Care Providers of Minnesota presents one of its most popular and longest-running programs:
NURSE MANAGERS’ EDUCATION SERIES
While this signature certificate series is now a virtual experience, the quality of education and presenters upholds Care Providers of Minnesota’s high standards. Each module will be presented live, and participants have the opportunity to engage with presenters. In addition, each module will be archived and available for 30 days after live presentation.
NURSE MANAGERS’ EDUCATION SERIES FEBRUARY 23-APRIL 7, 2021
21.25 hours | 13 modules* | 13 speakers | 1 great learning opportunity The NURSE MANAGERS’ EDUCATION SERIES is designed for home care nurses who manage the multitude of tasks they face every day in assisted living, housing with services, and home care operations.
COMPREHENSIVE LEARNING EXPERIENCES & CAREER INVESTMENT—VIRTUAL EDITION
*Seven modules are shared with the Housing Managers’ Education Series
Nurse Managers' Education Series February 23 – April 7 | Virtual Event
FEBRUARY Tuesday, February 23 10:00 AM Wednesday, February 24 1:00 PM
AGENDA Nurse documentation—Best practices in charting April J. Boxeth, Attorney/Partner, Voigt, Rodè, Boxeth & Coffin Aaron M. Sagedahl, Attorney, Voigt, Rodè, Boxeth & Coffin
Medication management in assisted living & home care
Joe Litsey, RPh, PharmD, CGP, Director of Consulting Services, Thrifty White Pharmacy Services
MARCH Tuesday, March 2 1:00 PM Wednesday, March 3 10:00 AM Wednesday, March 10 10:00 AM Thursday, March 11 10:30 AM Wednesday, March 17 9:00 AM Wednesday, March 24 1:00 PM Thursday, March 25 1:00 PM Wednesday, March 31 1:00 PM
New Laws Affecting Assisted Living**
Jill Schewe, Director of Assisted Living, Housing & Home Care, Care Providers of Minnesota
Personalized dementia care—Bridging the gap between the person-centered approach & the human experience Krisie Barron, LSW, Caregiver Specialist, Embrace
Growing a Healthy Relationship—Housing Managers & Nurse Managers**
Amanda Johnson, Vice President of Clinical Operations, Tealwood Senior Living
Clinical care in a pandemic
Cindy Fronning, Director of Education, National Association of Directors of Nursing Administration in LTC (NADONA)
Legal Issues for Housing & Nurse Managers**
Rebecca K. Coffin, Attorney/Partner, Voigt, Rodè & Boxeth & Coffin Robert Rodè, Attorney/Partner, Voigt, Rodè, Boxeth & Coffin
Addressing Concerns & Complaints: When, How, & Why?**
April J. Boxeth, Attorney/Partner, Voigt, Rodè, Boxeth & Coffin Rebecca K. Coffin, Attorney/Partner, Voigt, Rodè & Boxeth & Coffin
Dealing with difficult behaviors
Randy Beckett, DNP, FNP-C, PMHNP-BC, Vice President Clinical Services, Encounter Telehealth
Leadership Beyond COVID-19: Re-Ignite the Passion Within**
Lisa Thomson, Chief Marketing & Strategy Officer, Pathway Health
APRIL Tuesday, April 6 1:00 PM 3:00 PM Wednesday, April 7 9:00 AM
Survey Preparation & Success**
Doug Beardsley, Vice President of Member Services, Care Providers of Minnesota
Electronic Monitoring **
Doug Beardsley, Vice President of Member Services, Care Providers of Minnesota
Clinical decision making in assisted living & home care settings
Dr. Robert G. Sonntag, MD, CRMD, Geriatrician, Medical Director, Health Partners
**Session is shared between the two signature education series CARE PROVIDERS OF MINNESOTA 7851 Metro Parkway, Suite 200 Bloomington, MN 55425
www.careproviders.org 1-952-854-2844 MN Toll-Free 1-800-462-0024
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2021 NURSE MANAGERS’ EDUCATION SERIES
APPENDIX
2021 NURSE MANAGERS’ EDUCATION SERIES
APPENDIX OF OTHER RESOURCES A. 2019 Statutes Basic Home Care Comprehensive Home Care Housing with Services Assisted Living Vulnerable Adults Act Electronic Monitoring Disclosure of Special Care Status B. Statement of Home Care Services C. MDH Website References for Housing with Services and Home Care D. Reporting—Minnesota Vulnerable Adults Act and MAARC E. Federal Fair Housing Act Guidance F. EW Residential Services (Customized Living) - Workbook – Released 2/11/2020. Printout of select pages from workbook Customized Living Component Service Definitions: A Reference Guide for Computing Time for Rate-Setting Tools Additional resources: https://mn.gov/dhs/partners-and-providers/policies-procedures/ aging/elderly-waiver-residential-services/ G. New Laws Affecting Assisted Living/Home Care Changes to Licensed Comprehensive Home Care Regulations Assisted Living Licensure Retaliation Prohibited in a Registered Housing with Services Establishment HWS-AL Sample Retaliation Policy Do I need an AL License–Decision Tree Routes to becoming an Assisted Living Director–Flow Chart I’m OK Check–Decision Tree H. Electronic Monitoring Electronic Monitoring FAQs
2021 NURSE MANAGERS’ EDUCATION SERIES
2 0 1 9
STATUTES
BASI CHOMECARE COMPREHENSI V EHOMECARE HOUSI NGWI THSERV I CES ASSI STEDL I V I NG V UL NERABL EADUL T SACT EL ECTRONI CMONI TORI NG DI SCL OSUREOFSPECI ALCAREST A TUS
7851 Metro Parkway, Suite 200 Bloomington, MN 55425 952-854-2844 800-462-0024
2019 Statutes
Home Care (Basic & Comprehensive)—144A Housing with Services—144D Assisted Living—144G Vulnerable Adults Act Reporting—626.557 Electronic Monitoring—144.6502 Disclosure of Special Care Status—325F.72
Distributed by Care Providers of Minnesota © 2019 by the Revisor of Statutes, State of Minnesota. All rights reserved. October 2019
BASIC HOME CARE COMPREHENSIVE HOME CARE HOUSING WITH SERVICES ASSISTED LIVING VULNERABLE ADULTS ACT ELECTRONIC MONITORING
2019 STATUTES HOME CARE STATUTES—144A
DISCLOSURE OF SPECIAL CARE STATUS
PAGE #
Acceptance of Clients
37
Advertising
35
Assessments—Client Review & Monitoring—Basic License
38
Assessments—Temporary Plan for Initiation of Services
38
Assessments & Monitoring—Comprehensive License
38, 41 & 42
Background Studies—New License Application Owners & Managers
32
Background Studies—Staff, Contractors & Volunteers
33
Basic Home Care Description
11
Bill of Rights Bill of Rights—Assisted Living Addendum
5 7
Bill of Rights—Notification to Clients
37
Client Records— Required
47
Client Records—Access to Records
47
Client Records—Record Retention
48
Client Records—Required Contents
47
Client Records—Transfer of Records to Other Provider
48
Complaints—Record Retention
40
Complaints—Policies, Investigation and Documentation
40
Comprehensive Home Care Description
11
Definitions Dementia & Alzheimer's Disease—Notice & Staff Training Requirements
1 37 & 52
Direct Home Care Services Definition
10
Disaster & Emergency Preparedness Plan
40
Discontinuing Life-Sustaining Treatment
40
Handling of Client Finances
36
Hearings
28
Home Care & Assisted Living Advisory Council
54
Infection Prevention—Communicable Diseases
54
Infection Prevention—Infection Control Program
54
Infection Prevention—TB
54
Innovation Variance
34
License—Applications
14
License—Changes in Ownership (CHOWs)
16
License—Display of License
35
License—Exclusions from Home Care Licensure
12
HOME CARE STATUTES—144A
PAGE #
License—Exemptions from Home Care Licensure
11
License—Fees & Renewal Fees
17
License—Immediate Temporary Suspension
29
License—Renewal
15
License—Required
10
License—Suspension or Conditional Licenses
28
License—Temporary/Initial Licenses Maltreatment Compensation Fund
19 24 & 26
Maltreatment Reporting—Vulnerable Adults Act
36
Medicare Certified Providers—Coordination of Surveys
33
Medicare Certified Providers—Equivalencies
33
Medication Management—Administration of Medications
42
Medication Management—Assessment & Provision of Services
41 & 42
Medication Management—Client Refusal
42
Medication Management—Clients Who Will Be Away From Home
43
Medication Management—Delegation to Unlicensed Personnel
42
Medication Management—Documentation of Administration
43
Medication Management—Documentation of Medication Setup
43
Medication Management—General
41
Medication Management—Individualized Medication Management Plan
42
Medications—Disposal or Disposition
45
Medications—Loss or Spillage
45
Medications—OTC & Dietary Supplements Not Prescribed
44
Medications—Packaging & Original Containers
45
Medications—Prescribed & Nonprescribed
44
Medications—Prohibition of Sharing Medications
45
Medications—Provided by Client or Family Members
44
Medications—Storage
45
Prescriptions— Renewals
44
Prescriptions—Records Confidential
44
Prescriptions—Required for Managed Medications
44
Prescriptions—Verbal Orders
44
Quality Management Requirement
35
Referrals to Other Providers of Services
38
Regularly Engaged Home Care Services—Definition
10
Service Plan—Required Elements, Implementation & Revisions
38
Service Plan—Termination of Service Plan
39
Staff—Training & Competency Evaluations for Unlicensed Staff
49
Staff—Availability of Staff for Consultation
53
Staff—Delegation of Home Care Tasks
49
Staff—Documentation of Required Annual Training
53
Staff—Documentation of Required Orientation
52
Staff—Documentation of Supervision of Staff Performing Home Care Services
53
Staff—Employee Records
36
Staff—Individual Contractors
49
Staff—Nurses & Other Licensed Health Professionals
48
Staff—Qualifications, Training & Competency
48
HOME CARE STATUTES—144A
PAGE #
Staff—Required Annual Training
52
Staff—Required Orientation Topics
51
Staff—Supervision of Staff Performing Home Care Services
53
Staff—Temporary Staff
49
Staff—Unlicensed Personnel Qualifications
48
Statement of Home Care Services
37
Surveys—Fines for Correction Orders
23
Surveys—Fines for Maltreatment
24
Surveys—Frequency
9 & 20 & 22
Surveys—Process
22
Surveys—Reconsiderations for Correction Orders
25
Surveys—Correction Orders
23
Surveys—Enforcement
27
Surveys—Follow-Up Surveys
23
Surveys—Level & Scope of Correction Orders
24
Surveys—Temporary/Initial License Survey
20
Surveys—Types of Surveys
21
Termination of Home Care Services (AL)
7
Treatments & Therapies—Administration
46
Treatments & Therapies—Documentation
46
Treatments & Therapies—Elements of an Individualized Plan
46
Treatments & Therapies—Orders or Prescriptions
46
Treatments & Therapies—Policies & Procedures
45
Treatments & Therapies—Provision of Services
45
HOUSING WITH SERVICES STATUTES—144D
PAGE #
Arranged Home Care Provider Disclosure
62
Contracts—Documentation and Storage
62
Contracts—Record Retention
62
Contracts—Required Elements for Housing with Services
60
Definitions—Housing with Services Establishments
57
Dementia Care Training Required
63
Dementia Care Training—Enforcement and Fines
65
Housing with Services—Emergency Planning and Preparedness
67
Housing with Services—Manager Requirements
66
Housing with Services—Optional Registration
59
Housing with Services—Registration Required
59
Lease—Terminations
66
Long-Term Care Insurance—Definition
58
Other Laws
63
Registration of Housing with Services
59
Restraints
66
ASSISTED LIVING STATUTES—144G
PAGE #
Assisted Living—Assistance with Arranged Home Care Providers
73
Assisted Living—Awake Staff Exemption
72
ASSISTED LIVING STATUTES—144G
PAGE #
Assisted Living—Nursing Assessment
73
Assisted Living—Termination of Housing with Services Contract
73
Assisted Living Term—Annual Registration with HWS Registration
71
Assisted Living Term—Title Protection
70
Minimum Requirements for Assisted Living
71
Reimbursement Under Assisted Living Service Packages
75
Reservation of Rights
74
Retaliation—Determined by Commissioner of Health
77
Retaliation Prohibited
75
Retaliation Prohibited —Employee
76
Retaliation Prohibited —Resident
76
Uniform Consumer Information Guide
75
August 1, 2021, Assisted Living Licensure
VULNERABLE ADULT ACT REPORTING STATUTES—626.557
77-159
PAGE #
Abuse Prevention Plans
174
VAA—Definitions—Abuse
177
VAA—Definitions—Accident
178
VAA—Definitions—Facility
178
VAA—Definitions—Financial Exploitation
179
VAA—Definitions—Immediate
179
VAA—Definitions—Maltreatment
180
VAA—Definitions—Mandated Reporter
180
VAA—Definitions—Neglect
180
VAA—Definitions—Vulnerable Adult VAA—External Investigation Requirements VAA—Information Required in Report
182 265 - 174 164
VAA—Internal Reporting
162
VAA—Protections for Reporters
163
VAA—Report Not Required VAA—Retaliation Prohibited for Good Faith Reporting VAA—Timing of Required Reports
ELECTRONIC MONITORING STATUTES—144.6502
161 & 162 175 161 & 162
PAGE #
Consent Form—Required Elements
186
Consent Notification—Exceptions—Notification to OOLCT
185
Consent Notification to Facilities
185
Consent to Electronic Monitoring
183
Electronic Monitoring—Definitions
183
Electronic Monitoring—Admissibility of Evidence
188
Electronic Monitoring—Dissemination of Recordings
188
Electronic Monitoring—Liability
188
Electronic Monitoring—OOLTC Immunity from Liability
188
Electronic Monitoring—Penalties
188
ELECTRONIC MONITORING STATUTES—144.6502
PAGE #
Electronic Monitoring—Required Signs at Public Entrances
187
Electronic Monitoring Authorized
183
Electronic Monitoring Device—Costs and Installation
187
Electronic Monitoring Device—Obstruction
187
Employee Discipline Related to Electronic Monitoring
188
Resident Protections Related to Electronic Monitoring
188
Roommate Refusal of Consent Related to Electronic Monitoring
184
DISCLOSURE OF SPECIAL CARE STATUS—325F.72
PAGE #
Disclosure of Special Care Status
191
Required Elements of Disclosure
191
MINNESOTA STATUTES 2019
144A.43
Minnesota's Comprehensive and Basic Licensed Home Care Regulations
HOME CARE PROGRAM 144A.43 DEFINITIONS. Subdivision 1. Applicability. The definitions in this section apply to sections 144.699, subdivision 2,and 144A.43 to 144A.482. Subd. 1a. Agent. "Agent" means the person upon whom all notices and orders shall be served and who is authorized to accept service of notices and orders on behalf of the home care provider. Subd. 1b. Applicant. "Applicant" means an individual, organization, association, corporation, unit of government, or other entity that applies for a temporary license, license, or renewal of the applicant's homecare provider license under section 144A.472. Subd. 1c. Client. "Client" means a person to whom home care services are provided. Subd. 1d. Client record. "Client record" means all records that document information about the homecare services provided to the client by the home care provider. Subd. 1e. Client representative. "Client representative" means a person who, because of the client'sneeds, makes decisions about the client's care on behalf of the client. A client representative may be aguardian, health care agent, family member, or other agent of the client. Nothing in this section expands ordiminishes the rights of persons to act on behalf of clients under other law. Subd. 2. Commissioner. "Commissioner" means the commissioner of health. Subd. 2a. Controlled substance. "Controlled substance" has the meaning given in section 152.01,subdivision 4. Subd. 2b. Department. "Department" means the Minnesota Department of Health.
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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144A.43
MINNESOTA STATUTES 2019
Subd. 2c. 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. 2d. Dietitian. "Dietitian" is a person licensed under sections 148.621 to 148.633. Subd. 2e. Dietetics or nutrition practice. "Dietetics or nutrition practice" is performed by a licensed dietitian or licensed nutritionist and includes the activities of assessment, setting priorities and objectives, providing nutrition counseling, developing and implementing nutrition care services, and evaluating and maintaining appropriate standards of quality of nutrition care under sections 148.621 to 148.633. Subd. 3. Home care service. "Home care service" means any of the following services delivered in the home of a person whose illness, disability, or physical condition creates a need for the service: (1) assistive tasks provided by unlicensed personnel; (2) services provided by a registered nurse or licensed practical nurse, physical therapist, respiratory therapist, occupational therapist, speech-language pathologist, dietitian or nutritionist, or social worker; (3) medication and treatment management services; or (4) the provision of durable medical equipment services when provided with any of the home care services listed in clauses (1) to (3). Subd. 3a. Hands-on assistance. "Hands-on assistance" means physical help by another person without which the client is not able to perform the activity. Subd. 3b. Home. "Home" means the client's temporary or permanent place of residence. Subd. 4. Home care provider. "Home care provider" means an individual, organization, association, corporation, unit of government, or other entity that is regularly engaged in the delivery of at least one home care service, directly in a client's home for a fee and who has a valid current temporary license or license issued under sections 144A.43 to 144A.482. Subd. 5. [Repealed by amendment, 2013 c 108 art 11 s 7] Subd. 6. License. "License" means a basic or comprehensive home care license issued by the commissioner to a home care provider. Subd. 7. Licensed health professional. "Licensed health professional" means a person, other than a registered nurse or licensed practical nurse, who provides home care services within the scope of practice of the person's health occupation license, registration, or certification as regulated and who is licensed by the appropriate Minnesota state board or agency. Subd. 8. Licensee. "Licensee" means a home care provider that is licensed under this chapter. Subd. 9. Managerial official. "Managerial official" means an administrator, director, officer, trustee, or employee of a home care provider, however designated, who has the authority to establish or control business policy. Subd. 10. Medication. "Medication" means a prescription or over-the-counter drug. For purposes of this chapter only, medication includes dietary supplements.
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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MINNESOTA STATUTES 2019
144A.43
Subd. 11. Medication administration. "Medication administration" means performing a set of tasks that include the following: (1) checking the client's medication record; (2) preparing the medication as necessary; (3) administering the medication to the client; (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 client, or the client's refusal to take the medication. Subd. 12. Medication management. "Medication management" means the provision of any of the following medication-related services to a client: (1) performing medication setup; (2) administering medication; (3) storing and securing medications; (4) documenting medication activities; (5) verifying and monitoring 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 client's medications; and (9) coordinating and communicating with the prescriber. Subd. 12a. Medication reconciliation. "Medication reconciliation" means the process of identifying the most accurate list of all medications the client is taking, including the name, dosage, frequency, and route by comparing the client record to an external list of medications obtained from the client, hospital, prescriber, or other provider. Subd. 13. Medication setup. "Medication setup" means arranging medications by a nurse, pharmacy, or authorized prescriber for later administration by the client or by comprehensive home care staff. Subd. 14. Nurse. "Nurse" means a person who is licensed under sections 148.171 to 148.285. Subd. 15. Occupational therapist. "Occupational therapist" means a person who is licensed under sections 148.6401 to 148.6449. Subd. 16. Over-the-counter drug. "Over-the-counter drug" means a drug that is not required by federal law to bear the symbol "Rx only." Subd. 17. Owner. "Owner" means a proprietor, a general partner, a limited partner who has five percent or more equity interest in a limited partnership, a person who owns or controls voting stock in a corporation in an amount equal to or greater than five percent of the shares issued and outstanding, or a corporation that owns equity interest in a licensee or applicant for a license.
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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MINNESOTA STATUTES 2019
Subd. 18. Pharmacist. "Pharmacist" has the meaning given in section 151.01, subdivision 3. Subd. 19. Physical therapist. "Physical therapist" means a person who is licensed under sections 148.65 to 148.78. Subd. 20. Physician. "Physician" means a person who is licensed under chapter 147. Subd. 21. Prescriber. "Prescriber" means a person who is authorized by sections 148.235; 151.01, subdivision 23; and 151.37 to prescribe prescription drugs. Subd. 22. Prescription. "Prescription" has the meaning given in section 151.01, subdivision 16a. Subd. 23. Regularly scheduled. "Regularly scheduled" means ordered or planned to be completed at predetermined times or according to a predetermined routine. Subd. 24. Reminder. "Reminder" means providing a verbal or visual reminder to a client. Subd. 25. Respiratory therapist. "Respiratory therapist" means a person who is licensed under chapter 147C. Subd. 26. Revenues. "Revenues" means all money received by a licensee derived from the provision of home care services, including fees for services and appropriations of public money for home care services. Subd. 27. Service plan. "Service plan" means the written plan between the client or client's representative and the temporary licensee or licensee about the services that will be provided to the client. Subd. 28. Social worker. "Social worker" means a person who is licensed under chapter 148D or 148E. Subd. 29. Speech-language pathologist. "Speech-language pathologist" has the meaning given in section 148.512. Subd. 30. Standby assistance. "Standby assistance" means the presence of another person to assist a client with an assistive task by providing cues, oversight, and minimal physical assistance. Subd. 31. Substantial compliance. "Substantial compliance" means complying with the requirements in this chapter sufficiently to prevent unacceptable health or safety risks to the home care client. Subd. 32. Survey. "Survey" means an inspection of a licensee or applicant for licensure for compliance with this chapter. Subd. 33. Surveyor. "Surveyor" means a staff person of the department authorized to conduct surveys of home care providers and applicants. Subd. 34. Temporary license. "Temporary license" means the initial basic or comprehensive home care license the department issues after approval of a complete written application and before the department completes the temporary license survey and determines that the temporary licensee is in substantial compliance. Subd. 35. Treatment or therapy. "Treatment" or "therapy" means the provision of care, other than medications, ordered or prescribed by a licensed health professional provided to a client to cure, rehabilitate, or ease symptoms. Subd. 36. Unit of government. "Unit of government" means every city, county, town, school district, other political subdivisions of the state, or agency of the state or federal government, which includes any instrumentality of a unit of government.
