

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4626.0235​

(c) a hand antiseptic after handwashing as specified under part 4626.0085;​ (d) incentive programs such as paid sick leave that assist or encourage food​ employees not to work when they are ill; or​ (e) other control measures approved by the regulatory authority; and​ (5) documentation that corrective action is taken when requirements in this section are​ not followed.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0230

PREVENTING CONTAMINATION WHEN TASTING. 3-301.12​

A food employee shall not use a utensil more than once to taste food that is to be sold or served.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0235

PREVENTING CROSS-CONTAMINATION. 3-302.11​

A. Food must be protected from cross-contamination by:​ (1) except as specified in unit (c), separating raw animal foods during storage,​ preparation, holding, and display from:​ (a) raw ready-to-eat food including other raw animal food such as fish for sushi, or​ molluscan shellfish, or other raw ready-to-eat food such as fruits and vegetables;P1​ (b) cooked ready-to-eat food;P1 and​ (c) frozen, commercially processed and packaged raw animal food that is stored or​ displayed with or above frozen, commercially processed and packaged, ready-to-eat food;​ (2) except when combined as ingredients, separating types of raw animal foods from​ each other such as beef, fish, lamb, pork, and poultry during storage, preparation, holding, and​ display by:​ (a) using separate equipment for each type of food;P1 or​ (b) arranging each type of food in equipment so that cross-contamination of one​ type with another is prevented;P1 and​ (c) preparing each type of food at different times or in separate areas;P1​ (3) cleaning equipment and utensils as specified in part 4626.0845, item A, and sanitizing​ as specified in part 4626.0905;​

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60​

(4) storing the food in packages, covered containers, or wrappings, except as specified​ in item B;​ (5) cleaning hermetically sealed containers of food of visible soil before opening;​ (6) protecting food containers that are received packaged together in a case or overwrap​ from cuts when the case or overwrap is opened;​ (7) storing damaged, spoiled, or recalled food being held in the food establishment as​ specified in part 4626.1505; and​ (8) separating fruits and vegetables, before they are washed as specified in part​ 4626.0255, from ready-to-eat food.​ B. Item A, subitem (4), does not apply to:​ (1) whole, uncut, raw fruits and vegetables and nuts in the shell that require peeling or​ hulling before consumption;​ (2) primal cuts, quarters, or sides of raw meat or slab bacon that are hung on clean,​ sanitized hooks or placed on clean, sanitized racks;​ (3) whole, uncut, processed meats such as country hams and smoked or cured sausages​ that are placed on clean, sanitized racks;​ (4) food being cooled as specified in part 4626.0390, item B, subitem (2); or​ (5) shellstock.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0240 FOOD STORAGE CONTAINERS IDENTIFIED WITH COMMON NAME OF​ FOOD. 3-302.12​ Working containers holding food or food ingredients that are removed from their original​ packages for use in the food establishment, such as cooking oils, flour, herbs, potato flakes, salt,​ spices, and sugar must be identified with the common name of the food except that containers​ holding food that can be readily and unmistakably recognized, including dry pasta, need not be​ identified. The identification must be in English and any other language used by the employees of​ the food establishment who handle food.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

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4626.0245

4626.0255​

PASTEURIZED EGGS; SUBSTITUTE FOR RAW EGGS. 3-302.13​

Pasteurized eggs or egg products must be substituted for raw eggs in the preparation of food​ such as Caesar salad, hollandaise or Bearnaise sauce, mayonnaise, meringue, eggnog, ice cream,​ and egg-fortified beverages that are not:​ A. cooked as specified in part 4626.0340, item A, subitem (1) or (2);P1 or​ B. included in part 4626.0340, item D, subitem (1).P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0250

PROTECTION FROM UNAPPROVED ADDITIVES. (SEE ALSO 4626.0170)​ 3-302.14​

A. Food must be protected from contamination that may result from the addition of:​ (1) unsafe or unapproved food or color additives;P1 and​ (2) unsafe or unapproved levels of approved food and color additives.P1​ B. A food employee shall not:​ (1) apply sulfiting agents to fresh fruits and vegetables intended for raw consumption​ or to a food considered to be a good source of B1 vitamin;P1 or​ (2) serve or sell food specified in subitem (1) that is treated with sulfiting agents before​ receipt by the food establishment, except for grapes.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0255

WASHING FRUITS AND VEGETABLES. 3-302.15​

A. Raw fruits and vegetables must be thoroughly washed in water or by using chemicals​ specified in part 4626.1625 to remove soil and other contaminants before being cut, combined with​ other ingredients, cooked, served, or offered for human consumption in ready-to-eat form except​ for whole, raw fruits and vegetables that are intended for washing by the consumer before​ consumption.​ B. Devices used for on-site generation of chemicals meeting the requirements in Code of​ Federal Regulations, title 21, subpart D, section 173.315, for the washing of raw, whole fruits and​ vegetables must be used according to the manufacturer's instructions.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

4626.0255​

MINNESOTA RULES​

62​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0260

ICE USED AS EXTERIOR COOLANT; PROHIBITED AS INGREDIENT.​ 3-303.11​

Ice must not be used as a food after use as a medium for cooling the exterior surfaces of food​ such as melons or fish, packaged foods such as canned beverages, or cooling coils and tubes of​ equipment.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0265

FOOD IN CONTACT WITH WATER OR ICE. 3-303.12​

A. Packaged food must not be stored in direct contact with ice or water if the food is subject​ to the entry of water because of the nature of its packaging, wrapping, or container or its positioning​ in the ice or water.​ B. Bottled and canned beverages on retail display must not be stored in contact with water​ or undrained ice.​ C. Whole, raw fruits or vegetables; cut, raw vegetables such as celery, carrot sticks, and​ cut potatoes; and tofu may be immersed in ice or water.​ D. Raw poultry and raw fish that are received immersed in ice in shipping containers may​ remain in that condition while in storage awaiting preparation, display, service, or sale.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0270

FOOD CONTACT WITH EQUIPMENT AND UTENSILS. 3-304.11​

Food must only contact surfaces of:​ A. equipment and utensils that are cleaned as specified in parts 4626.0840 to 4626.0885​ and sanitized as specified in parts 4626.0900 and 4626.0905;P1​ B. single-service and single-use articles;P1 or​ C. linens such as cloth napkins specified in part 4626.0280 that are laundered as required​ by parts 4626.0910 to 4626.0930.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

63​

MINNESOTA RULES​

4626.0275

4626.0285​

IN-USE UTENSILS; BETWEEN-USE STORAGE. 3-304.12​

A. During pauses in food preparation or dispensing, food preparation and dispensing utensils​ must be stored:​ (1) except as specified in item B, in the food with the handles above the top of the food​ and the container;​ (2) in food that is not TCS food, with the handles above the top of the food within​ containers or equipment that can be closed, such as bins of sugar, flour, or cinnamon;​ (3) on a clean portion of the food preparation table or cooking equipment only if the​ in-use utensil and the food-contact surface of the food preparation table or cooking equipment are​ cleaned and sanitized at a frequency specified in parts 4626.0845 and 4626.0900;​ (4) in running water of sufficient velocity to flush particulates to the drain, if used with​ moist food such as ice cream, mashed potatoes, or cooked rice;​ (5) in a clean, protected location if the utensils, including ice scoops, are used only with​ a food that is not TCS food; or​ (6) in a container of water if the water is maintained at a temperature of at least 135​ degrees F (57 degrees C) and the container is cleaned at a frequency specified in part 4626.0845,​ item D.​ B. For consumer self-service of bulk food, a manual dispensing utensil must be stored as​ specified in Minnesota Statutes, section 31.84, subdivision 2.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0280 LINENS AND NAPKINS; USE LIMITATION. 3-304.13​ Linens such as cloth napkins must not be used in contact with food unless they are used to line​ a container for the service of foods and the linens and napkins are replaced each time the container​ is refilled for a new consumer.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0285

WIPING CLOTHS; USE LIMITATION. 3-304.14​

A. Cloths used for wiping food spills from tableware and carry-out containers that occur​ as food is being served must be maintained dry and used for no other purpose.​ B. Cloths used for wiping counters and other equipment surfaces must be:​

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64​

(1) held between uses in a chemical sanitizer solution at a concentration specified in​ part 4626.0805; and​ (2) laundered daily as specified in part 4626.0915, item D.​ C. Cloths used for wiping surfaces in contact with raw animal foods must be kept separate​ from cloths used for other purposes.​ D. Dry wiping cloths and the chemical sanitizing solutions specified in item B, subitem​ (1), in which wet wiping cloths are held between uses must be free of food debris and visible soil.​ E. Containers of chemical sanitizing solutions specified in item B, subitem (1), in which​ wet wiping cloths are held between uses must be stored and used in a manner that prevents​ contamination of food, equipment, utensils, linens, or single-service or single-use articles.​ F. Single-use disposable sanitizer wipes must be used according to U.S. Environmental​ Protection Agency-approved manufacturer's label use instructions.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0287

GLOVES; USE LIMITATION. 3-304.15​

A. If used, single-use gloves must be used for only 1 task such as working with ready-to-eat​ food or with raw animal food, used for no other purpose, and discarded when damaged or soiled,​ or when interruptions occur in the operation.P1​ B. Except as specified in item C, slash-resistant gloves that are used to protect the hands​ during operations requiring cutting must be used in direct contact only with food that is subsequently​ cooked as specified in parts 4626.0340 to 4626.0349, such as frozen food or a primal cut of meat.​ C. Slash-resistant gloves may be used with ready-to-eat food that will not be subsequently​ cooked if the slash-resistant gloves have a smooth, durable, and nonabsorbent outer surface; or if​ the slash-resistant gloves are covered with a smooth, durable, nonabsorbent glove, or a single-use​ glove.​ D. Cloth gloves must not be used in direct contact with food unless the food is subsequently​ cooked as required under parts 4626.0340 to 4626.0349, such as frozen food or a primal cut of​ meat.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

65​

MINNESOTA RULES​

4626.0290

4626.0295​

USING CLEAN TABLEWARE FOR SECOND PORTIONS AND REFILLS.​ 3-304.16​

A. Except for refilling a consumer's drinking cup or container without contact between the​ pouring utensil and the lip-contact area of the drinking cup or container, food employees shall not​ use tableware, including single-service articles soiled by the consumer to provide second portions​ or refills.​ B. Except as specified in item C, self-service consumers shall not be allowed to use soiled​ tableware, including single-service articles to obtain additional food from the display and serving​ equipment.​ C. Drinking cups and containers may be reused by self-service consumers if refilling is a​ contamination-free process as specified in part 4626.0575, items A, B, and D.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0295

REFILLING RETURNABLES. 3-304.17​

A. Except as specified in this part, empty containers returned to a food establishment for​ cleaning and refilling with food must be cleaned and refilled in a regulated food processing plant.P1​ B. A take-home food container returned to a food establishment may be refilled at a food​ establishment with food if the food container is:​ (1) designed and constructed for reuse and in accordance with the requirements specified​ under parts 4626.0450, 4626.0505, and 4626.0515;P1​ (2) one that was initially provided by the food establishment to the consumer, either​ empty or filled with food by the food establishment, for the purpose of being returned for reuse;​ and​ (3) subject to the following steps before being refilled with food:​ (a) cleaned as specified under parts 4626.0840 to 4626.0885;​ (b) sanitized as specified under parts 4626.0900 to 4626.0905;P1 and​ (c) visually inspected by a food employee to verify that the container, as returned,​ meets the requirements under parts 4626.0450 to 4626.0470, 4626.0490, and 4626.0515.P1​ C. A take-home food container returned to a food establishment may be refilled at a food​ establishment with a beverage if:​ (1) the beverage is not TCS food;​ (2) the design of the container and of the rinsing equipment and the nature of the​ beverage, when considered together, allow effective cleaning at home or in the food establishment;​

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66​

(3) facilities for rinsing before refilling returned containers with fresh, hot water that​ is under pressure and not recirculated are provided as part of the dispensing system;​ (4) the consumer-owned container returned to the food establishment for refilling is​ refilled for sale or service only to the same consumer; and​ (5) the container is refilled by:​ (a) an employee of the food establishment; or​ (b) the owner of the container if the beverage system includes a contamination-free​ transfer process as specified under part 4626.0575, items A, B, and D, that cannot be bypassed by​ the container owner.​ D. Consumer-owned, personal take-out beverage containers, such as thermally insulated​ bottles, nonspill coffee cups, promotional beverage glasses, and vinegar and oil containers, may​ be refilled by employees or the consumer if refilling is a contamination-free process as specified​ under part 4626.0575, items A, B, and D.​ E. Consumer-owned containers that are not food-specific may be filled at a water vending​ machine or system.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0300

FOOD STORAGE. 3-305.11​

A. Except as specified in items B and C, food must be protected from contamination by​ storing the food:​ (1) in a clean, dry location;​ (2) where it is not exposed to splash, dust, or other contamination; and​ (3) at least 6 inches (15 cm) above the floor.​ B. Food in packages and working containers may be stored less than 6 inches (15 cm) above​ the floor on case lot handling equipment specified in part 4626.0665.​ C. Pressurized beverage containers, cased food in waterproof containers, such as bottles​ or cans, and milk containers in plastic crates may be stored on a floor that is clean and not exposed​ to floor moisture.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

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4626.0305

4626.0320​

FOOD STORAGE; PROHIBITED AREAS. 3-305.12​

Food must not be stored:​ A. in locker rooms;​ B. in toilet rooms;​ C. in dressing rooms;​ D. in garbage rooms;​ E. in mechanical rooms;​ F. under sewer lines that are not shielded to intercept potential drips;​ G. under leaking water lines, including leaking automatic fire sprinkler heads, or under​ lines on which water has condensed;​ H. under open stairwells; or​ I. under other sources of contamination.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0310

VENDED TCS FOOD; ORIGINAL CONTAINER. 3-305.13​

TCS food dispensed through a vending machine must be in the package in which it was placed​ at the food establishment or food processing plant at which it was prepared.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0315 UNPACKAGED FOOD; PROTECTION FROM CONTAMINATION. 3-305.14​ During preparation, unpackaged food must be protected from environmental sources of​ contamination.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0320

FOOD DISPLAY; PROTECTION FROM CONTAMINATION. 3-306.11​

A. Except for nuts in the shell and whole, raw fruits and vegetables that are intended for​ hulling, peeling, or washing by the consumer before consumption, food on display must be protected​

​

4626.0320​

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68​

from contamination by the use of packaging; counter, service line, or salad bar food guards; display​ cases; or other effective means.P1​ B. Food preparation and cooking areas must be protected by an impervious shield or by a​ separation distance to ensure customer safety and prevent food contamination by customers.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0325

CONDIMENTS; PROTECTION. 3-306.12​

A. Condiments must be protected from contamination by being kept in dispensers that are​ designed to provide protection, protected food displays provided with the proper utensils, original​ containers designed for dispensing, or individual packages or portions.​ B. Condiments at a vending machine location must be in individual packages or provided​ in dispensers that are filled at a location that is approved by the regulatory authority, such as the​ food establishment that provides food to the vending machine location, a food processing plant that​ is regulated by the agency that has jurisdiction over the operation, or a properly equipped facility​ that is located on the site of the vending machine location.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0330

CONSUMER SELF-SERVICE OPERATIONS. 3-306.13​

A. Raw, unpackaged animal food, such as beef, lamb, pork, poultry, and fish, must not be​ offered for consumer self-service.P1 This item does not apply to:​ (1) consumer self-service of ready-to-eat foods at buffets or salad bars that serve foods​ such as sushi or raw shellfish;​ (2) ready-to-cook individual portions for immediate cooking and consumption on the​ premises such as consumer-cooked meats or consumer-selected ingredients for Mongolian barbecue;​ (3) raw, frozen, shell-on shrimp, or lobster; or​ (4) raw shell eggs.​ B. Consumer self-service operations for ready-to-eat foods must be provided with suitable​ utensils or effective dispensing methods that protect the food from contamination.P2​ C. Consumer self-service operations such as buffets and salad bars must be monitored by​ food employees trained in safe operating procedures.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

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4626.0340​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0335

RETURNED FOOD; RE-SERVICE OF FOOD. 3-306.14​

A. Except as specified in item B, after being served or sold and in the possession of a​ consumer, food that is unused or returned by the consumer must not be offered as food for human​ consumption.P1​ B. Except as specified in part 4626.0447, item G, a container of food that is not TCS food​ may be re-served from one consumer to another if:​ (1) the food is dispensed so that it is protected from contamination and the container​ is closed between uses, such as a narrow-neck bottle containing ketchup, steak sauce, or wine; or​ (2) the food, such as crackers, salt, or pepper, is in an unopened original package and​ is maintained in sound condition.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0337 MISCELLANEOUS SOURCES OF CONTAMINATION. 3-307.11​ Food must be protected from contamination that may result from a factor or source not specified​ in parts 4626.0225 to 4626.0335.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ DESTROYING ORGANISMS​ 4626.0340

COOKING RAW ANIMAL FOODS. 3-401.11​

A. Except as specified in items B to D, raw animal foods, such as eggs, fish, meat, poultry,​ and foods containing these raw animal foods, must be cooked to heat all parts of the food to a​ temperature and for a time that complies with one of the following methods based on the food that​ is being cooked:​ (1) 145 degrees F (63 degrees C) or above for 15 seconds for:P1​ (a) raw eggs that are broken and prepared in response to a consumer's order and for​ immediate service;P1 and​ (b) except as specified in subitems (2) and (3) and items B and C, fish and meat​ including game animals commercially raised for food as specified in part 4626.0160, item A, and​ game animals under a voluntary inspection program as specified in part 4626.0160, item A;P1​

​

4626.0340​

MINNESOTA RULES​

70​

(2) 155 degrees F (68 degrees C) or above for 15 seconds or the temperature specified​ in the following chart that corresponds to the holding time for ratites; mechanically tenderized and​ injected meats; the following if they are comminuted: fish, meat, game animals commercially raised​ for food as specified in part 4626.0160, item A, and game animals under a voluntary inspection​ program as specified in part 4626.0160, item A; and raw eggs that are not prepared as specified in​ subitem (1), unit (a):P1​ Minimum Temperature °F​ (°C)​

Time​

145 (63)​

3 minutes​

150 (66)​

1 minute​

158 (70)​

< 1 second (instantaneous); or​

(3) 165 degrees F (74 degrees C) or above for 15 seconds for poultry; baluts, wild​ animals as specified in part 4626.0160, item C; stuffed fish; stuffed meat; stuffed pasta; stuffed​ poultry; stuffed ratites; or stuffing containing fish, meat, poultry, or ratites.P1​ B. Whole meat roasts including beef, corned beef, lamb, pork, and cured pork roasts such​ as ham must be cooked:​ (1) in an oven that is preheated to the temperature specified for the roast's weight in the​ following chart and that is held at that temperature:P2​ Oven Type​

Oven Temperature Based on Roast Weight​ Less than 10 lbs (4.5 kg)​

10 lbs (4.5 kg) or more​

Still dry​

350°F (177°C) or more​

250°F (121°C) or more​

Convection​

325°F (163°C) or more​

250°F (121°C) or more​

High humidity1​

250°F (121°C) or less​

250°F (121°C) or less​

1

Relative humidity greater than 90 percent for at least 1 hour as measured in the cooking chamber​ or exit of the oven; or in a moisture-impermeable bag that provides 100 percent humidity.​ ; and​ (2) as specified in the following chart, to heat all parts of the food to a temperature and​ for the holding time that corresponds to that temperature:P1​ Temperature​ °F (°C)​ 130 (54.4)​

Time in​ Minutes*​ 112​

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MINNESOTA RULES​

4626.0340​

131 (55.0)​

89​

133 (56.1)​

56​

135 (57.2)​

36​

136 (57.8)​

28​

138 (58.9)​

18​

140 (60.0)​

12​

142 (61.1)​

8​

144 (62.2)​

5​

145 (62.8)​

4​

Temperature​ °F (°C)​

Time in​ Seconds*​

147 (63.9)​

134 seconds​

149 (65.0)​

85 seconds​

151 (66.1)​

54 seconds​

153 (67.2)​

34 seconds​

155 (68.3)​

22 seconds​

157 (69.4)​

14 seconds​

158 (70.0)​

0 seconds​

*Holding time may include postoven heat rise.​ C. A raw or undercooked whole-muscle, intact beef steak may be served or offered for sale​ in a ready-to-eat form if:​ (1) the food establishment serves a population that is not a highly susceptible population;​ (2) the steak is labeled to indicate that it is "whole-muscle, intact beef" as specified in​ part 4626.0130, item E; and​ (3) the steak is cooked on both the top and bottom to a surface temperature of 145​ degrees F (63 degrees C) or above and a cooked color change is achieved on all external surfaces.​ D. A raw animal food such as raw egg, raw fish, raw-marinated fish, raw molluscan shellfish,​ or steak tartare; or a partially cooked food such as lightly cooked fish, soft-cooked eggs, or rare​ meat other than whole-muscle, intact beef steaks as specified in item C, may be served or offered​ for sale upon consumer request or selection in a ready-to-eat form if:​

​

4626.0340​

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72​

(1) the food establishment serves a population that is not a highly susceptible population;​ (2) the food, if served or offered for service by consumer selection from a children's​ menu, does not contain comminuted meat;P2 and​ (3) the consumer is informed as specified in part 4626.0442 that to ensure its safety,​ the food should be cooked as specified in item A or B; or​ (4) the regulatory authority grants a variance from item A or B as specified in part​ 4626.1690 based on a HACCP plan that:​ (a) is submitted by the licensee and approved as specified in part 4626.1700;​ (b) documents scientific data or other information showing that a lesser time and​ temperature regimen results in a safe food; and​ (c) verifies that equipment and procedures for food preparation and training of food​ employees at the food establishment meet the conditions of the variance.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0345

MICROWAVE COOKING. 3-401.12​

Raw animal foods cooked in a microwave oven must be:​ A. rotated or stirred throughout or midway during cooking to compensate for uneven​ distribution of heat;​ B. covered to retain surface moisture;​ C. heated to a temperature of at least 165 degrees F (74 degrees C) in all parts of the food;P1​ and​ D. allowed to stand covered for 2 minutes after cooking to obtain temperature equilibrium.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0347 PLANT FOOD; COOKING FOR HOT HOLDING. 3-401.13​ Raw fruits and vegetables that are cooked for hot holding must be cooked to a temperature of​ 135 degrees F (57 degrees C).P2​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​

73​

MINNESOTA RULES​

4626.0350​

4626.0349 NONCONTINUOUS COOKING OF RAW ANIMAL FOODS. 3-401.14​ Raw animal foods that are cooked using a noncontinuous cooking process must be:​ A. subject to an initial heating process that is no longer than 60 minutes in duration;P1​ B. immediately after initial heating, cooled according to the time and temperature parameters​ for cooked TCS food in part 4626.0385, item A;P1​ C. after cooling, held frozen or cold, as specified for TCS food in part 4626.0395, item A,​ subitem (2);P1​ D. prior to sale or service, cooked using a process that heats all parts of the food to a​ temperature and for a time specified in part 4626.0340, items A to C;P1​ E. cooled according to the time and temperature parameters for cooked TCS food in part​ 4626.0385, item A, if not either hot held as specified in part 4626.0395, item A, served immediately,​ or held using time as a public health control as specified in part 4626.0408 after complete cooking;P1​ and​ F. prepared and stored according to written procedures that:​ (1) have obtained prior approval from the regulatory authority based on meeting the​ requirements of this part;P2​ (2) are maintained in the food establishment and are available to the regulatory authority​ upon request;P2​ (3) describe how the requirements in items A to E are to be monitored and documented​ by the licensee and the corrective actions to be taken if the requirements are not met;P2​ (4) describe how the foods, after initial heating, but prior to complete cooking, are to​ be marked or otherwise identified as foods that must be cooked as specified in item D prior to being​ offered for sale or service;P2 and​ (5) describe how the foods, after initial heating but prior to cooking are to be separated​ from ready-to-eat foods as specified in part 4626.0235, item A.P2​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0350

PARASITE DESTRUCTION. 3-402.11​

A. Except as specified in item B, before service or sale in ready-to-eat form, raw,​ raw-marinated, partially cooked, or marinated-partially cooked fish must be:​ (1) frozen and stored at a temperature of -4 degrees F (-20 degrees C) or below for a​ minimum of 168 hours (7 days) in a freezer;P1​

​

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74​

(2) frozen at -31 degrees F (-35 degrees C) or below until solid and stored at -31 degrees​ F (-35 degrees C) or below for a minimum of 15 hours;P1 or​ (3) frozen at -31 degrees F (-35 degrees C) or below until solid and stored at -4 degrees​ F (-20 degrees C) or below for a minimum of 24 hours.P1​ B. Item A does not apply to:​ (1) molluscan shellfish;​ (2) a scallop product consisting only of the shucked adductor muscle;​ (3) tuna of the species Thunnus alalunga, Thunnus albacares (Yellowfin tuna), Thunnus​ atlanticus, Thunnus maccoyii (Bluefin tuna, Southern), Thunnus obesus (Bigeye tuna), or Thunnus​ thynnus (Bluefin tuna, Northern);​ (4) aquacultured fish, such as salmon, that:​ (a) if raised in open water, are raised in net-pens; or​ (b) are raised in land-based operations such as ponds or tanks; and​ (c) are fed formulated feed, such as pellets, that contains no live parasites infective​ to the aquacultured fish; or​ (5) fish eggs that have been removed from the skein and rinsed.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0355

PARASITE DESTRUCTION; RECORDS. 3-402.12​

A. Except as specified in item B, and part 4626.0350, item B, if raw, raw-marinated, partially​ cooked, or marinated-partially cooked fish are served or sold in ready-to-eat form, the person in​ charge shall record the freezing temperature and time to which the fish are subjected and shall retain​ the records at the food establishment for 90 calendar days beyond the time of service or sale of the​ fish.P2​ B. If the fish are frozen by a supplier, a written agreement or statement from the supplier​ stipulating that the fish supplied are frozen to a temperature and for a time specified in part 4626.0350​ may substitute for the records specified in item A.​ C. If raw, raw-marinated, partially cooked, or marinated-partially cooked fish are served​ or sold in ready-to-eat form, and the fish are raised and fed as specified in part 4626.0350, item B,​ subitem (4), a written agreement or statement from the supplier or aquaculturist stipulating that the​ fish were raised and fed as specified in part 4626.0350, item B, subitem (4), must be obtained by​ the person in charge and retained in the records of the food establishment for 90 calendar days​ beyond the time of service or sale of the fish.P2​

​

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4626.0367​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0357 FOODS PREPARED FOR IMMEDIATE SERVICE. 3-403.10​ Cooked and refrigerated food that is prepared for immediate service in response to an individual​ consumer order, such as a roast beef sandwich au jus, may be served at any temperature.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0360

REHEATING FOR HOT HOLDING. 3-403.11​

A. Except as specified in items B, C, and E, TCS food that is cooked, cooled, and reheated​ for hot holding must be reheated so that all parts of the food reach a temperature of at least 165​ degrees F (74 degrees C) for 15 seconds.P1​ B. Except as specified in item C, TCS food reheated in a microwave oven for hot holding​ must be reheated so that all parts of the food reach a temperature of at least 165 degrees F (74​ degrees C) and the food is rotated or stirred, covered, and allowed to stand covered for 2 minutes​ after reheating.P1​ C. Ready-to-eat TCS food that has been commercially processed, and packaged in a food​ processing plant that is inspected by the food regulatory authority that has jurisdiction over the​ plant, must be heated to a temperature of at least 135 degrees F (57 degrees C) when being reheated​ for hot holding.P1​ D. Reheating for hot holding as specified in items A to C must be done rapidly and the​ time the food is between 41 degrees F (5 degrees C) and the temperatures specified in items A to​ C must not exceed 2 hours.P1​ E. Remaining unsliced portions of meat roasts that are cooked as specified in part 4626.0340,​ item B, may be reheated for hot holding using the oven parameters and minimum time and​ temperature conditions specified in part 4626.0340, item B.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0365 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0367 TREATING JUICE. 3-404.11​ Juice packaged in a food establishment must be:​

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76​

A. treated under a HACCP plan as specified in parts 4626.1730 to 4626.1735 to attain a​ 5-log reduction, which is equal to a 99.999 percent reduction, of the most resistant microorganism​ of public health significance;P1 or​ B. labeled, if not treated to yield a 5-log reduction of the most resistant microorganism of​ public health significance:​ (1) as specified in part 4626.0435;P2 and​ (2) as specified in Code of Federal Regulations, title 21, section 101.17 (g). Juices that​ have not been specifically processed to prevent, reduce, or eliminate the presence of pathogens​ must be labeled with the following: "WARNING: This product has not been pasteurized and,​ therefore, may contain harmful bacteria that can cause serious illness in children, the elderly, and​ persons with weakened immune systems."P2​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0368 JUICE; TREATED. 3-202.110​ Prepackaged juice must:​ A. be obtained from a processor with a HACCP system as specified in Code of Federal​ Regulations, title 21, part 120;P2 and​ B. be obtained pasteurized or otherwise treated to attain a 5-log reduction of the most​ resistant microorganism of public health significance as specified in Code of Federal Regulations,​ title 21, subpart B, section 120.24.P1​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0370

FROZEN FOOD. 3-501.11​

Stored frozen foods must be maintained frozen.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0375 SLACKING TCS FOOD. 3-501.12​ Frozen TCS food that is slacked to moderate the temperature must be held:​ A. under mechanical refrigeration that maintains the food temperature at 41 degrees F (5​ degrees C) or less; or​

77​

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4626.0380​

B. at any temperature if the food remains frozen.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0380

THAWING. 3-501.13​

A. Except as specified in item subitem (4), TCS food must be thawed:​ (1) under mechanical refrigeration that maintains the food temperature at 41 degrees F​ (5 degrees C) or less;​ (2) completely submerged under running water:​ (a) at a water temperature of 70 degrees F (21 degrees C) or less;​ (b) with sufficient water velocity to agitate and float off loose particles in an​ overflow; and​ (c) for a period of time that does not allow thawed portions of ready-to-eat food to​ rise above 41 degrees F (5 degrees C); or​ (d) for a period of time that does not allow thawed portions of a raw animal food​ requiring cooking as specified in part 4626.0340, items A and B, to be above 41 degrees F (5 degrees​ C) for more than 4 hours including:​ i. the time the food is exposed to the running water and the time needed for​ preparation for cooking; or​ ii. the time it takes under mechanical refrigeration to lower the food temperature​ to 41 degrees F (5 degrees C);​ (3) as part of a cooking process if the food that is frozen is:​ (a) cooked as specified in part 4626.0340, items A and B, or 4626.0345; or​ (b) thawed in a microwave oven and immediately transferred to conventional cooking​ equipment, with no interruption in the process; or​ (4) using any procedure if a portion of frozen ready-to-eat food is thawed and prepared​ for immediate service in response to an individual consumer's order.​ B. Reduced oxygen packaged fish that bears a label indicating that it is to be kept frozen​ until time of use must be removed from the reduced oxygen environment:​ (1) prior to thawing under refrigeration as specified in item A, subitem (1); or​ (2) prior to, or immediately upon, completion of thawing using procedures specified​ in item A, subitem (2).​

4626.0380​

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78​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0385

COOLING REQUIREMENTS. 3-501.14​

A. Cooked TCS food must be cooled:​ (1) within 2 hours from 135 degrees F (57 degrees C) to 70 degrees F (21 degrees C);P1​ and​ (2) within a total of 6 hours from 135 degrees F (57 degrees C) to 41 degrees F (5​ degrees C) or less.P1​ B. TCS food must be cooled within 4 hours to 41 degrees F (5 degrees C) or less, if prepared​ from ingredients at ambient temperature, such as reconstituted foods and canned tuna.P1​ C. Except as specified in item D, TCS food received in compliance with laws allowing a​ temperature above 41 degrees F (5 degrees C) during shipment from the supplier as specified in​ part 4626.0165, item B, must be cooled within 4 hours to 41 degrees F (5 degrees C) or less.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0390

COOLING METHODS. 3-501.15​

A. Cooling must be accomplished according to the time and temperature criteria in part​ 4626.0385 by using one or more of the following methods based on the type of food being cooled:​ (1) placing the food in shallow pans;P2​ (2) separating the food into smaller or thinner portions;P2​ (3) using rapid cooling equipment;P2​ (4) stirring the food in a container placed in an ice water bath;P2​ (5) using containers that facilitate heat transfer;P2​ (6) adding ice as an ingredient;P2 or​ (7) other effective methods.P2​ B. When placed in cooling or cold holding equipment, food containers in which food is​ being cooled must be:​ (1) arranged in the equipment to provide maximum heat transfer through the container​ walls; and​

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4626.0400​

(2) loosely covered or uncovered if protected from overhead contamination as specified​ in part 4626.0300, item A, subitem (2), during the cooling period to facilitate heat transfer from​ the surface of the food.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0395 TCS FOOD; HOT AND COLD HOLDING. 3-501.16​ A. Except during preparation, cooking, or cooling, or when time is used as the public health​ control as specified in part 4626.0408, and except as specified in items B and C, TCS food must​ be maintained:​ (1) at 135 degrees F (57 degrees C) or above, except that roasts cooked to a temperature​ and for a time specified in part 4626.0340, item B, or reheated as specified in part 4626.0360, item​ E, may be held at a temperature of 130 degrees F (54 degrees C) or above;P1 or​ (2) at 41 degrees F (5 degrees C) or below under mechanical refrigeration.P1​ B. Eggs that have not been treated to destroy all viable Salmonellae must be stored in​ refrigerated equipment that maintains an ambient air temperature of 45 degrees F (7 degrees C) or​ less.P1​ C. TCS food in a homogenous liquid form may be maintained outside of the temperature​ control requirements, as specified in item A, while contained within specially designed equipment​ that complies with the design and construction requirements in part 4626.0575, item E.​ D. For a special event food stand, delivery vehicle, retail food vehicle, portable structure,​ or cart, dry ice or cold packs may be substituted for mechanical refrigeration required in this part​ and part 4626.0375 if the temperatures in parts 4626.0370 to 4626.0420 are maintained. Mechanical​ refrigeration must be provided for TCS foods held for 4 hours or longer.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0400

DATE MARKING; READY-TO-EAT TCS FOOD. 3-501.17​

A. (1) This part does not apply to items E and F or to food packaged using a reduced oxygen​ packaging method as specified in part 4626.0420.​ (2) Refrigerated, ready-to-eat TCS food prepared and held in a food establishment for​ more than 24 hours must be clearly marked using an effective method to indicate the day or date​ by which the food must be consumed on the premises, sold, or discarded, which is 7 calendar days​ or less from the date of preparation. The date of the preparation must be counted as day 1.P2​

​

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80​

B. Refrigerated, ready-to-eat TCS food prepared and packaged by a processing plant and​ opened and held for more than 24 hours must be clearly marked using an effective method to​ indicate the day or date by which the food must be consumed on the premises, sold, or discarded,​ which is 7 calendar days or less from the date the original container is opened;P2 and​ (1) the date the original container is opened in the food establishment must be counted​ as day 1;P2 and​ (2) the day or date marked by the food establishment must not exceed the manufacturer's​ use-by date.P2​ C. A refrigerated, ready-to-eat TCS food ingredient or a portion of a refrigerated, ready-to-eat​ TCS food that is subsequently combined with additional ingredients or portions of food must retain​ the date marking of the earliest-prepared or first-prepared ingredient.P2​ D. A date marking system that meets the criteria in items A and B may include:​ (1) using a method approved by the regulatory authority based on meeting the​ requirements of this part for refrigerated, ready-to-eat TCS food that is frequently rewrapped, such​ as lunchmeat or a roast, or for which date marking is impractical, such as soft-serve mix or milk​ in a dispensing machine;​ (2) marking the date or day of preparation, with a procedure to discard the food on or​ before the last date or day by which the food must be consumed on the premises, sold, or discarded​ as specified in item A;​ (3) marking the date or day the original container is opened in a food establishment,​ with a procedure to discard the food on or before the last date or day by which the food must be​ consumed on the premises, sold, or discarded as specified in item B; or​ (4) using calendar dates, days of the week, color-coded marks, or other effective marking​ methods, provided that the marking system is disclosed to the regulatory authority upon request.​ E. Items A and B do not apply to individual meal portions served or repackaged for sale​ from a bulk container upon a consumer's request.​ F. Items A and B do not apply to shellstock.​ G. Item B does not apply to the following foods prepared and packaged by a food processing​ plant inspected by a regulatory authority:​ (1) deli salads, such as ham salad, seafood salad, chicken salad, egg salad, pasta salad,​ potato salad, and macaroni salad, manufactured according to Code of Federal Regulations, title 21,​ part 110;​ (2) hard cheeses containing not more than 39 percent moisture such as cheddar, gruyere,​ parmesan reggiano, and romano, as defined in Code of Federal Regulations, title 21, part 133;​

​

81​

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4626.0408​

(3) semi-soft cheese containing more than 39 percent moisture, such as blue, edam,​ gorgonzola, gouda, and monterey jack, but not more than 50 percent moisture, as defined in Code​ of Federal Regulations, title 21, part 133;​ (4) cultured dairy products such as yogurt, sour cream, and buttermilk, as defined in​ Code of Federal Regulations, title 21, part 131;​ (5) preserved fish products, such as pickled herring and dried or salted cod, and other​ acidified fish products defined in Code of Federal Regulations, title 21, part 114;​ (6) shelf-stable, dry fermented sausages, such as pepperoni and Genoa salami; and​ (7) shelf-stable salt-cured products such as prosciutto and Parma (ham).​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0405

READY-TO-EAT, TCS FOOD; DISPOSITION. 3-501.18​

A. A food specified in part 4626.0400, item A or B, must be discarded if:​ (1) the time exceeds 7 days as specified in part 4626.0400, item A, except time that the​ product is frozen;P1 or​ (2) it is in a container or package that does not bear a date or day.P1​ B. Refrigerated, ready-to-eat TCS food prepared in a food establishment and dispensed​ through a refrigerated vending machine with an automatic shutoff control must be discarded if the​ time exceeds 7 days as specified in part 4626.0400, item A.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0408 TIME AS PUBLIC HEALTH CONTROL. 3-501.19​ A. Except as specified in item D, if time only, rather than in conjunction with temperature​ control, is used as the public health control for a working supply of TCS food before cooking, or​ for ready-to-eat TCS food that is displayed or held for sale or service, written procedures must be​ prepared in advance, maintained in the food establishment, and made available to the regulatory​ authority upon request that specify:P2​ (1) methods of compliance with item B, subitems (1) to (3), or C;P2 and​ (2) methods of compliance with part 4626.0385 for food that is prepared, cooked, and​ refrigerated before time is used as a public health control.P2​

4626.0408​

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82​

B. If time only, rather than in conjunction with temperature control, is used as the public​ health control up to a maximum of 4 hours:​ (1) the food must have an initial temperature of less than 41 degrees F (5 degrees C)​ or greater than 135 degrees F (57 degrees C) when it is removed from temperature control;P1​ (2) the food must be marked or otherwise identified to indicate the time that is 4 hours​ past the point in time when the food is removed from temperature control;P2​ (3) the food must be cooked and served, served at any temperature if ready-to-eat, or​ discarded within 4 hours from the point in time when the food is removed from temperature control;P1​ and​ (4) the food in unmarked containers or packages, or food marked to exceed a 4-hour​ limit, must be discarded.P1​ C. If time only, rather than in conjunction with temperature control, is used as the public​ health control up to a maximum of 6 hours:​ (1) the food must have an initial temperature of 41 degrees F (5 degrees C) or less when​ removed from temperature control and the food temperature must not exceed 70 degrees F (21​ degrees C) within a maximum time period of 6 hours;P1​ (2) the food must be monitored to ensure the warmest portion of the food does not​ exceed 70 degrees F (21 degrees C) during the 6-hour period;P2​ (3) the food must be marked or otherwise identified to indicate:P2​ (a) the time when the food is removed from 41 degrees F (5 degrees C) or less cold​ holding temperature control;P2 and​ (b) the time that is 6 hours past the time when the food is removed from cold holding​ temperature control;P2​ (4) the food must be:​ (a) discarded if the temperature of the food exceeds 70 degrees F (21 degrees C);P1​ or​ (b) cooked and served, served at any temperature if ready-to-eat, or discarded within​ a maximum of 6 hours from the time the food is removed from 41 degrees F (5 degrees C) or less​ cold holding temperature control;P1 and​ (5) the food in unmarked containers or packages, or marked with a time that exceeds​ the 6-hour limit, must be discarded.P1​ D. A food establishment that serves a highly susceptible population may not use time as​ specified in item A, B, or C as the public health control for raw eggs.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​

83​

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4626.0420​

History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0410 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0415

SPECIALIZED PROCESSING VARIANCE REQUIREMENTS. 3-502.11​

A food establishment must obtain a variance from the regulatory authority as specified in parts​ 4626.1690 to 4626.1700 before:​ A. smoking food as a method of food preservation rather than as a method of flavor​ enhancement;P2​ B. curing food;P2​ C. using food additives or adding components, such as vinegar:​ (1) as a method of food preservation rather than as a method of flavor enhancement;P2​ or​ (2) to render a food so that it is not TCS;P2​ D. packaging TCS food using a reduced oxygen packaging method except where the growth​ of and toxin formation by Clostridium botulinum and the growth of Listeria monocytogenes are​ controlled as specified in part 4626.0420;P2​ E. operating a molluscan shellfish life-support system display tank used to store and display​ shellfish that are offered for human consumption;P2​ F. custom processing game animals that are for personal use as food and not for sale or​ service in a food establishment and not under USDA or "state equal to" inspections;P2​ G. sprouting seeds or beans;P2 or​ H. preparing food by any method that is not in compliance with this Code.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0420

REDUCED OXYGEN PACKAGING WITHOUT A VARIANCE; CRITERIA.​ 3-502.12​

A. Except for a food establishment that obtains a variance as specified in part 4626.0415,​ a food establishment that packages TCS food using a reduced oxygen packaging method must​ control the growth and toxin formation of Clostridium botulinum and the growth of Listeria​ monocytogenes.P1​

​

4626.0420​

MINNESOTA RULES​

84​

B. Except as specified in item F, a food establishment that packages TCS food using a​ reduced oxygen packaging method must have a HACCP plan that contains the information in part​ 4626.1735 and that:P2​ (1) identifies the food to be packaged;P2​ (2) except as specified in items C to E, requires that the packaged food must be​ maintained at 41 degrees F (5 degrees C) or less and meet at least 1 of the following criteria:P2​ (a) has an aw of 0.91 or less;P2​ (b) has a pH of 4.6 or less;P2​ (c) is a meat or poultry product cured at a food processing plant regulated by the​ USDA using substances specified in Code of Federal Regulations, title 9, subpart C, section 424.21,​ and is received in an intact package;P2 or​ (d) is a food with a high level of competing organisms such as raw meat, raw poultry,​ or raw vegetables;P2​ (3) describes how the package must be prominently and conspicuously labeled on the​ principal display panel in bold type on a contrasting background, with instructions to:P2​ (a) maintain the food at 41 degrees F (5 degrees C) or below;P2 and​ (b) discard the food if within 30 calendar days of its packaging it is not served for​ on-premises consumption, or consumed if served or sold for off-premises consumption;P2​ (4) limits the refrigerated shelf life to no more than 30 calendar days from packaging​ to consumption, except the time the product is maintained frozen, or the original manufacturer's​ "sell by" or "use by" date, whichever occurs first;P1​ (5) includes operational procedures that:​ (a) prohibit contacting ready-to-eat food with bare hands as specified in part​ 4626.0225, item A;P2​ (b) identify a designated work area and the method by which:P2​ i. physical barriers or methods of separation of raw foods and ready-to-eat foods​ minimize cross-contamination;P2 and​ ii. access to the processing equipment is limited to responsible trained personnel​ familiar with the potential hazards of the operation;P2​ (c) delineate cleaning and sanitization procedures for food-contact surfaces;P2​ (6) describes the training program that ensures that the individual responsible for the​ reduced oxygen packaging operation understands the:P2​ (a) concepts required for a safe operation;P2​

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MINNESOTA RULES​

4626.0420​

(b) equipment and facilities;P2 and​ (c) procedures in subitem (5) and part 4626.1735, items C and D;P2 and​ (7) is provided to the regulatory authority prior to implementation as required by part​ 4626.1730, item B.​ C. Except for fish that is frozen before, during, and after packaging, a food establishment​ must not package fish using a reduced oxygen packaging method. Reduced oxygen packaged fish​ must be held frozen until used or removed from reduced oxygen packaging prior to the thawing​ process.P1​ D. Except as specified in items C and F, a food establishment that packages TCS food using​ a cook-chill or sous-vide process must:​ (1) provide to the regulatory authority prior to implementation a HACCP plan that​ contains the information in part 4626.1735, items C and D;P2​ (2) ensure the food is:​ (a) prepared and consumed on the premises, or prepared and consumed off the​ premises but within the same business entity with no distribution or sale of the packaged product​ to another business entity or the consumer;P2​ (b) cooked to heat all parts of the food to a temperature and for a time as specified​ in part 4626.0340, items A to C;P1​ (c) protected from contamination before and after cooking as specified in parts​ 4626.0225 to 4626.0337 and 4626.0340 to 4626.0367;P1​ (d) placed in a package with an oxygen barrier and sealed before cooking, or placed​ in a package and sealed immediately after cooking and before reaching a temperature below 135​ degrees F (57 degrees C);P1​ (e) cooled to 41 degrees F (5 degrees C) in the sealed package or bag as specified​ in part 4626.0385 and subsequently:P1​ i. cooled to 34 degrees F (1 degree C) within 48 hours of reaching 41 degrees​ F (5 degrees C) and held at that temperature until consumed or discarded within 30 days after the​ date of packaging;P1​ ii. held at 41 degrees F (5 degrees C) or less for no more than 7 days, at which​ time the food must be consumed or discarded;P1 or​ iii. held frozen with no shelf life restriction while frozen until consumed or​ used;P1​ (f) held in a refrigeration unit that is equipped with an electronic system that​ continuously monitors time and temperature and is visually examined for proper operation twice​ daily;P2​

​

4626.0420​

MINNESOTA RULES​

86​

(g) if transported off-site to a satellite location of the same business entity, equipped​ with verifiable electronic monitoring devices to ensure that times and temperatures are monitored​ during transportation;P2 and​ (h) labeled with the product name and the date packaged;P2​ (3) maintain the records required to confirm that cooling and cold holding refrigeration​ time/temperature parameters are required as part of the HACCP plan and:​ (a) make records available to the regulatory authority upon request; P2and​ (b) hold records for at least 6 months;P2 and​ (4) implement written operational procedures as specified in item B, subitem (5), and​ a training program as specified in item B, subitem (6).P2​ E. Except as specified in item F, a food establishment that packages cheese using a reduced​ oxygen packaging method must:​ (1) limit the cheeses packaged to those that are commercially manufactured in a food​ processing plant with no ingredients added in the food establishment and that meet the standards​ of identity as specified in Code of Federal Regulations, title 21, section 133.150; 133.169; or​ 133.187;P1​ (2) have a HACCP plan that contains the information in part 4626.1735, items C and​ D;P2​ (3) label the package on the principal display panel with a "use by" date that does not​ exceed 30 days from its packaging or the original manufacturer's "sell by" or "use by" date, whichever​ occurs first;P2 and​ (4) discard the reduced oxygen packaged cheese if it is not sold for off-premises​ consumption or consumed within 30 calendar days of its packaging.P2​ F. A HACCP plan is not required when a food establishment uses a reduced oxygen​ packaging method to package TCS food that is always:​ (1) labeled with the production time and date;​ (2) held at 41 degrees F (5 degrees C) or less during refrigerated storage; and​ (3) removed from its package in the food establishment within 48 hours after packaging.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

87​

MINNESOTA RULES​

4626.0435​

FOOD IDENTITY​ 4626.0425 PACKAGED FOOD; STANDARDS OF IDENTITY. 3-601.11​ Packaged food must comply with parts 1545.0360 to 1545.0410 and chapter 1550; the standard​ of identity requirements in Code of Federal Regulations, title 21, parts 131 to 169, and Code of​ Federal Regulations, title 9, part 319; and the general requirements in Code of Federal Regulations,​ title 21, part 130.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0430

FOOD HONESTLY PRESENTED. 3-601.12​

A. Food must be offered for human consumption in a way that does not mislead or misinform​ the consumer.​ B. Food or color additives, colored overwraps, or lights must not be used to misrepresent​ the true appearance, color, or quality of food.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0435

FOOD LABELS. 3-602.11​

A. Food packaged in a food establishment must be labeled as specified in law, including​ Code of Federal Regulations, title 21, part 101, and Code of Federal Regulations, title 9, part 317.​ B. Label information must include:​ (1) the common name of the food, or absent a common name, an adequately descriptive​ identity statement;​ (2) if made from two or more ingredients, a list of ingredients and subingredients in​ descending order of predominance by weight, including a declaration of artificial color or flavor​ and chemical preservatives, if contained in the food;​ (3) an accurate declaration of the quantity of contents;​ (4) the name and place of business of the manufacturer, packer, or distributor;​ (5) the name of the food source for each major food allergen contained in the food​ unless the food source is already part of the common or usual name of the respective ingredient;P2​ (6) except as exempted under United States Code, title 21, section 343(q)(3) to (5),​ nutrition labeling that includes information specified in Code of Federal Regulations, title 21, part​ 101, and Code of Federal Regulations, title 9, part 317, subpart B; and​

​

4626.0435​

MINNESOTA RULES​

88​

(7) for any salmonid fish containing canthaxanthin or astaxanthin as a color additive,​ the labeling of the bulk fish container, including a list of ingredients, displayed on the retail container​ or by other written means, such as a counter card, and must disclose the use of canthaxanthin or​ astaxanthin.​ C. Bulk food that is available for consumer self-dispensing must be prominently labeled​ with the following information in plain view of the consumer:​ (1) the manufacturer's or processor's label that was provided with the food; or​ (2) a card, sign, or other method of notification that includes the information in item​ B, subitems (1), (2), and (6).​ D. Bulk, unpackaged foods such as bakery products and unpackaged foods that are portioned​ to consumer specification need not be labeled if:​ (1) a health, nutrient content, or other claim is not made;​ (2) labeling is not required under parts 1520.1600 and 1545.0810 to 1545.0880, chapter​ 1550, and Minnesota Statutes, section 31.82; and​ (3) the food is manufactured or prepared on the premises of the food establishment or​ at another food establishment or a food processing plant that is owned by the same person and is​ regulated by the food regulatory agency that has jurisdiction.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0440

OTHER FORMS OF INFORMATION. 3-602.12​

A. If required by law, consumer warnings must be provided.​ B. A food establishment's or manufacturer's dating information on foods must not be​ concealed or altered.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0442 CONSUMER ADVISORY; DISCLOSURE. 3-603.11​ A. Except as specified in parts 4626.0340, items C and D, subitem (4), and 4626.0447,​ item C, if an animal food such as beef, eggs, fish, lamb, milk, pork, poultry, or shellfish is served​ or sold raw, undercooked, or without otherwise being processed to eliminate pathogens, either in​ ready-to-eat form or as an ingredient in another ready-to-eat food, the license holder shall inform​ consumers of the significantly increased risk of consuming such foods by way of a disclosure and​

​

89​

MINNESOTA RULES​

4626.0445​

reminder, as specified in items B and C, using brochures, deli case or menu advisories, label​ statements, table tents, placards, or other effective written means.P2​ B. The disclosure must include:​ (1) a description of the animal-derived foods, such as "oysters on the half shell (raw​ oysters)," "raw-egg Caesar salad," and "hamburgers (can be cooked to order)";P2 or​ (2) identification of the animal-derived foods by asterisking them to a footnote that​ states the items are served raw or undercooked, or contain, or may contain, raw or undercooked​ ingredients.P2​ C. The reminder must include asterisking the animal-derived foods requiring disclosure to​ a footnote that states:​ (1) regarding the safety of these items, written information is available upon request;P2​ (2) consuming raw or undercooked meats, poultry, seafood, shellfish, or eggs may​ increase your risk of foodborne illness;P2 or​ (3) consuming raw or undercooked meats, poultry, seafood, shellfish, or eggs may​ increase your risk of foodborne illness, especially if you have certain medical conditions.P2​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: November 13, 2019​ CONTAMINATED FOOD​ 4626.0445 UNSAFE, ADULTERATED, OR CONTAMINATED FOOD. 3-701.11​ A. A food that is unsafe or adulterated as specified in part 4626.0125 or not honestly​ presented as specified in part 4626.0430 must be discarded or reconditioned according to Minnesota​ Statutes, section 31.495.P1​ B. Food that is not from an approved source specified in parts 4626.0130 to 4626.0160​ must be discarded.P1​ C. Ready-to-eat food that may have been contaminated by an employee who has been​ restricted or excluded as specified in part 4626.0045 must be discarded.P1​ D. Food that is contaminated by food employees, consumers, or other persons through​ contact with hands, bodily discharges, including nasal or oral discharges, or other means must be​ discarded.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.0447​

MINNESOTA RULES​

90​

4626.0447 FOOD SERVED TO A HIGHLY SUSCEPTIBLE POPULATION. 3-801.11​ In a food establishment that serves a highly susceptible population, the criteria in this part must​ be followed.​ A. The following criteria apply to juice:​ (1) for the purposes of this item only, children who are age 9 or less and receive food​ in a school, day care setting, or similar facility that provides custodial care are included as highly​ susceptible populations;​ (2) prepackaged juice or a prepackaged beverage containing juice that bears a warning​ label as specified in Code of Federal Regulations, title 21, part 101, subpart A, section 101.17 (g),​ or a packaged juice or beverage containing juice that bears a warning label as specified in part​ 4626.0367, item B, must not be served or offered for sale;P1 and​ (3) unpackaged juice that is prepared on the premises for service or sale in a ready-to-eat​ form must be processed under a HACCP plan that contains the information in part 4626.1735, items​ C to E, and Code of Federal Regulations, title 21, part 120, subpart B, section 120.24.P1​ B. Pasteurized eggs or egg products must be substituted for raw eggs in the preparation of:​ (1) foods such as Caesar salad, hollandaise or Bearnaise sauce, mayonnaise, meringue,​ eggnog, ice cream, and egg-fortified beverages;P1 and​ (2) except as specified in item F, recipes in which more than 1 egg is broken and the​ eggs are combined.P1​ C. The following foods may not be served or offered for sale in a ready-to-eat form:​ (1) raw animal foods such as raw fish, raw marinated fish, raw molluscan shellfish, and​ steak tartare;P1​ (2) a partially cooked animal food such as lightly cooked fish, rare meat, soft-cooked​ eggs that are made from raw eggs, and meringue;P1 and​ (3) raw seed sprouts.P1​ D. Food employees may not contact ready-to-eat food as specified in part 4626.0225, item​ A.P1​ E. Time only, as the public health control as specified in part 4626.0408, item D, may not​ be used for raw eggs.P1​ F. Item B, subitem (2), does not apply if:​ (1) the raw eggs are combined immediately before cooking for one consumer's serving​ at a single meal, cooked as specified in part 4626.0340, item A, subitem (1), and served immediately,​ such as an omelet, souffle, or scrambled eggs;​

91​

MINNESOTA RULES​

4626.0450​

(2) the raw eggs are combined as an ingredient immediately before baking and the eggs​ are thoroughly cooked to a ready-to-eat form, such as a cake, muffin, or bread; or​ (3) the preparation of the food is conducted under a HACCP plan that:​ (a) identifies the food to be prepared;​ (b) prohibits contacting ready-to-eat food with bare hands;​ (c) includes specifications and practices that ensure:​ i. Salmonella Enteritidis growth is controlled before and after cooking; and​ ii. Salmonella Enteritidis is destroyed by cooking the eggs according to the​ temperature and time specified in part 4626.0340, item A, subitem (2);​ (d) contains the information in part 4626.1735, item D, including procedures that:​ i. control cross-contamination of ready-to-eat food with raw eggs; and​ ii. delineate cleaning and sanitization procedures for food-contact surfaces; and​ (e) describes the training program that ensures that the food employee responsible​ for the preparation of the food understands the procedures to be used.​ G. Except as specified in item H, food may be re-served as specified in part 4626.0335,​ item B, subitems (1) and (2).​ H. Food may not be re-served under the following conditions:​ (1) any food served to patients or clients who are under contact precautions in medical​ isolation, quarantine, or protective environment isolation may not be re-served to others outside;​ or​ (2) packages of food from any patients, clients, or other consumers must not be re-served​ to persons in protective environment isolation.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ EQUIPMENT CONSTRUCTION MATERIALS​ 4626.0450

FOOD-CONTACT SURFACES; CHARACTERISTICS AND MATERIALS.​ 4-101.11​

Materials that are used in the construction of utensils and food-contact surfaces of equipment​ must not allow the migration of deleterious substances or impart colors, odors, or tastes to food​ and under normal use conditions must be:P1​ A. safe;P1​

4626.0450​

MINNESOTA RULES​

92​

B. durable, corrosion-resistant, and nonabsorbent;​ C. sufficient in weight and thickness to withstand repeated warewashing;​ D. finished to have a smooth, easily cleanable surface; and​ E. resistant to pitting, chipping, crazing, scratching, scoring, distortion, and decomposition.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0455

CAST IRON; USE LIMITATION. 4-101.12​

A. Except as specified in items B and C, cast iron must not be used for utensils or​ food-contact surfaces of equipment.​ B. Cast iron may be used as a surface for cooking.​ C. Cast iron may be used in utensils for serving food if the utensils are used only as part​ of an uninterrupted process from cooking through service.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0460 LEAD; USE LIMITATION. 4-101.13​ A. Ceramic, china, crystal utensils, and decorative utensils, such as hand-painted ceramic​ or china, that are used in contact with food must be lead-free or contain levels of lead not exceeding​ the limits of the following utensil categories:P1​ Utensil Category​

Ceramic Article Description​

Maximum Lead mg/L​

Beverage mugs, cups, pitchers​

Coffee mugs​

0.5​

Large hollowware (excluding​ pitchers)​

Bowls ≥ 1.16 quart (1.1 liter)​

1.0​

Small hollowware (excluding​ cups and mugs)​

Bowls < 1.16 quart (1.1 liter)​

2.0​

Flat tableware​

Plates, saucers​

3.0​

B. Pewter alloys containing lead in excess of 0.05 percent must not be used as a food-contact​ surface.P1​ C. Solder and flux containing lead in excess of 0.2 percent must not be used as a food-contact​ surface.​

​

93​

MINNESOTA RULES​

4626.0490​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: October 17, 2019​ 4626.0465

COPPER; USE LIMITATION. 4-101.14​

A. Except as specified in item B, copper and copper alloys, such as brass, must not be used​ in contact with a food that has a pH below 6, such as vinegar, fruit juice, or wine, or for a fitting​ or tubing installed between a backflow prevention device and a carbonator.P1​ B. Copper and copper alloys may be used in contact with beer brewing ingredients that​ have a pH below 6 in the prefermentation and fermentation steps of a beer brewing operation such​ as a brewpub or microbrewery.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0470

GALVANIZED METAL; USE LIMITATION. 4-101.15​

Galvanized metal must not be used for utensils or food-contact surfaces of equipment that are​ used in contact with acidic food.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0475

SPONGES; USE LIMITATION. 4-101.16​

Sponges must not be used in contact with cleaned and sanitized or in-use food-contact surfaces.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0480 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0485 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0490

WOOD; USE LIMITATION. 4-101.17​

A. Except as specified in items B to D, wood and wood wicker must not be used as a​ food-contact surface.​ B. Hard maple or an equivalently hard, close-grained wood may be used for:​

4626.0490​

MINNESOTA RULES​

94​

(1) cutting boards, cutting blocks, bakers' tables, and utensils such as rolling pins,​ doughnut dowels, salad bowls, and chopsticks; and​ (2) wooden paddles used in confectionery operations for pressure scraping kettles when​ manually preparing confections at a temperature of 230 degrees F (110 degrees C) or above.​ C. Whole, uncut, raw fruits and vegetables and nuts in the shell may be kept in the wood​ shipping containers in which they were received, until the fruits, vegetables, or nuts are used.​ D. If the nature of the food requires removal of rinds, peels, husks, or shells before​ consumption, the whole, uncut, raw food may be kept in:​ (1) untreated wood containers; or​ (2) treated wood containers if the containers are treated with a preservative that meets​ the requirements in Code of Federal Regulations, title 21, section 178.3800.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0493

NONSTICK COATINGS; USE LIMITATIONS. 4-101.18​

Multiuse kitchenware such as frying pans, griddles, sauce pans, cookie sheets, and waffle bakers​ that have a nonstick coating must be used with nonscouring or nonscratching utensils and cleaning​ aids.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0495

NON-FOOD-CONTACT SURFACES; CHARACTERISTICS. 4-101.19​

Non-food-contact surfaces of equipment that are exposed to splash, spillage, or other food​ soiling or that require frequent cleaning must be constructed of a corrosion-resistant, nonabsorbent,​ and smooth material.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0500

SINGLE-SERVICE AND SINGLE-USE ARTICLES; CHARACTERISTICS.​ 4-102.11​

Materials that are used to make single-service and single-use articles:​ A. must not:​

95​

MINNESOTA RULES​

4626.0506​

(1) allow the migration of deleterious substances;P1 or​ (2) impart colors, odors, or tastes to food; and​ B. must be:​ (1) safe;P1 and​ (2) clean.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ EQUIPMENT DESIGN AND CONSTRUCTION​ 4626.0505

EQUIPMENT AND UTENSILS. 4-201.11​

Equipment and utensils must be designed and constructed to be durable and to retain their​ characteristic qualities under normal use conditions.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0506 EQUIPMENT.​ A. The following equipment, including types of equipment listed in this part that are custom​ fabricated, must be certified or classified for sanitation by an American National Standards Institute​ (ANSI) accredited certification program for food service equipment:​ (1) manual warewashing sinks;​ (2) mechanical warewashing equipment;​ (3) mechanical refrigeration units except for units or equipment designed and used to​ maintain food in a frozen state;​ (4) walk-in freezers;​ (5) food hot-holding equipment;​ (6) cooking equipment, except for microwave ovens and toasters;​ (7) ice machines;​ (8) mechanical slicers;​ (9) mechanical tenderizers and grinders; and​ (10) food preparation surfaces including sinks used for food preparation.​

4626.0506​

MINNESOTA RULES​

96​

B. Exhaust hoods must meet the requirements in the Minnesota Mechanical Code, Minnesota​ Rules, chapter 1346.​ C. Vending machines and machines used to dispense water or food must be certified or​ classified for sanitation by an American National Standards Institute (ANSI) accredited certification​ program or be accredited to meet the standards of the National Automatic Merchandising Association​ (NAMA) specified in NAMA Standard for the Sanitary Design and Construction of Food and​ Beverage Vending Machines. This publication is incorporated by reference, is subject to infrequent​ change, and can be found at www.namanow.org/vending/certified-companies.​ D. Vending machines that vend water must meet the standards in parts 1550.3200 to​ 1550.3320.​ E. If a standard developed by an ANSI-accredited standards developer is not available for​ a piece of equipment specified in item A, the equipment must:​ (1) be designed for commercial use;​ (2) be durable, smooth, and easily cleanable;​ (3) be readily accessible for cleaning; and​ (4) have food-contact surfaces that are not toxic.​ F. A neighborhood kitchen may use equipment other than ANSI-certified equipment required​ in item A to heat and serve food previously cooked in a primary approved commercial kitchen. A​ neighborhood kitchen may also prepare and serve food other than raw animal foods, provided that​ grease or moisture does not accumulate on adjacent surfaces.​ G. A food establishment that is an adult care center, child care center, or boarding​ establishment does not need to comply with item A if approved by the regulatory authority and the​ food establishment:​ (1) serves only non-TCS food; or​ (2) prepares TCS foods only for same-day service.​ H. A bed and breakfast serving only 1 meal a day does not need to comply with item A.​ I. A special event food stand, retail food vehicle, portable structure, or cart does not need​ to comply with item A.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​

97​

MINNESOTA RULES​

4626.0510

4626.0520​

FOOD TEMPERATURE MEASURING DEVICES. 4-201.12​

Food temperature measuring devices must not have sensors or stems constructed of glass, except​ that thermometers with glass sensors or stems that are encased in a shatterproof coating such as​ candy thermometers may be used.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0515

MULTIUSE FOOD-CONTACT SURFACES; CHARACTERISTICS. 4-202.11​

A. Multiuse food-contact surfaces must be:​ (1) smooth;P2​ (2) free of breaks, open seams, cracks, chips, inclusions, pits, and similar imperfections;P2​ (3) free of sharp internal angles, corners, and crevices;P2​ (4) finished to have smooth welds and joints;P2 and​ (5) except as specified in item B, accessible for cleaning and inspection by one of the​ following methods:​ (a) without being disassembled;P2​ (b) by disassembling without the use of tools;P2 or​ (c) by easy disassembling with the use of hand-held tools commonly available to​ maintenance and cleaning personnel, such as screwdrivers, pliers, open-end wrenches, and Allen​ wrenches.P2​ B. Item A, subitem (5), does not apply to cooking oil storage tanks, distribution lines for​ cooking oils, or beverage syrup lines or tubes.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0520

CIP EQUIPMENT. 4-202.12​

A. CIP equipment must meet the characteristics in part 4626.0515 and must be designed​ and constructed so that:​ (1) cleaning and sanitizing solutions circulate throughout a fixed system and contact​ all interior food-contact surfaces;P2 and​ (2) the system is self-draining or capable of being completely drained of cleaning and​ sanitizing solutions.​

​

4626.0520​

MINNESOTA RULES​

98​

B. CIP equipment that is not designed to be disassembled for cleaning must be designed​ with inspection access points to ensure that all interior food-contact surfaces throughout the fixed​ system are effectively cleaned.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0525

"V"-TYPE THREADS; USE LIMITATION. 4-202.13​

Except for hot oil cooking or filtering equipment, "V"-type threads must not be used on​ food-contact surfaces.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0530

HOT OIL FILTERING EQUIPMENT. 4-202.14​

Hot oil filtering equipment must meet the characteristics specified in part 4626.0515 or 4626.0520​ and must be readily accessible for filter replacement and cleaning.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0535

CAN OPENERS. 4-202.15​

Cutting or piercing parts of can openers must be readily removable for cleaning and replacement.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0540

NON-FOOD-CONTACT SURFACES. 4-202.16​

Non-food-contact surfaces must be free of unnecessary ledges, projections, and crevices, and​ designed and constructed to allow easy cleaning and to facilitate maintenance.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0545

KICK PLATES, REMOVABLE; ENCLOSED HOLLOW BASES. 4-202.17​

A. Kick plates must be designed so that the areas behind them are accessible for inspection​ and cleaning by being:​

​

99​

MINNESOTA RULES​

4626.0560​

(1) removable by one of the methods in part 4626.0515, item A, subitem (5), or capable​ of being rotated open; and​ (2) removable or capable of being rotated open without unlocking equipment doors.​ B. In new or extensively remodeled establishments, enclosed hollow bases are prohibited.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0550

VENTILATION HOOD SYSTEMS; FILTERS. 4-202.18​

Filters or other grease extracting equipment must be designed to be readily removable for​ cleaning and replacing if not designed to be cleaned in place.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0555

TEMPERATURE MEASURING DEVICES; FOOD. 4-203.11​

A. Food temperature measuring devices that are scaled only in Celsius or dually scaled in​ Celsius and Fahrenheit must be accurate to plus or minus 1 degree C in the intended range of use.P2​ B. Food temperature measuring devices that are scaled only in Fahrenheit must be accurate​ to plus or minus 2 degrees F in the intended range of use.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0560

TEMPERATURE MEASURING DEVICES; AMBIENT AIR AND WATER.​ 4-203.12​

A. Ambient air and water temperature measuring devices that are scaled in Celsius or dually​ scaled in Celsius and Fahrenheit must be designed to be easily readable and accurate to plus or​ minus 1.5 degrees C in the intended range of use.P2​ B. Ambient air and water temperature measuring devices that are scaled only in Fahrenheit​ must be accurate to plus or minus 3 degrees F in the intended range of use.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.0563​

MINNESOTA RULES​

100​

4626.0563 PRESSURE MEASURING DEVICES; MECHANICAL WAREWASHING​ EQUIPMENT. 4-203.13​ Pressure measuring devices that display the pressures in the water supply line for the fresh hot​ water sanitizing rinse must have increments of 1 pound per square inch (7 kilopascals) or smaller​ and must be accurate to plus or minus 2 pounds per square inch (plus or minus 14 kilopascals) in​ the range indicated on the manufacturer's data plate.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0565

VENTILATION HOOD SYSTEMS, DRIP PREVENTION. 4-204.11​

Exhaust ventilation hood systems in food preparation and warewashing areas, including hoods,​ fans, guards, ducting, and other components, must be designed to prevent grease or condensation​ from draining or dripping onto food, equipment, utensils, linens, and single-service and single-use​ articles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0570

EQUIPMENT OPENINGS, CLOSURES, AND DEFLECTORS. 4-204.12​

A. A cover or lid for equipment must overlap the opening and be sloped to drain.​ B. An opening located within the top of a unit of equipment that is designed for use with​ a cover or lid must be flanged upward at least 2/10 inch (5 millimeters).​ C. Except as specified in item D, fixed piping, temperature measuring devices, rotary shafts,​ and other parts extending into equipment must be provided with a watertight joint at the point where​ the item enters the equipment.​ D. If a watertight joint is not provided:​ (1) the piping, temperature measuring devices, rotary shafts, and other parts extending​ through the openings must be equipped with an apron designed to deflect condensation, drips, and​ dust from openings into the food; and​ (2) the opening must be flanged as specified in item B.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

101​

MINNESOTA RULES​

4626.0575

4626.0580​

DISPENSING EQUIPMENT; PROTECTION OF EQUIPMENT AND FOOD.​ 4-204.13​

In equipment that dispenses or vends liquid food or ice in unpackaged form:​ A. the delivery tube, chute, orifice, and splash surfaces directly above the container receiving​ the food must be designed in a manner, such as with barriers, baffles, or drip aprons, so that drips​ from condensation and splash are diverted from the opening of the container receiving the food;​ B. the delivery tube, chute, and orifice must be protected from manual contact such as by​ being recessed;​ C. the delivery tube or chute and orifice of equipment used to vend liquid food or ice in​ unpackaged form to self-service consumers must be designed so that the delivery tube or chute and​ orifice are protected from dust, insects, rodents, and other contamination by a self-closing door if​ the equipment is:​ (1) located in an outside area that does not otherwise afford the protection of an enclosure​ against rain, windblown debris, insects, rodents, and other contaminants that are present in the​ environment; or​ (2) available for self-service during hours when it is not under the full-time supervision​ of a food employee;​ D. the dispensing equipment actuating lever or mechanism and filling device of consumer​ self-service beverage dispensing equipment must be designed to prevent contact with the lip-contact​ surface of glasses or cups that are refilled; and​ E. the dispensing equipment in which TCS food in a homogenous liquid form is maintained​ outside of the temperature control requirements in part 4626.0395, item A, must:​ (1) be specifically designed and equipped to maintain the commercial sterility of​ aseptically packaged food in a homogenous liquid form for a specified duration from the time of​ opening the packaging within the equipment;P1 and​ (2) conform to the requirements for this equipment as specified in NSF 18-2016 (Manual​ Food and Beverage Dispensing Equipment). This publication is incorporated by reference, is subject​ to frequent change, and can be found at www.nsfpdf.com.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0580