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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MINNESOTA STATUTES 2019
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Subd. 37. Unlicensed personnel. "Unlicensed personnel" are individuals not otherwise licensed or certified by a governmental health board or agency who provide home care services in the client's home. Subd. 38. Verbal. "Verbal" means oral and not in writing. History: 1987 c 378 s 3; 1989 c 194 s 1; 1989 c 304 s 137; 1992 c 513 art 6 s 5,6; 1995 c 207 art 9 s 20; 1997 c 22 art 2 s 2,8; 1997 c 113 s 1; 2002 c 252 s 2-4,24; 2009 c 174 art 2 s 4; 2013 c 108 art 11 s 7; 2014 c 275 art 1 s 135; 2016 c 158 art 1 s 59; 1Sp2017 c 6 art 11 s 54; 1Sp2019 c 9 art 11 s 38-40 144A.44 HOME CARE BILL OF RIGHTS. Subdivision 1. Statement of rights. (a) A client who receives home care services in the community or in an assisted living facility licensed under chapter 144G has these rights: (1) receive written information, in plain language, about rights before receiving services, including what to do if rights are violated; (2) receive care and services according to a suitable and up-to-date plan, and subject to accepted health care, medical or nursing standards and person-centered care, to take an active part in developing, modifying, and evaluating the plan and services; (3) be told before receiving services the type and disciplines of staff who will be providing the services, the frequency of visits proposed to be furnished, other choices that are available for addressing home care needs, and the potential consequences of refusing these services; (4) be told in advance of any recommended changes by the provider in the service plan and to take an active part in any decisions about changes to the service plan; (5) refuse services or treatment; (6) know, before receiving services or during the initial visit, any limits to the services available from a home care provider; (7) be told before services are initiated what the provider charges for the services; to what extent payment may be expected from health insurance, public programs, or other sources, if known; and what charges the client may be responsible for paying; (8) know that there may be other services available in the community, including other home care services and providers, and to know where to find information about these services; (9) choose freely among available providers and to change providers after services have begun, within the limits of health insurance, long-term care insurance, medical assistance, other health programs, or public programs; (10) have personal, financial, and medical information kept private, and to be advised of the provider's policies and procedures regarding disclosure of such information; (11) access the client's own records and written information from those records in accordance with sections 144.291 to 144.298; (12) be served by people who are properly trained and competent to perform their duties; (13) be treated with courtesy and respect, and to have the client's property treated with respect;
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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144A.44
MINNESOTA STATUTES 2019
(14) be free from physical and verbal abuse, neglect, financial exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and the Maltreatment of Minors Act; (15) reasonable, advance notice of changes in services or charges; (16) know the provider's reason for termination of services; (17) at least ten calendar days' advance notice of the termination of a service by a home care provider, except at least 30 calendar days' advance notice of the service termination shall be given by a home care provider for services provided to a client residing in an assisted living facility as defined in section 144G.08, subdivision 7. This clause does not apply in cases where: (i) the client engages in conduct that significantly alters the terms of the service plan with the home care provider; (ii) the client, person who lives with the client, or others create an abusive or unsafe work environment for the person providing home care services; or (iii) an emergency or a significant change in the client's condition has resulted in service needs that exceed the current service plan and that cannot be safely met by the home care provider; (18) a coordinated transfer when there will be a change in the provider of services; (19) complain to staff and others of the client's choice about services that are provided, or fail to be provided, and the lack of courtesy or respect to the client or the client's property and the right to recommend changes in policies and services, free from retaliation including the threat of termination of services; (20) know how to contact an individual associated with the home care provider who is responsible for handling problems and to have the home care provider investigate and attempt to resolve the grievance or complaint; (21) know the name and address of the state or county agency to contact for additional information or assistance; (22) assert these rights personally, or have them asserted by the client's representative or by anyone on behalf of the client, without retaliation; and (23) place an electronic monitoring device in the client's or resident's space in compliance with state requirements. (b) When providers violate the rights in this section, they are subject to the fines and license actions in sections 144A.474, subdivision 11, and 144A.475. (c) Providers must do all of the following: (1) encourage and assist in the fullest possible exercise of these rights; (2) provide the names and telephone numbers of individuals and organizations that provide advocacy and legal services for clients and residents seeking to assert their rights; (3) make every effort to assist clients or residents in obtaining information regarding whether Medicare, medical assistance, other health programs, or public programs will pay for services; (4) make reasonable accommodations for people who have communication disabilities, or those who speak a language other than English; and
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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MINNESOTA STATUTES 2019
144A.442
(5) provide all information and notices in plain language and in terms the client or resident can understand. (d) No provider may require or request a client or resident to waive any of the rights listed in this section at any time or for any reasons, including as a condition of initiating services or entering into an assisted living contract. Subd. 2. Interpretation and enforcement of rights. These rights are established for the benefit of clients who receive home care services. All home care providers, including those exempted under section 144A.471, must comply with this section. The commissioner shall enforce this section and the home care bill of rights requirement against home care providers exempt from licensure in the same manner as for licensees. A home care provider may not request or require a client to surrender any of these rights as a condition of receiving services. This statement of rights does not replace or diminish other rights and liberties that may exist relative to clients receiving home care services, persons providing home care services, or providers licensed under sections 144A.43 to 144A.482. History: 1987 c 378 s 4; 1991 c 133 s 1; 1998 c 407 art 2 s 81; 1Sp2001 c 9 art 1 s 39; 2002 c 379 art 1 s 113; 2007 c 147 art 7 s 75; art 10 s 15; 2009 c 79 art 8 s 7; 2013 c 108 art 11 s 8; 2014 c 275 art 1 s 135; 2019 c 60 art 1 s 47; art 4 s 16 144A.441 ASSISTED LIVING BILL OF RIGHTS ADDENDUM. Assisted living clients, as defined in section 144G.01, subdivision 3, shall be provided with the home care bill of rights required by section 144A.44, except that the home care bill of rights provided to these clients must include the following provision in place of the provision in section 144A.44, subdivision 1, clause (17): "(17) the right to reasonable, advance notice of changes in services or charges, including at least 30 days' advance notice of the termination of a service by a provider, except in cases where: (i) the recipient of services engages in conduct that alters the conditions of employment as specified in the employment contract between the home care provider and the individual providing home care services, or creates an abusive or unsafe work environment for the individual providing home care services; (ii) an emergency for the informal caregiver or a significant change in the recipient's condition has resulted in service needs that exceed the current service provider agreement and that cannot be safely met by the home care provider; or (iii) the provider has not received payment for services, for which at least ten days' advance notice of the termination of a service shall be provided." History: 2006 c 282 art 19 s 1; 2014 c 275 art 1 s 24; 2019 c 60 art 4 s 35 NOTE: This section is repealed by Laws 2019, chapter 60, article 4, section 35, effective August 1, 2021. Laws 2019, chapter 60, article 4, section 35. 144A.442 ASSISTED LIVING CLIENTS; SERVICE TERMINATION. If an arranged home care provider, as defined in section 144D.01, subdivision 2a, who is not also Medicare certified terminates a service agreement or service plan with an assisted living client, as defined in section 144G.01, subdivision 3, the home care provider shall provide the assisted living client and the legal or designated representatives of the client, if any, with a written notice of termination which includes the following information:
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(1) the effective date of termination; (2) the reason for termination; (3) without extending the termination notice period, an affirmative offer to meet with the assisted living client or client representatives within no more than five business days of the date of the termination notice to discuss the termination; (4) contact information for a reasonable number of other home care providers in the geographic area of the assisted living client, as required by section 144A.4791, subdivision 10; (5) a statement that the provider will participate in a coordinated transfer of the care of the client to another provider or caregiver, as required by section 144A.44, subdivision 1, clause (18); (6) the name and contact information of a representative of the home care provider with whom the client may discuss the notice of termination; (7) a copy of the home care bill of rights; and (8) a statement that the notice of termination of home care services by the home care provider does not constitute notice of termination of the housing with services contract with a housing with services establishment. History: 2006 c 282 art 19 s 2; 2014 c 275 art 1 s 25; 2016 c 158 art 1 s 60; 2019 c 60 art 4 s 35 NOTE: This section is repealed by Laws 2019, chapter 60, article 4, section 35, effective August 1, 2021. Laws 2019, chapter 60, article 4, section 35. 144A.45 REGULATION OF HOME CARE SERVICES. Subdivision 1. Regulations. The commissioner shall regulate home care providers pursuant to sections 144A.43 to 144A.482. The regulations shall include the following: (1) provisions to assure, to the extent possible, the health, safety, well-being, and appropriate treatment of persons who receive home care services while respecting a client's autonomy and choice; (2) requirements that home care providers furnish the commissioner with specified information necessary to implement sections 144A.43 to 144A.482; (3) standards of training of home care provider personnel; (4) standards for provision of home care services; (5) standards for medication management; (6) standards for supervision of home care services; (7) standards for client evaluation or assessment; (8) requirements for the involvement of a client's health care provider, the documentation of health care providers' orders, if required, and the client's service plan; (9) the maintenance of accurate, current client records; (10) the establishment of basic and comprehensive levels of licenses based on services provided; and
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MINNESOTA STATUTES 2019
144A.47
(11) provisions to enforce these regulations and the home care bill of rights. Subd. 1a. [Repealed by amendment, 2013 c 108 art 11 s 9] Subd. 1b. [Repealed by amendment, 2013 c 108 art 11 s 9] Subd. 2. Regulatory functions. The commissioner shall: (1) license, survey, and monitor without advance notice, home care providers in accordance with sections 144A.43 to 144A.482; (2) survey every temporary licensee within one year of the temporary license issuance date subject to the temporary licensee providing home care services to a client or clients; (3) survey all licensed home care providers on an interval that will promote the health and safety of clients; (4) with the consent of the client, visit the home where services are being provided; (5) issue correction orders and assess civil penalties in accordance with section 144.653, subdivisions 5 to 8, for violations of sections 144A.43 to 144A.482; (6) take action as authorized in section 144A.475; and (7) take other action reasonably required to accomplish the purposes of sections 144A.43 to 144A.482. Subd. 3. [Repealed, 1997 c 113 s 22] Subd. 4. [Repealed by amendment, 2013 c 108 art 11 s 9] Subd. 5. [Repealed by amendment, 2013 c 108 art 11 s 9] Subd. 6. MS 2018 [Repealed, 1Sp2019 c 9 art 11 s 112] History: 1987 c 378 s 5; 1989 c 282 art 2 s 25; 1991 c 286 s 8; 1997 c 113 s 2,3; 1998 c 254 art 1 s 30,31; 2002 c 252 s 5,6,24; 2003 c 37 s 2; 2008 c 326 art 1 s 2,3; 2009 c 174 art 2 s 5,6; 2010 c 246 s 1,2; 2013 c 43 s 16; 2013 c 108 art 11 s 9; 2014 c 275 art 1 s 135 144A.46 [Repealed, 2014 c 275 art 1 s 134] 144A.4605 [Repealed, 2014 c 275 art 1 s 134] 144A.461 [Repealed, 2014 c 275 art 1 s 134] 144A.465 [Repealed, 2014 c 275 art 1 s 134] 144A.47 INFORMATION AND REFERRAL SERVICES. The commissioner shall ensure that information and referral services relating to home care are available in all regions of the state. The commissioner shall collect and make available information about available home care services, sources of payment, providers, and the rights of consumers. The commissioner may require home care providers to provide information requested for the purposes of this section as a condition of registration or licensure. The commissioner may publish and make available: (1) general information describing home care services in the state;
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(2) limitations on hours, availability of services, and eligibility for third-party payments, applicable to individual providers; and (3) other information the commissioner determines to be appropriate. History: 1987 c 378 s 7; 1995 c 207 art 9 s 21 HOME CARE LICENSING 144A.471 HOME CARE PROVIDER AND HOME CARE SERVICES. Subdivision 1. License required. A home care provider may not open, operate, manage, conduct, maintain, or advertise itself as a home care provider or provide home care services in Minnesota without a temporary or current home care provider license issued by the commissioner of health. Subd. 2. Determination of direct home care service. (a) "Direct home care service" means a home care service provided to a client by the home care provider or its employees, and not by contract. Factors that must be considered in determining whether an individual or a business entity provides at least one home care service directly include, but are not limited to, whether the individual or business entity: (1) has the right to control, and does control, the types of services provided; (2) has the right to control, and does control, when and how the services are provided; (3) establishes the charges; (4) collects fees from the clients or receives payment from third-party payers on the clients' behalf; (5) pays individuals providing services compensation on an hourly, weekly, or similar basis; (6) treats the individuals providing services as employees for the purposes of payroll taxes and workers' compensation insurance; and (7) holds itself out as a provider of home care services or acts in a manner that leads clients or potential clients to believe that it is a home care provider providing home care services. (b) None of the factors listed in this subdivision is solely determinative. Subd. 3. Determination of regularly engaged. (a) "Regularly engaged" means providing, or offering to provide, home care services as a regular part of a business. The following factors must be considered by the commissioner in determining whether an individual or a business entity is regularly engaged in providing home care services: (1) whether the individual or business entity states or otherwise promotes that the individual or business entity provides home care services; (2) whether persons receiving home care services constitute a substantial part of the individual's or the business entity's clientele; and (3) whether the home care services provided are other than occasional or incidental to the provision of services other than home care services. (b) None of the factors listed in this subdivision is solely determinative.
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Subd. 4. Penalties for operating without license. A person involved in the management, operation, or control of a home care provider that operates without an appropriate license is guilty of a misdemeanor. This section does not apply to a person who has no legal authority to affect or change decisions related to the management, operation, or control of a home care provider. Subd. 5. Basic and comprehensive levels of licensure. An applicant seeking to become a home care provider must apply for either a basic or comprehensive home care license. Subd. 6. Basic home care license provider. Home care services that can be provided with a basic home care license are assistive tasks provided by licensed or unlicensed personnel that include: (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 client to take regularly scheduled medication, which includes bringing the client previously set-up medication, medication in original containers, or liquid or food to accompany the medication; (4) providing verbal or visual reminders to the client to perform regularly scheduled treatments and exercises; (5) preparing modified diets ordered by a licensed health professional; and (6) assisting with laundry, housekeeping, meal preparation, shopping, or other household chores and services if the provider is also providing at least one of the activities in clauses (1) to (5). Subd. 7. Comprehensive home care license provider. Home care services that may be provided with a comprehensive home care license include any of the basic home care services listed in subdivision 6, and one or more of the following: (1) services of an advanced practice nurse, registered nurse, licensed practical nurse, physical therapist, respiratory therapist, occupational therapist, speech-language pathologist, dietitian or nutritionist, or social worker; (2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed health professional within the person's scope of practice; (3) medication management services; (4) hands-on assistance with transfers and mobility; (5) treatment and therapies; (6) assisting clients with eating when the clients have complicating eating problems as identified in the client 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; or (7) providing other complex or specialty health care services. Subd. 8. Exemptions from home care services licensure. (a) Except as otherwise provided in this chapter, home care services that are provided by the state, counties, or other units of government must be licensed under this chapter.
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(b) An exemption under this subdivision does not excuse the exempted individual or organization from complying with applicable provisions of the home care bill of rights in section 144A.44. The following individuals or organizations are exempt from the requirement to obtain a home care provider license: (1) an individual 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, and 256B.0659; (2) a provider that is licensed by the commissioner of human services to provide semi-independent living services for persons with developmental disabilities under section 252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020; (3) a provider that is licensed by the commissioner of human services to provide home and community-based services for persons with developmental disabilities under section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930; (4) an individual or organization that provides only home management services, if the individual or organization is registered under section 144A.482; or (5) an individual who is licensed in this state as a nurse, dietitian, social worker, occupational therapist, physical therapist, or speech-language pathologist who provides health care services in the home independently and not through any contractual or employment relationship with a home care provider or other organization. Subd. 9. Exclusions from home care licensure. The following are excluded from home care licensure and are not required to provide the home care bill of rights: (1) an individual or business entity providing only coordination of home care that includes one or more of the following: (i) determination of whether a client needs home care services, or assisting a client in determining what services are needed; (ii) referral of clients to a home care provider; (iii) administration of payments for home care services; or (iv) administration of a health care home established under section 256B.0751; (2) an individual who is not an employee of a licensed home care provider if the individual: (i) only provides services as an independent contractor to one or more licensed home care providers; (ii) provides no services under direct agreements or contracts with clients; and (iii) is contractually bound to perform services in compliance with the contracting home care provider's policies and service plans; (3) a business that provides staff to home care providers, such as a temporary employment agency, if the business: (i) only provides staff under contract to licensed or exempt providers; (ii) provides no services under direct agreements with clients; and
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(iii) is contractually bound to perform services under the contracting home care provider's direction and supervision; (4) any home care services conducted by and for the adherents of any recognized church or religious denomination for its members through spiritual means, or by prayer for healing; (5) an individual who only provides home care services to a relative; (6) an individual not connected with a home care provider that provides assistance with basic home care needs if the assistance is provided primarily as a contribution and not as a business; (7) an individual not connected with a home care provider that shares housing with and provides primarily housekeeping or homemaking services to an elderly or disabled person in return for free or reduced-cost housing; (8) an individual or provider providing home-delivered meal services; (9) an individual providing senior companion services and other older American volunteer programs (OAVP) established under the Domestic Volunteer Service Act of 1973, United States Code, title 42, chapter 66; (10) an employee of a nursing home or home care provider licensed under this chapter or an employee of a boarding care home licensed under sections 144.50 to 144.56 when responding to occasional emergency calls from individuals residing in a residential setting that is attached to or located on property contiguous to the nursing home, boarding care home, or location where home care services are also provided; (11) an employee of a nursing home or home care provider licensed under this chapter or an employee of a boarding care home licensed under sections 144.50 to 144.56 when providing occasional minor services free of charge to individuals residing in a residential setting that is attached to or located on property contiguous to the nursing home, boarding care home, or location where home care services are also provided; (12) a member of a professional corporation organized under chapter 319B that does not regularly offer or provide home care services as defined in section 144A.43, subdivision 3; (13) the following organizations established to provide medical or surgical services that do not regularly offer or provide home care services as defined in section 144A.43, subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit corporation organized under chapter 317A, a partnership organized under chapter 323, or any other entity determined by the commissioner; (14) an individual or agency that provides medical supplies or durable medical equipment, except when the provision of supplies or equipment is accompanied by a home care service; (15) a physician licensed under chapter 147; (16) an individual who provides home care services to a person with a developmental disability who lives in a place of residence with a family, foster family, or primary caregiver; (17) a business that only provides services that are primarily instructional and not medical services or health-related support services; (18) an individual who performs basic home care services for no more than 14 hours each calendar week to no more than one client;
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(19) an individual or business licensed as hospice as defined in sections 144A.75 to 144A.755 who is not providing home care services independent of hospice service; (20) activities conducted by the commissioner of health or a community health board as defined in section 145A.02, subdivision 5, including communicable disease investigations or testing; or (21) administering or monitoring a prescribed therapy necessary to control or prevent a communicable disease, or the monitoring of an individual's compliance with a health directive as defined in section 144.4172, subdivision 6. [See Note.] History: 2013 c 108 art 11 s 10; 2014 c 262 art 5 s 6; 2014 c 275 art 1 s 135; 2014 c 291 art 7 s 28; 2016 c 179 s 6; 2019 c 60 art 4 s 17,18 NOTE: The amendment to subdivision 9 striking clauses (10) and (11) by Laws 2019, chapter 60, article 4, section 18, is effective July 1, 2021. Laws 2019, chapter 60, article 4, section 18, the effective date. 144A.472 HOME CARE PROVIDER LICENSE; APPLICATION AND RENEWAL. Subdivision 1. License applications. Each application for a home care provider license must include information sufficient to show that the applicant meets the requirements of licensure, including: (1) the applicant's name, e-mail address, physical address, and mailing address, including the name of the county in which the applicant resides and has a principal place of business; (2) the initial license fee in the amount specified in subdivision 7; (3) the e-mail address, physical address, mailing address, and telephone number of the principal administrative office; (4) the e-mail address, physical address, mailing address, and telephone number of each branch office, if any; (5) the names, e-mail and mailing addresses, and telephone numbers of all owners and managerial officials; (6) documentation of compliance with the background study requirements of section 144A.476 for all persons involved in the management, operation, or control of the home care provider; (7) documentation of a background study as required by section 144.057 for any individual seeking employment, paid or volunteer, with the home care provider; (8) evidence of workers' compensation coverage as required by sections 176.181 and 176.182; (9) documentation of liability coverage, if the provider has it; (10) identification of the license level the provider is seeking; (11) documentation that identifies the managerial official who is in charge of day-to-day operations and attestation that the person has reviewed and understands the home care provider regulations; (12) documentation that the applicant has designated one or more owners, managerial officials, or employees as an agent or agents, which shall not affect the legal responsibility of any other owner or managerial official under this chapter;
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(13) the signature of the officer or managing agent on behalf of an entity, corporation, association, or unit of government; (14) verification that the applicant has the following policies and procedures in place so that if a license is issued, the applicant will implement the policies and procedures and keep them current: (i) requirements in sections 626.556, reporting of maltreatment of minors, and 626.557, reporting of maltreatment of vulnerable adults; (ii) conducting and handling background studies on employees; (iii) orientation, training, and competency evaluations of home care staff, and a process for evaluating staff performance; (iv) handling complaints from clients, family members, or client representatives regarding staff or services provided by staff; (v) conducting initial evaluation of clients' needs and the providers' ability to provide those services; (vi) conducting initial and ongoing client evaluations and assessments and how changes in a client's condition are identified, managed, and communicated to staff and other health care providers as appropriate; (vii) orientation to and implementation of the home care client bill of rights; (viii) infection control practices; (ix) reminders for medications, treatments, or exercises, if provided; and (x) 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; and (15) other information required by the department. Subd. 2. Comprehensive home care license applications. In addition to the information and fee required in subdivision 1, applicants applying for a comprehensive home care license must also provide verification that the applicant has the following policies and procedures in place so that if a license is issued, the applicant will implement the policies and procedures in this subdivision and keep them current: (1) conducting initial and ongoing assessments of the client's needs by a registered nurse or appropriate licensed health professional, including how changes in the client's conditions are identified, managed, and communicated to staff and other health care providers, as appropriate; (2) ensuring that nurses and licensed health professionals have current and valid licenses to practice; (3) medication and treatment management; (4) delegation of home care tasks by registered nurses or licensed health professionals; (5) supervision of registered nurses and licensed health professionals; and (6) supervision of unlicensed personnel performing delegated home care tasks. Subd. 3. License renewal. (a) Except as provided in section 144A.475, a license may be renewed for a period of one year if the licensee satisfies the following:
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(1) submits an application for renewal in the format provided by the commissioner at least 30 days before expiration of the license; (2) submits the renewal fee in the amount specified in subdivision 7; (3) has provided home care services within the past 12 months; (4) complies with sections 144A.43 to 144A.4798; (5) provides information sufficient to show that the applicant meets the requirements of licensure, including items required under subdivision 1; (6) provides verification that all policies under subdivision 1 are current; and (7) provides any other information deemed necessary by the commissioner. (b) A renewal applicant who holds a comprehensive home care license must also provide verification that policies listed under subdivision 2 are current. Subd. 4. MS 2018 [Repealed, 2019 c 60 art 4 s 35] Subd. 5. Changes in ownership. (a) A home care license issued by the commissioner may not be transferred to another party. Before acquiring ownership of or a controlling interest in a home care provider business, a prospective owner must apply for a new license. A change of ownership is a transfer of operational control of the home care provider business and includes: (1) transfer of the business to a different or new corporation; (2) in the case of a partnership, the dissolution or termination of the partnership under chapter 323A, with the business continuing by a successor partnership or other entity; (3) relinquishment of control of the provider to another party, including to a contract management firm that is not under the control of the owner of the business' assets; (4) transfer of the business by a sole proprietor to another party or entity; or (5) transfer of ownership or control of 50 percent or more of the controlling interest of a home care provider business not covered by clauses (1) to (4). (b) An employee who was employed by the previous owner of the home care provider business prior to the effective date of a change in ownership under paragraph (a), and who will be employed by the new owner in the same or a similar capacity, shall be treated as if no change in employer occurred, with respect to orientation, training, tuberculosis testing, background studies, and competency testing and training on the policies identified in subdivision 1, clause (14), and subdivision 2, if applicable. (c) Notwithstanding paragraph (b), a new owner of a home care provider business must ensure that employees of the provider receive and complete training and testing on any provisions of policies that differ from those of the previous owner within 90 days after the date of the change in ownership. Subd. 6. Notification of changes of information. The temporary licensee or licensee shall notify the commissioner in writing within ten working days after any change in the information required in subdivision 1, except the information required in subdivision 1, clause (5), is required at the time of license renewal.