VENDING MACHINE; VENDING STAGE CLOSURE. 4-204.14​

The dispensing compartment of a vending machine, including a machine that is designed to​ vend prepackaged snack food that is not TCS, such as chips, party mixes, and pretzels, must be​ equipped with a self-closing door or cover if the machine is:​

​

4626.0580​

MINNESOTA RULES​

102​

A. located in an outside area that does not otherwise afford the protection of an enclosure​ against rain, windblown debris, insects, rodents, and other contaminants that are present in the​ environment; or​ B. available for self-service during hours when it is not under the full-time supervision of​ a food employee.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0585

BEARINGS AND GEAR BOXES; LEAKPROOF. 4-204.15​

Equipment containing bearings and gears that require lubricants must be designed and constructed​ so that the lubricant cannot leak, drip, or be forced into food or onto food-contact surfaces.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0590

BEVERAGE TUBING; SEPARATION. 4-204.16​

Except for cold plates that are constructed integrally with an ice storage bin, beverage tubing​ and cold-plate beverage cooling devices must not be installed in contact with stored ice.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0595

ICE UNITS; SEPARATION OF DRAINS. 4-204.17​

Liquid waste drain lines must not pass through an ice machine or ice storage bin.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0600

CONDENSER UNIT; SEPARATION. 4-204.18​

If a condenser unit is an integral component of equipment, the condenser unit must be separated​ from the food and food storage space by a dustproof barrier.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

103​

MINNESOTA RULES​

4626.0605

4626.0615​

CAN OPENERS ON VENDING MACHINES. 4-204.19​

Cutting or piercing parts of can openers on vending machines must be protected from manual​ contact, dust, insects, rodents, and other contamination.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ MOLLUSCAN SHELLFISH TANKS. 4-204.110​

4626.0610

A. Except as specified in item B, molluscan shellfish life support system display tanks must​ be used only to display shellfish that are not offered for human consumption and must be​ conspicuously marked so that it is obvious to the consumer that the shellfish are for display only.P1​ B. Molluscan shellfish life support system display tanks used to store or display shellfish​ that are offered for human consumption must be operated and maintained according to a variance​ granted by the regulatory authority as specified in parts 4626.1690 to 4626.1715, and a HACCP​ plan that:P2​ (1) is submitted by the licensee and approved by the regulatory authority as specified​ in parts 4626.1690 to 4626.1715;P2 and​ (2) ensures that:​ (a) water used with fish other than molluscan shellfish does not flow into the​ molluscan tank;P2​ (b) the safety and quality of the shellfish as they were received are not compromised​ by use of the tank;P2 and​ (c) the identity of the source of the shellstock is retained as specified in part​ 4626.0220.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0615

VENDING MACHINES; AUTOMATIC SHUTOFF. 4-204.111​

A. A machine vending TCS food must have an automatic control that prevents the machine​ from vending food:​ (1) if there is a power failure, mechanical failure, or other condition that results in an​ internal machine temperature that cannot maintain food temperatures as specified in parts 4626.0370​ and 4626.0395;P1 and​ (2) if a condition specified in this part occurs, until the machine is serviced and restocked​ with food that has been maintained at temperatures specified in parts 4626.0370 and 4626.0395.P1​

​

4626.0615​

MINNESOTA RULES​

104​

B. When the automatic shutoff within a machine vending TCS food is activated:​ (1) in a refrigerated vending machine, the ambient air temperature must not exceed 41​ degrees F (5 degrees C) for more than 30 minutes immediately after the machine is filled, serviced,​ or restocked;P1 or​ (2) in a hot holding vending machine, the ambient air temperature must not be less than​ 135 degrees F (57 degrees C) for more than 120 minutes immediately after the machine is filled,​ serviced, or restocked.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0620

AMBIENT AIR TEMPERATURE MEASURING DEVICES. 4-204.112​

A. In a mechanically refrigerated or hot food storage unit, the sensor of a temperature​ measuring device must be located to measure the air temperature or a simulated product temperature​ in the warmest part of a mechanically refrigerated unit and in the coolest part of a hot food storage​ unit.​ B. Except as specified in item C, cold or hot holding equipment used for TCS food must​ be designed to include and must be equipped with at least 1 integral or permanently affixed​ temperature measuring device that is located to allow easy viewing of the device's temperature​ display.​ C. Item B does not apply to equipment for which the placement of a temperature measuring​ device is not a practical means for measuring the ambient air surrounding the food because of the​ design, type, and use of the equipment, such as calrod units, heat lamps, cold plates, bainmaries,​ steam tables, insulated food transport containers, and salad bars.​ D. Temperature measuring devices must be designed to be easily readable.​ E. Food temperature measuring devices and water temperature measuring devices on​ warewashing machines must have a numerical scale, printed record, or digital readout in increments​ no greater than 2 degrees F or 1 degree C in the intended range of use.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0625

WAREWASHING MACHINES; DATA PLATE OPERATING​ SPECIFICATIONS. 4-204.113​

A warewashing machine must be provided with an easily accessible and readable data plate​ affixed to the machine by the manufacturer that indicates the machine's design and operating​ specifications, including the:​

​

105​

MINNESOTA RULES​

4626.0640​

A. temperatures required for washing, rinsing, and sanitizing;​ B. pressure required for the fresh water sanitizing rinse unless the machine is designed to​ use only a pumped sanitizing rinse; and​ C. conveyor speed for conveyor machines or cycle time for stationary rack machines.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0630

WAREWASHING MACHINES; INTERNAL BAFFLES. 4-204.114​

Warewashing machine wash and rinse tanks must be equipped with baffles, curtains, or other​ means to minimize internal cross-contamination of the solutions in wash and rinse tanks.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0635

WAREWASHING MACHINES; TEMPERATURE MEASURING DEVICES.​ 4-204.115​

A warewashing machine must be equipped with a temperature measuring device that indicates​ the temperature of the water:​ A. in each wash and rinse tank;P2 and​ B. as the water enters the hot water sanitizing final rinse manifold or in the chemical​ sanitizing solution tank.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0640

MANUAL WAREWASHING EQUIPMENT; HEATERS AND BASKETS.​ 4-204.116​

If hot water is used for sanitization in manual warewashing operations, the sanitizing​ compartment of the sink must be:​ A. designed with an integral heating device that is capable of maintaining water at a​ temperature not less than 171 degrees F (77 degrees C);P2 and​ B. provided with a rack or basket to allow complete immersion of equipment and utensils​ into the hot water.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

4626.0640​

MINNESOTA RULES​

106​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0643 WAREWASHING MACHINES; AUTOMATIC DISPENSING OF DETERGENTS​ AND SANITIZERS. 4-204.117​ A warewashing machine that is installed after September 8, 1998, must be equipped to:​ A. automatically dispense detergents and sanitizers;P2 and​ B. incorporate a visual means to verify that detergents and sanitizers are delivered or a​ visual or audible alarm to signal if the detergents and sanitizers are not delivered to the respective​ washing and sanitizing cycles.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0645

WAREWASHING MACHINES; FLOW PRESSURE DEVICE. 4-204.118​

A. Warewashing machines that provide a fresh hot water sanitizing rinse must be equipped​ with a pressure gauge, or similar device such as a transducer, that measures and displays the water​ pressure in the supply line immediately before entering the warewashing machine.​ B. If the flow pressure measuring device is upstream of the fresh hot water sanitizing rinse​ control valve, the device must be mounted in a 1/4-inch (6.4 millimeter) iron pipe size (IPS) valve.​ C. Items A and B do not apply to a machine that uses only a pumped or recirculated​ sanitizing rinse.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0650 WAREWASHING SINKS AND DRAINBOARDS; SELF-DRAINING. 4-204.119​ Sinks and drainboards of warewashing sinks and machines must be self-draining.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0655

EQUIPMENT; DRAINAGE. 4-204.120​

Compartments that are subject to accumulation of moisture due to conditions such as​ condensation, food or beverage drip, or water from melting ice, must be sloped to an outlet that​ allows complete draining.​

​

107​

MINNESOTA RULES​

4626.0670​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0660

VENDING MACHINES; LIQUID WASTE PRODUCTS. 4-204.121​

A. Vending machines designed to store beverages that are packaged in containers made​ from paper products must be equipped with diversion devices and retention pans or drains for​ container leakage.​ B. Vending machines that dispense liquid food in bulk must be:​ (1) provided with an internally mounted waste receptacle for the collection of drips,​ spillage, overflow, or other internal wastes; and​ (2) equipped with an automatic shutoff device that will place the machine out of​ operation before the waste receptacle overflows.​ C. The shutoff device in item B, subitem (2), must prevent water or liquid food from​ continuously running if there is a failure of a flow control device in the water or liquid food system​ or waste accumulation that could lead to overflow of the waste receptacle.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0665

CASE LOT HANDLING APPARATUSES; MOVEABILITY. 4-204.122​

Apparatuses, such as dollies, pallets, racks, and skids, used to store and transport large quantities​ of packaged foods received from a supplier in a cased or overwrapped lot must be designed to be​ moved by hand or by conveniently available apparatuses such as hand trucks and forklifts.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0670

VENDING MACHINE DOORS AND OPENINGS. 4-204.123​

A. Vending machine doors and access opening covers to food and container storage spaces​ must be tight-fitting so that the space along the entire interface between the doors or covers and​ the cabinet of the machine, if the doors or covers are in a closed position, is no greater than 1/16​ inch (1.5 millimeters) by:​ (1) being covered with louvers, screens, or materials that provide an equivalent opening​ of not greater than 1/16 inch (1.5 millimeters). Screening of 12 or more mesh to 12 mesh to 1 inch​ (2.5 centimeters) meets this requirement;​ (2) being effectively gasketed;​

4626.0670​

MINNESOTA RULES​

108​

(3) having interface surfaces that are at least 1/2-inch (13 millimeters) wide; or​ (4) having jambs or surfaces to form an L-shaped entry path to the interface.​ B. Vending machine service connection openings through an exterior wall of a machine​ must be closed by sealants, clamps, or grommets so that the openings are no larger than 1/16 inch​ (1.5 millimeters).​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ EQUIPMENT NUMBERS AND CAPACITIES​ 4626.0675

COOLING, HEATING, AND HOLDING CAPACITIES. 4-301.11​

Equipment for cooling and heating food, and holding cold and hot food, must be sufficient in​ number and capacity to provide the food temperatures specified in parts 4626.0360, 4626.0370,​ 4626.0385, and 4626.0395.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0680

MANUAL WAREWASHING; SINK COMPARTMENT REQUIREMENTS.​ 4-301.12​

A. Except as specified in items C to H, a sink with at least 3 compartments and with​ integrally attached drainboards at each end must be provided for manually washing, rinsing, and​ sanitizing equipment and utensils.P2​ B. Sink compartments must be large enough to accommodate immersion of the largest​ equipment and utensils. If equipment or utensils are too large for the warewashing sink, a​ warewashing machine or alternative equipment specified in item C must be used.P2​ C. Alternative manual warewashing equipment that meets the requirements in parts​ 4626.0875 and 4626.0880 may be used when there are special cleaning needs or constraints and​ its use is approved by the regulatory authority. Alternative manual warewashing equipment may​ include:​ (1) high-pressure detergent sprayers;​ (2) low- or line-pressure spray detergent foamers;​ (3) other task-specific cleaning equipment;​ (4) brushes or other implements; or​ (5) receptacles that substitute for the compartments of a multicompartment sink.​

109​

MINNESOTA RULES​

4626.0690​

D. The regulatory authority may allow mechanical warewashing equipment in lieu of the​ required 3-compartment sink as long as the mechanical warewashing equipment is capable of​ accommodating the largest piece of equipment to be washed, rinsed, and sanitized and meets the​ requirements of parts 4626.0506 and 4626.0905.​ E. A food cart that does not have an approved 3-compartment sink installed on the cart​ must have a separate licensed facility, or an agreement with a licensed facility. The facility must​ have an approved 3-compartment sink or mechanical warewashing machine where all the utensils​ and multiuse equipment for the food cart are washed, rinsed, and sanitized before and after use at​ an event.P2​ F. A mobile food unit must be equipped with warewashing facilities consisting of at least​ a 3-compartment sink, either freestanding or installed in a counter.P2​ G. A seasonal temporary food stand that is disassembled after each use may use 3 containers​ of sufficient size to immerse utensils in lieu of the requirement in item A.​ H. A special event food stand may be equipped with a warewashing facility consisting of​ at least 3 containers of sufficient size to fully immerse all multiuse equipment and utensils.​ I. A food cart, special event food stand, temporary food establishment, retail food vehicle,​ portable structure, or cart is exempt from the manual warewashing sink and equipment requirements​ of this part if no multiuse utensils or equipment are used in the operation of the food establishment.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0685

DRAINBOARDS. 4-301.13​

A. Integral drainboards, utensil racks, or tables large enough to accommodate all soiled​ and cleaned items that may accumulate during hours of operation must be provided for necessary​ utensil holding before cleaning and after sanitizing.​ B. Hot water sanitizing machines must have space for and a minimum of 3 racks for drying​ utensils.​ C. Chemical sanitizing machines must have space for and a minimum of 5 racks for drying​ utensils.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0690

VENTILATION HOOD SYSTEMS; ADEQUACY. 4-301.14​

Ventilation hood systems and devices must be sufficient in number and capacity to prevent​ grease or condensation from collecting on walls and ceilings.​

​

4626.0690​

MINNESOTA RULES​

110​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0695

CLOTHES WASHERS AND DRYERS. 4-301.15​

A. Except as specified in item B, if work clothes or linens are laundered on the premises,​ a mechanical clothes washer and dryer must be provided and used.​ B. If on-premises laundering is limited to wiping cloths intended to be used moist, or wiping​ cloths are air-dried as specified in part 4626.0940, a mechanical clothes washer and dryer need not​ be provided.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0700

UTENSILS; CONSUMER SELF-SERVICE. 4-302.11​

A food dispensing utensil must be available for each container displayed at consumer self-service​ units such as a buffet or salad bar.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0705

FOOD TEMPERATURE MEASURING DEVICES REQUIRED. 4-302.12​

A. Food temperature measuring devices must be provided and readily accessible for use​ in ensuring attainment and maintenance of the food temperatures specified in parts 4626.0165 and​ 4626.0340 to 4626.0420.P2​ B. A temperature measuring device with a suitable small diameter probe that is designed​ to measure the temperature of thin masses must be provided and readily accessible to accurately​ measure the temperature in thin foods such as meat patties and fish fillets.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0710

TEMPERATURE MEASURING DEVICES; WAREWASHING. 4-302.13​

A. In manual warewashing operations, a temperature measuring device must be provided​ and readily accessible for frequently measuring the washing and sanitizing temperatures.P2​ B. In hot water mechanical warewashing operations, an irreversible registering temperature​ indicator must be provided and readily accessible for measuring the utensil surface temperature.P2​

111​

MINNESOTA RULES​

4626.0725​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0715

SANITIZING SOLUTIONS; TESTING DEVICES. 4-302.14​

A test kit or other device that accurately measures the concentration in mg/L of sanitizing​ solutions must be provided.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ EQUIPMENT LOCATION AND INSTALLATION​ 4626.0720 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0721 CLEANING AGENTS AND SANITIZERS; AVAILABILITY. 4-303.11​ A. Cleaning agents that are used to clean equipment and utensils specified under parts​ 4626.0840 to 4626.0885 must be provided and available for use during all hours of operation.​ B. Except for those that are generated onsite at the time of use, chemical sanitizers that are​ used to sanitize equipment and utensils specified in parts 4626.0900 and 4626.0905 must be provided​ and available for use during all hours of operation.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0725

FIXED EQUIPMENT; SPACING OR SEALING. 4-402.11​

A. Equipment that is fixed because it is not easily movable must be installed so that it is:​ (1) spaced to allow access for cleaning along the sides of, behind, and above the​ equipment;​ (2) spaced from adjoining equipment, walls, and ceilings a distance of not more than​ 1/32 inch (1 millimeter); or​ (3) sealed to adjoining equipment or walls, if the equipment is exposed to spillage or​ seepage.​ B. Counter-mounted equipment that is not easily movable must be installed to allow cleaning​ of the equipment and areas underneath and around the equipment by being:​ (1) sealed; or​

4626.0725​

MINNESOTA RULES​

112​

(2) elevated on legs specified in part 4626.0730, item D.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0730

FIXED EQUIPMENT; ELEVATION OR SEALING. 4-402.12​

A. Except as specified in items B and C, floor-mounted equipment that is not easily movable​ must be sealed to the floor or elevated on legs that provide at least a 6-inch (15 centimeter) clearance​ between the floor and the equipment.​ B. If no part of the floor under the floor-mounted equipment is more than 6 inches (15​ centimeters) from the point of cleaning access, the clearance space may be 4 inches (10 centimeters).​ C. This part does not apply to display shelving units, display refrigeration units, and display​ freezer units located in the consumer shopping areas if the floor under the units is maintained clean.​ D. Except as specified in item E, counter-mounted equipment that is not easily movable​ must be elevated on legs that provide at least a 4-inch (10 centimeter) clearance between the table​ and the equipment.​ E. The clearance space between the table and counter-mounted equipment must be:​ (1) 3 inches (7.5 centimeters) if the horizontal distance of the table top under the​ equipment is no more than 20 inches (50 centimeters) from the point of access for cleaning; or​ (2) 2 inches (5 centimeters) if the horizontal distance of the table top under the equipment​ is no more than 3 inches (7.5 centimeters) from the point of access for cleaning.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ EQUIPMENT MAINTENANCE AND OPERATION​ 4626.0735

EQUIPMENT; GOOD REPAIR AND PROPER ADJUSTMENT. 4-501.11​

A. Equipment must be maintained in a state of repair and condition that meets the​ requirements in parts 4626.0450 to 4626.0670.​ B. Equipment components such as doors, seals, hinges, fasteners, and kick plates must be​ kept intact, tight, and adjusted according to manufacturer's specifications.​ C. Cutting or piercing parts of can openers must be kept sharp to minimize the creation of​ metal fragments that can contaminate food when the container is opened.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

113​

MINNESOTA RULES​

4626.0755​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0740

CUTTING SURFACES. 4-501.12​

Surfaces such as cutting blocks and boards that are subject to scratching and scoring must be​ resurfaced if they can no longer be effectively cleaned and sanitized, or discarded if they are not​ capable of being resurfaced.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0745

MICROWAVE OVENS. 4-501.13​

Microwave ovens must meet the safety standards in Code of Federal Regulations, title 21,​ section 1030.10.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0750

WAREWASHING EQUIPMENT AND FOOD PREPARATION SINKS;​ CLEANING FREQUENCY. 4-501.14​

A warewashing machine; the compartments of sinks, basins, or other receptacles used for​ washing and rinsing equipment, utensils, or raw foods, or laundering wiping cloths; and drainboards​ or other equipment used to substitute for drainboards as specified in part 4626.0685 must be cleaned:​ A. before use;​ B. throughout the day at a frequency necessary to prevent recontamination of equipment​ and utensils and to ensure that the equipment performs its intended function; and​ C. if used, at least every 24 hours.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0755

WAREWASHING MACHINE; MANUFACTURER'S OPERATING​ INSTRUCTIONS. 4-501.15​

A. A warewashing machine and its auxiliary components must be operated according to​ the machine's data plate and other manufacturer's instructions.​ B. A warewashing machine's conveyor speed or automatic cycle times must be maintained​ accurately timed according to manufacturer's specifications.​

​

4626.0755​

MINNESOTA RULES​

114​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0760

WAREWASHING SINKS; USE LIMITATION. 4-501.16​

A. A warewashing sink must not be used for handwashing or dumping mop water.​ B. For food establishments licensed before September 8, 1998:​ (1) a warewashing sink may be used to wash wiping cloths, wash produce, or thaw food​ if the sink is cleaned as specified in part 4626.0750 before and after each time it is used to wash​ wiping cloths, wash produce, or thaw food; and​ (2) sinks used to wash or thaw food must be sanitized as specified in parts 4626.0900​ and 4626.0905 before and after using the sink to wash or thaw food.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0765

WAREWASHING EQUIPMENT; CLEANING AGENTS. 4-501.17​

When used for warewashing, the wash compartment of a sink, mechanical warewasher, or wash​ receptacle of alternative manual warewashing equipment specified in part 4626.0680, item C, must​ contain a wash solution of soap, detergent, acid cleaner, alkaline cleaner, degreaser, abrasive cleaner,​ or other cleaning agent according to the cleaning agent manufacturer's label instructions.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0770

WAREWASHING EQUIPMENT; CLEAN SOLUTIONS. 4-501.18​

The wash, rinse, and sanitize solutions must be maintained clean.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0775

MANUAL WAREWASHING EQUIPMENT; WASH SOLUTION​ TEMPERATURE. 4-501.19​

The temperature of the wash solution in manual warewashing equipment must be maintained​ at not less than 110 degrees F (43 degrees C) or the temperature specified on the cleaning agent​ manufacturer's label instructions.P2​

​

115​

MINNESOTA RULES​

4626.0790​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0780 FOOD PREPARATION SINKS.​ A. A newly licensed food establishment must have a separate food preparation sink if food​ will be washed or thawed using a sink.​ B. If a food establishment is extensively remodeled, or adds a food product to the menu​ that requires washing or thawing in a sink, a separate food preparation sink must be provided.​ C. A food preparation sink must not be used for anything other than food preparation.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0785

MECHANICAL WAREWASHING EQUIPMENT; WASH SOLUTION​ TEMPERATURE. 4-501.110​

A. The temperature of the wash solution in spray-type warewashers that use hot water to​ sanitize must not be less than:​ (1) for a stationary rack, single temperature machine, 165 degrees F (74 degrees C);P2​ (2) for a stationary rack, dual temperature machine, 150 degrees F (66 degrees C);P2​ (3) for a single tank, conveyor, dual temperature machine, 160 degrees F (71 degrees​ C);P2 or​ (4) for a multitank, conveyor, multitemperature machine, 150 degrees F (66 degrees​ C).P2​ B. The temperature of the wash solution in spray-type warewashers that use chemicals to​ sanitize must not be less than 120 degrees F (49 degrees C).P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0790

MANUAL WAREWASHING EQUIPMENT; HOT WATER SANITIZATION​ TEMPERATURES. 4-501.111​

If immersion in hot water is used for sanitizing in a manual operation, the temperature of the​ water must be maintained at 171 degrees F (77 degrees C) or above.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

4626.0790​

MINNESOTA RULES​

116​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0795

MECHANICAL WAREWASHING EQUIPMENT; HOT WATER​ SANITIZATION TEMPERATURES. 4-501.112​

A. Except as specified in item B, in a mechanical operation, the temperature of the fresh​ hot water sanitizing rinse as it enters the manifold must not be more than 194 degrees F (90 degrees​ C) or less than:P2​ (1) for a stationary rack, single temperature machine, 165 degrees F (74 degrees C);P2​ or​ (2) for all other machines, 180 degrees F (82 degrees C).P2​ B. The maximum temperature specified in item A does not apply to high pressure and​ temperature systems with wand-type, hand-held spraying devices used for in-place cleaning and​ sanitizing of equipment, such as meat saws.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0800

MECHANICAL WAREWASHING EQUIPMENT; SANITIZATION RINSE​ PRESSURE. 4-501.113​

The flow pressure of the fresh hot water sanitizing rinse in a warewashing machine, as measured​ in the water line immediately downstream or upstream from the fresh hot water sanitizing rinse​ control valve, must be within the range specified on the machine manufacturer's data plate and must​ not be less than 5 pounds per square inch (35 kilopascals) or more than 30 pounds per square inch​ (200 kilopascals).​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0805 MANUAL AND MECHANICAL WAREWASHING EQUIPMENT; CHEMICAL​ SANITIZATION, TEMPERATURE, PH, CONCENTRATION, AND HARDNESS.​ 4-501.114​ A. A chemical sanitizer used in a sanitizing solution for a manual or mechanical operation​ at the exposure times specified in part 4626.0905, item C, must meet the requirements of part​ 4626.1620. The sanitizer must be used according to this part and the manufacturer's label approved​ by the U.S. Environmental Protection Agency.P1​ B. The sanitizer must not exceed the amount specified on the manufacturer's label approved​ by the U.S. Environmental Protection Agency.P1​

​

117​

MINNESOTA RULES​

4626.0805​

C. If a sanitizer is used in an amount less than the maximum amount specified on the label​ in item B, the sanitizer must be used as specified in this item.P1​ (1) Unless the product label specifies otherwise, a chlorine solution must have a​ minimum concentration of 50 ppm,P1 and:​ (a) a minimum temperature of 75 degrees F (24 degrees C) for water with a pH of​ 8 or less;P1 or​ (b) a minimum temperature of 100 degrees F (38 degrees C) for water with a pH​ of 8.1 to 10.P1​ (2) An iodine solution must have:​ (a) a minimum temperature of 68 degrees F (20 degrees C);P1​ (b) a pH of 5.0 or less, unless the manufacturer's use directions included in the​ labeling specify a higher pH limit of effectiveness;P1 and​ (c) a concentration between 12.5 mg/L and 25 mg/L.P1​ (3) A quaternary ammonium compound solution must:​ (a) have a minimum temperature of 75 degrees F (24 degrees C);P1​ (b) have a concentration specified in Code of Federal Regulations, title 21, part​ 178, subpart B, section 178.1010, and as indicated by the manufacturer's use directions included​ in the labeling;P1 and​ (c) be used only in water with 500 mg/L hardness or less or in water having a​ hardness no greater than specified by the manufacturer's label.P1​ D. If another solution of a chemical specified under items A to C is used, the licensee shall​ demonstrate that the solution achieves sanitization as defined in part 4626.0020, subpart 75, and​ the use of the solution must be approved by the regulatory authority.P1​ E. If a chemical sanitizer other than chlorine, iodine, or a quaternary ammonium compound​ is used, the chemical sanitizer must be applied according to U.S. Environmental Protection​ Agency-registered label use instructions.P1​ F. If a chemical sanitizer is generated by a device located on site at the food establishment,​ it must be used as specified in items A to D and must be produced by a device that:​ (1) complies with regulation as specified in United States Code, title 7, sections 136 to​ 136q;P1​ (2) complies with Code of Federal Regulations, title 40, sections 152.500 and 156.10;P1​ (3) displays the U.S. Environmental Protection Agency device manufacturing facility​ registration number on the device;P2 and​

4626.0805​

MINNESOTA RULES​

118​

(4) is operated and maintained according to the manufacturer's instructions.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0810

MANUAL WAREWASHING EQUIPMENT; CHEMICAL SANITIZATION​ USING DETERGENT-SANITIZERS. 4-501.115​

If a detergent-sanitizer is used to sanitize in a cleaning and sanitizing procedure where there is​ no distinct water rinse between the washing and sanitizing steps, the agent applied in the sanitizing​ step must be the same detergent-sanitizer that is used in the washing step.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0815

WAREWASHING EQUIPMENT TEST KIT. 4-501.116​

Concentration of the sanitizing solution must be accurately determined by using a test kit or​ other device.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0820 UTENSILS AND TEMPERATURE MEASURING DEVICES; GOOD REPAIR​ AND PROPER CALIBRATION. 4-502.11​ A. Utensils must be maintained in a state of repair or condition that complies with parts​ 4626.0450 to 4626.0670 or must be discarded.​ B. Food temperature measuring devices must be calibrated according to manufacturer's​ specifications as necessary to ensure their accuracy.P2​ C. Ambient air temperature, water pressure, and water temperature measuring devices must​ be maintained in good repair and be accurate within the intended range of use.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0825 SINGLE-SERVICE AND SINGLE-USE ARTICLES; REQUIRED USE. 4-502.12​ A food establishment without facilities specified in parts 4626.0840 to 4626.0905 for cleaning​ and sanitizing kitchenware and tableware must provide only single-use kitchenware, single-service​

​

119​

MINNESOTA RULES​

4626.0840​

articles, and single-use articles for use by food employees and single-service articles for use by the​ consumer.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0830

SINGLE-SERVICE AND SINGLE-USE ARTICLES; RE-USE LIMITATION.​ 4-502.13​

Single-service and single-use articles must not be re-used.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0833 BULK MILK CONTAINERS.​ The bulk milk container dispensing tube must be cut on the diagonal leaving no more than 1​ inch protruding from the chilled dispensing head.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0835

SHELLS; USE LIMITATION. 4-502.14​

Mollusk and crustacea shells must not be used more than once as serving containers.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ CLEANING EQUIPMENT AND UTENSILS​ 4626.0840

EQUIPMENT, FOOD-CONTACT SURFACES, NON-FOOD-CONTACT​ SURFACES, AND UTENSILS. 4-601.11​

A. Equipment food-contact surfaces and utensils must be clean to sight and touch.P2​ B. The food-contact surfaces of cooking equipment and pans must be kept free of encrusted​ grease deposits and other soil accumulations.​ C. Non-food-contact surfaces of equipment must be kept free of an accumulation of dust,​ dirt, food residue, and other debris.​

​

4626.0840​

MINNESOTA RULES​

120​

D. Water filters used as part of a vending machine must be cleaned or replaced according​ to the manufacturer's instructions.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0845

EQUIPMENT; FOOD-CONTACT SURFACES, AND UTENSILS. 4-602.11​

A. Equipment food-contact surfaces and utensils must be cleaned:​ (1) except as specified in item B, before each use with a different type of raw animal​ food, such as beef, fish, lamb, pork, or poultry;P1​ (2) each time there is a change from working with raw foods to working with ready-to-eat​ foods;P1​ (3) between uses with raw fruits or vegetables and with TCS food;P1​ (4) before using or storing a food temperature measuring device;P1 and​ (5) at any time during the operation when contamination may have occurred.P1​ B. Item A, subitem (1), does not apply if the food-contact surface or utensil is in contact​ with a succession of different raw animal foods each requiring a higher cooking temperature than​ the previous type as specified in part 4626.0340.​ C. Except as specified in item D, if used with TCS food, equipment food-contact surfaces​ and utensils must be cleaned throughout the day at least once every 4 hours.P1​ D. Surfaces of utensils and equipment contacting TCS food may be cleaned less frequently​ than every 4 hours if:​ (1) in storage, containers of TCS food and their contents are maintained at temperatures​ specified in part 4626.0395 and the containers are cleaned when they are empty;​ (2) utensils and equipment are used to prepare food in a refrigerated room or area that​ is maintained at one of the temperatures in the chart in unit (a):​ (a) the utensils and equipment are cleaned at the frequency in the following chart​ that corresponds to the temperature; and​ Temperature​

Cleaning Frequency​

41 degrees F (5 degrees C) or less​

24 hours​

greater than 41 degrees F to 45 degrees F (greater​ than 5 degrees C to 7.2 degrees C)​

20 hours​

121​

MINNESOTA RULES​

4626.0845​

greater than 45 degrees F to 50 degrees F (greater​ than 7.2 degrees C to 10 degrees C)​

16 hours​

greater than 50 degrees F to 55 degrees F (greater​ than 10 degrees C to 12.8 degrees C)​

10 hours​

(b) the cleaning frequency based on the ambient temperature of the refrigerated​ room or area is documented in the food establishment;​ (3) containers in serving areas such as salad bars, delis, and cafeteria lines that hold​ ready-to-eat TCS food that is maintained at the temperatures specified in part 4626.0395 are​ intermittently combined with additional supplies of the same food that is at the required temperature​ and the containers are cleaned at least every 24 hours;​ (4) temperature measuring devices are maintained in contact with food in a container​ of deli food or a roast, and held at the temperatures specified in part 4626.0395;​ (5) equipment such as a reach-in refrigerator that is used for storage of packaged or​ unpackaged food, if the equipment is cleaned at a frequency necessary to preclude accumulation​ of soil residues;​ (6) the cleaning schedule is approved based on consideration of:​ (a) characteristics of the equipment and its use;​ (b) the type of food involved;​ (c) the amount of food residue accumulation; and​ (d) the temperature at which the food is maintained during the operation and the​ potential for the rapid and progressive multiplication of pathogenic or toxigenic microorganisms​ that are capable of causing foodborne disease; or​ (7) in-use utensils are intermittently stored in a container of water in which the water​ is maintained at 135 degrees F (57 degrees C) or more and the utensils and container are cleaned​ at least every 24 hours or at a frequency necessary to preclude accumulation of soil residues.​ E. Except when dry cleaning methods are used as specified in part 4626.0860, surfaces of​ utensils and equipment contacting food that is not TCS food must be cleaned:​ (1) at any time when contamination may have occurred;​ (2) at least every 24 hours for iced tea dispensers and consumer self-service utensils​ such as tongs, scoops, or ladles;​ (3) before restocking consumer self-service equipment and utensils such as condiment​ dispensers and display containers; and​

​

4626.0845​

MINNESOTA RULES​

122​

(4) in equipment such as ice bins and beverage dispensing nozzles, and the enclosed​ components of equipment such as ice makers, cooking oil storage tanks and distribution lines,​ beverage and syrup dispensing lines or tubes, coffee bean grinders, and water vending equipment:​ (a) at a frequency specified by the manufacturer; or​ (b) absent manufacturer specifications, at a frequency necessary to preclude​ accumulation of soil or mold.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0850

COOKING AND BAKING EQUIPMENT. 4-602.12​

A. The food-contact surfaces of cooking and baking equipment must be cleaned at least​ every 24 hours. This part does not apply to hot oil cooking and filtering equipment if it is cleaned​ as specified in part 4626.0845, item D, subitem (6).​ B. The cavities and door seals of microwave ovens must be cleaned at least every 24 hours​ by using the manufacturer's recommended cleaning procedure.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0855

NON-FOOD-CONTACT SURFACES; CLEANING FREQUENCY. 4-602.13​

Non-food-contact surfaces of equipment must be cleaned at a frequency necessary to preclude​ accumulation of soil residues.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0860

DRY CLEANING. 4-603.11​

A. If used, dry cleaning methods such as brushing, scraping, and vacuuming must contact​ only surfaces that are soiled with dry food residues that are not TCS food.​ B. Cleaning equipment used in dry cleaning food-contact surfaces must not be used for​ any other purpose.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

123​

MINNESOTA RULES​

4626.0865

4626.0880​

PRECLEANING. 4-603.12​

A. Food debris on equipment and utensils must be scraped over a waste disposal unit or​ garbage receptacle or must be removed in a warewashing machine with a prewash cycle.​ B. If necessary for effective cleaning, utensils and equipment must be preflushed, presoaked,​ or scrubbed with abrasives.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0870

LOADING OF SOILED ITEMS; WAREWASHING MACHINES. 4-603.13​

Soiled items to be cleaned in a warewashing machine must be loaded into racks, trays, or baskets​ or onto conveyors in a position that:​ A. exposes the items to the unobstructed spray from all cycles; and​ B. allows the items to drain.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0875

WET CLEANING. 4-603.14​

A. Equipment food-contact surfaces and utensils must be effectively washed to remove or​ completely loosen soils by using the manual or mechanical means necessary, such as the application​ of detergents containing wetting agents and emulsifiers; acid, alkaline, or abrasive cleaners; hot​ water; brushes; scouring pads; high-pressure sprays; or ultrasonic devices.​ B. The washing procedures selected must be based on the type and purpose of the equipment​ or utensil and on the type of soil to be removed.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0880 WASHING; PROCEDURES FOR ALTERNATIVE MANUAL WAREWASHING​ EQUIPMENT. 4-603.15​ If washing in sink compartments or a warewashing machine is impractical, such as when the​ equipment is fixed or the utensils are too large, washing must be done by using alternative manual​ warewashing equipment specified in part 4626.0680, item C, according to the following procedures:​ A. equipment must be disassembled as necessary to allow access of the detergent solution​ to all parts;​

​

4626.0880​

MINNESOTA RULES​

124​

B. equipment components and utensils must be scraped or roughly cleaned to remove food​ particle accumulation; and​ C. equipment and utensils must be washed as specified in part 4626.0875, item A.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0885

UTENSILS AND EQUIPMENT; RINSING PROCEDURES. 4-603.16​

Washed utensils and equipment must be rinsed so that abrasives are removed and cleaning​ chemicals are removed or diluted through the use of water or a detergent-sanitizer solution using​ one of the following procedures:​ A. use of a distinct, separate water rinse after washing and before sanitizing if using:​ (1) a 3-compartment sink;​ (2) alternative manual warewashing equipment equivalent to a 3-compartment sink​ specified in part 4626.0680, item C; or​ (3) a 3-step washing, rinsing, and sanitizing procedure in a warewashing system for​ CIP equipment;​ B. use of a detergent-sanitizer specified in part 4626.0810 if using:​ (1) alternative warewashing equipment specified in part 4626.0680, item C, that is​ approved for use with a detergent-sanitizer; or​ (2) a warewashing system for CIP equipment;​ C. if using a warewashing machine that does not recycle the sanitizing solution as specified​ in item D, or alternative manual warewashing equipment, such as sprayers, use of a nondistinct​ water rinse that is:​ (1) integrated in the application of the sanitizing solution; and​ (2) wasted immediately after each application; or​ D. if using a warewashing machine that recycles the sanitizing solution for use in the next​ wash cycle, use of a nondistinct water rinse that is integrated in the application of the sanitizing​ solution.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0890 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​

125​

MINNESOTA RULES​

4626.0905​

SANITIZING EQUIPMENT AND UTENSILS​ 4626.0895 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.0900

BEFORE USE AFTER CLEANING. 4-702.11​

Utensils and food-contact surfaces of equipment must be sanitized before use after cleaning.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0905

HOT WATER AND CHEMICAL SANITIZATION. 4-703.11​

After being cleaned, equipment, food-contact surfaces, and utensils must be sanitized in:​ A. hot water manual operations by immersion for at least 30 seconds as specified in part​ 4626.0790;P1​ B. hot water mechanical operations by being cycled through equipment that is set up as​ specified in parts 4626.0755, 4626.0795, and 4626.0800 and achieving a utensil surface temperature​ of 160 degrees F (71 degrees C) as measured by an irreversible registering temperature indicator;P1​ or​ C. chemical manual or mechanical operations, including the application of sanitizing​ chemicals by immersion, manual swabbing, brushing, or pressure spraying methods, using a solution​ specified in part 4626.0805. Contact times must be consistent with U.S. Environmental Protection​ Agency-registered label use instructions by providing:​ (1) except as specified under subitem (2), a contact time of at least 10 seconds for a​ chlorine solution specified in part 4626.0805, item C, subitem (1);P1​ (2) a contact time of at least 7 seconds for a chlorine solution of 50 mg/L that has a pH​ of 10 or less and a temperature of at least 100 degrees F (38 degrees C) or a pH of 8 or less and a​ temperature of at least 75 degrees F (24 degrees C);P1​ (3) a contact time of at least 30 seconds for other chemical sanitizing solutions;P1 or​ (4) a contact time used in relationship with a combination of temperature, concentration,​ and pH that, when evaluated for efficacy, yields sanitization as defined in part 4626.0020, subpart​ 75.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.0910​

MINNESOTA RULES​

126​

LAUNDERING​ 4626.0910

CLEAN LINENS. 4-801.11​

Clean linens must be free from food residues and other soiling matter.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0915 LINENS, CLOTH GLOVES, AND WIPING CLOTHS; FREQUENCY OF​ LAUNDERING. 4-802.11​ A. Linens that do not come in direct contact with food must be laundered between operations​ if they become wet, sticky, or visibly soiled.​ B. Cloth gloves used as specified in part 4626.0287, item D, must be laundered before​ being used with a different type of raw animal food, such as beef, lamb, pork, fish, or poultry.​ C. Linens used as specified in part 4626.0280 and cloth napkins must be laundered between​ each use.​ D. Wet wiping cloths must be laundered daily.​ E. Dry wiping cloths must be laundered as necessary to prevent contamination of food and​ clean serving utensils.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0920

STORAGE OF SOILED LINENS. 4-803.11​

Soiled linens must be kept in clean, nonabsorbent receptacles or clean, washable laundry bags​ and stored and transported to prevent contamination of food, clean equipment, clean utensils, and​ single-service and single-use articles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0925

LINENS; MECHANICAL WASHING. 4-803.12​

A. Except as specified in item B, linens must be mechanically washed.​ B. In food establishments in which only wiping cloths are laundered as specified in part​ 4626.0695, item B, the wiping cloths may be laundered in a mechanical washer, a sink designated​

127​

MINNESOTA RULES​

4626.0940​

only for laundering wiping cloths, or a warewashing sink that is cleaned as specified in part​ 4626.0750.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0930

LAUNDRY FACILITIES; USE LIMITATIONS. 4-803.13​

A. Except as specified in item B, laundry facilities on the premises of a food establishment​ must be used only for the washing and drying of items used in the operation of the establishment.​ B. Separate laundry facilities located on the premises for general laundering for institutions​ providing boarding and lodging may also be used for laundering food establishment items.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ PROTECTING CLEAN ITEMS​ 4626.0935

EQUIPMENT AND UTENSILS; AIR-DRYING REQUIRED. 4-901.11​

A. Except as specified in item B, after cleaning and sanitizing, equipment and utensils must​ be air-dried.​ B. Utensils that have been air-dried may be polished with cloths that are maintained clean​ and dry.​ C. After cleaning and sanitizing, equipment and utensils must be adequately drained before​ contacting food if chemical sanitizer formulations and limits in Code of Federal Regulations, title​ 40, section 180.940, are used.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0940

WIPING CLOTHS; AIR-DRYING LOCATIONS. 4-901.12​

Wiping cloths laundered in a food establishment that does not have a mechanical clothes dryer​ specified in part 4626.0695, item B, must be air-dried in a location and in a manner that prevents​ contamination of food, equipment, utensils, linens, single-service and single-use articles, and the​ wiping cloths. This part does not apply if wiping cloths are stored after laundering in a sanitizing​ solution as specified in part 4626.0805.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

4626.0940​

MINNESOTA RULES​

128​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0945

LUBRICANTS; FOOD-CONTACT SURFACES. 4-902.11​

Lubricants as specified in part 4626.1640 must be applied to food-contact surfaces that require​ lubrication in a manner that does not contaminate the food-contact surfaces.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0950

EQUIPMENT REASSEMBLY. 4-902.12​

Equipment must be reassembled so that food-contact surfaces are not contaminated.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0955

EQUIPMENT, UTENSILS, LINENS, AND SINGLE-SERVICE AND​ SINGLE-USE ARTICLES; STORAGE. 4-903.11​

A. Except as specified in item D, clean equipment and utensils, laundered linens, and​ single-service and single-use articles must be stored:​ (1) in a clean, dry location;​ (2) where they are not exposed to splash, dust, or other contamination; and​ (3) at least 6 inches (15 centimeters) above the floor.​ B. Clean equipment and utensils must be stored as specified in item A and must be stored:​ (1) in a self-draining position that allows air drying; and​ (2) covered or inverted.​ C. Single-service and single-use articles must be stored as specified in item A and must be​ kept in the original protective package or stored by using other means that afford protection from​ contamination until used.​ D. Items that are kept in closed packages may be stored less than 6 inches (15 centimeters)​ above the floor on dollies, pallets, racks, and skids that are designed as specified in part 4626.0665.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

129​

MINNESOTA RULES​

4626.0960

4626.0965​

STORAGE PROHIBITIONS. 4-903.12​

A. Except as specified in item B, food, cleaned and sanitized equipment, utensils, laundered​ linens, or single-service and single-use articles must not be stored:​ (1) in locker rooms;​ (2) in toilet rooms;​ (3) in garbage rooms;​ (4) in mechanical rooms;​ (5) under sewer lines that are not shielded to intercept potential drips;​ (6) under leaking water lines including leaking automatic fire sprinkler heads or under​ lines on which water has condensed;​ (7) under open stairwells; or​ (8) under other sources of contamination.​ B. Laundered linens and single-service and single-use articles that are packaged or in a​ facility such as a cabinet may be stored in a locker room.​ C. If a mechanical clothes washer and dryer is provided, it must be located so that the​ washer and dryer is protected from contamination and is located only in an area where there is no​ exposed food, clean equipment, utensils, or linens, or unwrapped single-service or single-use articles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0965

KITCHENWARE AND TABLEWARE. 4-904.11​

A. Single-service and single-use articles and cleaned and sanitized utensils must be handled,​ displayed, and dispensed so that contamination of a food-contact or lip-contact surface is prevented.​ B. Knives, forks, and spoons that are not prewrapped must be presented so that only the​ handles are touched by employees and by consumers if consumer self-service is provided.​ C. Except as specified in item B, single-service articles that are intended for food contact​ or lip contact must be furnished for consumer self-service with the original individual wrapper​ intact or from an approved dispenser.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.0970​ 4626.0970

MINNESOTA RULES​

130​

SOILED TABLEWARE. 4-904.12​

Soiled tableware must be removed from consumer eating and drinking areas and handled so​ that clean tableware is not contaminated.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0975

PRESET TABLEWARE. 4-904.13​

A. Except as specified in item B, tableware that is preset must be protected from​ contamination by being wrapped, covered, or inverted.​ B. Preset tableware may be exposed if:​ (1) unused settings are removed when a consumer is seated; or​ (2) settings not removed when a consumer is seated are cleaned and sanitized before​ further use.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0977 RINSING EQUIPMENT AND UTENSILS AFTER CLEANING AND​ SANITIZING. 4-904.14​ After being cleaned and sanitized, equipment and utensils must not be rinsed before air drying​ or use unless:​ A. the rinse is applied directly from a drinking water supply by a warewashing machine​ that is maintained and operated as specified in parts 4626.0625 to 4626.0645 and 4626.0735 to​ 4626.0815; and​ B. the rinse is applied only after the equipment and utensils have been sanitized by the​ application of hot water, or by the application of a chemical sanitizer solution where the U.S.​ Environmental Protection Agency-registered label use instruction calls for rinsing off the sanitizer​ after it is applied in a commercial warewashing machine.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​

131​

MINNESOTA RULES​

4626.0995​

WATER​ 4626.0980 DRINKING WATER APPROVED SOURCE. 5-101.11​ Drinking water must be obtained from an approved source that meets the requirements in​ chapters 4720 and 4725 and Minnesota Statutes, section 31.175.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0985 DRINKING WATER SYSTEM FLUSHING AND DISINFECTION. 5-101.12​ A drinking water system must be flushed and disinfected according to chapters 4714, 4720,​ and 4725 before being placed in service after construction, repair, or modification and after an​ emergency situation, such as a flood, that may introduce contamination to the system.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 40 SR 71; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0990

BOTTLED DRINKING WATER. 5-101.13​

Bottled drinking water used or sold in a food establishment must be obtained from approved​ sources according to Code of Federal Regulations, title 21, part 129, and must comply with parts​ 1550.3200 to 1550.3320 and applicable federal and state laws.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.0995

DRINKING WATER STANDARDS. 5-102.11​

Except as specified in part 4626.1000:​ A. water from a public water system must meet the requirements of chapters 4714, 4720,​ and 4725;P1 and​ B. water from a nonpublic water system must meet the drinking water quality standards of​ noncommunity transient water systems.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 40 SR 71; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1000​ 4626.1000

MINNESOTA RULES​

132​

NONDRINKING WATER. 5-102.12​

Nondrinking water may be used only for nonculinary purposes such as air conditioning, nonfood​ equipment cooling, and fire protection.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1005

WATER SAMPLING. 5-102.13​

A. Drinking water from a public water system must be sampled and tested as required in​ chapter 4720.P2​ B. Drinking water from a nonpublic water system must be sampled at the same frequency​ and tested for the same parameters as a public noncommunity transient water system. Sample​ collection protocols must follow the requirements in chapter 4720.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1010 WATER SAMPLE REPORT; NOTIFICATION AND RETENTION. 5-102.14​ A. The most recent report of water quality shall be retained on file in the food establishment​ and the report shall be maintained as specified in chapter 4720.​ B. The licensee of a food establishment with a nonpublic water system shall notify the​ regulatory authority of the failure to comply with national primary drinking water regulations as​ follows:​ (1) within 48 hours for nitrate;P2​ (2) within 24 hours for total coliform;P2 and​ (3) immediately when the result is known for E. coli.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1015

WATER SYSTEM CAPACITY. 5-103.11​

A. The water source and system must be of sufficient capacity to meet the peak water​ demands of the food establishment.P2​ B. Hot water generation and distribution systems must be sufficient to meet the peak hot​ water demands throughout the food establishment.P2​

​

133​

MINNESOTA RULES​

4626.1035​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1020

WATER PRESSURE. 5-103.12​

Water under pressure must be provided to all fixtures, equipment, and nonfood equipment that​ are required to use water except that a seasonal temporary food stand that is disassembled after​ every use, a special event food stand, or a response to a temporary interruption of a water supply​ need not be under pressure.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1025 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ WATER SYSTEM. 5-104.11​

4626.1030

Water must be received from the source through the use of:​ A. an approved public water main regulated under chapter 4720;P2 or​ B. one or more of the following means that must be constructed, maintained, and operated​ according to applicable state laws and rules:​ (1) a nonpublic water main, water pumps, pipes, hoses, connections, and other​ appurtenances that comply with chapters 4714 and 4720;P2​ (2) water haulers that comply with parts 4720.4000 to 4720.4400;P2 or​ (3) water tanks that comply with parts 4626.1135 to 4626.1175 and 4720.4300 to​ 4720.4400.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 40 SR 71; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1035

ALTERNATIVE WATER SUPPLY. 5-104.12​

Water meeting the requirements of parts 4626.0980 to 4626.1020 must be made available for​ a food cart, mobile food unit, seasonal temporary food stand, or special event food stand without​ a permanent water supply, and for a food establishment with a temporary interruption of its water​ supply through:​ A. containers of commercially bottled drinking water that comply with Code of Federal​ Regulations, title 21, part 129, and parts 1550.3200 to 1550.3320;P2​

​

4626.1035​

MINNESOTA RULES​

134​

B. one or more closed portable water containers that comply with parts 4720.4300 to​ 4720.4400 and applicable state laws;P2​ C. an enclosed vehicular water tank that complies with parts 4720.4300 to 4720.4400;P2​ D. piping, tubing, or hoses connected to an adjacent source that complies with parts​ 4626.1140 and 4626.1160 and chapters 4720 and 4725;P2 or​ E. a water vending machine as defined in part 1550.3200, subpart 32.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ PLUMBING SYSTEM​ 4626.1040

PLUMBING SYSTEM; APPROVED MATERIALS, INSTALLATION, AND​ MAINTENANCE. 5-201.11​

A. A plumbing system must be designed, constructed, installed, and repaired with approved​ materials, equipment, and devices according to chapter 4714 and Minnesota Statutes, sections​ 326B.43 to 326B.49.P1​ B. A plumbing system must be maintained in good repair.​ C. A water filter must be made of safe materials.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; L 2007 c 140 art 6 s 15; art 13 s 4; 40 SR 71; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1045 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1050

HANDWASHING SINK; INSTALLATION. 5-202.12​

A. A handwashing sink must be equipped to provide water at a temperature to allow​ handwashing for at least 15 seconds through a mixing valve or combination faucet.P2​ B. A steam mixing valve must not be used at a handwashing sink.​ C. A self-closing, slow-closing, or metering faucet must provide a flow of water for at least​ 15 seconds without the need to reactivate the faucet.​ D. An automatic handwashing facility must be installed according to the manufacturer's​ instructions and specifications.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

135​

MINNESOTA RULES​

4626.1075​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1055 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1060 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1065

WATER CONDITIONING DEVICE; DESIGN. 5-202.15​

A water filter, screen, or other water conditioning device installed on water lines must be​ designed and located to facilitate disassembly for periodic servicing and cleaning. A water filter​ element must be a replaceable type.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1070

HANDWASHING SINKS; NUMBERS AND CAPACITY. 5-203.11​

A. Except as specified in items B and C, each food establishment must install at least 1​ handwashing sink, or the number of handwashing sinks necessary for the convenient use by​ employees in the areas specified in part 4626.1095.P2​ B. When food exposure is limited and handwashing sinks are not conveniently available​ at vending machine locations, employees may use chemically treated towelettes for handwashing.​ C. A special event food stand or seasonal temporary food stand that is disassembled after​ each use may use a handwashing device with water delivered under pressure or by gravity with a​ faucet or spigot that provides hands-free flow of water.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 40 SR 71; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1075

TOILETS AND URINALS. 5-203.12​

A. At least 1 toilet and not fewer than the number of toilets required by federal and state​ laws and rules must be provided. Urinals may be substituted for toilets if more than the minimum​ number of toilets required under state or federal laws and rules are provided.​ B. A plumbing fixture such as a handwashing sink, toilet, or urinal must be easily cleanable.​ C. A food cart, special event food stand, temporary food establishment, retail food vehicle,​ portable structure, or cart is exempt from item A.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

4626.1075​

MINNESOTA RULES​

136​

History: 23 SR 519; 40 SR 71; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1080

SERVICE SINK. 5-203.13​

A. At least 1 service sink or 1 curbed cleaning facility equipped with a floor drain must be​ provided and conveniently located for the cleaning of mops or similar wet floor cleaning tools and​ for the disposal of mop water and similar liquid waste. The service sink must not be used for any​ other purpose.​ B. Toilets and urinals must not be used as a service sink for the disposal of mop water and​ similar liquid waste.​ C. A food cart, special event food stand, temporary food establishment, retail food vehicle,​ portable structure, or cart is exempt from item A.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1085

BACKFLOW PREVENTION DEVICE; WHEN REQUIRED. 5-203.14​

A. A plumbing system must be installed to preclude backflow of a solid, liquid, or gas​ contaminant into the water supply system at each point of use at the food establishment according​ to chapter 4714.P1​ B. A backflow prevention device must be located so that it may be serviced and maintained.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1090 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1095

HANDWASHING SINKS. 5-204.11​

A handwashing sink must be located:​ A. to allow convenient use by employees in food preparation, food dispensing, and​ warewashing areas;P2 and​ B. in, or immediately adjacent to, toilet rooms.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

137​

MINNESOTA RULES​

4626.1125​

4626.1100 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1105 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1110

USING HANDWASHING SINKS. 5-205.11​

A. A handwashing sink must be maintained so that it is accessible at all times for employee​ use.P2​ B. A handwashing sink must not be used for purposes other than handwashing.P2​ C. An automatic handwashing facility must be used according to the manufacturer's​ instructions.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1115

CROSS-CONNECTIONS PROHIBITED. 5-205.12​

A. A person shall not create a cross-connection by connecting a pipe or conduit between​ the drinking water system and a nondrinking water system or a water system of unknown quality.P1​ B. The piping of a nondrinking water system must be durably identified so that it is readily​ distinguishable from piping that carries drinking water.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1120

SCHEDULING INSPECTION AND SERVICE FOR A WATER SYSTEM​ DEVICE. 5-205.13​

A device such as a water treatment device or backflow preventer must be scheduled for inspection​ and service according to the manufacturer's instructions and as necessary to prevent device failure​ based on local water conditions. Records demonstrating inspection and service must be maintained​ by the person in charge.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 40 SR 71; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1125

WATER RESERVOIR OF FOGGING DEVICES; CLEANING. 5-205.14​

A. A reservoir that is used to supply water to a produce fogger or similar device must be:​

4626.1125​

MINNESOTA RULES​

138​

(1) maintained according to the manufacturer's specifications;P1 and​ (2) cleaned according to the manufacturer's specifications or according to the procedures​ in item B, whichever is more stringent.P1​ B. Cleaning procedures must include at least the following steps and must be conducted at​ least once a week:​ (1) draining and complete disassembly of the water and aerosol contact parts;P1​ (2) brush-cleaning the reservoir, aerosol tubing, and discharge nozzles with a suitable​ detergent solution;P1​ (3) flushing the complete system with water to remove the detergent solution and​ particulate accumulation;P1 and​ (4) rinsing by immersing, spraying, or swabbing the reservoir, aerosol tubing, and​ discharge nozzles with an effective sanitizing chemical per the manufacturer's recommendations.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1130 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ WATER TANKS​ 4626.1135 WATER TANKS; APPROVED. 5-301.11​ A water tank used to supply a food establishment, a food cart, a temporary food establishment,​ or any appurtenances must meet:​ A. the requirements specified in parts 4626.1135 to 4626.1175;​ B. the requirements specified in part 4626.0450; and​ C. the standards for water haulers specified in parts 4720.4300 to 4720.4400.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1140 DRINKING WATER HOSE; CONSTRUCTION AND IDENTIFICATION.​ 5-302.16​ A hose used for conveying drinking water from a water tank must be:​ A. of a food grade material;P1​

139​

MINNESOTA RULES​

4626.1155​

B. durable, corrosion-resistant, and nonabsorbent;​ C. resistant to pitting, chipping, crazing, scratching, scoring, distortion, and decomposition;​ D. finished with a smooth interior surface; and​ E. clearly and durably identified as to its use if not permanently attached to the water source.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1145

FILTER; COMPRESSED AIR. 5-303.11​

A filter that does not pass oil or oil vapors must be installed in the air supply line between the​ compressor and drinking water system when compressed air is used to pressurize the water tank​ system.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1150 WATER INLET, OUTLET, AND HOSES; PROTECTIVE COVER OR DEVICE.​ 5-303.12​ A cap and keeper chain, closed cabinet, closed storage tube, or other approved protective cover​ or device must be provided for a water inlet, outlet, and hose when the device is not in use.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1155

MOBILE FOOD ESTABLISHMENT WATER TANK INLET. 5-303.13​

A mobile food establishment's water tank inlet must be:​ A. 3/4 inch (19.1 millimeters) in inner diameter or less; and​ B. provided with a hose connection of a size or type that will prevent its use for any other​ service.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1160​

MINNESOTA RULES​

140​

4626.1160 WATER SYSTEM FLUSHING AND SANITIZATION. 5-304.11​ A water tank, pump, and hose must be flushed and sanitized before being placed in service after​ construction, repair, modification, and periods of nonuse.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1165 WATER TANK, PUMP, AND HOSE; BACKFLOW PREVENTION. 5-304.12​ A person shall operate a water tank, pump, and hose so that backflow and other contamination​ of the water supply are prevented.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1170 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1175

WATER TANK, PUMP, AND HOSE; DEDICATION. 5-304.14​

A. Except as specified in item B, water tanks, pumps, and hoses used for conveying drinking​ water must be used for no other purpose.P1​ B. Water tanks, pumps, and hoses approved for liquid foods may be used for conveying​ drinking water if they are cleaned and sanitized before they are used to convey water.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ SEWAGE​ 4626.1180 SEWAGE HOLDING TANK CAPACITY AND DRAINAGE. 5-401.11​ A. A sewage holding tank in a mobile food unit or seasonal temporary food establishment​ must be:​ (1) sized 15 percent larger in capacity than the water supply tank; and​ (2) sloped to a drain that is 1 inch (25 millimeters) in inner diameter or greater, and​ equipped with a shut-off valve.​ B. The sewage must not be discharged on the ground.​

141​

MINNESOTA RULES​

4626.1200​

C. The regulatory authority may approve an alternate method for conveying and disposing​ of sewage from a mobile food unit or seasonal temporary food establishment in lieu of a​ waste-holding tank. The alternative method of conveying and disposing of sewage must meet the​ requirements of part 4626.1200.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1185 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1190

BACKFLOW PREVENTION. 5-402.11​

A. Except as specified in items B, C, and D, a direct connection must not exist between​ the sewage system and a drain originating from equipment in which food, portable equipment, or​ utensils are placed.P1​ B. Item A does not apply to floor drains that originate in refrigerated spaces that are​ constructed as an integral part of the building.​ C. If allowed by chapter 4714, a warewashing machine may have a direct connection​ between its waste outlet and a floor drain when the machine is located within 5 feet (1.5 meters)​ of a trapped floor drain and the machine outlet is connected to the inlet side of a properly vented​ floor drain trap.​ D. If allowed by chapter 4714, a warewashing or culinary sink may have a direct connection.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 40 SR 71; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1195

GREASE TRAP. 5-402.12​

If used, a grease trap must be located to be easily accessible for cleaning.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1200

CONVEYING SEWAGE. 5-402.13​

Sewage must be conveyed to the point of disposal through an approved sanitary sewage system​ or other system, including use of sewage transport vehicles, waste retention tanks, pumps, pipes,​ hoses, and connections that are constructed, maintained, and operated according to chapters 7080​ and 7081, and Minnesota Statutes, section 115.55.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

4626.1200​

MINNESOTA RULES​

142​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1205

REMOVING TEMPORARY FOOD ESTABLISHMENT WASTES. 5-402.14​

Sewage and other liquid wastes must be removed from a food cart, special event food stand,​ temporary food establishment, retail food vehicle, portable structure, or cart at an approved waste​ servicing area or by a sewage transport vehicle in such a way that a public health hazard or nuisance​ is not created.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1210

FLUSHING WASTE RETENTION TANK. 5-402.15​

A tank for liquid waste retention must be thoroughly flushed and drained in a sanitary manner​ during the servicing operation.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1215

APPROVED SEWAGE DISPOSAL SYSTEM. 5-403.11​

Sewage must be disposed through an approved facility that is:​ A. a public sewage treatment plant;P1 or​ B. an individual sewage disposal system that is sized, constructed, maintained, and operated​ according to chapters 7080 and 7081.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1220

OTHER LIQUID WASTES AND RAINWATER. 5-403.12​

Condensate drainage and other nonsewage liquids and rainwater must be drained from point​ of discharge to disposal according to chapters 7080, 7081, and 7083.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

143​

MINNESOTA RULES​

4626.1245​

REFUSE AND RECYCLABLES​ 4626.1225 REFUSE; INDOOR STORAGE AREA. 5-501.10​ If located within the food establishment, a storage area for refuse, recyclables, and returnables​ must meet the requirements in parts 4626.1325, 4626.1335 to 4626.1370, 4626.1395, and 4626.1400.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1230 REFUSE; OUTDOOR STORAGE SURFACE. 5-501.11​ An outdoor storage surface for refuse, recyclables, and returnables must be constructed of​ nonabsorbent material such as concrete or asphalt and must be smooth, durable, and sloped to drain.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1235 REFUSE; OUTDOOR ENCLOSURE. 5-501.12​ If used, an outdoor enclosure for refuse, recyclables, and returnables must be constructed of​ durable and cleanable materials.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1240 REFUSE; RECEPTACLES. 5-501.13​ A. Except as specified in item B, receptacles and waste handling units for refuse, recyclables,​ and returnables and for use with materials containing food residue must be durable, cleanable,​ insect- and rodent-resistant, leakproof, and nonabsorbent.​ B. Plastic bags and wet strength paper bags may be used to line receptacles for storage​ inside the food establishment or within closed outside receptacles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1245 REFUSE; RECEPTACLES IN VENDING MACHINES. 5-501.14​ A refuse receptacle must not be located within a vending machine, except that a receptacle for​ beverage bottle crown closures may be located within a vending machine.​

​

4626.1245​

MINNESOTA RULES​

144​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1250 REFUSE; OUTSIDE RECEPTACLES. 5-501.15​ A. Receptacles and waste handling units for refuse, recyclables, and returnables used with​ materials containing food residue and used outside the food establishment must be designed and​ constructed to have tight-fitting lids, doors, or covers.​ B. Receptacles and waste handling units for refuse and recyclables, such as an on-site​ compactor, must be installed so that accumulation of debris and insect and rodent attraction and​ harborage are minimized and effective cleaning is facilitated around and, if the equipment is not​ installed flush with the base pad, under the unit.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1255 REFUSE; STORAGE AREAS, ROOMS, AND RECEPTACLES; CAPACITY​ AND AVAILABILITY. 5-501.16​ A. An inside storage room and area, an outside storage area and enclosure, and receptacles​ must be of sufficient capacity to hold refuse, recyclables, and returnables that accumulate.​ B. A receptacle must be provided in each area of the food establishment or premises where​ refuse is generated or commonly discarded or where recyclables or returnables are placed.​ C. If disposable towels are used at handwashing sinks, a waste receptacle must be located​ at each sink or group of adjacent sinks.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1260

REFUSE; TOILET ROOM RECEPTACLE; COVERED. 5-501.17​

A toilet room must be provided with a covered receptacle for sanitary napkins or diapers.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

​

145​

MINNESOTA RULES​

4626.1275​

4626.1265 REFUSE; CLEANING IMPLEMENTS AND SUPPLIES. 5-501.18​ A. Except as specified in item B, suitable cleaning implements and supplies such as high​ pressure pumps, hot water, steam, and detergent, must be provided as necessary to effectively clean​ receptacles and waste handling units for refuse, recyclables, and returnables.​ B. Off-premises-based cleaning services with implements and supplies as specified in item​ A may be used if on-premises cleaning implements and supplies are not provided.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1270 REFUSE; STORAGE AREAS, REDEEMING MACHINES, EQUIPMENT, AND​ RECEPTACLES; LOCATION. 5-501.19​ A. An area designated for refuse, recyclables, returnables, and, except as specified in item​ B, a redeeming machine for recyclables or returnables must be located so that it is separate from​ food, equipment, utensils, linens, and single-service and single-use articles and a nuisance or a​ public health hazard is not created.​ B. A redeeming machine may be located in the packaged food storage area or consumer​ area of a food establishment if food, equipment, utensils, linens, and single-service and single-use​ articles are not subject to contamination from the machine and a public health hazard or nuisance​ is not created.​ C. The location of receptacles and waste handling units for refuse, recyclables, and​ returnables must not create a public health hazard or nuisance or interfere with the cleaning of​ adjacent space.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1275 STORING REFUSE, RECYCLABLES, AND RETURNABLES; INSECT AND​ RODENT CONTROL. 5-501.110​ Refuse, recyclables, and returnables must be stored in receptacles or waste handling units so​ that they are inaccessible to insects and rodents.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1280​ 4626.1280

MINNESOTA RULES​

146​

AREAS, ENCLOSURES, AND RECEPTACLES; GOOD REPAIR. 5-501.111​

Storage areas, enclosures, and receptacles for refuse, recyclables, and returnables must be​ maintained in good repair.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1285

OUTSIDE STORAGE PROHIBITIONS. 5-501.112​

A. Except as specified in item B, refuse receptacles not meeting the requirements specified​ in part 4626.1240, item A, including receptacles that are not rodent-resistant, unprotected plastic​ bags and paper bags, and baled units that contain materials with food residue, must not be stored​ outside.​ B. Cardboard or other packaging material that does not contain food residue and that is​ awaiting regularly scheduled delivery to a recycling or disposal site may be stored outside without​ being in a covered receptacle if it is stored so that it does not create a rodent harborage problem.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1290

COVERING RECEPTACLES. 5-501.113​

Receptacles and waste handling units for refuse, recyclables, and returnables must be kept​ covered:​ A. inside the food establishment:​ (1) if the receptacles and units contain food residue and are not in continuous use; or​ (2) after they are filled; and​ B. with tight-fitting lids or doors if kept outside the food establishment.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1295

USING DRAIN PLUGS. 5-501.114​

Drains in receptacles and waste handling units for refuse, recyclables, and returnables must​ have drain plugs in place.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

147​

MINNESOTA RULES​

4626.1315​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1300

MAINTAINING REFUSE AREAS AND ENCLOSURES. 5-501.115​

A storage area and enclosure for refuse, recyclables, or returnables must be maintained free of​ unnecessary items, as specified in part 4626.1580, and clean.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1305

CLEANING RECEPTACLES. 5-501.116​

A. Receptacles and waste handling units for refuse, recyclables, and returnables must be​ thoroughly cleaned in a way that does not contaminate food, equipment, utensils, linens, or​ single-service and single-use articles, and wastewater must be disposed of according to part​ 4626.1200 and applicable state laws and rules.​ B. Receptacles and waste handling units for refuse, recyclables, and returnables must be​ cleaned at a frequency necessary to prevent them from developing a build-up of soil or becoming​ attractants for insects and rodents.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1310 REFUSE, RECYCLABLES, AND RETURNABLES; REMOVAL FREQUENCY.​ 5-502.11​ Refuse, recyclables, and returnables must be removed from the premises at a frequency that​ will minimize the development of objectionable odors and other conditions that attract or harbor​ insects and rodents.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1315

RECEPTACLES OR VEHICLES. 5-502.12​

Refuse, recyclables, and returnables must be removed from the premises by way of:​ A. portable receptacles that are constructed and maintained according to applicable state​ laws and rules; or​ B. a transport vehicle that is constructed, maintained, and operated according to applicable​ state laws and rules.​

.​

4626.1315​

MINNESOTA RULES​

148​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1320 SOLID WASTE COMMUNITY OR INDIVIDUAL FACILITY. 5-503.11​ Solid waste not disposed of through the sewage system, such as through grinders and pulpers,​ must be recycled or disposed of in an approved public or private community recycling or refuse​ facility; or solid waste must be disposed of in an individual refuse facility such as a landfill or​ incinerator that is sized, constructed, maintained, and operated according to applicable state laws​ and rules.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ PHYSICAL FACILITY CONSTRUCTION MATERIALS​ 4626.1325 FLOORS, WALLS, AND CEILINGS; CHARACTERISTICS INDOOR AREAS​ AND MATERIALS. 6-101.11​ A. Except as specified in item B, materials for indoor floor, wall, and ceiling surfaces under​ conditions of normal use must be:​ (1) smooth, durable, and easily cleanable for areas where food establishment operations​ are conducted;​ (2) closely woven and easily cleanable carpet for all carpeted areas; and​ (3) nonabsorbent for areas subject to moisture such as food preparation areas, walk-in​ refrigerators, warewashing areas, toilet rooms, all servicing areas, and areas subject to flushing or​ spray cleaning methods.​ B. In any food cart, special event food stand, seasonal temporary food stand, seasonal​ permanent food stand, portable structure, or cart:​ (1) if graded to drain, a floor may be concrete, machine-laid asphalt, or dirt or gravel​ if it is covered with mats, removable platforms, duckboards, or other suitable materials approved​ by the regulatory authority that are effectively treated to control dust and mud; and​ (2) walls and ceilings must be constructed of a material that protects the interior from​ the weather and windblown dust and debris.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

149​

MINNESOTA RULES​

4626.1340​

4626.1330 OUTDOOR SURFACES; CHARACTERISTICS AND MATERIALS. 6-102.11​ A. Outdoor walking and driving areas must be surfaced with concrete, asphalt, gravel, or​ other materials that have been effectively treated to minimize dust, facilitate maintenance, and​ prevent muddy conditions.​ B. Exterior surfaces of buildings and mobile food units, seasonal permanent food stands,​ and retail food vehicles must be of weather-resistant materials and must comply with law.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ PHYSICAL FACILITY DESIGN AND CONSTRUCTION​ 4626.1335

FLOORS, WALLS, AND CEILINGS; CLEANABILITY. 6-201.11​

A. Except as specified in part 4626.1350, the floors, floor coverings, walls, wall coverings,​ and ceilings must be designed, constructed, and installed so they are smooth and easily cleanable,​ except that antislip floor coverings or applications may be used for safety reasons.​ B. Sealed concrete is prohibited in those areas described in part 4626.1325, item A, subitem​ (3), if food product packages, containers, or cases in those areas are opened. Sealed concrete is​ permitted in areas used exclusively for refuse storage.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1340

FLOORS, WALLS, AND CEILINGS; UTILITY LINES. 6-201.12​

A. Utility service lines and pipes must not be unnecessarily exposed.​ B. Exposed utility service lines and pipes must be installed so they do not obstruct or prevent​ cleaning of the floors, walls, or ceilings.​ C. Exposed horizontal utility service lines and pipes must not be installed directly on the​ floor.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1345​