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144A.472
Subd. 7. Fees; application, change of ownership, renewal, and failure to notify. (a) An initial applicant seeking temporary home care licensure must submit the following application fee to the commissioner along with a completed application: (1) for a basic home care provider, $2,100; or (2) for a comprehensive home care provider, $4,200. (b) A home care provider who is filing a change of ownership as required under subdivision 5 must submit the following application fee to the commissioner, along with the documentation required for the change of ownership: (1) for a basic home care provider, $2,100; or (2) for a comprehensive home care provider, $4,200. (c) For the period ending June 30, 2018, a home care provider who is seeking to renew the provider's license shall pay a fee to the commissioner based on revenues derived from the provision of home care services during the calendar year prior to the year in which the application is submitted, according to the following schedule: License Renewal Fee Provider Annual Revenue
Fee
greater than $1,500,000
$6,625
greater than $1,275,000 and no more than $1,500,000
$5,797
greater than $1,100,000 and no more than $1,275,000
$4,969
greater than $950,000 and no more than $1,100,000
$4,141
greater than $850,000 and no more than $950,000
$3,727
greater than $750,000 and no more than $850,000
$3,313
greater than $650,000 and no more than $750,000
$2,898
greater than $550,000 and no more than $650,000
$2,485
greater than $450,000 and no more than $550,000
$2,070
greater than $350,000 and no more than $450,000
$1,656
greater than $250,000 and no more than $350,000
$1,242
greater than $100,000 and no more than $250,000
$828
greater than $50,000 and no more than $100,000
$500
greater than $25,000 and no more than $50,000
$400
no more than $25,000
$200
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(d) For the period between July 1, 2018, and June 30, 2020, a home care provider who is seeking to renew the provider's license shall pay a fee to the commissioner in an amount that is ten percent higher than the applicable fee in paragraph (c). A home care provider's fee shall be based on revenues derived from the provision of home care services during the calendar year prior to the year in which the application is submitted. (e) Beginning July 1, 2020, a home care provider who is seeking to renew the provider's license shall pay a fee to the commissioner based on revenues derived from the provision of home care services during the calendar year prior to the year in which the application is submitted, according to the following schedule: License Renewal Fee Provider Annual Revenue
Fee
greater than $1,500,000
$7,651
greater than $1,275,000 and no more than $1,500,000
$6,695
greater than $1,100,000 and no more than $1,275,000
$5,739
greater than $950,000 and no more than $1,100,000
$4,783
greater than $850,000 and no more than $950,000
$4,304
greater than $750,000 and no more than $850,000
$3,826
greater than $650,000 and no more than $750,000
$3,347
greater than $550,000 and no more than $650,000
$2,870
greater than $450,000 and no more than $550,000
$2,391
greater than $350,000 and no more than $450,000
$1,913
greater than $250,000 and no more than $350,000
$1,434
greater than $100,000 and no more than $250,000
$957
greater than $50,000 and no more than $100,000
$577
greater than $25,000 and no more than $50,000
$462
no more than $25,000
$231
(f) If requested, the home care provider shall provide the commissioner information to verify the provider's annual revenues or other information as needed, including copies of documents submitted to the Department of Revenue. (g) At each annual renewal, a home care provider may elect to pay the highest renewal fee for its license category, and not provide annual revenue information to the commissioner. (h) A temporary license or license applicant, or temporary licensee or licensee that knowingly provides the commissioner incorrect revenue amounts for the purpose of paying a lower license fee, shall be subject to a civil penalty in the amount of double the fee the provider should have paid.
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(i) The fine for failure to comply with the notification requirements in section 144A.473, subdivision 2, paragraph (c), is $1,000. (j) 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. Fees collected under paragraphs (c), (d), and (e) are nonrefundable even if received before July 1, 2017, for temporary licenses or licenses being issued effective July 1, 2017, or later. (k) Fines and civil 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: 2013 c 108 art 11 s 11; 2014 c 275 art 1 s 135; 1Sp2017 c 6 art 10 s 68; 2019 c 60 art 4 s 19; 1Sp2019 c 9 art 11 s 41,42 144A.473 ISSUANCE OF TEMPORARY LICENSE AND LICENSE RENEWAL. Subdivision 1. Temporary license and renewal of license. (a) The department shall review each application to determine the applicant's knowledge of and compliance with Minnesota home care regulations. Before granting a temporary license or renewing a license, the commissioner may further evaluate the applicant or licensee by requesting additional information or documentation or by conducting an on-site survey of the applicant to determine compliance with sections 144A.43 to 144A.482. (b) Within 14 calendar days after receiving an application for a license, the commissioner shall acknowledge receipt of the application in writing. The acknowledgment must indicate whether the application appears to be complete or whether additional information is required before the application will be considered complete. (c) Within 90 days after receiving a complete application, the commissioner shall issue a temporary license, renew the license, or deny the license. (d) The commissioner shall issue a license that contains the home care provider's name, address, license level, expiration date of the license, and unique license number. All licenses, except for temporary licenses issued under subdivision 2, are valid for up to one year from the date of issuance. Subd. 2. Temporary license. (a) For new license applicants, the commissioner shall issue a temporary license for either the basic or comprehensive home care level. A temporary license is effective for up to one year from the date of issuance, except that a temporary license may be extended according to subdivision 3. Temporary licensees must comply with sections 144A.43 to 144A.482. (b) During the temporary license period, the commissioner shall survey the temporary licensee within 90 calendar days after the commissioner is notified or has evidence that the temporary licensee is providing home care services. (c) Within five days of beginning the provision of services, the temporary licensee must notify the commissioner that it is serving clients. The notification to the commissioner may be mailed or e-mailed to the commissioner at the address provided by the commissioner. If the temporary licensee does not provide home care services during the temporary license period, then the temporary license expires at the end of the period and the applicant must reapply for a temporary home care license. (d) A temporary licensee may request a change in the level of licensure prior to being surveyed and granted a license by notifying the commissioner in writing and providing additional documentation or
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materials required to update or complete the changed temporary license application. The applicant must pay the difference between the application fees when changing from the basic level to the comprehensive level of licensure. No refund will be made if the provider chooses to change the license application to the basic level. (e) If the temporary licensee notifies the commissioner that the licensee has clients within 45 days prior to the temporary license expiration, the commissioner may extend the temporary license for up to 60 days in order to allow the commissioner to complete the on-site survey required under this section and follow-up survey visits. Subd. 3. Temporary licensee survey. (a) If the temporary licensee is in substantial compliance with the survey, the commissioner shall issue either a basic or comprehensive home care license. If the temporary licensee is not in substantial compliance with the survey, the commissioner shall either: (1) not issue a license and terminate the temporary license; or (2) extend the temporary license for a period not to exceed 90 days and apply conditions, as permitted under section 144A.475, subdivision 2, to the extension of a temporary license. If the temporary licensee is not in substantial compliance with the survey within the time period of the extension, or if the temporary licensee does not satisfy the license conditions, the commissioner may deny the license. (b) If the temporary licensee whose basic or comprehensive license has been denied or extended with conditions disagrees with the conclusions of the commissioner, then the temporary licensee may request a reconsideration by the commissioner or commissioner's designee. The reconsideration request process must be conducted internally by the commissioner or commissioner's designee, and chapter 14 does not apply. (c) The temporary licensee requesting reconsideration must make the request in writing and must list and describe the reasons why the temporary licensee disagrees with the decision to deny the basic or comprehensive home care license or the decision to extend the temporary license with conditions. (d) The reconsideration request and supporting documentation must be received by the commissioner within 15 calendar days after the date the temporary licensee receives the correction order. (e) A temporary licensee whose license is denied is permitted to continue operating as a home care provider during the period of time when: (1) a reconsideration request is in process; (2) an extension of a temporary license is being negotiated; (3) the placement of conditions on a temporary license is being negotiated; or (4) a transfer of home care clients from the temporary licensee to a new home care provider is in process. (f) A temporary licensee whose license is denied must comply with the requirements for notification and transfer of clients in section 144A.475, subdivision 5. History: 2013 c 108 art 11 s 12; 2014 c 275 art 1 s 135; 2016 c 179 s 7; 1Sp2019 c 9 art 11 s 43 144A.474 SURVEYS AND INVESTIGATIONS. Subdivision 1. Surveys. The commissioner shall conduct surveys of each home care provider. By June 30, 2016, the commissioner shall conduct a survey of home care providers on a frequency of at least once every three years. Survey frequency may be based on the license level, the provider's compliance history,
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the number of clients served, or other factors as determined by the department deemed necessary to ensure the health, safety, and welfare of clients and compliance with the law. Subd. 2. Types of home care surveys. (a) "Initial full survey" means the survey of a new temporary licensee conducted after the department is notified or has evidence that the temporary licensee is providing home care services to determine if the provider is in compliance with home care requirements. Initial full surveys must be completed within 14 months after the department's issuance of a temporary basic or comprehensive license. (b) "Change in ownership survey" means a full survey of a new licensee due to a change in ownership. Change in ownership surveys must be completed within six months after the department's issuance of a new license due to a change in ownership. (c) "Core survey" means periodic inspection of home care providers to determine ongoing compliance with the home care requirements, focusing on the essential health and safety requirements. Core surveys are available to licensed home care providers who have been licensed for three years and surveyed at least once in the past three years with the latest survey having no widespread violations beyond Level 1 as provided in subdivision 11. Providers must also not have had any substantiated licensing complaints, substantiated complaints against the agency under the Vulnerable Adults Act or Maltreatment of Minors Act, or an enforcement action as authorized in section 144A.475 in the past three years. (1) The core survey for basic home care providers must review compliance in the following areas: (i) reporting of maltreatment; (ii) orientation to and implementation of the home care bill of rights; (iii) statement of home care services; (iv) initial evaluation of clients and initiation of services; (v) client review and monitoring; (vi) service plan implementation and changes to the service plan; (vii) client complaint and investigative process; (viii) competency of unlicensed personnel; and (ix) infection control. (2) For comprehensive home care providers, the core survey must include everything in the basic core survey plus these areas: (i) delegation to unlicensed personnel; (ii) assessment, monitoring, and reassessment of clients; and (iii) medication, treatment, and therapy management. (d) "Full survey" means the periodic inspection of home care providers to determine ongoing compliance with the home care requirements that cover the core survey areas and all the legal requirements for home care providers. A full survey is conducted for all temporary licensees, for licensees that receive licenses due to an approved change in ownership, for providers who do not meet the requirements needed for a core survey, and when a surveyor identifies unacceptable client health or safety risks during a core survey. A full
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survey must include all the tasks identified as part of the core survey and any additional review deemed necessary by the department, including additional observation, interviewing, or records review of additional clients and staff. (e) "Follow-up surveys" means surveys conducted to determine if a home care provider has corrected deficient issues and systems identified during a core survey, full 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 surveys, shall be concluded with an exit conference and written information provided on the process for requesting a reconsideration of the survey results. (f) Upon receiving information alleging that a home care provider has violated or is currently violating a requirement of sections 144A.43 to 144A.482, the commissioner shall investigate the complaint according to sections 144A.51 to 144A.54. Subd. 3. Survey process. The survey process for core surveys shall include the following as applicable to the particular licensee and setting surveyed: (1) presurvey review of pertinent documents and notification to the ombudsman for long-term care; (2) an entrance conference with available staff; (3) communication with managerial officials or the registered nurse in charge, if available, and ongoing communication with key staff throughout the survey regarding information needed by the surveyor, clarifications regarding home care requirements, and applicable standards of practice; (4) presentation of written contact information to the provider about the survey staff conducting the survey, the supervisor, and the process for requesting a reconsideration of the survey results; (5) a brief tour of a sample of the housing with services establishments in which the provider is providing home care services; (6) a sample selection of home care clients; (7) information-gathering through client and staff observations, client and staff interviews, and reviews of records, policies, procedures, practices, and other agency information; (8) interviews of clients' family members, if available, with clients' consent when the client can legally give consent; (9) except for complaint surveys conducted by the Office of Health Facilities Complaints, an on-site exit conference, with preliminary findings shared and discussed with the provider, documentation that an exit conference occurred, and written information provided on the process for requesting a reconsideration of the survey results; and (10) postsurvey analysis of findings and formulation of survey results, including correction orders when applicable. Subd. 4. Scheduling surveys. Surveys and investigations shall be conducted without advance notice to home care providers. Surveyors may contact the home care provider on the day of a survey to arrange for someone to be available at the survey site. The contact does not constitute advance notice. Subd. 5. Information provided by home care provider. The home care provider shall provide accurate and truthful information to the department during a survey, investigation, or other licensing activities.
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Subd. 6. Providing client records. Upon request of a surveyor, home care providers shall provide a list of current and past clients or client representatives that includes addresses and telephone numbers and any other information requested about the services to clients within a reasonable period of time. Subd. 7. Contacting and visiting clients. Surveyors may contact or visit a home care provider's clients to gather information without notice to the home care provider. Before visiting a client, a surveyor shall obtain the client's or client's representative's permission by telephone, by mail, or in person. Surveyors shall inform all clients or client's representatives of their right to decline permission for a visit. Subd. 8. Correction orders. (a) A correction order may be issued whenever the commissioner finds upon survey or during a complaint investigation that a home care provider, a managerial official, or an employee of the provider is not in compliance with sections 144A.43 to 144A.482. The correction order shall cite the specific statute and document areas of noncompliance and the time allowed for correction. (b) The commissioner shall mail copies of any correction order to the last known address of the home care provider, or electronically scan the correction order and e-mail it to the last known home care provider e-mail address, 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 home care provider, 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 home care provider must document in the provider's records any action taken to comply with the correction order. The commissioner may request a copy of this documentation and the home care provider's action to respond to the correction order in future surveys, upon a complaint investigation, and as otherwise needed. Subd. 9. Follow-up surveys. For providers that have Level 3 or Level 4 violations under subdivision 11, or any violations determined to be widespread, the department shall conduct a follow-up survey within 90 calendar days of the survey. When conducting a follow-up survey, the surveyor will 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. 10. Performance incentive. A licensee is eligible for a performance incentive if there are no violations identified in a core or full survey. The performance incentive is a ten percent discount on the licensee's next home care renewal license fee. Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be assessed based on the level and scope of the violations described in paragraph (b) and imposed immediately with no opportunity to correct the violation first as follows: (1) Level 1, no fines or enforcement; (2) Level 2, a fine of $500 per violation, in addition to any of the enforcement mechanisms authorized in section 144A.475 for widespread violations; (3) Level 3, a fine of $3,000 per incident, in addition to any of the enforcement mechanisms authorized in section 144A.475; (4) Level 4, a fine of $5,000 per incident, in addition to any of the enforcement mechanisms authorized in section 144A.475;
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(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; and (6) the fines in clauses (1) to (4) are increased and immediate fine imposition is authorized for both surveys and investigations conducted. 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. (b) Correction orders for violations are categorized by both level and scope and fines shall be assessed as follows: (1) level of violation: (i) Level 1 is a violation that has no potential to cause more than a minimal impact on the client and does not affect health or safety; (ii) Level 2 is a violation that did not harm a client's health or safety but had the potential to have harmed a client's health or safety, but was not likely to cause serious injury, impairment, or death; (iii) Level 3 is a violation that harmed a client'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 (iv) Level 4 is a violation that results in serious injury, impairment, or death; (2) scope of violation: (i) isolated, when one or a limited number of clients are affected or one or a limited number of staff are involved or the situation has occurred only occasionally; (ii) pattern, when more than a limited number of clients 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 (iii) 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 clients. (c) If the commissioner finds that the applicant or a home care provider 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-mail to the applicant's or provider's last known e-mail address. The noncompliance notice must list the violations not corrected. (d) For every violation identified by the commissioner, the commissioner shall issue an immediate fine pursuant to paragraph (a), clause (6). The license holder must still correct the violation in the time specified. The issuance of an immediate fine can occur in addition to any enforcement mechanism authorized under section 144A.475. The immediate fine may be appealed as allowed under this subdivision. (e) The license holder must pay the fines assessed on or before the payment date specified. If the license holder fails to fully comply with the order, the commissioner may issue a second fine or suspend the license until the license holder complies by paying the fine. A timely appeal shall stay payment of the fine until the commissioner issues a final order.
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(f) A license holder 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 a second fine. The commissioner shall notify the license holder by mail to the last known address in the licensing record that a second fine has been assessed. The license holder may appeal the second fine as provided under this subdivision. (g) A home care provider that has been assessed a fine under this subdivision has a right to a reconsideration or a hearing under this section and chapter 14. (h) When a fine has been assessed, the license holder may not avoid payment by closing, selling, or otherwise transferring the licensed program to a third party. In such an event, the license holder shall be liable for payment of the fine. (i) 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. (j) Fines collected under paragraph (a), clauses (1) to (4), 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. (k) Fines collected under paragraph (a), clause (5), shall be deposited in a dedicated special revenue account and appropriated to the commissioner to provide compensation according to subdivision 14 to clients subject to maltreatment. A client may choose to receive compensation from this fund, not to exceed $5,000 for each substantiated finding of maltreatment, or take civil action. This paragraph expires July 31, 2021. Subd. 12. Reconsideration. (a) The commissioner shall make available to home care providers a correction order reconsideration process. This process may be used to challenge the correction order issued, including the level and scope described in subdivision 11, and any fine assessed. During the correction order reconsideration request, the issuance for the correction orders under reconsideration are not stayed, but the department shall post information on the website with the correction order that the licensee has requested a reconsideration and that the review is pending. (b) A licensed home care provider may request from the commissioner, in writing, a correction order reconsideration regarding any correction order issued to the provider. 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 the writing or reviewing of 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 home care provider for a correction order reconsideration within 60 days of the date the provider requests a reconsideration. The commissioner's response shall identify the commissioner's decision regarding each citation challenged by the home care provider. (c) 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;
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(3) correction order cited an incorrect home care licensing requirement, the correction order is amended by changing the correction order to the appropriate statutory reference; (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; (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. (d) If the correction order findings are changed by the commissioner, the commissioner shall update the correction order website. (e) This subdivision does not apply to temporary licensees. Subd. 13. Home care surveyor training. (a) Before conducting a home care survey, each home care surveyor must receive training on the following topics: (1) Minnesota home care licensure requirements; (2) Minnesota home care bill of rights; (3) Minnesota Vulnerable Adults Act and reporting of maltreatment of minors; (4) principles of documentation; (5) survey protocol and processes; (6) Offices of the Ombudsman roles; (7) Office of Health Facility Complaints; (8) Minnesota landlord-tenant and housing with services laws; (9) types of payors for home care services; and (10) Minnesota Nurse Practice Act for nurse surveyors. (b) Materials used for the training in paragraph (a) shall be posted on the department website. Requisite understanding of these topics will be reviewed as part of the quality improvement plan in section 144A.483. Subd. 14. Maltreatment compensation fund. (a) Once a finding of maltreatment for which the licensee is determined to be responsible is substantiated and any request for reconsideration, if applicable, is completed, the commissioner shall pay the fine assessed under subdivision 11, paragraph (a), clause (5), as compensation to the client who was subject to the maltreatment, if: (1) the client chooses to receive a compensation payment of either $1,000 or $5,000 as determined by the fine assessed under subdivision 11, paragraph (a), clause (5), depending on the level of maltreatment; and (2) the client accepts payment of compensation under this subdivision as payment in full and agrees to waive any civil claims, including claims under section 626.557, subdivision 20, arising from the specific maltreatment incident that resulted in the fine.
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(b) The commissioner shall notify the client that the client may reject a compensation payment under this subdivision and instead pursue any civil claims. (c) Except as provided in paragraph (a), nothing in this subdivision affects the rights available to clients under section 626.557 or prevents a client from filing a maltreatment report in the future. (d) This subdivision expires July 31, 2021. History: 2013 c 108 art 11 s 13; 2014 c 275 art 1 s 135; 2014 c 291 art 6 s 13,14; 1Sp2017 c 6 art 10 s 69; 2019 c 60 art 4 s 20-22; 1Sp2019 c 9 art 11 s 44 144A.475 ENFORCEMENT. Subdivision 1. Conditions. (a) The commissioner may refuse to grant a temporary 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 home care provider or owner or managerial official of the home care provider: (1) is in violation of, or during the term of the license has violated, any of the requirements in sections 144A.471 to 144A.482; (2) permits, aids, or abets the commission of any illegal act in the provision of home care; (3) performs any act detrimental to the health, safety, and welfare of a client; (4) obtains the license by fraud or misrepresentation; (5) knowingly made or 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 home care provider's books, records, files, or employees; (7) interferes with or impedes a representative of the department in contacting the home care provider's clients; (8) interferes with or impedes a representative of the department in the enforcement of this chapter or has failed to fully cooperate with an inspection, survey, or investigation by the department; (9) destroys or makes unavailable any records or other evidence relating to the home care provider's compliance with this chapter; (10) refuses to initiate a background study under section 144.057 or 245A.04; (11) fails to timely pay any fines assessed by the department; (12) violates any local, city, or township ordinance relating to home care services; (13) has repeated incidents of personnel performing services beyond their competency level; or (14) has operated beyond the scope of the home care provider's license level. (b) A violation by a contractor providing the home care services of the home care provider is a violation by the home care provider.
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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 provider. 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 home care provider's practices and submit reports to the commissioner at the cost of the home care provider; (2) requiring supervision of the home care provider or staff practices at the cost of the home care provider 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 home care provider or employees to obtain training at the cost of the home care provider; (4) requiring the home care provider to submit reports to the commissioner; (5) prohibiting the home care provider from taking any new clients for a period of time; or (6) any other action reasonably required to accomplish the purpose of this subdivision and section 144A.45, subdivision 2. (b) A home care provider subject to this subdivision may continue operating during the period of time home care clients are being transferred to other providers. Subd. 3. Notice. (a) Prior to any suspension, revocation, or refusal to renew a license, the home care provider shall be entitled to notice and a hearing as provided by sections 14.57 to 14.69. 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 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 persons in the provider's care, provided: (1) advance notice is given to the home care provider; (2) after notice, the home care provider 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 the 30 days unless there is an extension granted by an administrative law judge pursuant to subdivision 3b. (b) If the commissioner determines there are: (1) level 4 violations; or (2) violations that pose an imminent risk of harm to the health or safety of persons in the provider's care, the commissioner may immediately temporarily suspend a license, prohibit delivery of services by a provider, 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 144A.474, subdivision 11, paragraph (b).
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Subd. 3a. 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 4 violations as defined in section 144A.474, subdivision 11, paragraph (b), the commissioner shall act immediately to temporarily suspend the license under the provisions in subdivision 3. Subd. 3b. Expedited hearing. (a) Within five business days of receipt of the license holder'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 4 violations as defined in section 144A.474, subdivision 11, paragraph (b), or that there were violations that posed an imminent risk of harm to the health and safety of persons in the provider's care. (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 license holder 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 clients in subdivision 5. These requirements remain if an appeal is requested. Subd. 3c. 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 services by a provider for not more than 90 days, or issue a conditional license, if the commissioner determines that there are: (1) level 4 violations; or
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(2) violations that pose an imminent risk of harm to the health or safety of persons in the provider's care. (b) For purposes of this subdivision, "level 4" has the meaning given in section 144A.474, subdivision 11, paragraph (b). (c) A notice stating the reasons for the immediate temporary suspension or conditional license and informing the license holder of the right to an expedited hearing under subdivision 3b must be delivered by personal service to the address shown on the application or the last known address of the license holder. The license holder 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 license holder receives notice. If an appeal is made by personal service, it must be received by the commissioner within five calendar days after the license holder received the order. (d) A license holder whose license is immediately temporarily suspended must comply with the requirements for notification and transfer of clients in subdivision 5. These requirements remain if an appeal is requested. Subd. 4. Time limits for appeals. To appeal the assessment of civil penalties under section 144A.45, subdivision 2, clause (5), and an action against a license under this section, a provider must request a hearing no later than 15 days after the provider receives notice of the action. Subd. 5. Plan required. (a) The process of suspending, revoking, or refusing to renew a license must include a plan for transferring affected clients' care to other providers by the home care provider, which will be monitored by the commissioner. Within three calendar days of being notified of the revocation, refusal to renew, or suspension, the home care provider 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 clients, including full names and all contact information on file; (2) a list of each client's representative or emergency contact person, including full names and all contact information on file; (3) the location or current residence of each client; (4) the payor sources for each client, including payor source identification numbers; and (5) for each client, a copy of the client'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 home care provider 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 clients to qualified providers. Within three calendar days of being notified of the final revocation, refusal to renew, or suspension action, the home care provider must notify and disclose to each of the home care provider's clients, or the client's representative or emergency contact persons, that the commissioner is taking action against the home care provider's license by providing a copy of the revocation, refusal to renew, or suspension notice issued by the commissioner. If the provider does not comply with the disclosure requirements in this section, the commissioner shall notify the clients, client representatives, or emergency contact persons about the action being taken. Lead agencies, county adult protection and case managers, and the Office of Ombudsman for Long-Term Care may also provide this
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information. The revocation, refusal to renew, or suspension notice is public data except for any private data contained therein. (c) A home care provider subject to this subdivision may continue operating during the period of time home care clients are being transferred to other providers. Subd. 6. Owners and managerial officials; refusal to grant license. (a) The owner and managerial officials of a home care provider whose Minnesota license has not been renewed or that has been revoked because of noncompliance with applicable laws or rules shall not be eligible to apply for nor will be granted a home care license, including other licenses under this chapter, 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 owner and managerial officials already have enrollment status, their enrollment will be terminated by the Department of Human Services. (b) The commissioner shall not issue a license to a home care provider for five years following the effective date of license nonrenewal or revocation if the owner or managerial official, including any individual who was an owner or managerial official of another home care 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 any home care provider that includes any individual as an owner or managerial official who was an owner or managerial official of a home care provider whose Minnesota license was not renewed or was revoked as described in paragraph (a) for five years following the effective date of the nonrenewal or revocation. (d) The commissioner shall notify the home care provider 30 days in advance of the date of nonrenewal, suspension, or revocation of the license. Within ten days after the receipt of the notification, the home care provider may request, in writing, that the commissioner stay the nonrenewal, revocation, or suspension of the license. The home care provider 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 client health, safety, or well-being. The commissioner shall determine whether the stay will be granted within 30 days of receiving the provider's request. The commissioner may propose additional restrictions or limitations on the provider's license and require that the granting of 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 home care provider poses to client health, safety, and well-being; (2) the compliance history of the home care provider; and (3) the appropriateness of any limits suggested by the home care provider. If the commissioner grants the stay, the order shall include any restrictions or limitation on the provider's license. The failure of the provider 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. 7. Request for hearing. A request for a hearing must be in writing and must:
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(1) be mailed or delivered to the department or the commissioner's designee; (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 home care provider believes constitutes a defense or mitigating factor. Subd. 8. Informal conference. At any time, the applicant or home care provider and the commissioner may hold an informal conference to exchange information, clarify issues, or resolve issues. Subd. 9. 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 home care provider or an employee of the home care provider from illegally engaging in activities regulated by sections 144A.43 to 144A.482. The commissioner may bring an action under this subdivision in the district court in Ramsey County or in the district in which a home care provider is providing services. 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 home care provider, or by an employee of the home care provider, would create an imminent risk of harm to a recipient of home care services. Subd. 10. Subpoena. In matters pending before the commissioner under sections 144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance of witnesses and the production of all necessary papers, 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 of health 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 the taking of 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: 2013 c 108 art 11 s 14; 2014 c 275 art 1 s 135; 2014 c 291 art 6 s 15-17; 2016 c 179 s 8-10; 2019 c 60 art 4 s 23,24; 1Sp2019 c 9 art 11 s 45-47 144A.476 BACKGROUND STUDIES. Subdivision 1. Prior criminal convictions; owner and managerial officials. (a) Before the commissioner issues a temporary license, issues a license as a result of an approved change in ownership, or renews a license, an owner or managerial official is required to complete a background study under section 144.057. No person may be involved in the management, operation, or control of a home care provider if the person has been disqualified under chapter 245C. If an individual is disqualified under section 144.057 or chapter 245C, the individual may request reconsideration of the disqualification. If the individual requests reconsideration and the commissioner sets aside or rescinds the disqualification, the individual is eligible to be involved in the management, operation, or control of the provider. 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 provider.
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(b) For purposes of this section, owners of a home care provider subject to the background check requirement are those individuals whose ownership interest provides sufficient authority or control to affect or change decisions related to the operation of the home care provider. An owner includes a sole proprietor, a general partner, or any other individual whose individual ownership interest can affect the management and direction of the policies of the home care provider. (c) For the purposes of this section, managerial officials subject to the background check requirement are individuals who provide direct contact as defined in section 245C.02, subdivision 11, or individuals who have the responsibility for the ongoing management or direction of the policies, services, or employees of the home care provider. Data collected under this subdivision shall be classified as private data on individuals under section 13.02, subdivision 12. (d) The department shall not issue any license if the applicant or owner or managerial official has been unsuccessful in having a background study disqualification set aside under section 144.057 and chapter 245C; if the owner or managerial official, as an owner or managerial official of another home care provider, was substantially responsible for the other home care provider's failure to substantially comply with sections 144A.43 to 144A.482; or if an owner that has ceased doing business, either individually or as an owner of a home care provider, was issued a correction order for failing to assist clients in violation of this chapter. Subd. 2. Employees, contractors, and volunteers. (a) Employees, contractors, and volunteers of a home care provider are subject to the background study required by section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall be construed to prohibit a home care provider from requiring self-disclosure of criminal conviction information. (b) Termination of an employee in good faith reliance on information or records obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not subject the home care provider to civil liability or liability for unemployment benefits. History: 2013 c 108 art 11 s 15; 2014 c 275 art 1 s 135; 2019 c 60 art 4 s 25; 1Sp2019 c 9 art 11 s 48 144A.477 COMPLIANCE. Subdivision 1. Medicare-certified providers; coordination of surveys. If feasible, the commissioner shall survey licensees to determine compliance with this chapter at the same time as surveys for certification for Medicare if Medicare certification is based on compliance with the federal conditions of participation and on survey and enforcement by the Department of Health as agent for the United States Department of Health and Human Services. Subd. 2. Medicare-certified providers; equivalent requirements. For home care providers licensed to provide comprehensive home care services that are also certified for participation in Medicare as a home health agency under Code of Federal Regulations, title 42, part 484, the following state licensure regulations are considered equivalent to the federal requirements: (1) quality management, section 144A.479, subdivision 3; (2) personnel records, section 144A.479, subdivision 7; (3) acceptance of clients, section 144A.4791, subdivision 4; (4) referrals, section 144A.4791, subdivision 5; (5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792, subdivisions 2 and 3;
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(6) individualized monitoring and reassessment, sections 144A.4791, subdivision 8, and 144A.4792, subdivisions 2 and 3; (7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792, subdivision 5, and 144A.4793, subdivision 3; (8) client complaint and investigation process, section 144A.4791, subdivision 11; (9) prescription orders, section 144A.4792, subdivisions 13 to 16; (10) client records, section 144A.4794, subdivisions 1 to 3; (11) qualifications for unlicensed personnel performing delegated tasks, section 144A.4795; (12) training and competency staff, section 144A.4795; (13) training and competency for unlicensed personnel, section 144A.4795, subdivision 7; (14) delegation of home care services, section 144A.4795, subdivision 4; (15) availability of contact person, section 144A.4797, subdivision 1; and (16) supervision of staff, section 144A.4797, subdivisions 2 and 3. Violations of requirements in clauses (1) to (16) may lead to enforcement actions under section 144A.474. History: 2013 c 108 art 11 s 16; 2014 c 275 art 1 s 135 144A.478 INNOVATION VARIANCE. Subdivision 1. Definition. For purposes of this section, "innovation variance" means a specified alternative to a requirement of this chapter. An innovation variance may be granted to allow a home care provider to offer home care 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 clients, and is likely to improve the services provided. The innovative variance cannot change any of the client's rights under section 144A.44, home care bill of rights. Subd. 2. Conditions. The commissioner may impose conditions on the granting of 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 law 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
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(5) justification that an innovation variance will not impair the services provided, will not adversely affect the health, safety, or welfare of clients, and is likely to improve the services provided. The commissioner may require additional information from the home care provider 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 home care provider. 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. 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 licensee's clients; (2) the home care provider has failed to comply with the terms of the innovation variance; (3) the home care provider 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: 2013 c 108 art 11 s 17; 2014 c 275 art 1 s 135 144A.479 HOME CARE PROVIDER RESPONSIBILITIES; BUSINESS OPERATION. Subdivision 1. Display of license. The original current license must be displayed in the home care provider's principal business office and copies must be displayed in any branch office. The home care provider must provide a copy of the license to any person who requests it. Subd. 2. Advertising. Home care providers shall not use false, fraudulent, or misleading advertising in the marketing of services. For purposes of this section, advertising includes any verbal, written, or electronic means of communicating to potential clients about the availability, nature, or terms of home care services. Subd. 3. Quality management. The home care provider shall engage in quality management appropriate to the size of the home care provider and relevant to the type of services the home care provider provides. The quality management activity means evaluating the quality of care by periodically reviewing client 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 clients. 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. Subd. 4. Provider restrictions. (a) This subdivision does not apply to licensees that are Minnesota counties or other units of government. (b) A home care provider or staff cannot accept powers-of-attorney from clients for any purpose, and may not accept appointments as guardians or conservators of clients. (c) A home care provider cannot serve as a client's representative.
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Subd. 5. Handling of client's finances and property. (a) A home care provider may assist clients with household budgeting, including paying bills and purchasing household goods, but may not otherwise manage a client's property. A home care provider must provide a client with receipts for all transactions and purchases paid with the client's funds. When receipts are not available, the transaction or purchase must be documented. A home care provider must maintain records of all such transactions. (b) A home care provider or staff may not borrow a client's funds or personal or real property, nor in any way convert a client's property to the home care provider's or staff's possession. (c) Nothing in this section precludes a home care provider or staff from accepting gifts of minimal value, or precludes the acceptance of donations or bequests made to a home care provider that are exempt from income tax under section 501(c) of the Internal Revenue Code of 1986. Subd. 6. Reporting maltreatment of vulnerable adults and minors. (a) All home care providers must comply with requirements for the reporting of maltreatment of minors in section 626.556 and the requirements for the reporting of maltreatment of vulnerable adults in section 626.557. Each home care provider must establish and implement a written procedure to ensure that all cases of suspected maltreatment are reported. (b) Each home care provider must develop and implement an individual abuse prevention plan for each vulnerable minor or adult for whom home care services are provided by a home care provider. The plan shall contain an individualized review or assessment of the person's susceptibility to abuse by another individual, including other vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors; and statements of the specific measures to be taken to minimize the risk of abuse to that person and other vulnerable adults or minors. For purposes of the abuse prevention plan, the term abuse includes self-abuse. Subd. 7. Employee records. The home care provider must maintain current records of each paid employee, regularly scheduled volunteers providing home care services, and of each individual contractor providing home care 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 statute or other 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 providing supervision; (4) documentation of annual performance reviews which identify areas of improvement needed and training needs; (5) for individuals providing home care services, verification that any health screenings required by infection control programs established under section 144A.4798 have taken place and the dates of those screenings; and (6) documentation of the background study as required under section 144.057. Each employee record must be retained for at least three years after a paid employee, home care volunteer, or contractor ceases to be employed by or under contract with the home care provider. If a home care provider ceases operation, employee records must be maintained for three years.
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Subd. 8. Labor market reporting. A home care provider shall comply with the labor market reporting requirements described in section 256B.4912, subdivision 1a. History: 2013 c 108 art 11 s 18; 2014 c 275 art 1 s 135; 1Sp2019 c 9 art 11 s 49,50 144A.4791 HOME CARE PROVIDER RESPONSIBILITIES WITH RESPECT TO CLIENTS. Subdivision 1. Home care bill of rights; notification to client. (a) The home care provider shall provide the client or the client's representative a written notice of the rights under section 144A.44 before the date that services are first provided to that client. The provider shall make all reasonable efforts to provide notice of the rights to the client or the client's representative in a language the client or client's representative can understand. (b) In addition to the text of the home care bill of rights in section 144A.44, subdivision 1, the notice shall also contain the following statement describing how to file a complaint with these offices. "If you have a complaint about the provider or the person providing your home care services, you may call, write, or visit 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." The statement should include 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 the Ombudsman for Long-Term Care, and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The statement should also include the home care provider's name, address, e-mail, telephone number, and name or title of the person at the provider to whom problems or complaints may be directed. It must also include a statement that the home care provider will not retaliate because of a complaint. (c) The home care provider shall obtain written acknowledgment of the client's receipt of the home care bill of rights or shall document why an acknowledgment cannot be obtained. The acknowledgment may be obtained from the client or the client's representative. Acknowledgment of receipt shall be retained in the client's record. Subd. 2. Notice of services for dementia, Alzheimer's disease, or related disorders. The home care provider that provides services to clients with dementia shall provide in written or electronic form, to clients 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. This information satisfies the disclosure requirements in section 325F.72, subdivision 2, clause (4). Subd. 3. Statement of home care services. Prior to the date that services are first provided to the client, a home care provider must provide to the client or the client's representative a written statement which identifies if the provider has a basic or comprehensive home care license, the services the provider is authorized to provide, and which services the provider cannot provide under the scope of the provider's license. The home care provider shall obtain written acknowledgment from the clients that the provider has provided the statement or must document why the provider could not obtain the acknowledgment. Subd. 4. Acceptance of clients. No home care provider may accept a person as a client unless the home care provider has staff, sufficient in qualifications, competency, and numbers, to adequately provide the services agreed to in the service plan and that are within the provider's scope of practice.
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Subd. 5. Referrals. If a home care provider reasonably believes that a client is in need of another medical or health service, including a licensed health professional, or social service provider, the home care provider shall: (1) determine the client's preferences with respect to obtaining the service; and (2) inform the client of resources available, if known, to assist the client in obtaining services. Subd. 6. Initiation of services. When a provider provides home care services to a client before the individualized review or assessment by a licensed health professional or registered nurse as required in subdivisions 7 and 8 is completed, the licensed health professional or registered nurse must complete a temporary plan with the client and orient staff assigned to deliver services as identified in the temporary plan. Subd. 7. Basic individualized client review and monitoring. (a) When services being provided are basic home care services, an individualized initial review of the client's needs and preferences must be conducted at the client's residence with the client or client's representative. This initial review must be completed within 30 days after the date that home care services are first provided. (b) Client monitoring and review must be conducted as needed based on changes in the needs of the client and cannot exceed 90 days from the date of the last review. The monitoring and review may be conducted at the client's residence or through the utilization of telecommunication methods based on practice standards that meet the individual client's needs. Subd. 8. Comprehensive assessment, monitoring, and reassessment. (a) When the services being provided are comprehensive home care services, an individualized initial assessment must be conducted in person by a registered nurse. When the services are provided by other licensed health professionals, the assessment must be conducted by the appropriate health professional. This initial assessment must be completed within five days after the date that home care services are first provided. (b) Client monitoring and reassessment must be conducted in the client's home no more than 14 days after the date that home care services are first provided. (c) Ongoing client monitoring and reassessment must be conducted as needed based on changes in the needs of the client and cannot exceed 90 days from the last date of the assessment. The monitoring and reassessment may be conducted at the client's residence or through the utilization of telecommunication methods based on practice standards that meet the individual client's needs. Subd. 9. Service plan, implementation, and revisions to service plan. (a) No later than 14 days after the date that home care services are first provided, a home care provider shall finalize a current written service plan. (b) The service plan and any revisions must include a signature or other authentication by the home care provider and by the client or the client's representative documenting agreement on the services to be provided. The service plan must be revised, if needed, based on client review or reassessment under subdivisions 7 and 8. The provider must provide information to the client about changes to the provider's fee for services and how to contact the Office of the Ombudsman for Long-Term Care. (c) The home care provider must implement and provide all services required by the current service plan.
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(d) The service plan and revised service plan must be entered into the client's record, including notice of a change in a client's fees when applicable. (e) Staff providing home care services must be informed of the current written service plan. (f) The service plan must include: (1) a description of the home care services to be provided, the fees for services, and the frequency of each service, according to the client's current review or assessment and client preferences; (2) the identification of the staff or categories of staff who will provide the services; (3) the schedule and methods of monitoring reviews or assessments of the client; (4) the schedule and methods of monitoring staff providing home care services; and (5) a contingency plan that includes: (i) the action to be taken by the home care provider and by the client or client's representative if the scheduled service cannot be provided; (ii) information and a method for a client or client's representative to contact the home care provider; (iii) names and contact information of persons the client wishes to have notified in an emergency or if there is a significant adverse change in the client's condition; 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 client under those chapters. Subd. 10. Termination of service plan. (a) If a home care provider terminates a service plan with a client, and the client continues to need home care services, the home care provider shall provide the client and the client's representative, if any, with a written notice of termination which includes the following information: (1) the effective date of termination; (2) the reason for termination; (3) a list of known licensed home care providers in the client's immediate geographic area; (4) a statement that the home care provider will participate in a coordinated transfer of care of the client to another home care provider, health care provider, or caregiver, as required by the home care bill of rights, section 144A.44, subdivision 1, clause (17); (5) the name and contact information of a person employed by the home care provider with whom the client may discuss the notice of termination; and (6) if applicable, a statement that the notice of termination of home care services does not constitute notice of termination of the housing with services contract with a housing with services establishment. (b) When the home care provider voluntarily discontinues services to all clients, the home care provider must notify the commissioner, lead agencies, and ombudsman for long-term care about its clients and comply with the requirements in this subdivision.