MINNESOTA RULES​

150​

4626.1345 FLOOR AND WALL JUNCTURES; COVED AND ENCLOSED OR SEALED.​ 6-201.13​ A. In food establishments in which cleaning methods other than water flushing are used​ for cleaning floors, the floor and wall junctures must be coved and closed to no larger than 1/32​ inch (1 millimeter).​ B. The floors in food establishments in which water flushing cleaning methods are used​ must be provided with drains and graded to drain, and the floor and wall junctures must be coved​ and sealed.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1350

FLOOR CARPETING; RESTRICTIONS AND INSTALLATION. 6-201.14​

A. Carpeting or similar material must not be installed as a floor covering in food preparation​ areas; walk-in refrigerators or freezers; warewashing areas; toilet room areas where handwashing​ sinks, toilets, and urinals are located; refuse storage areas; wait stations; dressing rooms; locker​ rooms; janitorial areas; within 3 feet around permanently installed bars and salad bars, other food​ service equipment, and food storage rooms; or other areas where the floor is subject to moisture,​ flushing, or spray cleaning methods.​ B. If carpeting is installed as a floor covering in areas other than those specified in item A,​ it must be:​ (1) securely attached to the floor with a durable mastic, by using a stretch and tack​ method, or by another method; and​ (2) installed tightly against the wall under the coving or installed away from the wall​ with a space between the carpet and the wall and with the edges of the carpet secured by metal​ stripping or some other means.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1355

FLOOR COVERING; MATS AND DUCKBOARDS. 6-201.15​

Mats and duckboards must be designed to be removable and easily cleanable.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

151​

MINNESOTA RULES​

4626.1360

4626.1375​

WALL AND CEILING COVERINGS AND COATINGS. 6-201.16​

A. Wall and ceiling covering materials must be attached so that they are easily cleanable.​ B. Except in areas used only for dry storage, concrete, porous blocks or bricks used for​ indoor wall construction must be finished and sealed to provide a smooth, nonabsorbent, easily​ cleanable surface.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1365

WALLS AND CEILINGS; ATTACHMENTS. 6-201.17​

A. Except as specified in item B, attachments to walls and ceilings such as light fixtures,​ mechanical room ventilation system components, vent covers, wall mounted fans, decorative items,​ and other attachments must be easily cleanable.​ B. In a consumer area, wall and ceiling surfaces and decorative items and attachments that​ are provided for ambiance need not comply with item A if they are kept clean.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1370

WALLS AND CEILINGS; STUDS, JOISTS, AND RAFTERS. 6-201.18​

Except for temporary food establishments, studs, joists, and rafters must not be exposed in areas​ subject to moisture.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1375

LIGHT BULBS; PROTECTIVE SHIELDING. 6-202.11​

A. Except as specified in item B, light bulbs must be shielded, coated, or otherwise​ shatter-resistant in areas where there is exposed food; clean equipment, utensils, and linens; or​ unwrapped single-service and single-use articles.​ B. Shielded, coated, or otherwise shatter-resistant bulbs need not be used in areas used only​ for storing food in unopened packages, if:​ (1) the integrity of the packages cannot be affected by broken glass falling onto them;​ and​ (2) the packages are capable of being cleaned of debris from broken bulbs before the​ packages are opened.​

4626.1375​

MINNESOTA RULES​

152​

C. An infrared or other heat lamp must be protected against breakage by a shield surrounding​ and extending beyond the bulb so that only the face of the bulb is exposed.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1380

HEATING, VENTILATING, AND AIR CONDITIONING SYSTEM VENTS.​ 6-202.12​

Heating, ventilating, and air conditioning systems must be designed and installed so that make-up​ air intake and exhaust vents do not cause contamination of food, food-contact surfaces, equipment,​ or utensils. Systems must be installed according to chapter 1346.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1385

INSECT CONTROL DEVICES; DESIGN AND INSTALLATION. 6-202.13​

A. Insect control devices that are used to electrocute or stun flying insects must be designed​ to retain the insect within the device.​ B. Insect control devices must be installed so that:​ (1) the devices are not located over a food preparation area; and​ (2) dead insects and insect fragments are prevented from being impelled onto or falling​ on exposed food; clean equipment, utensils, and linens; and unwrapped single- service and single-use​ articles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1390

TOILET ROOMS; ENCLOSED. 6-202.14​

Except where a toilet room is located outside a food establishment and does not open directly​ into the food establishment, such as a toilet room that is provided by the management of a shopping​ mall, a toilet room located on the premises must be completely enclosed and provided with a​ tight-fitting and self-closing door or as specified in part 4626.1555.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

153​

MINNESOTA RULES​

4626.1395

4626.1395​

OUTER OPENINGS; PROTECTED. 6-202.15​

A. Except in food carts, special event food stands, temporary food establishments, retail​ food vehicles, portable structures, carts, or outside areas used for beverage service, such as alcohol​ bar service or as specified in items B, C, E, and F and under item D, outer openings of a food​ establishment must be protected against the entry of insects and rodents by:​ (1) filling or closing holes and other gaps along floors, walls, and ceilings;​ (2) closed, tight-fitting windows; and​ (3) solid self-closing, tight-fitting doors.​ B. Item A does not apply if a food establishment opens into a larger structure, such as a​ mall, airport, or office building, or into an attached structure, such as a porch, and the outer openings​ from the larger or attached structure are protected against the entry of insects and rodents.​ C. Exterior doors used as exits need not be self-closing if they are:​ (1) solid and tight-fitting;​ (2) designated for use only when an emergency exists, by the fire protection authority​ that has jurisdiction over the food establishment; and​ (3) limited-use so they are not used for entrance or exit from the building for purposes​ other than the designated emergency exit use.​ D. Except as specified in items B and E, if the windows or doors of a food establishment,​ or those of a larger structure where a food establishment is located, are kept open for ventilation​ or other purposes, the openings must be protected against the entry of insects and rodents by:​ (1) 16 mesh to 1 inch (25 mm) screens;​ (2) properly designed and installed air curtains to control flying insects; or​ (3) other effective means.​ E. Item D does not apply to a temporary food establishment that does not have windows​ and doors.​ F. Item D does not apply if flying insects and other pests are absent due to the location of​ the establishment, the weather, or other limiting condition.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1400​ 4626.1400

MINNESOTA RULES​

154​

EXTERIOR WALLS AND ROOFS; PROTECTIVE BARRIER. 6-202.16​

A. Except as specified in item B, perimeter walls and roofs of a food establishment must​ effectively protect the establishment from the weather and the entry of insects, rodents, and other​ animals.​ B. A food cart, special event food stand, temporary food establishment, retail vehicle,​ portable structure, or cart must provide protection during adverse weather by its construction or​ location. Food activities must cease if protection fails.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1405 OUTDOOR FOOD VENDING AREAS; OVERHEAD PROTECTION. 6-202.17​ If located outside, a machine used to vend food must be provided with overhead protection​ except that machines vending canned beverages need not comply with this part.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1410

OUTDOOR SERVICING AREAS; OVERHEAD PROTECTION. 6-202.18​

Servicing areas must be provided with overhead protection except that areas used only for​ loading water or discharging sewage and other liquid waste, through the use of a closed system of​ hoses, need not be provided with overhead protection.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1415

OUTDOOR WALKING AND DRIVING SURFACES; GRADED TO DRAIN.​ 6-202.19​

The exterior walking and driving surfaces must be graded to drain.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1420 OUTDOOR REFUSE AREAS; CURBED AND GRADED TO DRAIN. 6-202.110​ Outdoor refuse areas must be constructed according to law and must be curbed and graded to​ drain to collect and dispose of liquid waste that results from the refuse and from cleaning the area​ and waste receptacles.​

​

155​

MINNESOTA RULES​

4626.1445​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1425

PRIVATE HOMES AND LIVING OR SLEEPING QUARTERS; USE​ PROHIBITION. 6-202.111​

A private home, a room used as living or sleeping quarters, or an area directly opening into a​ room used as living or sleeping quarters must not be used for conducting food establishment​ operations.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1430

LIVING OR SLEEPING QUARTERS; SEPARATION. 6-202.112​

Living or sleeping quarters located on the premises of a food establishment, including those​ provided for lodging registration clerks or resident managers, must be separated from rooms and​ areas used for food establishment operations by complete partitioning and solid self-closing doors.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ PHYSICAL FACILITY NUMBERS AND CAPACITIES​ 4626.1435 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1440

HANDWASHING SOAP; AVAILABILITY. 6-301.11​

Each handwashing sink or group of 2 adjacent handwashing sinks must be provided with a​ supply of soap.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1445

HAND DRYING PROVISION. 6-301.12​

Each handwashing sink or group of adjacent handwashing sinks must be provided with:​ A. individual, disposable towels;P2​ B. a continuous towel system that supplies the user with a clean towel;P2​

Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.​

4626.1445​

MINNESOTA RULES​

156​

C. a heated-air hand drying device;P2 or​ D. a hand drying device that employs an air-knife system that delivers high velocity,​ pressurized air at ambient temperatures.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1450

DISPOSABLE TOWELS; WASTE RECEPTACLE. 6-301.20​

A waste receptacle must be provided as specified in part 4626.1255, item B, for each​ handwashing lavatory or group of adjacent lavatories that is provided with individual, disposable​ towels specified in part 4626.1255, item C.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1455

HANDWASHING AIDS AND DEVICES; USE RESTRICTIONS. 6-301.13​

A sink used for food preparation or utensil washing, or a service sink or curbed cleaning facility​ used for the disposal of mop water or similar wastes, must not be provided with the handwashing​ aids and devices required for a handwashing sink as specified in parts 4626.1440 to 4626.1450.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: October 17, 2019​ 4626.1457 HANDWASHING SIGNAGE. 6-301.14​ A sign or poster that notifies food employees to wash their hands must be provided at all​ handwashing sinks used by food employees and must be clearly visible to food employees.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1460 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1465

TOILET TISSUE; AVAILABILITY. 6-302.11​

A supply of toilet tissue must be available at each toilet.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

157​

MINNESOTA RULES​

4626.1475​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1470

LIGHTING INTENSITY. 6-303.11​

The light intensity must be:​ A. at least 10 foot-candles (108 lux) at a distance of 30 inches (75 cm) above the floor, in​ walk-in refrigeration units and dry food storage areas, and in other areas and rooms during periods​ of cleaning;​ B. at least 20 foot-candles (215 lux):​ (1) at a surface where food is provided for consumer self-service, such as buffets and​ salad bars, or where fresh produce or packaged foods are sold or offered for consumption;​ (2) inside equipment such as reach-in and under-counter refrigerators; and​ (3) at a distance of 30 inches (75 cm) above the floor in areas used for handwashing,​ warewashing, and equipment and utensil storage, and in toilet rooms; and​ C. at least 50 foot-candles (540 lux) at a surface where a food employee is working with​ food or working with utensils or equipment, such as knives, slicers, grinders, or saws where employee​ safety is a factor.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1475

VENTILATION; MECHANICAL. 6-304.11​

A. All rooms must have sufficient mechanical tempered make-up air and exhaust ventilation​ to keep them free of grease, excessive heat, steam, condensation, vapors, obnoxious or disagreeable​ odors, smoke, and fumes according to the applicable provisions of the Minnesota Building Code​ and the Minnesota State Mechanical Code.​ B. All ventilation systems, furnaces, gas- or oil-fired room heaters, and water heaters shall​ be designed, installed, and operated according to chapters 1305, 1346, and 7511.​ C. All ventilation systems must be operated as designed while the ventilated equipment is​ in use.​ D. Ventilation systems equipped with filters must not be operated with the filters removed.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1480​

MINNESOTA RULES​

4626.1480

DRESSING ROOMS AND LOCKERS; DESIGNATION. 6-305.11​

158​

A. Dressing rooms or dressing areas must be designated if employees routinely change​ clothes in the establishment.​ B. Lockers or other suitable facilities must be provided for the orderly storage of employees'​ clothing and other possessions.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1485 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ PHYSICAL FACILITY PLACEMENT​ 4626.1490 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1495

TOILET ROOMS; CONVENIENCE AND ACCESSIBILITY. 6-402.11​

Toilet rooms must be conveniently located and accessible to employees during all hours of​ operation.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1500 EMPLOYEE BREAK AREAS, LOCKERS; LOCATION. 6-403.11​ A. Areas designated for employees to eat, drink, and use tobacco must be located so that​ food, equipment, linens, and single-service and single-use articles are protected from contamination.​ B. Lockers or other suitable facilities must be located in a designated room or area where​ contamination of food, equipment, utensils, linens, and single-service and single-use articles cannot​ occur.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1505 RETURNED PRODUCTS; SEGREGATION AND LOCATION. 6-404.11​ Products that are held by the licensee for credit, redemption, or return to the distributor, including​ damaged, spoiled, or recalled products, must be segregated and held in designated areas that are​ separated from food, equipment, utensils, linens, and single-service and single-use articles.P2​

​

159​

MINNESOTA RULES​

4626.1525​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1510 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ PHYSICAL FACILITY MAINTENANCE AND OPERATION​ 4626.1515 PHYSICAL FACILITIES; GOOD REPAIR. 6-501.11​ Physical facilities must be maintained in good repair.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1520 PHYSICAL FACILITIES; CLEANING FREQUENCY AND RESTRICTIONS.​ 6-501.12​ A. Physical facilities must be cleaned as often as necessary to keep them clean.​ B. Cleaning must be done after closing or during other periods when the least amount of​ food is exposed. This item does not apply to cleaning that is necessary due to a spill or other accident.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1525

CLEANING FLOORS; DUSTLESS METHODS. 6-501.13​

A. Except as specified in item B, only dustless methods of cleaning must be used, such as​ wet cleaning, vacuum cleaning, mopping with treated dust mops, or sweeping using a broom and​ dust-arresting compounds.​ B. Spills or drippage on floors that occur between normal floor cleaning times may be​ cleaned:​ (1) without the use of dust-arresting compounds; and​ (2) in the case of liquid spills or drippage, with the use of a small amount of absorbent​ compound such as sawdust or diatomaceous earth applied immediately before spot cleaning.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1530​ 4626.1530

MINNESOTA RULES​

160​

CLEANING VENTILATION SYSTEMS; NUISANCE AND DISCHARGE​ PROHIBITION. 6-501.14​

A. Intake and exhaust air ducts must be cleaned and filters changed so they are not a source​ of contamination by dust, dirt, and other materials.​ B. If vented to the outside, ventilation systems must not create a public health hazard or​ nuisance or unlawful discharge.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1535

CLEANING MAINTENANCE TOOLS; PREVENTING CONTAMINATION.​ 6-501.15​

Food preparation sinks, handwashing sinks, and warewashing equipment must not be used for​ the cleaning of maintenance tools, the preparation or holding of maintenance materials, or the​ disposal of mop water and similar liquid wastes.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1540

DRYING MOPS. 6-501.16​

After use, mops must be placed in a position that allows them to air-dry without soiling walls,​ equipment, or supplies.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1545

ABSORBENT MATERIALS ON FLOORS; USE LIMITATION. 6-501.17​

Except as specified in part 4626.1525, item B, sawdust, wood shavings, granular salt, baked​ clay, diatomaceous earth, or similar absorbent materials must not be used on floors.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1550 CLEANING OF PLUMBING FIXTURES. 6-501.18​ Plumbing fixtures such as handwashing sinks, toilets, and urinals must be cleaned as often as​ necessary to keep them clean.​

​

161​

MINNESOTA RULES​

4626.1565​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1555

CLOSING TOILET ROOM DOORS. 6-501.19​

Except during cleaning and maintenance operations, toilet room doors as specified in part​ 4626.1390 must be kept closed. Toilet room entries designed without doors do not need to comply​ with this provision.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1560

USING DRESSING ROOMS AND LOCKERS. 6-501.110​

A. Dressing rooms must be used by employees if the employees regularly change clothes​ in the establishment.​ B. Lockers or other suitable facilities must be used for the orderly storage of employee​ clothing and other possessions.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1565

CONTROLLING PESTS. 6-501.111​

The premises must be maintained free of insects, rodents, and other pests. The presence of​ insects, rodents, and other pests must be controlled to eliminate their presence on the premises by:​ A. routinely inspecting incoming shipments of food and supplies;​ B. routinely inspecting the premises for evidence of pests;​ C. using pest control methods if pests are found, such as trapping devices or other means​ of pest control as specified in parts 4626.1610, 4626.1650, and 4626.1655;P2and​ D. eliminating harborage conditions.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1570​

MINNESOTA RULES​

162​

4626.1570 REMOVING DEAD OR TRAPPED BIRDS, INSECTS, RODENTS, AND OTHER​ PESTS. 6-501.112​ Dead or trapped birds, insects, rodents, and other pests must be removed from control devices​ and the premises at a frequency that prevents accumulation, decomposition, or attraction of pests.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1575

STORING MAINTENANCE TOOLS. 6-501.113​

Maintenance tools such as brooms, mops, vacuum cleaners, and similar items must be:​ A. stored so they do not contaminate food, equipment, utensils, linens, and single-service​ and single-use articles; and​ B. stored in an orderly manner that facilitates cleaning the area used for storing maintenance​ tools.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1580 MAINTAINING PREMISES; UNNECESSARY ITEMS AND LITTER. 6-501.114​ The premises must be free of:​ A. items that are unnecessary to the operation or maintenance of the establishment, such​ as equipment that is nonfunctional or no longer used; and​ B. litter.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1585

PROHIBITING ANIMALS. 6-501.115​

A. Except as specified in items B and C, live animals must not be allowed on the premises​ of a food establishment.P2​ B. Live animals may be allowed in the following situations if the contamination of food;​ clean equipment, utensils, and linens; and unwrapped single-service and single-use articles does​ not result:​ (1) edible fish or decorative fish in aquariums, shellfish or crustacea on ice or under​ refrigeration, and shellfish or crustacea in display tank systems;​

​

163​

MINNESOTA RULES​

4626.1595​

(2) patrol dogs accompanying police or security officers in offices and dining, sales,​ and storage areas, and sentry dogs running loose in outside fenced areas;​ (3) service animals that are controlled by the disabled employee or person in areas that​ are not used for food preparation and that are usually open for customers, such as dining and service​ areas, if no health or safety hazard will result from the presence or activities of the service animal;​ (4) pets in the common dining areas of institutional care facilities at times other than​ during meals if:​ (a) effective partitioning and self-closing doors separate the common dining areas​ from food storage or food preparation areas;​ (b) condiments, equipment, and utensils are stored in enclosed cabinets or removed​ from the common dining areas when pets are present; and​ (c) dining areas including tables, countertops, and similar surfaces are effectively​ cleaned before the next meal service; and​ (5) in food establishments licensed by either the department, Minnesota Department​ of Agriculture, or a delegated authority in areas that are not used for food preparation, storage,​ sales, display, or dining, in which there are caged animals or animals that are similarly confined.​ C. Live or dead fish bait must be stored so that contamination of food; clean equipment,​ utensils, and linens; and unwrapped single-use articles cannot result.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; L 2005 c 56 s 2; 43 SR 295​ Published Electronically: January 2, 2019​ TOXIC LABELING​ 4626.1590 POISONOUS OR TOXIC MATERIALS; IDENTIFYING INFORMATION.​ 7-101.11​ Containers of poisonous or toxic materials and personal care items must bear a legible​ manufacturer's label.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1595 POISONOUS OR TOXIC MATERIALS; COMMON NAME. 7-102.11​ Working containers used for storing poisonous or toxic materials such as cleaners and sanitizers​ taken from bulk supplies must be clearly and individually identified with the common name of the​ material.P2​

​

4626.1595​

MINNESOTA RULES​

164​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ TOXIC SUPPLIES AND APPLICATIONS​ 4626.1600 POISONOUS OR TOXIC MATERIALS; STORAGE. 7-201.11​ Poisonous or toxic materials must be stored so they cannot contaminate food, equipment,​ utensils, linens, and single-service and single-use articles by:​ A. separating the poisonous or toxic materials by spacing or partitioning;P1 and​ B. locating the poisonous or toxic materials in an area that is not above food, equipment,​ utensils, linens, and single-service or single-use articles. This item does not apply to equipment​ and utensil cleaners and sanitizers that are stored in warewashing areas for availability and​ convenience if the materials are stored to prevent contamination of food, equipment, utensils, linens,​ and single-service and single-use articles.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1605 POISONOUS OR TOXIC MATERIALS; RESTRICTION. 7-202.11​ A. Only those poisonous or toxic materials that are required for the operation and​ maintenance of a food establishment, such as for the cleaning and sanitizing of equipment and​ utensils and the control of insects and rodents, may be allowed in a food establishment.P2​ B. Item A does not apply to packaged poisonous or toxic materials that are for retail sale.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1610 POISONOUS OR TOXIC MATERIALS; CONDITIONS OF USE. 7-202.12​ Poisonous or toxic materials must be:​ A. used according to:​ (1) Minnesota Statutes, chapter 18B and this Code;​ (2) the manufacturer's use directions included in labeling and, for a pesticide, the​ manufacturer's label instructions that state that use is allowed in a food establishment;P1 and​ (3) the conditions of licensing, if licensing is required, for use of the pest control​ materials;P1​

​

165​

MINNESOTA RULES​

4626.1625​

B. applied so that:​ (1) a hazard to employees or other persons is not constituted;P1 and​ (2) contamination, including toxic residues due to drip, drain, fog, splash, or spray on​ food, equipment, utensils, linens, and single-service and single-use articles, is prevented and for a​ restricted use pesticide, this is achieved by:P1​ (a) removing the items;P1​ (b) covering the items with impermeable covers;P1​ (c) taking other appropriate preventive actions;P1 and​ (d) cleaning and sanitizing equipment and utensils after the application;P1 and​ C. for a restricted-use pesticide, applied only by an applicator certified as defined in the​ Federal Insecticide, Fungicide, and Rodenticide Act, United States Code, title 7, section 136(e),​ and Minnesota Statutes, chapter 18B, or under the direct supervision of a certified applicator.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: November 13, 2019​ 4626.1615

POISONOUS OR TOXIC MATERIAL CONTAINERS. 7-203.11​

A container previously used to store poisonous or toxic materials must not be used to store,​ transport, or dispense food.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1620

SANITIZERS; CRITERIA. 7-204.11​

Chemical sanitizers, including chemical sanitizing solutions generated on site and other chemical​ antimicrobials applied to food-contact surfaces, must meet the requirements in Code of Federal​ Regulations, title 40, part 180, subpart D, section 180.940, or part 180, subpart E, section 180.2020.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1625 CHEMICALS FOR WASHING, TREATMENT, STORAGE AND PROCESSING;​ FRUITS AND VEGETABLES; CRITERIA. 7-204.12​ A. Chemicals, including those generated on site, used to wash or peel raw, whole fruits​ and vegetables must:​

4626.1625​

MINNESOTA RULES​

166​

(1) be an approved food additive listed for this intended use in Code of Federal​ Regulations, title 21, section 173;P1​ (2) be generally recognized as safe (GRAS) for this intended use;P1 or​ (3) be the subject of an effective food-contact notification for this intended use (only​ effective for the manufacturer or supplier identified in the notification);P1 and​ (4) meet the requirements in Code of Federal Regulations, title 40, section 156.P1​ B. Ozone as an antimicrobial agent used in the treatment, storage, and processing of fruits​ and vegetables in a food establishment must meet the requirements specified in Code of Federal​ Regulations, title 21, part 173, subpart D, section 173.368.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1630

BOILER WATER ADDITIVES; CRITERIA. 7-204.13​

Chemicals used as boiler water additives must meet the requirements in Code of Federal​ Regulations, title 21, part 173, subpart D, section 173.310.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1635

DRYING AGENTS; CRITERIA. 7-204.14​

A. Drying agents used in conjunction with sanitization must contain only components that​ are listed as one of the following:​ (1) generally recognized as safe for use in food as specified in Code of Federal​ Regulations, title 21, part 182 or 184;P1​ (2) generally recognized as safe for the intended use as specified in Code of Federal​ Regulations, title 21, part 186;P1​ (3) generally recognized as safe for the intended use as determined by experts qualified​ in scientific training and experience to evaluate the safety of substances added directly or indirectly​ to food as described in Code of Federal Regulations, title 21, part 170, subpart B, section 170.30;P1​ (4) the subject of an effective Food Contact Notification (FCN) for use as a component​ of a drying agent as described in United States Code, title 21, section 348(h);P1​ (5) approved for use as a drying agent under a prior sanction as described in United​ States Code, title 21, section 321(s)(4);P1​

​

167​

MINNESOTA RULES​

4626.1655​

(6) specifically regulated as an indirect food additive for use as a drying agent as​ specified in Code of Federal Regulations, title 21, parts 174 to 178;P1 or​ (7) approved for use as a drying agent under the threshold of regulation process​ established by Code of Federal Regulations, title 21, part 170, subpart B, section 170.39.P1​ B. When sanitization is with chemicals, the approval required under item A, subitem (5)​ or (7), or the regulation as an indirect food additive as required under item A, subitem (6), must be​ specifically for use with chemical sanitizing solutions.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: November 13, 2019​ 4626.1640 LUBRICANTS; INCIDENTAL FOOD-CONTACT; CRITERIA. 7-205.11​ Lubricants must meet the requirements in Code of Federal Regulations, title 21, part 178, subpart​ D, section 178.3570, if they are used on food-contact surfaces, on bearings and gears located on or​ within food-contact surfaces, or on bearings and gears that are located so that lubricants may leak,​ drip, or be forced into food or onto food-contact surfaces.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1645

RESTRICTED USE PESTICIDES; CRITERIA. 7-206.11​

Restricted use pesticides specified in part 4626.1610, item C, must meet the requirements in​ Code of Federal Regulations, title 40, part 152, subpart A, section 152.1.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1650

RODENT BAIT STATIONS. 7-206.12​

Rodent bait must be contained in a covered, tamper-resistant bait station.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1655

TRACKING POWDERS; PEST CONTROL AND MONITORING. 7-206.13​

A. Except as specified in item B, a tracking powder pesticide must not be used in a food​ establishment.P1​

​

4626.1655​

MINNESOTA RULES​

168​

B. If used, a nontoxic tracking powder such as talcum or flour must not contaminate food,​ equipment, utensils, linens, and single-service and single-use articles.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1660 EMPLOYEE MEDICINES; RESTRICTION AND STORAGE. 7-207.11​ A. Only those medicines that are necessary for the health of employees may be allowed in​ a food establishment. This part does not apply to medicines that are stored or displayed for retail​ sale.P2​ B. Medicine that is in a food establishment for an employee's use must be labeled as specified​ in part 4626.1590 and located to prevent the contamination of food, equipment, utensils, linens,​ and single-service and single-use articles.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1665

REFRIGERATED MEDICINES; STORAGE. 7-207.12​

Medicines belonging to employees or children in a day care center that require refrigeration​ and are stored in a food refrigerator must be:​ A. stored in a package or container and kept inside a covered, leakproof container that is​ identified as a container for the storage of medicines;P1 and​ B. located so they are inaccessible to children.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1670 FIRST AID STORAGE. 7-208.11​ First aid supplies that are in a food establishment for employee use must be:​ A. labeled as specified in part 4626.1590;P2 and​ B. stored in a kit or container that is located to prevent the contamination of food, equipment,​ utensils, linens, and single-service and single-use articles.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

169​

MINNESOTA RULES​

4626.1675

4626.1685​

PERSONAL CARE ITEMS; STORAGE. 7-209.11​

Except as specified in parts 4626.1665 and 4626.1670, employees shall store personal care​ items in facilities as specified in part 4626.1560, item B.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ TOXIC RETAIL SALE​ 4626.1680

POISONOUS OR TOXIC MATERIALS; SEPARATION. 7-301.11​

Poisonous or toxic materials must be stored and displayed for retail sale so they cannot​ contaminate food, equipment, utensils, linens, and single-service and single-use articles by:​ A. separating the poisonous or toxic materials by spacing or partitioning;P1 and​ B. locating the poisonous or toxic materials in an area that is not above food, equipment,​ utensils, linens, and single-service or single-use articles.P1​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ CODE APPLICABILITY​ 4626.1685

PUBLIC HEALTH PROTECTION. 8-101.10​

In enforcing this Code, the regulatory authority shall assess existing facilities or equipment that​ were in use before September 8, 1998, based on the following considerations:​ A. whether the facilities or equipment are in good repair and capable of being maintained​ in a sanitary condition;​ B. whether food-contact surfaces comply with parts 4626.0450 to 4626.0495 and 4626.0506,​ item A;​ C. whether the capacities of cooling, heating, and holding equipment are sufficient to​ comply with part 4626.0675; and​ D. whether the existence of a documented agreement with the licensee that the facilities or​ equipment will be replaced as specified in the documented agreement.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1690​ 4626.1690

MINNESOTA RULES​

170​

VARIANCE REQUEST; PROCEDURES. 8-103.11​

A person may ask the regulatory authority to grant a variance from the provisions of this Code​ according to parts 4626.1690 to 4626.1715.​ A. A variance must not be granted from:​ (1) part 4626.0020, subpart 35;​ (2) parts 4626.0040 to 4626.0120;​ (3) part 4626.1565; and​ (4) parts 4626.1590 to 4626.1675.​ B. The applicant for a variance shall be the person to whom the rule applies.​ C. The person requesting the variance shall submit the request in writing to the regulatory​ authority with the appropriate fee, if required. If a variance is granted, the person shall retain the​ information and variance in the person's files. A request must contain:​ (1) the specified language in the rule or rules from which the variance is requested;P2​ (2) the reasons why the rule cannot be met;P2​ (3) the alternative measures that will be taken to ensure a comparable degree of​ protection to health or the environment if a variance is granted;P2​ (4) the length of time for which the variance is requested;P2​ (5) a statement that the person applying for the variance will comply with the terms of​ the variance, if granted;P2​ (6) other relevant information the regulatory authority determines necessary to properly​ evaluate the request for the variance;P2 and​ (7) a HACCP plan, if required under part 4626.1730, that includes the information in​ part 4626.1735 that is relevant to the variance requested.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1695 VARIANCE REQUEST; CRITERIA FOR DECISION.​ The regulatory authority shall grant a variance if:​ A. the variance was requested in the manner prescribed in part 4626.1690;​ B. the variance will have no potential adverse effect on public health, safety, or the​ environment;​

171​

MINNESOTA RULES​

4626.1700​

C. the alternative measures to be taken, if any, are equivalent to or superior to those​ prescribed;​ D. strict compliance with the rule will impose an undue burden on the applicant;​ E. the variance does not vary a statutory standard or preempt federal law or rule; and​ F. the variance has only future effect.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1700 VARIANCE CONDITIONS; HACCP; NOTIFICATION OF DECISION. 8-103.12​ A. In granting a variance, the regulatory authority may attach conditions that the regulatory​ authority determines are needed to protect the public health, safety, or the environment.​ B. If a HACCP plan is required to verify that the variance provides protection to the public​ health, safety, and environment that is equivalent to or superior to those prescribed in rule or law,​ the licensee shall:​ (1) comply with the HACCP plan and procedures submitted and approved as the basis​ for the variance;P1 and​ (2) maintain and provide to the regulatory authority, on request, the records specified​ in part 4626.1735, items D and E, subitem (3), that demonstrate that the following are routinely​ employed:​ (a) procedures for monitoring critical control points;P2​ (b) monitoring of the critical control points;P2​ (c) verification of the effectiveness of an operation or process;P2 and​ (d) necessary corrective actions if there is failure at a critical control point.P2​ C. The regulatory authority shall notify the person in writing of the regulatory authority's​ decision to grant or deny the variance.​ (1) If a variance is granted, the notification must specify the period of time for which​ the variance must be effective and the alternative measures or conditions, if any, the applicant shall​ meet.​ (2) If a variance is denied, the regulatory authority shall specify the reasons for the​ denial.​ D. Variances granted are not transferable.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​

4626.1700​

MINNESOTA RULES​

172​

History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1705 VARIANCES; EFFECT OF ALTERNATIVE MEASURES OR CONDITIONS.​ 8-103.13​ A. Alternative measures or conditions attached to a variance have the force and effect of​ law.​ B. If a person violates alternative measures or conditions attached to a variance, the person​ is subject to the enforcement actions and penalties provided in law or rule.​ C. A person to whom a variance has been issued shall notify the regulatory authority in​ writing within 30 days of a material change in the conditions upon which the variance was granted.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1710 RENEWAL OF VARIANCE.​ A. A request for the renewal of a variance must be submitted to the regulatory authority in​ writing 30 days before its expiration date.​ B. Renewal requests must contain the information in part 4626.1690.​ C. The regulatory authority shall renew a variance if the person continues to satisfy the​ criteria in part 4626.1695 and demonstrates compliance with the alternative measures or conditions​ imposed at the time the original variance was approved.​ D. This part does not apply if there has been a material change in the conditions upon which​ the variance was granted.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1715 VARIANCE DENIAL, REVOCATION, OR REFUSAL TO RENEW; APPEALS.​ A. The regulatory authority shall deny, revoke, or refuse to renew a variance if the regulatory​ authority determines that the criteria in part 4626.1695 or the conditions in part 4626.1700 are not​ met.​ B. A person may appeal the denial, revocation, or refusal to renew a variance by requesting,​ in writing, a contested case hearing under the Administrative Procedure Act, Minnesota Statutes,​ chapter 14, within 30 days of receipt of the notice of denial, revocation, or refusal to renew the​ variance.​

​

173​

MINNESOTA RULES​

4626.1721​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ PLAN SUBMISSION AND APPROVAL​ 4626.1720

PLANS; REVIEW REQUIRED. 8-201.11​

A. A license applicant or licensee shall submit or cause to be submitted and receive approval​ of properly prepared plans and specifications and the required plan review application and plan​ review fee, to the regulatory authority for plan review and approval before beginning:​ (1) the construction of a food establishment;P2​ (2) the conversion of an existing structure for use as a food establishment;P2 or​ (3) the extensive remodeling of a food establishment or a change of type of food​ establishment or food operation if the regulatory authority determines that plans and specifications​ are necessary to ensure compliance with this Code.P2​ B. Plans, specifications, an application form, and the fee specified in Minnesota Statutes,​ chapter 28A or 157, must be submitted to the regulatory authority at least 30 days before beginning​ construction, extensive remodeling, or conversion of a food establishment.P2​ C. Special event food stands and retail food vehicles, portable structures, or carts are exempt​ from the requirement to submit plans and specifications.​ D. The regulatory authority shall approve the completed plans and specifications if they​ meet the requirements of this Code, and the regulatory authority shall report its findings to the​ license applicant or licensee within 30 days of the date the completed plans are received.​ E. Plans and specifications that are not approved as submitted must be changed to comply​ or be deleted from the project.P2​ F. A license applicant, licensee, or person who is subject to licensure under Minnesota​ Statutes, chapter 28A or 157, that starts work on construction, extensive remodeling, or conversion​ of a food establishment before plan approval, shall stop work on the project when the regulatory​ authority determines that the work is likely to lead to noncompliance with this Code and the​ regulatory authority orders work to stop. The work must not resume until plans have been submitted​ according to items A and B, and have been approved by the regulatory authority.P2​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1721 [Renumbered 1560.9000]​ Published Electronically: October 11, 2007​

4626.1725​ 4626.1725

MINNESOTA RULES​

174​

CONTENTS OF PLANS AND SPECIFICATIONS. 8-201.12​

The plans and specifications for a food establishment must include:​ A. the intended menu;​ B. a description of the project including the anticipated volume of food to be stored,​ prepared, sold, or served;​ C. 1 complete set of plans drawn to scale, including the proposed layout, mechanical​ schematics, construction materials, and finish schedules for items such as floors, base coves, walls,​ and ceilings;​ D. the proposed equipment types, manufacturers, model numbers, locations on the layout,​ dimensions, performance capacities, and installation specifications;​ E. the HACCP plan as specified in part 4626.1730, if required;​ F. counters and cabinetry shop drawings, indicating cabinet construction, and countertop​ finish;​ G. the unique well number and individual sewage treatment system certificate of compliance​ for individual sewage disposal systems;​ H. a copy of the zoning approval or building permit from the local unit of government; and​ I. other information that may be required by the regulatory authority for the review of the​ proposed construction, conversion, or modification.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1730

WHEN A HACCP PLAN IS REQUIRED. 8-201.13​

A. Before engaging in an activity that requires a HACCP plan, a license applicant or licensee​ shall submit to the regulatory authority for approval a properly prepared HACCP plan as specified​ in part 4626.1735 and the relevant provisions of this Code if:​ (1) a variance is required as specified in part 4626.0340, item D, subitem (4); 4626.0415;​ or 4626.0610, item B; or​ (2) the regulatory authority determines that a food preparation or processing method​ requires a variance based on a plan submittal specified in part 4626.1725, an inspection finding, or​ a variance request.​ B. Before engaging in reduced oxygen packaging without a variance as specified in part​ 4626.0420, a license applicant or licensee shall submit a properly prepared HACCP plan to the​ regulatory authority.​

​

175​

MINNESOTA RULES​

4626.1735​

Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1735

CONTENTS OF HACCP PLAN. (SEE ALSO PART 4626.0420) 8-201.14​

For a food establishment that is required under part 4626.1730 to have a HACCP plan, the​ licensee shall submit to the regulatory authority a properly prepared HACCP plan that includes:​ A. general information such as the name of the license applicant or licensee, the food​ establishment address, and contact information;​ B. a categorization of the types of TCS foods that are to be controlled under the HACCP​ plan;P2​ C. a flow diagram or chart for each specific food or category type that identifies:​ (1) each step in the process;P2​ (2) the hazards and controls for each step in the flow diagram or chart;P2​ (3) the steps that are critical control points;P2​ (4) the ingredients, materials, and equipment used in the preparation of that food;P2 and​ (5) formulations or recipes that delineate methods and procedural control measures that​ address the food safety concerns involved;P2​ D. a critical control points summary for each specific food or category type that clearly​ identifies:​ (1) each critical control point;P2​ (2) the critical limits for each critical control point;P2​ (3) the method and frequency for monitoring and controlling each critical control point​ by the designated food employee or the person in charge;P2​ (4) the method and frequency for the person in charge to routinely verify that the food​ employee is following standard operating procedures and monitoring critical control points;P2​ (5) action to be taken by the designated food employee or person in charge if the critical​ limits for each critical control point are not met;P2 and​ (6) records to be maintained by the person in charge to demonstrate that the HACCP​ plan is properly operated and managed;P2​ E. supporting documents such as:​ (1) food employee and supervisory training plan that addresses the food safety issues​ of concern;P2​

4626.1735​

MINNESOTA RULES​

176​

(2) copies of blank records forms that are necessary to implement the HACCP plan;P2​ and​ (3) additional scientific data or other information, as required by the regulatory authority,​ supporting the determination that food safety is not compromised by the proposal;P2 and​ F. any other information required by the regulatory authority.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: November 13, 2019​ 4626.1740

TRADE SECRETS. 8-202.10​

The regulatory authority shall treat as confidential, in accordance with Minnesota Statutes,​ section 13.02, information that meets the criteria in Minnesota Statutes, chapter 325C, for a trade​ secret and is contained in the plans and specifications submitted as specified in parts 4626.1725​ and 4626.1735.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1745

PREOPERATIONAL INSPECTIONS. 8-203.10​

The regulatory authority shall conduct one or more preoperational inspections to verify that the​ food establishment is constructed and equipped according to the approved plans and approved​ modifications of those plans.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1750 NOTICE OF OPENING.​ The food establishment licensee shall provide notice of opening to the regulatory authority at​ least 14 calendar days before the opening date.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

177​

MINNESOTA RULES​

4626.1770​

LICENSE TO OPERATE​ 4626.1755 LICENSE REQUIRED. 8-301.11​ A. A person shall not operate a food establishment without a valid license to operate issued​ by the regulatory authority.P2​ B. The license must be posted in a location in the food establishment that is conspicuous​ to consumers.​ C. A license must not be transferred from one person to another person, from one food​ establishment to another, or from one type of operation to another.P2​ D. A void license must be surrendered to the regulatory authority immediately by anyone​ in possession of it.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1760

LICENSE APPLICATION. 8-302.11​

An applicant shall submit a written application for a license on a form provided by the regulatory​ authority according to Minnesota Statutes, chapter 28A or 157.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1765 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1770

QUALIFICATIONS AND RESPONSIBILITIES OF APPLICANTS. 8-302.13​

To qualify for a license, an applicant shall:​ A. be an owner of the food establishment or an officer of the legal ownership;​ B. comply with the requirements of this Code;​ C. agree to allow access to the food establishment and provide information as required​ under Minnesota Statutes, section 157.20, subdivision 1; and​ D. pay the applicable license fees at the time the application is submitted.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​

4626.1775​

MINNESOTA RULES​

178​

4626.1775 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1777 DENIAL OF APPLICATION FOR LICENSE; NOTICE. 8-303.30​ If an application for a license to operate is denied, the regulatory authority shall provide the​ applicant with a notice that includes:​ A. the specific reasons and Code citations for the license denial;​ B. the actions, if any, that the applicant shall take to qualify for a license; and​ C. advising the applicant of the applicant's right to appeal and the appeal process and time​ frames that are provided by law.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1780 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ INSPECTION AND CORRECTION OF VIOLATIONS​ 4626.1785

INSPECTION. 8-401.10​

The regulatory authority shall inspect a food establishment according to:​ A. Minnesota Statutes, chapters 28A, 30, 31, and 34A, for food establishments regulated​ by the Department of Agriculture;​ B. Minnesota Statutes, chapter 157, for establishments regulated by the Department of​ Health; and​ C. rules adopted under Minnesota Statutes, chapters 28A, 30, 31, 31A, 34A, and 157.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1787 PERFORMANCE AND RISK-BASED INSPECTIONS. 8-401.20​ Within the parameters in part 4626.1785, the regulatory authority shall prioritize and conduct​ more frequent inspections based upon:​ A. the hazards associated with the particular foods that are prepared, stored, or served;​ B. a history of noncompliance with priority 1 or priority 2 items of this Code; or​ C. a history of noncompliance with HACCP plan requirements.​

179​

MINNESOTA RULES​

4626.1792​

Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1790

ALLOWED AT REASONABLE TIMES AFTER DUE NOTICE. 8-402.11​

After the regulatory authority presents official credentials and provides notice of the purpose​ of and an intent to conduct an inspection, the person in charge of the food establishment shall allow​ the regulatory authority to determine if the food establishment is in compliance with the Code by​ allowing access to the food establishment, allowing inspection, and providing information and the​ records specified in the Code and to which the regulatory authority is entitled according to law,​ during the food establishment's hours of operation and other reasonable times.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1791 DOCUMENTING INFORMATION AND OBSERVATIONS. 8-403.10​ The regulatory authority shall document on an inspection report form:​ A. administrative information about the food establishment's legal identity, street and​ mailing addresses, type of establishment and operation, inspection date, and other information such​ as type of water supply and sewage disposal, status of the license, and personnel certificates that​ may be required; and​ B. specific factual observations of violations or other deviations of this Code, including​ the specific code citation and a correct by or comply by date, that requires correction by the license​ holder.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1792 ISSUING A REPORT. 8-403.30​ The regulatory authority shall provide a copy of the completed inspection report and the notice​ to correct violations to the licensee or to the person in charge.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​

4626.1795​ 4626.1795

MINNESOTA RULES​

180​

CEASING OPERATIONS AND EMERGENCY REPORTING. 8-404.11​

A. Except as specified in item B, a licensee shall immediately discontinue operations and​ notify the regulatory authority if an imminent health hazard may exist because of an emergency​ such as a fire, flood, extended interruption of electrical or water service, sewage backup, misuse​ of poisonous or toxic materials, onset of an apparent foodborne illness outbreak, gross insanitary​ occurrence or condition, or other circumstance that may endanger public health.​ B. A licensee need not discontinue operations in an area of an establishment that is​ unaffected by the imminent health hazard.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1797 RESUMPTION OF OPERATIONS. 8-404.12​ If operations are discontinued as specified in part 4626.1795, or otherwise according to law,​ the licensee shall obtain approval from the regulatory authority before resuming operations.​ Statutory Authority: MS s 31.101; 31.11; 144.07; 157.011​ History: 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1800 FOOD SAMPLES.​ The regulatory authority may collect, without cost, and examine samples of food as often as​ necessary for enforcement of this Code.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1805 EMBARGO.​ A. The regulatory authority may embargo and forbid the sale of, or cause to be removed​ or destroyed, any food that is:​ (1) unwholesome or adulterated;​ (2) prepared, processed, handled, packaged, transported, or stored in an unwholesome​ manner;​ (3) unfit for human consumption; or​ (4) otherwise prohibited by law.​ B. Equipment and utensils that do not meet the requirements of this Code may be embargoed.​

181​

MINNESOTA RULES​

4626.1825​

C. The regulatory authority may release equipment and utensils from an embargo when​ the licensee notifies the regulatory authority that the equipment or utensils have been modified to​ meet the requirements of this Code and after inspection of the equipment and utensils by the​ regulatory authority.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1810 CONDEMNATION.​ The regulatory authority may condemn and cause to be removed any food, equipment, clothing,​ or utensils found in a food establishment, the use of which does not comply with this Code or that​ is being used in violation of this Code, and may also condemn and cause to be removed any​ equipment, clothing, or utensils that because of dirt, filth, extraneous matter, insects, corrosion,​ open seams, or chipped or cracked surfaces are unfit for use.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1815 TAG.​ The regulatory authority may place a tag to indicate the embargo or the condemnation on food,​ equipment, utensils, or clothing. No person shall remove the tag except under the direction of the​ regulatory authority.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.08; 144.12; 157.011​ History: 23 SR 519​ Published Electronically: October 11, 2007​ MISCELLANEOUS HEALTH AND SAFETY​ 4626.1820 MINNESOTA CLEAN INDOOR AIR ACT.​ A food establishment must meet the requirements of the Minnesota Clean Indoor Air Act,​ Minnesota Statutes, sections 144.411 to 144.417, and rules adopted under those sections.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.07; 144.08; 144.12; 157.011​ History: 23 SR 519; 43 SR 295​ Published Electronically: January 2, 2019​ 4626.1825 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​

4626.1830​

MINNESOTA RULES​

182​

TEMPORARY AND PORTABLE FOOD ESTABLISHMENTS​ 4626.1830 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1835 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1840 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1845 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1850 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1855 SPECIAL EVENT FOOD STANDS.​ This part applies to special event food stands.​ A. In conjunction with the notice of opening required in part 4626.1750, the applicant for​ a license to operate a special event food stand shall provide to the regulatory authority information​ on the:​ (1) sources of the food;​ (2) type and volume of food to be served, held, prepared, packaged, or otherwise​ provided for human consumption;​ (3) equipment used to serve, hold, prepare, package, or otherwise provide food for​ human consumption;​ (4) time period and location of operation;​ (5) facilities for washing hands;​ (6) facilities for multiuse utensil and warewashing for other than prepackaged products;​ (7) source of water; and​ (8) methods of liquid and solid waste disposal.​ B. Dry ice or cold packs may be substituted for the mechanical refrigeration required in​ parts 4626.0375 and 4626.0395 if the temperatures in parts 4626.0370 to 4626.0420 are maintained.​ Mechanical refrigeration shall be available for potentially hazardous foods held for four hours or​ longer.​ C. Drained ice may be used as a cooling medium only for water-impervious beverage​ containers.​

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4626.1855​

D. Domestic slow cookers are prohibited.​ E. Food preparation and cooking areas shall be protected by an impervious shield or by a​ separation distance to ensure customer safety and prevent food contamination by customers.​ F. A handwashing device supplied with running water at a temperature between 21 degrees​ C and 43.5 degrees C (70 degrees F and 110 degrees F), soap, nail brush, and paper towels shall​ be provided at all stands where food is prepared.​ G. Water shall be supplied under pressure or by gravity with a faucet.​ H. A water inlet shall be protected from contamination and designed to preclude attachment​ of a nonpotable service connection.​ I. A water tank shall comply with the provisions for an alternate water supply specified in​ parts 4626.1035 and 4626.1135 to 4626.1175.​ J. A stand shall provide protection during adverse weather by its construction or location.​ Food activities shall cease if protection fails.​ K. Single-service disposable eating and drinking utensils shall be used.​ L. For warewashing multiuse utensils, a washing facility shall be available consisting of​ at least three containers of sufficient size to immerse utensils.​ M. Space shall be provided for air drying kitchenware, tableware, and utensils.​ N. Towel drying is prohibited.​ O. The sanitization procedures specified in parts 4626.0895 to 4626.0905 shall be used.​ P. For stands that are disassembled after each use, a gravity-fed handwashing device and​ three containers of sufficient size to immerse utensils may be used in lieu of the requirements of​ items F and G, if:​ (1) only beverages are served from an original container or bulk beverage dispenser;​ (2) only prepackaged nonpotentially hazardous food is sold, prepared, or served; or​ (3) the menu is limited to prepackaged potentially hazardous foods cooked or prepared​ to order, or precut or prewashed foods that have been obtained from a licensed food establishment.​ Q. A waste holding tank and waste removal shall comply with parts 4626.1180 to 4626.1220.​ R. The regulatory authority may restrict the type of food served or the method of food​ preparation based on equipment limitations, the unavailability of a permanent establishment for​ utensil and warewashing, adverse climatic conditions, or any other condition that poses a hazard​ to public health.​ Statutory Authority: MS s 31.101; 31.11; 144.05; 144.08; 144.12; 157.011​

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History: 23 SR 519​ Published Electronically: October 11, 2007​ 4626.1860 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1865 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.1870 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.2000 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.2005 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.2010 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.2015 Subpart 1. [Repealed, 43 SR 295]​ Subp. 2. [Repealed, 43 SR 295]​ Subp. 3. [Repealed, 43 SR 295]​ Subp. 4. [Repealed, 43 SR 295]​ Subp. 5. [Repealed, 43 SR 295]​ Subp. 6. [Repealed, 43 SR 295]​ Subp. 7. [Repealed, 43 SR 295]​ Subp. 8. [Repealed, 43 SR 295]​ Subp. 9. [Repealed, L 2009 c 79 art 10 s 51]​ Published Electronically: January 2, 2019​ 4626.2020 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​ 4626.2025 [Repealed, 43 SR 295]​ Published Electronically: January 2, 2019​

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4659.0020​

CHAPTER 4659​ DEPARTMENT OF HEALTH​ ASSISTED LIVING FACILITIES​ 4659.0010​

APPLICABILITY AND PURPOSE.​

4659.0020​

DEFINITIONS.​

4659.0030​

RESPONSIBILITY TO MEET STANDARDS.​

4659.0040​

LICENSING IN GENERAL.​

4659.0050​

FINES FOR NONCOMPLIANCE.​

4659.0060​

ASSISTED LIVING LICENSURE; CONVERSION OF EXISTING ASSISTED LIVING PROVIDERS.​

4659.0080​

VARIANCE.​

4659.0090​

UNIFORM CHECKLIST DISCLOSURE OF SERVICES.​

4659.0100​

EMERGENCY DISASTER AND PREPAREDNESS PLAN; INCORPORATION BY REFERENCE.​

4659.0110​

MISSING RESIDENT PLAN.​

4659.0120​

PROCEDURES FOR RESIDENT TERMINATION AND DISCHARGE PLANNING.​

4659.0130​

CONDITIONS FOR PLANNED CLOSURES.​

4659.0140​

INITIAL ASSESSMENTS AND CONTINUING ASSESSMENTS.​

4659.0150​

UNIFORM ASSESSMENT TOOL.​

4659.0160​

RELINQUISHING AN ASSISTED LIVING FACILITY WITH DEMENTIA CARE LICENSE.​

4659.0180​

STAFFING.​

4659.0190​

TRAINING REQUIREMENTS.​

4659.0200​

NONRENEWAL OF HOUSING, REDUCTION IN SERVICES; REQUIRED NOTICES.​

4659.0210​

TERMINATION APPEALS; PROCEDURES AND TIMELINES FOR APPEALS.​

4659.0010 APPLICABILITY AND PURPOSE.​ This chapter establishes the criteria and procedures for regulating assisted living facilities and​ assisted living facilities with dementia care and must be read in conjunction with Minnesota Statutes,​ chapter 144G. The licensee is legally responsible for ensuring compliance by the licensee's facility,​ and any individual or entity acting on its behalf, with this chapter and Minnesota Statutes, chapter​ 144G.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0020 DEFINITIONS.​ Subpart 1. Scope. For purposes of this chapter, the definitions in this part have the meanings​ given them.​

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Subp. 2. Assisted living director or director. "Assisted living director" or "director" has the​ meaning given in Minnesota Statutes, section 144G.08, subdivision 6.​ Subp. 3. Assisted living facility or facility. "Assisted living facility" or "facility" has the​ meaning given in Minnesota Statutes, section 144G.08, subdivision 7.​ Subp. 4. Assisted living facility with dementia care or facility with dementia care. "Assisted​ living facility with dementia care" or "facility with dementia care" has the meaning given in​ Minnesota Statutes, section 144G.08, subdivision 8.​ Subp. 5. Assisted living services. "Assisted living services" has the meaning given in Minnesota​ Statutes, section 144G.08, subdivision 9.​ Subp. 6. Board. "Board" means the Board of Executives for Long Term Services and Supports.​ Subp. 7. Case manager. "Case manager" means an individual who provides case management​ services and develops a resident's coordinated service and support plan according to Minnesota​ Statutes, sections 256B.49, subdivision 15, and 256S.07 to 256S.10.​ Subp. 8. Clinical nurse supervisor. "Clinical nurse supervisor" means a facility's registered​ nurse as required under Minnesota Statutes, section 144G.41, subdivision 4.​ Subp. 9. Commissioner. "Commissioner" means the commissioner of health.​ Subp. 10. Competency evaluation. "Competency evaluation" means the training and​ competency evaluation required under Minnesota Statutes, section 144G.61.​ Subp. 11. Competent. "Competent" means appropriately trained and able to perform an assisted​ living service, supportive service, or delegated health care task or duty under this chapter and​ Minnesota Statutes, chapter 144G.​ Subp. 12. Department. "Department" means the Department of Health.​ Subp. 13. Dementia. "Dementia" has the meaning given in Minnesota Statutes, section 144G.08,​ subdivision 16.​ Subp. 14. Elopement. "Elopement" means when a secured dementia unit resident leaves the​ secured dementia unit, including any attached outdoor space, without the level of staff supervision​ required by the resident's most recent nursing assessment.​ Subp. 15. Investigator. "Investigator" means a department staff member that conducts​ complaint investigations according to Minnesota Statutes, section 144G.30.​ Subp. 16. Licensed health professional. "Licensed health professional" has the meaning​ given in Minnesota Statutes, section 144G.08, subdivision 29.​ Subp. 17. Licensee. "Licensee" has the meaning given in Minnesota Statutes, section 144G.08,​ subdivision 32.​ Subp. 18. Medication. "Medication" has the meaning given in Minnesota Statutes, section​ 144G.08, subdivision 37.​

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Subp. 19. Ombudsman. "Ombudsman" means the Office of Ombudsman for Long-Term​ Care.​ Subp. 20. Person-centered planning and service delivery. "Person-centered planning and​ service delivery" means providing supportive and assisted living services according to Minnesota​ Statutes, section 245D.07, subdivision 1a, paragraph (b).​ Subp. 21. Prospective resident. "Prospective resident" means a nonresident individual that​ is seeking to become a resident of an assisted living facility.​ Subp. 22. Representatives. "Representatives" includes both a designated representative as​ defined under Minnesota Statutes, section 144G.08, subdivision 19, and a legal representative as​ defined under Minnesota Statutes, section 144G.08, subdivision 28.​ Subp. 23. Resident. "Resident" has the meaning given in Minnesota Statutes, section 144G.08,​ subdivision 59.​ Subp. 24. Resident record. "Resident record" has the meaning given in Minnesota Statutes,​ section 144G.08, subdivision 60.​ Subp. 25. Safe location. "Safe location" has the meaning given in Minnesota Statutes, section​ 144G.55, subdivision 2.​ Subp. 26. Service plan. "Service plan" has the meaning given in Minnesota Statutes, section​ 144G.08, subdivision 63.​ Subp. 27. Supportive services. "Supportive services" has the meaning given in Minnesota​ Statutes, section 144G.08, subdivision 68.​ Subp. 28. Survey. "Survey" has the meaning given in Minnesota Statutes, section 144G.08,​ subdivision 69.​ Subp. 29. Surveyor. "Surveyor" has the meaning given in Minnesota Statutes, section 144G.08,​ subdivision 70.​ Subp. 30. Unlicensed personnel. "Unlicensed personnel" has the meaning given in Minnesota​ Statutes, section 144G.08, subdivision 73.​ Subp. 31. Wandering. "Wandering" means random or repetitive locomotion by a resident.​ This movement may be goal-directed such as when the resident appears to be searching for something​ such as an exit, or may be non-goal-directed or aimless.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​

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4659.0030 RESPONSIBILITY TO MEET STANDARDS.​ The licensee is responsible for the management, operation, and control of the facility, and for​ providing housing and assisted living services according to this chapter and Minnesota Statutes,​ chapter 144G.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0040 LICENSING IN GENERAL.​ Subpart 1. Issuance of assisted living facility license.​ A. Upon approving an application for an assisted living facility license, the commissioner​ must issue a single license for each building that is operated by the licensee as an assisted living​ facility and is located at a separate address.​ B. For purposes of this part, "campus" has the meaning given in Minnesota Statutes, section​ 144G.08, subdivision 4a.​ Subp. 2. License to be posted.​ A. For a license issued under subpart 1, item A, the facility must post the original license​ certificate issued by the commissioner at the main public entrance of the facility.​ B. A campus with multiple buildings must post the original license certificate issued by​ the commissioner at the main public entrance of each building licensed as a facility on the campus.​ A separate license certificate shall be issued for each building on the campus.​ Subp. 3. Required submissions to ombudsman.​ A. A licensee must submit a complete, current, and unsigned copy of its assisted living​ contract to the ombudsman under Minnesota Statutes, section 144G.50, subdivision 1, paragraph​ (c), clause (1), within 30 calendar days of receiving a provisional license or a permanent license.​ B. The contract under item A must include all of the facility's standard contract provisions.​ If the licensee has multiple standard contracts, it must provide a copy of each contract to the​ ombudsman. The licensee is not required to submit a copy of each individual resident's contract to​ the ombudsman to be in compliance with this subpart. If the licensee changes its service offerings​ or the standard provisions in a contract, the facility must submit a complete and current contract to​ the ombudsman within 30 calendar days of the change.​ C. A licensee required to provide written disclosure to the ombudsman under Minnesota​ Statutes, section 325F.72, subdivision 1, must do so within 30 calendar days of receiving a​ provisional assisted living facility with dementia care license or, if a licensee does not receive a​ provisional license, within 30 calendar days after receiving a license.​

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Subp. 4. Location for submissions to ombudsman. Unless specific notice requirements are​ provided in rule or statute, notices that licensees are required to provide to the ombudsman under​ this part; Minnesota Statutes, chapter 144G; and Minnesota Statutes, section 325F.72, must be​ provided in writing in the manner required by the ombudsman.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0050 FINES FOR NONCOMPLIANCE.​ Fines for violations of parts 4659.0120 and 4659.0130 will be assessed under Minnesota Statutes,​ section 144G.31.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0060 ASSISTED LIVING LICENSURE; CONVERSION OF EXISTING ASSISTED​ LIVING PROVIDERS.​ Upon approval of a license application submitted under Minnesota Statutes, section 144G.191,​ subdivision 4, paragraph (a), the commissioner shall issue a license that is not a provisional license​ as defined in Minnesota Statutes, section 144G.08, subdivision 55.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0080 VARIANCE.​ Subpart 1. Request for variance. A license applicant or licensee may request at any time that​ the commissioner grant a variance from the provisions of this chapter. The request must be made​ in writing to the commissioner and must specify the following:​ A. the name and address of the license applicant or licensee requesting the variance;​ B. the rule requirement from which the variance is requested;​ C. the variance requested and the time period for which the variance is requested;​ D. the specific alternative actions, if any, that the license applicant or licensee proposes to​ follow;​ E. the reasons for the request, including why the license applicant or licensee cannot comply​ with a requirement in this chapter;​

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F. justification that the variance will not impair the services provided, and will not adversely​ affect the health, safety, or welfare of residents or the residents' rights under Minnesota Statutes,​ chapter 144G, including the assisted living bill of rights;​ G. a signed statement attesting to the accuracy of the facts asserted in the variance request;​ and​ H. the name, address, and contact information of any person or entity the license applicant​ or licensee knows would be adversely affected by granting the variance, including prospective​ residents, residents, and their representatives.​ The commissioner may require additional information from the license applicant or licensee before​ acting on the request.​ Subp. 1a. Notice. The commissioner shall make reasonable efforts to ensure that persons or​ entities who may be affected by the variance have timely notice of the variance request, including​ affected prospective residents, residents, and their representatives. In addition, the agency shall​ notify the ombudsman of all variance requests. The commissioner may require the license applicant​ or licensee requesting the variance to serve notice on the persons or entities entitled to notice under​ this subpart.​ Subp. 2. Criteria for evaluation. The decision to grant or deny a variance or variance renewal​ request must be based on the department's evaluation of the following criteria:​ A. whether the alternative measures, if any, comply with the intent of this chapter and are​ equivalent to or superior to those prescribed in this chapter;​ B. whether compliance with this chapter poses an undue burden on the license applicant​ or licensee; and​ C. whether the variance adversely affects the health, safety, or welfare of the residents or​ any of the residents' rights under Minnesota Statutes, chapter 144G, including the assisted living​ bill of rights.​ Subp. 3. Duration and conditions. The commissioner may limit the duration of any variance.​ The commissioner may impose conditions on granting a variance that the commissioner considers​ necessary to protect public health, safety, or the environment. A variance has prospective effect​ only. The commissioner may not grant a variance from a statute or court order. Conditions attached​ to the variance are an enforceable part of the rule to which the variance applies.​ Subp. 4. Decision and timing. (a) The commissioner must notify the license applicant or​ licensee and all persons or entities entitled to notice under subpart 1a, in writing, of the​ commissioner's decision to grant or deny a variance request or variance renewal request, or to​ revoke a variance. If the variance request or variance renewal request is granted, the notification​ must specify the period of time for which the variance is effective and the alternative measures or​ conditions, if any, to be met by the license applicant or licensee. If the commissioner denies, revokes,​ or refuses to renew a variance, the commissioner must notify the license applicant or licensee, in​ writing, of the reasons for the decision and the right to appeal the decision under subpart 8.​

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(b) The commissioner shall grant or deny a variance request or variance renewal request as​ soon as practicable, and within 60 days of receipt of the completed variance application, unless the​ license applicant or licensee agrees to a later date. Failure of an agency to act on a request for a​ variance or variance renewal within 60 days constitutes approval of the variance or variance renewal.​ Subp. 5. Renewal. A licensee seeking to renew a variance must submit the request required​ under subpart 1 at least 45 days before the expiration date of the variance.​ Subp. 6. Violation of variances. A failure of the licensee to comply with the terms of the​ granted variance is a violation of this chapter.​ Subp. 7. Denial, revocation, or refusal to renew. The commissioner shall deny, revoke, or​ refuse to renew a variance if:​ A. the variance adversely impacts the health, safety, or welfare of residents or the residents'​ rights under Minnesota Statutes, chapter 144G, and the assisted living bill of rights;​ B. the license applicant or licensee has otherwise failed to demonstrate that a variance​ should be granted under the criteria in subpart 2;​ C. the license applicant or licensee has failed to comply with the terms of the variance​ under subparts 3 and 4;​ D. the license applicant or licensee notifies the commissioner in writing that it wishes to​ relinquish the variance; or​ E. the revocation, denial, or refusal to renew a variance is required by a change in law.​ Subp. 8. Appeal procedure. A license applicant or licensee may appeal the denial, revocation,​ or refusal to renew a variance by requesting a hearing from the commissioner. The request must​ be made in writing to the commissioner and delivered personally or by mail within ten calendar​ days after the license applicant or licensee receives the notice. If mailed, the request must be​ postmarked within ten calendar days after the license applicant or licensee receives the notice. The​ request for hearing must set forth in detail the reasons why the license applicant or licensee contends​ the decision of the commissioner should be reversed or modified. At the hearing, the applicant or​ licensee has the burden of proving by a preponderance of the evidence that the variance should be​ granted or renewed, except in a proceeding challenging the revocation of a variance, where the​ department has the burden of proving by a preponderance of the evidence that a revocation is​ appropriate. Hearings under this subpart must be conducted under the Administrative Procedure​ Act in Minnesota Statutes, chapter 14, and the rules of the Office of Administrative Hearings related​ to contested case proceedings in parts 1400.5010 to 1400.8400.​ Subp. 9. Fees and costs. When requesting a variance under this part, the license applicant or​ licensee shall pay a fee as provided under Minnesota Statutes, section 14.056, subdivision 2.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​

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4659.0090 UNIFORM CHECKLIST DISCLOSURE OF SERVICES.​ Subpart 1. Definition. For purposes of this part "Uniform Checklist Disclosure of Services"​ or "checklist" means the checklist developed and posted by the commissioner under subpart 2 and​ Minnesota Statutes, section 144G.40, subdivision 2, that an assisted living facility must provide to​ prospective residents before a contract is executed to enhance understanding of policies and services​ that are provided and are not provided by the facility.​ Subp. 2. Uniform checklist disclosure of services. The commissioner shall post a Uniform​ Checklist Disclosure of Services template with a comprehensive list of assisted living services,​ developed according to Minnesota Statutes, section 144G.40, subdivision 2, paragraph (c), on the​ department's website for facility use. The commissioner shall update the checklist on an as-needed​ basis.​ Subp. 3. Submission of checklist to commissioner.​ A. An applicant or licensee shall submit a completed checklist with the license application​ or renewal.​ B. Whenever a facility changes the services that the facility offers under the assisted living​ facility contract, the facility must submit an updated checklist to the commissioner within 30​ calendar days of the change in services.​ Subp. 4. Use of uniform checklist disclosure of services. A facility shall:​ A. provide an up-to-date checklist to each prospective resident and each prospective​ resident's representatives who request information about the facility;​ B. provide the checklist separately from all other documents and forms; and​ C. not use another form to substitute for the checklist.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0100 EMERGENCY DISASTER AND PREPAREDNESS PLAN; INCORPORATION​

BY REFERENCE.​ A. Assisted living facilities shall comply with the federal emergency preparedness​ regulations for long-term care facilities under Code of Federal Regulations, title 42, section 483.73,​ or successor requirements.​ B. This part references documents, specifications, methods, and standards in "State​ Operations Manual Appendix Z - Emergency Preparedness for All Provider and Certified Supplier​ Types: Interpretive Guidance," which is incorporated by reference. This material is subject to​ frequent change and is available from the United States Centers for Medicare & Medicaid Services.​ It is conveniently available online at​ https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/SOM%20Appendix%20Z%202019.pdf,​

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4659.0110​

or by mail to U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore,​ MD 21244.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0110 MISSING RESIDENT PLAN.​ Subpart 1. Applicability.​ A. This part applies only to a resident who receives assisted living services:​ (1) who is incapable of taking appropriate action for self-preservation under emergency​ conditions; or​ (2) who is identified as at risk for wandering or elopement according to the resident's​ most recent assessment or review.​ B. For purposes of this subpart, a resident is incapable of taking appropriate action for​ self-preservation under emergency conditions if the resident:​ (1) is not ambulatory or mobile; or​ (2) lacks the physical, mental, or cognitive capability to:​ (a) recognize a danger, signal, or alarm requiring residents to evacuate from a​ facility;​ (b) initiate and complete the evacuation without requiring more than minimal​ assistance from another person;​ (c) select an alternative means of escape or take appropriate action if the primary​ evacuation route from the facility is blocked or inaccessible; and​ (d) remain at a designated location outside the facility until further instruction is​ given.​ Subp. 2. Missing resident policies and procedures.​ A. The facility must develop and follow a missing resident plan that includes at least the​ following:​ (1) identify a staff member for each shift who is responsible for implementing the​ missing resident plan, and ensure at least one staff member who is responsible for implementing​ the missing-resident plan is on site 24 hours a day, seven days a week;​ (2) require that staff alert the staff member identified in subitem (1) immediately if it​ is suspected that a resident may be missing;​

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(3) identify staff by position description who are responsible for searching for missing​ residents or suspected missing residents;​ (4) require that staff conduct an immediate and thorough search of the facility, the​ facility's premises, and the immediate neighborhood in each direction when a resident is suspected​ to be missing;​ (5) require that a suspected missing resident be considered missing if the resident is​ not located after staff complete the search in subitem (4);​ (6) require that staff immediately notify local law enforcement when a facility​ determines, under subitem (5) or otherwise, that a resident is missing;​ (7) require that staff immediately contact the resident's representatives and the resident's​ case manager, if applicable, when a resident is determined missing; and​ (8) require that staff cooperate with local law enforcement and provide any information​ that is necessary to identify and locate the missing resident.​ B. When a resident is missing or is suspected missing, a facility's implementation of a​ missing resident plan does not relieve the facility of its obligation to provide assisted living services​ and appropriate care to all residents in the facility according to each resident's service plan, assisted​ living contract, and the requirements of this chapter and Minnesota Statutes, chapter 144G.​ Subp. 3. Additional notification required. After the missing resident is located, a staff member​ must immediately notify local law enforcement, the resident's representatives, and the resident's​ case manager, if any.​ Subp. 4. Review missing resident plan. The assisted living director and clinical nurse​ supervisor must review the missing resident plan at least quarterly and document any changes to​ the plan.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0120 PROCEDURES FOR RESIDENT TERMINATION AND DISCHARGE​ PLANNING.​ Subpart 1. Pretermination meeting notice.​ A. Before issuing a notice of termination, the facility must schedule a pretermination​ meeting under Minnesota Statutes, section 144G.52, subdivision 2, and provide written notice of​ the meeting to the resident and the resident's representatives at least five business days in advance​ of the scheduled meeting.​ B. The facility must schedule and participate in the pretermination meeting, and make​ reasonable efforts to ensure that the resident and the resident's representatives are able to attend the​ meeting. If an in-person meeting is impractical or impossible, the facility may schedule and​

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4659.0120​

participate in a meeting via telephone, video, or other means as provided for emergency relocations​ under subpart 2. If the resident or the resident's representatives fail to cooperate in the scheduling​ of the meeting or fail to appear at a properly noticed meeting, the facility may issue a notice of​ termination, provided that the facility demonstrates reasonable efforts to ensure the resident's and​ the resident's representatives' attendance at the meeting and that proper notice was provided to all​ parties. If the resident or resident's representatives fail to comply with agreements reached at the​ pretermination meeting, the facility may proceed with a notice of termination without holding​ another pretermination meeting, so long as notice of termination is provided at least seven days​ before the notice is issued.​ C. For a resident who receives a home and community-based services waiver under​ Minnesota Statutes, section 256B.49 and chapter 256S, the facility must provide written notice of​ the pretermination meeting to the resident's case manager at least five business days in advance.​ D. In addition to the notice requirements under Minnesota Statutes, section 144G.52,​ subdivision 2, the pretermination meeting written notice under item A must include:​ (1) a proposed time, date, and location of the meeting;​ (2) a detailed explanation of the reason or reasons for the proposed termination;​ (3) a list of facility individuals who will attend the meeting;​ (4) an explanation that the resident may invite family members, representatives, relevant​ health professionals, a representative from the Office of Ombudsman for Long-Term Care, and​ other individuals of the resident's choosing to participate in the pretermination meeting;​ (5) contact information for the Office of Ombudsman for Long-Term Care and the​ Office for Ombudsman for Mental Health and Developmental Disabilities and a statement that the​ ombudsman offices provide advocacy services to residents;​ (6) the name and contact information of an individual at the facility whom the resident​ may contact about the meeting or to request an accommodation;​ (7) notice that attendees may request reasonable accommodations for a communication​ disability or if they speak a language other than English; and​ (8) notice that if the resident's housing or services are terminated, the resident has the​ right to appeal under part 4659.0210 and Minnesota Statutes, section 144G.54.​ E. The facility must provide written notice to the resident, the resident's representatives,​ and the resident's case manager of any change to the date, time, or location of the pretermination​ meeting.​ Subp. 2. Emergency relocation notice.​ A. If there is an emergency relocation under Minnesota Statutes, section 144G.52,​ subdivision 9, and the licensee intends to issue a notice of termination following the relocation,​ and an in-person pretermination meeting is impractical or impossible, the facility must use telephonic,​