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Subd. 11. Client complaint and investigative process. (a) The home care provider must have a written policy and system for receiving, investigating, reporting, and attempting to resolve complaints from its clients or clients' representatives. The policy should clearly identify the process by which clients may file a complaint or concern about home care services and an explicit statement that the home care provider will not discriminate or retaliate against a client for expressing concerns or complaints. A home care provider must have a process in place to conduct investigations of complaints made by the client or the client's representative about the services in the client's plan that are or are not being provided or other items covered in the client's home care bill of rights. This complaint system must provide reasonable accommodations for any special needs of the client or client's representative if requested. (b) The home care provider must document the complaint, name of the client, investigation, and resolution of each complaint filed. The home care provider must maintain a record of all activities regarding complaints received, including the date the complaint was received, and the home care provider's investigation and resolution of the complaint. This complaint record must be kept for each event for at least two years after the date of entry and must be available to the commissioner for review. (c) The required complaint system must provide for written notice to each client or client's representative that includes: (1) the client's right to complain to the home care provider about the services received; (2) the name or title of the person or persons with the home care provider to contact with complaints; (3) the method of submitting a complaint to the home care provider; and (4) a statement that the provider is prohibited against retaliation according to paragraph (d). (d) A home care provider must not take any action that negatively affects a client in retaliation for a complaint made or a concern expressed by the client or the client's representative. Subd. 12. Disaster planning and emergency preparedness plan. The home care provider must have a written plan of action to facilitate the management of the client's care and services in response to a natural disaster, such as flood and storms, or other emergencies that may disrupt the home care provider's ability to provide care or services. The licensee must provide adequate orientation and training of staff on emergency preparedness. Subd. 13. Request for discontinuation of life-sustaining treatment. (a) If a client, family member, or other caregiver of the client requests that an employee or other agent of the home care provider discontinue a life-sustaining 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 home care provider of the client's request. (b) Upon being informed of a request for termination of treatment, the home care provider shall promptly: (1) inform the client that the request will be made known to the physician or advanced practice registered nurse who ordered the client's treatment; (2) inform the physician or advanced practice registered nurse of the client's request; and (3) work with the client and the client's physician or advanced practice registered nurse to comply with the provisions of the Health Care Directive Act in chapter 145C.
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(c) This section does not require the home care provider to discontinue treatment, except as may be required by law or court order. (d) This section does not diminish the rights of clients to control their treatments, refuse services, or terminate their relationships with the home care provider. (e) This section shall be construed in a manner consistent with chapter 145B or 145C, whichever applies, and declarations made by clients under those chapters. Subd. 14. Application of other law. Home care providers may exercise the authority and are subject to the protections in section 152.34. History: 2013 c 108 art 11 s 19; 2014 c 275 art 1 s 135; 2016 c 179 s 11; 2018 c 170 s 3; 1Sp2019 c 9 art 11 s 51-56 144A.4792 MEDICATION MANAGEMENT. Subdivision 1. Medication management services; comprehensive home care license. (a) This subdivision applies only to home care providers with a comprehensive home care license that provide medication management services to clients. Medication management services may not be provided by a home care provider who has a basic home care license. (b) A comprehensive home care provider who 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 client and client representative, if any; disposing of unused medications; and educating clients and client representatives about medications. When controlled substances are being managed, stored, and secured by the comprehensive home care provider, 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 22. Subd. 2. Provision of medication management services. (a) For each client who requests medication management services, the comprehensive home care provider 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 client. The assessment must include an identification and review of all medications the client 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: (1) identify interventions needed in management of medications to prevent diversion of medication by the client or others who may have access to the medications; and
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(2) provide instructions to the client or client's representative on interventions to manage the client's medications and prevent diversion of medications. "Diversion of medications" means the misuse, theft, or illegal or improper disposition of medications. Subd. 3. Individualized medication monitoring and reassessment. The comprehensive home care provider must monitor and reassess the client's medication management services as needed under subdivision 2 when the client presents with symptoms or other issues that may be medication-related and, at a minimum, annually. Subd. 4. Client refusal. The home care provider must document in the client's record any refusal for an assessment for medication management by the client. The provider must discuss with the client the possible consequences of the client's refusal and document the discussion in the client's record. Subd. 5. Individualized medication management plan. (a) For each client receiving medication management services, the comprehensive home care provider must prepare and include in the service plan a written statement of the medication management services that will be provided to the client. The provider must develop and maintain a current individualized medication management record for each client based on the client'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 client's needs and preferences, risk of diversion, and consistent with the manufacturer's directions; (3) documentation of specific client instructions relating to the administration of medications; (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 client-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 comprehensive home care provider 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;
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(2) specified, in writing, specific instructions for each client and documented those instructions in the client's records; and (3) communicated with the unlicensed personnel about the individual needs of the client. Subd. 8. Documentation of administration of medications. Each medication administered by comprehensive home care provider staff must be documented in the client'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 client's needs when medication was not administered as prescribed and in compliance with the client'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 clients who will be away from home. (a) A home care provider who is providing medication management services to the client and controls the client's access to the medications must develop and implement policies and procedures for giving accurate and current medications to clients for planned or unplanned times away from home according to the client's individualized medication management plan. The policy and procedures must state that: (1) for planned time away, the medications must be obtained from the pharmacy or set up by a licensed nurse according to appropriate state and federal laws and nursing standards of practice; (2) for unplanned time away, when the pharmacy is not able to provide the medications, a licensed nurse or unlicensed personnel shall give the client or client's representative medications in amounts and dosages needed for the length of the anticipated absence, not to exceed seven calendar days; (3) the client or client's representative must be provided written information on medications, including any special instructions for administering or handling the medications, including controlled substances; (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 client's name and the dates and times that the medications are scheduled; and (5) the client or client's representative must be provided in writing the home care provider's name and information on how to contact the home care provider. (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 clients; 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 client. The procedures must address: (i) the type of container or containers to be used for the medications appropriate to the provider's medication system;
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(ii) how the container or containers must be labeled; (iii) the written information about the medications to be given to the client or client's representative; (iv) how the unlicensed staff must document in the client's record that medications have been given to the client or the client's representative, including documenting the date the medications were given to the client or the client's representative and who received the medications, the person who gave the medications to the client, the number of medications that were given to the client, and other required information; (v) how the registered nurse shall be notified that medications have been given to the client or client's representative and whether the registered nurse needs to be contacted before the medications are given to the client or the client's 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 staff must document in the client's record any unused medications that are returned to the provider, including the name of each medication and the doses of each returned medication. Subd. 11. Prescribed and nonprescribed medication. The comprehensive home care provider must determine whether the comprehensive home care provider shall require a prescription for all medications the provider manages. The comprehensive home care provider must inform the client or the client's representative whether the comprehensive home care provider requires a prescription for all over-the-counter and dietary supplements before the comprehensive home care provider agrees to manage those medications. Subd. 12. Medications; over-the-counter; dietary supplements not prescribed. A comprehensive home care provider 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 provider must verify that the medications are up-to-date and stored as appropriate. 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 comprehensive home care provider is managing for the client. 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 client'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 client or family members. When the comprehensive home care provider is aware of any medications or dietary supplements that are being used by the client and are not included in the assessment for medication management services, the staff must advise the registered nurse and document that in the client's record.
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Subd. 19. Storage of medications. A comprehensive home care provider providing storage of medications outside of the client's private living space 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 client may be used or saved for use by anyone other than the client. Subd. 22. Disposition of medications. (a) Any current medications being managed by the comprehensive home care provider must be given to the client or the client's representative when the client's service plan ends or medication management services are no longer part of the service plan. Medications that have been stored in the client's private living space for a client who is deceased or that have been discontinued or that have expired may be given to the client or the client's representative for disposal. (b) The comprehensive home care provider will dispose of any medications remaining with the comprehensive home care provider that are discontinued or expired or upon the termination of the service contract or the client's death according to state and federal regulations for disposition of medications and controlled substances. (c) Upon disposition, the comprehensive home care provider must document in the client'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) Comprehensive home care providers 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 must be made in the client'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 the comprehensive home care provider of medication management to 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: 2013 c 108 art 11 s 20; 2014 c 275 art 1 s 26,135; 2016 c 179 s 12; 1Sp2019 c 9 art 11 s 57-60 144A.4793 TREATMENT AND THERAPY MANAGEMENT SERVICES. Subdivision 1. Providers with a comprehensive home care license. This section applies only to home care providers with a comprehensive home care license that provide treatment or therapy management services to clients. Treatment or therapy management services cannot be provided by a home care provider that has a basic home care license. Subd. 2. Policies and procedures. (a) A comprehensive home care provider who 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
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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 of treatment or therapy activities, educating and communicating with clients about treatments or therapy they are receiving, monitoring and evaluating the treatment and therapy, and communicating with the prescriber. Subd. 3. Individualized treatment or therapy management plan. For each client receiving management of ordered or prescribed treatments or therapy services, the comprehensive home care provider must prepare and include in the service plan a written statement of the treatment or therapy services that will be provided to the client. The provider must also develop and maintain a current individualized treatment and therapy management record for each client which must contain at least the following: (1) a statement of the type of services that will be provided; (2) documentation of specific client 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 client-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 of a treatment or therapy is delegated or assigned to unlicensed personnel, the home care provider 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 client and the unlicensed personnel has demonstrated the ability to competently follow the procedures; (2) specified, in writing, specific instructions for each client and documented those instructions in the client's record; and (3) communicated with the unlicensed personnel about the individual needs of the client. Subd. 5. Documentation of administration of treatments and therapies. Each treatment or therapy administered by a comprehensive home care provider must be documented in the client's 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 client'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 client, a description of the treatment or therapy to be provided, and the frequency, duration, and other
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information needed to administer the treatment or therapy. Treatment and therapy orders must be renewed at least every 12 months. History: 2013 c 108 art 11 s 21; 2014 c 275 art 1 s 135; 1Sp2019 c 9 art 11 s 61 144A.4794 CLIENT RECORD REQUIREMENTS. Subdivision 1. Client record. (a) The home care provider must maintain records for each client for whom it is providing services. Entries in the client records must be current, legible, permanently recorded, dated, and authenticated with the name and title of the person making the entry. (b) Client 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 home care provider shall establish and implement written procedures to control use, storage, and security of client's records and establish criteria for release of client information. (c) The home care provider may not disclose to any other person any personal, financial, medical, or other information about the client, except: (1) as may be required by law; (2) to employees or contractors of the home care provider, another home care provider, other health care practitioner or provider, or inpatient facility needing information in order to provide services to the client, but only such information that is necessary for the provision of services; (3) to persons authorized in writing by the client or the client's representative to receive the information, including third-party payers; and (4) to representatives of the commissioner authorized to survey or investigate home care providers under this chapter or federal laws. Subd. 2. Access to records. The home care provider must ensure that the appropriate records are readily available to employees or contractors authorized to access the records. Client records must be maintained in a manner that allows for timely access, printing, or transmission of the records. Subd. 3. Contents of client record. Contents of a client record include the following for each client: (1) identifying information, including the client's name, date of birth, address, and telephone number; (2) the name, address, and telephone number of an emergency contact, family members, client's representative, if any, or others as identified; (3) names, addresses, and telephone numbers of the client's health and medical service providers and other home care 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) client's advance directives, if any; (6) the home care provider's current and previous assessments and service plans; (7) all records of communications pertinent to the client's home care services;
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(8) documentation of significant changes in the client's status and actions taken in response to the needs of the client including reporting to the appropriate supervisor or health care professional; (9) documentation of incidents involving the client and actions taken in response to the needs of the client including reporting to the appropriate supervisor or health care professional; (10) documentation that services have been provided as identified in the service plan; (11) documentation that the client has received and reviewed the home care bill of rights; (12) documentation that the client has been provided the statement of disclosure on limitations of services under section 144A.4791, subdivision 3; (13) documentation of complaints received and resolution; (14) discharge summary, including service termination notice and related documentation, when applicable; and (15) other documentation required under this chapter and relevant to the client's services or status. Subd. 4. Transfer of client records. If a client transfers to another home care provider or other health care practitioner or provider, or is admitted to an inpatient facility, the home care provider, upon request of the client or the client's representative, shall take steps to ensure a coordinated transfer including sending a copy or summary of the client's record to the new home care provider, the facility, or the client, as appropriate. Subd. 5. Record retention. Following the client's discharge or termination of services, a home care provider must retain a client'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 client records if the home care provider ceases business. History: 2013 c 108 art 11 s 22; 2014 c 275 art 1 s 135 144A.4795 HOME CARE PROVIDER RESPONSIBILITIES; STAFF. Subdivision 1. Qualifications, training, and competency. All staff providing home care services must: (1) be trained and competent in the provision of home care services consistent with current practice standards appropriate to the client's needs; and (2) be informed of the home care bill of rights under section 144A.44. Subd. 2. Licensed health professionals and nurses. (a) Licensed health professionals and nurses providing home care services as an employee of a licensed home care provider must possess a current Minnesota license or registration to practice. (b) Licensed health professionals and registered nurses must be competent in assessing client needs, planning appropriate home care services to meet client 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. 3. Unlicensed personnel. (a) Unlicensed personnel providing basic home care services must have: (1) successfully completed a training and competency evaluation appropriate to the services provided by the home care provider and the topics listed in subdivision 7, paragraph (b); or
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(2) demonstrated competency by satisfactorily completing a written or oral test on the tasks the unlicensed personnel will perform and in the topics listed in subdivision 7, paragraph (b); and successfully demonstrated competency of topics in subdivision 7, paragraph (b), clauses (5), (7), and (8), by a practical skills test. Unlicensed personnel providing home care services for a basic home care provider may not perform delegated nursing or therapy tasks. (b) Unlicensed personnel performing delegated nursing tasks for a comprehensive home care provider must: (1) have successfully completed training and demonstrated competency by successfully completing a written or oral test of the topics in subdivision 7, paragraphs (b) and (c), and a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5) and (7), and (c), 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 subdivision 4 and any other training or competency requirements within the licensed health professional scope of practice relating to delegation or assignment of tasks to unlicensed personnel. Subd. 4. Delegation of home care tasks. 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 comprehensive home care provider 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 client needs and preferences. Subd. 5. Individual contractors. When a home care provider contracts with an individual contractor excluded from licensure under section 144A.471 to provide home care services, the contractor must meet the same requirements required by this section for personnel employed by the home care provider. Subd. 6. Temporary staff. When a home care provider contracts with a temporary staffing agency excluded from licensure under section 144A.471, those individuals must meet the same requirements required by this section for personnel employed by the home care provider and shall be treated as if they are staff of the home care provider. Subd. 7. Requirements for instructors, training content, and competency evaluations for unlicensed personnel. (a) Instructors and competency evaluators must meet the following requirements: (1) training and competency evaluations of unlicensed personnel providing basic home care services must be conducted by individuals with work experience and training in providing home care services listed in section 144A.471, subdivisions 6 and 7; and (2) training and competency evaluations of unlicensed personnel providing comprehensive home care services must be conducted by a registered nurse, or another instructor may provide training in conjunction
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with the registered nurse. If the home care provider is providing services by licensed health professionals only, then that specific training and competency evaluation may be conducted by the licensed health professionals as appropriate. (b) Training and competency evaluations for all unlicensed personnel must include the following: (1) documentation requirements for all services provided; (2) reports of changes in the client's condition to the supervisor designated by the home care provider; (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 for providers working with the elderly or individuals at risk 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 client and showing respect for the client and the client's preferences, cultural background, and family; (12) awareness of confidentiality and privacy; (13) understanding appropriate boundaries between staff and clients and the client's family; (14) procedures to utilize in handling various emergency situations; and (15) awareness of commonly used health technology equipment and assistive devices. (c) In addition to paragraph (b), training and competency evaluation for unlicensed personnel providing comprehensive home care services must include: (1) observation, reporting, and documenting of client 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 client; (4) recognizing physical, emotional, cognitive, and developmental needs of the client;
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(5) safe transfer techniques and ambulation; (6) range of motioning and positioning; and (7) administering medications or treatments as required. (d) When the registered nurse or licensed health professional delegates tasks, they must ensure that prior to the delegation the unlicensed personnel is trained in the proper methods to perform the tasks or procedures for each client and are able to demonstrate the ability to competently follow the procedures and perform the tasks. If an unlicensed personnel has not regularly performed the delegated home care 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 client's record. History: 2013 c 108 art 11 s 23; 2014 c 275 art 1 s 135 144A.4796 ORIENTATION AND ANNUAL TRAINING REQUIREMENTS. Subdivision 1. Orientation of staff and supervisors to home care. All staff providing and supervising direct home care services must complete an orientation to home care licensing requirements and regulations before providing home care services to clients. The orientation may be incorporated into the training required under subdivision 6. The orientation need only be completed once for each staff person and is not transferable to another home care provider. Subd. 2. Content. (a) The orientation must contain the following topics: (1) an overview of sections 144A.43 to 144A.4798; (2) introduction and review of all the provider's policies and procedures related to the provision of home care services by the individual staff person; (3) handling of emergencies and use of emergency services; (4) compliance with and reporting of the maltreatment of minors or vulnerable adults under sections 626.556 and 626.557; (5) home care bill of rights under section 144A.44; (6) handling of clients' complaints, reporting of complaints, and where to report complaints including information on the Office of Health Facility Complaints and the Common Entry Point; (7) 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 (8) review of the types of home care services the employee will be providing and the provider's scope of licensure. (b) In addition to the topics listed in paragraph (a), orientation may also contain training on providing services to clients 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:
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(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence, and 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. Verification and documentation of orientation. Each home care provider shall retain evidence in the employee record of each staff person having completed the orientation required by this section. Subd. 4. Orientation to client. Staff providing home care services must be oriented specifically to each individual client and the services to be provided. This orientation may be provided in person, orally, in writing, or electronically. Subd. 5. Training required relating to Alzheimer's disease and related disorders. For home care providers that provide services for persons with Alzheimer's or related disorders, all direct care staff and supervisors working with those clients must receive training that includes a current explanation of Alzheimer's disease and related disorders, effective approaches to use to problem-solve when working with a client's challenging behaviors, and how to communicate with clients who have Alzheimer's or related disorders. Subd. 6. Required annual training. (a) All staff that perform direct home care services must complete at least eight hours of annual training for each 12 months of employment. The training may be obtained from the home care provider or another source and must include topics relevant to the provision of home care services. The annual training must include: (1) training on reporting of maltreatment of minors under section 626.556 and maltreatment of vulnerable adults under section 626.557, whichever is applicable to the services provided; (2) review of the home care bill of rights in section 144A.44; (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 of communicable diseases; and (4) review of the provider's policies and procedures relating to the provision of home care services and how to implement those policies and procedures. (b) In addition to the topics listed in paragraph (a), annual training may also contain training on providing services to clients 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) health impacts related to untreated age-related hearing loss, such as increased incidence of dementia, falls, hospitalizations, isolation, and depression; or
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(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. 7. Documentation. A home care provider must retain documentation in the employee records of the staff who have satisfied the orientation and training requirements of this section. History: 2013 c 108 art 11 s 24; 2014 c 275 art 1 s 135; 2017 c 51 s 1,2; 1Sp2019 c 9 art 11 s 62 144A.4797 PROVISION OF SERVICES. Subdivision 1. Availability of contact person to staff. (a) A home care provider with a basic home care license must have a person available to staff for consultation on items relating to the provision of services or about the client. (b) A home care provider with a comprehensive home care license must have a registered nurse available for consultation to staff performing delegated nursing tasks and must have an appropriate licensed health professional available if performing other delegated services such as therapies. (c) 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. Supervision of staff; basic home care services. (a) Staff who perform basic home care services 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 home care provider having the authority, skills, and ability to provide the supervision of unlicensed personnel and who can implement changes as needed, and train staff. (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 client. Supervisory review of staff must be provided at a frequency based on the staff person's competency and performance. (c) For an individual who is licensed as a home care provider, this section does not apply. Subd. 3. Supervision of staff providing delegated nursing or therapy home care tasks. (a) Staff who perform delegated nursing or therapy home care tasks must be supervised by an appropriate licensed health professional or a registered nurse periodically 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 client. (b) The direct supervision of staff performing delegated tasks must be provided within 30 days after the date on which the individual begins working for the home care provider and first performs delegated tasks for clients 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. 4. Documentation. A home care provider must retain documentation of supervision activities in the personnel records.
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Subd. 5. Exemption. This section does not apply to an individual licensed under sections 144A.43 to 144A.4798. History: 2013 c 108 art 11 s 25; 2014 c 275 art 1 s 135; 1Sp2019 c 9 art 11 s 63 144A.4798 DISEASE PREVENTION AND INFECTION CONTROL. Subdivision 1. Tuberculosis (TB) infection control. (a) A home care provider 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. This program must include a tuberculosis infection control plan that covers all paid and unpaid employees, contractors, students, and volunteers. The commissioner shall provide technical assistance regarding implementation of the guidelines. (b) The home care provider must maintain written evidence of compliance with this subdivision. Subd. 2. Communicable diseases. A home care provider 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. 3. Infection control program. A home care provider must establish and maintain an effective infection control program that complies with accepted health care, medical, and nursing standards for infection control. History: 2013 c 108 art 11 s 26; 1Sp2019 c 9 art 11 s 64 144A.4799 DEPARTMENT OF HEALTH LICENSED HOME CARE PROVIDER ADVISORY COUNCIL. Subdivision 1. Membership. The commissioner of health shall appoint eight persons to a home care and assisted living program advisory council consisting of the following: (1) three public members as defined in section 214.02 who shall be persons who are currently receiving home care services, persons who have received home care services within five years of the application date, persons who have family members receiving home care services, or persons who have family members who have received home care services within five years of the application date; (2) three Minnesota home care licensees representing basic and comprehensive levels of licensure who may be a managerial official, an administrator, a supervising registered nurse, or an unlicensed personnel performing home care tasks; (3) one member representing the Minnesota Board of Nursing; (4) one member representing the Office of Ombudsman for Long-Term Care; and (5) beginning July 1, 2021, one member of a county health and human services or county adult protection office. Subd. 2. Organizations and meetings. The advisory council shall be organized and administered under section 15.059 with per diems and costs paid within the limits of available appropriations. Meetings will be held quarterly and hosted by the department. Subcommittees may be developed as necessary by the commissioner. Advisory council meetings are subject to the Open Meeting Law under chapter 13D.
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144A.482
Subd. 3. Duties. (a) At the commissioner's request, the advisory council shall provide advice regarding regulations of Department of Health licensed home care providers in this chapter, including advice on the following: (1) community standards for home care practices; (2) enforcement of licensing standards and whether certain disciplinary actions are appropriate; (3) ways of distributing information to licensees and consumers of home care and assisted living; (4) training standards; (5) identifying emerging issues and opportunities in home care and assisted living; (6) identifying the use of technology in home and telehealth capabilities; (7) allowable home care licensing modifications and exemptions, including a method for an integrated license with an existing license for rural licensed nursing homes to provide limited home care services in an adjacent independent living apartment building owned by the licensed nursing home; and (8) recommendations for studies using the data in section 62U.04, subdivision 4, including but not limited to studies concerning costs related to dementia and chronic disease among an elderly population over 60 and additional long-term care costs, as described in section 62U.10, subdivision 6. (b) The advisory council shall perform other duties as directed by the commissioner. (c) The advisory council shall annually make recommendations to the commissioner for the purposes in section 144A.474, subdivision 11, paragraph (i). The recommendations shall address ways the commissioner may improve protection of the public under existing statutes and laws and include but are not limited to projects that create and administer training of licensees and their employees to improve residents' lives, supporting ways that licensees can improve and enhance quality care and ways to provide technical assistance to licensees to improve compliance; information technology and data projects that analyze and communicate information about trends of violations or lead to ways of improving client care; communications strategies to licensees and the public; and other projects or pilots that benefit clients, families, and the public. History: 2013 c 108 art 11 s 27; 2014 c 291 art 6 s 18; 2016 c 179 s 13,14; 1Sp2017 c 6 art 10 s 70; 2019 c 60 art 4 s 26; 1Sp2019 c 9 art 11 s 65,66 144A.48 MS 2002 [Repealed, 2002 c 252 s 25] 144A.481 MS 2018 [Repealed, 1Sp2019 c 9 art 11 s 112]
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MINNESOTA STATUTES 2019
144D.01
CHAPTER 144D HOUSING WITH SERVICES ESTABLISHMENT 144D.01
DEFINITIONS.
144D.06
OTHER LAWS.
144D.015
DEFINITION FOR PURPOSES OF LONG-TERM CARE INSURANCE.
144D.065
TRAINING IN DEMENTIA CARE REQUIRED.
144D.02
REGISTRATION REQUIRED.
144D.066
ENFORCEMENT OF DEMENTIA CARE TRAINING REQUIREMENTS.
144D.025
OPTIONAL REGISTRATION.
144D.07
RESTRAINTS.
144D.03
REGISTRATION.
144D.08
UNIFORM CONSUMER INFORMATION GUIDE.
144D.04
HOUSING WITH SERVICES CONTRACTS.
144D.045
INFORMATION CONCERNING ARRANGED HOME CARE PROVIDERS.
144D.09
TERMINATION OF LEASE.
144D.10
MANAGER REQUIREMENTS.
144D.05
AUTHORITY OF COMMISSIONER.
144D.11
EMERGENCY PLANNING.
144D.001 MS 2006 [Renumbered 15.001] 144D.01 DEFINITIONS. Subdivision 1. Scope. As used in sections 144D.01 to 144D.06, the following terms have the meanings given them. Subd. 2. Adult. "Adult" means a natural person who has attained the age of 18 years. Subd. 2a. Arranged home care provider. "Arranged home care provider" means a home care provider licensed under chapter 144A that provides services to some or all of the residents of a housing with services establishment and that is either the establishment itself or another entity with which the establishment has an arrangement. Subd. 3. Commissioner. "Commissioner" means the commissioner of health or the commissioner's designee. Subd. 3a. Direct-care staff. "Direct-care staff" means staff and employees who provide home care services listed in section 144A.471, subdivisions 6 and 7. Subd. 4. Housing with services establishment or establishment. (a) "Housing with services establishment" or "establishment" means: (1) an establishment 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, one or more regularly scheduled health-related services or two or more regularly scheduled supportive services, whether offered or provided directly by the establishment or by another entity arranged for by the establishment; or (2) an establishment that registers under section 144D.025. (b) Housing with services establishment does not include: (1) a nursing home licensed under chapter 144A; (2) a hospital, certified boarding care home, or supervised living facility licensed under sections 144.50 to 144.56; (3) a board and lodging establishment licensed under chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, or under chapter 245D or 245G;
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(4) a board and lodging establishment which serves as a shelter for battered women or other similar purpose; (5) a family adult foster care home licensed by the Department of Human Services; (6) private homes in which the residents are related by kinship, law, or affinity with the providers of services; (7) residential settings for persons with developmental disabilities in which the services are licensed under chapter 245D; (8) a home-sharing arrangement such as when an elderly or disabled person or single-parent family makes lodging in a private residence available to another person in exchange for services or rent, or both; (9) a duly organized condominium, cooperative, common interest community, or owners' association of the foregoing 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; (10) services for persons with developmental disabilities that are provided under a license under chapter 245D; or (11) a temporary family health care dwelling as defined in sections 394.307 and 462.3593. Subd. 5. Supportive services. "Supportive services" means help with personal laundry, handling or assisting with personal funds of residents, or arranging for medical services, health-related services, social services, or transportation to medical or social services appointments. Arranging for services does not include making referrals, assisting a resident in contacting a service provider of the resident's choice, or contacting a service provider in an emergency. Subd. 6. Health-related services. "Health-related services" include professional nursing services, home health aide tasks, or the central storage of medication for residents. Subd. 7. Family adult foster care home. "Family adult foster care home" means an adult foster care home that is licensed by the Department of Human Services, that is the primary residence of the license holder, and in which the license holder is the primary caregiver. History: 1995 c 207 art 9 s 29; 1997 c 107 s 1; 1997 c 113 s 7-10; 3Sp1997 c 3 s 6; 1999 c 245 art 3 s 8; 2002 c 375 art 2 s 3; 2005 c 56 s 1; 2006 c 282 art 19 s 4; 2013 c 108 art 9 s 3; 2015 c 71 art 8 s 41; 2016 c 111 s 1; 2016 c 158 art 1 s 62; 2016 c 179 s 16; 2017 c 40 art 1 s 33; 2018 c 182 art 2 s 3; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.015 DEFINITION FOR PURPOSES OF LONG-TERM CARE INSURANCE. For purposes of consistency with terminology commonly used in long-term care insurance policies and notwithstanding chapter 144G, a housing with services establishment that is registered under section 144D.03 and that holds, or makes arrangements with an individual or entity that holds any type of home care license and all other licenses, permits, registrations, or other governmental approvals legally required for delivery
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144D.03
of the services the establishment offers or provides to its residents, constitutes an "assisted living facility" or "assisted living residence." History: 2004 c 185 s 1; 2006 c 282 art 19 s 5; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.02 REGISTRATION REQUIRED. No entity may establish, operate, conduct, or maintain a housing with services establishment in this state without registering and operating as required in sections 144D.01 to 144D.06. History: 1995 c 207 art 9 s 30; 2006 c 282 art 19 s 6; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.025 OPTIONAL REGISTRATION. An establishment that meets all the requirements of this chapter except that fewer than 80 percent of the adult residents are age 55 or older, or a supportive housing establishment developed and funded in whole or in part with funds provided specifically as part of the plan to end long-term homelessness required under Laws 2003, chapter 128, article 15, section 9, may, at its option, register as a housing with services establishment. History: 2002 c 375 art 2 s 4; 2005 c 159 art 5 s 2; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.03 REGISTRATION. Subdivision 1. Registration procedures. The commissioner shall establish forms and procedures for annual registration of housing with services establishments. The commissioner shall charge an annual registration fee of $155. No fee shall be refunded. A registered establishment shall notify the commissioner within 30 days of the date it is no longer required to be registered under this chapter or of any change in the business name or address of the establishment, the name or mailing address of the owner or owners, or the name or mailing address of the managing agent. There shall be no fee for submission of the notice. Subd. 1a. Surcharge for injunctive relief actions. The commissioner shall assess each housing with services establishment that offers or provides assisted living under chapter 144G a surcharge on the annual registration fee paid under subdivision 1, to pay for the commissioner's costs related to bringing actions for injunctive relief under section 144G.02, subdivision 2, paragraph (b), on or after July 1, 2007. The commissioner shall assess surcharges using a sliding scale under which the surcharge amount increases with the client capacity of an establishment. The commissioner shall adjust the surcharge as necessary to recover the projected costs of bringing actions for injunctive relief. The commissioner shall adjust the surcharge in accordance with section 16A.1285. Subd. 2. Registration information. The establishment shall provide the following information to the commissioner in order to be registered: (1) the business name, street address, and mailing address of the establishment;
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144D.03
MINNESOTA STATUTES 2019
(2) the name and mailing address of the owner or owners of the establishment and, if the owner or owners are not natural persons, identification of the type of business entity of the owner or owners, and the names and addresses of the officers and members of the governing body, or comparable persons for partnerships, limited liability corporations, or other types of business organizations of the owner or owners; (3) the name and mailing address of the managing agent, whether through management agreement or lease agreement, of the establishment, if different from the owner or owners, and the name of the on-site manager, if any; (4) verification that the establishment has entered into a housing with services contract, as required in section 144D.04, with each resident or resident's representative; (5) verification that the establishment is complying with the requirements of section 325F.72, if applicable; (6) the name and address of at least one natural person who shall be responsible for dealing with the commissioner on all matters provided for in sections 144D.01 to 144D.06, and on whom personal service of all notices and orders shall be made, and who shall be authorized to accept service on behalf of the owner or owners and the managing agent, if any; (7) the signature of the authorized representative of the owner or owners or, if the owner or owners are not natural persons, signatures of at least two authorized representatives of each owner, one of which shall be an officer of the owner; and (8) whether services are included in the base rate to be paid by the resident. Personal service on the person identified under clause (6) by the owner or owners in the registration shall be considered service on the owner or owners, and it shall not be a defense to any action that personal service was not made on each individual or entity. The designation of one or more individuals under this subdivision shall not affect the legal responsibility of the owner or owners under sections 144D.01 to 144D.06. History: 1995 c 207 art 9 s 31; 1997 c 113 s 11; 1Sp2001 c 9 art 1 s 41; 2002 c 379 art 1 s 113; 2006 c 282 art 19 s 7,8; 2007 c 147 art 10 s 11; 1Sp2010 c 1 art 17 s 1; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.04 HOUSING WITH SERVICES CONTRACTS. Subdivision 1. Contract required. No housing with services establishment may operate in this state unless a written housing with services contract, as defined in subdivision 2, is executed between the establishment and each resident or resident's representative and unless the establishment operates in accordance with the terms of the contract. The resident or the resident's representative shall be given a complete copy of the contract and all supporting documents and attachments and any changes whenever changes are made. Subd. 2. Contents of contract. A housing with services contract, which need not be entitled as such to comply with this section, shall include at least the following elements in itself or through supporting documents or attachments: (1) the name, street address, and mailing address of the establishment; (2) the name and mailing address of the owner or owners of the establishment and, if the owner or owners is not a natural person, identification of the type of business entity of the owner or owners;
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144D.04
(3) the name and mailing address of the managing agent, through management agreement or lease agreement, of the establishment, if different from the owner or owners; (4) the name and address of at least one natural person who is authorized to accept service of process on behalf of the owner or owners and managing agent; (5) a statement describing the registration and licensure status of the establishment and any provider providing health-related or supportive services under an arrangement with the establishment; (6) the term of the contract; (7) a description of the services to be provided to the resident in the base rate to be paid by the resident, including a delineation of the portion of the base rate that constitutes rent and a delineation of charges for each service included in the base rate; (8) a description of any additional services, including home care services, available for an additional fee from the establishment directly or through arrangements with the establishment, and a schedule of fees charged for these services; (9) a conspicuous notice informing the tenant of the policy concerning the conditions under which and the process through which the contract may be modified, amended, or terminated, including whether a move to a different room or sharing a room would be required in the event that the tenant can no longer pay the current rent; (10) a description of the establishment's complaint resolution process available to residents including the toll-free complaint line for the Office of Ombudsman for Long-Term Care; (11) the resident's designated representative, if any; (12) the establishment's referral procedures if the contract is terminated; (13) requirements of residency used by the establishment to determine who may reside or continue to reside in the housing with services establishment; (14) billing and payment procedures and requirements; (15) a statement regarding the ability of a resident to receive services from service providers with whom the establishment does not have an arrangement; (16) a statement regarding the availability of public funds for payment for residence or services in the establishment; and (17) a statement regarding the availability of and contact information for long-term care consultation services under section 256B.0911 in the county in which the establishment is located. Subd. 2a. Additional contract requirements. (a) For a resident receiving one or more health-related services from the establishment's arranged home care provider, as defined in section 144D.01, subdivision 6, the contract must include the requirements in paragraph (b). A restriction of a resident's rights under this subdivision is allowed only if determined necessary for health and safety reasons identified by the home care provider's registered nurse in an initial assessment or reassessment, as defined under section 144A.4791, subdivision 8, and documented in the written service plan under section 144A.4791, subdivision 9. Any restrictions of those rights for people served under chapter 256S and section 256B.49 must be documented
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144D.04
MINNESOTA STATUTES 2019
in the resident's coordinated service and support plan (CSSP), as defined under sections 256B.49, subdivision 15, and 256S.10. (b) The contract must include a statement: (1) regarding the ability of a resident to furnish and decorate the resident's unit within the terms of the lease; (2) regarding the resident's right to access food at any time; (3) regarding a resident's right to choose the resident's visitors and times of visits; (4) regarding the resident's right to choose a roommate if sharing a unit; and (5) notifying the resident of the resident's right to have and use a lockable door to the resident's unit. The landlord 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. Subd. 3. Contracts in permanent files. Housing with services contracts and related documents executed by each resident or resident's representative shall be maintained by the establishment in files from the date of execution until three years after the contract is terminated. The contracts and the written disclosures required under section 325F.72, if applicable, shall be made available for on-site inspection by the commissioner upon request at any time. History: 1995 c 207 art 9 s 32; 1Sp2001 c 9 art 1 s 42,43; 2002 c 379 art 1 s 113; 2006 c 282 art 19 s 9; 2007 c 147 art 7 s 75; 1Sp2010 c 1 art 17 s 2; 2012 c 247 art 4 s 4; 1Sp2017 c 6 art 2 s 1,2; art 10 s 73; 2019 c 54 art 2 s 3; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.045 INFORMATION CONCERNING ARRANGED HOME CARE PROVIDERS. If a housing with services establishment has one or more arranged home care providers, the establishment shall arrange to have that arranged home care provider deliver the following information in writing to a prospective resident, prior to the date on which the prospective resident executes a contract with the establishment or the prospective resident's move-in date, whichever is earlier: (1) the name, mailing address, and telephone number of the arranged home care provider; (2) the name and mailing address of at least one natural person who is authorized to accept service of process on behalf of the entity described in clause (1); (3) a description of the process through which a home care service agreement or service plan between a resident and the arranged home care provider, if any, may be modified, amended, or terminated; (4) the arranged home care provider's billing and payment procedures and requirements; and (5) any limits to the services available from the arranged provider. History: 2006 c 282 art 19 s 10; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48.
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MINNESOTA STATUTES 2019
144D.065
144D.05 AUTHORITY OF COMMISSIONER. The commissioner shall, upon receipt of information which may indicate the failure of the housing with services establishment, a resident, a resident's representative, or a service provider to comply with a legal requirement to which one or more of them may be subject, make appropriate referrals to other governmental agencies and entities having jurisdiction over the subject matter. The commissioner may also make referrals to any public or private agency the commissioner considers available for appropriate assistance to those involved. The commissioner shall have standing to bring an action for injunctive relief in the district court in the district in which an establishment is located to compel the housing with services establishment to meet the requirements of this chapter or other requirements of the state or of any county or local governmental unit to which the establishment is otherwise subject. Proceedings for securing an injunction may be brought by the commissioner through the attorney general or through the appropriate county attorney. The sanctions in this section do not restrict the availability of other sanctions. History: 1995 c 207 art 9 s 33; 2006 c 282 art 19 s 11; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.06 OTHER LAWS. In addition to registration under this chapter, a housing with services establishment must comply with chapter 504B and the provisions of section 325F.72, and shall obtain and maintain all other licenses, permits, registrations, or other governmental approvals required of it. A housing with services establishment is not required to obtain a lodging license under chapter 157 and related rules. History: 1995 c 207 art 9 s 34; 1996 c 305 art 1 s 36; 1997 c 113 s 13; 1999 c 199 art 2 s 5; 1Sp2001 c 9 art 1 s 44; 2002 c 379 art 1 s 113; 1Sp2017 c 6 art 10 s 74; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.065 TRAINING IN DEMENTIA CARE REQUIRED. (a) If a housing with services establishment registered under this chapter has a special program or special care unit for residents with Alzheimer's disease or other dementias or advertises, markets, or otherwise promotes the establishment as providing services for persons with Alzheimer's disease or other dementias, whether in a segregated or general unit, employees of the establishment and of the establishment's arranged home care provider 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
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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) 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 (4) 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 related disorders; (2) assistance with activities of daily living; (3) problem solving with challenging behaviors; and (4) communication skills. (c) The establishment 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. This information satisfies the disclosure requirements of section 325F.72, subdivision 2, clause (4). (d) Housing with services establishments not included in paragraph (a) that provide assisted living services under chapter 144G must meet the following training requirements: (1) supervisors of direct-care staff must have at least four 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 four 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 four 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 supervisor meeting the requirements under paragraph (a), 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) 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 (4) new employees may satisfy the initial training requirements by producing written proof of previously completed required training within the past 18 months. History: 2003 c 37 s 3; 2006 c 282 art 19 s 12; 2014 c 291 art 6 s 19; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48.
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MINNESOTA STATUTES 2019
144D.066
144D.066 ENFORCEMENT OF DEMENTIA CARE TRAINING REQUIREMENTS. Subdivision 1. Enforcement. (a) The commissioner shall enforce the dementia care training standards for staff working in housing with services settings and for housing managers according to clauses (1) to (3): (1) for dementia care training requirements in section 144D.065, the commissioner shall review training records as part of the home care provider survey process for direct care staff and supervisors of direct care staff, in accordance with section 144A.474. The commissioner may also request and review training records at any time during the year; (2) for dementia care training standards in section 144D.065, the commissioner shall review training records for maintenance, housekeeping, and food service staff and other staff not providing direct care working in housing with services settings as part of the housing with services registration application and renewal application process in accordance with section 144D.03. The commissioner may also request and review training records at any time during the year; and (3) for housing managers, the commissioner shall review the statement verifying compliance with the required training described in section 144D.10, paragraph (d), through the housing with services registration application and renewal application process in accordance with section 144D.03. The commissioner may also request and review training records at any time during the year. (b) The commissioner shall specify the required forms and what constitutes sufficient training records for the items listed in paragraph (a), clauses (1) to (3). Subd. 2. Fines for noncompliance. (a) Beginning January 1, 2017, the commissioner may impose a $200 fine for every staff person required to obtain dementia care training who does not have training records to show compliance. For violations of subdivision 1, paragraph (a), clause (1), the fine will be imposed upon the home care provider, and may be appealed under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. For violations of subdivision 1, paragraph (a), clauses (2) and (3), the fine will be imposed on the housing with services registrant and may be appealed under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. Prior to imposing the fine, the commissioner must allow two weeks for staff to complete the required training. Fines collected under this section shall be deposited in the state treasury and credited to the state government special revenue fund. (b) The housing with services registrant and home care provider must allow for the required training as part of employee and staff duties. Imposition of a fine by the commissioner does not negate the need for the required training. Continued noncompliance with the requirements of sections 144D.065 and 144D.10 may result in revocation or nonrenewal of the housing with services registration or home care license. The commissioner shall make public the list of all housing with services establishments that have complied with the training requirements. Subd. 3. Technical assistance. From January 1, 2016, to December 31, 2016, the commissioner shall provide technical assistance instead of imposing fines for noncompliance with the training requirements. During the year of technical assistance, the commissioner shall review the training records to determine if the records meet the requirements and inform the home care provider. The commissioner shall also provide information about available training resources. History: 2015 c 71 art 8 s 42; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48.
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144D.07
MINNESOTA STATUTES 2019
144D.07 RESTRAINTS. Residents must be free from any physical or chemical restraints imposed for purposes of discipline or convenience. History: 1997 c 113 s 12; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.08 UNIFORM CONSUMER INFORMATION GUIDE. All housing with services establishments shall make available to all prospective and current residents information consistent with the uniform format and the required components adopted by the commissioner under section 144G.06. This section does not apply to an establishment registered under section 144D.025 serving the homeless. History: 1Sp2010 c 1 art 17 s 3; 2013 c 43 s 19; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.09 TERMINATION OF LEASE. The housing with services establishment shall include with notice of termination of lease information about how to contact the ombudsman for long-term care, including the address and telephone number along with a statement of how to request problem-solving assistance. History: 1Sp2010 c 1 art 17 s 4; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.10 MANAGER REQUIREMENTS. (a) The person primarily responsible for oversight and management of a housing with services establishment, as designated by the owner of the housing with services establishment, must obtain at least 30 hours of continuing education every two years of employment as the manager in topics relevant to the operations of the housing with services establishment and the needs of its tenants. Continuing education earned to maintain a professional license, such as nursing home administrator license, nursing license, social worker license, and real estate license, can be used to complete this requirement. (b) For managers of establishments identified in section 325F.72, this continuing education must include at least eight hours of documented training on the topics identified in section 144D.065, paragraph (b), within 160 working hours of hire, and two hours of training on these topics for each 12 months of employment thereafter. (c) For managers of establishments not covered by section 325F.72, but who provide assisted living services under chapter 144G, this continuing education must include at least four hours of documented training on the topics identified in section 144D.065, paragraph (b), within 160 working hours of hire, and two hours of training on these topics for each 12 months of employment thereafter. (d) A statement verifying compliance with the continuing education requirement must be included in the housing with services establishment's annual registration to the commissioner of health. The establishment
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MINNESOTA STATUTES 2019
144D.11
must maintain records for at least three years demonstrating that the person primarily responsible for oversight and management of the establishment has attended educational programs as required by this section. (e) New managers may satisfy the initial dementia training requirements by producing written proof of previously completed required training within the past 18 months. (f) This section does not apply to an establishment registered under section 144D.025 serving the homeless. History: 2014 c 291 art 6 s 20; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144D.11 EMERGENCY PLANNING. (a) Each registered housing with services establishment 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 tenants upon signing a lease; (4) post emergency exit diagrams on each floor; and (5) have a written policy and procedure regarding missing tenants. (b) Each registered housing with services establishment must provide emergency and disaster training to all staff during the initial staff orientation and annually thereafter and must make emergency and disaster training available to all tenants annually. Staff who have not received emergency and disaster training are allowed to work only when trained staff are also working on site. (c) Each registered housing with services location must conduct and document a fire drill or other emergency drill at least every six months. To the extent possible, drills must be coordinated with local fire departments or other community emergency resources. History: 2014 c 291 art 6 s 21; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48.