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video, or other electronic format for the meeting under Minnesota Statutes, section 144G.52,​ subdivision 2.​ B. If the pretermination meeting is held through telephonic, video, or other electronic format​ under Minnesota Statutes, section 144G.52, subdivision 2, paragraph (d), the facility must ensure​ that the resident, the resident's representatives, and any case manager or representative of an​ ombudsman's office are able to participate in the pretermination meeting. The facility must make​ reasonable efforts to ensure that anyone else the resident invites to the meeting is able to participate.​ C. If a pretermination meeting is held after an emergency relocation, the licensee must​ issue a notice to the resident, the resident's representatives, and the resident's case manager, if​ applicable, containing the information in subpart 1, item D, at least 24 hours in advance of the​ pretermination meeting. The notice must include detailed instructions on how to access the means​ of communication for the meeting.​ D. If notice to the ombudsman is required under Minnesota Statutes, section 144G.52,​ subdivision 9, paragraph (c), clause (3), the facility must provide the notice as soon as practicable,​ and in any event no later than 24 hours after the notice requirement is triggered.​ Subp. 3. Identifying and offering accommodations, modifications, and alternatives. In​ addition to the requirements in Minnesota Statutes, section 144G.52, subdivision 2, paragraph (a),​ clause (2), at the pretermination meeting, the facility must collaborate with the resident and the​ resident's representatives, case manager, and any other individual invited by the resident to identify​ and offer any potential reasonable accommodations, modifications, interventions, or alternatives​ that can address the issues underlying the termination.​ Subp. 4. Summarizing pretermination meeting outcomes. Within 24 hours after the​ pretermination meeting, the facility must provide the resident and the resident's representatives and​ case manager, if present at the pretermination meeting, with a written summary of the meeting,​ including any agreements reached about any accommodation, modification, intervention, or​ alternative that will be used to avoid terminating the resident's assisted living contract.​ Subp. 5. Providing notice.​ A. A facility must provide written notice of the resident's contract termination by hand​ delivery or by first-class mail. Service of the notice must be proved by affidavit of the person​ effectuating service.​ B. If sent by mail, the facility must mail the notice to the resident's last known address.​ C. A facility providing a notice to the ombudsman under Minnesota Statutes, section​ 144G.52, subdivision 7, paragraph (a), must provide the notice as soon as practicable, but in any​ event no later than two business days after the facility provided notice to the resident. The notice​ must include a phone number for the resident, or, if the resident does not have a phone number, the​ phone number of the resident's representatives or case manager.​

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4659.0120​

Subp. 6. Resident-relocation evaluation.​ A. If the facility terminates the resident's contract or the resident plans to move out of the​ facility because the facility has initiated the pretermination or termination process, the facility must​ prepare a written resident-relocation evaluation. The evaluation must include:​ (1) the resident's current service plan;​ (2) a list of safe and appropriate housing and service providers that are in reasonably​ close geographic proximity to the facility and are able to accept a new resident;​ (3) the resident's needs and choices; and​ (4) the right of the resident to tour the safe location and appropriate service provider,​ if applicable, prior to relocation.​ B. The facility must provide a written copy of the resident-relocation evaluation to the​ resident and the resident's representatives and case manager as soon as practicable but no later than​ the planning conference under subpart 7, item A.​ Subp. 7. Resident-relocation plan.​ A. If the facility terminates the resident's contract or the resident plans to move out of the​ facility because the facility has initiated the pretermination or termination process, the facility must​ hold a planning conference and develop a written relocation plan with the resident, the resident's​ representatives and case manager, if any, and other individuals invited by the resident.​ B. The relocation plan must incorporate the resident-relocation evaluation developed in​ subpart 6.​ C. The resident-relocation plan must include:​ (1) the date and time that the resident will move;​ (2) the contact information of the receiving facility;​ (3) how the resident and the resident's personal property, including pets, will be​ transported to the new housing provider;​ (4) how the facility will care for and store the resident's belongings;​ (5) recommendations to assist the resident to adjust to the new living environment;​ (6) recommendations for addressing the stress that a resident with dementia may​ experience when moving to a new living environment, if applicable;​ (7) recommendations for ensuring the safe and proper transfer of the resident's​ medications and durable medical equipment;​ (8) arrangements that have been made for the resident's follow-up care and meals;​

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(9) a plan for transferring and reconnecting phone, Internet services, and any electronic​ monitoring equipment; and​ (10) who is responsible for paying moving expenses and how the expenses will be paid.​ D. The facility must implement the resident-relocation plan, must comply with the​ coordinated move requirements in Minnesota Statutes, section 144G.55, and must provide a copy​ of the plan to the resident and, with the resident's consent, to the resident's representatives and case​ manager, if applicable.​ Subp. 8. Providing resident-relocation information to receiving facility or other service​ provider. In addition to the requirements in Minnesota Statutes, section 144G.43, subdivision 4,​ and with the resident's consent, the facility must provide the following information in writing to​ the resident's receiving facility or other service provider:​ A. the name and address of the facility, the dates of the resident's admission and discharge,​ and the name and address of a person at the facility to contact for additional information;​ B. names and addresses of any significant social or community contacts the resident has​ identified to the facility;​ C. the resident's most recent service or care plan, if the resident has received services from​ the facility; and​ D. the resident's current "do not resuscitate" order and "physician order for life-sustaining​ treatment," if any.​ Subp. 9. Resident discharge summary. At the time of discharge, the facility must provide​ the resident, and, with the resident's consent, the resident's representatives and case manager, with​ a written discharge summary that includes:​ A. a summary of the resident's stay that includes diagnoses, courses of illnesses, allergies,​ treatments and therapies, and pertinent lab, radiology, and consultation results;​ B. a final summary of the resident's status from the latest assessment or review under​ Minnesota Statutes, section 144G.70, if applicable, that includes the resident status, including​ baseline and current mental, behavioral, and functional status;​ C. a reconciliation of all predischarge medications with the resident's postdischarge​ prescribed and over-the-counter medications; and​ D. a postdischarge plan that is developed with the resident and, with the resident's consent,​ the resident's representatives, which will help the resident adjust to a new living environment. The​ postdischarge plan must indicate where the resident plans to reside, any arrangements that have​ been made for the resident's follow-up care, and any postdischarge medical and nonmedical services​ the resident will need.​ Subp. 10. Services pending appeal. If the resident needs additional services during a pending​ termination appeal, the facility must contact and inform the resident's representatives and case​

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4659.0130​

manager, if any, of the resident's responsibility to contract and ensure payment for those services​ according to Minnesota Statutes, section 144G.54, subdivision 6.​ Subp. 11. Expedited termination.​ A. A facility seeking an expedited termination under Minnesota Statutes, section 144G.52,​ subdivision 5, must comply with all of the requirements of this part.​ B. If the facility seeks a termination or expedited termination on the basis of Minnesota​ Statutes, section 144G.52, subdivision 5, paragraph (b), clause (2), the facility must provide the​ assessment that forms the basis of the expedited termination to the resident with the notice of​ termination and include the name and contact information of any medical professionals who​ performed the assessment.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0130 CONDITIONS FOR PLANNED CLOSURES.​ Subpart 1. Planned closure; notifying commissioner and ombudsman.​ A. Before voluntarily closing, a facility must submit to the commissioner, the Office of​ Ombudsman for Mental Health and Developmental Disabilities, and the Office of the Ombudsman​ for Long Term Care the following in writing:​ (1) the proposed closure plan; and​ (2) the name and contact information for a facility staff person who is responsible for​ managing the facility during the facility's closure process.​ B. A facility may not accept new residents or enter into new assisted living contracts for​ any new residents as of the date that written notification of the closure is submitted under item A.​ C. A licensee must comply with the requirements of this part when the licensee decides to​ not renew the assisted living contracts of all of its residents.​ Subp. 2. Proposed closure plan; contents. A facility's proposed closure plan must include:​ A. the reason for the closure and the proposed date of closure;​ B. a proposed timetable for relocating residents, and how the facility will facilitate residents'​ relocations;​ C. a list identifying each resident that will need to be relocated;​ D. for those residents identified under item C:​ (1) the resident's current levels of care, whether the resident receives services from the​ facility, and any special needs or medical conditions;​

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(2) the resident's payment source and, if applicable, medical assistance identification​ number;​ (3) the names and contact information of the resident's representatives and case manager,​ if any; and​ (4) the names and contact information for those residents who do not have a​ representative or case manager but who the facility has reason to believe may have diminished​ cognitive capacity;​ E. identification of at least two safe and appropriate housing providers and, for residents​ receiving services, appropriate service providers that are in reasonably close geographic proximity​ to the facility and may be able to accept a resident;​ F. the roles and responsibilities of the licensee, assisted living director, and any temporary​ managers or monitors during the closure process, and their contact information;​ G. policies and procedures for ongoing operations and management of the facility during​ the closure process that ensure:​ (1) payment of all operating expenses;​ (2) staffing and resources to continue providing services, medications, treatments, and​ supplies to meet each resident's needs, as ordered by the resident's physician or practitioner, until​ closure;​ (3) residents' meals, medications, and treatments are not disrupted during the closure​ process;​ (4) transportation of residents during discharge and transfer;​ (5) residents' telephone, Internet services, and any electronic monitoring equipment are​ transferred and reconnected;​ (6) residents' personal funds are accounted for, maintained, and reported to the resident​ and resident's representatives during the closure process; and​ (7) residents' belongings are labeled and kept safe, and residents are given contact​ information for retrieving missing items after the facility has closed.​ Subp. 3. Commissioner acknowledgment of notice.​ A. Within 14 calendar days of receiving notice under subpart 1, the commissioner shall​ acknowledge receipt in writing of a facility's planned closure to the licensee.​ B. Within 45 calendar days of acknowledging receipt of the notice under subpart 1, the​ commissioner shall approve the proposed closure plan and verify in writing the effective date of​ the closure to the licensee.​

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4659.0130​

(1) During this period, the commissioner may contact the licensee about necessary​ amendments to the closure plan before the commissioner approves it and verifies the effective date​ of the closure.​ (2) During this period, the licensee must establish and maintain ongoing communication​ with the commissioner regarding the status of the closure of the facility and timely respond to the​ commissioner's inquiries.​ C. When the commissioner receives written notices of at least three license relinquishments​ or planned closures within 30 calendar days from the same licensee, the commissioner shall approve​ and verify the effective date of each closure in writing to the licensee within 75 calendar days of​ acknowledging receipt of the third notice.​ D. No residents may be relocated pursuant to a proposed closure plan until the commissioner​ approves the proposed closure plan or until a modified closure plan is agreed upon by the​ commissioner and the licensee.​ Subp. 4. Notice to residents. The licensee shall provide the same written notice of the closure​ to each resident and the resident's representatives and case manager that was submitted in subpart​ 1 and approved by the commissioner. The notice must include contact information for the Office​ of the Ombudsman for Long Term Care, the Office of Ombudsman for Mental Health and​ Developmental Disabilities, and a primary facility contact that the resident and the resident's​ representatives and case manager can contact to discuss relocating the resident out of the facility​ due to the planned closure.​ Subp. 5. Resident-relocation evaluation.​ A. After the commissioner approves the closure plan, the facility must prepare a written​ resident-relocation evaluation for each resident identified under subpart 2, item C. The evaluation​ must include:​ (1) the resident's current service plans;​ (2) the list of safe and appropriate housing and service providers identified under subpart​ 2, item E;​ (3) the resident's needs and choices; and​ (4) the right of the resident to tour the safe location and appropriate service provider,​ if applicable, prior to relocation.​ B. The facility must provide a written copy of the resident-relocation evaluation to the​ resident and the resident's representatives and case manager as soon as practicable but no later than​ the planning conference under subpart 6, item A.​

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Subp. 6. Resident-relocation plan.​ A. The facility must hold a planning conference and develop a written resident-relocation​ plan with each resident and the resident's representatives, case manager, and other individuals​ invited by the resident to the planning conference.​ B. The relocation plan must incorporate the relocation evaluation developed in subpart 5.​ C. The resident-relocation plan must comply with part 4659.0120, subpart 7, item C.​ D. The facility must implement the resident-relocation plan, must comply with the​ coordinated move requirements under Minnesota Statutes, section 144G.55, and must provide a​ copy of the resident-relocation plan to the resident and, with the resident's consent, the resident's​ representatives and case manager, if applicable.​ E. The department may visit the facility to monitor the closure process.​ Subp. 7. Resident-relocation verification. Within 14 calendar days of all residents having​ left the facility, the licensee, based on information provided by the resident or resident's​ representatives, case manager, or family members, shall notify the commissioner in writing that​ the licensee completed the closure and verify to the commissioner that the licensee complied with​ the coordinated move requirements in Minnesota Statutes, section 144G.55.​ Subp. 8. Information regarding resident relocation to receiving provider. The facility must​ comply with part 4659.0120, subpart 8, for all residents who relocate due to the closure.​ Subp. 9. Disbursing resident funds. Within 30 calendar days of the effective date of the​ facility closure, the facility must follow the requirements of Minnesota Statutes, section 144G.42,​ subdivision 5.​ Subp. 10. Resident discharge summary. When a resident moves out of the facility, the facility​ must provide the resident with a written discharge summary that complies with part 4659.0120,​ subpart 9.​ Subp. 11. License forfeiture. The licensee forfeits its assisted living facility license or assisted​ living facility with dementia care license upon the effective date of closure identified in subpart 3.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0140 INITIAL ASSESSMENTS AND CONTINUING ASSESSMENTS.​ Subpart 1. Admissions.​ A. The assisted living director, in cooperation with the clinical nurse supervisor, is​ responsible for admitting residents to the facility according to the facility's admission policies.​

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4659.0140​

B. Unless otherwise provided by law, an assisted living facility must not admit or retain a​ resident unless it can provide sufficient care and supervision to meet the resident's needs, based on​ the resident's known physical, mental, cognitive, or behavioral condition. The facility is in compliance​ with this provision if the resident has voluntarily elected to receive care and supervision for the​ resident's needs through the use of an unaffiliated service provider as permitted under Minnesota​ Statutes, section 144G.50, subdivision 2, paragraph (e), clause (4).​ C. Prospective residents who are denied admission must be informed of the reason for the​ denial.​ Subp. 2. Nursing assessment.​ A. A nursing assessment or reassessment under Minnesota Statutes, section 144G.70,​ subdivision 2, paragraphs (b) and (c), must be conducted on a prospective resident or resident​ receiving any of the assisted living services identified in Minnesota Statutes, section 144G.08,​ subdivision 9, clauses (6) to (12).​ B. The nursing assessment or reassessment under item A must:​ (1) address part 4659.0150, subpart 2, items A to N;​ (2) be conducted in person unless an exception under Minnesota Statutes, section​ 144G.70, subdivision 2, paragraph (b), applies;​ (3) be conducted using a uniform assessment tool that complies with part 4659.0150;​ and​ (4) be in writing, dated, and signed by the registered nurse who conducted the​ assessment.​ Subp. 3. Individualized review.​ A. An individualized review or subsequent review under Minnesota Statutes, section​ 144G.70, subdivision 2, paragraph (d), must be conducted for a prospective resident or resident​ receiving only the assisted living services identified in Minnesota Statutes, section 144G.08,​ subdivision 9, clauses (1) to (5).​ B. An individualized initial review or review under Minnesota Statutes, section 144G.70,​ subdivision 2, paragraph (d), for a prospective resident or resident must:​ (1) address part 4659.0150, subpart 2, items A to C and N;​ (2) be conducted in person unless an exception under Minnesota Statutes, section​ 144G.70, subdivision 2, paragraph (b) applies;​ (3) be conducted using a uniform assessment tool that complies with part 4659.0150;​ and​ (4) be in writing, dated, and signed by the nurse who conducted the individualized​ review.​

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Subp. 4. Assessor; qualifications.​ A. A registered nurse shall complete nursing assessments and reassessments required under​ Minnesota Statutes, section 144G.70, subdivision 2, paragraphs (b) and (c). Ongoing monitoring​ may be completed by other licensed nurses acting within the scope of their licenses under Minnesota​ Statutes, section 148.171.​ B. A staff member who meets the qualifications in Minnesota Statutes, section 144G.60,​ subdivision 2, shall conduct the individualized initial review and subsequent reviews.​ Subp. 5. Temporary service plan admission. If a facility admits an individual according to​ a temporary service plan under Minnesota Statutes, section 144G.70, subdivision 3, the nurse​ assessment must be conducted within 72 hours of initiating services.​ Subp. 6. Consumer protections under temporary service plan. An individual who is admitted​ to an assisted living facility under a temporary service plan under Minnesota Statutes, section​ 144G.70, subdivision 3, and has not executed an assisted living contract shall receive the same​ consumer protections and rights under Minnesota Statutes, chapter 144G, provided to a resident​ who has executed an assisted living contract.​ Subp. 7. Weekend assessments. An assisted living facility must be able to conduct a nursing​ assessment on a holiday or on a weekend for a resident who is ready to be discharged from the​ hospital and return to the facility.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0150 UNIFORM ASSESSMENT TOOL.​ Subpart 1. Definition. For purposes of this part, "Uniform Assessment Tool" means an​ assessment tool that meets the requirements of this part and is used by a licensee to comprehensively​ evaluate a resident's or prospective resident's physical, mental, and cognitive needs.​ Subp. 2. Assessment tool elements. Each facility must develop a uniform assessment tool.​ The facility may use any acceptable form or format for the tool, such as an online or a hard-copy​ paper assessment tool, as long as the tool includes the elements identified in this subpart. A uniform​ assessment tool must address the following:​ A. the resident's personal lifestyle preferences, including:​ (1) sleep schedule, dietary and social needs, leisure activities, and any other customary​ routine that is important to the resident's quality of life;​ (2) spiritual and cultural preferences; and​ (3) advance health care directives and end-of-life preferences, including whether a​ person has or wants to seek a "do not resuscitate" order and "do not attempt resuscitation order" or​ "physician/provider orders for life-sustaining treatment" order;​

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4659.0150​

B. activities of daily living, including:​ (1) toileting pattern, bowel, and bladder control;​ (2) dressing, grooming, bathing, and personal hygiene;​ (3) mobility, including ambulation, transfers, and assistive devices; and​ (4) eating, dental status, oral care, and assistive devices and dentures, if applicable;​ C. instrumental activities of daily living, including:​ (1) ability to self manage medications;​ (2) housework and laundry; and​ (3) transportation;​ D. physical health status, including:​ (1) a review of relevant health history and current health conditions, including medical​ and nursing diagnoses;​ (2) allergies and sensitivities related to medication, seasonality, environment, and food​ and if any of the allergies or sensitivities are life threatening;​ (3) infectious conditions;​ (4) a review of medications according to Minnesota Statutes, section 144G.71,​ subdivision 2, including prescriptions, over-the-counter medications, and supplements, and for​ each:​ (a) the reason taken;​ (b) any side effects, contraindications, allergic or adverse reactions, and actions to​ address these issues;​ (c) the dosage;​ (d) the frequency of use;​ (e) the route administered or taken;​ (f) any difficulties the resident faces in taking the medication;​ (g) whether the resident self administers the medication;​ (h) the resident's preferences in how to take medication;​ (i) interventions needed in management of medications to prevent diversion of​ medication by the resident or others who may have access to the medications; and​

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(j) provide instructions to the resident and resident's legal or designated​ representatives on interventions to manage the resident's medications and prevent diversion of​ medications;​ (5) a review of medical, dental, and emergency room visits in the past 12 months,​ including visits to a primary health care provider, hospitalizations, surgeries, and care from a​ postacute care facility;​ (6) a review of any reports from a physical therapist, occupational therapist, speech​ therapist, or cognitive evaluations within the last 12 months;​ (7) weight; and​ (8) initial vital signs if indicated by health conditions or medications;​ E. emotional and mental health conditions, including:​ (1) review of history of and any diagnoses of mood disorders, including depression,​ anxiety, bipolar disorder, and thought or behavioral disorders;​ (2) current symptoms of mental health conditions and behavioral expressions of​ concerns; and​ (3) effective medication treatment and nonmedication interventions;​ F. cognition, including:​ (1) a review of any neurocognitive evaluations and diagnoses; and​ (2) current memory, orientation, confusion, and decision-making status and ability;​ G. communication and sensory capabilities, including:​ (1) hearing;​ (2) vision;​ (3) speech;​ (4) assistive communication and sensory devices including hearing aids; and​ (5) the ability to understand and be understood;​ H. pain, including:​ (1) location, frequency, intensity, and duration; and​ (2) effectiveness of medication and nonmedication alternatives;​ I. skin conditions;​ J. nutritional and hydration status and preferences;​ K. list of treatments, including type, frequency, and level of assistance needed;​

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4659.0150​

L. nursing needs, including potential to receive nursing-delegated services;​ M. risk indicators, including:​ (1) risk for falls including history of falls;​ (2) emergency evacuation ability;​ (3) complex medication regimen;​ (4) risk for dehydration, including history of urinary tract infections and current fluid​ intake pattern;​ (5) risk for emotional or psychological distress due to personal losses;​ (6) unsuccessful prior placements;​ (7) elopement risk including history or previous elopements;​ (8) smoking, including the ability to smoke without causing burns or injury to the​ resident or others or damage to property; and​ (9) alcohol and drug use, including the resident's alcohol use or drug use not prescribed​ by a physician;​ N. who has decision-making authority for the resident, including:​ (1) the presence of any advance health care directive or other legal document that​ establishes a substitute decision maker; and​ (2) the scope of decision-making authority of a substitute decision maker under subitem​ (1); and​ O. the need for follow-up referrals for additional medical or cognitive care by health​ professionals.​ Subp. 3. Record keeping. Assessment tool results, including those from an assessment​ supplement, must be maintained in the resident's record as required under Minnesota Statutes,​ section 144G.43.​ Subp. 4. Licensee attestation. An applicant for an assisted living facility license or a licensee​ renewing an assisted living facility license must attest to the commissioner in a manner determined​ by the commissioner that the uniform assessment tool used by the applicant or licensee complies​ with this part.​ Subp. 5. Department access to uniform assessment tool. At the time of a survey, investigation,​ or other licensing activity, the licensee must provide the department access to or copy of the uniform​ assessment tool as required under Minnesota Statutes, section 144G.30, subdivision 4, to verify​ compliance with this part.​ Statutory Authority: MS s 144G.09​

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4659.0150​

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History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0160 RELINQUISHING AN ASSISTED LIVING FACILITY WITH DEMENTIA​ CARE LICENSE.​ Subpart 1. Voluntary relinquishment; notifying commissioner and ombudsman. Before​ relinquishing an assisted living facility with dementia care license, a licensee shall submit to the​ commissioner and ombudsman in writing:​ A. the transition plan; and​ B. the name and contact information of another individual, in addition to the facility director,​ responsible for the daily operation and management of the facility during the relinquishment process.​ Subp. 2. Transitional plan; contents. In addition to the requirements under Minnesota Statutes,​ section 144G.80, subdivision 3, paragraph (a), clause (2), the transition plan must include:​ A. the reason for relinquishing the license and the proposed date of relinquishment;​ B. the proposed timetable for resident transitions, the resources that the facility will provide,​ and how the facility will facilitate resident transitions;​ C. a list of residents who may require a change in service plan because of the relinquishment​ and a description of the residents' respective levels of care, special needs, or conditions; and​ D. a list identifying each resident, if any, to whom the facility expects to issue a notice of​ termination of housing or assisted living services because of relinquishment.​ Subp. 3. Notice to residents.​ A. Along with the notice to residents required under Minnesota Statutes, section 144G.80,​ subdivision 3, the facility shall:​ (1) notify all residents and their representatives and case managers, if any, in writing​ of the license relinquishment, the proposed date that the license will be relinquished, and the reason​ for the license relinquishment; and​ (2) provide a primary facility contact that the resident and the resident's representatives​ and case manager, if any, can contact to discuss transitioning the resident out of the facility.​ B. Once the facility has notified residents according to item A, the facility must revise​ advertising materials and disclosure information to remove any reference that the facility is an​ assisted living facility with dementia care and communicate to all potential residents and new​ residents entering the facility that the licensee will be relinquishing its license.​

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4659.0160​

Subp. 4. Resident-relocation evaluation.​ A. For each resident identified according to subpart 2, item D, whose contract the facility​ terminates, the facility must prepare a resident-relocation evaluation and comply with part 4659.0120,​ subpart 6.​ B. The resident-relocation evaluation under item A may include recommendations for​ continuing to receive housing and assisted living services from the assisted living facility that is​ relinquishing its assisted living facility with dementia care license.​ Subp. 5. Resident-relocation plan. For each resident identified in subpart 2, item D, whose​ contract the facility terminates, the facility must hold a planning conference and develop a written​ relocation plan and comply with part 4659.0120, subpart 7.​ Subp. 6. Verifying resident relocation. Within 14 calendar days of all residents identified in​ subpart 2, item D, whose contracts the facility terminates, having left the facility, the licensee, based​ on information provided by each resident or resident's representatives, case manager, or family​ member, shall verify to the commissioner in writing that the residents are safely relocated according​ to this part and the coordinated move requirements in Minnesota Statutes, section 144G.55.​ Subp. 7. Information regarding resident relocation to receiving provider. The facility must​ comply with part 4659.0120, subpart 8, for all residents who relocate due to the license​ relinquishment.​ Subp. 8. Disbursement of resident funds. Within 30 calendar days of the effective date of​ the license relinquishment, the facility must follow the requirements of Minnesota Statutes, section​ 144G.42, subdivision 5, for all residents who relocate due to the license relinquishment.​ Subp. 9. Resident discharge summary. When a resident moves out of the facility, the facility​ must provide the resident with a written discharge summary that complies with part 4659.0120,​ subpart 9.​ Subp. 10. Assisted living facility with dementia care license forfeiture.​ A. The licensee forfeits its assisted living facility with a dementia care license upon the​ proposed date of license relinquishment under subpart 2, item A, unless the commissioner has​ approved an extension to that date in writing.​ B. The commissioner shall reclassify the license to the assisted living facility license​ category as of the date of relinquishment.​ C. A licensee shall not reapply for an assisted living facility with dementia care license​ until one year after the date of license relinquishment.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​

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4659.0180​

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4659.0180 STAFFING.​ Subpart 1. Definition. For purposes of this part, "direct-care staff" means staff who provide​ services for residents that include assistance with activities of daily living, medication administration,​ resident-focused activities, supervision, and support.​ Subp. 2. Clinical nurse supervisor. The facility's clinical nurse supervisor may also fulfill​ any of the responsibilities that a registered nurse is required to perform at the facility under Minnesota​ Statutes, chapter 144G​ Subp. 3. Direct-care staffing; plan required. A clinical nurse supervisor must develop and​ implement a written staffing plan that provides an adequate number of qualified direct-care staff​ to meet the residents' needs 24 hours a day, seven days a week. When developing a direct-care​ staffing plan, the clinical nurse supervisor must ensure that staffing levels are adequate to address​ the following:​ A. each resident's needs, as identified in the resident's service plan and assisted living​ contract;​ B. each resident's acuity level, as determined by the most recent assessment or individualized​ review;​ C. the ability of staff to timely meet the residents' scheduled and reasonably foreseeable​ unscheduled needs given the physical layout of the facility premises;​ D. whether the facility has a secured dementia care unit; and​ E. staff experience, training, and competency.​ Subp. 4. Daily staffing schedule.​ A. The clinical nurse supervisor must develop a 24-hour daily staffing schedule. The​ schedule must:​ (1) include direct-care staff work schedules for each direct-care staff member showing​ all work shifts, including days and hours worked; and​ (2) identify the direct-care staff member's resident assignments or work location.​ B. The daily work schedule in item A must be posted, after redacting direct-care staff​ members' resident assignments, at the beginning of each work shift in a central location in each​ building of a facility or campus, accessible to staff, residents, volunteers, and the public. The facility​ shall not disclose any information that is protected by law from public disclosure.​ Subp. 5. Direct-care staff availability. A minimum of two direct-care staff must be scheduled​ and available to assist at all times whenever a resident requires the assistance of two direct-care​ staff for scheduled reasonably foreseeable and unscheduled needs, as reflected in the resident's​ assessments and service plan.​

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4659.0190​

Subp. 6. Direct-care staff availability; night supervision. During the hours of 10:00 p.m.​ to 6:00 a.m., direct-care staff shall respond to a resident's request for assistance with health or safety​ needs within a reasonable amount of time as provided in Minnesota Statutes, section 144G.41,​ subdivision 1, clause (12), item (ii).​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0190 TRAINING REQUIREMENTS.​ Subpart 1. Training policy. A facility must establish, implement, and keep current policies​ and procedures for staff orientation, training, and competency evaluation, and a process for evaluating​ staff performance as required under Minnesota Statutes, section 144G.41, subdivision 2, that meets:​ A. the orientation, training, and competency requirements under this part and Minnesota​ Statutes, sections 144G.42 and 144G.60 to 144G.64; and​ B. for a facility with an assisted living facility with dementia care license, the additional​ staff training requirements under Minnesota Statutes, sections 144G.80, 144G.82, and 144G.83.​ Subp. 2. Additional orientation. In addition to the staff orientation requirements identified​ in subpart 1, the facility's training policy must include orientation training on:​ A. the staff person's job description upon hire and whenever there is a change to the job​ description that changes the nature of the job or how the job is to be performed;​ B. the facility's organization chart and the roles of staff within the facility, and the services​ offered by the facility as identified in the uniform checklist disclosure of services; and​ C. the identification of incidents of maltreatment as defined under Minnesota Statutes,​ section 626.5572, subdivision 15, including abuse, financial exploitation, and neglect, and an​ explanation that any act that constitutes maltreatment is prohibited.​ Subp. 3. Additional training requirements for assisted living facilities with dementia care​ licenses.​ A. In addition to the other training requirements identified in subpart 1, direct care​ dementia-trained staff under Minnesota Statutes, section 144G.83, subdivision 1, and other staff​ having direct contact with residents of a facility that has an assisted living facility with dementia​ care license must receive training on the following topics:​ (1) understanding cognitive impairment, and behavioral and psychological symptoms​ of dementia; and​ (2) standards of dementia care, including nonpharmacological dementia care practices​ that are person-centered and evidence-informed.​

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B. A facility with an assisted living facility with dementia care license is responsible for​ ensuring and maintaining documentation that individuals providing or overseeing staff training​ relating to dementia and dementia care have the work experience and training required under​ Minnesota Statutes, section 144G.83, subdivision 3, and have successfully passed a skills competency​ or knowledge test required by the commissioner before the individual provides or oversees staff​ training. The commissioner must publish and update as needed a list of acceptable skills competency​ or knowledge tests on the department's website that are based on current best practice standards in​ the field of dementia care and meet requirements of Minnesota Statutes, section 144G.83, subdivision​ 3, clause (2).​ Subp. 4. Staff competency; retraining. The facility's training policy must identify the​ requirements for retraining staff when the facility determines that a staff person is not demonstrating​ competency when performing assigned tasks. If retraining does not result in competency, the facility​ must identify the additional steps it will follow to ensure the staff person achieves competency, the​ time frame for completing the additional steps, and the actions the facility will take to protect​ resident rights until competency is achieved.​ Subp. 5. Portability of staff training.​ A. Unlicensed personnel providing assisted living services who transfer from one licensed​ assisted living facility to another or who are newly hired by a licensed assisted living facility may​ satisfy the training requirements under Minnesota Statutes, section 144G.61, subdivision 2, by​ providing written proof of previously completed training within the past 18 months.​ B. The facility must complete an evaluation of the competency of the unlicensed personnel​ in the areas where the previously completed training is being accepted by the facility before the​ staff person may provide assisted living services to residents. Competency evaluations must be​ conducted by a competency evaluator under subpart 6 and Minnesota Statutes, section 144G.61,​ subdivision 1, and maintained under Minnesota Statutes, section 144G.42, subdivision 8.​ Subp. 6. Training records and documentation.​ A. The facility must maintain a record of staff training and competency required under this​ part and Minnesota Statutes, chapter 144G, that documents the following information for each​ competency evaluation, training, retraining, and orientation topic:​ (1) facility name, location, and license number;​ (2) name of the training topic or training program, and the training methodology, such​ as classroom style, web-based training, video, or one-to-one training;​ (3) date of the training and competency evaluation, and the total amount of time of the​ training and competency evaluation;​ (4) name and title of the instructor and the instructor's signature, and the name and title​ of the competency evaluator, if different from the instructor, and the evaluator's signature with a​ statement attesting that the employee successfully completed the training and competency evaluation;​ and​

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4659.0200​

(5) name and title of the staff person completing the training, and the staff person's​ signature with a statement attesting that the staff person successfully completed the training as​ described in the training documentation.​ B. Documentation of the completed competency evaluation, training, retraining, or​ orientation must be provided to the employee at the time the evaluation or training is completed.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0200 NONRENEWAL OF HOUSING, REDUCTION IN SERVICES; REQUIRED​ NOTICES.​ Subpart 1. Relocation requirements for nonrenewal of housing and reduction in services. A​ facility that decides not to renew a resident's housing under Minnesota Statutes, section 144G.53,​ paragraph (a), clause (1), or that reduces a resident's services to the extent that the resident is required​ to move under Minnesota Statutes, section 144G.55, subdivision 1, paragraph (a), must comply​ with part 4659.0120, subparts 6 to 9.​ Subp. 2. Service reduction notice.​ A. A facility providing notice to the ombudsman under Minnesota Statutes, section 144G.55,​ subdivision 1, paragraph (f), must provide the notice as soon as practicable but no later than two​ calendar days after determining that the resident will move.​ B. The notice under item A must include:​ (1) the resident's name and contact information;​ (2) the names and contact information for the resident's representatives and case manager,​ if any;​ (3) a description of the reduction of service; and​ (4) the reasons that the facility, resident, resident's representatives, or case manager has​ provided for why the reduction in services will require the resident to move.​ Subp. 3. Change in facility operations notice.​ A. A facility sending notice to the ombudsman or the Office of Ombudsman for Mental​ Health and Developmental Disabilities under Minnesota Statutes, section 144G.56, subdivision 5,​ paragraph (a), clause (4), must provide the notice in writing and as soon as practicable.​ B. The notice under item A must include:​ (1) the effective date of the proposed transfer;​ (2) the facility's plan for notifying residents and their representatives, case managers,​ and family members of the transfers;​

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(3) the facility's plan for safely transferring residents and their belongings;​ (4) the facility's plans for minimizing the number of transfers, considering residents'​ needs and preferences, and providing reasonable accommodations to residents regarding the transfers;​ and​ (5) the affected residents' names, living unit numbers, and phone numbers or, if the​ affected residents do not have phone numbers, their representatives' phone numbers.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​ 4659.0210 TERMINATION APPEALS; PROCEDURES AND TIMELINES FOR APPEALS.​ Subpart 1. Resident appeal notice of termination. Upon receipt of the facility's written notice​ of an assisted living contract termination, a resident has:​ A. 30 calendar days to appeal a termination under Minnesota Statutes, section 144G.52,​ subdivision 7, paragraph (b), based on nonpayment of rent or services, or violating the assisted​ living contract; and​ B. 15 calendar days to appeal an expedited termination of housing or services under​ Minnesota Statutes, section 144G.52, subdivision 7, paragraph (c).​ Subp. 2. Contact commissioner to start appeal. Within the timelines stated in subpart 1, the​ resident or an individual acting on the resident's behalf shall contact the department in writing to​ request an appeal of the termination. The failure of a resident to request a hearing within the provided​ timelines constitutes a waiver of the right to a hearing.​ Subp. 3. Hearing process.​ A. Hearings under Minnesota Statutes, section 144G.54, shall be conducted in an expedited​ process, with a hearing held as soon as practicable, but in no event later than 14 calendar days after​ the Office of Administrative Hearings receives the request for hearing, unless the chief administrative​ law judge determines, under Minnesota Statutes, section 144G.54, subdivision. 3, paragraph (c),​ that the hearing should be a formal contested case proceeding conducted under parts 1400.5010 to​ 1400.8400 and Minnesota Statutes, chapter 14.​ B. Formal contested case proceedings shall be held according to parts 1400.5010 to​ 1400.8400 and Minnesota Statutes, sections 14.57 to 14.62.​ C. If the resident is unable to provide self-representation at the hearing or wishes to have​ an individual present on the resident's behalf, an individual of the resident's choosing may present​ the resident's appeal to the administrative law judge on the resident's behalf.​ D. In cases involving unrepresented residents, the administrative law judge shall take​ appropriate steps to identify and develop in the hearing relevant facts necessary for making an​ informed and fair decision. An unrepresented resident shall be provided an adequate opportunity​

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4659.0210​

to respond to testimony or other evidence presented at the hearing. The administrative law judge​ shall ensure that an unrepresented resident has a full and reasonable opportunity at the hearing to​ establish a record for appeal.​ Subp. 4. Order of commissioner. If a hearing has been held, the commissioner may issue a​ final order within 14 calendar days after receipt of the recommendation of the administrative law​ judge. The parties may, within the first seven of those 14 calendar days, submit additional written​ argument to the commissioner on the recommendation and the commissioner will consider the​ written arguments. If the commissioner does not issue a final order within 14 calendar days after​ receipt of the recommendation, the recommendation of the administrative law judge constitutes the​ final order. Final orders may be appealed in the manner provided in Minnesota Statutes, sections​ 14.63 to 14.69.​ Statutory Authority: MS s 144G.09​ History: 46 SR 33​ Published Electronically: August 11, 2021​

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CHAPTER 6400​ BOARD OF EXECUTIVES FOR LONG TERM SERVICES AND SUPPORTS​ LICENSING OF NURSING HOME ADMINISTRATORS​ GENERAL​ 6400.5000​

SCOPE.​

6400.5100​

DEFINITIONS.​

6400.5150​

APPLICABILITY.​

6400.5200​

USE OF TITLE.​

6400.6000​

LICENSURE REQUIREMENTS.​

6400.6100​

APPLYING FOR LICENSURE.​ COURSE REQUIREMENTS​

6400.6400​

GENERAL COURSE REQUIREMENTS.​

6400.6550​

SPECIFIC COURSE REQUIREMENTS.​

6400.6560​

WAIVER OF ALL COURSE REQUIREMENTS.​

6400.6570​

EVIDENCE OF COURSE COMPLETION.​

6400.6600​

PRACTICUM COURSE.​

6400.6655​

PRACTICUM DURATION.​

6400.6660​

ACADEMIC PROGRAM REVIEW.​ LICENSES AND PERMITS​

6400.6700​

ENDORSEMENT.​

6400.6710​

LICENSEE RESPONSIBILITIES.​

6400.6720​

DISPLAYING LICENSES.​

6400.6730​

DUPLICATE LICENSES.​

6400.6740​

RENEWING LICENSES.​

6400.6750​

LICENSE REINSTATEMENT.​

6400.6760​

VERIFICATION OF MINNESOTA LICENSE.​

6400.6770​

ACTING ADMINISTRATOR PERMITS.​ CONTINUING EDUCATION​

6400.6800​

CONTINUING EDUCATION REQUIREMENTS.​

6400.6850​

NUMBER OF CE CREDITS FOR ACTIVITIES.​

6400.6870​

SPONSORING CONTINUING EDUCATION.​ DISCIPLINE​

6400.6900​

GROUNDS FOR DISCIPLINE.​

6400.6950​

APPLICABILITY.​

6400.7000​

USE OF TITLE.​

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Besides Scope (6400.5000) and Definitions (6400.5100), Licensed Assisted Living Director (LALD) Rules are found at 6400.6950 - 6400.7095

MINNESOTA RULES​

6400.0100​ 6400.7005​

LICENSURE REQUIREMENTS.​

6400.7010​

APPLYING FOR LICENSURE.​ COURSE REQUIREMENTS​

6400.7015​

CORE COURSE REQUIREMENTS.​

6400.7020​

MINNESOTA COURSE REQUIREMENTS.​

6400.7025​

EVIDENCE OF COURSE COMPLETION.​

6400.7030​

ASSISTED LIVING DIRECTOR IN RESIDENCE; FIELD EXPERIENCE.​

6400.7040​

COURSE PROVIDER REVIEW.​ LICENSES AND PERMITS​

6400.7045​

ENDORSEMENT.​

6400.7050​

LICENSEE RESPONSIBILITIES.​

6400.7055​

DISPLAYING LICENSES.​

6400.7060​

DUPLICATE LICENSES.​

6400.7065​

RENEWING LICENSES.​

6400.7070​

LICENSE REINSTATEMENT.​

6400.7075​

VERIFICATION OF MINNESOTA LICENSE.​

6400.7080​

ASSISTED LIVING DIRECTOR IN RESIDENCE PERMITS.​

6400.7085​

SHARED DIRECTOR.​ CONTINUING EDUCATION​

6400.7090​

CONTINUING EDUCATION REQUIREMENTS.​

6400.7091​

NUMBER OF CE CREDITS FOR ACTIVITIES.​

6400.7092​

SPONSORING CONTINUING EDUCATION.​ STANDARDS OF PRACTICE​

6400.7095​

STANDARDS OF PRACTICE; ENFORCEMENT.​

6400.0100 Subpart 1. [Repealed, 21 SR 1564]​ Subp. 1a. [Repealed, 21 SR 1564]​ Subp. 2. [Repealed, 21 SR 1564]​ Subp. 3. [Repealed, 21 SR 1564]​ Subp. 4. [Repealed, 21 SR 1564]​ Subp. 5. [Repealed, 21 SR 1564]​ Subp. 6. [Repealed, 21 SR 1564]​ Subp. 7. [Repealed by amendment, 8 SR 1480]​ Subp. 8. [Repealed, 21 SR 1564]​

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3​ Subp. 9. [Renumbered subp. 1a]​

Subp. 10. [Repealed by amendment, 8 SR 1480]​ Published Electronically: June 11, 2008​ 6400.0200 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.0300 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.0400 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.0450 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.0500 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.0600 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.0700 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.0800 Subpart 1. [Repealed, 21 SR 1564]​ Subp. 2. [Repealed, 21 SR 1564]​ Subp. 3. [Repealed, 21 SR 1564]​ Subp. 4. [Repealed by amendment, 8 SR 1480]​ Subp. 5. [Repealed, 21 SR 1564]​ Subp. 6. [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.0900 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.1000 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.1100 [Repealed by amendment, 8 SR 1480]​ Published Electronically: June 11, 2008​ 6400.1200 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.1300 [Repealed, 21 SR 1564]​

Official Publication of the State of Minnesota​ Revisor of Statutes​

6400.1300​

6400.1300​

MINNESOTA RULES​

Published Electronically: June 11, 2008​ 6400.1400 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.1500 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.1600 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.1700 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.1800 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.1900 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.2000 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.2100 [Repealed, 13 SR 2686]​ Published Electronically: June 11, 2008​ 6400.2200 Subpart 1. [Repealed, 21 SR 1564]​ Subp. 2. [Repealed, 13 SR 2686]​ Published Electronically: June 11, 2008​ 6400.2300 [Repealed, 13 SR 2686]​ Published Electronically: June 11, 2008​ 6400.2400 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.2500 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.2600 [Repealed, 8 SR 1480]​ Published Electronically: June 11, 2008​ 6400.2700 [Repealed, 13 SR 2686]​ Published Electronically: June 11, 2008​ 6400.2800 [Repealed, 13 SR 2686]​ Published Electronically: June 11, 2008​ 6400.2900 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​

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6400.5100​

6400.3000 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.3100 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ 6400.3200 [Repealed, 21 SR 1564]​ Published Electronically: June 11, 2008​ GENERAL​ 6400.5000 SCOPE.​ This chapter applies to:​ A. individuals who:​ (1) are applicants or prospective applicants for licensure as nursing home administrators​ under Minnesota Statutes, section 144A.20;​ (2) are applicants for designation as acting administrators under Minnesota Statutes,​ section 144A.27;​ (3) are applicants or prospective applicants for licensure as health services executives​ under Minnesota Statutes, section 144A.26;​ (4) are licensees of the board;​ (5) hold permits issued by the board to serve as acting administrators under Minnesota​ Statutes, section 144A.27, or to serve as assisted living directors in residence under part 6400.7080;​ and​ (6) are applicants or prospective applicants for licensure as assisted living directors;​ B. individuals and organizations that sponsor continuing education programs to enable​ licensees to update their knowledge and meet license renewal requirements;​ C. academic institutions that offer courses to meet the academic course requirements for​ nursing home administrator licensure; and​ D. academic institutions that offer courses to meet the academic course requirements for​ assisted living directors.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 24 SR 1780; 45 SR 753; 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.5100 DEFINITIONS.​ Subpart 1. Scope. The terms used in this chapter have the meanings given them in this part.​

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6400.5100​

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6​

Subp. 2. Accredited. "Accredited" means approved by a regional accrediting organization for​ higher education.​ Subp. 3. Acting administrator. "Acting administrator" means an individual, designated by​ the controlling persons of the employing nursing facility, who has been issued a permit by the board​ under part 6400.6770.​ Subp. 3a. Administrator in residence or AIR. "Administrator in residence" or "AIR" means​ an individual who works, as part of a formal AIR program, under the guidance and supervision of​ a preceptor who is a licensed administrator or a health services executive meeting the qualifications​ established for preceptors by their respective states.​ Subp. 3b. Administrator in residence program or AIR program. "Administrator in residence​ program" or "AIR program" means a supervised internship during which the AIR works under the​ guidance and supervision of a preceptor who is a licensed administrator or health services executive​ meeting the qualifications established for preceptors by their respective states.​ Subp. 4. Assistant administrator. "Assistant administrator" means an individual who reports​ to the nursing home administrator, assumes charge of the facility in the administrator's absence,​ and has ongoing managerial and supervisory authority over both administrative and resident care​ functions, operations, and staff in a nursing facility.​ Subp. 4a. Assistant director. "Assistant director" means an individual who reports to the​ assisted living director, assumes charge of the assisted living facility in the director's absence, and​ has ongoing managerial and supervisory authority over both administrative and resident care​ functions, operations, and staff in an assisted living facility.​ Subp. 4b. Assisted living contract. "Assisted living contract" has the meaning given in​ Minnesota Statutes, section 144G.08, subdivision 5.​ Subp. 4c. Assisted living director or director. "Assisted living director" or "director" has​ the meaning given in Minnesota Statutes, section 144G.08, subdivision 6.​ Subp. 4d. Assisted living director in residence or ALDIR. "Assisted living director in​ residence" or "ALDIR" means an individual, designated by the controlling individuals of the​ employing assisted living facility, who has been issued a permit by the board under part 6400.7080.​ Subp. 4e. Assisted living facility. "Assisted living facility" has the meaning given in Minnesota​ Statutes, section 144G.08, subdivision 7.​ Subp. 4f. Assisted living facility with dementia care. "Assisted living facility with dementia​ care" has the meaning given in Minnesota Statutes, section 144G.08, subdivision 8.​ Subp. 4g. Assisted living services. "Assisted living services" has the meaning given in​ Minnesota Statutes, section 144G.08, subdivision 9.​ Subp. 5. Board. "Board" means the Minnesota Board of Executives for Long Term Services​ and Supports.​

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6400.5100​

Subp. 6. CE credit or continuing education credit. "CE credit" or "continuing education​ credit" means a unit of measurement of continuing education activity.​ Subp. 7. Clock hour. "Clock hour" means an instructional session of 60 consecutive minutes,​ excluding breaks, registration, meals, and social activities.​ Subp. 7a. Controlling individual. "Controlling individual" has the meaning given in Minnesota​ Statutes, section 144G.08, subdivision 15.​ Subp. 7b. Delegation of authority policy. "Delegation of authority policy" means the individual​ assisted living facility policy that identifies the director and chain of command in the event of the​ absence of the director, ensuring that, at all times, an individual on site has been designated as the​ responsible individual for long-term services and supports.​ Subp. 8. Director of nurses. "Director of nurses" means the individual designated by a nursing​ facility to perform duties consistent with the responsibilities of the director of nursing services​ under part 4658.0505, whether in Minnesota or another jurisdiction.​ Subp. 9. Domains of practice. "Domains of practice" means the tasks performed by long-term​ care administrators and the knowledge, skills, and abilities identified as necessary to perform those​ tasks by NAB in its job analysis of long-term care administrator. The NAB domains of practice for​ long-term care administrator are found in the Final Report of the Job Analysis of the Practice of​ Long-term Care Administrators prepared for the National Association of Boards of Examiners for​ Long-Term Care Administrators. This document is incorporated by reference. It is available on the​ board's website and is subject to change every five years.​ Subp. 9a. [Repealed, 45 SR 1073]​ Subp. 9b. Health services executive or HSE. "Health services executive" or "HSE" means​ an individual who has been validated by NAB as a health services executive and has met the​ education and practice requirements for the minimum qualifications of a nursing home administrator,​ assisted living director, and home and community-based services provider. The HSE meets the​ Minnesota requirement for the administrator of record, required for the Centers for Medicare and​ Medicaid Services (CMS) minimum requirements of participation.​ Subp. 9c. Higher education. "Higher education" means education at a public or private​ university, college, community college, or technical college.​ Subp. 10. License. "License" means a written document issued by the board to indicate that​ the bearer has been found by the board to meet all requirements for practice as a licensed nursing​ home administrator, health services executive, or licensed assisted living director in Minnesota. It​ includes an original license issued for meeting the requirements of part 6400.6000 or 6400.7005,​ a renewal license issued for meeting the requirements of part 6400.6700 or 6400.7065, and a​ reinstated license issued under part 6400.6750 or 6400.7070. It does not include a permit to serve​ as an acting administrator or director in residence.​

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Subp. 11. Licensee. "Licensee" means an individual who holds a valid license to practice as​ a nursing home administrator, health services executive, or licensed assisted living director granted​ by the board under this chapter.​ Subp. 11a. Long-term care administrator. "Long-term care administrator" means an individual​ who manages the daily operations and staff of long-term services and supports communities. A​ long-term care administrator oversees business management, health care services, and personal​ supports for the communities they manage. All licensed health services executives, licensed nursing​ home administrators, and licensed assisted living directors are long-term care administrators.​ Subp. 11b. Manager. "Manager" has the meaning given in Minnesota Statutes, section 144G.08,​ subdivision 35.​ Subp. 11c. Managerial official. "Managerial official" has the meaning given in Minnesota​ Statutes, section 144G.08, subdivision 36.​ Subp. 11d. Mentor. "Mentor" means the licensed assisted living director or licensed health​ services executive directing the field experience of the assisted living director in residence.​ Subp. 12. NAB. "NAB" means the National Association of Boards of Examiners for Long-Term​ Care Administrators, Inc.​ Subp. 13. Nursing facility. "Nursing facility" means a facility licensed as a nursing home to​ provide nursing care to five or more persons under Minnesota Statutes, sections 144A.02 to 144A.10,​ by the Minnesota Department of Health or a similar facility licensed under similar provisions in​ another jurisdiction.​ Subp. 14. Nursing home administrator. "Nursing home administrator" means an individual​ who has the responsibilities outlined in part 4658.0060 in a nursing facility in Minnesota or another​ jurisdiction and is licensed by the licensing authority of the jurisdiction responsible for the facility.​ Subp. 14a. Ombudsman. "Ombudsman" has the meaning given in Minnesota Statutes, section​ 144G.08, subdivision 46.​ Subp. 15. Permit. "Permit" means the acting license referred to in Minnesota Statutes, section​ 144A.27, which, for purposes of this chapter, is a temporary authorization issued by the board to​ an individual who meets the qualifications of part 6400.6770 or 6400.7080.​ Subp. 16. Preceptor. "Preceptor" means a nursing home administrator or health services​ executive who meets the standards in part 6400.6600, subpart 3, and supervises an applicant for​ licensure during the practicum course.​ Subp. 16a. Professional degree. "Professional degree" means a degree that prepares an​ individual to work in a particular profession often meeting the academic requirements for licensure​ or accreditation.​ Subp. 16b. Professional practice analysis. "Professional practice analysis" means the analysis​ used to identify the domains of practice, tasks performed, knowledge needed, and skills used by​ individuals responsible for leadership in organizations that provide long-term services and supports.​

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6400.5200​

Subp. 16c. Quality assurance performance improvement or QAPI. "Quality assurance​ performance improvement" or "QAPI" means a procedure that seeks to ensure continuous quality​ improvement. QAPI is not a standardized procedure but challenged by unique environmental factors​ and leadership skills to encourage and support people.​ Subp. 17. Related individual. "Related individual" means a spouse, natural or adoptive parent,​ stepparent, natural or adoptive grandparent, stepgrandparent, natural or adoptive child, sibling,​ guardian, stepbrother, stepsister, aunt, uncle, niece, nephew, first cousin, or spouse of any person​ named in the above groups even after the marriage ends by death or divorce.​ Subp. 18. Resident.​ A. "Resident," when used in parts 6400.5200 to 6400.6900, means an individual living in​ a nursing facility.​ B. "Resident," when used in parts 6400.7000 to 6400.7095, means an individual living in​ an assisted living facility who has executed an assisted living contract.​ Subp. 19. Root cause analysis or RCA. "Root cause analysis" or "RCA" means a method of​ problem-solving used for identifying the root causes of faults or problems.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 24 SR 1780; 41 SR 599; 45 SR 753; 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.5150 APPLICABILITY.​ Parts 6400.5200 to 6400.6900 apply to nursing home administrators and health services​ executives.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 45 SR 753​ Published Electronically: January 22, 2021​ 6400.5200 USE OF TITLE.​ Subpart 1. Licensed nursing home administrator. Only an individual who is qualified as a​ licensed nursing home administrator and who holds a valid license under this chapter for the current​ licensure period may use the title "Licensed Nursing Home Administrator" and the abbreviation​ "L.N.H.A." after the individual's name.​ Subp. 2. Licensed health services executive. Only an individual who is qualified as a licensed​ health services executive and who holds a valid license under this chapter for the current licensure​ period may use the title "Licensed Health Services Executive" and the abbreviation "L.H.S.E." after​ the individual's name.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​

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MINNESOTA RULES​

6400.5200​

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History: 21 SR 1564; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6000 LICENSURE REQUIREMENTS.​ Subpart 1. License; nursing home administrator. The board shall issue an individual a license​ to practice as a nursing home administrator in Minnesota upon determining that the individual:​ A. has filed a completed application for licensure under part 6400.6100;​ B. meets the requirements specified in Minnesota Statutes, section 144A.20;​ C. has obtained a bachelor's degree from an accredited postsecondary institution;​ D. has passed the national examination for nursing home administrator developed by NAB​ to test knowledge of subjects pertinent to the domains of practice of nursing home administration​ as identified in the NAB job analysis for nursing home administrator;​ E. has passed the state examination given by the board to test knowledge of Minnesota​ laws and rules governing nursing facility operations in Minnesota;​ F. has presented evidence, as specified in part 6400.6570, that the applicant has satisfactorily​ completed courses in each of the areas specified in part 6400.6550, or qualifies for waivers under​ part 6400.6560;​ G. has successfully completed a criminal background check;​ H. has not had an application rejected by the board under part 6400.6100, subpart 5; and​ I. has paid the required fees.​ Subp. 2. License; health services executive. The board shall issue an individual a license to​ practice as a health services executive in Minnesota upon determining that the individual:​ A. has filed a completed application for licensure under part 6400.6100;​ B. meets the requirements in Minnesota Statutes, section 144A.26, subdivision 2;​ C. has passed the state examination given by the board to test knowledge of Minnesota​ laws governing nursing facility operations in Minnesota;​ D. has passed the state examination given by the board to test knowledge of Minnesota​ laws governing assisted living facilities in Minnesota;​ E. has successfully completed a criminal background check;​ F. has not had an application rejected by the board under part 6400.6100, subpart 5; and​ G. has paid the required fees.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​

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History: 21 SR 1564; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6100 APPLYING FOR LICENSURE.​ Subpart 1. Application contents. An individual applying for licensure shall do so electronically​ or on forms provided by the board. The information requested shall include personal identifying​ and locating data including name, home and work addresses and telephone numbers, active e-mail​ addresses, and Social Security number; education and degree information; employment and practice​ history; licensure and disciplinary history; and information relating to criminal convictions, use of​ alcohol and drugs, and other issues which may reflect on ability and fitness to practice. The​ application shall also include a recent full-face two-inch by three-inch photograph affixed to the​ application as indicated and notarized as a true likeness. The notary seal shall be placed next to the​ picture and shall fall partly upon the photograph and partly upon the application.​ Subp. 2. Applicant responsibility. An applicant must provide the board with all information,​ documents, and fees necessary to meet licensure requirements.​ Subp. 3. Application expiration. Applications expire 18 months after the date the application​ form is filed with the board. If the applicant does not fulfill all licensure requirements within the​ 18-month application period, the applicant must resubmit the application and another application​ fee to continue to seek licensure.​ Subp. 4. Examination attempts and score expiration.​ A. If an applicant does not pass the NAB or state examination on the second attempt, the​ applicant must submit to the board a study plan and wait six months from the date of the examination​ attempt to sit for the examination a third time. If an applicant does not pass the NAB or state​ examination on the third attempt, the applicant must submit a revised study plan and wait one year​ from the date of the third examination attempt to sit for the examination a fourth time. The applicant​ may also be required to reapply in order to comply with subpart 3.​ B. Examination scores expire two years after the date the examination was taken if the​ applicant has not become fully licensed within that two years.​ Subp. 5. Grounds for rejection. The board shall reject an applicant who does not meet the​ requirements of part 6400.6000 within the time period of application validity. The board may reject​ an applicant who has been found to have committed acts in this or any other jurisdiction which, if​ performed by a licensee of the Minnesota board, would be grounds for discipline under part​ 6400.6900, subpart 1, taking into account the considerations in part 6400.6900, subpart 3.​ Subp. 6. Notice of rejection. An applicant for licensure whose application has been rejected​ by the board shall be given written notice of the disqualification and the reasons for it and of the​ right to a hearing under Minnesota Statutes, chapter 14.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​

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History: 21 SR 1564; 41 SR 599; 45 SR 753​ Published Electronically: January 22, 2021​ COURSE REQUIREMENTS​ 6400.6400 GENERAL COURSE REQUIREMENTS.​ An applicant for licensure must satisfactorily complete courses to prepare the applicant to​ perform the duties of a nursing home administrator. The courses must include those specified in​ part 6400.6550.​ Statutory Authority: MS s 16A.1285; 144A.21; 144A.24; 214.06​ History: 21 SR 1564; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6500 [Repealed, 45 SR 753]​ Published Electronically: January 22, 2021​ 6400.6550 SPECIFIC COURSE REQUIREMENTS.​ Subpart 1. Organizational management. An applicant must complete a course in organizational​ management covering the basic management functions of:​ A. planning and objective setting;​ B. organizing and delegating; and​ C. observing, monitoring, and evaluating outcomes, including customer satisfaction.​ Subp. 2. Health care accounting. An applicant must complete a course in health care​ accounting, beyond introductory accounting, covering:​ A. budgeting and fiscal resource allocation; and​ B. interpreting financial information to monitor financial performance and position and to​ make managerial decisions.​ Subp. 3. Gerontology. An applicant must complete a course in gerontology covering:​ A. the physical, social, and psychological aspects of the aging process; and​ B. programs and services designed to meet the needs of the aged population.​ Subp. 4. Health care and medical needs. An applicant must complete a course in health care​ and medical needs of nursing facility residents covering:​ A. the anatomic and physiologic changes that are associated with the aging process;​ B. the impact and management of common syndromes associated with aging, including​ vision and hearing impairment, nutrition and malnutrition, and balance and mobility impairment;​

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C. basic medical and pharmacological terminology;​ D. prevention and management of conditions such as pressure ulcers and delirium;​ E. common psychiatric and neurodegenerative disorders such as dementias (including​ Alzheimer's), depression, anxiety, psychotic disorders, and alcohol and drug abuse;​ F. advance care planning and the role of palliative care and end-of-life care; and​ G. emerging medical trends and technology used in the long-term services and supports​ setting.​ Subp. 5. Long-term services and supports. An applicant must complete a course in the​ organization, operations, functions, services, and programs of long-term services and supports​ covering:​ A. governing and oversight bodies and their relationship to the administrator;​ B. administrative responsibilities and structures;​ C. operations and functions of each facility department;​ D. functions and roles of professional and nonprofessional staff and consulting personnel;​ and​ E. issues of cultural diversity and human relationships between and among employees and​ residents of nursing facilities and their family members.​ Subp. 6. Human resources. An applicant must complete a course in human resource​ management covering:​ A. staffing;​ B. equal employment opportunity, affirmative action, and workforce diversity;​ C. compensation and benefits;​ D. coaching and performance management;​ E. training and development;​ F. labor relations, including union contract negotiation and administration;​ G. employment law; and​ H. workplace culture, accountability and fairness, just culture and learning concepts.​ Subp. 7. Regulatory management. An applicant must complete a course in regulatory​ management covering the legal, regulatory, and funding provisions and requirements governing​ operations of long-term services and supports and health care programs including:​ A. resident rights, resident choice, resident risk, and protection from maltreatment;​

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B. professional and biomedical ethics, including advance directives;​ C. guardianship and conservatorship;​ D. liability, negligence, and malpractice;​ E. data confidentiality, privacy, and practices;​ F. professional licensing, certification, and reporting for staff and consulting personnel;​ G. health and safety codes, including OSHA and the National Life Safety Code;​ H. Medicare and Medicaid, standards for managed care and subacute care, and third-party​ payer requirements and reimbursement;​ I. federal and state nursing home survey and compliance regulations and processes;​ J. requirements affecting the quality of care and life of residents, including measurement​ of outcomes from clinical and resident-satisfaction perspectives;​ K. resident acuity and assessment methodology;​ L. quality assessment and assurance; and​ M. customer choice.​ Subp. 8. Quality measurement and performance improvement. An applicant must complete​ a course in the accumulation and analysis of data to inform management decision making including:​ A. strategic uses of data and information;​ B. data accumulation, storage, integration from multiple sources, manipulation, and​ presentation;​ C. needs assessment and analysis methodologies;​ D. measures, analysis, and assessment of outcomes, including customer satisfaction and​ quality improvement;​ E. utilizing quality measurement and performance improvement tools and methodologies;​ and​ F. problem-solving skills.​ Subp. 9. Practicum. An applicant must complete or have waived, based upon prior experience​ under part 6400.6655, subpart 2, a practicum course as described in part 6400.6600.​ Subp. 10. Effective date. An applicant who applies on or after September 1, 2017, must follow​ the requirements in this part.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.23; 144A.24; 214.06​

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History: 41 SR 599; 45 SR 753; 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.6560 WAIVER OF ALL COURSE REQUIREMENTS.​ Subpart 1. Waiver of all course requirements. The board shall waive part 6400.6550 if the​ applicant meets all other licensure requirements and submits satisfactory evidence of having actively​ and effectively served full time for a minimum of two continuous years within the immediate past​ five years as the licensed nursing home administrator and chief executive officer of one or more​ nursing facilities in a single jurisdiction regulated by the licensing board of that jurisdiction. Time​ working as an acting administrator under an acting license or permit or as an administrator in​ residence does not count to meet this requirement. To determine the effectiveness of the applicant's​ service, the board shall review the results of the two most recent regulatory inspections of the​ nursing facilities administered by the applicant.​ Subp. 2. [Repealed, 24 SR 1780]​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 24 SR 1780; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6570 EVIDENCE OF COURSE COMPLETION.​ Subpart 1. Types of evidence. Evidence to verify satisfactory completion of requirements​ specified in part 6400.6550 must consist of one or more of the following:​ A. transcripts showing completion at an accredited academic institution of a course of study​ approved by NAB as providing coverage of the domains of practice identified in the job analysis​ performed by NAB for nursing home administrator;​ B. transcripts or attestation of the program director showing completion of an academic​ program designated by the board as an approved academic program under part 6400.6660; or​ C. transcripts and other supporting documentation such as course outlines, course catalog​ descriptions, and text coverage information, showing completion of individual academic courses​ taken for credit at an accredited postsecondary institution which meet the requirements of part​ 6400.6550, provided that applicants may supplement evidence of completion of an accredited​ academic course which covers at least two-thirds of the topics listed in part 6400.6550, subpart 1,​ 4, 5, 6, 7, or 8, with evidence of completion of continuing education courses for the remaining​ topics. The continuing education courses must be approved by the board in the same manner as the​ board reviews and approves clock hours for continuing education courses for licensees under part​ 6400.6870, subparts 2 and 3.​ Subp. 2. Supplementing evidence older than seven years. Evidence presented under subpart​ 1 for completion of academic programs, including the practicum course, or academic courses taken​ more than seven years prior to the submittal of the information to the board must be supplemented​ by either:​

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A. evidence that the applicant has been employed within the immediate past seven years​ in activities requiring use of the knowledge gained in the course; or​ B. evidence that the applicant has completed continuing education within the past two years​ to renew and update knowledge gained in any academic course taken more than seven years prior.​ Subp. 3. No additional fees required. No fees in excess of fees associated with the standard​ application process may be charged to applicants for review of continuing education courses​ submitted as evidence to meet course requirements.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6600 PRACTICUM COURSE.​ Subpart 1. Requirements and content. The practicum course must be the NAB administrator​ in residence program with a completed assessment or a course approved by the board and taken​ for academic credit at an accredited postsecondary institution. It must provide practical learning​ experiences to complement the student's academic training and work or volunteer experience in​ long-term services and supports, general health care, and management. Except as provided in subpart​ 1a, the practicum must include, but need not be limited to, the following:​ A. a rotation through the departments of the nursing facility to provide the student exposure​ to and knowledge of all functions of the nursing facility. Whenever possible, the student shall be​ assigned to perform tasks not requiring special skill or licensure within each department. The time​ to be spent in each department for a student with prior experience shall vary in relation to the prior​ experience of the student. The time to be spent by a student without prior experience in management,​ health care, or long-term services and supports must be divided approximately equally between​ administrative and resident care departments. The rotation experience of every student must include​ time at the facility during all work shifts;​ B. participation in or review of the findings and results of regulatory inspections of the​ facility;​ C. observation of the integrative and administrative role of the administrator through​ attendance with the administrator at meetings with staff, governing bodies, community groups,​ resident councils, and other groups;​ D. observation of the relationships between the facility and community and other health​ care providers and organizations operating in the continuum of health care;​ E. participation in an in-service education session;​ F. completion of a major project, study, or research effort designed to improve operations​ at the facility or provide information upon which a major decision facing the facility and its​ management can be made; and​

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G. after assessment, the completion of a QAPI or RCA on identified areas of need.​ Subp. 1a. Exception to requirements and content. Subpart 1, items B and E, need not be​ included in the practicum of a student taking a practicum of 200 hours or less if the student has​ participated in the specified activities during prior health care work experience.​ Subp. 2. Facility requirements. The practicum course must be conducted within a nursing​ facility and require the student's attention to practicum activities at the facility for at least 20 hours​ per week. Upon mutual agreement of the academic institution and nursing facility preceptor, a​ licensed nursing facility may serve as the practicum site for a student who is employed by the​ nursing facility, provided that the student is relieved of all previous duties during the time of the​ practicum experience.​ Subp. 3. Preceptor requirements. The practicum must be supervised by a preceptor who is​ a currently licensed nursing home administrator or health services executive who has been licensed​ and practicing as a nursing home administrator or health services executive for at least two years.​ A preceptor may not supervise a student who is a related individual or who resides in the immediate​ household of the preceptor.​ Subp. 4. Faculty requirements. Each student practicum must be coordinated with a faculty​ advisor from an academic institution. The faculty advisor shall work cooperatively with the preceptor​ to review results of student practicum experiences in the preceptor's facility. The faculty advisor​ shall consult periodically with each student enrolled in the practicum to review the student's​ experience and assist the student in relating the facility practicum experience to the other required​ academic courses.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 45 SR 753; 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.6650 [Repealed, 45 SR 753]​ Published Electronically: January 22, 2021​ 6400.6655 PRACTICUM DURATION.​ Subpart 1. Duration of individual student practicums. An applicant must complete a​ 1,000-hour practicum unless the applicant presents evidence to the board that the applicant has​ experience as described in subpart 2 for a reduction in the number of practicum hours. The board​ shall determine the minimum number of hours of practicum to be completed by an applicant by​ comparing the applicant's expertise to the requirements in subpart 2 and shall notify the applicant​ of the board's decision.​ Subp. 2. Waiver and minimum number of hours. An individual may qualify for a reduction​ in hours or waiver of the 1,000-hour practicum by providing evidence of the following documented​ health care experience and satisfying the board-approved assessment tool:​

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A. 750 hours for an individual with two or more years of managerial or administrative​ employment experience, including supervision of at least 25 employees and responsibility for an​ annual budget of at least $1,000,000;​ B. 750 hours for an individual who has two or more years of employment in a hospital or​ nursing facility in any professional capacity or in any direct patient care capacity;​ C. 500 hours for an individual who has served two or more years as a department manager​ with supervisory and budgetary responsibility or meets one or more of the following criteria:​ (1) the individual does not meet the requirements for assistant administrator under item​ D or the definition in part 6400.5100, but has otherwise held that title in a nursing facility or hospital​ and has performed under the title for two or more years;​ (2) the individual has served, for two or more years, as director of nurses in a hospital​ or registered housing with services establishment that has an arranged comprehensive home care​ license; or​ (3) the individual has served as a housing manager in an assisted living facility or​ registered housing with services establishment that has an arranged comprehensive home care​ license;​ D. 200 hours for an individual who has served one or more years as a full-time hospital​ administrator or hospital assistant administrator with responsibility for both resident care and​ administrative functions, or who has served two or more years as a full-time director of nurses in​ a nursing facility; or​ E. the documented experience requirement is waived for an individual who has one year​ of continuous full-time employment as the assistant administrator, chief executive officer, senior​ leadership person with a nursing home administrator or health services executive reporting directly​ to them, or an equivalent role with responsibility for both resident care and administrative functions.​ Time working as an acting administrator under an acting license or permit in the same nursing​ facility where the individual also served as the assistant administrator, chief executive officer, or​ equivalent role meets this requirement if the individual's employment under both titles combined​ was one continuous year.​ Subp. 3. Method of measuring experience. The amount of experience required to qualify for​ a practicum reduction under subpart 2, items C, D, and E, shall be measured in full-time equivalency​ at the rate of 35 hours per week.​ Subp. 4. Effective date. An applicant who applies on or after September 1, 2017, must follow​ the requirements in this part.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 41 SR 599; 45 SR 753​ Published Electronically: January 22, 2021​