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CHAPTER 144G ASSISTED LIVING NOTE: Sections 144G.01 to 144G.06 are assisted living title protections that are repealed August 1, 2021. Section 144G.07 expires July 31, 2021. 144G.01
DEFINITIONS.
144G.51
ARBITRATION.
144G.02
ASSISTED LIVING; PROTECTED TITLE; REGULATORY FUNCTION.
144G.52
ASSISTED LIVING CONTRACT TERMINATIONS.
144G.53
NONRENEWAL OF HOUSING.
144G.03
ASSISTED LIVING REQUIREMENTS.
144G.54
APPEALS OF CONTRACT TERMINATIONS.
144G.04
RESERVATION OF RIGHTS.
144G.55
COORDINATED MOVES.
144G.05
REIMBURSEMENT UNDER ASSISTED LIVING SERVICE PACKAGES.
144G.56
TRANSFER OF RESIDENTS WITHIN FACILITY.
144G.06
UNIFORM CONSUMER INFORMATION GUIDE.
144G.57
PLANNED CLOSURES.
144G.07
RETALIATION PROHIBITED. 144G.60
STAFFING REQUIREMENTS.
STAFFING REQUIREMENTS
ASSISTED LIVING LICENSURE 144G.08
DEFINITIONS.
144G.61
STAFF COMPETENCY EVALUATIONS.
144G.09
COMMISSIONER OVERSIGHT AND AUTHORITY OVER ASSISTED LIVING FACILITIES.
144G.62
DELEGATION AND SUPERVISION.
144G.63
ORIENTATION AND ANNUAL TRAINING REQUIREMENTS.
144G.64
TRAINING IN DEMENTIA CARE REQUIRED.
144G.70
SERVICES.
144G.71
MEDICATION MANAGEMENT.
144G.72
TREATMENT AND THERAPY MANAGEMENT SERVICES.
144G.10
ASSISTED LIVING FACILITY LICENSE.
144G.11
APPLICABILITY OF OTHER LAWS.
144G.12
APPLICATION FOR LICENSURE.
144G.13
BACKGROUND STUDIES OF LICENSE APPLICANTS.
144G.15
CONSIDERATION OF APPLICATIONS.
144G.16
PROVISIONAL LICENSE.
144G.17
LICENSE RENEWAL.
144G.18
NOTIFICATION OF CHANGES IN INFORMATION.
144G.19
TRANSFER OF LICENSE PROHIBITED.
SERVICES
ASSISTED LIVING FACILITIES WITH DEMENTIA CARE 144G.80
ADDITIONAL LICENSING REQUIREMENTS FOR ASSISTED LIVING FACILITIES WITH DEMENTIA CARE.
144G.81
ADDITIONAL REQUIREMENTS FOR ASSISTED LIVING FACILITIES WITH SECURED DEMENTIA CARE UNITS.
144G.82
ADDITIONAL RESPONSIBILITIES OF ADMINISTRATION FOR ASSISTED LIVING FACILITIES WITH DEMENTIA CARE.
144G.83
ADDITIONAL TRAINING REQUIREMENTS FOR ASSISTED LIVING FACILITIES WITH DEMENTIA CARE.
144G.84
SERVICES FOR RESIDENTS WITH DEMENTIA.
ENFORCEMENT 144G.20
ENFORCEMENT.
SURVEYS, CORRECTION ORDERS, AND FINES 144G.30
SURVEYS AND INVESTIGATIONS.
144G.31
VIOLATIONS AND FINES.
144G.32
RECONSIDERATION OF CORRECTION ORDERS AND FINES.
144G.33
INNOVATION VARIANCE.
OPERATIONS AND PHYSICAL PLANT REQUIREMENTS 144G.40
HOUSING AND SERVICES.
144G.401
PAYMENT FOR SERVICES UNDER DISABILITY WAIVERS.
RESIDENT RIGHTS AND PROTECTIONS 144G.90
REQUIRED NOTICES.
144G.91
ASSISTED LIVING BILL OF RIGHTS.
144G.911
RESTRICTIONS UNDER HOME AND COMMUNITY-BASED WAIVERS.
144G.41
MINIMUM ASSISTED LIVING FACILITY REQUIREMENTS.
144G.42
BUSINESS OPERATION.
144G.43
RESIDENT RECORD REQUIREMENTS.
144G.92
RETALIATION PROHIBITED.
MINIMUM SITE, PHYSICAL ENVIRONMENT, AND FIRE SAFETY REQUIREMENTS.
144G.93
CONSUMER ADVOCACY AND LEGAL SERVICES.
144G.95
OFFICE OF OMBUDSMAN FOR LONG-TERM CARE.
144G.9999
RESIDENT QUALITY OF CARE AND OUTCOMES IMPROVEMENT TASK FORCE.
144G.45
CONTRACTS, TERMINATIONS, AND RELOCATIONS 144G.50
ASSISTED LIVING CONTRACT REQUIREMENTS.
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144G.01
MINNESOTA STATUTES 2019
144G.01 DEFINITIONS. Subdivision 1. Scope; other definitions. For purposes of sections 144G.01 to 144G.05, the following definitions apply. In addition, the definitions provided in section 144D.01 also apply to sections 144G.01 to 144G.05. Subd. 2. Assisted living. "Assisted living" means a service or package of services advertised, marketed, or otherwise described, offered, or promoted using the phrase "assisted living" either alone or in combination with other words, whether orally or in writing, and which is subject to the requirements of this chapter. Subd. 3. Assisted living client; client. "Assisted living client" or "client" means a housing with services resident who receives assisted living that is subject to the requirements of this chapter. Subd. 4. Commissioner. "Commissioner" means the commissioner of health. History: 2006 c 282 art 19 s 13; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144G.02 ASSISTED LIVING; PROTECTED TITLE; REGULATORY FUNCTION. Subdivision 1. Protected title; restriction on use. No person or entity may use the phrase "assisted living," whether alone or in combination with other words and whether orally or in writing, to advertise, market, or otherwise describe, offer, or promote itself, or any housing, service, service package, or program that it provides within this state, unless the person or entity is a housing with services establishment that meets the requirements of this chapter, or is a person or entity that provides some or all components of assisted living that meet the requirements of this chapter. A person or entity entitled to use the phrase "assisted living" shall use the phrase only in the context of its participation in assisted living that meets the requirements of this chapter. A housing with services establishment offering or providing assisted living that is not made available to residents in all of its housing units shall identify the number or location of the units in which assisted living is available, and may not use the term "assisted living" in the name of the establishment registered with the commissioner under chapter 144D, or in the name the establishment uses to identify itself to residents or the public. Subd. 2. Authority of commissioner. (a) The commissioner, upon receipt of information that may indicate the failure of a housing with services establishment, the arranged home care provider, an assisted living client, or an assisted living client's representative to comply with a legal requirement to which one or more of the entities may be subject, shall make appropriate referrals to other governmental agencies and entities having jurisdiction over the subject matter. The commissioner may also make referrals to any public or private agency the commissioner considers available for appropriate assistance to those involved. (b) In addition to the authority with respect to licensed home care providers under section 144A.45 and with respect to housing with services establishments under chapter 144D, the commissioner shall have standing to bring an action for injunctive relief in the district court in the district in which a housing with services establishment is located to compel the housing with services establishment or the arranged home care provider to meet the requirements of this chapter or other requirements of the state or of any county or local governmental unit to which the establishment or arranged home care provider is otherwise subject. Proceedings for securing an injunction may be brought by the commissioner through the attorney general
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144G.03
or through the appropriate county attorney. The sanctions in this section do not restrict the availability of other sanctions. History: 2006 c 282 art 19 s 14; 2013 c 108 art 11 s 33; 2014 c 275 art 1 s 134,138; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144G.03 ASSISTED LIVING REQUIREMENTS. Subdivision 1. Verification in annual registration. A registered housing with services establishment using the phrase "assisted living," pursuant to section 144G.02, subdivision 1, shall verify to the commissioner in its annual registration pursuant to chapter 144D that the establishment is complying with sections 144G.01 to 144G.05, as applicable. Subd. 2. Minimum requirements for assisted living. (a) Assisted living shall be provided or made available only to individuals residing in a registered housing with services establishment. Except as expressly stated in this chapter, a person or entity offering assisted living may define the available services and may offer assisted living to all or some of the residents of a housing with services establishment. The services that comprise assisted living may be provided or made available directly by a housing with services establishment or by persons or entities with which the housing with services establishment has made arrangements. (b) A person or entity entitled to use the phrase "assisted living," according to section 144G.02, subdivision 1, shall do so only with respect to a housing with services establishment, or a service, service package, or program available within a housing with services establishment that, at a minimum: (1) provides or makes available health-related services under a home care license. At a minimum, health-related services must include: (i) assistance with self-administration of medication, medication management, or medication administration as defined in section 144A.43; and (ii) assistance with at least three of the following seven activities of daily living: bathing, dressing, grooming, eating, transferring, continence care, and toileting. All health-related services shall be provided in a manner that complies with applicable home care licensure requirements in chapter 144A and sections 148.171 to 148.285; (2) provides necessary assessments of the physical and cognitive needs of assisted living clients by a registered nurse, as required by applicable home care licensure requirements in chapter 144A and sections 148.171 to 148.285; (3) has and maintains 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 applicable home care licensure requirements in chapter 144A and sections 148.171 to 148.285; (4) provides staff access to an on-call registered nurse 24 hours per day, seven days per week; (5) has and maintains a system to check on each assisted living client at least daily;
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144G.03
MINNESOTA STATUTES 2019
(6) provides a means for assisted living clients to request assistance for health and safety needs 24 hours per day, seven days per week, from the establishment or a person or entity with which the establishment has made arrangements; (7) has a person or persons available 24 hours per day, seven days per week, who is responsible for responding to the requests of assisted living clients for assistance with health or safety needs, who shall be: (i) awake; (ii) located in the same building, in an attached building, or on a contiguous campus with the housing with services establishment in order to respond within a reasonable amount of time; (iii) capable of communicating with assisted living clients; (iv) capable of recognizing the need for assistance; (v) capable of providing either the assistance required or summoning the appropriate assistance; and (vi) capable of following directions; (8) offers to provide or make available at least the following supportive services to assisted living clients: (i) two meals per day; (ii) weekly housekeeping; (iii) weekly laundry service; (iv) upon the request of the client, reasonable assistance with arranging for transportation to medical and social services appointments, and the name of or other identifying information about the person or persons responsible for providing this assistance; (v) upon the request of the client, reasonable assistance with accessing community resources and social services available in the community, and the name of or other identifying information about the person or persons responsible for providing this assistance; and (vi) periodic opportunities for socialization; and (9) makes available to all prospective and current assisted living clients information consistent with the uniform format and the required components adopted by the commissioner under section 144G.06. This information must be made available beginning no later than six months after the commissioner makes the uniform format and required components available to providers according to section 144G.06. Subd. 3. Exemption from awake-staff requirement. A housing with services establishment that offers or provides assisted living is exempt from the requirement in subdivision 2, paragraph (b), clause (7), item (i), that the person or persons available and responsible for responding to requests for assistance must be awake, if the establishment meets the following requirements: (1) the establishment has a maximum capacity to serve 12 or fewer assisted living clients; (2) the person or persons available and responsible for responding to requests for assistance are physically present within the housing with services establishment in which the assisted living clients reside; (3) the establishment has a system in place that is compatible with the health, safety, and welfare of the establishment's assisted living clients;
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MINNESOTA STATUTES 2019
144G.03
(4) the establishment's housing with services contract, as required by section 144D.04, includes a statement disclosing the establishment's qualification for, and intention to rely upon, this exemption; (5) the establishment files with the commissioner, for purposes of public information but not review or approval by the commissioner, a statement describing how the establishment meets the conditions in clauses (1) to (4), and makes a copy of this statement available to actual and prospective assisted living clients; and (6) the establishment indicates on its housing with services registration, under section 144D.02 or 144D.03, as applicable, that it qualifies for and intends to rely upon the exemption under this subdivision. Subd. 4. Nursing assessment. (a) A housing with services establishment offering or providing assisted living shall: (1) offer to have the arranged home care provider conduct a nursing assessment by a registered nurse of the physical and cognitive needs of the prospective resident and propose a service plan prior to the date on which a prospective resident executes a contract with a housing with services establishment or the date on which a prospective resident moves in, whichever is earlier; and (2) 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 housing with services establishment or the date on which a prospective resident moves in, whichever is earlier. (b) An arranged home care provider is not obligated to conduct a nursing assessment by a registered nurse when requested by a prospective resident if either the geographic distance between the prospective resident and the provider, or urgent or unexpected circumstances, do not permit the assessment to be conducted prior to the date on which the prospective resident executes a contract or moves in, whichever is earlier. When such circumstances occur, the arranged home care provider shall offer to conduct a telephone conference whenever reasonably possible. (c) The arranged home care provider shall comply with applicable home care licensure requirements in chapter 144A and sections 148.171 to 148.285, with respect to the provision of a nursing assessment prior to the delivery of nursing services and the execution of a home care service plan or service agreement. Subd. 5. Assistance with arranged home care provider. The housing with services establishment shall provide each assisted living client with identifying information about a person or persons reasonably available to assist the client with concerns the client may have with respect to the services provided by the arranged home care provider. The establishment shall keep each assisted living client reasonably informed of any changes in the personnel referenced in this subdivision. Upon request of the assisted living client, such personnel or designee shall provide reasonable assistance to the assisted living client in addressing concerns regarding services provided by the arranged home care provider. Subd. 6. Termination of housing with services contract. If a housing with services establishment terminates a housing with services contract with an assisted living client, the establishment shall provide the assisted living client, and the legal or designated representative of the assisted living client, if any, with a written notice of termination which includes the following information: (1) the effective date of termination; (2) the section of the contract that authorizes the termination;
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144G.03
MINNESOTA STATUTES 2019
(3) without extending the termination notice period, an affirmative offer to meet with the assisted living client and, if applicable, client representatives, within no more than five business days of the date of the termination notice to discuss the termination; (4) an explanation that: (i) the assisted living client must vacate the apartment, along with all personal possessions, on or before the effective date of termination; (ii) failure to vacate the apartment by the date of termination may result in the filing of an eviction action in court by the establishment, and that the assisted living client may present a defense, if any, to the court at that time; and (iii) the assisted living client may seek legal counsel in connection with the notice of termination; (5) a statement that, with respect to the notice of termination, reasonable accommodation is available for the disability of the assisted living client, if any; and (6) the name and contact information of the representative of the establishment with whom the assisted living client or client representatives may discuss the notice of termination. History: 2006 c 282 art 19 s 15; 2016 c 179 s 17,18; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144G.04 RESERVATION OF RIGHTS. Subdivision 1. Use of services. Nothing in this chapter requires an assisted living client to utilize any service provided or made available in assisted living. Subd. 2. Housing with services contracts. Nothing in this chapter requires a housing with services establishment to execute or refrain from terminating a housing with services contract with a prospective or current resident who is unable or unwilling to meet the requirements of residency, with or without assistance. Subd. 3. Provision of services. Nothing in this chapter requires the arranged home care provider to offer or continue to provide services under a service agreement or service plan to a prospective or current resident of the establishment whose needs cannot be met by the arranged home care provider. Subd. 4. Altering operations; service packages. Nothing in this chapter requires a housing with services establishment or arranged home care provider offering assisted living to fundamentally alter the nature of the operations of the establishment or the provider in order to accommodate the request or need for facilities or services by any assisted living client, or to refrain from requiring, as a condition of residency, that an assisted living client pay for a package of assisted living services even if the client does not choose to utilize all or some of the services in the package. History: 2006 c 282 art 19 s 16; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48.
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MINNESOTA STATUTES 2019
144G.07
144G.05 REIMBURSEMENT UNDER ASSISTED LIVING SERVICE PACKAGES. Notwithstanding the provisions of this chapter, the requirements for the elderly waiver program's assisted living payment rates under sections 256S.201 and 256S.202 shall continue to be effective and providers who do not meet the requirements of this chapter may continue to receive payment under sections 256S.201 and 256S.202, as long as they continue to meet the definitions and standards for assisted living and assisted living plus set forth in the federally approved Elderly Home and Community Based Services Waiver Program (Control Number 0025.91). Providers of assisted living for the community access for disability inclusion (CADI) and Brain Injury (BI) waivers shall continue to receive payment as long as they continue to meet the definitions and standards for assisted living and assisted living plus set forth in the federally approved CADI and BI waiver plans. History: 2006 c 282 art 19 s 17; 2012 c 216 art 14 s 2; 2015 c 78 art 6 s 31; 2019 c 54 art 2 s 4; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144G.06 UNIFORM CONSUMER INFORMATION GUIDE. The commissioner shall adopt a uniform format for the guide to be used by individual providers, and the required components of materials to be used by providers to inform assisted living clients of their legal rights, and shall make the uniform format and the required components available to assisted living providers. History: 2006 c 282 art 19 s 18; 1Sp2010 c 1 art 17 s 5; 2014 c 286 art 7 s 3; 2019 c 60 art 1 s 48 NOTE: This section is repealed by Laws 2019, chapter 60, article 1, section 48, effective August 1, 2021. Laws 2019, chapter 60, article 1, section 48. 144G.07 RETALIATION PROHIBITED. Subdivision 1. Definitions. For the purposes of this section: (1) "facility" means a housing with services establishment registered under section 144D.02 and operating under title protection under sections 144G.01 to 144G.07; and (2) "resident" means a resident of a facility. Subd. 2. Retaliation prohibited. A facility or agent of a facility may not retaliate against a resident or employee if the resident, employee, or any person 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 administrator 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;
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MINNESOTA STATUTES 2019
(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 (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. 3. 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; (7) an arbitrary increase in charges or fees; (8) unauthorized removal, tampering with, or deprivation of technology, communication, or electronic monitoring devices; or (9) any oral or written communication of false information about a person advocating on behalf of the resident. Subd. 4. Retaliation against an employee. For purposes of this section, to retaliate against an employee means any of the following actions taken 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.
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144G.08
Subd. 5. 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 3 within 30 days of an initial action described in subdivision 2, 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. History: 2019 c 60 art 3 s 3 NOTE: This section, as added by Laws 2019, chapter 60, article 3, section 3, expires July 31, 2021. Laws 2019, chapter 60, article 3, section 3, the effective date. 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. 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). 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 modified diets ordered by a licensed health professional; (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, or social worker;
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(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 person-centered 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 organization 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 a person 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. [See Note.]
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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. Beginning August 1, 2021, no assisted living facility may operate in Minnesota unless it is licensed under this chapter. 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. Subd. 2. Licensure categories. (a) The categories in this subdivision are established for assisted living facility licensure.
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(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 required to 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, 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;
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(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 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;
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(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 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.
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(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. 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.
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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; (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
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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 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 officials restrictions. 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.
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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 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
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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 (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.
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(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 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
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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 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
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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, 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
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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:
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(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 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; and
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(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. Subd. 2. Policies and procedures. Each assisted living facility must have policies and procedures in place to address the following and keep them current: (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. All assisted living facilities must establish and maintain an infection control program. 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. 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. 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 (4) to representatives of the commissioner authorized to survey or investigate facilities under this chapter or federal laws.
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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 have a comprehensive fire protection system that includes: (1) protection throughout by an approved supervised automatic sprinkler system according to building code requirements established in Minnesota Rules, part 1305.0903, or smoke detectors in each occupied room installed and maintained in accordance with the National Fire Protection Association (NFPA) Standard 72; (2) portable fire extinguishers installed and tested in accordance with the NFPA Standard 10; and (3) the physical environment, including walls, floors, ceiling, all furnishings, grounds, systems, and equipment that is kept in 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) Fire drills in assisted living facilities shall be conducted in accordance with the residential board and care requirements in the Life Safety Code, except that fire drills in secured dementia care units shall be conducted in accordance with section 144G.81, subdivision 2.
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(c) 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 be continued 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 most current 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, new construction, modifications, renovations, alterations, changes of use, or additions. 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 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
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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 (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.
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(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 a resident unless it has executed a written contract with the resident. (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 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
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(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 on the 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. (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;
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(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. (f) 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. 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."
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(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. 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 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
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services from another provider of the resident's choosing that may allow the resident to avoid the termination. 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 emergency if 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 (4). (b) The resident 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 (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 move to 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 evaluations for 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 specifically to 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 person-centered 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 life-sustaining 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 most current edition of the NFPA Standard 101, Life Safety Code, Healthcare (limited care) chapter. The minimum design standards shall be met 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 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) outdoor activities. (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) Access to secured outdoor space and walkways that allow residents to enter and return without staff assistance must be provided. 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 available in 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.
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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 visits at any time by the resident's family, guardian, conservator, health care agent, attorney, advocate, or religious or 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 persons of 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 resident or 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
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(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 available to a resident under section 626.557. History: 2019 c 60 art 1 s 42,47
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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;
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(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
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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 626.556, subdivision 10i, 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, 626.556, subdivision 10i, 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
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by July 1, 1996. The program must include but need not be limited to the following areas: (1) information 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
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may also investigate to determine whether the conditions which resulted in the reported maltreatment place 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;
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(5) review of pertinent documentation of the alleged incident; and (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.
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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). (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;
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(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; (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.
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(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 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.
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(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 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
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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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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.
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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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;
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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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.
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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MINNESOTA STATUTES 2019
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:
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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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
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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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
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
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MINNESOTA STATUTES 2019
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.