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6400.6660 ACADEMIC PROGRAM REVIEW.​ Subpart 1. Program review and approval. Upon request of an academic institution, the board​ shall review courses offered by the institution, and upon finding conformity between the proposed​ program and the requirements of this chapter, shall approve the institution as offering courses which​ meet all or some portion of the course requirements for licensure. If the institution offers courses​ which are approved by the board to meet all course requirements of part 6400.6550, the board shall​ designate the institution as an approved academic program. If the institution offers courses approved​ by the board to meet five or more of the courses required in part 6400.6550, the board shall designate​ the institution as an approved course provider.​ Subp. 2. Requesting course review. In submitting a program of study offered by an academic​ institution to meet all or some of the course requirements, the institution shall provide the following​ information in an application package for review by the board:​ A. indication of whether the institution is requesting designation as an approved program​ or as an approved course provider;​ B. evidence of the institution's current accreditation by a regional accrediting organization​ for higher education;​ C. designation of a faculty member to serve as program director to coordinate the institution's​ program or course offerings with the board. The program director shall have authority to accept​ courses of equivalent content to those accepted by the board to fulfill academic course requirements​ specified in part 6400.6550 from students transferring to the institution and the program and from​ students enrolled in the program who cannot arrange class schedules to permit timely completion​ of the board-approved courses. The program director must report approval of courses so substituted​ to the board for each affected student who makes application for licensure to the board;​ D. evidence of the establishment and use of an advisory group of administrators and others​ in the long-term services and supports industry, including names and experience of group members​ and frequency of meetings, to review course requirements and practicum activities in order to​ provide guidance to keep courses current and make student experiences reality based and practical;​ E. a description of the course of study offered or recommended by the institution for those​ interested in licensure as a nursing home administrator in Minnesota. Nothing in this chapter restricts​ institutions from designing or implementing curricula, or establishing requirements for courses,​ majors, or other designations offered by the institution, more comprehensive than required under​ this chapter for licensure;​ F. a topic-by-topic review of all course requirements outlined in part 6400.6550 showing​ where and how within the institution's course offerings the outlined topics are covered;​ G. an outline of each course offered by the institution to fulfill one or more of the licensure​ course requirements listing texts and materials used in the course; and​ H. identification of one or more qualified faculty members to:​

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(1) coordinate practicum experiences for students;​ (2) ensure that all practicums are conducted according to the requirements of part​ 6400.6600;​ (3) provide instruction, or evidence of the use of the NAB preceptor training materials​ and self-assessment, to any administrator becoming a preceptor for the first time after September​ 1, 1997, regarding objectives for the practicum and procedures to follow to structure and supervise​ a successful practicum experience for a student; and​ (4) ensure that each practicum is initiated with a signed learning agreement between​ the student, faculty advisor, and preceptor outlining the roles and responsibilities of all three parties,​ the time to be spent by the student in each facility department in relation to the student's prior​ experience, and the learning outcomes expected for the student.​ Subp. 3. Review and approval process. Upon receipt of an application package for approval​ of an academic institution program to meet board course requirements, the board shall acknowledge​ receipt of the request and identify any missing requirements to the program director. Upon receipt​ of all required information, the board shall review all materials presented and may conduct an​ on-site visit or request an appearance by one or more representatives of the institution at a meeting​ to review all material for conformance to requirements. Board members shall base their decision​ to approve or reject an academic institution program on whether or not the application materials​ presented provide assurance that students completing the program at the institution will cover the​ course topics outlined in part 6400.6550 with sufficient depth to enable the board to infer student​ attainment of the knowledge, skills, and abilities to begin work as a nursing home administrator.​ If the application package and discussion with program officials fail to show compliance with the​ rules or to provide sufficient evidence to satisfy the board members that they can infer beginning​ level competency among students completing the proposed course offerings, the board shall notify​ the program director in writing of the deficiencies the institution must remedy. Once all deficiencies​ are satisfactorily remedied, the board shall grant approval to the program or courses in writing and​ include reference to the institution's offerings in its correspondence with students interested in​ learning where courses approved by the board to meet licensure requirements are available. If the​ deficiencies are not corrected, the board shall deny approval for the program by written notice to​ the program director.​ Subp. 4. Annual update. Annually on or before September 1, the program director of an​ institution with an approved program or courses shall file with the board on forms prescribed by​ the board for that purpose a report indicating the following:​ A. number of students with known intent to pursue licensure as nursing home administrators​ in Minnesota enrolled during the past academic year in courses meeting board requirements;​ B. any changes in any of the information presented to satisfy the requirements outlined in​ this part and part 6400.6550 since the initial application or since the update report of the preceding​ year; and​

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C. to the extent available, a schedule of when throughout the academic year the approved​ courses will be offered by the institution.​ Subp. 5. Five-year program review.​ A. Every fifth year following the board's initial approval of an academic institution's program​ or courses, the program director shall provide a complete review of the institution's program by​ submitting to the board by September 1 of the fifth year, a review application package in the same​ format and incorporating the same information as required in subpart 2 for a new program approval​ application. Where no change has occurred since the initial application, the program director may​ submit a copy of the initially submitted information with an updated date and attestation that the​ information is current.​ B. The board shall review the five-year program review package submitted by the institution​ and approve or deny continued board approval for the program as provided in subpart 3. Where​ the board finds it necessary to deny continued approval to a program or to specific courses, the​ board shall provide information to the program director about ways in which students currently​ enrolled in the program may obtain supplementary or alternative courses to complete the requirements​ for licensure in view of the revocation of approval for courses offered by the institution. The program​ director shall provide the information to all students enrolled in the previously approved program​ or courses and shall work with the students to provide a smooth transition to alternative institutions​ offering approved courses.​ C. In addition to the five-year program review, if the board receives information that the​ success rates fall below the national average for candidates from the program who, during any​ January 1 through December 31 period, wrote for the first time the national examination for nursing​ home administrators developed by NAB, the board must take one of the actions described in subitems​ (1) to (3).​ (1) If success rates are below the national average for one period, the board shall require​ the director to identify factors that are potentially affecting the low success rate on the licensure​ examination. The director shall submit a plan of corrective action by a specified date. The plan of​ action must be on a board-supplied form and include the signature of the director and another​ institutional administrative academic representative. If the following year the success rate is above​ the national average, no action by the board is required.​ (2) If success rates are below the national average for any two consecutive periods, the​ board shall notify the director of a survey to identify additional factors affecting the low success​ rate and review progress on the plan for corrective action submitted the previous year. The survey​ must include the director, faculty, students, and an institutional administrative academic​ representative. The director shall submit a revised plan of corrective action by a specified date. The​ plan of corrective action must be on a board-supplied form and include the signature of the director​ and another institutional administrative academic representative. If the following year the success​ rate is above the national average, no action is required by the board.​ (3) If success rates are below the national average for any three consecutive periods,​ the board shall require the director and another institutional administrative academic representative​

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to meet with a committee of board members and board staff for a survey for compliance with all​ applicable rules and for the implementation of the plan for corrective action submitted the previous​ year. Upon completion of the survey, the board shall take action in compliance with subpart 3.​ Subp. 6. [Repealed, 41 SR 599]​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 41 SR 599; 45 SR 753; 45 SR 1073​ Published Electronically: June 4, 2021​ LICENSES AND PERMITS​ 6400.6700 ENDORSEMENT.​ Subpart 1. License; nursing home administrator. The board shall issue a license to a nursing​ home administrator who has been issued and currently holds a license as a nursing home​ administrator in another jurisdiction provided that:​ A. the other jurisdiction maintains requirements for nursing home administrator licensure​ which are substantially equivalent to those required under part 6400.6000 or the applicant is currently​ certified as a nursing home administrator and provides the board evidence of having successfully​ completed a professional certification program in nursing facility administration endorsed by NAB;​ B. the applicant has passed the Minnesota state examination within the immediate past two​ years;​ C. the applicant is in good standing as a nursing home administrator in each jurisdiction​ from which the applicant has ever received a nursing home administrator license; and​ D. the applicant has applied for licensure and paid the applicable fees.​ Subp. 2. License; health services executive. The board shall issue a license to a health services​ executive who has been issued and currently holds a license as a health services executive in another​ jurisdiction provided that the applicant:​ A. meets the requirements in Minnesota Statutes, section 144A.26, subdivision 2;​ B. is in good standing as a health services executive in each jurisdiction from which the​ applicant has ever received a health services executive license;​ C. has passed the state examination given by the board to test knowledge of Minnesota​ laws governing nursing home facilities in Minnesota;​ D. has passed the state examination given by the board to test knowledge of Minnesota​ laws governing assisted living facilities in Minnesota; and​ E. has applied for licensure and paid the applicable fees.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​

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History: 21 SR 1564; 24 SR 1780; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6710 LICENSEE RESPONSIBILITIES.​ Each licensee shall:​ A. comply with the laws of Minnesota and the rules of the board and other Minnesota state​ agencies regarding licensure as a nursing home administrator or health services executive and​ operation of a nursing facility in Minnesota;​ B. provide notice to the board within five working days of any change in mailing address​ or telephone number pursuant to Minnesota Statutes, section 13.41, subdivision 2, paragraph (b);​ C. provide notice to the board within five working days of any change in employment as​ a nursing home administrator or health services executive for a nursing facility;​ D. provide notice to the board within five working days of the occurrence of any reprimand,​ restriction, limitation, condition, revocation, suspension, surrender, or other disciplinary action or​ the bringing of charges against any license the licensee holds as a nursing home administrator,​ health services executive, or other health care professional in Minnesota or any other jurisdiction;​ and​ E. cooperate with the board by providing data, reports, or information requested by the​ board and complying with requests to attend conferences, meetings, or hearings scheduled by the​ board concerning license renewal or complaint investigation and discipline.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 24 SR 1780; 41 SR 599; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6720 DISPLAYING LICENSES.​ A licensee actively practicing shall display the board-issued license, not a photocopy, in a​ conspicuous place in the facility which the licensee administers, visible to residents and visitors.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 41 SR 599; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6730 DUPLICATE LICENSES.​ Upon receipt of a notarized statement from a licensee that the licensee's license has been lost,​ mutilated, or destroyed, or that the licensee has had a name change, the board shall issue a duplicate​ license. Licensees obtaining duplicate licenses are subject to the applicable fee under part 6400.6970.​ Statutory Authority: MS s 16A.1285; 144A.21; 144A.24; 214.06​

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History: 21 SR 1564​ Published Electronically: June 11, 2008​ 6400.6740 RENEWING LICENSES.​ Subpart 1. Forms, time for renewal. Every individual who holds a valid license issued by​ the board shall annually apply to the board on or before June 1 for renewal of the individual's license​ and shall report any information pertinent to continued licensure requested by the board on forms​ provided for that purpose. The applicant shall submit evidence satisfactory to the board and subject​ to audit under part 6400.6800, subpart 3, that during the annual period immediately preceding the​ renewal application the licensee has complied with the rules of the board and completed continuing​ education requirements for license renewal.​ Subp. 2. Fees. Upon making an application for license renewal, the licensee shall pay the​ annual fee. If submitting CE credits which include clock hours for workshops, seminars, institutes,​ or home study courses which have not been preapproved by the board, the licensee shall also pay​ a fee for review of clock hours based upon the total number of nonpreapproved clock hours being​ submitted for CE credit to meet renewal requirements. If the application for renewal has not been​ received by June 30 of each year, the license shall lapse and the holder of a lapsed license shall be​ subject to the reinstatement procedure and late renewal fees.​ Subp. 3. Exemption from renewal. Pursuant to Minnesota Statutes, section 326.56, a licensee​ who is in active military service, as defined in Minnesota Statutes, section 190.05, for the armed​ forces of the United States or is employed outside the United States in employment that is essential​ to the prosecution of any war or the national defense, as defined in Minnesota Statutes, section​ 326.56, and whose license was in effect at the time of entry into the armed forces or engagement​ in employment outside the United States, is not obligated to renew licensure. The board must be​ notified in writing by the licensee regarding the qualifications for this exemption. The exemption​ ceases six months after discharge from active service or termination of the aforementioned​ employment. A license renewal notice shall be sent to the licensee at the time that a license renewal​ notice would normally be sent to the licensee. The licensee may be requested to reconfirm exempt​ status. If the licensee no longer qualifies for the exemption, the requirements for license renewal​ must be met.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 41 SR 599; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6750 LICENSE REINSTATEMENT.​ A nursing home administrator or health services executive previously licensed in this state​ whose license has lapsed may apply under items A to C for reinstatement of a license within five​ years of the date the individual was last licensed. If an individual's license has been revoked or if​ the individual has not been licensed for five years or more, the license cannot be reinstated but the​ former licensee may apply for relicensure under the requirements in part 6400.6000.​

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A. If a license has been lapsed in Minnesota for less than two years prior to the date of the​ application for reinstatement, the board must reinstate the license if the former licensee has not had​ disciplinary action against a license in Minnesota or another jurisdiction during the time the​ Minnesota license was lapsed and the former licensee:​ (1) files with the board a completed application for reinstatement;​ (2) provides evidence of having completed the continuing education requirements under​ part 6400.6800, subpart 2, for each of the years the license has lapsed; and​ (3) pays the license renewal and late fees in part 6400.6970 for each of the years the​ license has lapsed.​ B. If a license has been lapsed in Minnesota for more than two years but less than five years​ prior to the date of the application for reinstatement and the former licensee has been continuously​ licensed as a nursing home administrator or health services executive in one or more other​ jurisdictions since the date the license lapsed in Minnesota, the board must reinstate the license if​ the former licensee has not had disciplinary action against a license in Minnesota or another​ jurisdiction during the time the Minnesota license was lapsed and the former licensee:​ (1) files with the board a completed application for reinstatement;​ (2) provides evidence of having completed the continuing education requirements under​ part 6400.6800, subpart 2, for each of the years the license has lapsed;​ (3) pays the license renewal and late fees specified in part 6400.6970 for each of the​ years the license has lapsed; and​ (4) successfully completes the state examination.​ C. If a license has been lapsed in Minnesota for more than two years but less than five years​ prior to the date of the application for reinstatement and the former licensee has not been continuously​ licensed in one or more jurisdictions since the date the license lapsed in Minnesota, the board must​ reinstate the license if the former licensee has not had disciplinary action against a license in​ Minnesota or another jurisdiction during the time the Minnesota license was lapsed and the former​ licensee:​ (1) files with the board a completed application for reinstatement;​ (2) provides evidence of having completed the continuing education requirements under​ part 6400.6800, subpart 2, for each of the years the license has lapsed;​ (3) pays the license renewal and late fees specified in part 6400.6970 for each of the​ years the license has lapsed;​ (4) successfully completes the state examination; and​ (5) successfully completes the NAB examination.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​

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History: 21 SR 1564; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6760 VERIFICATION OF MINNESOTA LICENSE.​ Upon request and payment of a fee under part 6400.6970 by the licensee, the board shall issue​ a certified statement of the licensee's licensure status and examination scores to another jurisdiction.​ Statutory Authority: MS s 16A.1285; 144A.21; 144A.24; 214.06​ History: 21 SR 1564​ Published Electronically: June 11, 2008​ 6400.6770 ACTING ADMINISTRATOR PERMITS.​ Subpart 1. Board to issue permits. When the controlling persons of a nursing home designate​ an acting nursing home administrator under Minnesota Statutes, section 144A.27, the designee​ must secure an acting administrator's permit within 30 days of the termination of the previous​ licensed administrator. The board shall issue a permit to serve a facility as an acting administrator​ for up to six months from the termination of the facility's previous licensed administrator to an​ individual who meets the qualifications specified in subpart 2. A permit to serve a facility as an​ acting administrator is valid only for the holder's work with that facility and shall not be transferable​ to another facility. A permit to serve as acting administrator is not renewable beyond the six months​ for which it was issued. The board may issue a second permit to serve a facility as an acting​ administrator for up to six months from the expiration of the original acting administrator permit​ when the board finds the second permit to be in the best interests of the public. In no event shall​ the board issue successive permits for a total duration of longer than one year.​ Subp. 2. Qualifications. An applicant for a permit to serve a facility as an acting nursing home​ administrator must furnish satisfactory evidence that the applicant:​ A. has graduated from high school or holds a commissioner of education-selected high​ school equivalency certification or has completed an associate or higher degree from an accredited​ postsecondary institution;​ B. is at least 21 years of age;​ C. has experience in the management of a nursing home or related facility or program or​ has completed a majority of the courses required for licensure under part 6400.6550;​ D. has passed within the last two years the state examination under parts 6400.6000, item​ E, and 6400.6100, subpart 4; and​ E. is in good standing in each jurisdiction from which the applicant has ever received a​ nursing facility administrator license.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​

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History: 21 SR 1564; 24 SR 1780; 41 SR 599; 45 SR 753; L 2017 1Sp5 art 10 s 7​ Published Electronically: January 22, 2021​ CONTINUING EDUCATION​ 6400.6800 CONTINUING EDUCATION REQUIREMENTS.​ Subpart 1. Renewal requirements. At the time of license renewal, each licensee shall provide​ evidence satisfactory to the board that the licensee has completed in the preceding year 20 CE​ credits of acceptable continuing education activities as specified in this part and part 6400.6850.​ Licensees in their first year of licensure shall have the number of CE credits required for license​ renewal prorated for the number of months they were licensed during the preceding year. For​ purposes of obtaining and presenting CE credits, a year shall run from May 1 to April 30.​ Subp. 2. Evidence of CE requirement completion. Licensees must maintain proof as described​ in part 6400.6850 of having completed the number of CE credits claimed at the time of renewal​ and shall, upon request of the board, make that proof available for audit to verify completion of the​ number and validity of credits claimed. Documentation to prove completion of CE credits must be​ maintained by each licensee for four years from the last day of the licensure year in which the​ credits were earned.​ Subp. 3. Audit. The board shall annually select on a random basis at least five percent of the​ licensees applying for renewal to have their claims of CE credits audited for compliance with board​ requirements. Nothing in this subpart shall prevent the board from requiring any individual licensee​ to provide evidence satisfactory to the board of having completed the CE credits required for license​ renewal.​ Subp. 4. Acceptable content for CE activities. Unless otherwise specified in part 6400.6850,​ the content of continuing education activities must relate to one or more of the following:​ A. administration of services for persons needing long-term services and supports;​ B. current issues and trends in long-term services and supports;​ C. the relationship of long-term services and supports to other aspects of the health care​ continuum; and​ D. responsibilities, tasks, knowledges, skills, and abilities required to perform nursing home​ administrator or health services executive functions as outlined in the NAB domains of practice.​ Subp. 5. Unacceptable content for CE activities. Subjects for continuing education which​ will not be accepted to meet license renewal requirements include, but are not limited to, general​ personal development including stress management, facility or company orientation, facility or​ company policies or procedural issues, organizational functions such as business meetings and​ election of officers, and medical treatment at a clinical level beyond that required for licensure as​ a nursing home administrator or health services executive.​

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Subp. 6. Requirements; subject areas. When compelled by an advancement in scope of​ practice or emerging long-term services and supports issues, the board shall require all licensees​ to attend continuing education programs in specified subject areas after giving public written notice​ to each licensee on or before May 1.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 45 SR 753; 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.6850 NUMBER OF CE CREDITS FOR ACTIVITIES.​ Acceptable activities to meet continuing education requirements for license renewal and the​ number of CE credits that licensees may obtain for each are described in items A to K.​ A. A licensee who attends board-approved seminars, webinars, institutes, or workshops​ shall receive CE credit on a clock-hour basis for the actual amount of time spent in the seminar​ rounded to the nearest lower one-quarter hour. To verify clock hours of attendance at seminars,​ institutes, or workshops, a licensee must maintain an attendance certificate provided by the​ sponsoring organization.​ B. A licensee who completes board-approved home study courses, including correspondence​ work, televised courses, and audio or video tapes, shall receive CE credit for the number of clock​ hours reasonably required to complete the home study course as determined by the board. To verify​ completion of the course, the licensee must maintain a certificate of course completion from the​ sponsor which must include evidence of successful completion of a test corrected by the sponsor​ to ascertain attainment of the knowledge conveyed in the course.​ C. A licensee who attends seminars, webinars, institutes, or workshops, or completes home​ study courses approved by the NAB/National Continuing Education Review Service (NCERS),​ shall receive CE credit on the basis of clock hours assigned by NAB/NCERS. To verify clock hours​ of attendance at NAB approved seminars, institutes, or workshops, or completion of NAB approved​ home study courses, the licensee must maintain a certificate provided by the NAB approved sponsor.​ D. A licensee who attends, in another state, seminars, webinars, institutes, or workshops​ approved by the nursing home administrator or health services executive licensing authority of the​ other state shall receive CE credit on the basis of the number of clock hours attended. To verify​ clock hours of attendance at seminars, institutes, or workshops approved by another state licensing​ authority, the licensee must maintain a certificate of attendance from the sponsor including​ verification of the approval from the state licensing authority.​ E. A licensee who completes academic courses applicable to the domains of practice taken​ at an accredited postsecondary institution shall receive nine CE credits per quarter credit and 12​ CE credits per semester credit. To verify completion of academic courses the licensee must maintain​ a copy of an academic transcript showing the course grade and date it was awarded.​ F. A licensee who writes an article on a topic related to long-term services and supports​ that is published in a national periodical shall receive two CE credits for an article of 500 to 1,000​

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words and one additional CE credit for each additional 500 words to a maximum of ten credits per​ year. To verify publication the licensee must maintain a copy of the periodical containing the​ published article.​ G. A licensee who presents a paper or lecture on a topic related to long-term services and​ supports of at least one hour at a national or statewide meeting shall receive two CE credits per one​ hour of initially presented lectures and one CE credit per hour of lectures repeating previously​ presented material to a maximum of ten CE credits per year. To verify the presentation, the licensee​ must maintain a copy of the text of the information delivered and a copy of the program for the​ conference or workshop at which the paper or lecture was delivered.​ H. A licensee who delivers a lecture on a topic related to long-term services and supports​ of at least one hour at an academic institution or through a course provider shall receive two CE​ credits per one hour of initially presented lectures and one CE credit per hour of lectures repeating​ previously developed material to a maximum of ten CE credits per year. To verify lecture delivery,​ the licensee shall maintain corroboration from the participating academic institution.​ I. A licensee who serves as a member of a board, committee, council, or work group which​ includes members from several nursing facilities or organizations and deals primarily with issues​ in nursing facility operation or long-term services and supports shall receive CE credit per​ membership position held provided the group meets at least quarterly or for at least four hours of​ work in a year to a maximum of six CE credits per year for all membership positions combined.​ Where the licensee verifies that the licensee's participation on a single board, committee, council,​ or work group exceeded the minimum specified for a single CE credit by double the amount of​ hours of attendance, the licensee shall receive two CE credits per membership position to a maximum​ of six CE credits per year for all membership positions combined. To verify board, committee,​ council, or work group participation the licensee must maintain written verification of membership​ and attendance from an officer of the group and must provide the learning objectives of the meeting.​ J. A licensee who serves as a preceptor for a student's nursing facility administration​ practicum shall receive two CE credits per month spent serving as a preceptor to a maximum of 16​ CE credits per year. To verify preceptor service the licensee must maintain corroboration of service​ from the participating academic institution. A licensee who attends training sessions to prepare​ administrators to be preceptors shall receive CE credit on the same clock-hour basis as for seminars,​ institutes, and workshops under item A.​ K. Other continuing education activities not specified in items A to J may be approved for​ up to ten CE credits per year on an individual basis upon submission of information to the board​ concerning the activity in which the licensee has engaged, the results of the learning, the number​ of hours involved, the number of CE credits requested, and some means of verifying completion​ of the activity. The board shall consider the information submitted and determine whether to approve​ the activity and, if so, what number of CE credits to award for the activity and shall notify the​ requesting licensee of the board's determination. In making its determination, the board shall consider​ whether the activity contributed to the advancement and extension of professional skill and​ knowledge of the licensee in matters related to the practice of nursing facility administration.​

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Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 41 SR 599; 45 SR 753; 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.6870 SPONSORING CONTINUING EDUCATION.​ Subpart 1. Applying for program approval. Individuals, groups, or organizations wishing​ to sponsor educational seminars, institutes, workshops, or home study programs shall submit the​ following, in writing, to the board to obtain review and approval for clock hours of CE credit for​ licensees to use in meeting continuing education requirements for license renewal:​ A. date, time, and location of presentation;​ B. presentation content, showing specific time periods, topic titles, and speakers including​ their professional qualifications;​ C. number of clock hours requested to be approved;​ D. a statement indicating the sponsor's willingness to maintain a means of verifying​ attendance and provide each attendee a certificate of attendance or other appropriate means of​ attesting to the number of clock hours actually attended by each attendee;​ E. for home study programs, evidence of a testing process to measure the participant's​ attainment of knowledge and information provided in study materials; and​ F. a fee under part 6400.6970 based on the number of clock hours requested to be reviewed​ and approved.​ Subp. 2. Licensee sponsored programs and courses. A licensee who attends a seminar,​ institute, or workshop, or participates in a home study course which has not been reviewed and​ approved by the board for a sponsor, may serve as the sponsor of a program and obtain review of​ the program and assignment of clock hours by submitting to the board office:​ A. a copy of the seminar program or other document identifying the program content and​ other information required of program sponsors under subpart 1, items A to C; and​ B. a fee in the same amount as would be charged to a sponsor under part 6400.6970, based​ on the total number of clock hours requested to be reviewed and approved.​ Subp. 3. Review of sponsor requests. The board shall review sponsor requests and approve​ CE credit clock hours for programs with acceptable content, qualified presenters, and acceptable​ means of verifying attendance or measuring knowledge attainment under subpart 1 and part​ 6400.6800, subpart 4, and notify the requesting sponsor of the decision.​ Subp. 4. Designation of registered continuing education sponsors. An organization which​ annually sponsors many educational seminars, institutes, workshops, or home study courses, may​ request designation by the board as a registered continuing education sponsor on an annual basis​ beginning May 1 and ending April 30. Registered continuing education sponsors may assign CE​ credit clock hours to their own program offerings applying the provisions of this chapter. The board​

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shall review and approve requests for designation and authority as a registered continuing education​ sponsor provided the requesting agency meets the following requirements:​ A. the sponsor is a regionally accredited university or college or division thereof or a state​ or national membership organization in the field of health care;​ B. the sponsor has been a proven sponsor of continuing education programs acceptable to​ the board under subpart 3, for the two years preceding the request to be named a registered sponsor;​ C. the sponsor has complied fully with the board's criteria for sponsors of continuing​ education programming;​ D. the sponsor has made application on forms prescribed by the board and paid a​ nonrefundable filing fee of ten percent of the registered continuing education sponsor fee as specified​ in part 6400.6970;​ E. the sponsor has signed an agreement to comply with the rules of the board in assigning​ clock hours to continuing education programs, providing certificates of attendance to participants,​ and providing the board with pertinent information concerning sponsored programs; and​ F. the sponsor has paid the balance of the registered sponsor fee specified in part 6400.6970​ within 30 days of notification by the board of approval of the organization as a registered continuing​ education sponsor.​ Subp. 5. Performance review of registered sponsors. The board shall review performance​ of registered sponsors annually upon the sponsor's request to renew the one-year sponsor agreement​ with the board or more frequently if determined necessary in the judgment of the board and may​ remove registered sponsor status from an organization upon 30 days' notice if the sponsor has been​ found to violate the terms of the agreement with the board.​ Subp. 6. Course program provider waiver. A course program provider approved by the​ board is exempt from the annual fee by validating attendance and recording and merging the verified​ attendance records with the board's online continuing education attendance system.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 45 SR 753​ Published Electronically: January 22, 2021​ DISCIPLINE​ 6400.6900 GROUNDS FOR DISCIPLINE.​ Subpart 1. Criteria. The board may impose disciplinary action as described in subpart 2 against​ an applicant, the holder of a permit to serve as an acting administrator, or a licensee, when the board​ determines, by a preponderance of the evidence and after due notice and an opportunity to be heard​ at a contested case hearing, that the applicant, permit holder, or licensee:​

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A. has been convicted of a felony or gross misdemeanor, including a finding or verdict of​ guilt, whether or not the adjudication of guilt has been withheld or not entered, an admission of​ guilt, or a no contest plea, when the felony or gross misdemeanor is reasonably related to the practice​ of nursing home administration, as evidenced by a certified copy of the conviction;​ B. has been convicted of a crime against a minor, including a finding or verdict of guilt,​ whether or not adjudication of guilt has been withheld or not entered, an admission of guilt, or a​ no contest plea;​ C. is not eligible to be employed as a nursing home administrator or health services executive​ under Minnesota Statutes, section 144A.04, subdivision 6;​ D. has failed to comply with Minnesota Statutes, section 626.557, the Vulnerable Adult​ Act;​ E. has violated a statute, rule, or order that the board issued or is empowered to enforce or​ that pertains to administration of a nursing facility or to the responsibilities of a nursing home​ administrator or health services executive;​ F. has discriminated against any resident or employee, based on age, race, sex, religion,​ color, creed, national origin, marital status, status with regard to public assistance, sexual orientation,​ or disability;​ G. has committed acts of misconduct substantially related to the qualifications, function,​ or duties of a nursing home administrator or health services executive and evidenced unfitness to​ perform as a nursing home administrator or health services executive in a manner consistent with​ protecting resident health, safety, and welfare;​ H. has engaged in fraudulent, deceptive, or dishonest conduct, whether or not the conduct​ relates to the practice of nursing home administration, that adversely affects the individual's ability​ or fitness to practice as a nursing home administrator or health services executive;​ I. has engaged in unprofessional conduct or any other conduct with potential for causing​ harm to the public or facility residents including any departure from or failure to conform to the​ minimum standards of acceptable and prevailing practice, as specified in state and federal statutes​ and rules concerning administration of nursing home facilities, without actual injury having to be​ established;​ J. has failed to exercise true regard for the safety, health, or life of a resident;​ K. has willfully permitted the unauthorized or illegal disclosure of information relating to​ a resident;​ L. has engaged in sexual harassment, made sexual advances toward, or engaged in sexual​ contact with any resident, student, or trainee under the licensee's supervision, or engaged in sexual​ harassment of an employee, consultant, or visitor to the facility in which the licensee practices;​ M. has practiced fraud, deceit, cheating, or misrepresentation, or provided misleading​ omission or material misstatement of fact, in securing, procuring, renewing, or maintaining a license;​

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N. has used the licensee's professional status, title, position, or relationship as a licensee to​ coerce, improperly influence, or obtain money, property, or services from a resident, resident's​ family member or visitor, employee, or any person served by or doing business with the nursing​ facility that the licensee administers or is employed by;​ O. has paid, given, has caused to be paid or given, or offered to pay or give to any person,​ a commission or other consideration for solicitation or procurement either directly or indirectly for​ nursing home patronage. Nothing in this item shall be construed to limit or restrict commercial​ advertisement;​ P. has knowingly aided, advised, or allowed an unlicensed person to engage in the unlicensed​ practice of nursing home administration;​ Q. has practiced fraudulent, misleading, or deceptive advertising with respect to the facility​ of which the licensee is administrator or health services executive;​ R. has wrongfully transmitted or surrendered possession of the licensee's license to any​ other person, either temporarily or permanently;​ S. has falsely impersonated another licensee;​ T. has practiced without current licensure;​ U. has made a false statement or knowingly provided false or misleading information to​ the board, failed to submit reports as required by the board, failed to cooperate with an investigation​ of the board, the Office of the Attorney General, or the Minnesota Department of Health, or violated​ an order of the board;​ V. has been the subject of a reprimand, restriction, limitation, condition, revocation,​ suspension, surrender, or other disciplinary action against the person's nursing home administrator​ or health services executive license in another jurisdiction;​ W. has failed to report a reprimand, restriction, limitation, condition, revocation, suspension,​ surrender, or other disciplinary action against the person's license as a nursing home administrator​ or health services executive in another jurisdiction or failed to report the existence of a complaint​ or other charges against the person's nursing home administrator or health services executive license​ in this or another jurisdiction or has been refused a license as a nursing home administrator or health​ services executive by any other jurisdiction for reasons not related strictly to a difference in academic​ or experience requirements among jurisdictions;​ X. has abused or is dependent on alcohol, a legend drug as defined in Minnesota Statutes,​ chapter 151, a chemical as defined in Minnesota Statutes, chapter 151, or a controlled substance​ as defined in Minnesota Statutes, chapter 152, and this abuse or dependency has affected the​ performance of the licensee's duties; or​ Y. has failed to meet minimum standards of acceptable and prevailing practice when​ supervising an administrator in residence during the practicum.​

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Subp. 2. Actions. If grounds for disciplinary action exist under subpart 1, the board shall take​ one or more of the following actions:​ A. refuse to grant a permit;​ B. refuse to grant or renew a license;​ C. revoke a license or permit;​ D. suspend a license or permit;​ E. impose limitations or conditions on a license or permit;​ F. censure or reprimand the licensee or permit holder;​ G. refuse to permit an applicant to take the licensure examination or refuse to release an​ applicant's examination score; or​ H. any other action authorized by statute.​ Subp. 3. Considerations. In determining what action to take under subpart 2, the board shall​ consider:​ A. responsibility and response of the individual prior to, during, and after the occurrence;​ B. extenuating circumstances;​ C. repeat complaints against the individual; and​ D. severity of or potential harm to residents.​ Statutory Authority: MS s 16A.1285; 144A.20; 144A.21; 144A.23; 144A.24; 214.06​ History: 21 SR 1564; 45 SR 753​ Published Electronically: January 22, 2021​ 6400.6950 APPLICABILITY.​ Subpart 1. Assisted living directors. Parts 6400.7000 to 6400.7095 apply to assisted living​ directors.​ Subp. 2. Health services executives. Health services executives licensed under this chapter​ must meet the responsibilities in part 6400.7050 and are subject to the standards of practice in part​ 6400.7095.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.6970 [Repealed, L 2019 1Sp9 art 10 s 53]​ Published Electronically: October 30, 2019​

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6400.7005​

6400.7000 USE OF TITLE.​ Only an individual who is licensed as an assisted living director and who holds a valid license​ under this chapter for the current licensure period may use the title "Licensed Assisted Living​ Director" and the abbreviation "L.A.L.D." after the individual's name.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7005 LICENSURE REQUIREMENTS.​ Subpart 1. License; assisted living director. The board shall issue an individual a license to​ practice as an assisted living director in Minnesota upon determining that the individual:​ A. has filed a completed application for licensure under part 6400.7010 before or within​ six months of hire;​ B. meets the requirements specified in Minnesota Statutes, section 144A.20;​ C. has successfully completed a criminal background check under Minnesota Statutes,​ section 214.075;​ D. has not had an application rejected by the board under part 6400.7010;​ E. has paid the required fees;​ F. meets one of the following education and work experience requirements:​ (1) a high school diploma or equivalent plus two years of work experience in the​ continuum of long-term services and supports, including one year in a management or supervisory​ position;​ (2) an associate's degree plus one year of work experience in the continuum of long-term​ services and supports, including six months in a management or supervisory position; or​ (3) a bachelor's degree plus six months of work experience in a management or​ supervisory experience in the continuum of long-term services and supports;​ G. has read parts 6400.7000 to 6400.7095 and the Department of Health rules relating to​ the licensure of assisted living facilities; and​ H. meets one of the following subitems for education, experience, and training:​ (1) has successfully:​ (a) completed a core course of study covering the topics listed in part 6400.7015;​ (b) completed a Minnesota-based course of study covering the topics listed in part​ 6400.7020;​

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(c) completed a director in residence field experience according to part 6400.7030;​ (d) passed the NAB core knowledge and line of service examinations for assisted​ living directors to test knowledge of subjects pertinent to the domains of practice of assisted living​ as identified in the NAB job analysis for assisted living directors; and​ (e) passed the state examination approved by the board to test the knowledge of​ Minnesota laws governing assisted living facility operations in Minnesota;​ (2) meets all requirements under part 6400.7045, subpart 1 or 2, for qualification by​ endorsement; or​ (3) applies for licensure by July 1, 2021, attests that the applicant has read the laws​ governing assisted living facilities, and:​ (a) has training that relates to the domains of practice for assisted living as identified​ in the NAB job analysis for assisted living directors and has a higher education degree in nursing,​ social services, or mental health, or another professional degree;​ (b) has at least three years of supervisory, management, or operational experience​ and higher education training related to the domains of practice for assisted living as identified in​ the NAB job analysis for assisted living directors;​ (c) has completed at least 1,000 hours of an executive-in-training program provided​ by an assisted living director licensed under this subitem on or before July 1, 2021; or​ (d) has managed a housing with services establishment operating under assisted​ living title protection for at least three years.​ Subp. 2. Continuing education requirements for select licensees. All individuals licensed​ under subpart 1, item H, subitem (3), must complete, within the first year of licensure, at least seven​ hours of continuing education in topics related to assisted living facilities.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7010 APPLYING FOR LICENSURE.​ Subpart 1. Application contents. An applicant for licensure must apply electronically through​ the board's online services. The application must include the following information:​ A. the applicant's name;​ B. the applicant's e-mail, home, and work addresses;​ C. the applicant's telephone numbers;​ D. the applicant's Social Security number;​

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E. the applicant's education and degree information;​ F. the applicant's employment and practice history;​ G. the applicant's health care professional licensure and disciplinary history in Minnesota​ and other jurisdictions;​ H. the applicant's evidence of successful completion of a criminal background check under​ Minnesota Statutes, section 214.075;​ I. the applicant's criminal convictions, if any; and​ J. use of alcohol or drugs or a mental, physical, or psychological condition, which may​ reflect on ability and fitness to practice.​ Subp. 2. Applicant responsibility. An applicant must provide the board with all information,​ documents, and fees necessary to meet licensure requirements.​ Subp. 3. Application expiration. Applications expire 18 months after the date that the​ application form is filed with the board. If the applicant does not fulfill all licensure requirements​ within the 18-month application period, the applicant must resubmit the application and another​ application fee to continue to seek licensure.​ Subp. 4. Examination attempts and score expiration. Examination scores expire two years​ after the date that the examination was taken if the applicant has not become fully licensed within​ that two years.​ Subp. 5. Grounds for denial. The board shall deny an application for licensure that does not​ meet the requirements of part 6400.7005 within the 18-month application period. The board shall​ deny an application for licensure where the applicant has committed acts in this or any other​ jurisdiction that would be grounds for discipline under part 6400.7095, subpart 1, taking into account​ the considerations in part 6400.7095, subpart 3.​ Subp. 6. Notice of denial. If the board denies an application for licensure, the board must​ provide written notice to the applicant of the denial, the reasons for the denial, and the right to a​ hearing under Minnesota Statutes, chapter 14, within 30 days of receiving notice of the denial.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ COURSE REQUIREMENTS​ 6400.7015 CORE COURSE REQUIREMENTS.​ Subpart 1. Basic requirements of course of study. An applicant must complete a course of​ study with a minimum of 80 hours in core subjects necessary to perform the duties of an assisted​ living director and including the requirements of this part.​

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Subp. 2. Customer care, services, and supports. An applicant must complete a course in​ customer care, services, and supports covering:​ A. quality systems, including customer satisfaction, problem identification, data collection,​ root cause analysis, and quality management programs;​ B. hospitality, including models for customer engagement and satisfaction;​ C. coordination and arrangement of services with physicians, hospice, home care, podiatrists,​ audiologists, and other health care and community service providers; and​ D. how to address complaints and resident and family councils.​ Subp. 3. Human resources. An applicant must complete a course in human resources covering:​ A. recruitment practices;​ B. screening practices;​ C. hiring principles;​ D. employee training;​ E. employee retention and satisfaction, including performance management;​ F. employment policies and procedures; and​ G. compliance requirements related to state and federal laws.​ Subp. 4. Finance. An applicant must complete a course in finance covering financial​ management, including invoicing and managing revenue cycle, operating and capital budgeting,​ budgeting and rate setting, accounting, quality and performance assessments related to financial​ and business operations, and Medicaid and other payment sources.​ Subp. 5. Environment. An applicant must complete a course in assisted living facilities​ environment covering:​ A. risk management, including risk identification and emergency plans for both shelter in​ place and evacuation;​ B. culinary services, including diets and meals, safety and sanitation;​ C. plant operations, including preventative maintenance, comfort and security issues,​ infection control, environmental design, assistive technology, and compliance with the Occupational​ Safety and Health Administration (OSHA) and the Americans with Disabilities Act;​ D. current regulatory requirements on the physical plant; and​ E. grounds and contracts management.​ Subp. 6. Management and leadership. An applicant must complete a course in management​ and leadership covering:​

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A. leadership styles and theories;​ B. confidentiality under state and federal law, including the Health Insurance Portability​ and Accountability Act (HIPAA);​ C. marketing, including community connections and legal marketing practices;​ D. management practices, including team building;​ E. culturally sensitive workplaces, services, and practices; and​ F. problem-solving and ethical decision-making.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7020 MINNESOTA COURSE REQUIREMENTS.​ An applicant must complete a course of study with a minimum of 40 hours in subjects necessary​ to perform the duties of an assisted living director in Minnesota, including:​ A. person-centered care practices;​ B. vulnerable adult protection under Minnesota Statutes, chapter 626, including all reporting​ requirements;​ C. Minnesota statutes or rules governing assisted living, including survey compliance and​ preparedness;​ D. landlord-tenant law, including fair housing and consumer transparency in collateral;​ E. role of the state ombudsman, including coordination and collaboration roles of​ governmental authorities, and resident rights;​ F. elder care rights, including voice of the family, learning objectives, and addressing​ complaints;​ G. practice acts for the Minnesota health-related licensing boards, as defined in Minnesota​ Statutes, section 214.01, subdivision 2;​ H. client and family relationships; and​ I. health and wellness topics, including diets, nutrition, and hydration; basic concepts in​ gerontology and geriatrics; common conditions and diagnoses in an assisted living setting; and​ medication management and preventing diversion.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​

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6400.7025 EVIDENCE OF COURSE COMPLETION.​ Subpart 1. Types of evidence. Evidence to verify satisfactory completion of requirements in​ part 6400.7005 must consist of documentation or attestation of the program director designated in​ part 6400.7040, subpart 2, showing completion of a course of study approved by the board or NAB​ including the domains of practice identified in NAB's job analysis for assisted living directors and​ the topics listed in parts 6400.7015 and 6400.7020. Attestations of course completion by the course​ provider must be submitted to the board.​ Subp. 2. Supplementing evidence older than seven years. Evidence presented under subpart​ 1 for completion of academic programs or academic courses taken more than seven years prior to​ the submission of information to the board must be supplemented by either:​ A. evidence that the applicant has been employed within the last seven years in a capacity​ that required using the knowledge gained in the core course requirements; or​ B. evidence that the applicant has completed continuing education within the past two years​ to renew and update knowledge gained in any academic course taken more than seven years prior​ to submission.​ Subp. 3. No additional fees required. No fees in excess of fees associated with the standard​ application process may be charged to applicants for review of continuing education courses​ submitted as evidence to meet course requirements.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7030 ASSISTED LIVING DIRECTOR IN RESIDENCE; FIELD EXPERIENCE.​ Subpart 1. Field experience requirements and content. An applicant for licensure as an​ assisted living director must complete a field experience. The field experience must provide practical​ learning experiences to complement the ALDIR's ongoing core training and work or volunteer​ experience in assisted living, long-term services and supports, general health care, and management.​ The field experience must follow the National Administrator in Training Program Manual ("program​ manual") or a similar training program preapproved by the board. The program manual is​ incorporated by reference. The program manual is available on the board's website and is subject​ to change every five years. The field experience must be conducted within an assisted living facility​ or facilities and require the ALDIR's residency to average 20 hours per week. Upon mutual agreement​ of the ALDIR and the director, an assisted living facility may serve as the field experience site for​ a student who is employed by the assisted living facility, provided that the ALDIR is relieved of​ all previous duties during the time of the field experience.​

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Subp. 2. Mentor.​ A. The field experience must be completed under the direction of a mentor. A mentor must​ be a licensed assisted living director or a licensed health services executive. A mentor must be​ licensed and practicing for at least two years or be licensed on or before July 1, 2021.​ B. A mentor must:​ (1) ensure that the ALDIR complies with the domains of practice and NAB administrator​ in training manual;​ (2) ensure that the ALDIR has experience with professional practice analysis; and​ (3) not supervise an ALDIR who is a related individual or who resides in the immediate​ household of the mentor.​ Subp. 3. Duration. Before beginning the field experience, the ALDIR must complete a​ self-assessment prescribed by the board that identifies topics where education, experience, and​ training are needed. The ALDIR must share the results of the self-assessment with the mentor and​ allow the mentor to provide input into the self-assessment. The mentor must determine the duration​ of the field experience, with 480 hours recommended but a minimum of 320 hours required and a​ maximum of 1,000 hours allowed, and the focus of the field experience based on the topics identified​ in the self-assessment.​ Subp. 4. Contents and topics for field experience. Regardless of the areas identified in the​ self-assessment, the field experience must include, but need not be limited to, the following:​ A. exposure to all areas of operations within the assisted living facility to provide the​ ALDIR with knowledge of all functions of the assisted living facility;​ B. review of the findings and results of regulatory inspections and responses of the assisted​ living facility;​ C. observation of the integrative and administrative role of the director through attendance​ with the director or mentor at meetings with staff, families, governing bodies, community groups,​ resident councils, or other groups;​ D. observation of the relationships between the assisted living facility and community and​ other health care providers and organizations operating in the continuum of health care; and​ E. participation in and completion of a quality assurance and performance improvement​ project.​ Subp. 5. Completion of self-assessment. At the end of each field experience and as part of​ the licensure process, the ALDIR and the mentor must provide evidence to the board demonstrating​ completion of the board-approved self-assessment and remediation of any areas identified in the​ self-assessment as deficient.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​

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History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7040 COURSE PROVIDER REVIEW.​ Subpart 1. Program review and approval. Upon request of a course provider, the board shall​ review course content offered by the course provider, and upon finding conformity between the​ proposed program and the requirements of this chapter, shall approve the course provider as offering​ courses that meet all of the course requirements for licensure.​ Subp. 2. Requesting course review. When submitting a program of study offered by a course​ provider to meet the course requirements, the course provider shall provide the following information​ in an application for the board's review:​ A. designation of a program director to coordinate the course provider's program or course​ offerings with the board. If the program director determines that courses from students transferring​ into the course provider's program or courses from students enrolled in the program who cannot​ arrange class schedules to permit timely completion of the board-approved courses are equivalent​ in content to those accepted by the board to fulfill the course requirements in parts 6400.7015 and​ 6400.7020, the program director must submit the students' equivalent courses to the board. The​ board must determine that the courses are equivalent in content to fulfill the course requirements​ in parts 6400.7015 and 6400.7020;​ B. evidence of the establishment and use of an advisory group of assisted living directors​ and others in the long-term services and supports industry, including the names and experience of​ group members and the frequency of meetings, to review course requirements and practicum​ activities;​ C. a published marketing description of the course of study offered or recommended by​ the provider for those interested in licensure as an assisted living director in Minnesota. Nothing​ in this chapter restricts course providers from designing or implementing curricula, or establishing​ requirements for courses, majors, or other designations offered by the institution, more​ comprehensive than required under this chapter for licensure;​ D. a topic-by-topic review of how each course offered by the course provider meets the​ requirements in parts 6400.7015 and 6400.7020;​ E. an outline of each course offered by the course provider to fulfill one or more of the​ licensure course requirements, listing texts and materials used in the course; and​ F. identification of one or more course providers to:​ (1) coordinate director in training field experiences for students; and​ (2) provide instruction to any director becoming a mentor for the first time regarding​ objectives for the director in training or evidence of use of NAB's mentor training modules.​

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Subp. 3. Review and approval process. Upon receipt of an application package for approval​ of a course provider's program to meet board course requirements, the board shall acknowledge​ receipt of the request and identify any missing requirements to the program director. Upon receipt​ of all required information, the board shall review all materials presented and may request an​ appearance by one or more representatives of the program at a meeting to review all material for​ conformance to requirements. The board shall base its decision to approve or reject the course​ provider's program on whether the application materials presented cover the course topics outlined​ in parts 6400.7015 and 6400.7020 with sufficient depth to enable students to attain the knowledge,​ skills, and abilities required to begin work as an assisted living director. If the application package​ and discussion with program officials fail to show compliance with parts 6400.7015 and 6400.7020​ or to provide sufficient evidence to satisfy the board members that they can infer beginning-level​ competency among students completing the proposed course, the board shall notify the program​ director in writing of the deficiencies the course provider must remedy. Once all deficiencies are​ satisfactorily remedied, the board shall grant approval to the course provider in writing and include​ reference to the course provider's offerings in its correspondence with students interested in learning​ where courses approved by the board to meet licensure requirements are available. If the deficiencies​ are not corrected, the board shall deny approval for the course provider's program by written notice​ to the program director.​ Subp. 4. Annual review. Annually on or before September 1, the program director of a course​ provider with an approved program or courses shall file with the board on forms prescribed by the​ board for that purpose a report indicating:​ A. any changes in any of the information presented to satisfy the requirements outlined in​ this part since the initial application or since the updated report of the preceding year; and​ B. to the extent available, a schedule of when throughout the year the approved courses​ will be offered by the course provider or the link to the course website.​ Subp. 5. Five-year course provider review.​ A. Every fifth year following the board's initial approval of a course provider's program or​ courses, the program director shall provide a complete review of the course provider's program by​ submitting to the board by September 1 of the fifth year a review application package in the same​ format and incorporating the same information as required in subpart 2 for a new program approval​ application. When no change has occurred since the initial application, the program director may​ submit a copy of the initially submitted information with an updated date and attestation that the​ information is current.​ B. The board shall review the five-year program review package submitted by the course​ provider and approve or deny continued board approval for the program as provided in subpart 3.​ If the board finds it necessary to deny continued approval to a program or to specific courses, the​ board shall provide information to the program director about ways in which students currently​ enrolled in the program may obtain supplementary or alternative courses to complete the requirements​ for licensure in view of the revocation of approval for courses offered by the course provider. The​ program director shall provide the information to all students enrolled in the previously approved​

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program or courses and shall work with the students to provide a smooth transition to alternative​ course providers offering approved courses.​ C. In addition to the five-year program review, if the board receives information that the​ success rates fall below the national average for candidates from the program who, during the​ annual review period, wrote for the first time the national examination for assisted living directors​ developed by NAB, the board must take one of the actions described in subitems (1) to (3):​ (1) if success rates are below the national average for one period, the board shall require​ the program director to identify factors that potentially affect the low success rate of the licensure​ examination. The director shall submit a plan of corrective action by a specified date. The plan of​ action must be on a board-supplied form and include the signature of the program director and​ another course provider representative. If during the following year the success rate is above the​ national average, no action by the board is required;​ (2) if the success rates are below the national average for two consecutive periods, the​ board shall notify the program director of a survey to identify additional factors affecting the low​ success rate and review progress on the plan for corrective action submitted the previous year. The​ survey must include the director, presenters, students, and a course presenter representative. The​ program director shall submit a revised plan of corrective action by a specified date. The plan of​ corrective action must be on a board-supplied form and include the signatures of the program​ director and course provider representative. If during the following year the success rate is above​ the national average, no action is required by the board; or​ (3) if success rates are below the normal average for three consecutive periods, the​ board shall require the program director and another course provider representative to meet with a​ committee of board members and board staff for a survey for compliance with all applicable rules​ and for the implementation of the plan for corrective action submitted the previous year. Upon​ completion of the survey, the board shall take action according to subpart 3.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ LICENSES AND PERMITS​ 6400.7045 ENDORSEMENT.​ Subpart 1. License; assisted living director. The board shall issue an assisted living director​ license to an individual who has been issued and currently holds a license as an assisted living​ director in another jurisdiction if:​ A. the other jurisdiction maintains requirements for assisted living director licensure that​ are equivalent to those required under part 6400.7005 or the applicant is currently licensed as an​ assisted living director and provides the board evidence of having successfully completed a​ professional program in assisted living administration endorsed by NAB or approved by the board;​

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B. the applicant has successfully completed a course covering the course requirements in​ part 6400.7020;​ C. the applicant has passed the Minnesota state examination within the previous two years;​ D. the applicant is in good standing as an assisted living director in each jurisdiction from​ which the applicant has ever received an assisted living director license; and​ E. the applicant has made application for licensure under part 6400.7010 and has paid the​ applicable fees.​ Subp. 2. License; nursing home administrator. The board shall issue an assisted living​ director license to an individual who has been issued and currently holds a license as a nursing​ home administrator in Minnesota or another jurisdiction if the individual:​ A. provides the board evidence of having successfully completed a professional program​ in assisted living administration endorsed by NAB or approved by the board;​ B. has successfully completed a course covering the Minnesota course requirements in part​ 6400.7020, unless the applicant graduated from an educational institution approved by the board;​ C. has passed the Minnesota state examination within the immediate past two years;​ D. is in good standing as a nursing home administrator in each jurisdiction from which the​ applicant has ever received a nursing home administrator license; and​ E. has applied for licensure under part 6400.7010 and paid the applicable fees.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7050 LICENSEE RESPONSIBILITIES.​ Each licensee shall:​ A. comply with the laws of Minnesota and the rules of the board and other Minnesota state​ agencies regarding licensure as an assisted living director and operation of an assisted living facility​ in Minnesota;​ B. provide notice to the board within five working days of any change in e-mail address,​ mailing address, or telephone number pursuant to Minnesota Statutes, section 13.41, subdivision​ 2, paragraph (b);​ C. provide notice to the board within five working days of any change in employment as​ an assisted living director for an assisted living facility;​ D. notify the board within five working days of any formal disciplinary action or charge​ against any license the licensee holds as an assisted living director, health services executive, or​ other health care professional in Minnesota or any other jurisdiction;​

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E. cooperate with the board by providing data, reports, or information requested by the​ board that is relevant to the board's licensure and disciplinary authority and complying with requests​ to attend conferences, meetings, or hearings scheduled by the board concerning license renewal or​ complaint investigations and discipline;​ F. provide, when requested, a defined delegation of authority, in the case of director​ absences, at each assisted living facility where the licensed assisted living director serves as director;​ and​ G. be responsible for the general administration and management of the assisted living​ facility and oversee the day-to-day operation of the assisted living facility. This includes​ responsibility for:​ (1) ensuring that services and support are provided to residents in a manner that protects​ their health, safety, and well-being and is consistent with residents' rights, including the right to​ choose to refuse services;​ (2) maintaining compliance with applicable laws and regulations;​ (3) developing and implementing all policies, procedures, and services required in​ Minnesota Statutes, chapter 144G;​ (4) ensuring staff and volunteers comply with residents' rights;​ (5) maintaining buildings and grounds;​ (6) recruiting, hiring, training, and supervising staff; and​ (7) ensuring the development, implementation, and monitoring of an individualized,​ person-centered plan of care for each resident, regardless of the internal or contracted service model.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7055 DISPLAYING LICENSES.​ A licensee actively practicing shall display the board-issued license, not a photocopy, in a​ conspicuous place in the assisted living facility that the licensee directs, that is visible to residents​ and visitors.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7060 DUPLICATE LICENSES.​ Upon receipt of a notarized statement from a licensee that the licensee's license has been lost,​ mutilated, or destroyed, or that the licensee has had a name change, the board shall issue a duplicate​

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6400.7065​

license. A licensee may also apply for a duplicate license to display at each assisted living facility​ where the licensee serves as the assisted living director under this chapter. Licensees obtaining​ duplicate licenses are subject to the applicable fee.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7065 RENEWING LICENSES.​ Subpart 1. Forms; time for renewal. Every individual who holds a valid license issued by​ the board shall annually apply to the board on or before October 1 for renewal of the individual's​ license and shall report any information pertinent to continued licensure requested by the board.​ The applicant shall submit evidence satisfactory to the board and subject to audit under part​ 6400.7090, subpart 3, that during the annual period immediately preceding the renewal application​ the licensee has complied with the rules of the board and completed continuing education​ requirements for license renewal.​ Subp. 2. Fees. Upon making an application for license renewal, the licensee shall pay the​ annual fee. If submitting CE credits that include clock hours for workshops, seminars, institutes,​ or home study courses that have not been preapproved by the board, the licensee shall also pay a​ fee for review of clock hours based upon the total number of non-preapproved clock hours being​ submitted for CE credit to meet renewal requirements. If the application for renewal has not been​ received by October 31 of each year, the license lapses and the holder of a lapsed license is subject​ to the reinstatement procedure and late renewal fees.​ Subp. 3. Exemption from renewal. Pursuant to Minnesota Statutes, section 326.56, a licensee​ who is in active service, as defined in Minnesota Statutes, section 190.05, for the armed forces of​ the United States or is employed outside of the United States in employment that is essential to the​ prosecution of any war or the national defense, according to Minnesota Statutes, section 326.56,​ and whose license was in effect at the time of entry into the armed forces or engagement in​ employment outside the United States, is not obligated to renew licensure. The board must be​ notified in writing by the licensee regarding the qualifications for this exemption. The exemption​ ceases six months after discharge from active service or termination of the aforementioned​ employment. A license renewal notice shall be sent to the licensee at the time that a license renewal​ notice would normally be sent to the licensee. The licensee may be requested to reconfirm exempt​ status. If the licensee no longer qualifies for the exemption, the requirements for license renewal​ must be met.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​

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6400.7070 LICENSE REINSTATEMENT.​ An assisted living director previously licensed in this state whose license has lapsed may apply​ under items A to C for reinstatement of a license within five years of the date the individual was​ last licensed. If an individual's license has been revoked or if the individual has not been licensed​ for five years or more, the license cannot be reinstated but the former licensee may apply for​ relicensure under the requirements in part 6400.7010.​ A. If a license has been lapsed in Minnesota for less than two years prior to the date of the​ application for reinstatement, the board must reinstate the license if the former licensee has not had​ disciplinary action against a health care professional license in Minnesota or another jurisdiction​ during the time that the Minnesota license was lapsed and the former licensee:​ (1) files with the board a completed application for reinstatement;​ (2) provides evidence of having completed the continuing education requirements under​ part 6400.7090, subpart 1, for each of the years the license has lapsed; and​ (3) pays the license renewal and late fees for each of the years the license has lapsed.​ B. If a license has been lapsed in Minnesota for more than two years but less than five years​ prior to the date of the application for reinstatement and the former licensee has been continuously​ licensed as an assisted living director or health services executive in one or more other jurisdictions​ since the date the license lapsed in Minnesota, the board must reinstate the license if the former​ licensee has not had disciplinary action against a health care professional license in Minnesota or​ another jurisdiction during the time the Minnesota license was lapsed and the former licensee:​ (1) files with the board a completed application for reinstatement;​ (2) provides evidence of having completed the continuing education requirements under​ part 6400.7090, subpart 1, for each of the years the license has lapsed;​ (3) pays the license renewal and late fees for each of the years the license has lapsed;​ and​ (4) successfully completes the state examination.​ C. If a license has been lapsed in Minnesota for more than two years but less than five years​ prior to the date of the application for reinstatement and the former licensee has not been continuously​ licensed in one or more jurisdictions since the date the license lapsed in Minnesota, the board must​ reinstate the license if the former licensee has not had disciplinary action against a health care​ professional license in Minnesota or another jurisdiction during the time that the Minnesota license​ was lapsed and the former licensee:​ (1) files with the board a completed application for reinstatement;​ (2) provides evidence of having completed the continuing education requirements under​ part 6400.7090, subpart 1, for each of the years the license has lapsed;​ (3) pays the license renewal and late fees for each of the years the license has lapsed;​

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(4) successfully completes the state examination; and​ (5) successfully completes the NAB core knowledge and line of service examinations.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7075 VERIFICATION OF MINNESOTA LICENSE.​ Upon request and payment of a fee under this chapter by the licensee, the board shall issue a​ certified statement of the licensee's licensure status and examination scores to another jurisdiction.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7080 ASSISTED LIVING DIRECTOR IN RESIDENCE PERMITS.​ Subpart 1. Board to issue permits. When the controlling individuals of an assisted living​ facility designate an ALDIR under this part, the designee must secure a permit within 30 days of​ the designation. To secure a permit, the ALDIR must designate on the permit application the person​ who will serve as a mentor during the director in residence field experience. The board shall issue​ a permit to serve an assisted living facility as an assisted living director in residence for up to one​ year. A permit to serve as an ALDIR is not renewable beyond the one year for which it was issued.​ Subp. 2. Qualifications. An applicant for a permit to serve an assisted living facility as an​ ALDIR must furnish satisfactory evidence that the applicant:​ A. has graduated from high school or holds a general education development (GED)​ certificate of equivalent competency;​ B. has experience in the management of an assisted living facility or related facility or​ program or is enrolled with a course program approved by the board within six months of​ designation;​ C. is in good standing in each jurisdiction from which the applicant has ever received a​ health care license;​ D. has successfully completed a criminal background check under Minnesota Statutes,​ section 214.075; and​ E. has established a mentor relationship, including providing information about the mode​ and frequency of communication between the mentor and the assisted living director in residence.​ Subp. 3. Responsibilities. The assisted living director in residence must meet the licensee​ responsibilities set forth in part 6400.7050.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​

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History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7085 SHARED DIRECTOR.​ A. With approval of the board, an assisted living facility may share the services of a licensed​ assisted living director or a permitted assisted living director in residence. The director or director​ in residence must maintain an on-site presence to administer, manage, and supervise each assisted​ living facility and meet the domains of practice according to the requirements of this chapter.​ B. Within 15 days after assuming the position, the shared director or director in residence​ must submit an application to serve as a shared director, on forms provided by the board. All​ applications for a shared director arrangement must be signed by a legal representative of the facility​ or by a controlling individual.​ C. The board shall consider the following criteria to determine whether to approve the​ shared arrangement:​ (1) education and experience of the director or assisted living director in residence;​ (2) geographic location and distance between assisted living facilities;​ (3) whether the assisted living facilities share common management or common​ ownership;​ (4) external or regional administrative support and clinical support;​ (5) number of assisted living facilities to be shared;​ (6) services provided at each assisted living facility;​ (7) number of residents at each assisted living facility;​ (8) licensed staffing at each assisted living facility;​ (9) proposed duration of the shared director arrangement;​ (10) compliance and complaint history;​ (11) written delegation of authority policy;​ (12) communication plan for residents, families, and staff; and​ (13) acknowledgment of ongoing satisfaction of resident contracts at each assisted​ living facility.​ D. If the proposed shared assisted living facilities are five or fewer in number, are all within​ a 60-mile radius and have common management, and the assisted living facilities' licenses and the​ license or permit of the proposed director are in good standing, the board shall administratively​ approve the shared assisted living facility arrangement.​

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E. The board shall review all shared assisted living facility arrangements approved or denied​ administrative approval under item D at the board's next regularly scheduled board meeting following​ the approval or denial. The board must determine, according to the criteria in item C, whether to​ ratify the administrative approval or approve the shared arrangement previously denied administrative​ approval.​ F. If the board approves the request to serve as a shared director, the licensee or permit​ holder must:​ (1) establish procedures and delegate authority for on-site operations in the director's​ or assisted living director in residence's absence;​ (2) be available to staff at each assisted living facility that the licensee or permit holder​ directs;​ (3) post at each assisted living facility a board-issued license or permit in a conspicuous​ place within the assisted living facility;​ (4) post at each assisted living facility the procedure to contact the person in charge on​ the premises in the absence of the director or assisted living director in residence; and​ (5) make communication plans available to residents, families, and staff at each assisted​ living facility the licensee or permit holder directs.​ G. If the board does not approve the request to serve as a shared director, the board shall​ provide the director written notice of the board's decision and a remediation plan.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ CONTINUING EDUCATION​ 6400.7090 CONTINUING EDUCATION REQUIREMENTS.​ Subpart 1. Renewal requirements. At the time of license renewal, each licensee shall provide​ evidence to the board that the licensee has completed in the preceding two years 30 continuing​ education credits of continuing education activities as specified in this part and Minnesota Statutes,​ section 144A.20, subdivision 4, paragraph (c). Licensees in their first year of licensure shall have​ the number of CE credits required for license renewal prorated for the number of months they were​ licensed during the preceding year. For purposes of obtaining and presenting CE credits, a year​ runs from September 1 to August 31.​ Subp. 2. Evidence of continuing education requirement completion. Licensees must maintain​ proof as described in part 6400.7091 of having completed the number of CE credits claimed at the​ time of renewal and shall, upon request of the board, make that proof available for audit to verify​ completion of the number and validity of credits claimed. Documentation to prove completion of​

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CE credits must be maintained by each licensee for four years from the last day of the licensure​ year in which the credits were earned.​ Subp. 3. Audit. The board shall annually select on a random basis at least five percent of the​ licensees applying for renewal to have their claims of CE credits audited for compliance with board​ requirements. Nothing in this subpart prevents the board from requiring any individual licensee​ from providing evidence to the board of having completed the CE credits required for license​ renewal.​ Subp. 4. Acceptable content for continuing education activities. Unless otherwise specified​ in part 6400.7091, the content of continuing education activities must relate to one or more of the​ following:​ A. administration of services for persons needing long-term services and supports;​ B. current issues and trends in long-term services and supports and assisted living licensure;​ C. the relationship of long-term services and supports to other aspects of the health care​ continuum; and​ D. responsibilities, tasks, knowledge, skills, and abilities required to perform assisted living​ director functions as outlined in the NAB domains of practice.​ Subp. 5. Credits to maintain another professional license. Continuing education required​ to maintain another professional license, such as a nursing home administrator license, nursing​ license, social worker license, mental health professional license, or real estate license, may be used​ to satisfy the requirements of subpart 4 when approved by the board. The board shall approve​ continuing education credits under this subpart when the continuing education is related to the​ domains of practice of assisted living as identified in the NAB job analysis for assisted living​ directors.​ Subp. 6. Unacceptable content for continuing education activities. Subjects for continuing​ education that are not acceptable to meet license renewal requirements include:​ A. general personal development including stress management;​ B. assisted living facility or company orientation;​ C. assisted living facility or company policies or procedural issues;​ D. organizational functions such as business meetings and election of officers;​ E. medical treatment at a clinical level beyond that required for licensure as an assisted​ living director; and​ F. any other subject unrelated to content specified under subpart 4.​ Subp. 7. Requirements in specified subjects. The board shall, when compelled by advancement​ in scope of practice or emerging long-term services and supports issues, and by public written​

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notice to each licensee on or before September 1, require all licensees to attend continuing education​ programs in specified subjects.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7091 NUMBER OF CE CREDITS FOR ACTIVITIES.​ Acceptable activities to meet continuing education requirements for license renewal and the​ number of continuing education credits that licensees may obtain for each are described in items​ A to K.​ A. A licensee who attends board-approved seminars, webinars, institutes, or workshops​ shall receive CE credit on a clock-hour basis for the actual amount of time spent in the seminar​ rounded to the nearest lower one-quarter hour. To verify clock hours of attendance at seminars,​ webinars, institutes, or workshops, a licensee must maintain an attendance certificate provided by​ the sponsoring organization.​ B. A licensee who completes board-approved home study courses, including correspondence​ work, televised courses, and audio or video recordings, shall receive CE credit for the number of​ clock hours reasonably required to complete the home study course as determined by the board.​ To verify completion of the course, the licensee must maintain a certificate of course completion​ from the sponsor that must include evidence of passing a test corrected by the sponsor.​ C. A licensee who attends seminars, webinars, institutes, or workshops, or completes home​ study courses approved by NAB shall receive CE credit on the basis of clock hours assigned by​ NAB. To verify clock hours of attendance at NAB-approved seminars, webinars, institutes, or​ workshops, or completion of NAB-approved home study courses, the licensee must maintain a​ certificate provided by the NAB-approved sponsor.​ D. A licensee who attends, in another state, seminars, webinars, institutes, or workshops​ approved by the assisted living director or health services executive licensing authority of the other​ state shall receive CE credit on the basis of the number of clock hours attended. To verify clock​ hours of attendance at seminars, webinars, institutes, or workshops approved by another state's​ licensing authority, the licensee must maintain a certificate of attendance from the sponsor including​ verification of the state's licensing authority's approval.​ E. A licensee who passes academic courses applicable to the domains of practice taken at​ an accredited postsecondary institution shall receive nine CE credits per quarter credit and 12 CE​ credits per semester credit. To verify passage of academic courses, the licensee must maintain a​ copy of an academic transcript showing the course grade and the date it was awarded.​ F. A licensee who writes an article on a topic related to long-term services and supports​ that is published in a national periodical shall receive two CE credits for an article of 500 to 1,000​ words and one additional credit for each additional 500 words to a maximum of ten CE credits per​

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year. To verify publication, the licensee must maintain a copy of the periodical containing the​ published article.​ G. A licensee who presents a paper or lecture on a topic related to long-term services and​ supports of at least one hour at a national or statewide meeting shall receive two CE credits per one​ hour of initially presented lectures and one CE credit per hour of lectures repeating previously​ presented material to a maximum of ten CE credits per year. To verify the presentation, the licensee​ must maintain a copy of the text of the information delivered and a copy of the program for the​ conference or workshop at which the paper or lecture was delivered.​ H. A licensee who delivers a lecture on a topic related to long-term services and supports​ of at least one hour at an academic institution or through a course provider shall receive two CE​ credits per one hour of initially presented lectures and one CE credit per hour of lectures repeating​ previously developed material to a maximum of ten CE credits per year. To verify lecture delivery,​ the licensee shall maintain corroboration from the participating academic institution.​ I. A licensee who serves as a member of a board, committee, council, or work group that​ includes members from several nursing or assisted living facilities or organizations and deals​ primarily with issues in assisted living facility operation or long-term services and supports shall​ receive CE credit per membership position held provided the group meets at least quarterly or for​ at least four hours of work in a year to a maximum of six CE credits per year for all membership​ positions combined. Where the licensee verifies that the licensee's participation on a single board,​ committee, council, or work group exceeded the minimum specified for a single CE credit by double​ the amount of hours of attendance, the licensee shall receive two CE credits per membership position​ to a maximum of six CE credits per year for all membership positions combined. To verify board,​ committee, council, or work group participation, the licensee must maintain written verification of​ membership and attendance from an officer of the group and must provide the learning objectives​ of the meeting.​ J. A mentor for an assisted living director in residence's field experience shall receive two​ CE credits per month spent serving as director to a maximum of 16 CE credits per year. To verify​ mentor service, the mentor must maintain documentation of service from the participating course​ provider. An individual who attends training sessions to prepare mentors to oversee field experiences​ shall receive CE credit on the same clock-hour basis as for seminars, webinars, institutes, and​ workshops under item A. This item also applies to a health services executive applying for licensure​ renewal under part 6400.6740 who serves as a mentor for an assisted living director in residence's​ field experience.​ K. Other continuing education activities not specified in items A to J may be approved for​ up to ten CE credits per year on an individual basis upon submission of information to the board​ concerning the activity in which the licensee has engaged, the results of the learning, the number​ of hours involved, the number of CE credits requested, and some means of verifying completion​ of the activity. The board shall consider the information submitted and determine whether to approve​ the activity and, if so, what number of CE credits to award for the activity, and shall notify the​ requesting licensee of the board's determination. In making its determination, the board shall consider​

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whether the activity contributed to the advancement and extension of professional skill and​ knowledge of the licensee in matters related to the practice of assisted living facility direction.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ 6400.7092 SPONSORING CONTINUING EDUCATION.​ Subpart 1. Applying for individual program approval. Individuals, groups, or organizations​ wishing to sponsor educational seminars, webinars, institutes, workshops, or home study programs​ shall submit the following, in writing, to the board to obtain review and approval for clock hours​ of CE credit for licensees to use in meeting continuing education requirements for license renewal:​ A. date, time, and location of presentation;​ B. presentation content, showing specific time periods, topics, titles, and speakers including​ their professional qualifications;​ C. number of clock hours requested;​ D. a statement indicating the sponsor's willingness to maintain a means of verifying​ attendance and provide each attendee a certificate of attendance or other appropriate means of​ attesting to the number of clock hours actually attended by each attendee;​ E. for home study programs, evidence of a testing process to measure the participant's​ attainment of knowledge and information provided in study materials; and​ F. a fee based on the number of clock hours requested to be reviewed and approved.​ Subp. 2. Licensee-sponsored programs and courses. A licensed director who attends a​ seminar, webinar, institute, or workshop, or participates in a home study course that has not been​ reviewed and approved by the board for a sponsor, may serve as the sponsor of a program and​ obtain review of the program and assignment of clock hours by submitting to the board:​ A. a copy of the seminar program or other document identifying the program content and​ other information required of program sponsors under subpart 1, items A to C; and​ B. a fee in the same amount as would be charged to a sponsor under subpart 1, based on​ the total number of clock hours requested to be reviewed and approved.​ Subp. 3. Review of sponsor requests. The board shall review sponsor requests and approve​ CE credit hours for programs with content, presenters, and means of verifying attendance or​ measuring knowledge attainment under subpart 1 and part 6400.7090, subpart 4, and notify the​ requesting sponsor of the decision.​ Subp. 4. Designation of registered continuing education sponsors. An organization that​ annually sponsors multiple educational seminars, webinars, institutes, workshops, or home study​ courses may request designation by the board as a registered continuing education sponsor on an​

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annual basis beginning September 1 and ending August 31. Registered continuing education sponsors​ may assign CE credit hours to their own program offerings applying the provisions of this chapter.​ The board shall review and approve requests for designation and authority as a registered continuing​ education sponsor if the sponsor:​ A. is a regionally accredited university or college or division thereof or a state or national​ membership organization in the field of health care;​ B. has been a sponsor of continuing education programs approved by the board under​ subpart 3 for the two years preceding the request to be named a registered sponsor;​ C. has complied fully with the board's criteria for sponsors of continuing education​ programming;​ D. has requested designation on forms prescribed by the board;​ E. has signed an agreement to:​ (1) comply with the rules of the board in assigning clock hours to continuing education​ programs;​ (2) provide certificates of attendance to participants; and​ (3) provide the board with information concerning sponsored programs; and​ F. has paid the balance of the registered sponsor fee within 30 days of notification by the​ board of approval of the organization as a registered continuing education sponsor.​ Subp. 5. Performance review of registered sponsors. The board shall review performance​ of registered sponsors annually upon the sponsor's request to renew the one-year sponsor agreement​ with the board or more frequently if determined necessary in the judgment of the board and shall​ remove registered sponsor status from an organization upon 30 days' notice if the sponsor has been​ found to violate the terms of the agreement with the board.​ Subp. 6. Course program provider waiver. A course program provider approved by the​ board is exempt from the annual fee by validating attendance and recording and merging the verified​ attendance records with the board's online continuing education attendance system.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​ STANDARDS OF PRACTICE​ 6400.7095 STANDARDS OF PRACTICE; ENFORCEMENT.​ Subpart 1. Criteria. The board may impose disciplinary action as described in subpart 2 against​ an applicant, the holder of a permit to serve as a director in residence, or a licensee when the board​

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determines, by a preponderance of the evidence and after notice and an opportunity to be heard at​ a contested case hearing, that the applicant, permit holder, or licensee:​ A. has been convicted of a felony or gross misdemeanor, including a finding or verdict of​ guilt, whether or not the adjudication of guilt has been withheld or not entered, an admission of​ guilt, or a no contest plea, when the felony or gross misdemeanor is related to the practice of assisted​ living director, as evidenced by a certified copy of the conviction;​ B. has been convicted of a crime against a minor, including a finding or verdict of guilt,​ whether or not adjudication of guilt has been withheld or not entered, an admission of guilt, or a​ no contest plea;​ C. is not eligible to be employed as an assisted living director under Minnesota Statutes,​ section 144A.20, subdivision 4;​ D. has failed to comply with Minnesota Statutes, section 626.557, the Vulnerable Adult​ Act;​ E. has violated a statute, rule, or order that the board issued or is empowered to enforce or​ that pertains to directing an assisted living facility or to the responsibilities of an assisted living​ director;​ F. has discriminated against any resident or employee based on age, race, sex, religion,​ color, creed, national origin, marital status, status with regard to public assistance, sexual orientation,​ or disability;​ G. has committed acts of misconduct related to qualifications, functions, or duties of an​ assisted living director and evidenced unfitness to perform as an assisted living director in a manner​ consistent with protecting resident health, safety, and welfare;​ H. has engaged in fraudulent, deceptive, or dishonest conduct, whether or not the conduct​ relates to the practice of assisted living facility direction, that adversely affects the individual's​ ability or fitness to practice as an assisted living director or health services executive;​ I. has engaged in unprofessional conduct, including any departure from or failure to conform​ to the minimum standards of acceptable and prevailing practice, as specified in state and federal​ statutes and rules concerning administration of assisted living facilities, without actual injury having​ to be established;​ J. has failed to take good faith efforts to protect the safety, health, or life of a resident;​ K. has willfully permitted the unauthorized or illegal disclosure of information relating to​ a resident;​ L. has engaged in sexual harassment, made sexual advances toward, or engaged in sexual​ contact with any resident, student, or trainee under the individual's supervision, or engaged in sexual​ harassment of an employee, consultant, or visitor to the facility in which the individual practices;​

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M. has practiced fraud, deceit, cheating, or misrepresentation, or provided misleading​ omission or material misstatement of fact, in securing, procuring, renewing, or maintaining a license​ or permit;​ N. has used the individual's professional status, title, position, or relationship as a licensee​ or permit holder to coerce, improperly influence, or obtain money, property, or services from a​ resident, a resident's family member or visitor, an employee, or any person served by or doing​ business with the assisted living facility that the individual administers or is employed by;​ O. has paid, given, caused to be paid or given, or offered to pay or give to any person a​ commission or other consideration for solicitation or procurement either directly or indirectly for​ assisted living facility patronage. Nothing in this item shall be construed to limit or restrict​ commercial advertisement;​ P. has knowingly aided, advised, or allowed an unlicensed person to engage in the unlicensed​ practice of assisted living facility direction;​ Q. has practiced fraudulent, misleading, or deceptive advertising with respect to the facility​ of which the licensee is director;​ R. has wrongfully transmitted or surrendered possession of the individual's license or permit​ to any other person, either temporarily or permanently;​ S. has falsely impersonated another licensee or permit holder;​ T. has practiced without a current license or permit;​ U. has made a false statement or knowingly provided false or misleading information to​ the board; failed to submit reports as required by the board; failed to cooperate with an investigation​ of the board, the Office of the Attorney General, or the Minnesota Department of Health; or violated​ an order of the board;​ V. has been the subject of a reprimand, restriction, limitation, condition, revocation,​ suspension, surrender, or other disciplinary action against the person's assisted living director license​ in another jurisdiction or any other health care professional license or permit in Minnesota or another​ jurisdiction;​ W. has failed to report a reprimand, restriction, limitation, condition, revocation, suspension,​ surrender, or other disciplinary action against the person's license in another jurisdiction or failed​ to report the existence of a complaint or other charges against the person's license in this or another​ jurisdiction or has been refused a license as an assisted living director by any other jurisdiction for​ reasons other than a difference in academic or experience requirements among jurisdictions;​ X. has abused or is dependent on alcohol, a legend drug as defined in Minnesota Statutes,​ chapter 151, a chemical as defined in Minnesota Statutes, chapter 151, or a controlled substance​ as defined in Minnesota Statutes, chapter 152, and this abuse or dependency has negatively affected​ the performance of the individual's duties; or​

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Y. has failed to meet the requirements of part 6400.7030 when mentoring an assisted living​ director in residence during the field experience.​ Subp. 2. Actions. If grounds for disciplinary action exist under subpart 1, the board shall take​ one or more of the following actions:​ A. refuse to grant a permit;​ B. refuse to grant or renew a license;​ C. revoke a license or permit;​ D. suspend a license or permit;​ E. impose limitations or conditions on a license or permit;​ F. censure or reprimand the licensee or permit holder; or​ G. refuse to permit an applicant to take the licensure examination or refuse to release an​ applicant's examination score.​ Subp. 3. Considerations. In determining what action to take under subpart 2, the board shall​ consider:​ A. the responsibility and response of the individual prior to, during, and after the occurrence​ warranting disciplinary action under subpart 1;​ B. extenuating circumstances;​ C. repeated complaints against the individual; and​ D. the severity of or the potential of harm to residents.​ Statutory Authority: MS s 144A.20; 144A.21; 144A.22; 144A.23; 144A.24; 214.06​ History: 45 SR 1073​ Published Electronically: June 4, 2021​

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Miscellaneous References Table of Contents

TOPIC Appendix Z - Definitions Appendix Z - Establishment of Program Appendix Z - Develop and Maintain Program Appendix Z - Maintain and Update Annually Appendix Z - Address Resident Population Appendix Z - Collaboration Appendix Z - Develop Policies and Procedures Appendix Z - P/P for Subsistence Needs Appendix Z - P/P for Tracking Staff and Residents Appendix Z - P/P for Evacuations Appendix Z - P/P for Sheltering in Place Appendix Z - P/P for Documentation Appendix Z - P/P for Surge Planning and Use of Volunteers Appendix Z - P/P for Arrangements with Other Facilities Appendix Z - P/P for 1135 Waivers Appendix Z - P/P for Communication Plan Appendix Z - P/P for Communication Plan Details Appendix Z - P/P for Communication Plan Contacts Appendix Z - P/P for Communication - Means of Communicating Appendix Z - P/P for Communication - Information Sharing Regarding Residents Appendix Z - P/P for Communication - Information Sharing Regarding Facility Appendix Z - P/P for Communication - Sharing Emergency Preparedness Plan Appendix Z - Training and Testing Program Appendix Z - Training Appendix Z - Testing and Exercises Appendix Z - Emergency and Standby Systems Appendix Z - Integrated Healthcare Systems

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Vulnerable Adult Act - Definitions Vulnerable Adult Act - Reporting Requirements

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Electronic Monitoring

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Liquor License

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Salon/Cosmetology Services

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I'm OK Checks

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Dislosure of Special Care Status

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Appendix Z Definitions All-Hazards Approach: An all-hazards approach is an integrated approach to emergency preparedness that focuses on identifying hazards and developing emergency preparedness capacities and capabilities that can address those as well as a wide spectrum of emergencies or disasters. This approach includes preparedness for natural, man-made, and or facility emergencies that may include but is not limited to: care-related emergencies; equipment and power failures; interruptions in communications, including cyber-attacks; loss of a portion or all of a facility; and, interruptions in the normal supply of essentials, such as water and food.

Planning for using an all-hazards approach should also include emerging infectious disease (EID) threats. Examples of EIDs include Influenza, Ebola, Zika Virus and others. All facilities must develop an all-hazards emergency preparedness program and plan.

Community Partners: Community partners are considered any emergency management officials (fire, police, emergency medical services, etc.) for full-scale and community- based exercises, however can also include community partners that assist in an emergency, such as surrounding providers and suppliers.

Disaster: A hazard impact causing adverse physical, social, psychological, economic or political effects that challenges the ability to respond rapidly and effectively. Despite a stepped-up capacity and capability (call-back procedures, mutual aid, etc.) and change from routine management methods to an incident command/management process, the outcome is lower than expected compared with a smaller scale or lower magnitude impact (see “emergency” for important contrast between the two terms).

Reference: Assistant Secretary for Preparedness and Response (ASPR) 2017-2022 Health Care Preparedness and Response Capabilities Document (ICDRM/GWU Emergency Management Glossary of Terms) (November 2016).

Emergency/Disaster: An event that can affect the facility internally as well as the overall target population or the community at large or community or a geographic area.

Emergency: A hazard impact causing adverse physical, social, psychological, economic or political effects that challenges the ability to respond rapidly and effectively. It requires a stepped-up capacity and capability (call-back procedures, mutual aid, etc.) to meet the expected outcome, and commonly requires change from routine management methods to an incident command process to achieve the expected outcome (see “disaster” for important contrast between the two terms).

Reference: Assistant Secretary for Preparedness and Response (ASPR) 2017-2022 Health Care Preparedness and Response Capabilities Document (ICDRM/GWU Emergency Management Glossary of Terms) (November 2016).

Emergency Preparedness Program: The Emergency Preparedness Program describes a facility’s comprehensive approach to meeting the health, safety and security needs of the facility, its staff, their patient population and community prior to, during and after an emergency or disaster. The program encompasses four core elements: 1. Emergency Plan that is based on a Risk Assessment and incorporates an all hazards approach; 2. Policies and Procedures; 3. Communication Plan; and 4. Training and Testing Program.

Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 1

Emergency Plan: An emergency plan provides the framework for the emergency preparedness program. The emergency plan is developed based on facility- and communitybased risk assessments that assist a facility in anticipating and addressing facility, patient, staff and community needs and support continuity of business operations.

Facility-Based: We consider the term “facility-based” to mean the emergency preparedness program is specific to the facility. It includes but is not limited to hazards specific to a facility based on its geographic location; dependent patient/resident/client and community population; facility type and potential surrounding community assets- i.e., rural area versus a large metropolitan area.

Full-Scale Exercise: A full scale exercise is an operations-based exercise that typically involves multiple agencies, jurisdictions, and disciplines performing functional (for example, joint field office, emergency operation centers, etc.) and integration of operational elements involved in the response to a disaster event, i.e., ‘‘boots on the ground’’ response activities (for example, hospital staff treating mock patients). Though there is no specific number of entities required to participate in a full-scale community- based exercise, it is recommended that it be a collaborative exercise which involves, at a minimum, local or state emergency officials to develop community-based responses to potential threats.

Functional Exercise (FE): The Department of Homeland Security’s (DHS’s) Homeland Security Exercise and Evaluation Program (HSEEP) explains that FEs are an operationsbased exercise that is designed to validate and evaluate capabilities, multiple functions and/or sub-functions, or interdependent groups of functions. FEs are typically focused on exercising plans, policies, procedures, and staff members involved in management, direction, command, and control functions. For additional details, please visit HSEEP guidelines located at https://preptoolkit.fema.gov/documents/1269813 1269861/HSEEP_Revision_Apr13_Fina l.pdf/65bc7843-1d10-47b7-bc0d-45118a4d21da Mock Disaster Drill: A mock disaster drill is a coordinated, supervised activity usually employed to validate a specific function or capability in a single agency or organization. Mock disaster drills are commonly used to provide training on new equipment, validate procedures, or practice and maintain current skills. For example, mock disaster drills may be appropriate for establishing a community-designated disaster receiving center or shelter. Mock disaster drills can also be used to determine if plans can be executed as designed, to assess whether more training is required, or to reinforce best practices. A mock disaster drill is useful as a stand-alone tool, but a series of drills can be used to prepare several organizations to collaborate in an FSE. Risk Assessment: The term risk assessment describes a process facilities use to assess and document potential hazards that are likely to impact their geographical region, community, facility and patient population and identify gaps and challenges that should be considered and addressed in developing the emergency preparedness program. The term risk assessment is meant to be comprehensive, and may include a variety of methods to assess and document potential hazards and their impacts. The healthcare industry has also referred to risk assessments as a Hazard Vulnerability Assessments or Analysis (HVA) as a type of risk assessment commonly used in the healthcare industry.

Staff: The term "staff" refers to all individuals that are employed directly by a facility. The phrase "individuals providing services under arrangement" means services furnished under Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 2

arrangement that are subject to a written contract conforming with the requirements specified in section 1861(w) of the Act. Table-top Exercise (TTX): A tabletop exercise involves key personnel discussing simulated scenarios in an informal setting. TTXs can be used to assess plans, policies, and procedures.

A tabletop exercise is a discussion-based exercise that involves senior staff, elected or appointed officials, and other key decision making personnel in a group discussion centered on a hypothetical scenario. TTXs can be used to assess plans, policies, and procedures without deploying resources.

Workshop: A workshop, for the purposes of this guidance, is a planning meeting, seminar or practice session, which establishes the strategy and structure for an exercise program. We are aligning our definitions with the HSEEP guidelines. For additional details, see HSEEP guidelines at https://preptoolkit.fema.gov/documents/1269813/1269861/HSEEP_Revision_Apr13_Fina l.pdf/65bc7843-1d10-47b7-bc0d-45118a4d21da.

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E 0001 Establishment of the Emergency Program

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REGULATORY TEXT (E0001) The facility must comply with all applicable Federal, State and local emergency preparedness requirements. The facility must establish and maintain a comprehensive emergency preparedness program that meets the requirements of this section. The emergency preparedness program and its elements must be reviewed and updated annually for LTC facilities.

INTERPRETIVE GUIDELINES (E0001) Under this condition/requirement, facilities are required to develop an emergency preparedness program that meets all of the standards specified within the condition/requirement. The emergency preparedness program must describe a facility's comprehensive approach to meeting the health, safety, and security needs of their staff and resident population during an emergency or disaster situation. The program must also address how the facility would coordinate with other healthcare facilities, as well as the whole community during an emergency or disaster (natural, man-made, facility). The emergency preparedness program must be reviewed annually. All facilities are expected to make the appropriate changes to their emergency program in the event changes are required more frequently outside of their update cycles.

A comprehensive approach to meeting the health and safety needs of a resident population should encompass the elements for emergency preparedness planning based on the “all-hazards” definition and specific to the location of the facility. For instance, a facility in a large flood zone, or tornado prone region, should have included these elements in their overall planning in order to meet the health, safety, and security needs of the staff and of the resident population. Additionally, if the resident population has limited mobility, facilities should have an approach to address these challenges during emergency events.

The term “comprehensive” in this requirement is to ensure that facilities do not only choose one potential emergency that may occur in their area, but rather consider a multitude of events and be able to demonstrate that they have considered this during their development of the emergency preparedness plan. As emerging infectious disease outbreaks may affect any facility in any location across the country, a comprehensive emergency preparedness program should include emerging infectious diseases and pandemics during a public health emergency (PHE). The comprehensive emergency preparedness program emerging infectious disease planning should encompass how facilities will plan, coordinate and respond to a localized and widespread pandemic, similar to what is occurring with the 2019 Novel Coronavirus (COVID-19) PHE. Facilities should ensure their emergency preparedness programs are aligned with their State and local emergency plans/pandemic plans.

Documentation and Requirements The emergency preparedness program must be in writing. The requirements under the emergency preparedness Final Rule allow for documentation flexibility. While facilities are required to meet all of the provisions applicable to their provider/supplier type, how Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 4

they document their efforts is subject to their discretion. CMS is not requiring a hard copy/paper, electronic or any particular system for meeting the requirements. It is up to each individual facility to be able to demonstrate in writing their emergency preparedness program. CMS would also recommend, but is not requiring, facilities to develop a crosswalk as applicable for where their documents are located. For instance, if their emergency plan is located in a binder, specify this for surveyors. If there are policies and procedures to specific standards/requirements, identify where these are located.

Providers and suppliers are encouraged to keep documentation and their written emergency preparedness program based on the requirements for their provider type.

Inpatient providers should maintain documentation and records for at least 2 years.

Outpatient providers for at least four years. CMS is recommending this process due to the requirements related to training and testing exercises. Inpatient providers are required to have 2 exercises per year, therefore surveyors will review most recent two- years of documentation to determine compliance. For outpatient providers, testing exercises are required annually, alternating full-scale exercises every other year, with the opposite years allowing for the exercise of choice. In order to determine compliance, surveyors will be required to review at least the past 2 cycles (generally 4 years) of emergency testing exercises.

Additionally, CMS is not requiring approval of the Emergency Program or official “signoff,” however, CMS does recommend facilities check with their State Agencies and local emergency planning coordinators (LEPCs) as some states require approval of the emergency preparedness plans as part of state licensure.

SURVEY PROCEDURES (E0001) 1. Interview the facility leadership and ask him/her/them to describe the facility’s emergency preparedness program.

2. Ask to see the facility’s written policy and documentation on the emergency preparedness program.

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E 0004 Develop and Maintain Emergency Preparedness Program

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REGULATORY TEXT (E0004) The facility must comply with all applicable Federal, State and local emergency preparedness requirements. The facility must develop establish and maintain a comprehensive emergency preparedness program that meets the requirements of this section. The facility must develop and maintain an emergency preparedness plan that must be reviewed, and updated at least annually.

INTERPRETIVE GUIDELINES (E0004) Facilities are required to develop and maintain an emergency preparedness plan. The plan must include all of the required elements under the standard. The plan must be reviewed and updated at least annually. The periodic review must be documented to include the date of the review and any updates made to the emergency plan based on the review. The format of the emergency preparedness plan that a facility uses is at its discretion.

An emergency plan is one part of a facility's emergency preparedness program. The plan provides the framework, which includes conducting facility-based and community- based risk assessments that will assist a facility in addressing the needs of their resident populations, along with identifying the continuity of business operations which will provide support during an actual emergency.

Elements of the Emergency Plan In addition, the emergency plan supports, guides, and ensures a facility's ability to collaborate with local emergency preparedness officials. This approach is specific to the location of the facility and considers particular hazards most likely to occur in the surrounding area.

These include, but are not limited to: • Natural disasters • Man-made disasters, • Facility-based disasters that include but are not limited to: o Care-related emergencies; o Equipment and utility failures, including but not limited to power, water, gas, etc.; o Interruptions in communication, including cyber-attacks; o Loss of all or portion of a facility; and o Interruptions to the normal supply of essential resources, such as water, food, fuel (heating, cooking, and generators), and in some cases, medications and medical supplies (including medical gases, if applicable).

• Emerging infectious diseases (EIDs) such as Influenza, Ebola, Zika Virus and others. o These EIDs may require modifications to facility protocols to protect the health and safety of patients, such as isolation and personal protective equipment (PPE) measures.

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Emerging Infectious Diseases (EIDs) As facilities develop or make revisions to their emergency preparedness plans, EID’s are a potential threat which can impact the operations and continuity of care within a healthcare setting and should be considered. The type of infectious diseases to consider or the carerelated emergencies that are a result of infectious diseases are not specified. Adding EID’s within a facility’s risk assessment ensures that facilities consider having infection prevention personnel involved in the planning, development and revisions to the emergency preparedness program, as these individuals would likely be coordinating activities within the facility during a potential surge of patients.

Some examples of EID’s may include, but are not limited to: • Potentially infectious Bio-Hazardous Waste • Bioterrorism • Pandemic Flu • Highly Communicable Diseases (such as Ebola, Zika Virus, SARS, or novel COVID-19 or SARS-CoV-2) EID’s may be localized to a certain community or be widespread (as seen with the COVID19 PHE) and therefore plans for coordination with local, state, and federal officials are essential. Facilities should engage and coordinate with their local healthcare systems and healthcare coalitions, and their state and local health departments when deciding on ways to meet surge needs in their community.

Understanding the Terminology CMS recognizes that there are differences in terminology used within the emergency preparedness industry pertaining to “continuity of operations” and “business continuity.”

CMS considers “continuity of business” to incorporate all continuity operations and business continuity, which involves planning to ensure business operations will continue even during a disaster. The concept of continuity is the facility’s ability to continue operations or services related to resident care and to ensure resident safety and quality of care is continued in an emergency event. The emergency plan provides the framework, which includes conducting facility-based and community-based risk assessments that will assist a facility in addressing the needs of their resident populations, along with identifying the continuity of business operations which will provide support to services that are necessary during an actual emergency (81 FR 63875-63876). For additional information related to continuity of operations, please visit the Federal Emergency Management Agency’s (FEMA’s) Continuity Guidance Circular at https://www.fema.gov/sites/default/files/2020-07/Continuity-GuidanceCircular_031218.pdf.

Essential Services and Continuity of Care When evaluating potential interruptions to the normal supply of essential services, the facility should take into account the likely durations of such interruptions. Arrangements or contracts to re-establish essential utility services during an emergency should describe the timeframe within which the contractor is required to initiate services after the start of the emergency, how they will be procured and delivered in the facility’s local area, and that the contractor will continue to supply the essential items throughout and to the end of Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 7

emergencies of varying duration. However, CMS recognizes that contractors may be subject to the same hardships as the community they serve, and there are no guarantees in the event of a disaster that the contractor would be able to fulfill their duties.

The emergency plan should take into account contingency planning, such as evacuation triggers in the event essential resources provided by the contractor cannot be fulfilled.

Finally, facilities should also include in their planning and revisions of existing plans, contracts and inventory of supply needs; availability of personal protective equipment (PPE); critical care equipment; and transportation options/needs to be prepared for surge events. NOTE: This is also further delineated under the facility policies and procedures required by facilities under the emergency preparedness program.

SURVEY PROCEDURES (E0004) 1. Verify the facility has an emergency preparedness plan by asking to see a copy of the plan.

2. Ask facility leadership to identify the hazards (e.g., natural, man-made, facility, geographic, etc.) that were identified in the facility’s risk assessment and how the risk assessment was conducted.

3. Review the plan to verify it contains all of the required elements.

4. Verify that the plan is reviewed and updated annually by looking for documentation of the date of the review and updates that were made to the plan based on the review.

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E 0006 Maintain Emergency Preparedness Plan and Update Annually

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REGULATORY TEXT (E0006) Emergency Plan. The LTC facility must develop and maintain an emergency preparedness plan that must be reviewed, and updated at least annually. The plan must do the following: 1.

Be based on and include a documented, facility-based and community-based risk assessment, utilizing an all-hazards approach. The plan shall be based on and include a documented, facility-based and community-based risk assessment, utilizing an allhazards approach, including missing residents.

2.

Include strategies for addressing emergency events identified by the risk assessment.

INTERPRETIVE GUIDELINES (E0006) Risk Assessments Using All-Hazards Approach Facilities are expected to develop an emergency preparedness plan that is based on the facility-based and community-based risk assessment using an “all-hazards” approach.

Though a format is not specified, facilities must document the risk assessment. An example consideration may include, but is not limited to, natural disasters prevalent in a facility’s geographic region such as wildfires, tornados, flooding, etc. An all-hazards approach is an integrated approach to emergency preparedness planning that focuses on capacities and capabilities that are critical to preparedness for a full spectrum of emergencies or disasters, including pandemics and EIDs as noted under E-0004. This approach is specific to the location of the facility considering the types of hazards most likely to occur in the area, but should also include unforeseen widespread communicable diseases. Thus, all-hazards planning does not specifically address every possible threat or risk but ensures the facility will have the capacity to address a broad range of related emergencies.

Also, a risk assessment is facility-based, which, among other things, considers a facility’s resident population and vulnerabilities. Facility-based and community-based risk assessments are intended to assist a facility in addressing the needs of their resident populations, along with identifying the continuity of business operations which will provide support during an actual emergency. For instance, if a facility has a population which is primarily dependent on medical equipment the risk assessment would identify a higher impact for emergencies that lead to power failures. Facilities are encouraged to utilize the concepts outlined in the National Preparedness System, published by the United States Department of Homeland Security’s Federal Emergency Management Agency (FEMA), as well as guidance provided by the Agency for Healthcare Research and Quality (AHRQ).

Understanding Community-Based “Community” is not defined in order to afford facilities the flexibility in deciding which healthcare facilities and agencies it considers to be part of its community for emergency planning purposes. However, the term could mean entities within a state or multi-state Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 9

region. The goal of the provision is to ensure that healthcare providers collaborate with other entities within a given community to promote an integrated response. Conducting integrated planning with state and local entities could identify potential gaps in state and local capabilities that can then be addressed in advance of an emergency.

Facilities may rely on a community-based risk assessment developed by other entities, such as public health agencies, emergency management agencies, and regional health care coalitions or in conjunction with conducting its own facility-based assessment. If this approach is used, facilities are expected to have a copy of the community-based risk assessment and to work with the entity that developed it to ensure that the facility’s emergency plan is in alignment.

Development of Risk Assessments based on the Plan • • • • • • •

When developing an emergency preparedness plan, facilities are expected to consider, among other things, the following: Identification of all business functions essential to the facility’s operations that should be continued during an emergency; Identification of all risks or emergencies that the facility may reasonably expect to confront; Identification of all contingencies for which the facility should plan; Consideration of the facility’s location; Assessment of the extent to which natural or man-made emergencies may cause the facility to cease or limit operations; and, Determination of what arrangements may be necessary with other health care facilities, or other entities that might be needed to ensure that essential services could be provided during an emergency.

Risk Assessment Considerations Based on the community threat and hazard identification process, facilities should select a comprehensive risk assessment tool that evaluates their risk and potential for hazards.

The comprehensive risk assessment should include all risks that could disrupt the facility’s operations and necessitate emergency response planning to address the risk mitigation requirements and ensure continuity of care.

Using an all-hazards approach helps facilities consider and prepare for a variety of risks which may impact their healthcare settings. Facilities should categorize the various probable risks and hazards identified by likelihood of occurrence and further create supplemental risk assessments based on the disaster or public health emergency. For example:

•

For power loss and potential disruptions of services: Facilities can consider using a heat index or heat risk assessment to identify situations which present concerns related to resident care and safety. Facilities are required to maintain safe temperatures under (b) policies and procedures (see Tag E-0015); therefore, a heat risk assessment can be considered as an additional risk assessment, but is not required. Facilities may find it helpful to refer to ASPR TRACIE for the Natural Disasters Topic Collection at https://asprtracie.hhs.gov/technical- resources/36/natural-disasters/27.

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NOTE: In situations where the facility does not own the structure(s) where care is provided, it is the facility’s responsibility to discuss emergency preparedness concerns with the landlord to ensure continuation of care if the structure of the and its utilities are impacted.

•

For public health emergencies, such as EIDs or pandemics: Facilities should consider risk assessments to include the needs of the resident population they serve in relation to a communicable or emerging infectious disease outbreak. Planning should include a process to evaluate the facility’s needs based on the specific characteristics of an EID that includes, but is not limited to: o Influx in need for PPE; o Considerations for screening patients and visitors; which may also include testing considerations for staff, visitors and patients for infectious diseases; o Transfers and discharges of patients; o Home-based healthcare settings; o Physical Environment, including but not limited to changes needed for distancing, isolation, or capacity/surge.

Planning for Staffing in Emergencies: Facilities must develop strategies for addressing emergency events that were identified during the development of the facility- and community-based risk assessments.

Examples of these strategies may include, but are not limited to, developing a staffing strategy if staff shortages were identified during the risk assessment or developing a surge capacity strategy if the facility has identified it would likely be requested to accept additional patients during an emergency. Facilities will also want to consider evacuation plans. For example, a facility in a large metropolitan city may plan to utilize the support of other large community facilities as alternate care sites for its patients if the facility needs to be evacuated. The facility is also expected to have a backup evacuation plan for instances in which nearby facilities are also affected by the emergency and are unable to receive patients.

Additional Specific Requirements for LTC For LTC facilities, written plans and the procedures are required to also include missing residents and clients, respectively, within their emergency plans.

SURVEY PROCEDURES (E0006) 1. Ask to see the written documentation of the facility’s risk assessments and associated strategies.

2. Interview the facility leadership and ask which hazards (e.g., natural, man-made, facility, geographic) were included in the facility’s risk assessment, why they were included and how the risk assessment was conducted.

3. Verify the risk-assessment is facility-based and community-based, and based on an all-hazards approach specific to the geographic location of the facility and encompasses potential hazards, such as EIDs. Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 11

NOTE: Surveyors are not expected to analyze a facility’s risk assessment to determine whether the identified risks are appropriate. Surveyors may take into consideration the geographic location and review the remaining standards to determine that the facility has addressed the hazards within their risk assessment through their policies and procedures.

However, the intent is that surveyors review the risk assessments to determine if the facility has a risk assessment which is facility-based and also community-based. The facility’s risk assessment should describe a process facilities use to assess and document potential hazards that are likely to impact their geographical region, community, facility and resident population. The ranking of priority of the hazards and the format of the risk assessment is at the discretion and expertise of the facility.

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E 0007 EP Addresses Resident/Client Population

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REGULATORY TEXT (E0007) Emergency Plan. The LTC facility must develop and maintain an emergency preparedness plan that must be reviewed, and updated at least annually. The plan must do all of the following: •

Address resident population, including, but not limited to, persons at-risk; the type of services the LTC facility has the ability to provide in an emergency; and continuity of operations, including delegations of authority and succession plans.

INTERPRETIVE GUIDELINES (E0007) Resident Population The emergency plan must specify the population served within the facility, such as inpatients and/or outpatients, and their unique vulnerabilities in the event of an emergency or disaster. A facility’s emergency plan must also address persons at-risk. As defined by the Pandemic and All-Hazards Preparedness Act (PAHPA) of 2006, members of at-risk populations may have additional needs in one or more of the following functional areas: maintaining independence, communication, transportation, supervision, and medical care.

In addition to those individuals specifically recognized as at-risk in the PAHPA (children, senior citizens, and pregnant women), “at-risk populations” are also individuals who may need additional response assistance including those who have disabilities, live in institutionalized settings, are from diverse cultures and racial and ethnic backgrounds, have limited English proficiency or are non- English speaking, lack transportation, have chronic medical disorders, or have pharmacological dependency. At-risk populations would also include, but are not limited to, the elderly, persons in hospitals and nursing homes, people with physical and mental disabilities as well as others with access and functional needs, and infants and children. At-risk populations, in the event of emerging infectious diseases and communicable diseases, may also include older adults and people of any age with underlying medical conditions or who are immunocompromised, in which exposure may place them at higher risk for severe illnesses.

Mobility and Transfer Mobility is an important part in effective and timely evacuations, and therefore facilities are expected to properly plan to identify patients who would require additional assistance, ensure that means for transport are accessible and available and that those involved in transport, as well as the patients and residents are made aware of the procedures to evacuate.

The plan should also address ways the facility will address identified resident needs that can’t be addressed by in house services in an emergency, such as just in time contracts or emergency transfers. Ultimately, the delegations of authority and succession plans need to include plans on how the facility ensures resident safety is protected and patients will receive care at the facility or if transferred, under what circumstances transfers will occur.

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Surge and Staffing The emergency plan must also address the types of services that the facility would be able to provide in an emergency. The emergency plan must identify which staff would assume specific roles in another’s absence through succession planning and delegations of authority. Succession planning is a process for identifying and developing internal people with the potential to fill key business leadership positions in the company. Succession planning increases the availability of experienced and capable employees that are prepared to assume these roles as they become available. During times of emergency, facilities must have employees who are capable of assuming various critical roles in the event that current staff and leadership are not available. At a minimum, there should be a qualified person who "is authorized in writing to act in the absence of the administrator or person legally responsible for the operations of the facility."

This does not mean that the facility must have documentation which lists each role and the designee for those roles within the same policy. Facilities may have a general plan which outlines the roles and responsibilities of the different individuals (e.g., incident commander, public information officer, resident liaison, etc.) and refers to those individuals by their titles.

For example, a Facility Incident Commander may be the Facility Administrator. Also, an Emergency Department Charge Nurse of the Day may be the facility’s identified person as the Safety Officer. However, if the facility chooses to follow this process without individual name identification, the individual serving in the role during the time of the survey should be able to adequately describe their role and responsibility during an emergency.

The emergency plan should also include ways the facility will respond to identified resident needs that cannot be addressed by in-house services in an emergency, such as use of just-in-time contracts or emergency transfers. As discussed under E-0001, CMS recognizes the variability in terminology in continuity of operations, business continuity, and other terms used by the emergency management industry. The intent behind this requirement is to ensure continuity of operations, including emergency preparedness succession planning, ultimately to ensure the facility has plans in place to continue functioning during an emergency and provide care in a safe setting, which may require some/all evacuations.

Ultimately, the delegations of authority and succession plans, which are different from the “continuity” plans, are documented plans which outline the specific individuals and alternate/successors who can activate the facilities emergency plans to ensure resident safety is protected and patients will receive care at the facility or if transferred, under what circumstances transfers will occur.

General Considerations In addition to the facility- and community-based risk assessment, continuity of operations planning generally considers elements such as: essential personnel, essential functions, critical resources, vital records and IT data protection, alternate facility identification and location, and financial resources. Facilities are encouraged to refer to and utilize resources from various agencies such as FEMA and Assistant Secretary for Preparedness and Response (ASPR) when developing strategies for ensuring continuity of operations.

Facilities are encouraged to refer to and utilize resources from various agencies such as FEMA and ASPR when developing strategies for ensuring continuity of operations.

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SURVEY PROCEDURES (E0007) Interview leadership and ask them to describe the following: 1. The facility’s resident populations that would be at risk during an emergency event; 2. Strategies the facility has put in place to address the needs of at-risk or vulnerable resident populations; 3. Services that the facility would be able to provide during an emergency and any plans to address services needed that cannot be provided by the facility during an emergency as part of continuity of operations and services; 4. How the facility plans to continue operations during an emergency; 5. Delegations of authority and succession plans.

Verify that all of the above are included in the written emergency plan.

If the facility has delegations and succession plans which identifies roles and responsibilities over individual facility staff names (e.g., Safety Officer = Emergency Department Charge Nurse or Pharmacy Department Lead), identify the individual who would be designated in one of the roles and interview the individual asking them to describe their role based on the facility’s emergency program.

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Met □ Unmet □

E 0009 Process for EP Collaboration REGULATORY TEXT (E0009) Emergency Plan. The plan must do the following: •

Include a process for cooperation and collaboration with local, tribal, regional, State, and Federal emergency preparedness officials' efforts to maintain an integrated response during a disaster or emergency situation.

INTERPRETIVE GUIDELINES (E0009) Cooperation and Collaboration While the responsibility for ensuring a coordinated disaster preparedness response lies upon the state and local emergency planning authorities, the facility must have a process to engage in collaborative planning for an integrated emergency response. The facility must include this integrated response process in its emergency plan. Facilities are encouraged to participate in a healthcare coalition as it may provide assistance in planning and addressing broader community needs that may also be supported by local health department and emergency management resources. While every detail of the cooperation and collaboration process is not required to be documented in writing, it is expected that the facility has documented sufficient details to support verification of the process.

When deciding on ways to meet public health emergency needs in their community, facilities are expected to engage and coordinate with their local healthcare systems (including any emergency-related Alternate Care Sites), and their local and state health departments, and federal agency staff and also encouraged to engage with their healthcare coalitions, as applicable. Facility awareness of the state’s emergency preparedness programs and pandemic plan ensures coordination occurs with the community. Coordination should be pre-planned and facility management should know the state and local emergency contacts (further defined within a facilities communication plan).

SURVEY PROCEDURES (E0009) 1. Interview facility leadership and ask them to describe their process for ensuring cooperation and collaboration with local, tribal, regional, State, and Federal emergency preparedness officials' efforts to ensure an integrated response during a disaster or emergency situation.

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E 0013 Development of EP Policies and Procedures

Met □ Unmet □

REGULATORY TEXT (E0013) Policies and procedures.

Facilities must develop and implement emergency preparedness policies and procedures, based on the emergency plan, risk assessment, and the communication plan. The policies and procedures must be reviewed and updated at least annually.

INTERPRETIVE GUIDELINES (E0013) Facilities must develop and implement policies and procedures per the requirements of this standard. The policies and procedures are expected to align with the identified hazards within the facility’s risk assessment and the facility’s overall emergency preparedness program. CMS also recommends that facilities include strategies and succession planning, as well as contingencies which support their response to any disaster or public health emergency (also see requirements at E-0024).

Facilities should also consider updates to their emergency preparedness policies and procedures during a disaster, including planning for an emergency event with a duration longer than expected. For instance, during public health emergencies such as pandemics, the Centers for Disease Control and Prevention (CDC) and other public health agencies may issue event-specific guidance and recommendations to healthcare workers. Facilities should ensure their programs have policies in place to update or provide additional emergency preparedness procedures to staff. This may include a policy delegating an individual to monitor guidance by public health agencies and issuing directives and recommendations to staff such as use of PPE when entering the building; isolation of patients under investigation (PUIs); and, any other applicable guidance in a public health emergency.

CMS does not specify where the facility must have the emergency preparedness policies and procedures. A facility may choose whether to incorporate the emergency policies and procedures within their emergency plan or to be part of the facility’s Standard Operating Procedures or Operating Manual. CMS does not specify the type of documentation- i.e., hard copy, electronic or other system-based emergency plans. However, the facility must be able to demonstrate compliance upon survey, therefore CMS recommends that facilities have a central place to house the emergency preparedness program documents (to include all policies and procedures) to facilitate review. Furthermore, since the format of the documentation is at the discretion of the facility, surveyors can identify a facility’s reviews and updates of the emergency program through meeting minutes ( facilities need to be clear if the entire program or any specific policy was reviewed and updated); through electronic or hard copy signatures on the table of contents of the emergency program documentation; or another manner. Facilities should clearly document the date of review and update and what the update entailed.

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Review the written policies and procedures which address the facility’s emergency plan and verify the following: 1. Policies and procedures were developed based on the facility- and communitybased risk assessment and communication plan, utilizing an all-hazards approach.

2. Ask to see documentation that verifies the policies and procedures have been reviewed and updated on an annual basis. Format is at the discretion of the facility.

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E 0015 Subsistence needs for staff and patients

Met □ Unmet □

REGULATORY TEXT (E0015) Policies and procedures.

Facilities must develop and implement emergency preparedness policies and procedures, based on the emergency plan, risk assessment, and the communication plan. The policies and procedures must be reviewed and updated annually for LTC facilities.

At a minimum, the policies and procedures must address the following: The provision of subsistence needs for staff and patients whether they evacuate or shelter in place, include, but are not limited to the following: • Food • Water • Medical supplies • Pharmaceutical supplies • Alternate sources of energy to maintain the following: o Temperatures to protect resident health and safety and for the safe and sanitary storage of provisions. o Emergency lighting. o Fire detection, extinguishing, and alarm systems.

• Sewage and waste disposal.

INTERPRETIVE GUIDELINES (E0015) Facilities must be able to provide for adequate subsistence for all patients and staff for the duration of an emergency or until all its patients have been evacuated and its operations cease. Facilities have flexibility in identifying their individual subsistence needs that would be required during an emergency.

Provisions There are no requirements or standards establishing a set amount of provisions to be provided in facilities. However, some states laws or accrediting organization requirements do specify a set amount or duration of subsistence items to have on hand, therefore facilities should check with their state agencies and accrediting organizations to determine if any additional requirements exist. Facilities also are required to continue to meet existing health and safety standards, such as physical environment at §482.41(a)(1) for hospitals, which address requirements like the emergency power and lighting in at least the operating, recovery, intensive care, and emergency rooms, and stairwells. In all other areas not serviced by the emergency supply source, battery lamps and flashlights must be available.

Provisions include, but are not limited to, food, pharmaceuticals and medical supplies.

Provisions should be stored in an area which is less likely to be affected by disaster, such as storing these resources above ground-level to protect from possible flooding.

Additionally, when inpatient facilities determine their supply needs, they are expected to consider the possibility that volunteers, visitors, and individuals from the community may arrive at the facility to offer assistance or seek shelter. Inpatient providers must ensure that Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 19

they have policies and procedures that address food, water, medical/pharmaceutical needs for both staff and patients during an emergency, regardless of whether they evacuate or not.

Evacuation efforts may be delayed, therefore facilities affected by this provision should account for resident and staff needs leading up to or during an evacuation.

Alternate Energy Sources & Temperatures It is up to each individual facility, based on its risk assessment, to determine the most appropriate alternate energy sources to maintain temperatures to protect resident health and safety and for the safe and sanitary storage of provisions, emergency lighting, fire detection, extinguishing, and alarm systems, and sewage and waste disposal and continuity of treatments.

Facilities are not required to upgrade their alternate energy source or electrical systems, but after review of their risk assessment may find it prudent to make modifications.

Regardless of the alternate sources of energy a facility chooses to utilize, it must be in accordance with local and state laws, manufacturer requirements, as well as applicable LSC requirements.

Facilities must establish policies and procedures that determine how required heating and cooling of their facility will be maintained during an emergency situation, as necessary, if there were a loss of the primary power source. Facilities are not required to heat and cool the entire building evenly, but must ensure safe temperatures are maintained in those areas deemed necessary to protect patients, other people who are in the facility, and for provisions stored in the facility during the course of an emergency, as determined by the facility risk assessment. If unable to meet the temperature needs, a facility should have a relocation/evacuation plan (that may include internal relocation, relocation to other buildings on the campus or full evacuation). The relocation/evacuation should take place in a timely manner so as not to expose patients and residents to unsafe temperatures.

Note: For Nursing Homes who were initially certified after October 1, 2990, there are additional requirements to maintain a temperature range of 71 (min) to 81 (max) degrees F. Facilities should include their Medicare [and Medicaid, as applicable] certification date[s] in the front of their plan.

If used, portable generators should be connected to a facility’s electrical circuits via a power transfer system, as recommended by the generators’ manufacturer. A power transfer system typically consists of a transfer switch, generator power cord and power inlet box in accordance with manufacturer instructions and NFPA 70, Article 400.8, individual extension cords should not be run from portable generator outlet receptacles to electrical appliances.

If a facility’s risk assessment determines the best way to maintain temperatures, emergency lighting, fire detection and extinguishing systems and sewage and waste disposal would be through the use of a portable and mobile generator, rather than a permanent generator, then the LSC provisions such as generator testing, maintenance, etc. outlined under the NFPA guidelines requirements would not be applicable, except for NFPA 70 - National Electrical Code.

Per NFPA 70, portable and mobile generators should: • Have all wiring to each unit installed in accordance with the requirements of any of the wiring methods in Chapter 3.

• Be designed and located to minimize the hazards that might cause complete failure Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 20

• • •

due to flooding, fires, icing, and vandalism.

Be located so that adequate ventilation is provided. Typically, this may be accomplished by locating a portable or mobile generator outside of the building.

Be located or protected so that sparks cannot reach adjacent combustible material.

Be operated, tested and maintained in accordance with manufacturer, local and/or State requirements.

For requirements regarding permanently installed generators, please refer to applicable NFPA Codes and Standards. If a health surveyor is unclear whether the facility is complying with the alternate sources of energy and temperature requirements, the health surveyor must consult with their LSC surveyors.

Extension cords or other temporary wiring devices may not be used to connect electrical equipment in the facility to a portable and mobile generator due to the potential for shock, fire, and tripping hazards when using such devices. For portable generators, they must be connected and provide emergency power to a facility’s electrical system circuits via a power transfer system as recommended by the generator manufacturer. A power transfer system typically consists of a generator power supply cord, power inlet box mounted outside, and transfer switch connected to the facility electrical panel.

The type of protection needed for the fuel stored by the facility for use by the portable and mobile generator will depend on the amount of fuel stored and the location of the storage, as per the appropriate NFPA standard.

If a facility has a permanent generator to maintain emergency power, LSC and NFPA 110 provisions such as generator location, testing, fuel storage and maintenance, etc. will apply and the facility may be subject to LSC surveys to ensure compliance is met. Please also refer to Tag E0041 Emergency and Standby Power Systems for additional requirements for LTC facilities, CAHs and Hospitals.

As an example, some facilities have contracted services with companies who maintain portable emergency generators for the facilities off-site. In the event of an emergency where the facility is unable to reschedule patients or evacuate, the generators are brought to the location in advance to assist in the event of loss of power. Facilities which are not specifically required by the EP Final Rule to have a generator, but are required to meet the provision for alternate sources of energy, may consider this approach for their facility.

Sewage and Waste Disposal Facilities are not required to provide onsite treatment of sewage or waste, but must make provisions for maintaining necessary services.

Additionally, CMS would expect facilities under this requirement to ensure current practices are followed, such as those outlined by the Environmental Protection Agency (EPA) and under State-specific laws. Maintaining necessary services may include, but are not limited to, access to medical gases; treatment of soiled linens; disposal of bio- hazard materials for different infectious diseases; and may require additional assistance from transportation companies for safe and appropriate disposal in accordance with nationally accepted industry guidelines for emergency preparedness.

Additional General Guidance Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 21

As part of the cooperation and collaboration with emergency preparedness officials, facilities should also confer with health department and emergency management officials, to determine the types and duration of energy sources that could be available to assist them in providing care to their resident population during an emergency. As part of the risk assessment planning, facilities should determine the feasibility of relying on these sources and plan accordingly.

SURVEY PROCEDURES (E0015) 1. Verify the emergency plan includes policies and procedures for the provision of subsistence needs including, but not limited to, food, water and pharmaceutical supplies for patients and staff by reviewing the plan.

2. Verify the emergency plan includes policies and procedures to ensure adequate alternate energy sources necessary to maintain: o Temperatures to protect resident health and safety and for the safe and sanitary storage of provisions; o Emergency lighting; and, o Fire detection, extinguishing, and alarm systems.

3. Verify the emergency plan includes policies and procedures to provide for sewage and waste disposal.

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E 0018 Procedures for Tracking of Staff and Patients

Met □ Unmet □

REGULATORY TEXT (E0018) Facilities must develop and implement emergency preparedness policies and procedures, based on the emergency plan, risk assessment, and the communication plan. The policies and procedures must be reviewed and updated annually for LTC facilities.

At a minimum, the policies and procedures must address the following: •

A system to track the location of on-duty staff and sheltered residents in the facility’s care during an emergency. If on-duty staff and sheltered residents are relocated during the emergency, the facility must document the specific name and location of the receiving facility or other location.

INTERPRETIVE GUIDELINES (E0018) Facilities must develop a means to track patients and on-duty staff in the facility’s care during an emergency event. In the event staff and patients are relocated, the facility must document the specific name and location of the receiving facility or other location for sheltered patients and on-duty staff who leave the facility during the emergency.

LTC facilities are required to track the location of sheltered patients and staff during and after an emergency.

CMS does not specify which type of tracking system should be used; rather, a facility has the flexibility to determine how best to track patients and staff, whether it uses an electronic database, hard copy documentation, or some other method. However, it is important that the information be readily available, accurate, and shareable among officials within and across the emergency response systems as needed in the interest of the resident. It is recommended that a facility that is using an electronic database consider backing up its computer system with a secondary source, such as hard copy documentation in the event of power outages. The tracking systems set up by facilities may want to consider who is responsible for compiling/securing resident records and what information is needed during tracking a resident throughout an evacuation. A number of states already have such tracking systems in place or under development and the systems are available for use by health care providers and suppliers. Additionally, tracking of staff can often be more challenging based on the mechanism used for signing in and out for payment of staff based on hours worked, especially in the event of a power failure. Facilities can consider implementing a staff tracking system such as designating an area or protocol to check in with a designated person(s) during the emergency.

Facilities are encouraged to leverage the support and resources available to them through local and national healthcare systems, healthcare coalitions, and healthcare organizations for resources and tools for tracking patients. While collaboration with healthcare coalitions is encouraged, it is not a requirement. Though the precise details of the actual collaboration with state and local emergency officials is not required to be documented, it is expected that sufficient information is documented to support verification of the process as part of the investigation.

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Facilities are not required to track the location of patients who have voluntarily left on their own, or have been appropriately discharged, since they are no longer in the facility’s care.

However, this information must be documented in the resident’s medical record should any questions later arise as to the resident’s whereabouts.

CMS also recommend facilities ensure they follow their evacuation procedures as outlined under this section during disasters and emergencies. Facilities are required follow all state/local mandates or requirements under most CoPs/CfCs. If your local community, region, or state declares a state of emergency and is requiring a mandatory evacuation of the area, facilities should abide by these laws and mandates.

SURVEY PROCEDURES (E0018) 1. Ask staff to describe and/or demonstrate the tracking system used to document locations of residents and staff.

2. Verify that the tracking system is documented as part of the facilities’ emergency plan policies and procedures

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E 0020 Policies and Procedures including Evacuation

Met □ Unmet □

REGULATORY TEXT (E0020) Facilities must develop and implement emergency preparedness policies and procedures, based on the emergency plan, risk assessment, and the communication plan. The policies and procedures must be reviewed and updated annually for LTC facilities.

At a minimum, the policies and procedures must address the following: •

Safe evacuation from the facility, which includes consideration of care and treatment needs of evacuees; staff responsibilities; transportation; identification of evacuation location(s); and primary and alternate means of communication with external sources of assistance.

INTERPRETIVE GUIDELINES (E00020) Evacuations and Resident Population Considerations Facilities must develop policies and procedures that provide for the safe evacuation of patients from the facility and include all of the requirements of this standard.

Facilities must have policies and procedures which address the needs of evacuees. The facility should also consider in development of the policies and procedures, the evacuation protocols for not only the evacuees, but also staff members and families/resident representatives or other personnel who sought potential refuge at the facility. Additionally, the policies and procedures must address staff responsibilities during evacuations. Facilities must consider the resident population needs as well as their care and treatment. For example, if an evacuation is in progress and the facility must evacuate, leadership should consider the needs for critically ill patients to be evacuated and accompanied by staff who could provide care and treatment enroute to the designated relocation site, in the event trained medical professionals are unavailable by the transportation services.

Triaging Considerations Facilities must consider in their development of policies and procedures, the needs of their resident population and what designated transportation services would be most appropriate.

For instance, if a facility primarily cares for critically ill patients with ventilation needs and lifesaving equipment, the transportation services should be able to assist in evacuation of this special population and be equipped to do so. Additionally, facilities may also find it prudent to consider alternative methods for evacuation and resident care and treatment, such as mentioned above to have staff members evacuate with patients in given situations.

Additionally, facilities should consider their triaging system when coordinating the tracking and potential evacuation of residents. For instance, a triaging system for evacuation may consider the most critical patients first followed by those less critical and dependent on lifesaving equipment. Considerations for prioritization may be based on, among other things, acuity, mobility status (stretch- bound/wheelchair/ambulatory), and location of the unit, availability of a known transfer destination or some combination thereof. Included within this Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 25

system should be who (specifically) will be tasked with making triage decisions. Following the triaging system, staff should consider the communication of resident care requirements to the in-taking facility, such as attaching hard copy of standard abbreviated resident health condition/history, injuries, allergies, and treatment rendered. On the same method for communicating this information, a facility could consider color coordination of triage level (i.e., green folder with this information is for less critical patients; red folders for critical and urgent evacuated patients, etc.). Additionally, this hard copy could include family member/representative contact information.

Resident safety should be the number one priority and it is expected that facilities provide care in a safe setting, therefore any existing guidance on resident rights and safe setting should be continued. It would be prudent for facilities to consider how they would address a situation where a resident refuses to evacuate, therefore leaving a resident in an unsafe environment is not acceptable.

The facilities policies and procedures must outline primary and alternate means for communication with external sources for assistance. For instance, primary methods may be via regular telephone services to contact transportation companies for evacuation or reporting evacuation needs to emergency officials; whereas alternate means account for loss of power or telephone services in the local area. In this event, alternate means may include satellite phones for contacting evacuation assistance.

Triage and coordination of evacuation requires planning and communication of plans within the facility and with entities that assist in providing services such as transportation and lifesaving equipment.

SURVEY PROCEDURES (E0020) 1. Review the emergency plan to verify it includes policies and procedures for safe evacuation from the facility and that it includes all of the required elements.

2. Ask staff to describe how they would handle a situation in which a resident refused to evacuate.

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E 0022 Policies and Procedures including Shelter in Place

Met □ Unmet □

REGULATORY TEXT (E0022) Facilities must develop and implement emergency preparedness policies and procedures, based on the emergency plan, risk assessment, and the communication plan. The policies and procedures must be reviewed and updated annually for LTC facilities.

At a minimum, the policies and procedures must address the following: •

A means to shelter in place for patients, staff, and volunteers who remain in the facility.

INTERPRETIVE GUIDELINES (E0022) Emergency plans must include a means for sheltering all patients, staff, and volunteers who remain in the facility in the event that an evacuation cannot be executed. In certain disaster situations (such as tornadoes) , sheltering in place may be more appropriate as opposed to evacuation and would require a facility to have a means to shelter in place for such emergencies. Therefore, facilities are required to have policies and procedures for sheltering in place which align with the facility’s risk assessment.

Facilities are expected to include in their policies and procedures the criteria for determining which patients and staff would be sheltered in place. When developing policies and procedures for sheltering in place, facilities should consider the ability of their building(s) to survive a disaster and what proactive steps they could take prior to an emergency to facilitate sheltering in place or transferring of patients to alternate settings if their facilities were affected by the emergency. For example, if it is dangerous to evacuate or the emergency affects available sites for transfer or discharge, then the patients would remain in the facility until it was safe to effectuate transfers or discharges. The plan should take into account the appropriate facilities in the community to which patients could be transferred in the event of an emergency. Facilities must determine their policies based on the type of emergency and the types of patients, staff, volunteers and visitors that may be present during an emergency. Based on its emergency plan, a facility could decide to have various approaches to sheltering some or all of its patients and staff.

SURVEY PROCEDURES (E0022) 1. Verify the emergency plan includes policies and procedures for how it will provide a means to shelter in place for patients, staff and volunteers who remain in a facility.

2. Review the policies and procedures for sheltering in place and evaluate if they e facility’s emergency plan and risk assessment.

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E 0023 Policies and Procedures - Documentation

Met □ Unmet □

REGULATORY TEXT (E0023) Facilities must develop and implement emergency preparedness policies and procedures, based on the emergency plan, risk assessment, and the communication plan. The policies and procedures must be reviewed and updated annually for LTC facilities.

At a minimum, the policies and procedures must address the following: •

A system of medical documentation that preserves resident information, protects confidentiality of resident information, and secures and maintains availability of records.

INTERPRETIVE GUIDELINES (E0023) In addition to any existing requirements for resident records found in existing laws, under this standard, facilities are required to ensure that resident records are secure and readily available to support continuity of care during an emergency. This requirement does not supersede or take away any requirements found under the provider/supplier’s medical records regulations, but rather, this standard adds to such regulations. These policies and procedures must also be in compliance with the Health Insurance Portability and Accountability Act (HIPAA), Privacy and Security Rules which protect the privacy and security of individual’s personal health information.

SURVEY PROCEDURES (E0023) 1. Ask to see a copy of the policies and procedures that documents the medical record documentation system the facility has developed to preserves resident information, protects confidentiality of resident information, and secures and maintains availability of records.

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E 0024 Policies and Procedures – Surge Planning & Use of Volunteers

Met □ Unmet □

REGULATORY TEXT (E0024) Facilities must develop and implement emergency preparedness policies and procedures, based on the emergency plan, risk assessment, and the communication plan. The policies and procedures must be reviewed and updated annually for LTC facilities.

At a minimum, the policies and procedures must address the following: •

The use of volunteers in an emergency or other emergency staffing strategies, including the process and role for integration of State and Federally designated health care professionals to address surge needs during an emergency.

INTERPRETIVE GUIDELINES (E0024) Surge Planning Emergencies, whether natural disasters, man-made disasters or infectious disease outbreaks, stress our healthcare systems through challenges with capacity and capability.

While it is not possible to predict every scenario which could result in surge situations, healthcare facilities must have policies and procedures which include emergency staffing strategies and plan for emergencies. These strategies encompass procedures to preserve the healthcare system while continuing to provide care for all patients, at the appropriate level (e.g., home-based care, outpatient, urgent care, emergency room, or hospitalization).

Facilities must have policies which address their ability to respond to a surge in patients. As required, these policies and procedures must be aligned with a facility’s risk assessment, and should include planning for EIDs. Concentrated efforts will be required to mobilize all aspects of the healthcare system to reduce transmission of disease, direct people to the right level of care, and decrease the burden on the healthcare system.

Surge Planning During Natural Disasters In most circumstances, staffing strategies and surge planning surrounding natural disasters, such as hurricanes, are generally event-specific and focus on evacuations, transfers, and staffing assistance from areas which are not impacted by the emergency.

Surge Planning for Infectious Diseases/Pandemics Infectious diseases may rise to the level of pandemic, causing severe impact on response and staffing strategies within the healthcare system. The primary goals in planning for infectious disease pandemics are to: • Reduce morbidity and mortality • Minimize disease transmission • Protect healthcare personnel Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 29

•

Preserve healthcare system functioning

Surge Planning Considerations Facilities are encouraged to consider development of policies and procedures that could be implemented during an emergency to reduce non-essential healthcare visits and slow surge within the facility, such as: • • • •

Instructing patients to use available advice lines, resident portals, and/or on-line selfassessment tools; Call options to speak to an office/clinic staff and identification of staff to conduct telephonic interactions with patients; Development of protocols so that staff can triage and assess patients quickly; Determine algorithms to identify which patients can be managed by telephone and advised to stay home, and which patients will need to be sent for emergency care or come to your facility.

NOTE: Facilities are required to have a risk assessment in accordance with E-0004, however CMS recommends that facilities also consider implications or evaluation of staffing needs. For instance, if a facility identifies a particular hazard, the facility should consider what staffing needs are required to ensure patients continue to receive care.

Volunteers-Medical and Non-Medical Facilities are expected to include in its emergency plan a method for contacting off-duty staff during an emergency and procedures to address other contingencies in the event staff are not able to report to duty which may include, but are not limited to, utilizing staff from other facilities and state or federally-designated health professionals.

While not required to use volunteers as part of their plans to supplement or increase staffing during an emergency, the facility must have policies and procedures to address plans for emergency staffing needs. This could include the types of healthcare professionals they would use to assist during an emergency.

If facilities use volunteers as part of their emergency staffing strategy, policies and procedures should clearly outline what type of volunteers would be accepted during an emergency and what role these volunteers might play. For example, a facility might decide to use Red Cross Volunteers to assist in directing incoming patients during a surge situation.

Emergency staffing strategy policies and procedures should outline how the facility would ensure healthcare professionals used for emergency staffing are credentialed, licensed (as applicable) or able to provide medical support within the facility in accordance with any state and federal laws.

Resources Facilities are recommended to review the tools available related to planning for surge.

ASPR TRACIE has developed multiple documents which could provide additional Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 30

assistance during the development of policies and procedures, which include but are not limited to https://asprtracie.s3.amazonaws.com/documents/aspr-tracie-considerationsforthe-use-of-temporary-care-locations-for-managing-seasonal-patient-surge.pdf

SURVEY PROCEDURES (E0024) 1. Ask facility leadership to explain their staffing strategies. Do they use volunteers? If, no volunteers are used, does the facility have other emergency staffing strategies?

2. Verify the facility has included policies and procedures for the use of volunteers and other emergency staffing strategies in its emergency plan.

3. Verify that the facility’s program includes a policy and procedure which addresses surge needs during an emergency.

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E 0025 Policies and Procedures – Arrangements with Other Facilities

Met □ Unmet □

REGULATORY TEXT (E0025) Facilities must develop and implement emergency preparedness policies and procedures, based on the emergency plan, risk assessment, and the communication plan. The policies and procedures must be reviewed and updated annually for LTC facilities.

At a minimum, the policies and procedures must address the following: •

The development of arrangements with other facilities and other providers to receive residents in the event of limitations or cessation of operations to maintain the continuity of services to facility residents.

INTERPRETIVE GUIDELINES (E0025) Facilities are required to have policies and procedures which include prearranged transfer agreements, which may include written agreements or contracted arrangements with other facilities and other providers to receive patients in the event of limitations or cessation of operations to maintain the continuity of services to facility patients. Facilities should consider all needed arrangements for the transfer of patients during an evacuation. For example, if a nursing home or assisted living is required to evacuate, policies and procedures should address what facilities are nearby and outside the area of disaster which could accept the facility’s patients. Additionally, the policies and procedures and facility agreements should include pre-arranged agreements for transportation between the facilities.

The arrangements should be in writing, such as Memorandums of Understanding (MOUs) and Transfer Agreements, in order to demonstrate compliance.

When developing transfer agreements, facilities should take into account the resident population and the ability for the receiving facility to provide continuity of services. For example, if facility X has a transfer arrangement with facility Y, however facility Y is not able to accommodate and provide continuity of care due to the nature of the emergency, lack of resources, etc., contingency plans should be implemented. Facility X should have to plan accordingly to have the resident receive services at another facility, not facility Y. For LTC facilities, the facility is also responsible for the tracking of residents, therefore any written arrangements should account for the resident population, number of patients and the ability for the receiving facility or facilities to continue care to the residents/patients.

Finally, as the regulation requires policies and procedures to be reviewed every year, facilities should also consider reviewing their developed arrangements on the same scheduled review timeframe to ensure the contract/agreement/MOU is still applicable and able to be fulfilled to provide continuity of care.

SURVEY PROCEDURES (E0025)

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1. Ask to see copies of the arrangements and/or any agreements the facility has with other facilities to receive patients in the event the facility is not able to care for them during an emergency.

2. Ask facility leadership to explain the arrangements in place for transportation in the event of an evacuation.

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Met □ Unmet □

E 0026 Policies and Procedures – 135 Waivers REGULATORY TEXT (E0026)

Facilities must develop and implement emergency preparedness policies and procedures, based on the emergency plan, risk assessment, and the communication plan. The policies and procedures must be reviewed and updated annually for LTC facilities.

At a minimum, the policies and procedures must address the following: •

The role of the facility under a waiver declared by the Secretary, in accordance with section 1135 of the Act, in the provision of care and treatment at an alternate care site identified by emergency management officials.

INTERPRETIVE GUIDELINES (E0026) General The facility’s emergency preparedness program must include policies and procedures which outline the facility’s role in the provision of care and treatment under section 1135 waivers during a declared public health emergency in alternate care sites. Facilities should also be aware of what flexibilities are available with or without an 1135 waiver.

Alternate Care Site (ACS) ACS is a broad term for any building or structure that is temporarily converted for healthcare use. An ACS is one of several alternate care strategies that can be used in a disaster. A facility’s individual ACS structure and process may include several different models and require different planning considerations based on the type of emergency.

Models for a facility’s ACS may be dependent on factors such as: emergency/disaster spread across a community; anticipated longevity of operating in the ACS setting; level of capacity the ACS can provide and how this correlates with the need for transfers and discharge, among many other considerations.

The requirement under the emergency program is that facilities must develop and implement policies and procedures which describe the facility’s role in providing care at an ACS during emergencies. It is expected that state or local emergency management officials might designate such ACS’s, and would plan jointly with local facilities on issues related to staffing, equipment and supplies at such alternate sites. This requirement encourages providers to collaborate with their local emergency officials in such proactive planning to allow an organized and systematic response to assure continuity of care even when services at their facilities have been severely disrupted.

Planning related to the development of an ACS is a proactive step to ensuring continuity of services. While the establishment and use of an ACS are generally acceptable only during an emergency and require CMS approval, the facility’s program must address the facility’s ability to provide care in an alternate setting. Considerations may include resident population, supplies, equipment, and staffing as well as physical environment.

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Planning considerations also include the capabilities of an ACS if authorized during a declared public health emergency.

Section 1135 Emergency Waiver Policies and procedures must specifically address the facility’s role in emergencies where the Secretary waives or modifies certain statutory and regulatory requirements for healthcare facilities in response to emergencies under section 1135 of the Act related to the provision of care at an alternate care site identified by emergency officials. The Secretary is authorized to issue a section 1135 waiver only when both the President declares a disaster or emergency under the Stafford Act or the National Emergencies Act, and the HHS Secretary declares a Public Health Emergency under section 319 of the Public Health Services Act. Examples of 1135 waivers issued during prior emergencies have included waivers of various CoPs and CfCs; Licensure for Physicians or others to provide services in the affected State; EMTALA requirements; and Medicare Advantage out of network providers and HIPAA. Facilities’ policies and procedures should address what coordination efforts are required during a declared emergency in which a waiver of federal requirements under section 1135 of the Act has been issued by the Secretary related to alternate care sites. For example, due to a mass casualty incident in a geographic location, the Secretary may waive federal licensure requirements for physicians in order for these individuals to assist at a specific facility where they do not normally practice. In such cases, the provider or supplier should have policies and procedures which address the responsibilities of these physicians during this waiver period. The policies may establish, for example, a lead person in charge for accountability and oversight of assisting physicians not usually under contract with the facility.

Waivers issued under section 1135 of the Act are time-limited, and only waive federal requirements, not state requirements under their licensure authority. The purpose of section 1135 waivers are to ensure that sufficient health care items and services are available to meet the needs of the individuals in such areas. They are also intended to ensure healthcare providers (defined in section 1135(g)(2) of the Act) that can furnish such items or services in good faith, but are unable to comply with federal requirements, are allowed reimbursement during an emergency or disaster even if providers can’t comply with certain requirements that would under normal circumstances bar Medicare, Medicaid or CHIP payment. Section 1135 waivers typically end no later than the termination of the emergency period, or 60 days from the date the waiver or modification is first published unless the Secretary of HHS extends the waiver by notice for additional periods of up to 60 days, up to the end of the emergency period.

Facilities should also have in place policies and procedures which address emergency situations in which a declaration was not made and where an 1135 waiver may not be applicable, such as during a disaster affecting the single facility. In this case, policies and procedures should address potential transfers of patients; timelines of patients at alternate facilities, etc. CMS would expect that state or local emergency management officials might designate such alternate sites, and would plan jointly with local facilities on issues related to staffing, equipment and supplies. This requirement encourages providers to collaborate with their local emergency officials in proactive planning to allow an organized and systematic response to assure continuity of care even when services at their facilities have Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 35

been severely disrupted. Health department and emergency management officials, in collaboration with facility staff, would be responsible for determining the need to establish an alternate care site as part of the delivery of care during an emergency. The alternate care site staff would be expected to function in the capacity of their individual licensure and best practice requirements and laws. Decisions regarding staff responsibilities would be determined based on the facility- and community based assessments and the type of services staff could provide (81 FR at 63882). These elements should be included in the facilities policy and procedure under this standard.

During emergencies such as a widespread pandemic, a PHE may continue for a longer period of time than initially anticipated. In the event a facility is operating under a Section 1135 Waiver, including a potential blanket waiver, facilities should also consider their policies and procedures related to the use of the waiver flexibility and timeframe.

While facilities are authorized to use a Section 1135 waiver during the duration of the PHE, in accordance with state emergency and pandemic plans, it may be prudent for facilities to consider how to continue operations when the 1135 Waiver has expired (end of the declared PHE) as facilities are expected to come back into full compliance at the end of the declared emergency. For instance, in the event a pandemic PHE or EID has decreased in a specific community (as generally outlined by CDC), the facility may no longer need the flexibility provided in an 1135 waiver. Therefore, the facility should consider not using or forgoing the waiver and ensuring it is back in substantial compliance with the specific requirement(s) waived even while the PHE may continue. The intent behind an 1135 waiver is to provide relief and flexibilities while the facility is directly impacted or challenged with meeting the Medicare requirement(s).

For additional information on 1135 waivers and process for submission please visit the Quality, Safety & Oversight Group Emergency Preparedness Website https://www.cms.gov/Medicare/Provider-Enrollment-andCertification/SurveyCertEmergPrep/1135-Waivers . CMS also recommends providers and suppliers review the ACS Toolkit developed by ASPR which can be found at: https://files.asprtracie.hhs.gov/documents/acs-toolkit-ed1-20200330-1022.pdf.

NOTE: This policy and procedure requirement does not require a facility to have an 1135 waiver on hand at the time of the survey as such waivers are established or granted by CMS only during a declared emergency period. Section 1135 waivers by nature are time limited.

SURVEY PROCEDURES (E0026) 1. Verify the facility has included policies and procedures in its emergency plan describing the facility’s role in providing care and treatment at alternate care sites under an 1135 waiver.

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E 0029 Policies and Procedures – Communication Plan

Met □ Unmet □

REGULATORY TEXT (E0029) The facility must develop and maintain an emergency preparedness communication plan that complies with Federal, State, and local laws and must be reviewed and updated annually.

INTERPRETIVE GUIDELINES (E0029) Facilities must have a written emergency communication plan that contains how the facility coordinates resident care within the facility, across healthcare providers, and with state and local public health departments. The communication plan should include how the facility interacts and coordinates with emergency management agencies and systems to protect resident health and safety in the event of a disaster. The development of a communication plan will support the coordination of care. The plan must be reviewed annually and updated as necessary. CMS is allowing facilities flexibility in how they formulate and operationalize the requirements of the communication plan. Although the requirement for documentation of collaboration with state and local officials was removed (see 84 FR 51817, Sept. 30, 2019), facilities should continue to collaborate with state and local emergency officials. During the creation process for communication plans, facilities should also consult their applicable state and local emergency and pandemic plans.

Facilities in rural or remote areas with limited connectivity to communication methodologies such as the Internet, World Wide Web, or cellular capabilities need to ensure their communication plan addresses how they would communicate and comply with this requirement in the absence of these communication methodologies. For example, if a facility is located in a rural area, which has limited or no Internet and phone connectivity during an emergency, it should address what alternate means are available to alert local and State emergency officials. Optional communication methods facilities may consider include satellite phones, radios and short wave radios.

SURVEY PROCEDURES (E0029) 1. Verify that the facility has a written communication plan by asking to see the plan.

2. Ask to see evidence that the plan has been reviewed (and updated as necessary) at least annually.

3. Ask facility leadership or the designee responsible for the emergency program to verbally explain how they are to collaborate with Federal, State and local officials to ensure their communication plan complies with the Federal, State and local requirements.

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E 0030 Policies and Procedures – Communication Plan Details

Met □ Unmet □

REGULATORY TEXT (E0030) The communication plan must include all of the following: Names and contact information for the following: 1.

2.

3.

4.

5.

Staff.

Entities providing services under arrangement.

Patients' physicians.

Other facilities.

Volunteers.

INTERPRETIVE GUIDELINES (E0030) A facility must have the contact information for those individuals and entities outlined within the standard. The requirement to have contact information for “other facilities” requires a provider or supplier to have the contact information for another provider or supplier of the same type as itself. For instance, hospitals should have contact information for other hospitals and CORFs should have contact information for other CORFs, etc. While not required, facilities may also find it prudent to have contact information for other facilities not of the same type. For instance, a hospital may find it appropriate to have the contact information of LTC facilities within a reasonable geographic area, which could assist in facilitating resident transfers. Facilities have discretion in the formatting of this information, however it should be readily available and accessible to leadership, at a minimum, to the individual(s) designated as the emergency preparedness coordinator or person(s) responsible for the facility’s emergency preparedness program and management during an emergency event, during an emergency event.

Facilities which utilize electronic data storage should be able to provide evidence of data back-up with hard copies or demonstrate capability to reproduce contact lists or access this data during emergencies. All contact information must be reviewed and updated as necessary at least annually. Contact information contained in the communication plan must be accurate and current. Facilities must update contact information for incoming new staff and departing staff throughout the year and any other changes to information for those individuals and entities on the contact list.

SURVEY PROCEDURES (E0030) 1. Verify that all required contacts are included in the communication plan by asking to see a list of the contacts with their contact information.

2. Verify that all contact information has been reviewed and updated at least annually for LTC facilities) by asking to see evidence of the review.

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E 0031 Policies and Procedures – Communication Plan Contacts

Met □ Unmet □

REGULATORY TEXT (E0031) The communication plan must include all of the following: Contact information for the following: 1.

2.

3.

4.

Federal, State, tribal, regional, and local emergency preparedness staff.

The State Licensing and Certification Agency.

The Minnesota Office of Ombudsman for Long-Term Care.

Other sources of assistance.

INTERPRETIVE GUIDELINES (E0031) A facility must have the contact information for those individuals and entities outlined within the standard. Emergency management officials may include, but are not limited to, emergency management agencies which may be local to the community as well as local officials who support the Incident Command System depending on the nature of the disaster (e.g., fire, police, public health, etc.). Additionally, emergency management officials also include the state public health departments and State Survey Agencies as well as federal emergency preparedness officials (FEMA, ASPR, DHS, CMS, etc.) and tribal emergency officials, as applicable.

Facilities have discretion in the formatting of this information; however, it should be readily available and accessible to leadership during an emergency event. Facilities are encouraged but not required to maintain these contact lists both in electronic format and hard-copy format in the event that network systems to retrieve electronic files are not accessible. All contact information must be reviewed and updated at least annually.

NOTE: Even though the communications plan must include contact information, it does not specifically require the facility to have an individual contact for emergency management agencies. For instance, a state emergency management agency may have a specific phone line or contact method and not a specific individual person.

SURVEY PROCEDURES (E0031) 1. Verify that all required contacts are included in the communication plan by asking to see a list of the contacts with their contact information.

2. Verify that the facility has contact information for the State Survey Agency and/or public health departments.

3. Verify that all contact information has been reviewed and updated at least annually by asking to see evidence of the review.

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E 0032 Policies and Procedures – Means of Communicating

Met □ Unmet □

REGULATORY TEXT (E0032) The communication plan must include all of the following: Primary and alternate means for communicating with the following: 1. Facility staff.

2. Federal, State, tribal, regional, and local emergency management agencies.

INTERPRETIVE GUIDELINES (E0032) Facilities are required to have primary and alternate means of communicating with staff, Federal, State, tribal, regional, and local emergency management agencies. Facilities have the discretion to utilize alternate communication systems that best meets their needs.

However, it is expected that facilities would consider pagers, cellular telephones, radio transceivers (that is, walkie-talkies), and various other radio devices such as the NOAA Weather Radio and Amateur Radio Operators’ (HAM Radio) systems, as well as satellite telephone communications systems. CMS recognizes that some facilities, especially in remote areas, may have difficulty using some communication systems, such as cellular phones, even in non-emergency situations, which should be outlined within their risk assessment and addressed within the communications plan. It is expected these facilities would address such challenges when establishing and maintaining a well-designed communication system that will function during an emergency.

The communication plan should include procedures regarding when and how alternate communication methods are used, and who uses them. In addition, the facility should ensure that its selected alternative means of communication is compatible with communication systems of other facilities, agencies and state and local officials it plans to communicate with during emergencies. For example, if State X local emergency officials use the SHAred RESources (SHARES) High Frequency (HF) Radio program and facility Y is trying to communicate with RACES, it may be prudent to consider if these two alternate communication systems can communicate on the same frequencies. Facilities should identify their primary and alternate means of communication in their emergency preparedness communication plan. For instance, a primary means of communication may be cellular phones, hard wire lines and the facilities intercom system, whereas the facilities alternate means (given interruption of primary means) may be the SHAred RESources.

Facilities may seek information about the National Communication System (NCS), which offers a wide range of National Security and Emergency Preparedness communications services, the Government Emergency Telecommunications Services (GETS), the Telecommunications Service Priority (TSP) Program, Wireless Priority Service (WPS), and SHARES. Other communication methods could include, but are not limited to, satellite phones, radio, and short wave radio. The Radio Amateur Civil Emergency Services (RACES) is an integral part of emergency management operations.

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SURVEY PROCEDURES (E0032) 1. Verify the communication plan includes primary and alternate means for communicating with facility staff, Federal, State, tribal, regional and local emergency management agencies by reviewing the communication plan.

2. Ask to see the communications equipment or communication systems listed in the plan.

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E 0033 Policies and Procedures – Communication Plan – Information Sharing Met □ Unmet □ REGULATORY TEXT (E0033) The communication plan must include all of the following: 1. A method for sharing information and medical documentation for residents under the facility's care, as necessary, with other health providers to maintain the continuity of care.

2. A means, in the event of an evacuation, to release resident information as permitted under 45 CFR 164.510(b)(1)(ii).

3. A means of providing information about the general condition and location of residents under the facility’s care as permitted under 45 CFR 164.510(b)(4).

INTERPRETIVE GUIDELINES (E0033) Facilities are required to develop a method for sharing information and medical documentation for patients under the facility's care, as necessary, with other health care providers to maintain continuity of care. Such a system must ensure that information necessary to provide resident care is sent with an evacuated resident to the next care provider and would also be readily available for patients being sheltered in place. While the regulation does not specify timelines for delivering resident care information, facilities are expected to provide resident care information to receiving facilities during an evacuation, within a timeframe that allows for effective resident treatment and continuity of care. Facilities should not delay resident transfers during an emergency to assemble all resident reports, tests, etc. to send with the resident. Facilities should send all necessary resident information that is readily available and should include at least, resident name, age, DOB, allergies, current medications, medical diagnoses, current reason for admission (if inpatient), blood type, advance directives and next of kin/emergency contacts. There is no specified means (such as paper or electronic) for how facilities are to share the required information.

Facilities are also required to have a means, in the event of an evacuation, to release resident information as permitted under 45 CFR 164.510 and a means of providing information about the general condition and location of patients under the facility's care as permitted under 45 CFR 164.510(b)(4). Thus, facilities must have a communication system in place capable of generating timely, accurate information that could be disseminated, as permitted under 45 CFR 164.510(b)(4), to family members and others. Facilities have the flexibility to develop and maintain their own system in a manner that best meets its needs.

HIPAA requirements are not suspended during a national or public health emergency.

However, the HIPAA Privacy Rule specifically permits certain uses and disclosures of protected health information in emergency circumstances and for disaster relief purposes.

Section 164.510 ‘‘Uses and disclosures requiring an opportunity for the individual to agree to or to object,’’ is part of the ‘‘Standards for Privacy of Individually Identifiable Health Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 42

Information,’’ commonly known as ‘‘The Privacy Rule.’’ HIPAA Privacy Regulations at 45 CFR 164.510(b)(4), ‘‘Use and disclosures for disaster relief purposes,’’ establishes requirements for disclosing resident information to a public or private entity authorized by law or by its charter to assist in disaster relief efforts for purposes of notifying family members, personal representatives, or certain others of the resident’s location or general condition.

SURVEY PROCEDURES (E0033) 1. Verify the communication plan includes a method for sharing information and medical documentation for patients under the facility's care, as necessary, with other health providers to maintain the continuity of care by reviewing the communication plan.

2. Verify the facility has developed policies and procedures that address the means the facility will use to release resident information to include the general condition and location of patients, by reviewing the communication plan.

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E 0034 Policies and Procedures – Communication Plan – Information Sharing Met □ Unmet □ REGULATORY TEXT (E0034) The communication plan must include all of the following: 1. A means of providing information about the facility’s occupancy, needs, and its ability to provide assistance, to the authority having jurisdiction, the Incident Command Center, or designee.

INTERPRETIVE GUIDELINES (E0034) Facilities must have a means of providing information about the facility’s needs and its ability to provide assistance to the authority having jurisdiction (local and State emergency management agencies, local and state public health departments, the Incident Command Center, the Emergency Operations Center, or designee).

Reporting of a Facility’s Needs Generally, in small community emergency disasters, reporting the facility’s needs will be coordinated through established processes to report directly to local and state emergency officials. Reporting needs may include but are not limited to: shortages in PPE; need to evacuate or transfer patients; requests for assistance in transport; temporarily loss of part or all facility function; and, staffing shortages.

In large scale emergency disasters or pandemics, reporting of needs specific to a facility may be altered by local, state and federal public health and emergency management officials due to the potential volume of requests. Some emergency management officials at all levels of governance may require facilities to report specific data or slow reporting to manage volume. It is recommended that facilities verify their reporting requirements with their local Incident Command Structures or State Agencies.

Dependent on the emergency event and the anticipated longevity, facilities may need to report select criteria such as in an EID outbreak or the number of patients’ positive or persons under investigation (PUI). The facility’s process should include monitoring by the facility’s emergency management coordinator or designee of reporting requirements issued by CMS or other agencies with jurisdiction. Additional monitoring and reporting may be required by local and state public health agencies due to contact tracing requirements for extended periods of time or for time specific intervals. Facilities should identify local and state policies for reporting and contract tracing to ensure they have appropriate information to address requirements.

Facilities should actively engage with their healthcare coalitions, associations, accrediting organizations and other stakeholders during the onset of any wide-spread emergency. As state and federal emergency organizations may become overwhelmed with requests, these stakeholders may be able to reconcile needs-requests for specific providers and suppliers.

In situations in which a Presidential Declaration and a Public Health Emergency (PHE) have Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 44

been declared, and Section 1135 Waivers may be granted, these stakeholders (healthcare coalitions, associations, accrediting organizations and others) may have the ability to request and streamline 1135 waiver requests for their members, dependent on the severity of the emergency.

Reporting of a Facility’s Ability to Provide Assistance During widespread disasters, reporting a facility’s ability to provide assistance is critical within a community. Pre-planning and collaborating with emergency officials before an emergency to determine what assistance may be necessary directly supports surge planning within a community. For instance, in preparation for a natural disaster such as a hurricane, pre-planning reporting criteria such as the facility’s response--e.g., closing the outpatient services in a forecasted natural disaster--may facilitate the Incident Command as they would be aware of the operating status of the facility. Reporting the ability to provide assistance would also include pre-planning with public health and emergency officials in the local community to make them aware of what capabilities are available within the specific facility, e.g., number of beds, critical care equipment, staffing, etc.

During widespread disasters, facilities may be required to report the following to local officials: • • • •

Ability to care for patients requiring transfer from different healthcare settings; Availability of PPE; Availability of staff who may be able to assist in a mass casualty incident; Availability of electricity-dependent medical and assistive equipment, such as ventilators and other oxygen equipment (BiPAP, CPAP, etc.), renal replacement therapy machines (e.g., home and facility-based hemodialysis, peritoneal dialysis, continuous renal replacement therapy and other machines, etc.), and wheelchairs and beds.

LTC facilities must have a means for providing information about their occupancy.

Occupancy reporting is considered, but not limited to, reporting the number of patients currently at the facility receiving treatment and care or the facility’s occupancy percentage.

The facility should consider how its occupancy affects its ability to provide assistance. For example, if the facility’s occupancy is close to 100% the facility may not be able to accept patients from nearby facilities. The types of “needs” a facility may have during an emergency and should communicate to the appropriate authority would include but is not limited to, shortage of provisions such as food, water, medical supplies, assistance with evacuation and transfers, etc.

NOTE: The authority having jurisdiction varies by local, state and federal emergency management structures as well as the type of disaster. For example, in the event of a multi-state wildfire, the jurisdictional authority who would take over the Incident Command Center or state-wide coordination of the disaster would likely be a fire-related agency.

CMS is not prescribing the means that facilities must use in disseminating the required information. However, facilities should include in its communication plan, a process to communicate the required information.

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NOTE: As defined by the Federal Emergency Management Administration (FEMA), an Incident Command System (ICS) is a management system designed to enable effective and efficient domestic incident management by integrating a combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure. (FEMA, 2016). The industry, as well as providers/suppliers, use various terms to refer to the same function and CMS has used the term ‘‘Incident Command Center’’ to mean ‘‘Emergency Operations Center’’ or ‘‘Incident Command Post.’’

Local, State, Tribal and Federal emergency preparedness officials, as well as regional healthcare coalitions, can assist facilities in the identification of their Incident Command Centers and reporting requirements dependent on an emergency.

SURVEY PROCEDURES (E0034) 1. Verify the communication plan includes a means of providing information about the facility’s needs, and its ability to provide assistance, to the authority having jurisdiction, the Incident Command Center, or designee by reviewing the communication plan.

2. Verify if the facility’s communication plan includes a means of providing information about their occupancy.

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E 0035 Policies and Procedures – Communication Plan – Information Sharing Met □ Unmet □ REGULATORY TEXT (E0035) The communication plan must include all of the following: •

A method for sharing information from the emergency plan, that the facility has determined is appropriate, with residents and their families or representatives.

INTERPRETIVE GUIDELINES (E0035) Facilities are required to share emergency preparedness plans and policies with their residents, family members, and resident representatives, respectively. Facilities have flexibility in deciding what information from the emergency plan should be shared, as well as the timing and manner in which it should be disseminated. While CMS is not requiring facilities take specific steps or utilize specific strategies to share this information with residents or clients and their families or representatives, CMS would recommend that facilities provide a quick “Fact Sheet” or informational brochure to the family members and resident or client representatives which may highlight the major sections of the emergency plan and policies and procedures deemed appropriate by the facility. Other options include providing instructions on how to contact the facility in the event of an emergency on the public website or to include the information as part of the facility’s check-in procedures. The facility may provide this information to the surveyor during the survey to demonstrate compliance with the requirement.

SURVEY PROCEDURES (E0035) 1. Ask staff to demonstrate the method the facility has developed for sharing the emergency plan with residents or clients and their families or representatives.

2. Interview residents or clients and their families or representatives and ask them if they have been given information regarding the facility’s emergency plan.

3. Verify the communication plan includes a method for sharing information from the emergency plan, with residents or clients and their families or representatives by reviewing the plan.

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Met □ Unmet □

E 0036 Training and Testing Program REGULATORY TEXT (E0036)

The LTC facility must develop and maintain an emergency preparedness training and testing program that is based on the emergency plan, risk assessment, policies and procedures, and the communication plan. The training and testing program must be reviewed and updated at least annually.

INTERPRETIVE GUIDELINES (E0036) Training and Testing Program – General An emergency preparedness training and testing program as specified in this requirement must be documented, reviewed and updated. The training and testing program must reflect the risks identified in the facility’s risk assessment and be included in their emergency plan.

For example, a facility that identifies flooding as a risk should also include policies and procedures in their emergency plan for closing or evacuating their facility and include these in their training and testing program. This would include, but is not limited to, training and testing on how the facility will communicate the facility closure to required individuals and agencies, testing resident tracking systems and testing transportation procedures for safely moving patients to other facilities. Additionally, for facilities with multiple locations, such as multi-campus or multi-location hospitals, the facility’s training and testing program must reflect the facility’s risk assessment for each specific location.

Training Component Training refers to a facility’s responsibility to provide education and instruction to staff, contractors, and facility volunteers to ensure all individuals are aware of the emergency preparedness program. For training requirements, the facility must have a process outlined within its emergency preparedness program which encompasses staff and volunteer training complementing the risk assessment. The training for staff should at a minimum include training related to the facility’s policies and procedures. Facilities must maintain documentation of the training so that surveyors are able to clearly identify staff training and testing conducted. For example, facilities may have a sign-in roster of training conducted within their training files or inclusion of this training in their training program, or individual training certificates of completion within personnel records. A surveyor should be able to ask for a list of employees and to verify training on the emergency preparedness requirements.

Testing Component Testing requirements vary based on the provider type. Inpatient providers are required to conduct two testing exercises annually.

Testing is the concept in which training is operationalized and the facility is able to evaluate the effectiveness of the training as well as the overall emergency preparedness program. Testing includes conducting drills and/or exercises to test the emergency plan to Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 48

identify gaps and areas for improvement. Additionally, facilities should establish a process which includes participation of all staff in testing exercises over a period of time. Facilities are encouraged to consider their scheduled exercises and the appropriate departments to be included. For instance, if a clinically-relevant testing exercise is not necessarily applicable to some other departments or staff, then the staff which did not participate in one year should participate in the next testing exercise to ensure that over a period of time all shifts are incorporated. Additionally, CMS is not specifying a facility to utilize all required equipment in the testing (drills) or a percentage of the patients/residents that would be included in these drills, however facilities should test their exercises according to how they would respond to the emergency would it be an actual real emergency.

Under this standard, surveyors are to assess whether or not the facility has a training and testing program based on the facility’s risk assessment and has incorporated its policies and procedures, as well as its communication plan within training required for staff and its testing exercises.

SURVEY PROCEDURES (E0036) 1. Verify that the facility has a written training and testing program that meets the requirements of the regulation.

2. Refer back to the facility’s risk assessment to determine if the training and testing program is reflecting risks and hazards identified within the facility’s program.

3. Verify the program has been reviewed and updated at least annually by asking for documentation of the annual review as well as any updates made.

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E 0037 Training and Testing Program - Training

Met □ Unmet □

REGULATORY TEXT (E0037) Training Program. The LTC facility must do all of the following: 1. Initial training in emergency preparedness policies and procedures to all new and existing staff, individuals providing services under arrangement, and volunteers, consistent with their expected role.

2. Provide emergency preparedness training at least annually.

3. Maintain documentation of all emergency preparedness training.

4. Demonstrate staff knowledge of emergency procedures.

INTERPRETIVE GUIDELINES (E0037) Initial Training Facilities are required to provide initial training in emergency preparedness policies and procedures that are consistent with their roles in an emergency to all new and existing staff, individuals providing services under arrangement, and volunteers. This includes individuals who provide services on a per diem basis such as agency nursing staff and any other individuals who provide services on an intermittent basis and would be expected to assist during an emergency.

The training provided by the facility must be based on the facility’s risk assessment policies and procedures as well as the communication plan. The intent is that staff, volunteers and individuals providing services at the facility are familiar and trained on the facility’s processes for responding to an emergency. Training should include individualbased response activities in the event of a natural disasters, such as what the process is for staff in the event of a forecasted hurricane. It should also include the policies and procedures on how to shelter-in-place or evacuate. Training should include how the facility manages the continuity of care to its resident population, such as triage processes and transfer/discharge during mass casualty or surge events.

Furthermore, the facility must train staff based on the facility’s risk assessment. Training for staff should mirror the facility’s emergency plan and should include training staff on procedures that are relevant to the hazards identified. For example, for EID’s this may include proper use of PPE, assessing needs of patients and how to screen patients and provide care based on the facility’s capacity and capabilities and communications regarding reporting and providing information on resident status with caregiver and family members.

Continued Training After the initial training has been conducted for staff, facilities must provide training on their facility’s emergency plan at least every 2 years (except for LTC facilities which will still be required to provide training annually). Facilities have the flexibility to determine the focus of their initial and 2-year training, as long as it aligns with the emergency plan and risk Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 50

assessment. Initial and subsequent training should be modified as needed and if the facility updates the policies and procedures to include but not limited to incorporating any lessons learned from the most recent exercises and real-life emergencies that occurred in and during the review of the facility’s emergency program, CMS would expect the facility be able to demonstrate how they have updated the training as well. For example, the annual subsequent training could include training staff on new evacuation procedures that were identified as a best practice and documented in the facility “After Action Report” (AAR) during the last emergency drill and were incorporated into the emergency plan during the program’s review.

While facilities are required to provide initial and subsequent annual training to all staff, it is up to the facility to decide what level of training each staff member will be required to complete based on an individual's involvement or expected role during an emergency.

There may be core topics that apply to all staff, while certain clinical staff may require additional topics. For example, dietary staff who prepare meals may not need to complete annual training that is focused on resident evacuation procedures. Instead, the facility may provide training that focuses on the proper preparation and storage of food in an emergency. In addition, depending on specific staff duties during an emergency, a facility may determine that documented external training is sufficient to meet some or all of the facility's training requirements. For example, staff who work with radiopharmaceuticals may attend external training that teach staff how to handle radiopharmaceutical emergencies. It is up to the facility to decide if the external training meets the facility’s requirements.

Facilities must also be able to demonstrate additional training when the emergency plan is significantly updated. Facilities which may have changed their emergency plan should plan to conduct initial training to all staff on the new or revised sections of the plan. If a facility determines the need to add additional policies and procedures based on a new risk identified in the facility’s risk assessment, the facility must train all staff on the new policies and procedures and the staff responsibilities. Facilities are not required to re- train staff on the entire emergency plan, but can choose to train staff on the new or revised element of the emergency preparedness program. For example, a facility identifies during an influenza outbreak that additional policies and procedures and adjustments to the risk assessment are needed to address a significant influx of patients/clients/residents. The facility identifies clinical locations in which contagious patients can be triaged in a manner to minimize exposure to non-infected individuals. The training for this new or revised policy can be done without needing to re-train staff on the entire program.

LTC facilities must continue to provide initial and continued training on an annual basis.

Training of Volunteers and Contracted Staff Facilities may contract with individuals providing services who also provide services in multiple surrounding areas. For instance, an ICF/IID may contract a nutritionist who also provides services in other locations. Given that these contracted individuals may provide services at multiple facilities, it may not be feasible for them to receive formal training for each of the facilities for emergency preparedness programs. The expectation is that each individual knows the facility’s emergency program and their role during emergencies, however the delivery of such training is left to the facility to determine. Facilities in which these individuals provide services may develop some type of training documentation- i.e., the facility’s emergency plan, important contact information, and the facility’s expectation Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 51

for those individuals during an emergency etc. which documents that the individual received the information/training. Furthermore, if a surveyor asks one of these individuals what their role is during a disaster, or any relevant questions, then the expectation is that the individual can describe the emergency plans/their role.

Documentation Requirements Facilities must maintain documentation of the initial and annual training for all staff. The documentation must include the specific training completed as well as the methods used for demonstrating knowledge of the training program. Facilities have flexibility in ways to demonstrate staff knowledge of emergency procedures. The method chosen is likely based on the training delivery method. For example: computer-based or printed selflearning packets may contain a test to demonstrate knowledge. If facilities choose instructor-led training, a question and answer session could follow the training.

Regardless of the method, facilities must maintain documentation that training was completed and that staff are knowledgeable of emergency procedures.

SURVEY PROCEDURES (E0037) 1. Ask for copies of the facility’s initial and subsequent annual emergency preparedness trainings and annual emergency preparedness training offerings.

2. Interview various staff and ask questions regarding the facility’s initial and subsequent annual training course to verify staff knowledge of emergency procedures.

3. Review a sample of staff training files to verify staff have received initial and subsequent annual emergency preparedness training.

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E 0039 Training and Testing Program - Exercises

Met □ Unmet □

REGULATORY TEXT (E0039) The facility must conduct exercises to test the emergency plan at least twice per year, including unannounced staff drills using the emergency procedures.

The facility must do the following: 1. Participate in an annual full-scale exercise that is community-based; or a) When a community-based exercise is not accessible, conduct an annual individual, facility-based functional exercise. a) If the [LTC facility] facility experiences an actual natural or man- made emergency that requires activation of the emergency plan, the LTC facility is exempt from engaging its next required a full-scale community-based or individual, facility-based functional exercise following the onset of the emergency event.

2. Conduct an additional annual exercise that may include, but is not limited to the following: a) A second full-scale exercise that is community-based or an individual, facility based functional exercise; or b) A mock disaster drill; or c) A tabletop exercise or workshop that is led by a facilitator includes a group discussion, using a narrated, clinically-relevant emergency scenario, and a set of problem statements, directed messages, or prepared questions designed to challenge an emergency plan.

3. Analyze the facility's response to and maintain documentation of all drills, tabletop exercises, and emergency events , and revise the facility's emergency plan, as needed.

INTERPRETIVE GUIDELINES (E0039) Facilities must conduct exercises to test the emergency plan, which for LTC facilities also includes unannounced staff drills using the emergency procedures.

Understanding Exercises and Terminology A facility’s testing exercises require they be based on the individual facility’s risk assessment, policies and procedures, and communication plan and support the resident population it serves. Testing exercises should vary, based on the facility’s requirements, by cycles and frequency of testing. The intent is that testing exercise provide a comprehensive testing and training for staff, volunteers, and individuals providing services under arrangement as well community partners. Testing exercises must be based on the facility’s identified hazards, to include natural or man-made disasters. This should include EID outbreaks.

Facilities are expected to test their response to emergency events as outlined within their Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 53

comprehensive emergency preparedness program. Testing exercises should not test the same scenario year after year or the same response processes. The intent is to identify gaps in the facility’s emergency program as it relates to responding to various emergencies and ensure staff are knowledgeable on the facility’s program. In the event gaps are identified, facilities should update their emergency programs as outlined within the requirements for After-Action Report (AAR).

Full-Scale and Community Based Exercises

As the term full-scale exercise may vary by sector, facilities are not required to conduct a full-scale exercise as defined by FEMA or DHS’s Homeland Security Exercise and Evaluation Program (HSEEP). For the purposes of this requirement, a full scale exercise is defined and accepted as any operations-based exercise (drill, functional, or full-scale exercise) that assesses a facility’s functional capabilities by simulating a response to an emergency that would impact the facility’s operations and their given community. Fullscale exercises in the industry setting are large exercises in which multiple agencies participate and may only be available every three to five years; while functional exercises are similar in nature, but may not involve as many participants and in which each agency can choose its priorities to test within the confines of the exercise. Therefore, full-scale can include what is known as a “functional” exercise or drill in the industry and according to HSEEP. A full-scale exercise is also an operations-based exercise that typically involves multiple agencies, jurisdictions, and disciplines performing functional or operational elements. There is also definition for “community” as it is subject to variation based on geographic setting, (e.g., rural, suburban, urban, etc.), state and local agency roles and responsibilities, types of providers in a given area in addition to other factors. In doing so, facilities have the flexibility to participate in and conduct exercises that more realistically reflect the risks and composition of their communities. Facilities are expected to consider their physical location, agency and other facility responsibilities and needs of the community when planning or participating in their exercises. The term could, however, mean entities within a state or multi-state region.

In many areas of the country, State and local agencies (emergency management agencies and health departments) and some regional entities, such as healthcare coalitions may conduct an annual full-scale, community-based exercise in an effort to more broadly assess community-wide emergency planning, potential gaps, and the integration of response capabilities in an emergency. Facilities should actively engage these entities to identify potential opportunities, as appropriate, as they offer the facility the opportunity to not only assess their emergency plan but also better understand how they can contribute to, coordinate with, and integrate into the broader community’s response during an emergency. They also provide a collective forum for assessing their communications plans to ensure they have the appropriate contacts and understand how best to engage and communicate with their state and local public health and emergency management agencies and other relevant partners, such as a local healthcare coalition, during an emergency.

Facilities are expected to contact their local and state agencies and healthcare coalitions, where appropriate, to determine if an opportunity exists and determine if their participation would fulfill this requirement. It is also important to note that agencies and or healthcare coalitions conducting these exercises will not have the resources to fulfill individual facility Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 54

requirements and thus will only serve as a conduit for broader community engagement and coordination prior to, during and after the full-scale community-based exercise.

Facilities are responsible for resourcing their participation and ensuring that all requisite documentation is developed and available to demonstrate their compliance with this requirement.

Facilities are encouraged to engage with their area Health Care Coalitions (HCC) (partnerships between healthcare, public health, EMS, and emergency management) to explore integrated opportunities. Health Care Coalitions (HCCs) are groups of individual health care and response organizations who collaborate to ensure each member has what it needs to respond to emergencies and planned events. HCCs plan and conduct coordinated exercises to assess the health care delivery systems readiness. There is value in participating in HCCs for participating in strategic planning, information sharing and resource coordination. HCC’s do not coordinate individual facility exercises, but rather serve as a conduit to provide an opportunity for other provider types to participate in an exercise. HCCs should communicate exercise plans with local and state emergency preparedness agencies and HCCs will benefit the entire community’s preparedness. In addition, CMS does not regulate state and local government disaster planning agencies.

It is the sole responsibility of the facility to be in compliance.

Facilities which determine that a full-scale community-based exercise will be planned for the facility’s exercise requirement must also ensure that the exercise scenario developed is identified within the facility’s risk assessment. While generally local and state emergency officials plan emergency exercises which could occur within the geographic location or community, facilities must ensure that participation in the exercise would adequately test the facility’s emergency program (specifically its policies and procedures and communication plan). For instance, in the event the local or state full-scale exercise is testing the response to a major multiple car accident requiring airlift transfers of patients, a LTC facility or ESRD facility may not be impacted by this type of disaster or require activation of its emergency program, therefore the exercise may not be as appropriate. In this case, the facility could document that the scenario offered in this full- scale community based exercise and that the facility conducted an individual facility- based exercise to test its emergency program instead. However, if the state or local exercise is testing an EID outbreak, all facilities in the community may be impacted, therefore participation would be strongly recommended.

The intent behind full-scale and community based exercises is to ensure the facility’s emergency program and response capabilities complement the local and state emergency plans and support an integrated response while protecting the health and safety of residents.

Individual Facility-Based Exercises Facilities that are not able to identify a full-scale community-based exercise, can instead fulfill this part of their requirement by either conducting an individual facility-based exercise, documenting an emergency that required them to fully activate their emergency plan, or by conducting a smaller community-based exercise with other nearby facilities. Facilities that elect to develop a small community-based exercise have the opportunity to not only assess their own emergency preparedness plans but also better understand the whole community’s needs, identify critical interdependencies and or gaps and potentially minimize the financial Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 55

impact of this requirement. For example, a LTC facility, a hospital, an ESRD facility, and a home health agency, all within a given area, could conduct a small community-based exercise to assess their individual facility plans and identify interdependencies that may impact facility evacuations and or address potential surge scenarios due to a prolonged disruption in dialysis and home health care services. Those that elect to conduct a community-based exercise should make an effort to contact their local/state emergency officials and healthcare coalitions, where appropriate, and offer them the opportunity to attend as they can provide valuable insight into the broader emergency planning and response activities in their given area. Community partners are considered any emergency management officials (fire, police, emergency medical services, etc.) for full-scale and community-based exercises, however can also mean community partners that assist in an emergency, such as surrounding providers and suppliers.

Participation While the regulations do not specify a minimum number of staff, or the roles of staff in the exercises, it is strongly encouraged that facility leadership and department heads participate in exercises. If an exercise is conducted at the individual facility-based level and is testing a particular clinical area, staff who work in this clinical area should participate in the exercise for a clear understanding of their roles and responsibilities. Additionally, facilities can review which members of staff participated in the previous exercise, and include those who did not participate in the subsequent exercises to ensure all staff members have an opportunity to participate and gain insight and knowledge. Facilities can use a sign-in roster for the exercise to substantiate staff participation. A sufficient number of staff should participate in the exercise to test the scenario and thoroughly assess the risk, policy, procedure, or plan being tested.

Facilities that conduct an individual facility-based exercise will need to demonstrate how it addresses any risk(s) identified in its risk assessment. For example, an inpatient facility might test their policies and procedures for a flood that may require the evacuation of patients to an external site or to an internal safe “shelter-in-place” location (e.g., foyer, cafeteria, etc.) and include requirements for patients with access and functional needs and potential dependencies on life-saving electricity-dependent medical equipment. If the facility uses fire drills based on their risk assessment (e.g., wildfires) as a full-scale community based exercise in one given year (which is also a requirement for some providers/suppliers under Life Safety Code), the facility is encouraged to choose in the following year a different hazard in their risk assessment to conduct an exercise in order to ensure variability in the training and testing program. The intent of the requirements under the emergency preparedness condition for participation/condition for coverage, or requirement for LTC, is to test the facility’s ability to respond to any emergency outlined within their risk assessment. The purpose of testing the facility’s emergency program is to identify gaps in response which could result in adverse events for patients and staff and to adjust plans, policies and procedures to ensure resident and staff safety is maintained regardless of the type of emergency which occurs.

Table-Top Exercise and Workshops Facilities are also required to conduct an “exercise of choice” or, for some, only conduct a table-top exercise (TTX) or workshop. Please refer back to the definition section above.

TTX’s or workshops are expected to be group discussions led by a facilitator. CMS is not Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 56

defining whether or not the facilitator must be a staff member or contracted service.

Some facilities may find that a specific department lead may be best suited dependent on the scenario being tested, while other facilities may find an outside facilitator may be more appropriate to facilitate.

The intent behind TTX’s or workshops is to test an exercise based on the facility’s risk assessment. Some facilities may find it prudent to conduct a TTX or workshop prior to a full-scale or individual-facility based exercise in order to identify potential gaps or challenges and then update the policies and procedures accordingly to resolve the potential issue. This would allow for facilities to test their adjustments during a full-scale or individual facility-based exercise to determine if the corrective action was appropriate.

After-Action Reviews Each facility is responsible for documenting their compliance and ensuring that this information is available for review at any time for a period of no less than three (3) years.

Facilities should also document the lessons learned following their tabletop and full-scale exercises and real-life emergencies and demonstrate that they have incorporated any necessary improvements in their emergency preparedness program. Facilities may complete an after action review process to help them develop an actionable after action report (AAR). The process includes a roundtable discussion that includes leadership, department leads and critical staff who can identify and document lessons learned and necessary improvements in an official AAR. The AAR, at a minimum, should determine 1) what was supposed to happen; 2) what occurred; 3) what went well; 4) what the facility can do differently or improve upon; and 5) a plan with timelines for incorporating necessary improvement. Lastly, facilities that are a part of a healthcare system, can elect to participate in their system’s integrated and unified emergency preparedness program and exercises. However, those that do will still be responsible for documenting and demonstrating their individual facility’s compliance with the exercise and training requirements.

Exemption based on Actual Emergency Finally, an actual emergency event or response of sufficient magnitude that requires activation of the relevant emergency plans meets the full-scale exercise requirement and exempts the facility for engaging in their next required community-based full-scale exercise or individual, facility-based exercise for following the actual event; and facilities must be able to demonstrate this through written documentation. With the changed requirements as a result of the 2019 Burden Reduction final rule (81 FR 63859) for outpatient providers required to conduct full-scale exercises only every other year, opposite of their exercises of choice, these facilities are exempt from their next required full-scale or individual facilitybased exercise. For inpatient providers, the full-scale exercise would be annually. The intent is to ensure that facilities conduct at least one exercise per year.

For example, in the event an outpatient provider conducts a required full-scale community based exercise in January 2019, and completed the optional exercise of its choice in January 2020, and experiences an actual emergency in March 2020, the outpatient provider is exempt from next required full-scale community based or individual facility based exercise in January 2021. If the outpatient provider conducts a required full-scale community based exercise in January 2020, and has the optional exercise of its choice Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 57

scheduled for January 2021, and experiences an actual emergency in March 2020, the outpatient provider is exempt from next required full-scale community based or individual facility based exercise in January 2022, but must still conduct the required exercise of choice in January 2021. The exemption is based on the facility’s required full-scale exercise, not the exercise of choice, therefore the exemption may not be applicable until two years following the activation of the emergency plan, dependent on the cycle the facility has determined and the actual emergency event.

For inpatient providers, the exemption would apply for the next required full-scale exercise as well, however, it may be the same year or following year, as inpatient providers are required to perform two exercises per year. If an inpatient provider completed the full-scale exercise in January 2020 and is scheduled to conduct an exercise of choice in November 2020, but experiences an actual emergency in March 2020 which required activation of its emergency plan, the inpatient provider is exempt from the next required full-scale exercise in January 2021, but must complete the exercise of choice. If the inpatient provider conducted an exercise of choice prior to the actual emergency and had a full-scale exercise scheduled for November 2020, then the inpatient provider would be exempt from that full-scale exercise as it would not be the exercise of choice.

The exercises of choice, which allow facilities to choose one (e.g., another fullscale/individual facility based; mock disaster drill; or tabletop exercises) are not considered as the required full-scale community based or individual facility based exercises. Facilities which may have schedule full-scale exercises annually as part of their licensure or accrediting organizations requirements, would be exempt from their next required annual full-scale exercise. Facilities which have a full-scale exercise scheduled as part of their exercise of choice for the opposite years would be exempt from their next scheduled exercise following an emergency, which would still be July 2021 (using the above example).

Facilities must document that they had activated their emergency program based on an actual emergency. Documentation may include, but is not limited to: a section 1135 waiver issued to the facility (time limited and event-specific); documentation alerting staff of the emergency; documentation of facility closures; meeting minutes which addressed the time and event specific information. The facility must also complete an after action review and integrated corrective actions into their emergency preparedness program.

Resources For additional information and tools, please visit the CMS Quality, Safety & Oversight Group Emergency Preparedness website at: https://www.cms.gov/Medicare/ProviderEnrollment-and-Certification/SurveyCertEmergPrep/index.html or ASPR TRACIE.

SURVEY PROCEDURES (E0039) 1. Ask facility leadership to explain the participation of management and staff during scheduled exercises.

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2. Ask to see documentation of the exercises (which may include, but is not limited to, the exercise plan, the AAR, and any additional documentation used by the facility to support the exercise). Documentation must demonstrate the facility has conducted the exercises described in the standard.

3. Ask to see the documentation of the facility’s efforts to identify a full-scale community based exercise if they did not participate in one (i.e., date and personnel and agencies contacted and the reasons for the inability to participate in a community based exercise).

4. Request documentation of the facility’s analysis and response and how the facility updated its emergency program based on this analysis.

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Met □ Unmet □

E 0041 Emergency and Standby Systems REGULATORY TEXT (E0041)

Emergency and standby power systems - The facility must implement emergency and standby power systems based on their emergency plan.

Emergency generator location - The generator must be located in accordance with the location requirements found in the Health Care Facilities Code (NFPA 99 and Tentative Interim Amendments TIA 12–2, TIA 12–3, TIA 12–4, TIA 12–5, and TIA 12–6), Life Safety Code (NFPA 101 and Tentative Interim Amendments TIA 12–1, TIA 12–2, TIA 12–3, and TIA 12–4), and NFPA 110, when a new structure is built or when an existing structure or building is renovated.

Emergency generator inspection and testing - The facility must implement the emergency power system inspection, testing, and maintenance requirements found in the Health Care Facilities Code, NFPA 110, and Life Safety Code.

Emergency generator fuel - Facilities that maintain an onsite fuel source to power emergency generators must have a plan for how it will keep emergency power systems operational during the emergency, unless it evacuates.

INTERPRETIVE GUIDELINES (E0041) NOTE: Facilities are required to base their emergency power and stand-by systems on their emergency plans and risk assessments, including the policies. The determination of the appropriate alternate energy source should be made through the development of the facility’s risk assessment and emergency plan. If these facilities determine that a permanent generator is not required to meet the emergency power and stand-by systems requirements for this emergency preparedness regulation, then this section would not apply.

Emergency and standby power systems CMS requires Hospitals, CAHs and LTC facilities to comply with the 2012 edition of the National Fire Protection Association (NFPA) 101 – Life Safety Code (LSC) and the 2012 edition of the NFPA 99 – Health Care Facilities Code in accordance with the Final Rule (CMS–3277–F). NFPA 99 requires Hospitals, CAHs and certain LTC facilities to install, maintain, inspect and test an Essential Electric System (EES) in areas of a building where the failure of equipment or systems is likely to cause the injury or death of patients or caregivers. An EES is a system which includes an alternate source of power, distribution system, and associated equipment that is designed to ensure continuity of electricity to elected areas and functions during the interruption of normal electrical service. The EES alternate source of power for these facility types is typically a generator. (NOTE: LTC facilities are also expected to meet the requirements under Life Safety Code and NFPA 99 as outlined within the LTC Appendix of the SOM). In addition, NFPA 99 identifies the 2010 edition of NFPA 110 – Standard for Emergency and Standby Power Systems as a mandatory reference, which addresses the performance requirements for emergency and standby power systems and includes installation, maintenance, operation, and testing requirements.

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NFPA 99 contains emergency power requirements for emergency lighting, fire detection systems, extinguishing systems, and alarm systems. But, NFPA 99 does not specify emergency power requirements for maintaining supplies, and facility temperature requirements are limited to heating equipment for operating, delivery, labor, recovery, intensive care, coronary care, nurseries, infection/isolation rooms, emergency treatment spaces, and general patient/resident rooms. In addition, NFPA 99 does not require heating in general patient rooms during the disruption of normal power where the outside design temperature is higher than 20 degrees Fahrenheit or where a selected room(s) is provided for the needs of all patients (where patients would be internally relocated), then only that room(s) needs to be heated. Therefore, EES in Hospitals, CAHs and LTC facilities should include consideration for design to accommodate any additional electrical loads the facility determines to be necessary to meet all subsistence needs required by emergency preparedness plans, policies and procedures, unless the facility’s emergency plans, policies and procedures required under paragraph (a) and paragraph (b)(1)(i) and (ii) of this section determine that the hospital, CAH or LTC facility will relocate patients internally or evacuate in the event of an emergency. Facilities may plan to evacuate all patients, or choose to relocate internally only patients located in certain locations of the facility based on the ability to meet emergency power requirements in certain locations. For example, a hospital that has the ability to maintain temperature requirements in 50 percent of the inpatient locations during a power outage, may develop an emergency plan that includes bringing in alternate power, heating and/or cooling capabilities, and the partial relocation or evacuation of patients during a power outage instead of installing additional power sources to maintain temperatures in all inpatient locations. Or a LTC facility may decide to relocate residents to a part of the facility, such as a dining or activities room, where the facility can maintain the proper temperature requirements rather than the maintaining temperature within the entire facility. It is up to each facility to make emergency power system decisions based on its risk assessment and emergency plan.

If a Hospital, CAH or LTC facility determines that the use of a portable and mobile generator would be the best way to accommodate for additional electrical loads necessary to meet subsistence needs required by emergency preparedness plans, policies and procedures, then NFPA requirements on emergency and standby power systems such as generator installation, location, inspection and testing, and fuel would not be applicable to the portable generator and associated distribution system, except for NFPA 70 - National Electrical Code. (See E-0015 for Interpretive Guidance on portable generators.)

Emergency generator location NFPA 110 contains minimum requirements and considerations for the installation and environmental conditions that may have an effect on Emergency Power Supply System (EPSS) equipment, including, building type, classification of occupancy, hazard of contents, and geographic location. NFPA 110 requires that EPSS equipment, including generators, to be designed and located to minimize damage (e.g., flooding). The NFPA 110 generator location requirements apply to EPSS (e.g., generators) that are permanently attached and do not apply to portable and mobile generators used to provide or supplement emergency power to Hospitals, CAHs and LTC facilities. (See E-0015 for Interpretive Guidance on portable generators.)

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Under emergency preparedness, the regulations require that the generator and its associated equipment be located in accordance with the LSC, NFPA 99, and NFPA 110 when a new structure is built or an existing structure or building is renovated.

Therefore, new structures or building renovations that occur after November 15, 2016, (the effective date of the Emergency Preparedness Final Rule) must be in compliance with NFPA 110 generator location requirements to be determined as being in compliance with the Emergency Preparedness regulations.

Emergency generator inspection and testing NFPA 110 contains routine maintenance and operational testing requirements for emergency and standby power systems, including generators. Emergency generators required by NFPA 99 and the Emergency Preparedness Final Rule must be maintained and tested in accordance with NFPA 110 requirements, which are based on manufacturer recommendations, instruction manuals, and the minimum requirements of NFPA 110, Chapter 8.

Emergency generator fuel NFPA 110 permits fuel sources for generators to be liquid petroleum products (e.g., gas, diesel), liquefied petroleum gas (e.g., propane) and natural or synthetic gas (e.g., natural gas). Generators required by NFPA 99 are designated by Class, which defines the minimum time, in hours, that an EES is designed to operate at its rated load without having to be refueled. Generators required by NFPA 99 for Hospitals, CAHs and LTC facilities are designated Class X, which defines the minimum run time as being “other time, in hours, as required by application, code or user.” The 2010 edition of NFPA 110 also requires that generator installations in locations where the probability of interruption of off-site (e.g., natural gas) fuel supplies is high to maintain onsite storage of an alternate fuel source sufficient to allow full output of the ESS for the specified class.

The Emergency Preparedness Final Rule requires Hospitals, CAHs and LTC facilities that maintain onsite fuel sources (e.g., gas, diesel, propane) to have a plan to keep the EES operational for the duration of emergencies as defined by the facilities emergency plan, policy and procedures, unless it evacuates. This would include maintaining fuel onsite to maintain generator operation or it could include making arrangements for fuel delivery for an emergency event. If fuel is to be delivered during an emergency event, planning should consider limitations and delays that may impact fuel delivery during an event. In addition, planning should ensure that arranged fuel supply sources will not be limited by other community demands during the same emergency event. In instances when a facility maintains onsite fuel sources and plans to evacuate during an emergency, a sufficient amount of onsite fuel should be maintained to keep the EES operational until such time the building is evacuated.

SURVEY PROCEDURES (E0041) Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 62

1. Verify that the facility has the required emergency and standby power systems to meet the requirements of the facility’s emergency plan and corresponding policies and procedures 2. Review the emergency plan for “shelter in place” and evacuation plans. Based on those plans, does the facility have emergency power systems or plans in place to maintain safe operations while sheltering in place?

3. For facilities which are under construction or have existing buildings being renovated, verify the facility has a written plan to relocate the EPSS by the time construction is completed.

For hospitals, CAHs and LTC facilities with permanently attached generators: 1. For new construction that takes place between November 15, 2016 and is completed

by November 15, 2017, verify the generator is located and installed in accordance with NFPA 110 and NFPA 99 when a new structure is built or when an existing structure or building is renovated. The applicability of both NFPA 110 and NFPA 99 addresses only new, altered, renovated or modified generator locations.

2. Verify that the hospitals, CAHs and LTC facilities with an onsite fuel source maintains it in accordance with NFPA 110 for their generator, and have a plan for how to keep the generator operational during an emergency, unless they plan to evacuate.

Met □ Unmet □

E 0042 Integrated Healthcare Systems

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REGULATORY TEXT (E0042) If a facility is part of a healthcare system consisting of multiple separately certified healthcare facilities that elects to have a unified and integrated emergency preparedness program, the [facility] may choose to participate in the healthcare system's coordinated emergency preparedness program.

If elected, the unified and integrated emergency preparedness program must: 1. Demonstrate that each separately certified facility within the system actively participated in the development of the unified and integrated emergency preparedness program.

2. Be developed and maintained in a manner that takes into account each separately certified facility's unique circumstances, patient populations, and services offered.

3. Demonstrate that each separately certified facility is capable of actively using the unified and integrated emergency preparedness program and is in compliance with the program.

4. Include a unified and integrated emergency plan that meets the requirements of this section. The unified and integrated emergency plan must also be based on and include the following: i. A documented community-based risk assessment, utilizing an all-hazards approach. ii. A documented individual facility-based risk assessment for each separately certified facility within the health system, utilizing an all-hazards approach.

5. Include integrated policies and procedures that meet the requirements set forth in paragraph (b) of this section, a coordinated communication plan, and training and testing programs paragraphs (c) and (d) of this section, respectively.

INTERPRETIVE GUIDELINES (E0042) Healthcare systems that include multiple facilities that are each separately certified as a Medicare-participating provider or supplier have the option of developing a unified and integrated emergency preparedness program that includes all of the facilities within the healthcare system instead of each facility developing a separate emergency preparedness program. If an integrated healthcare system chooses this option, each certified facility in the system may elect to participate in the system’s unified and integrated emergency program or develop its own separate emergency preparedness program. It is important to understand that healthcare systems are not required to develop a unified and integrated emergency program. Rather it is a permissible option. In addition, the separately certified facilities within the healthcare system are not required to participate in the unified and integrated emergency preparedness program. It is simply an option for each facility. If this option is taken, the healthcare system’s unified emergency preparedness program should Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 64

be updated each time a facility enters or leaves the healthcare system’s program.

If a healthcare system elects to have a unified emergency preparedness program, the integrated program must demonstrate that each separately certified facility within the system that elected to participate in the system’s integrated program actively participated in the development of the program. Therefore, each facility should designate personnel who will collaborate with the healthcare system to develop the plan. The unified and integrated plan should include documentation that verifies each facility participated in the development of the plan. This could include the names of personnel at each facility who assisted in the development of the plan and the minutes from planning meetings. All components of the emergency preparedness program that are required to be reviewed and updated at least annually must include all participating facilities. Again, each facility must be able to prove that it was involved in the annual reviews and updates of the program. The healthcare system and each facility must document each facility’s active involvement with the reviews and updates, as applicable.

A unified program must be developed and maintained in a manner that takes into account the unique circumstances, patient populations, and services offered at each facility participating in the integrated program. For example, for a unified plan covering both a hospital and a LTC facility, the emergency plan must account for the residents in the LTC facility as well as those patients within a hospital, while taking into consideration the difference in services that are provided at a LTC facility and a hospital. The unique circumstances that should be addressed at each facility would include anything that would impact operations during an emergency, such as the location of the facility, resources such as the availability of staffing, medical supplies, subsistence, patients' and residents’ varying acuity and mobility at the different types of facilities in a unified healthcare system, etc.

Each separately certified facility must be capable of demonstrating during a survey that it can effectively implement the emergency preparedness program and demonstrate compliance with all emergency preparedness requirements at the individual facility level.

Compliance with the emergency preparedness requirements is the individual responsibility of each separately certified facility.

The unified emergency preparedness program must include a documented community– based risk assessment and an individual facility-based risk assessment for each separately certified facility within the health system, utilizing an all-hazards approach. This is especially important if the facilities in a healthcare system are located across a large geographic area with differing weather conditions.

Lastly, the unified program must have a coordinated communication plan and training and testing program. For example, if the unified emergency program incorporates a central point of contact at the “system” level who assists in coordination and communication, such as during an evacuation, each facility must have this information outlined within its individual plan.

This type of integrated healthcare system emergency program should focus the training and exercises to ensure communication plans and reporting mechanisms are seamless to the emergency management officials at state and local levels to avoid potential miscommunications between the system and the multiple facilities under its control.

The training and testing program in a unified emergency preparedness program must be Care Providers of MN - Based on LTC Requirements in CMS Appendix Z – From QSO-21-15-ALL Issued March 26, 2021 65

developed considering all of the requirements of each facility type. For example, if a healthcare system includes, hospitals, LTC facilities, ESRD facilities and ASCs, then the unified training and testing programs must meet all of the specific regulatory requirements for each of these facility types.

Because of the many different configurations of healthcare systems, from the different types of facilities in the system, to the varied locations of the facilities, it is not possible to specify how unified training and testing programs should be developed. There is no “one size fits all” model that can be prescribed. However, if the system decides to develop a unified and integrated training and testing program, the training and testing must be developed based on the community and facility based hazards assessments at each facility that is participating in the unified emergency preparedness program. Each facility must maintain individual training records of staff and records of all required training exercises.

SURVEY PROCEDURES (E0042) 1. Verify whether or not the facility has opted to be part of its healthcare system’s unified and integrated emergency preparedness program. Verify that they are by asking to see documentation of its inclusion in the program.

2. Ask to see documentation that verifies the facility within the system was actively involved in the development of the unified emergency preparedness program.

3. Ask to see documentation that verifies the facility was actively involved in the reviews of the program requirements and any program updates.

4. Ask to see a copy of the entire integrated and unified emergency preparedness program and all required components (emergency plan, policies and procedures, communication plan, training and testing program).

5. Ask facility leadership to describe how the unified and integrated emergency preparedness program is updated based on changes within the healthcare system such as when facilities enter or leave the system.

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MINNESOTA STATUTES 2020​

626.5572​

626.5572 DEFINITIONS.​ Subdivision 1. Scope. For the purpose of section 626.557, the following terms have the meanings given​ them, unless otherwise specified.​ Subd. 2. Abuse. "Abuse" means:​ (a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate, or aiding and​ abetting a violation of:​ (1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224;​ (2) the use of drugs to injure or facilitate crime as defined in section 609.235;​ (3) the solicitation, inducement, and promotion of prostitution as defined in section 609.322; and​ (4) criminal sexual conduct in the first through fifth degrees as defined in sections 609.342 to 609.3451.​ A violation includes any action that meets the elements of the crime, regardless of whether there is a​ criminal proceeding or conviction.​ (b) Conduct which is not an accident or therapeutic conduct as defined in this section, which produces​ or could reasonably be expected to produce physical pain or injury or emotional distress including, but not​ limited to, the following:​ (1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable adult;​ (2) use of repeated or malicious oral, written, or gestured language toward a vulnerable adult or the​ treatment of a vulnerable adult which would be considered by a reasonable person to be disparaging,​ derogatory, humiliating, harassing, or threatening;​ (3) use of any aversive or deprivation procedure, unreasonable confinement, or involuntary seclusion,​ including the forced separation of the vulnerable adult from other persons against the will of the vulnerable​ adult or the legal representative of the vulnerable adult; and​ (4) use of any aversive or deprivation procedures for persons with developmental disabilities or related​ conditions not authorized under section 245.825.​ (c) Any sexual contact or penetration as defined in section 609.341, between a facility staff person or a​ person providing services in the facility and a resident, patient, or client of that facility.​ (d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the vulnerable adult's​ will to perform services for the advantage of another.​ (e) For purposes of this section, a vulnerable adult is not abused for the sole reason that the vulnerable​ adult or a person with authority to make health care decisions for the vulnerable adult under sections 144.651,​ 144A.44, chapter 145B, 145C or 252A, or section 253B.03 or 524.5-313, refuses consent or withdraws​ consent, consistent with that authority and within the boundary of reasonable medical practice, to any​ therapeutic conduct, including any care, service, or procedure to diagnose, maintain, or treat the physical or​ mental condition of the vulnerable adult or, where permitted under law, to provide nutrition and hydration​ parenterally or through intubation. This paragraph does not enlarge or diminish rights otherwise held under​ law by:​

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(1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an involved family​ member, to consent to or refuse consent for therapeutic conduct; or​ (2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct.​ (f) For purposes of this section, a vulnerable adult is not abused for the sole reason that the vulnerable​ adult, a person with authority to make health care decisions for the vulnerable adult, or a caregiver in good​ faith selects and depends upon spiritual means or prayer for treatment or care of disease or remedial care of​ the vulnerable adult in lieu of medical care, provided that this is consistent with the prior practice or belief​ of the vulnerable adult or with the expressed intentions of the vulnerable adult.​ (g) For purposes of this section, a vulnerable adult is not abused for the sole reason that the vulnerable​ adult, who is not impaired in judgment or capacity by mental or emotional dysfunction or undue influence,​ engages in consensual sexual contact with:​ (1) a person, including a facility staff person, when a consensual sexual personal relationship existed​ prior to the caregiving relationship; or​ (2) a personal care attendant, regardless of whether the consensual sexual personal relationship existed​ prior to the caregiving relationship.​ Subd. 3. Accident. "Accident" means a sudden, unforeseen, and unexpected occurrence or event which:​ (1) is not likely to occur and which could not have been prevented by exercise of due care; and​ (2) if occurring while a vulnerable adult is receiving services from a facility, happens when the facility​ and the employee or person providing services in the facility are in compliance with the laws and rules​ relevant to the occurrence or event.​ Subd. 4. Caregiver. "Caregiver" means an individual or facility who has responsibility for the care of​ a vulnerable adult as a result of a family relationship, or who has assumed responsibility for all or a portion​ of the care of a vulnerable adult voluntarily, by contract, or by agreement.​ Subd. 5. Common entry point. "Common entry point" means the entity responsible for receiving reports​ of alleged or suspected maltreatment of a vulnerable adult under section 626.557.​ Subd. 6. Facility. (a) "Facility" means a hospital or other entity required to be licensed under sections​ 144.50 to 144.58; a nursing home required to be licensed to serve adults under section 144A.02; a facility​ or service required to be licensed under chapter 245A; an assisted living facility required to be licensed​ under chapter 144G; a home care provider licensed or required to be licensed under sections 144A.43 to​ 144A.482; a hospice provider licensed under sections 144A.75 to 144A.755; or a person or organization​ that offers, provides, or arranges for personal care assistance services under the medical assistance program​ as authorized under sections 256B.0625, subdivision 19a, 256B.0651 to 256B.0654, 256B.0659, or 256B.85.​ (b) For services identified in paragraph (a) that are provided in the vulnerable adult's own home or in​ another unlicensed location, the term "facility" refers to the provider, person, or organization that offers,​ provides, or arranges for personal care services, and does not refer to the vulnerable adult's home or other​ location at which services are rendered.​ Subd. 7. False. "False" means a preponderance of the evidence shows that an act that meets the definition​ of maltreatment did not occur.​​

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Subd. 8. Final disposition. "Final disposition" is the determination of an investigation by a lead​ investigative agency that a report of maltreatment under Laws 1995, chapter 229, is substantiated, inconclusive,​ false, or that no determination will be made. When a lead investigative agency determination has substantiated​ maltreatment, the final disposition also identifies, if known, which individual or individuals were responsible​ for the substantiated maltreatment, and whether a facility was responsible for the substantiated maltreatment.​ Subd. 9. Financial exploitation. "Financial exploitation" means:​ (a) In breach of a fiduciary obligation recognized elsewhere in law, including pertinent regulations,​ contractual obligations, documented consent by a competent person, or the obligations of a responsible party​ under section 144.6501, a person:​ (1) engages in unauthorized expenditure of funds entrusted to the actor by the vulnerable adult which​ results or is likely to result in detriment to the vulnerable adult; or​ (2) fails to use the financial resources of the vulnerable adult to provide food, clothing, shelter, health​ care, therapeutic conduct or supervision for the vulnerable adult, and the failure results or is likely to result​ in detriment to the vulnerable adult.​ (b) In the absence of legal authority a person:​ (1) willfully uses, withholds, or disposes of funds or property of a vulnerable adult;​ (2) obtains for the actor or another the performance of services by a third person for the wrongful profit​ or advantage of the actor or another to the detriment of the vulnerable adult;​ (3) acquires possession or control of, or an interest in, funds or property of a vulnerable adult through​ the use of undue influence, harassment, duress, deception, or fraud; or​ (4) forces, compels, coerces, or entices a vulnerable adult against the vulnerable adult's will to perform​ services for the profit or advantage of another.​ (c) Nothing in this definition requires a facility or caregiver to provide financial management or supervise​ financial management for a vulnerable adult except as otherwise required by law.​ Subd. 10. Immediately. "Immediately" means as soon as possible, but no longer than 24 hours from​ the time initial knowledge that the incident occurred has been received.​ Subd. 11. Inconclusive. "Inconclusive" means there is less than a preponderance of evidence to show​ that maltreatment did or did not occur.​ Subd. 12. Initial disposition. "Initial disposition" is the lead investigative agency's determination of​ whether the report will be assigned for further investigation.​ Subd. 13. Lead investigative agency. "Lead investigative agency" is the primary administrative agency​ responsible for investigating reports made under section 626.557.​ (a) The Department of Health is the lead investigative agency for facilities or services licensed or required​ to be licensed as hospitals, home care providers, nursing homes, boarding care homes, hospice providers,​ residential facilities that are also federally certified as intermediate care facilities that serve people with​ developmental disabilities, or any other facility or service not listed in this subdivision that is licensed or​ required to be licensed by the Department of Health for the care of vulnerable adults. "Home care provider"​ has the meaning provided in section 144A.43, subdivision 4, and applies when care or services are delivered​

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in the vulnerable adult's home, whether a private home or a housing with services establishment registered​ under chapter 144D, including those that offer assisted living services under chapter 144G.​ (b) The Department of Human Services is the lead investigative agency for facilities or services licensed​ or required to be licensed as adult day care, adult foster care, community residential settings, programs for​ people with disabilities, family adult day services, mental health programs, mental health clinics, chemical​ dependency programs, the Minnesota Sex Offender Program, or any other facility or service not listed in​ this subdivision that is licensed or required to be licensed by the Department of Human Services.​ (c) The county social service agency or its designee is the lead investigative agency for all other reports,​ including, but not limited to, reports involving vulnerable adults receiving services from a personal care​ provider organization under section 256B.0659.​ Subd. 14. Legal authority. "Legal authority" includes, but is not limited to: (1) a fiduciary obligation​ recognized elsewhere in law, including pertinent regulations; (2) a contractual obligation; or (3) documented​ consent by a competent person.​ Subd. 15. Maltreatment. "Maltreatment" means abuse as defined in subdivision 2, neglect as defined​ in subdivision 17, or financial exploitation as defined in subdivision 9.​ Subd. 16. Mandated reporter. "Mandated reporter" means a professional or professional's delegate​ while engaged in: (1) social services; (2) law enforcement; (3) education; (4) the care of vulnerable adults;​ (5) any of the occupations referred to in section 214.01, subdivision 2; (6) an employee of a rehabilitation​ facility certified by the commissioner of jobs and training for vocational rehabilitation; (7) an employee or​ person providing services in a facility as defined in subdivision 6; or (8) a person that performs the duties​ of the medical examiner or coroner.​ Subd. 17. Neglect. "Neglect" means:​ (a) The failure or omission by a caregiver to supply a vulnerable adult with care or services, including​ but not limited to, food, clothing, shelter, health care, or supervision which is:​ (1) reasonable and necessary to obtain or maintain the vulnerable adult's physical or mental health or​ safety, considering the physical and mental capacity or dysfunction of the vulnerable adult; and​ (2) which is not the result of an accident or therapeutic conduct.​ (b) The absence or likelihood of absence of care or services, including but not limited to, food, clothing,​ shelter, health care, or supervision necessary to maintain the physical and mental health of the vulnerable​ adult which a reasonable person would deem essential to obtain or maintain the vulnerable adult's health,​ safety, or comfort considering the physical or mental capacity or dysfunction of the vulnerable adult.​ (c) For purposes of this section, a vulnerable adult is not neglected for the sole reason that:​ (1) the vulnerable adult or a person with authority to make health care decisions for the vulnerable adult​ under sections 144.651, 144A.44, chapter 145B, 145C, or 252A, or sections 253B.03 or 524.5-101 to​ 524.5-502, refuses consent or withdraws consent, consistent with that authority and within the boundary of​ reasonable medical practice, to any therapeutic conduct, including any care, service, or procedure to diagnose,​ maintain, or treat the physical or mental condition of the vulnerable adult, or, where permitted under law,​ to provide nutrition and hydration parenterally or through intubation; this paragraph does not enlarge or​ diminish rights otherwise held under law by:​

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(i) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an involved family​ member, to consent to or refuse consent for therapeutic conduct; or​ (ii) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct; or​ (2) the vulnerable adult, a person with authority to make health care decisions for the vulnerable adult,​ or a caregiver in good faith selects and depends upon spiritual means or prayer for treatment or care of​ disease or remedial care of the vulnerable adult in lieu of medical care, provided that this is consistent with​ the prior practice or belief of the vulnerable adult or with the expressed intentions of the vulnerable adult;​ (3) the vulnerable adult, who is not impaired in judgment or capacity by mental or emotional dysfunction​ or undue influence, engages in consensual sexual contact with:​ (i) a person including a facility staff person when a consensual sexual personal relationship existed prior​ to the caregiving relationship; or​ (ii) a personal care attendant, regardless of whether the consensual sexual personal relationship existed​ prior to the caregiving relationship; or​ (4) an individual makes an error in the provision of therapeutic conduct to a vulnerable adult which does​ not result in injury or harm which reasonably requires medical or mental health care; or​ (5) an individual makes an error in the provision of therapeutic conduct to a vulnerable adult that results​ in injury or harm, which reasonably requires the care of a physician, and:​ (i) the necessary care is provided in a timely fashion as dictated by the condition of the vulnerable adult;​ (ii) if after receiving care, the health status of the vulnerable adult can be reasonably expected, as​ determined by the attending physician, to be restored to the vulnerable adult's preexisting condition;​ (iii) the error is not part of a pattern of errors by the individual;​ (iv) if in a facility, the error is immediately reported as required under section 626.557, and recorded​ internally in the facility;​ (v) if in a facility, the facility identifies and takes corrective action and implements measures designed​ to reduce the risk of further occurrence of this error and similar errors; and​ (vi) if in a facility, the actions required under items (iv) and (v) are sufficiently documented for review​ and evaluation by the facility and any applicable licensing, certification, and ombudsman agency.​ (d) Nothing in this definition requires a caregiver, if regulated, to provide services in excess of those​ required by the caregiver's license, certification, registration, or other regulation.​ (e) If the findings of an investigation by a lead investigative agency result in a determination of​substantiated maltreatment for the sole reason that the actions required of a facility under paragraph (c),​clause (5), item (iv), (v), or (vi), were not taken, then the facility is subject to a correction order. An individual​will not be found to have neglected or maltreated the vulnerable adult based solely on the facility's not having​taken the actions required under paragraph (c), clause (5), item (iv), (v), or (vi). This must not alter the lead​investigative agency's determination of mitigating factors under section 626.557, subdivision 9c, paragraph​(c).​​

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Subd. 18. Report. "Report" means a statement concerning all the circumstances surrounding the alleged​ or suspected maltreatment, as defined in this section, of a vulnerable adult which are known to the reporter​ at the time the statement is made.​ Subd. 19. Substantiated. "Substantiated" means a preponderance of the evidence shows that an act that​ meets the definition of maltreatment occurred.​ Subd. 20. Therapeutic conduct. "Therapeutic conduct" means the provision of program services, health​ care, or other personal care services done in good faith in the interests of the vulnerable adult by: (1) an​ individual, facility, or employee or person providing services in a facility under the rights, privileges and​ responsibilities conferred by state license, certification, or registration; or (2) a caregiver.​ Subd. 21. Vulnerable adult. (a) "Vulnerable adult" means any person 18 years of age or older who:​ (1) is a resident or inpatient of a facility;​ (2) receives services required to be licensed under chapter 245A, except that a person receiving outpatient​ services for treatment of chemical dependency or mental illness, or one who is served in the Minnesota Sex​ Offender Program on a court-hold order for commitment, or is committed as a sexual psychopathic personality​ or as a sexually dangerous person under chapter 253B, is not considered a vulnerable adult unless the person​ meets the requirements of clause (4);​ (3) receives services from a home care provider required to be licensed under sections 144A.43 to​ 144A.482; or from a person or organization that offers, provides, or arranges for personal care assistance​ services under the medical assistance program as authorized under section 256B.0625, subdivision 19a,​ 256B.0651, 256B.0653, 256B.0654, 256B.0659, or 256B.85; or​ (4) regardless of residence or whether any type of service is received, possesses a physical or mental​ infirmity or other physical, mental, or emotional dysfunction:​ (i) that impairs the individual's ability to provide adequately for the individual's own care without​ assistance, including the provision of food, shelter, clothing, health care, or supervision; and​ (ii) because of the dysfunction or infirmity and the need for care or services, the individual has an​ impaired ability to protect the individual's self from maltreatment.​ (b) For purposes of this subdivision, "care or services" means care or services for the health, safety,​ welfare, or maintenance of an individual.​ History: 1995 c 229 art 1 s 22; 2000 c 319 s 3; 1Sp2001 c 9 art 14 s 32; 2002 c 252 s 23,24; 2002 c​ 379 art 1 s 113; 2004 c 146 art 3 s 46; 2006 c 212 art 3 s 41; 2007 c 112 s 57; 2008 c 326 art 2 s 15; 2009​ c 79 art 6 s 20,21; art 8 s 75; 2009 c 119 s 17; 2009 c 142 art 2 s 48; 2011 c 28 s 16,17; 2012 c 216 art 9​ s 32; 2013 c 108 art 8 s 58; 2014 c 262 art 4 s 9; art 5 s 6; 2015 c 78 art 6 s 26-28; 2016 c 158 art 1 s​ 210,211; 2019 c 60 art 1 s 47; art 4 s 33​

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626.557 REPORTING OF MALTREATMENT OF VULNERABLE ADULTS.​ Subdivision 1. Public policy. The legislature declares that the public policy of this state is to protect​ adults who, because of physical or mental disability or dependency on institutional services, are particularly​ vulnerable to maltreatment; to assist in providing safe environments for vulnerable adults; and to provide​ safe institutional or residential services, community-based services, or living environments for vulnerable​ adults who have been maltreated.​ In addition, it is the policy of this state to require the reporting of suspected maltreatment of vulnerable​ adults, to provide for the voluntary reporting of maltreatment of vulnerable adults, to require the investigation​ of the reports, and to provide protective and counseling services in appropriate cases.​ Subd. 2. [Repealed, 1995 c 229 art 1 s 24]​ Subd. 3. Timing of report. (a) A mandated reporter who has reason to believe that a vulnerable adult​ is being or has been maltreated, or who has knowledge that a vulnerable adult has sustained a physical injury​ which is not reasonably explained shall immediately report the information to the common entry point. If​ an individual is a vulnerable adult solely because the individual is admitted to a facility, a mandated reporter​ is not required to report suspected maltreatment of the individual that occurred prior to admission, unless:​ (1) the individual was admitted to the facility from another facility and the reporter has reason to believe​ the vulnerable adult was maltreated in the previous facility; or​ (2) the reporter knows or has reason to believe that the individual is a vulnerable adult as defined in​ section 626.5572, subdivision 21, paragraph (a), clause (4).​ (b) A person not required to report under the provisions of this section may voluntarily report as described​ above.​ (c) Nothing in this section requires a report of known or suspected maltreatment, if the reporter knows​ or has reason to know that a report has been made to the common entry point.​ (d) Nothing in this section shall preclude a reporter from also reporting to a law enforcement agency.​ (e) A mandated reporter who knows or has reason to believe that an error under section 626.5572,​ subdivision 17, paragraph (c), clause (5), occurred must make a report under this subdivision. If the reporter​ or a facility, at any time believes that an investigation by a lead investigative agency will determine or should​ determine that the reported error was not neglect according to the criteria under section 626.5572, subdivision​ 17, paragraph (c), clause (5), the reporter or facility may provide to the common entry point or directly to​ the lead investigative agency information explaining how the event meets the criteria under section 626.5572,​ subdivision 17, paragraph (c), clause (5). The lead investigative agency shall consider this information when​ making an initial disposition of the report under subdivision 9c.​ Subd. 3a. Report not required. The following events are not required to be reported under this section:​ (1) A circumstance where federal law specifically prohibits a person from disclosing patient identifying​ information in connection with a report of suspected maltreatment, unless the vulnerable adult, or the​ vulnerable adult's guardian, conservator, or legal representative, has consented to disclosure in a manner​ which conforms to federal requirements. Facilities whose patients or residents are covered by such a federal​ law shall seek consent to the disclosure of suspected maltreatment from each patient or resident, or a guardian,​ conservator, or legal representative, upon the patient's or resident's admission to the facility. Persons who​

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are prohibited by federal law from reporting an incident of suspected maltreatment shall immediately seek​ consent to make a report.​ (2) Verbal or physical aggression occurring between patients, residents, or clients of a facility, or​ self-abusive behavior by these persons does not constitute abuse unless the behavior causes serious harm.​ The operator of the facility or a designee shall record incidents of aggression and self-abusive behavior to​ facilitate review by licensing agencies and county and local welfare agencies.​ (3) Accidents as defined in section 626.5572, subdivision 3.​ (4) Events occurring in a facility that result from an individual's error in the provision of therapeutic​ conduct to a vulnerable adult, as provided in section 626.5572, subdivision 17, paragraph (c), clause (4).​ (5) Nothing in this section shall be construed to require a report of financial exploitation, as defined in​ section 626.5572, subdivision 9, solely on the basis of the transfer of money or property by gift or as​ compensation for services rendered.​ Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter shall immediately​ make an oral report to the common entry point. The common entry point may accept electronic reports​ submitted through a web-based reporting system established by the commissioner. Use of a​ telecommunications device for the deaf or other similar device shall be considered an oral report. The​ common entry point may not require written reports. To the extent possible, the report must be of sufficient​ content to identify the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment,​ any evidence of previous maltreatment, the name and address of the reporter, the time, date, and location​ of the incident, and any other information that the reporter believes might be helpful in investigating the​ suspected maltreatment. A mandated reporter may disclose not public data, as defined in section 13.02, and​ medical records under sections 144.291 to 144.298, to the extent necessary to comply with this subdivision.​ (b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified under Title 19​ of the Social Security Act, a nursing home that is licensed under section 144A.02 and certified under Title​ 18 or Title 19 of the Social Security Act, or a hospital that is licensed under sections 144.50 to 144.58 and​ has swing beds certified under Code of Federal Regulations, title 42, section 482.66, may submit a report​ electronically to the common entry point instead of submitting an oral report. The report may be a duplicate​ of the initial report the facility submits electronically to the commissioner of health to comply with the​ reporting requirements under Code of Federal Regulations, title 42, section 483.12. The commissioner of​ health may modify these reporting requirements to include items required under paragraph (a) that are not​ currently included in the electronic reporting form.​ Subd. 4a. Internal reporting of maltreatment. (a) Each facility shall establish and enforce an ongoing​ written procedure in compliance with applicable licensing rules to ensure that all cases of suspected​ maltreatment are reported. If a facility has an internal reporting procedure, a mandated reporter may meet​ the reporting requirements of this section by reporting internally. However, the facility remains responsible​ for complying with the immediate reporting requirements of this section.​ (b) A facility with an internal reporting procedure that receives an internal report by a mandated reporter​ shall give the mandated reporter a written notice stating whether the facility has reported the incident to the​ common entry point. The written notice must be provided within two working days and in a manner that​ protects the confidentiality of the reporter.​

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(c) The written response to the mandated reporter shall note that if the mandated reporter is not satisfied​ with the action taken by the facility on whether to report the incident to the common entry point, then the​ mandated reporter may report externally.​ (d) A facility may not prohibit a mandated reporter from reporting externally, and a facility is prohibited​ from retaliating against a mandated reporter who reports an incident to the common entry point in good​ faith. The written notice by the facility must inform the mandated reporter of this protection from retaliatory​ measures by the facility against the mandated reporter for reporting externally.​ Subd. 5. Immunity; protection for reporters. (a) A person who makes a good faith report is immune​ from any civil or criminal liability that might otherwise result from making the report, or from participating​ in the investigation, or for failure to comply fully with the reporting obligation under section 609.234 or​ 626.557, subdivision 7.​ (b) A person employed by a lead investigative agency or a state licensing agency who is conducting or​ supervising an investigation or enforcing the law in compliance with this section or any related rule or​ provision of law is immune from any civil or criminal liability that might otherwise result from the person's​ actions, if the person is acting in good faith and exercising due care.​ (c) A person who knows or has reason to know a report has been made to a common entry point and​ who in good faith participates in an investigation of alleged maltreatment is immune from civil or criminal​ liability that otherwise might result from making the report, or from failure to comply with the reporting​ obligation or from participating in the investigation.​ (d) The identity of any reporter may not be disclosed, except as provided in subdivision 12b.​ (e) For purposes of this subdivision, "person" includes a natural person or any form of a business or​ legal entity.​ Subd. 5a. Financial institution cooperation. Financial institutions shall cooperate with a lead​ investigative agency, law enforcement, or prosecuting authority that is investigating maltreatment of a​ vulnerable adult and comply with reasonable requests for the production of financial records as authorized​ under section 13A.02, subdivision 1. Financial institutions are immune from any civil or criminal liability​ that might otherwise result from complying with this subdivision.​ Subd. 6. Falsified reports. A person or facility who intentionally makes a false report under the provisions​ of this section shall be liable in a civil suit for any actual damages suffered by the reported facility, person​ or persons and for punitive damages up to $10,000 and attorney fees.​ Subd. 7. Failure to report. A mandated reporter who negligently or intentionally fails to report is liable​ for damages caused by the failure. Nothing in this subdivision imposes vicarious liability for the acts or​ omissions of others.​ Subd. 8. Evidence not privileged. No evidence regarding the maltreatment of the vulnerable adult shall​ be excluded in any proceeding arising out of the alleged maltreatment on the grounds of lack of competency​ under section 595.02.​ Subd. 9. Common entry point designation. (a) Each county board shall designate a common entry​ point for reports of suspected maltreatment, for use until the commissioner of human services establishes a​ common entry point. Two or more county boards may jointly designate a single common entry point. The​ commissioner of human services shall establish a common entry point effective July 1, 2015. The common​ entry point is the unit responsible for receiving the report of suspected maltreatment under this section.​

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(b) The common entry point must be available 24 hours per day to take calls from reporters of suspected​ maltreatment. The common entry point shall use a standard intake form that includes:​ (1) the time and date of the report;​ (2) the name, address, and telephone number of the person reporting;​ (3) the time, date, and location of the incident;​ (4) the names of the persons involved, including but not limited to, perpetrators, alleged victims, and​ witnesses;​ (5) whether there was a risk of imminent danger to the alleged victim;​ (6) a description of the suspected maltreatment;​ (7) the disability, if any, of the alleged victim;​ (8) the relationship of the alleged perpetrator to the alleged victim;​ (9) whether a facility was involved and, if so, which agency licenses the facility;​ (10) any action taken by the common entry point;​ (11) whether law enforcement has been notified;​ (12) whether the reporter wishes to receive notification of the initial and final reports; and​ (13) if the report is from a facility with an internal reporting procedure, the name, mailing address, and​ telephone number of the person who initiated the report internally.​ (c) The common entry point is not required to complete each item on the form prior to dispatching the​ report to the appropriate lead investigative agency.​ (d) The common entry point shall immediately report to a law enforcement agency any incident in which​ there is reason to believe a crime has been committed.​ (e) If a report is initially made to a law enforcement agency or a lead investigative agency, those agencies​ shall take the report on the appropriate common entry point intake forms and immediately forward a copy​ to the common entry point.​ (f) The common entry point staff must receive training on how to screen and dispatch reports efficiently​ and in accordance with this section.​ (g) The commissioner of human services shall maintain a centralized database for the collection of​ common entry point data, lead investigative agency data including maltreatment report disposition, and​ appeals data. The common entry point shall have access to the centralized database and must log the reports​ into the database and immediately identify and locate prior reports of abuse, neglect, or exploitation.​ (h) When appropriate, the common entry point staff must refer calls that do not allege the abuse, neglect,​ or exploitation of a vulnerable adult to other organizations that might resolve the reporter's concerns.​ (i) A common entry point must be operated in a manner that enables the commissioner of human services​ to:​

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(1) track critical steps in the reporting, evaluation, referral, response, disposition, and investigative​ process to ensure compliance with all requirements for all reports;​ (2) maintain data to facilitate the production of aggregate statistical reports for monitoring patterns of​ abuse, neglect, or exploitation;​ (3) serve as a resource for the evaluation, management, and planning of preventative and remedial​ services for vulnerable adults who have been subject to abuse, neglect, or exploitation;​ (4) set standards, priorities, and policies to maximize the efficiency and effectiveness of the common​ entry point; and​ (5) track and manage consumer complaints related to the common entry point.​ (j) The commissioners of human services and health shall collaborate on the creation of a system for​ referring reports to the lead investigative agencies. This system shall enable the commissioner of human​ services to track critical steps in the reporting, evaluation, referral, response, disposition, investigation,​ notification, determination, and appeal processes.​ Subd. 9a. Evaluation and referral of reports made to common entry point. (a) The common entry​ point must screen the reports of alleged or suspected maltreatment for immediate risk and make all necessary​ referrals as follows:​ (1) if the common entry point determines that there is an immediate need for emergency adult protective​ services, the common entry point agency shall immediately notify the appropriate county agency;​ (2) if the report contains suspected criminal activity against a vulnerable adult, the common entry point​ shall immediately notify the appropriate law enforcement agency;​ (3) the common entry point shall refer all reports of alleged or suspected maltreatment to the appropriate​ lead investigative agency as soon as possible, but in any event no longer than two working days;​ (4) if the report contains information about a suspicious death, the common entry point shall immediately​ notify the appropriate law enforcement agencies, the local medical examiner, and the ombudsman for mental​ health and developmental disabilities established under section 245.92. Law enforcement agencies shall​ coordinate with the local medical examiner and the ombudsman as provided by law; and​ (5) for reports involving multiple locations or changing circumstances, the common entry point shall​ determine the county agency responsible for emergency adult protective services and the county responsible​ as the lead investigative agency, using referral guidelines established by the commissioner.​ (b) If the lead investigative agency receiving a report believes the report was referred by the common​ entry point in error, the lead investigative agency shall immediately notify the common entry point of the​ error, including the basis for the lead investigative agency's belief that the referral was made in error. The​ common entry point shall review the information submitted by the lead investigative agency and immediately​ refer the report to the appropriate lead investigative agency.​ Subd. 9b. Response to reports. Law enforcement is the primary agency to conduct investigations of​ any incident in which there is reason to believe a crime has been committed. Law enforcement shall initiate​ a response immediately. If the common entry point notified a county agency for emergency adult protective​ services, law enforcement shall cooperate with that county agency when both agencies are involved and​ shall exchange data to the extent authorized in subdivision 12b, paragraph (g). County adult protection shall​ initiate a response immediately. Each lead investigative agency shall complete the investigative process for​

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reports within its jurisdiction. A lead investigative agency, county, adult protective agency, licensed facility,​ or law enforcement agency shall cooperate with other agencies in the provision of protective services,​ coordinating its investigations, and assisting another agency within the limits of its resources and expertise​ and shall exchange data to the extent authorized in subdivision 12b, paragraph (g). The lead investigative​ agency shall obtain the results of any investigation conducted by law enforcement officials. The lead​ investigative agency has the right to enter facilities and inspect and copy records as part of investigations.​ The lead investigative agency has access to not public data, as defined in section 13.02, and medical records​ under sections 144.291 to 144.298, that are maintained by facilities to the extent necessary to conduct its​ investigation. Each lead investigative agency shall develop guidelines for prioritizing reports for investigation.​ Subd. 9c. Lead investigative agency; notifications, dispositions, determinations. (a) Upon request​ of the reporter, the lead investigative agency shall notify the reporter that it has received the report, and​ provide information on the initial disposition of the report within five business days of receipt of the report,​ provided that the notification will not endanger the vulnerable adult or hamper the investigation.​ (b) Upon conclusion of every investigation it conducts, the lead investigative agency shall make a final​ disposition as defined in section 626.5572, subdivision 8.​ (c) When determining whether the facility or individual is the responsible party for substantiated​ maltreatment or whether both the facility and the individual are responsible for substantiated maltreatment,​ the lead investigative agency shall consider at least the following mitigating factors:​ (1) whether the actions of the facility or the individual caregivers were in accordance with, and followed​ the terms of, an erroneous physician order, prescription, resident care plan, or directive. This is not a mitigating​ factor when the facility or caregiver is responsible for the issuance of the erroneous order, prescription, plan,​ or directive or knows or should have known of the errors and took no reasonable measures to correct the​ defect before administering care;​ (2) the comparative responsibility between the facility, other caregivers, and requirements placed upon​ the employee, including but not limited to, the facility's compliance with related regulatory standards and​ factors such as the adequacy of facility policies and procedures, the adequacy of facility training, the adequacy​ of an individual's participation in the training, the adequacy of caregiver supervision, the adequacy of facility​ staffing levels, and a consideration of the scope of the individual employee's authority; and​ (3) whether the facility or individual followed professional standards in exercising professional judgment.​ (d) When substantiated maltreatment is determined to have been committed by an individual who is​ also the facility license holder, both the individual and the facility must be determined responsible for the​ maltreatment, and both the background study disqualification standards under section 245C.15, subdivision​ 4, and the licensing actions under section 245A.06 or 245A.07 apply.​ (e) The lead investigative agency shall complete its final disposition within 60 calendar days. If the lead​ investigative agency is unable to complete its final disposition within 60 calendar days, the lead investigative​ agency shall notify the following persons provided that the notification will not endanger the vulnerable​ adult or hamper the investigation: (1) the vulnerable adult or the vulnerable adult's guardian or health care​ agent, when known, if the lead investigative agency knows them to be aware of the investigation; and (2)​ the facility, where applicable. The notice shall contain the reason for the delay and the projected completion​ date. If the lead investigative agency is unable to complete its final disposition by a subsequent projected​ completion date, the lead investigative agency shall again notify the vulnerable adult or the vulnerable adult's​ guardian or health care agent, when known if the lead investigative agency knows them to be aware of the​ investigation, and the facility, where applicable, of the reason for the delay and the revised projected​

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completion date provided that the notification will not endanger the vulnerable adult or hamper the​ investigation. The lead investigative agency must notify the health care agent of the vulnerable adult only​ if the health care agent's authority to make health care decisions for the vulnerable adult is currently effective​ under section 145C.06 and not suspended under section 524.5-310 and the investigation relates to a duty​ assigned to the health care agent by the principal. A lead investigative agency's inability to complete the​ final disposition within 60 calendar days or by any projected completion date does not invalidate the final​ disposition.​ (f) Within ten calendar days of completing the final disposition, the lead investigative agency shall​ provide a copy of the public investigation memorandum under subdivision 12b, paragraph (b), clause (1),​ when required to be completed under this section, to the following persons: (1) the vulnerable adult, or the​ vulnerable adult's guardian or health care agent, if known, unless the lead investigative agency knows that​ the notification would endanger the well-being of the vulnerable adult; (2) the reporter, if the reporter​ requested notification when making the report, provided this notification would not endanger the well-being​ of the vulnerable adult; (3) the alleged perpetrator, if known; (4) the facility; and (5) the ombudsman for​ long-term care, or the ombudsman for mental health and developmental disabilities, as appropriate.​ (g) If, as a result of a reconsideration, review, or hearing, the lead investigative agency changes the final​ disposition, or if a final disposition is changed on appeal, the lead investigative agency shall notify the parties​ specified in paragraph (f).​ (h) The lead investigative agency shall notify the vulnerable adult who is the subject of the report or the​ vulnerable adult's guardian or health care agent, if known, and any person or facility determined to have​ maltreated a vulnerable adult, of their appeal or review rights under this section or section 256.021.​ (i) The lead investigative agency shall routinely provide investigation memoranda for substantiated​ reports to the appropriate licensing boards. These reports must include the names of substantiated perpetrators.​ The lead investigative agency may not provide investigative memoranda for inconclusive or false reports​ to the appropriate licensing boards unless the lead investigative agency's investigation gives reason to believe​ that there may have been a violation of the applicable professional practice laws. If the investigation​ memorandum is provided to a licensing board, the subject of the investigation memorandum shall be notified​ and receive a summary of the investigative findings.​ (j) In order to avoid duplication, licensing boards shall consider the findings of the lead investigative​ agency in their investigations if they choose to investigate. This does not preclude licensing boards from​ considering other information.​ (k) The lead investigative agency must provide to the commissioner of human services its final​ dispositions, including the names of all substantiated perpetrators. The commissioner of human services​ shall establish records to retain the names of substantiated perpetrators.​ Subd. 9d. Administrative reconsideration; review panel. (a) Except as provided under paragraph (e),​ any individual or facility which a lead investigative agency determines has maltreated a vulnerable adult,​ or the vulnerable adult or an interested person acting on behalf of the vulnerable adult, regardless of the lead​ investigative agency's determination, who contests the lead investigative agency's final disposition of an​ allegation of maltreatment, may request the lead investigative agency to reconsider its final disposition. The​ request for reconsideration must be submitted in writing to the lead investigative agency within 15 calendar​ days after receipt of notice of final disposition or, if the request is made by an interested person who is not​ entitled to notice, within 15 days after receipt of the notice by the vulnerable adult or the vulnerable adult's​ guardian or health care agent. If mailed, the request for reconsideration must be postmarked and sent to the​

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lead investigative agency within 15 calendar days of the individual's or facility's receipt of the final disposition.​ If the request for reconsideration is made by personal service, it must be received by the lead investigative​ agency within 15 calendar days of the individual's or facility's receipt of the final disposition. An individual​ who was determined to have maltreated a vulnerable adult under this section and who was disqualified on​ the basis of serious or recurring maltreatment under sections 245C.14 and 245C.15, may request​ reconsideration of the maltreatment determination and the disqualification. The request for reconsideration​ of the maltreatment determination and the disqualification must be submitted in writing within 30 calendar​ days of the individual's receipt of the notice of disqualification under sections 245C.16 and 245C.17. If​ mailed, the request for reconsideration of the maltreatment determination and the disqualification must be​ postmarked and sent to the lead investigative agency within 30 calendar days of the individual's receipt of​ the notice of disqualification. If the request for reconsideration is made by personal service, it must be​ received by the lead investigative agency within 30 calendar days after the individual's receipt of the notice​ of disqualification.​ (b) Except as provided under paragraphs (e) and (f), if the lead investigative agency denies the request​ or fails to act upon the request within 15 working days after receiving the request for reconsideration, the​ person or facility entitled to a fair hearing under section 256.045, may submit to the commissioner of human​ services a written request for a hearing under that statute. The vulnerable adult, or an interested person acting​ on behalf of the vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review Panel​ under section 256.021 if the lead investigative agency denies the request or fails to act upon the request, or​ if the vulnerable adult or interested person contests a reconsidered disposition. The lead investigative agency​ shall notify persons who request reconsideration of their rights under this paragraph. The request must be​ submitted in writing to the review panel and a copy sent to the lead investigative agency within 30 calendar​ days of receipt of notice of a denial of a request for reconsideration or of a reconsidered disposition. The​ request must specifically identify the aspects of the lead investigative agency determination with which the​ person is dissatisfied.​ (c) If, as a result of a reconsideration or review, the lead investigative agency changes the final disposition,​ it shall notify the parties specified in subdivision 9c, paragraph (f).​ (d) For purposes of this subdivision, "interested person acting on behalf of the vulnerable adult" means​ a person designated in writing by the vulnerable adult to act on behalf of the vulnerable adult, or a legal​ guardian or conservator or other legal representative, a proxy or health care agent appointed under chapter​ 145B or 145C, or an individual who is related to the vulnerable adult, as defined in section 245A.02,​ subdivision 13.​ (e) If an individual was disqualified under sections 245C.14 and 245C.15, on the basis of a determination​ of maltreatment, which was serious or recurring, and the individual has requested reconsideration of the​ maltreatment determination under paragraph (a) and reconsideration of the disqualification under sections​ 245C.21 to 245C.27, reconsideration of the maltreatment determination and requested reconsideration of​ the disqualification shall be consolidated into a single reconsideration. If reconsideration of the maltreatment​ determination is denied and the individual remains disqualified following a reconsideration decision, the​ individual may request a fair hearing under section 256.045. If an individual requests a fair hearing on the​ maltreatment determination and the disqualification, the scope of the fair hearing shall include both the​ maltreatment determination and the disqualification.​ (f) If a maltreatment determination or a disqualification based on serious or recurring maltreatment is​ the basis for a denial of a license under section 245A.05 or a licensing sanction under section 245A.07, the​ license holder has the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505​ to 1400.8612. As provided for under section 245A.08, the scope of the contested case hearing must include​

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the maltreatment determination, disqualification, and licensing sanction or denial of a license. In such cases,​ a fair hearing must not be conducted under section 256.045. Except for family child care and child foster​ care, reconsideration of a maltreatment determination under this subdivision, and reconsideration of a​ disqualification under section 245C.22, must not be conducted when:​ (1) a denial of a license under section 245A.05, or a licensing sanction under section 245A.07, is based​ on a determination that the license holder is responsible for maltreatment or the disqualification of a license​ holder based on serious or recurring maltreatment;​ (2) the denial of a license or licensing sanction is issued at the same time as the maltreatment determination​ or disqualification; and​ (3) the license holder appeals the maltreatment determination or disqualification, and denial of a license​ or licensing sanction.​ Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment determination or​ disqualification, but does not appeal the denial of a license or a licensing sanction, reconsideration of the​ maltreatment determination shall be conducted under sections 260E.33 and 626.557, subdivision 9d, and​ reconsideration of the disqualification shall be conducted under section 245C.22. In such cases, a fair hearing​ shall also be conducted as provided under sections 245C.27, 260E.33, and 626.557, subdivision 9d.​ If the disqualified subject is an individual other than the license holder and upon whom a background​ study must be conducted under chapter 245C, the hearings of all parties may be consolidated into a single​ contested case hearing upon consent of all parties and the administrative law judge.​ (g) Until August 1, 2002, an individual or facility that was determined by the commissioner of human​ services or the commissioner of health to be responsible for neglect under section 626.5572, subdivision​ 17, after October 1, 1995, and before August 1, 2001, that believes that the finding of neglect does not meet​ an amended definition of neglect may request a reconsideration of the determination of neglect. The​ commissioner of human services or the commissioner of health shall mail a notice to the last known address​ of individuals who are eligible to seek this reconsideration. The request for reconsideration must state how​ the established findings no longer meet the elements of the definition of neglect. The commissioner shall​ review the request for reconsideration and make a determination within 15 calendar days. The commissioner's​ decision on this reconsideration is the final agency action.​ (1) For purposes of compliance with the data destruction schedule under subdivision 12b, paragraph​ (d), when a finding of substantiated maltreatment has been changed as a result of a reconsideration under​ this paragraph, the date of the original finding of a substantiated maltreatment must be used to calculate the​ destruction date.​ (2) For purposes of any background studies under chapter 245C, when a determination of substantiated​ maltreatment has been changed as a result of a reconsideration under this paragraph, any prior disqualification​ of the individual under chapter 245C that was based on this determination of maltreatment shall be rescinded,​ and for future background studies under chapter 245C the commissioner must not use the previous​ determination of substantiated maltreatment as a basis for disqualification or as a basis for referring the​ individual's maltreatment history to a health-related licensing board under section 245C.31.​ Subd. 9e. Education requirements. (a) The commissioners of health, human services, and public safety​ shall cooperate in the development of a joint program for education of lead investigative agency investigators​ in the appropriate techniques for investigation of complaints of maltreatment. This program must be developed​

by July 1, 1996. The program must include but need not be limited to the following areas: (1) information​

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collection and preservation; (2) analysis of facts; (3) levels of evidence; (4) conclusions based on evidence;​ (5) interviewing skills, including specialized training to interview people with unique needs; (6) report​ writing; (7) coordination and referral to other necessary agencies such as law enforcement and judicial​ agencies; (8) human relations and cultural diversity; (9) the dynamics of adult abuse and neglect within​ family systems and the appropriate methods for interviewing relatives in the course of the assessment or​ investigation; (10) the protective social services that are available to protect alleged victims from further​ abuse, neglect, or financial exploitation; (11) the methods by which lead investigative agency investigators​ and law enforcement workers cooperate in conducting assessments and investigations in order to avoid​ duplication of efforts; and (12) data practices laws and procedures, including provisions for sharing data.​ (b) The commissioner of human services shall conduct an outreach campaign to promote the common​ entry point for reporting vulnerable adult maltreatment. This campaign shall use the Internet and other means​ of communication.​ (c) The commissioners of health, human services, and public safety shall offer at least annual education​ to others on the requirements of this section, on how this section is implemented, and investigation techniques.​ (d) The commissioner of human services, in coordination with the commissioner of public safety shall​ provide training for the common entry point staff as required in this subdivision and the program courses​ described in this subdivision, at least four times per year. At a minimum, the training shall be held twice​ annually in the seven-county metropolitan area and twice annually outside the seven-county metropolitan​ area. The commissioners shall give priority in the program areas cited in paragraph (a) to persons currently​ performing assessments and investigations pursuant to this section.​ (e) The commissioner of public safety shall notify in writing law enforcement personnel of any new​ requirements under this section. The commissioner of public safety shall conduct regional training for law​ enforcement personnel regarding their responsibility under this section.​ (f) Each lead investigative agency investigator must complete the education program specified by this​ subdivision within the first 12 months of work as a lead investigative agency investigator.​ A lead investigative agency investigator employed when these requirements take effect must complete​ the program within the first year after training is available or as soon as training is available.​ All lead investigative agency investigators having responsibility for investigation duties under this​ section must receive a minimum of eight hours of continuing education or in-service training each year​ specific to their duties under this section.​ Subd. 10. Duties of county social service agency. (a) When the common entry point refers a report to​ the county social service agency as the lead investigative agency or makes a referral to the county social​ service agency for emergency adult protective services, or when another lead investigative agency requests​ assistance from the county social service agency for adult protective services, the county social service​ agency shall immediately assess and offer emergency and continuing protective social services for purposes​ of preventing further maltreatment and for safeguarding the welfare of the maltreated vulnerable adult. The​ county shall use a standardized tool made available by the commissioner. The information entered by the​ county into the standardized tool must be accessible to the Department of Human Services. In cases of​ suspected sexual abuse, the county social service agency shall immediately arrange for and make available​ to the vulnerable adult appropriate medical examination and treatment. When necessary in order to protect​ the vulnerable adult from further harm, the county social service agency shall seek authority to remove the​ vulnerable adult from the situation in which the maltreatment occurred. The county social service agency​ may also investigate to determine whether the conditions which resulted in the reported maltreatment place​

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other vulnerable adults in jeopardy of being maltreated and offer protective social services that are called​ for by its determination.​ (b) County social service agencies may enter facilities and inspect and copy records as part of an​ investigation. The county social service agency has access to not public data, as defined in section 13.02,​ and medical records under sections 144.291 to 144.298, that are maintained by facilities to the extent necessary​ to conduct its investigation. The inquiry is not limited to the written records of the facility, but may include​ every other available source of information.​ (c) When necessary in order to protect a vulnerable adult from serious harm, the county social service​ agency shall immediately intervene on behalf of that adult to help the family, vulnerable adult, or other​ interested person by seeking any of the following:​ (1) a restraining order or a court order for removal of the perpetrator from the residence of the vulnerable​ adult pursuant to section 518B.01;​ (2) the appointment of a guardian or conservator pursuant to sections 524.5-101 to 524.5-502, or​ guardianship or conservatorship pursuant to chapter 252A;​ (3) replacement of a guardian or conservator suspected of maltreatment and appointment of a suitable​ person as guardian or conservator, pursuant to sections 524.5-101 to 524.5-502; or​ (4) a referral to the prosecuting attorney for possible criminal prosecution of the perpetrator under chapter​ 609.​ The expenses of legal intervention must be paid by the county in the case of indigent persons, under​ section 524.5-502 and chapter 563.​ In proceedings under sections 524.5-101 to 524.5-502, if a suitable relative or other person is not available​ to petition for guardianship or conservatorship, a county employee shall present the petition with representation​ by the county attorney. The county shall contract with or arrange for a suitable person or organization to​ provide ongoing guardianship services. If the county presents evidence to the court exercising probate​ jurisdiction that it has made a diligent effort and no other suitable person can be found, a county employee​ may serve as guardian or conservator. The county shall not retaliate against the employee for any action​ taken on behalf of the ward or protected person even if the action is adverse to the county's interest. Any​ person retaliated against in violation of this subdivision shall have a cause of action against the county and​ shall be entitled to reasonable attorney fees and costs of the action if the action is upheld by the court.​ Subd. 10a. [Repealed, 1995 c 229 art 1 s 24]​ Subd. 10b. Investigations; guidelines. Each lead investigative agency shall develop guidelines for​ prioritizing reports for investigation. When investigating a report, the lead investigative agency shall conduct​ the following activities, as appropriate:​ (1) interview of the alleged victim;​ (2) interview of the reporter and others who may have relevant information;​ (3) interview of the alleged perpetrator;​ (4) examination of the environment surrounding the alleged incident;​ (5) review of pertinent documentation of the alleged incident; and​

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(6) consultation with professionals.​ Subd. 11. [Repealed, 1995 c 229 art 1 s 24]​ Subd. 11a. [Repealed, 1995 c 229 art 1 s 24]​ Subd. 12. [Repealed, 1995 c 229 art 1 s 24]​ Subd. 12a. [Repealed, 1983 c 273 s 8]​ Subd. 12b. Data management. (a) In performing any of the duties of this section as a lead investigative​ agency, the county social service agency shall maintain appropriate records. Data collected by the county​ social service agency under this section are welfare data under section 13.46. Notwithstanding section 13.46,​ subdivision 1, paragraph (a), data under this paragraph that are inactive investigative data on an individual​ who is a vendor of services are private data on individuals, as defined in section 13.02. The identity of the​ reporter may only be disclosed as provided in paragraph (c).​ Data maintained by the common entry point are confidential data on individuals or protected nonpublic​ data as defined in section 13.02. Notwithstanding section 138.163, the common entry point shall maintain​ data for three calendar years after date of receipt and then destroy the data unless otherwise directed by​ federal requirements.​ (b) The commissioners of health and human services shall prepare an investigation memorandum for​ each report alleging maltreatment investigated under this section. County social service agencies must​ maintain private data on individuals but are not required to prepare an investigation memorandum. During​ an investigation by the commissioner of health or the commissioner of human services, data collected under​ this section are confidential data on individuals or protected nonpublic data as defined in section 13.02.​ Upon completion of the investigation, the data are classified as provided in clauses (1) to (3) and paragraph​ (c).​ (1) The investigation memorandum must contain the following data, which are public:​ (i) the name of the facility investigated;​ (ii) a statement of the nature of the alleged maltreatment;​ (iii) pertinent information obtained from medical or other records reviewed;​ (iv) the identity of the investigator;​ (v) a summary of the investigation's findings;​ (vi) statement of whether the report was found to be substantiated, inconclusive, false, or that no​ determination will be made;​ (vii) a statement of any action taken by the facility;​ (viii) a statement of any action taken by the lead investigative agency; and​ (ix) when a lead investigative agency's determination has substantiated maltreatment, a statement of​ whether an individual, individuals, or a facility were responsible for the substantiated maltreatment, if known.​ The investigation memorandum must be written in a manner which protects the identity of the reporter​ and of the vulnerable adult and may not contain the names or, to the extent possible, data on individuals or​ private data listed in clause (2).​

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(2) Data on individuals collected and maintained in the investigation memorandum are private data,​ including:​ (i) the name of the vulnerable adult;​ (ii) the identity of the individual alleged to be the perpetrator;​ (iii) the identity of the individual substantiated as the perpetrator; and​ (iv) the identity of all individuals interviewed as part of the investigation.​ (3) Other data on individuals maintained as part of an investigation under this section are private data​ on individuals upon completion of the investigation.​ (c) After the assessment or investigation is completed, the name of the reporter must be confidential.​ The subject of the report may compel disclosure of the name of the reporter only with the consent of the​ reporter or upon a written finding by a court that the report was false and there is evidence that the report​ was made in bad faith. This subdivision does not alter disclosure responsibilities or obligations under the​ Rules of Criminal Procedure, except that where the identity of the reporter is relevant to a criminal prosecution,​ the district court shall do an in-camera review prior to determining whether to order disclosure of the identity​ of the reporter.​ (d) Notwithstanding section 138.163, data maintained under this section by the commissioners of health​ and human services must be maintained under the following schedule and then destroyed unless otherwise​ directed by federal requirements:​ (1) data from reports determined to be false, maintained for three years after the finding was made;​ (2) data from reports determined to be inconclusive, maintained for four years after the finding was​ made;​ (3) data from reports determined to be substantiated, maintained for seven years after the finding was​ made; and​ (4) data from reports which were not investigated by a lead investigative agency and for which there is​ no final disposition, maintained for three years from the date of the report.​ (e) The commissioners of health and human services shall annually publish on their websites the number​ and type of reports of alleged maltreatment involving licensed facilities reported under this section, the​ number of those requiring investigation under this section, and the resolution of those investigations. On a​ biennial basis, the commissioners of health and human services shall jointly report the following information​ to the legislature and the governor:​ (1) the number and type of reports of alleged maltreatment involving licensed facilities reported under​ this section, the number of those requiring investigations under this section, the resolution of those​ investigations, and which of the two lead agencies was responsible;​ (2) trends about types of substantiated maltreatment found in the reporting period;​ (3) if there are upward trends for types of maltreatment substantiated, recommendations for addressing​ and responding to them;​ (4) efforts undertaken or recommended to improve the protection of vulnerable adults;​

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(5) whether and where backlogs of cases result in a failure to conform with statutory time frames and​ recommendations for reducing backlogs if applicable;​ (6) recommended changes to statutes affecting the protection of vulnerable adults; and​ (7) any other information that is relevant to the report trends and findings.​ (f) Each lead investigative agency must have a record retention policy.​ (g) Lead investigative agencies, prosecuting authorities, and law enforcement agencies may exchange​ not public data, as defined in section 13.02, if the agency or authority requesting the data determines that​ the data are pertinent and necessary to the requesting agency in initiating, furthering, or completing an​ investigation under this section. Data collected under this section must be made available to prosecuting​ authorities and law enforcement officials, local county agencies, and licensing agencies investigating the​ alleged maltreatment under this section. The lead investigative agency shall exchange not public data with​ the vulnerable adult maltreatment review panel established in section 256.021 if the data are pertinent and​ necessary for a review requested under that section. Notwithstanding section 138.17, upon completion of​ the review, not public data received by the review panel must be destroyed.​ (h) Each lead investigative agency shall keep records of the length of time it takes to complete its​ investigations.​ (i) A lead investigative agency may notify other affected parties and their authorized representative if​ the lead investigative agency has reason to believe maltreatment has occurred and determines the information​ will safeguard the well-being of the affected parties or dispel widespread rumor or unrest in the affected​ facility.​ (j) Under any notification provision of this section, where federal law specifically prohibits the disclosure​ of patient identifying information, a lead investigative agency may not provide any notice unless the vulnerable​ adult has consented to disclosure in a manner which conforms to federal requirements.​ Subd. 13. [Repealed, 1995 c 229 art 1 s 24]​ Subd. 14. Abuse prevention plans. (a) Each facility, except home health agencies and personal care​ attendant services providers, shall establish and enforce an ongoing written abuse prevention plan. The plan​ shall contain an assessment of the physical plant, its environment, and its population identifying factors​ which may encourage or permit abuse, and a statement of specific measures to be taken to minimize the risk​ of abuse. The plan shall comply with any rules governing the plan promulgated by the licensing agency.​ (b) Each facility, including a home health care agency and personal care attendant services providers,​ shall develop an individual abuse prevention plan for each vulnerable adult residing there or receiving​ services from them. The plan shall contain an individualized assessment of: (1) the person's susceptibility​ to abuse by other individuals, including other vulnerable adults; (2) the person's risk of abusing other​ vulnerable adults; and (3) statements of the specific measures to be taken to minimize the risk of abuse to​ that person and other vulnerable adults. For the purposes of this paragraph, the term "abuse" includes​ self-abuse.​ (c) If the facility, except home health agencies and personal care attendant services providers, knows​ that the vulnerable adult has committed a violent crime or an act of physical aggression toward others, the​ individual abuse prevention plan must detail the measures to be taken to minimize the risk that the vulnerable​ adult might reasonably be expected to pose to visitors to the facility and persons outside the facility, if​ unsupervised. Under this section, a facility knows of a vulnerable adult's history of criminal misconduct or​

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physical aggression if it receives such information from a law enforcement authority or through a medical​ record prepared by another facility, another health care provider, or the facility's ongoing assessments of​ the vulnerable adult.​ Subd. 15. [Repealed, 1995 c 229 art 1 s 24]​ Subd. 16. [Repealed, 2014 c 262 art 4 s 9]​ Subd. 17. Retaliation prohibited. (a) A facility or person shall not retaliate against any person who​ reports in good faith suspected maltreatment pursuant to this section, or against a vulnerable adult with​ respect to whom a report is made, because of the report.​ (b) In addition to any remedies allowed under sections 181.931 to 181.935, any facility or person which​ retaliates against any person because of a report of suspected maltreatment is liable to that person for actual​ damages, punitive damages up to $10,000, and attorney fees.​ (c) There shall be a rebuttable presumption that any adverse action, as defined below, within 90 days​ of a report, is retaliatory. For purposes of this clause, the term "adverse action" refers to action taken by a​ facility or person involved in a report against the person making the report or the person with respect to​ whom the report was made because of the report, and includes, but is not limited to:​ (1) discharge or transfer from the facility;​ (2) discharge from or termination of employment;​ (3) demotion or reduction in remuneration for services;​ (4) restriction or prohibition of access to the facility or its residents; or​ (5) any restriction of rights set forth in section 144.651.​ Subd. 18. Outreach. The commissioner of human services shall maintain an aggressive program to​ educate those required to report, as well as the general public, about the requirements of this section using​ a variety of media. The commissioner of human services shall print and make available the form developed​ under subdivision 9.​ Subd. 19. [Repealed, 1995 c 229 art 1 s 24]​ Subd. 20. Cause of action for financial exploitation; damages. (a) A vulnerable adult who is a victim​ of financial exploitation as defined in section 626.5572, subdivision 9, has a cause of action against a person​ who committed the financial exploitation. In an action under this subdivision, the vulnerable adult is entitled​ to recover damages equal to three times the amount of compensatory damages or $10,000, whichever is​ greater.​ (b) In addition to damages under paragraph (a), the vulnerable adult is entitled to recover reasonable​ attorney fees and costs, including reasonable fees for the services of a guardian or conservator or guardian​ ad litem incurred in connection with a claim under this subdivision.​ (c) An action may be brought under this subdivision regardless of whether there has been a report or​ final disposition under this section or a criminal complaint or conviction related to the financial exploitation.​ Subd. 21. Contested case hearing. When an appeal of a lead investigative agency determination results​ in a contested case hearing under chapter 245A or 245C, the administrative law judge shall notify the​ vulnerable adult who is the subject of the maltreatment determination and, if known, a guardian of the​

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vulnerable adult appointed under section 524.5-310, or a health care agent designated by the vulnerable​ adult in a health care directive that is currently effective under section 145C.06, and whose authority to​ make health care decisions is not suspended under section 524.5-310, of the hearing. The notice must be​ sent by certified mail and inform the vulnerable adult of the right to file a signed written statement in the​ proceedings. A guardian or health care agent who prepares or files a written statement for the vulnerable​ adult must indicate in the statement that the person is the vulnerable adult's guardian or health care agent​ and sign the statement in that capacity. The vulnerable adult, the guardian, or the health care agent may file​ a written statement with the administrative law judge hearing the case no later than five business days before​ commencement of the hearing. The administrative law judge shall include the written statement in the hearing​ record and consider the statement in deciding the appeal. This subdivision does not limit, prevent, or excuse​ the vulnerable adult from being called as a witness testifying at the hearing or grant the vulnerable adult,​ the guardian, or health care agent a right to participate in the proceedings or appeal the administrative law​ judge's decision in the case. The lead investigative agency must consider including the vulnerable adult​ victim of maltreatment as a witness in the hearing. If the lead investigative agency determines that participation​ in the hearing would endanger the well-being of the vulnerable adult or not be in the best interests of the​ vulnerable adult, the lead investigative agency shall inform the administrative law judge of the basis for this​ determination, which must be included in the final order. If the administrative law judge is not reasonably​ able to determine the address of the vulnerable adult, the guardian, or the health care agent, the administrative​ law judge is not required to send a hearing notice under this subdivision.​ History: 1980 c 542 s 1; 1981 c 311 s 39; 1982 c 393 s 3,4; 1982 c 424 s 130; 1982 c 545 s 24; 1982​ c 636 s 5,6; 1983 c 273 s 1-7; 1984 c 640 s 32; 1984 c 654 art 5 s 58; 1985 c 150 s 1-6; 1985 c 293 s 6,7;​ 1Sp1985 c 14 art 9 s 75; 1986 c 444; 1987 c 110 s 3; 1987 c 211 s 2; 1987 c 352 s 11; 1987 c 378 s 17;​ 1987 c 384 art 2 s 1; 1988 c 543 s 13; 1989 c 209 art 2 s 1; 1991 c 181 s 2; 1994 c 483 s 1; 1994 c 636 art​ 2 s 60-62; 1Sp1994 c 1 art 2 s 34; 1995 c 189 s 8; 1995 c 229 art 1 s 1-21; 1996 c 277 s 1; 1996 c 305 art​ 2 s 66; 2000 c 465 s 3-5; 1Sp2001 c 9 art 5 s 31; art 14 s 30,31; 2002 c 289 s 4; 2002 c 375 art 1 s 22,23;​ 2002 c 379 art 1 s 113; 2003 c 15 art 1 s 33; 2004 c 146 art 3 s 45; 2004 c 288 art 1 s 80; 2005 c 56 s 1;​ 2005 c 98 art 2 s 17; 2005 c 136 art 5 s 5; 1Sp2005 c 4 art 1 s 55,56; 2006 c 253 s 21; 2007 c 112 s 55,56;​ 2007 c 147 art 7 s 75; art 10 s 15; 2009 c 119 s 11-16; 2009 c 142 art 2 s 46,47; 2009 c 159 s 107; 2010 c​ 329 art 2 s 6; 2010 c 352 art 1 s 23; 2010 c 382 s 81; 2011 c 28 s 9-14,17; 2012 c 216 art 9 s 30,31; 2013​ c 63 s 17; 2013 c 108 art 2 s 41-43; art 8 s 57; 2014 c 192 art 2 s 1; 2014 c 291 art 8 s 17; 2015 c 78 art 6​ s 23-25; 2019 c 50 art 1 s 128; 1Sp2020 c 2 art 8 s 144​

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144.6502​

144.6502 ELECTRONIC MONITORING IN CERTAIN FACILITIES.​ Subdivision 1. Definitions. (a) For the purposes of this section, the terms defined in this subdivision​ have the meanings given.​ (b) "Commissioner" means the commissioner of health.​ (c) "Department" means the Department of Health.​ (d) "Electronic monitoring" means the placement and use of an electronic monitoring device by a resident​ in the resident's room or private living unit in accordance with this section.​ (e) "Electronic monitoring device" means a camera or other device that captures, records, or broadcasts​ audio, video, or both, that is placed in a resident's room or private living unit and is used to monitor the​ resident or activities in the room or private living unit.​ (f) "Facility" means a facility that is:​ (1) licensed as a nursing home under chapter 144A;​ (2) licensed as a boarding care home under sections 144.50 to 144.56;​ (3) until August 1, 2021, a housing with services establishment registered under chapter 144D that is​ either subject to chapter 144G or has a disclosed special unit under section 325F.72; or​ (4) on or after August 1, 2021, an assisted living facility.​ (g) "Resident" means a person 18 years of age or older residing in a facility.​ (h) "Resident representative" means one of the following in the order of priority listed, to the extent the​ person may reasonably be identified and located:​ (1) a court-appointed guardian;​ (2) a health care agent as defined in section 145C.01, subdivision 2; or​ (3) a person who is not an agent of a facility or of a home care provider designated in writing by the​ resident and maintained in the resident's records on file with the facility.​ Subd. 2. Electronic monitoring authorized. (a) A resident or a resident representative may conduct​ electronic monitoring of the resident's room or private living unit through the use of electronic monitoring​ devices placed in the resident's room or private living unit as provided in this section.​ (b) Nothing in this section precludes the use of electronic monitoring of health care allowed under other​ law.​ (c) Electronic monitoring authorized under this section is not a covered service under home and​ community-based waivers under chapter 256S and sections 256B.0913, 256B.092, and 256B.49.​ (d) This section does not apply to monitoring technology authorized as a home and community-based​ service under chapter 256S or section 256B.0913, 256B.092, or 256B.49.​ Subd. 3. Consent to electronic monitoring. (a) Except as otherwise provided in this subdivision, a​ resident must consent to electronic monitoring in the resident's room or private living unit in writing on a​ notification and consent form. If the resident has not affirmatively objected to electronic monitoring and the​

​

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resident's medical professional determines that the resident currently lacks the ability to understand and​ appreciate the nature and consequences of electronic monitoring, the resident representative may consent​ on behalf of the resident. For purposes of this subdivision, a resident affirmatively objects when the resident​ orally, visually, or through the use of auxiliary aids or services declines electronic monitoring. The resident's​ response must be documented on the notification and consent form.​ (b) Prior to a resident representative consenting on behalf of a resident, the resident must be asked if​ the resident wants electronic monitoring to be conducted. The resident representative must explain to the​ resident:​ (1) the type of electronic monitoring device to be used;​ (2) the standard conditions that may be placed on the electronic monitoring device's use, including those​ listed in subdivision 6;​ (3) with whom the recording may be shared under subdivision 10 or 11; and​ (4) the resident's ability to decline all recording.​ (c) A resident, or resident representative when consenting on behalf of the resident, may consent to​ electronic monitoring with any conditions of the resident's or resident representative's choosing, including​ the list of standard conditions provided in subdivision 6. A resident, or resident representative when consenting​ on behalf of the resident, may request that the electronic monitoring device be turned off or the visual or​ audio recording component of the electronic monitoring device be blocked at any time.​ (d) Prior to implementing electronic monitoring, a resident, or resident representative when acting on​ behalf of the resident, must obtain the written consent on the notification and consent form of any other​ resident residing in the shared room or shared private living unit. A roommate's or roommate's resident​ representative's written consent must comply with the requirements of paragraphs (a) to (c). Consent by a​ roommate or a roommate's resident representative under this paragraph authorizes the resident's use of any​ recording obtained under this section, as provided under subdivision 10 or 11.​ (e) Any resident conducting electronic monitoring must immediately remove or disable an electronic​ monitoring device prior to a new roommate moving into a shared room or shared private living unit, unless​ the resident obtains the roommate's or roommate's resident representative's written consent as provided under​ paragraph (d) prior to the roommate moving into the shared room or shared private living unit. Upon obtaining​ the new roommate's signed notification and consent form and submitting the form to the facility as required​ under subdivision 5, the resident may resume electronic monitoring.​ (f) The resident or roommate, or the resident representative or roommate's resident representative if the​ representative is consenting on behalf of the resident or roommate, may withdraw consent at any time and​ the withdrawal of consent must be documented on the original consent form as provided under subdivision​ 5, paragraph (d).​ Subd. 4. Refusal of roommate to consent. If a resident of a facility who is residing in a shared room​ or shared living unit, or the resident representative of such a resident when acting on behalf of the resident,​ wants to conduct electronic monitoring and another resident living in or moving into the same shared room​ or shared living unit refuses to consent to the use of an electronic monitoring device, the facility shall make​ a reasonable attempt to accommodate the resident who wants to conduct electronic monitoring. A facility​ has met the requirement to make a reasonable attempt to accommodate a resident or resident representative​ who wants to conduct electronic monitoring when, upon notification that a roommate has not consented to​ the use of an electronic monitoring device in the resident's room, the facility offers to move the resident to​

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another shared room or shared living unit that is available at the time of the request. If a resident chooses to​ reside in a private room or private living unit in a facility in order to accommodate the use of an electronic​ monitoring device, the resident must pay either the private room rate in a nursing home setting, or the​ applicable rent in a housing with services establishment or assisted living facility. If a facility is unable to​ accommodate a resident due to lack of space, the facility must reevaluate the request every two weeks until​ the request is fulfilled. A facility is not required to provide a private room, a single-bed room, or a private​ living unit to a resident who is unable to pay.​ Subd. 5. Notice to facility; exceptions. (a) Electronic monitoring may begin only after the resident or​ resident representative who intends to place an electronic monitoring device and any roommate or roommate's​ resident representative completes the notification and consent form and submits the form to the facility.​ (b) Notwithstanding paragraph (a), the resident or resident representative who intends to place an​ electronic monitoring device may do so without submitting a notification and consent form to the facility​ for up to 14 days:​ (1) if the resident or the resident representative reasonably fears retaliation against the resident by the​ facility, timely submits the completed notification and consent form to the Office of Ombudsman for​ Long-Term Care, and timely submits a Minnesota Adult Abuse Reporting Center report or police report, or​ both, upon evidence from the electronic monitoring device that suspected maltreatment has occurred;​ (2) if there has not been a timely written response from the facility to a written communication from the​ resident or resident representative expressing a concern prompting the desire for placement of an electronic​ monitoring device and if the resident or a resident representative timely submits a completed notification​ and consent form to the Office of Ombudsman for Long-Term Care; or​ (3) if the resident or resident representative has already submitted a Minnesota Adult Abuse Reporting​ Center report or police report regarding the resident's concerns prompting the desire for placement and if​ the resident or a resident representative timely submits a completed notification and consent form to the​ Office of Ombudsman for Long-Term Care.​ (c) Upon receipt of any completed notification and consent form, the facility must place the original​ form in the resident's file or file the original form with the resident's housing with services contract. The​ facility must provide a copy to the resident and the resident's roommate, if applicable.​ (d) If a resident is conducting electronic monitoring according to paragraph (b) and a new roommate​ moves into the room or living unit, the resident or resident representative must submit the signed notification​ and consent form to the facility. In the event that a resident or roommate, or the resident representative or​ roommate's resident representative if the representative is consenting on behalf of the resident or roommate,​ chooses to alter the conditions under which consent to electronic monitoring is given or chooses to withdraw​ consent to electronic monitoring, the facility must make available the original notification and consent form​ so that it may be updated. Upon receipt of the updated form, the facility must place the updated form in the​ resident's file or file the original form with the resident's signed housing with services contract. The facility​ must provide a copy of the updated form to the resident and the resident's roommate, if applicable.​ (e) If a new roommate, or the new roommate's resident representative when consenting on behalf of the​ new roommate, does not submit to the facility a completed notification and consent form and the resident​ conducting the electronic monitoring does not remove or disable the electronic monitoring device, the facility​ must remove the electronic monitoring device.​

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(f) If a roommate, or the roommate's resident representative when withdrawing consent on behalf of the​ roommate, submits an updated notification and consent form withdrawing consent and the resident conducting​ electronic monitoring does not remove or disable the electronic monitoring device, the facility must remove​ the electronic monitoring device.​ Subd. 6. Form requirements. (a) The notification and consent form completed by the resident must​ include, at a minimum, the following information:​ (1) the resident's signed consent to electronic monitoring or the signature of the resident representative,​ if applicable. If a person other than the resident signs the consent form, the form must document the following:​ (i) the date the resident was asked if the resident wants electronic monitoring to be conducted;​ (ii) who was present when the resident was asked;​ (iii) an acknowledgment that the resident did not affirmatively object; and​ (iv) the source of authority allowing the resident representative to sign the notification and consent form​ on the resident's behalf;​ (2) the resident's roommate's signed consent or the signature of the roommate's resident representative,​ if applicable. If a roommate's resident representative signs the consent form, the form must document the​ following:​ (i) the date the roommate was asked if the roommate wants electronic monitoring to be conducted;​ (ii) who was present when the roommate was asked;​ (iii) an acknowledgment that the roommate did not affirmatively object; and​ (iv) the source of authority allowing the resident representative to sign the notification and consent form​ on the roommate's behalf;​ (3) the type of electronic monitoring device to be used;​ (4) a list of standard conditions or restrictions that the resident or a roommate may elect to place on the​ use of the electronic monitoring device, including but not limited to:​ (i) prohibiting audio recording;​ (ii) prohibiting video recording;​ (iii) prohibiting broadcasting of audio or video;​ (iv) turning off the electronic monitoring device or blocking the visual recording component of the​ electronic monitoring device for the duration of an exam or procedure by a health care professional;​ (v) turning off the electronic monitoring device or blocking the visual recording component of the​ electronic monitoring device while dressing or bathing is performed; and​ (vi) turning off the electronic monitoring device for the duration of a visit with a spiritual adviser,​ ombudsman, attorney, financial planner, intimate partner, or other visitor;​ (5) any other condition or restriction elected by the resident or roommate on the use of an electronic​ monitoring device;​

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(6) a statement of the circumstances under which a recording may be disseminated under subdivision​ 10;​ (7) a signature box for documenting that the resident or roommate has withdrawn consent; and​ (8) an acknowledgment that the resident consents to the Office of Ombudsman for Long-Term Care and​ its representatives disclosing information about the form. Disclosure under this clause shall be limited to:​ (i) the fact that the form was received from the resident or resident representative;​ (ii) if signed by a resident representative, the name of the resident representative and the source of​ authority allowing the resident representative to sign the notification and consent form on the resident's​ behalf; and​ (iii) the type of electronic monitoring device placed.​ (b) Facilities must make the notification and consent form available to the residents and inform residents​ of their option to conduct electronic monitoring of their rooms or private living unit.​ (c) Notification and consent forms received by the Office of Ombudsman for Long-Term Care are​ classified under section 256.9744.​ (d) A facility that contacts the Office of Ombudsman for Long-Term Care regarding an electronic​ monitoring device presumably placed in accordance with subdivision 5, paragraph (a) or (b), must provide​ the office with the type, make, and model number of the electronic monitoring device discovered by the​ facility.​ Subd. 7. Costs and installation. (a) A resident or resident representative choosing to conduct electronic​ monitoring must do so at the resident's own expense, including paying purchase, installation, maintenance,​ and removal costs.​ (b) If a resident chooses to place an electronic monitoring device that uses Internet technology for visual​ or audio monitoring, the resident may be responsible for contracting with an Internet service provider.​ (c) The facility shall make a reasonable attempt to accommodate the resident's installation needs, including​ allowing access to the facility's public-use Internet or Wi-Fi systems when available for other public uses.​ A facility has the burden of proving that a requested accommodation is not reasonable.​ (d) All electronic monitoring device installations and supporting services must be UL-listed.​ Subd. 8. Notice to visitors. (a) A facility must post a sign at each facility entrance accessible to visitors​ that states: "Electronic monitoring devices, including security cameras and audio devices, may be present​ to record persons and activities."​ (b) The facility is responsible for installing and maintaining the signage required in this subdivision.​ Subd. 9. Obstruction of electronic monitoring devices. (a) A person must not knowingly hamper,​ obstruct, tamper with, or destroy an electronic monitoring device placed in a resident's room or private living​ unit without the permission of the resident or resident representative. Checking the electronic monitoring​ device by facility staff for the make and model number does not constitute tampering under this subdivision.​ (b) It is not a violation of paragraph (a) if a person turns off the electronic monitoring device or blocks​ the visual recording component of the electronic monitoring device at the direction of the resident or resident​ representative, or if consent has been withdrawn.​

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Subd. 10. Dissemination of recordings. (a) No person may access any video or audio recording created​ through authorized electronic monitoring without the written consent of the resident or resident representative.​ (b) Except as required under other law, a recording or copy of a recording made as provided in this​ section may only be disseminated for the purpose of addressing health, safety, or welfare concerns of one​ or more residents.​ (c) A person disseminating a recording or copy of a recording made as provided in this section in violation​ of paragraph (b) may be civilly or criminally liable.​ Subd. 11. Admissibility of evidence. Subject to applicable rules of evidence and procedure, any video​ or audio recording created through electronic monitoring under this section may be admitted into evidence​ in a civil, criminal, or administrative proceeding.​ Subd. 12. Liability. (a) For the purposes of state law, the mere presence of an electronic monitoring​ device in a resident's room or private living unit is not a violation of the resident's right to privacy under​ section 144.651 or 144A.44.​ (b) For the purposes of state law, a facility or home care provider is not civilly or criminally liable for​ the mere disclosure by a resident or a resident representative of a recording.​ Subd. 13. Immunity from liability. The Office of Ombudsman for Long-Term Care and representatives​ of the office are immune from liability for conduct described in section 256.9742, subdivision 2.​ Subd. 14. Resident protections. (a) A facility must not:​ (1) refuse to admit a potential resident or remove a resident because the facility disagrees with the​ decision of the potential resident, the resident, or a resident representative acting on behalf of the resident​ regarding electronic monitoring;​ (2) retaliate or discriminate against any resident for consenting or refusing to consent to electronic​ monitoring, as provided in section 144.6512, 144G.07, or 144G.92; or​ (3) prevent the placement or use of an electronic monitoring device by a resident who has provided the​ facility or the Office of Ombudsman for Long-Term Care with notice and consent as required under this​ section.​ (b) Any contractual provision prohibiting, limiting, or otherwise modifying the rights and obligations​ in this section is contrary to public policy and is void and unenforceable.​ Subd. 15. Employee discipline. (a) An employee of the facility or an employee of a contractor providing​ services at the facility, including an arranged home care provider as defined in section 144D.01, subdivision​ 2a, who is the subject of proposed disciplinary action based upon evidence obtained by electronic monitoring​ must be given access to that evidence for purposes of defending against the proposed action.​ (b) An employee who obtains a recording or a copy of the recording must treat the recording or copy​ confidentially and must not further disseminate it to any other person except as required under law. Any​ copy of the recording must be returned to the facility or resident who provided the copy when it is no longer​ needed for purposes of defending against a proposed action.​ Subd. 16. Penalties. (a) The commissioner may issue a correction order as provided under section​ 144A.10, 144A.45, 144A.474, or 144G.30, upon a finding that the facility has failed to comply with:​

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(1) subdivision 5, paragraphs (c) to (f);​ (2) subdivision 6, paragraph (b);​ (3) subdivision 7, paragraph (c); or​ (4) subdivision 8, 9, 10, or 14.​ (b) For each violation of this section, the commissioner may impose a fine of up to $500 upon a finding​ of noncompliance with a correction order issued under this subdivision.​ (c) The commissioner may exercise the commissioner's authority under section 144D.05 to compel a​ housing with services establishment to meet the requirements of this section.​ History: 2019 c 54 art 1 s 33; 2019 c 60 art 1 s 47; art 3 s 1; 1Sp2019 c 9 art 11 s 105​

95

96

Question: Do I need a liquor or wine/beer license to serve alcohol in my Licensed Assisted Living?

Answer: It depends.

If your establishment purchases and provides the alcohol, most likely the answer is yes. Below are some resources to help you better understand your options. A good starting point is to inquire with the city your building is located in (they may direct you to the county the building is located in). As always, consult with an attorney regarding important decisions like this.

1. Minnesota Statute 340A.401 LICENSE REQUIRED. Except as provided in this chapter, no person may directly or indirectly, on any pretense or by any device, sell, barter, keep for sale, charge for possession, or otherwise dispose of alcoholic beverages as part of a commercial transaction without having obtained the required license or permit.

2. Licensing always starts at the City or County level.

3. Establishment must decide between a full liquor license or wine & strong beer license options, and if they intend to serve on Sunday.

4. A Wine and strong beer license must also be approved by the state Alcohol and Gambling Enforcement (a division of the MN Department of Public Safety).

5. There are additional insurance and surety bond requirements when serving alcohol 6. Don't forget that minors are prohibited to serve, dispense or handle intoxicating liquors

that are consumed on the premises; and work in rooms where liquor is served or consumed, with the following exception:

• 16-17 year-olds may perform busing, dishwashing or hosting duties in a restaurant where the presence of intoxicating liquors is incidental to food service and preparation

97

Common Scenarios in an Assisted Living Facilities Situation Resident purchases own alcohol and consumes in own unit/apartment Resident purchases own alcohol and brings beverage down to communal dining room Resident brings alcohol to "Party Room" or private dining room, and provides alcohol to guests Alcohol is made available/provided to residents (or their guests) by the Assisted Living in the establishment's dining room – no charge for the alcohol, but the meal is charged separately or included in the services of the building.

Alcohol is made available/provided to residents (or their guests) by the Assisted Living in the establishment's dining room – charged for per drink/bottle.

Alcohol is regularly made available/provided to residents (or their guests) by the Assisted Living in a "pub", billiards room, party room, etc.

Alcohol is made available/provided to residents (or their guests) by the Assisted Living for special events or infrequently scheduled activities.

Sacramental wine is served as part of a religious service

License Required?

No

Comments Clinical may need to be involved if medically contraindicated

No

May prohibit or limit per policy if desired.

No

May prohibit or limit per policy of desired.

Yes – part of a commercial transaction.

Yes – part of a commercial transaction.

Yes – part of a commercial transaction.

Maybe – contact your city.

No – if a rabbi, priest, or minister of a church or other established religious organization imports wine exclusively for sacramental purposes

98

Could consider an outside caterer who has the appropriate license and insurance

Common Types of Licenses License/Permit On-premise sale of Intoxicating liquor

Sunday onpremise sale of Intoxicating liquor

On-premise wine

Issued To

For What On-premise consumption of distilled spirits, wine, strong beer

Hotels, restaurants, bars, lounges, bowling centers, theaters Restaurants, hotels, clubs, and bowling centers with regular intoxicating liquor on-sale license

On-premise consumption of intoxicating liquor on Sundays On-premise consumption of wine in conjunction with sale of food; may also sell strong beer if at least 60% of gross receipts come from sale of meals

Restaurants seating at least 25 guests

Issued by Whom Cities Counties

Cities and counties where Sunday liquor referendums have passed

Cities Counties Then approved by the State

Alcohol License Resources •

League of MN Cities – Information Memo Regarding Liquor Licensing and Regulation http://www.lmnc.org/media/document/1/liquorlicensingandregulation.pdf

•

MN Liquor Rules 7515 - https://www.revisor.mn.gov/rules/?id=7515

•

MN Chapter 340A Liquor Laws - https://www.revisor.mn.gov/statutes/?id=340A

•

MN Labor Laws (prohibited work for minors) - http://www.dli.mn.gov/LS/ProhibWork18.asp

•

MN Alcohol and Gambling Enforcement (a Division of the MN Department of Public Safety) Forms https://dps.mn.gov/divisions/age/forms-documents/Pages/default.aspx

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2105.0397​

MINNESOTA RULES​

2105.0410 LICENSED SERVICES NOT OFFERED IN A LICENSED SALON.​ Subpart 1. Nursing homes; housing with services and assisted living facilities. This part​applies to nursing homes licensed under Minnesota Statutes, chapter 144A, housing with services​establishments registered under Minnesota Statutes, section 144D.02, and operating under title​protection under Minnesota Statutes, chapter 144G, and beginning August 1, 2021, assisted living​facilities licensed under Minnesota Statutes, chapter 144G.​ A. A salon as defined in Minnesota Statutes, section 155A.23, subdivision 9, that is located​in a nursing home, housing with services entity, or assisted living facility is required to be licensed​if any cosmetology services are provided to anyone other than the homebound residents of the​nursing home, housing with services entity, or assisted living facility. A resident of a housing with​services entity receiving comprehensive home care services and residents of an assisted living​facility receiving assisted living services are considered to be homebound residents. All residents​of a nursing home are considered homebound for the purposes of this part.​ B. A salon as defined in Minnesota Statutes, section 155A.23, subdivision 9, located in a​ nursing home, housing with services entity, or assisted living facility is not required to be licensed​if:​ (1) only homebound residents are served by the salon, and nonhomebound residents,​ staff, family members, or the public are never served by the salon; and​ (2) the use of the unlicensed salon is restricted to:​ (a) board-licensed practitioners of cosmetology services who have homebound​ service permits and provide services for homebound residents of the facility;​ (b) staff employed by the facility providing services to homebound residents of the​ facility, and the services are limited to washing hair, setting hair, trimming hair, filing nails, applying​ and removing nail polish, and makeup applications;​​ (c) family members providing services to their own homebound family members​ who are residents of the facility; and​ (d) volunteers providing services without compensation to homebound residents of​ the nursing home, housing with services entity, or assisted living facility.

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325F.721​

325F.721 PROVISION OF "I'M OKAY" CHECK SERVICES.​ Subdivision 1. Definitions. (a) For the purposes of this section, the following terms have the meanings​ given them.​ (b) "Covered setting" means an unlicensed setting providing sleeping accommodations to one or more​ adult residents, at least 80 percent of which are 55 years of age or older, and offering or providing, for a fee,​ supportive services. For the purposes of this section, covered setting does not mean:​ (1) emergency shelter, transitional housing, or any other residential units serving exclusively or primarily​ homeless individuals, as defined under section 116L.361;​ (2) a nursing home licensed under chapter 144A;​ (3) a hospital, certified boarding care, or supervised living facility licensed under sections 144.50 to​ 144.56;​ (4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts 9520.0500 to​ 9520.0670, or under chapter 245D or 245G;​ (5) services and residential settings licensed under chapter 245A, including adult foster care and services​ and settings governed under the standards in chapter 245D;​ (6) private homes in which the residents are related by kinship, law, or affinity with the providers of​ services;​ (7) a duly organized condominium, cooperative, and common interest community, or owners' association​ of the condominium, cooperative, and common interest community where at least 80 percent of the units​ that comprise the condominium, cooperative, or common interest community are occupied by individuals​ who are the owners, members, or shareholders of the units;​ (8) temporary family health care dwellings as defined in sections 394.307 and 462.3593;​ (9) settings offering services conducted by and for the adherents of any recognized church or religious​ denomination for its members exclusively through spiritual means or by prayer for healing;​ (10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with low-income​ housing tax credits pursuant to United States Code, title 26, section 42, and units financed by the Minnesota​ Housing Finance Agency that are intended to serve individuals with disabilities or individuals who are​ homeless, except for those developments that market or hold themselves out as assisted living facilities and​ provide assisted living services;​ (11) rental housing developed under United States Code, title 42, section 1437, or United States Code,​ title 12, section 1701q;​ (12) rental housing designated for occupancy by only elderly or elderly and disabled residents under​ United States Code, title 42, section 1437e, or rental housing for qualifying families under Code of Federal​ Regulations, title 24, section 983.56;​ (13) rental housing funded under United States Code, title 42, chapter 89, or United States Code, title​ 42, section 8011; or​ (14) an assisted living facility licensed under chapter 144G.​

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(c) "'I'm okay' check services" means providing a service to, by any means, check on the safety of a​ resident.​ (d) "Resident" means a person entering into written contract for housing and services with a covered​ setting.​ (e) "Supportive services" means:​ (1) assistance with laundry, shopping, and household chores;​ (2) housekeeping services;​ (3) provision of meals or assistance with meals or food preparation;​ (4) help with arranging, or arranging transportation to, medical, social, recreational, personal, or social​ services appointments; or​ (5) provision of social or recreational services.​ Arranging for services does not include making referrals or contacting a service provider in an emergency.​ Subd. 2. Disclosure of "I'm okay" check services. (a) A covered setting must prominently disclose in​ a written contract whether or not the setting itself or through a provider with which the setting has a business​ agreement offers "I'm okay" check services.​ (b) If the resident contracts for "I'm okay" check services, the written contract must detail the nature,​ extent, and frequency of the provision of these services.​ (c) A covered setting must disclose to prospective residents that the facility is not licensed as an assisted​ living facility under chapter 144G and, notwithstanding any contract for "I'm okay" check services, is not​ permitted to provide assisted living services, as defined in section 144G.08, subdivision 9, either directly​ or through a provider under a business relationship or other affiliation with the covered setting.​ History: 2019 c 60 art 1 s 47; art 3 s 4​ NOTE: This section, as added by Laws 2019, chapter 60, article 3, section 4, is effective for contracts​ entered into on or after August 1, 2021. Laws 2019, chapter 60, article 3, section 4, the effective date.​

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MINNESOTA STATUTES 2020​

325F.72​

325F.72 DISCLOSURE OF SPECIAL CARE STATUS REQUIRED.​ Subdivision 1. Persons to whom disclosure is required. Only assisted living facilities with dementia​ care licenses under chapter 144G may advertise, market, or otherwise promote the facility as providing​ specialized care for dementia or related disorders. All assisted living facilities with dementia care licenses​ shall provide a written disclosure to the following:​ (1) the commissioner of health, if requested;​ (2) the Office of Ombudsman for Long-Term Care; and​ (3) each person seeking placement within a residence, or the person's legal and designated representatives,​ as those terms are defined in section 144G.08, before an agreement to provide the care is entered into.​ [See Note.]​ Subd. 2. Content. Written disclosure shall include, but is not limited to, the following:​ (1) a statement of the overall philosophy and how it reflects the special needs of residents with Alzheimer's​ disease or other dementias;​ (2) the criteria for determining who may reside in the secured dementia care unit as defined in section​ 144G.08, subdivision 62;​ (3) the process used for assessment and establishment of the service plan, including how the plan is​ responsive to changes in the resident's condition;​ (4) staffing credentials, job descriptions, and staff duties and availability, including any training specific​ to dementia;​ (5) physical environment as well as design and security features that specifically address the needs of​ residents with Alzheimer's disease or other dementias;​ (6) frequency and type of programs and activities for residents of the assisted living facility with dementia​ care;​ (7) involvement of families in resident care and availability of family support programs;​ (8) fee schedules for additional services to the residents of the secured dementia care unit; and​ (9) a statement that residents will be given a written notice 30 calendar days prior to changes in the fee​ schedule.​ [See Note.]​ Subd. 3. Duty to update. Substantial changes to disclosures must be reported to the parties listed in​ subdivision 1 at the time the change is made.​ Subd. 4. Remedy. The attorney general may seek the remedies set forth in section 8.31 for repeated and​ intentional violations of this section. However, no private right of action may be maintained as provided​ under section 8.31, subdivision 3a.​ History: 1Sp2001 c 9 art 1 s 57; 2002 c 379 art 1 s 113; 2007 c 147 art 7 s 75; 2019 c 60 art 1 s 47;​ art 4 s 31,32​

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325F.72​

MINNESOTA STATUTES 2020​

NOTE: The amendments to subdivisions 1 and 2 by Laws 2019, chapter 60, article 4, sections 31 and​ 32, are effective August 1, 2021. Laws 2019, chapter 60, article 4, sections 31 and 32, the effective dates.​

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