Copyright © 2019 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
192
2021 NURSE MANAGERS’ EDUCATION SERIES
Statement of Home Care Services Comprehensive Home Care Provider Comprehensive Home Care Provider Name: Below is a list of all services that may be provided with a Comprehensive Home Care License. Each service that is offered by this provider is indicated by a check in the box next to the service. Advanced Practice Nurse Services
Complex or Specialty Healthcare Services
Registered Nurse Services
Assistance with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, and bathing
Licensed Practical Nurse Services Physical Therapy Services Occupational Therapy Services Speech Language Pathologist Services Respiratory Therapy Services Social Worker Services Services by a Dietitian or Nutritionist Medication Management Services Delegated tasks to unlicensed personnel Hands-on assistance with transfers and mobility Providing eating assistance for clients with complicating eating problems (i.e. difficulty swallowing, recurrent lung aspirations, or requiring the use of a tube, parenteral or intravenous instruments)
Providing standby assistance within arm’s reach for safety while performing daily activities Providing verbal or visual reminders to take regularly scheduled medication (includes bringing clients previously set-up medication, medication in original containers, or liquid or food to accompany the medication) Providing verbal or visual reminders to the client to perform regularly scheduled treatments and exercises Preparing modified diets ordered by licensed health professional Laundry Housekeeping/Other household chores Meal preparation Shopping
I have received a copy of this Statement of Home Care Services: Client Signature: ____________________________________________ Date: ___________________
Statement of Home Care Services – Comprehensive Home Care Provider (12/13)
2021 NURSE MANAGERS’ EDUCATION SERIES
Select MDH Website References Housing with Services Housing with Services Registration form http://www.health.state.mn.us/divs/fpc/profinfo/lic/fpc926_1.pdf Local Requirements Addendum to the HWS Registration form http://www.health.state.mn.us/divs/fpc/profinfo/lic/hwsaddendum.pdf Uniform Consumer Information Guide (UCIG) http://www.health.state.mn.us/divs/fpc/profinfo/lic/UCIguide.html Related Housing with Services/Assisted Living/UCIG Statutes 144D ‐ http://www.revisor.leg.state.mn.us/stats/144D/ 144G ‐ http://www.revisor.leg.state.mn.us/stats/144G/ Special Care Units ‐ https://www.revisor.mn.gov/statutes/?id=325F.72
Comprehensive and Basic Home Care Comprehensive Home Care Licensing http://www.health.state.mn.us/divs/fpc/homecare/index.html Comprehensive Home Care Statement of Home Care Services http://www.health.state.mn.us/divs/fpc/homecare/providers/compstatementserv.pdf Basic Home Care Licensing http://www.health.state.mn.us/divs/fpc/homecare/index.html Basic Home Care Statement of Home Care Services http://www.health.state.mn.us/divs/fpc/homecare/providers/basicstatementserv.pdf Forms for Home Care Providers http://www.health.state.mn.us/divs/fpc/homecare/providers/forms.html
Bill of Rights http://www.health.state.mn.us/divs/fpc/consumerinfo/index.html
2021 NURSE MANAGERS’ EDUCATION SERIES
MN Vulnerable Adults Act Reporting Refer to Appendix A for the current Minnesota Vulnerable Adults Act statute.
However, note that effective July 1, 2015, the referenced Common Entry Point (CEP) system has been replaced with the Minnesota Adult Abuse Reporting Center (MAARC).
Statewide 24/7/365 contact information for MAARC is:
mn.gov.dhs/reportadultabuse
2021 NURSE MANAGERS’ EDUCATION SERIES
2021 NURSE MANAGERS’ EDUCATION SERIES
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 DHS 02/11/2020
SD# 1
EW RS Rates
Information from Individual's Screening Document FALSE
SD# 4
Version
PMI
Client Last Name
Assigned SD#
Client First Name
Assessment/Change Date
Street Address
76
City
Assess. Effective Date
CL Start Date
CL End Date Max Start Date=06/30/2020
13
County of Residence
Prior Rate Use
State
Full monthly CL Rate on 01/00/1900
Zip
Has Prior Tool 16
DOB
Primary Diagnosis Health Plan
22
Case Manager's Name
+NPI
0
SD# 38
Dressing
SD# 39
Grooming
SD# 40
Bathing
41
Eating
42
Bed Mobility
43
Transferring
0
Health Plan ID
44
Walking
45
Behavior
46
Toileting
48
Clinical Monitoring
50
Current Case Mix
51
Orientation
52
Self Preservation
55
Hearing
56
Communication
57
Vision
58
Mental Status
60
Telephone Calling
61
Shopping
62
Meal Preparation
63
Light Housekeeping
64
Heavy Housekeeping
65
Laundry
66
Medication
68
Money Management
69
Transportation
67
Insulin Dependency
Wheeling
47
Special Treatment
49
Neuromuscular Diag.
Case Mix Last Assessment
74
Vent Dependent
Are you making a correction?
Get Client's Previous Data
0
Turn All Help on/off
Clear Cells by Group
no
0000
Last Case Mix value is from the PREVIOUS, not the current assessment
Authorize Rate As CL:T2030/T2030 TG
Exited/Failed to Enter CL Date Reason .
Authorize Type Valid
Dwelling License/Registration
Waiver Type
EW
Waiver Type Valid
no
Additional Required Information Delegate Agency
Case Manager's Phone# Case Manager's E-Mail Re-Type CM E-Mail
Optional Information Cc… Email Re-Type Cc… Email
Client's Legal Name: Legal Guardian: Print Client Name As: Print Case Mngr Name As: Print Provider Name As: Print Provider Address As:
Printed Notes:
Documentary Notes:
Copyright © 2009 - 2020 Minnesota Department of Human Services (DHS). All Rights Reserved
Confidential
2/26/2020 Not Valid for Rates or Plan
Page 1
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
Individualized EW - Customized Living Plan
Ver. 11.1.9 DHS 02/11/2020 Client Last Name
Client First Name
0
0
Housing with Services Provider Name
PMI 0
Housing with Services - Street Address
County/Tribe
0
Housing with Services - City
Case Manager
0
Housing with Services - ZIP Code
Health Plan
0
Housing with Services - County
Recipient Health Plan ID 00000000000000000000 Start Date for CL Service Mental Status Evaluation Self Preservation
Housing with Services - HF ID # Assessment Date
1/0/1900
Assess. Effective Date
1/0/1900
1/0/1900 0 0
Community Budget Cap $
In CL Plan?
In CL to meet need?
Dependency Description
Need Documented ?
Score
-
Can get in and out of bed or chair without human help
no
no
Can move in bed without assistance
no
no
Select Housing Type
no
no
Enter the number of individuals sharing the space
no
no
0
Uses toilet w/o help
Transferring Dependency
43
0
Positioning Dependency
42
0
Active Behavioral Support Dependency
45
0
Behavior requires no intervention
Orientation Dependency
51
0
Oriented
48
0
66
0
Hearing
55
0
No hearing impairment
Vision
57
0
Has no vision impairment
Communication
56
0
Communicates needs
N/A
Select food prep facilities location
Month no
no
no
no
Less that once a day
Provider Meets Standards for EW 24 hr CL.
-
Name: Address: City: ZipCode: Taxonomy Code(if Applicable):
no
46
N/A
The following will be used to validate the NPI/UMPI:
no Toileting Dependency
Foster Care Monthly Rate Limit
no
CL/RC Monthly Rate Limit $
Independent
24 Hour Support Needed for: SD Ref
MDH Provider HFID Web Site
Individual Eligible for 24 Hr CL
24 Hr CL Monthly Rate Limit
Clinical Monitoring Dependency Med Admin + 50 hrs/mo of service
Bring in Client's Address
NPI/UMPI
Case Mix
Year
Please enter the Month and Year the Client first moved in, or will move in, to any Residential Services residence.
Sensory and Communication Status
Confidential
2/26/2020 Not Valid for Rates or Plan
Page 2
Light housekeeping
63
0
Heavy housekeeping
64
0
Laundry - personal
65
0
Laundry-linens
65
0
Shopping
61
0
In CL Plan?
Dependency Description
SD Ref
In CL to meet need?
Homemaking
Need Documen ted?
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
no
no
no
no
no
no
no
no
no
no
Service Description
Min/ Day
Min/ Week
Hrs/ Mo
Total Hours/ Month
Monthly Rate per Component
0.00
$
-
0.00
$
-
0.00
$
-
0.00
$
-
0.00
$
-
$
-
0.00
$
-
0.00
$
-
0.00
$
-
0.00
$
-
$
-
Sub-total home- making $
-
Food Preparation Service Description 62
Score 62
0
no
no
no
no
no no
Lunch prep and serve
62
0
Supper prep and serve
62
0
Snack prep and serve
62
0
no
Score
Supportive Services SD Ref Making appts
60
0
Arrange Non-medical Transportat
60
0
Money Mgt
68
0
Dependency Description
Hrs/ Mo
no
no
no
no
no
no
Total Hours/ Month
0.00 Service Description
no
Need Documen ted?
Breakfast prep and serve
Min/ Week
no
In CL Plan?
Food Preparation and Service
no
0
In CL to meet need?
Individual Assistance w Meal Prep in Own Apartment
Min/ Day
Service Description
Meals per Month
Min/ Day
Min/ Week
Hrs/ Mo
Total Monthly
Total Hours/ Month
Sub-total Meals $
-
Monthly Rate per Component
0.00
$
-
0.00
$
-
0.00
$
-
0.00
$
-
0.00
$
-
0.00
$
-
0.00
$
-
0.00
$
-
Socialization with given Ratio of Staff/Resident Socialization - Individual Group Socialization: 1 Staff to 25 Residents Group Socialization: 1 Staff to 6 12 Residents Group Socialization: 1 Staff to 13 - 20 Residents Group Socialization: 1 Staff to over 20 Residents
no no no no no Standardized Total Monthly Hours
Confidential
2/26/2020 Not Valid for Rates or Plan
Sub-total Supportive Services $
0.00
Page 3
-
Group Transportation: Group Transportation: riders Group Transportation: riders Group Transportation: riders
69 2 riders 3-5
69
Score
Dependency Description
0 0
69
0
69
0
6 - 10 Over 10 69
0
In CL Plan?
SD Ref
Driver 1:1 Non-medical Transportation
In CL to meet need?
Non-Medical Transportation
Need Docum ented?
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
no
no
no
no
no
no
no
no
no
no
Service Description
Mo
Total Hours/ Month
Monthly Rate per Component
0.00
$
-
0.00
$
-
0.00
$
-
0.00
$
-
0.00 Total Miles/Mo
$
-
1:1 mileage
69
0
N/A
N/A
0
no
0.00
$
-
Group Mileage 2 riders
69
0
N/A
N/A
0
no
0.00
$
-
Group Mileage 3 - 5 riders
69
0
N/A
N/A
0
no
0.00
$
-
Group Mileage 6 - 10 riders
69
0
N/A
N/A
0
no
0.00
$
-
Group Mileage over 10 riders
69
0
N/A
N/A
0
no
0.00
$
-
In CL Plan?
Miles Per Week
Hrs/ Mo
In CL to meet need?
Day
Min/ Week
Need Docume nted?
Mileage
Min/ Day
Personal Care
SD Ref
Score
Dressing
38
0
Grooming
39
0
Dependency Description Can dress w/o help of any kind Can comb hair, wash face, shave or brush their teeth w/o help of any kind
Bathing
40
0
Eating
41
Continence Care Walking Assistance With Use of Wheelchair
Service Description
Min/ Day
Min/ Week
Hrs/ Mo
Total Hours/ Month
no
no
no
0.00
$
-
Independent
no
no
0.00
$
-
0
Eats w/o help
no
no
0.00
$
-
46
0
Uses toilet w/o help
no
no
0.00
$
-
44
0
no
no
0.00
$
-
None
0
no
no
0.00
$
-
Transferring
43
0
no
no
0.00
$
-
Positioning
42
0
Walks w/o help Does not use wheelchair, or receives no personal help Can get in and out of bed or chair without human help Can move in bed without assistance
no
no
0.00
$
-
2/26/2020 Not Valid for Rates or Plan
$
-
Monthly Rate per Component
no
Confidential
Sub-total Nonmedical Transportation
Sub-total Personal Care $
Page 4
-
In CL Plan?
Dependency Description
In CL to meet need?
Other Delegated Health Services
Need Docume nted?
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
Min/ Day
Min/ Week
Hrs/ Mo
Total Hours/ Month
Monthly Rate per Component
SD Ref
Score
Med Administration or assistance with selfadministration
66
0
no
no
0.00
$
-
Verbal or Visual Medication Reminders Insulin Injections Therapeutic Exercises Delegated clinical monitoring Delegated nursing tasks
66 67 N/A 48 48
0 0 N/A 0 0
no no
no no no no no no no no no no
0.00 0.00 0.00 0.00
$ $ $ $ $ $ $ $ $ $
-
Less than once a day
no
Service Description
0.00 0.00 0.00 0.00 0.00 0.00
Score Med Set Ups and Monitoring Insulin Draws
66 67
Dependency Description
no no
0 0
In CL to meet need?
Medication Mgt by Licensed Nurse
Need Documen ted?
Other Delegated Total Monthly Hrs
Min/ Day
Service Description
Min/ Week
Hrs/ Mo
-
0.00
Total Hours/ Month
0.00 0.00
no no
Sub-total Other Delegated Health Services $
Monthly Rate per Component $ $
Sub-total Med Manage- ment $ -
-
Personal Security Awareness of need for assistance Will the person summon assistance when necessary?
Summoning Device
If yes, how will they summon help? What mechanism will they use? Is the mechanism included in the CL Rate?
$
-
$
If no, how will staff know when the person needs assistance? Self-Preservation Self-Preservation Score
0
Can the person evacuate in an emergency?
Independent
If no, what is the emergency plan?
Emergency Backup Planning Hospital Name
Hospital Phone
Physician Name
Physician Phone
Emergency Contact Name
ER Contact Phone
Emergency Contact Relationship If Client needs emergency medical or psychiatric services, call 911, admit to the Hospital listed, notify the emergency contact
ER Backup Plan Details listed, and if necessary, the listed physician. In addition:
Confidential
2/26/2020 Not Valid for Rates or Plan
Page 5
-
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 Active Cognitive or Behavioral Support
Score
Implementation of written individual plan to address: 51 0 Wandering 51 0 Orientation issues 45 0 Anxiety 45 0 Verbal aggression 45 0 Physical aggression 45 0 Repetitive behavior 45 0 Agitation 45 0 Self-injurious behavior 45 0 Property destruction Other need related to mental health or cognitive challenge 0 0 0
Dependency Description
In CL Plan?
SD Ref
In CL to meet need?
Allowable Component Service
Need Documente d?
Does the recipient need service at additional times over and above those specified above to address needs specified in the table below? If yes, please specify the amount and type of service needed below.
Min/ Day
Service Description
Min/ Week
Hrs/ Mo
Total Hours/ Month
Monthly Rate per Component
no no no no no no no no no
no no no no no no no no no
0.00
$
-
0.00
$
-
no no
no no
0.00 0.00
$ $
-
no
no
0.00
$
-
Sub-total Active Cognitive or Behavioral Support $
-
0.00 Summary of Supervisory Support Frequency of contact. Indicate expected minimum as well as frequency at different times during the day/night. Mode of contact. Include description of how resident will request assistance or how staff will know when assistance is required. Competencies of Staff Providing Supervisory Support Training and Supervision of Staff Supervisory Support Scheduled Total CL Services (not final valid rate
$
Anticipated Days Absent Per Year? Go to new Prior Period Rate entry location Provider's equivalent non-public pay rate for these services if less than CL Rate --->
Confidential
2/26/2020 Not Valid for Rates or Plan
$0.00
Max Prior Rate is: N/A
You Must Select an Option --->
Page 6
-
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 Projected Hours of CL Service by Component Type Per
Month Week Day
Home Management/Homemaking and Support Services:
0.00
0.00
0
Home Care Aide Services:
0.00
0.00
0
Home Health Aide Services:
0.00
0.00
0
Medication Setups by Licensed Nurse:
0.00
0.00
0
0.00
0 0.00
0.00
Total hours:
Total Hours For All Audited Services
EW - Customized Living Budget Recap at CL Start Date of 01/00/1900 CL Budget Recap Needs Start Date for CL Service to Proceed Monthly EW CL/24 CL Service $ Rate Limit Rate Proportion of EW Limit and Difference % & $$$
-
N/A
$
Proposed Customized Living Customized Living Rate with $ Adjustment for Days Absent
-
Individual Customized Living Customized Living Rate $ Limited to Private Pay Rate
-
Does temporary rate apply?
Full Rate*
Temporary Rate*
-
EW Community Budget $ Cap
-
$
-
Monthly Cost of Proposed $ Non CL EW Services
-
$
-
Amount of Proposed Monthly EW Budget including CL Rate
$
-
$
-
Monthly - Customized Living Rate
$
-
$
-
Daily CL Rate (For Information only)
$
-
$
-
$
-
Since Rate is withing $.50 of Limit, Rate has been Auto Rounded to exactly the Limit
no
Application of 50% difference $ to computed CL rate.
-
Temporary Rate - If applicable
Percent Transition Adjustment is of Final Rate
Warning! Prior Authorized rate and prior rate question are not consistent or either the Full Rate or the Prior Authorized rate is less than $25 . Please Verify
#DIV/0!
All monthly Service Rates are calculated based the Component Rates and Service Limits in effect on the Service Start Date. During the year this rate may change. After 09/30/2010 'Temporary' rates no longer apply. The 'Print Rate Guide' should be used to determine the Service Rate valid for payment during the authorization period. Use the rate that corresponds to the time period during which services will be provided and paid. In all cases, Providers are required to bill ONLY for the days of actual service. Copyright © 2009 - 2020 Minnesota Department of Human Services (DHS). All Rights Reserved
Confidential
2/26/2020 Not Valid for Rates or Plan
Page 7
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 EW - Customized Living and State Plan Home Care Services Authorized
DHS 02/11/2020
Ver. 11.1.9
EW Service Name Adult Day Care Adult Day Care FADS Adult Day Care Bath Family Caregiver Coaching/Counseling (plus assessment) Family Caregiver Training and Ed Family Caregiver Fam Memory Care Case Management Case Management Case Mgt - Paraprofessional CDCS Background Checks
Unit 15 minutes 15 minutes 15 minutes
15 minutes 15 minutes 15 minutes 15 minutes 15 minutes 15 minutes One print
CDCS Mandatory Case Mgt Chore Services Companion Services
15 minutes 15 minutes 15 minutes
CDCS Home Delivered Meal Home Health Aide Extended Homemaker Envir Accessibility Adapts -Home Install Envir Accessibility Adapts -Home Assess Envir Accessibility Adapts -Vehicle Install Envir Accessibility Adapts -Vehicle Assess Personal Care Assistant 1:1
Provider Name and Number
# of Units/ Month
Unit Rate
Totals $ $ $ -
Start Date
End Date
Up To Rate Limit as of 02/26/2020 $3.45 $3.45 $7.65
$ $ $ $ $ $
-
$
-
Per Service 1Meal/Day 15 minutes 15 minutes Per Waiver Yr
$ $ $
-
$
-
Per Assess Per Waiver Yr
$
-
$
-
Per Assess 15 minutes
$ $
-
$18.11 $18.11 $18.11 $25.46 $25.46 $9.39 $25.00 Up to Required Case MGT Cap Amount $4.15 $2.57 Up to CDCS Cap Case Mix Cap $7.06 $8.01 $4.84 EAA Services <= $20,0000 EAA Services <= $20,0000 EAA Services <= $20,0000 EAA Services <= $20,0000 $4.45
Personal Care Assistant - Shared 1:2 15 minutes
$
-
$3.34
Personal Care Assistant - Shared 1:3 LPN Complex Extended LPN Regular Extended LPN shared 1:2 Extended RN Complex Extended RN Regular Extended RN shared 1:2 Extended
15 minutes 15 minutes 15 minutes 15 minutes 15 minutes 15 minutes 15 minutes
$ $ $ $ $ $ $
-
Respite Certified Facility Respite, Hospital Respite, In-home Respite, In-home Respite, Out of home Respite, Out of home Supplies and Equipment Supplies and Equipment Supplies and Equipment Supplies and Equipment Supplies and Equipment Transitional Services Transportation Transportation, Non-commercial
Per Diem Per Diem 15 minutes Per Diem 15 minutes Per Diem Total/Month Total/Month Total/Month Total/Month Total/Month Per Occurs 1-way trip Per Mile
$ $ $ $ $ $ $ $
-
$2.93 $7.84 $6.69 $5.02 $10.44 $8.71 $6.53 NF's Per diem for the Recipient's case mix $147.85 $5.77 $103.85 $5.77 $103.85 Up to Budget Cap Up to Budget Cap Up to Budget Cap Up to Budget Cap Up to Budget Cap Up to Budget Cap $20.21 $0.58
Total All EW Excluding CL Services
From 02/26/2020 $ -
CL Services Rate Summary by Effective Date Customized Living Services
Monthly
1
Estimated monthly total for proposed EW Services including CL Services
From 01/00/1900
From 10/01/2010
$
-
$
$
-
CL End Date
-
Client: PMI: Copyright © 2009 - 2020 Minnesota Department of Human Services (DHS). All Rights Reserved
Confidential
2/26/2020 Not Valid for Rates or Plan
Page 8
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 Request Approval to Exceed the CL Service Limit and/or the EW Case-mix Budget Cap Applies to All Residential Services Clients Clients leaving a Nursing Facility (NF) where they resided more than 30 days may qualify for a higher Community Case-mix EW Budget Cap (Conversion Budget Cap). Once established, this budget may be used for any combination of Residential Services. This means the client may exceed the standard RS Service Case–mix Rate Limits (CL or RC Limit). Once established, the Conversion Budget Cap may only increase by COLAs or legislative mandated. The Conversion Budget Cap coincides with the Waiver Span and must be reviewed each time the client is re-assessed. If the Conversion Budget Cap is reduced at re-assessment, this reduced value becomes the new Conversion Budget Cap. Complete this page for all clients exceeding the Community Casemix EW Budget Cap. A Conversion Budget Cap may never exceed the discharge NF Medicaid equivalent monthly rate, less the Maintenance Needs Allowance (MNA); or a lower amount approved at time of discharge. Any Conversion Budget Cap must be approved prior to authorization for payment. You may optionally set a Budget RS Limit for service planning which will be enforced. This Budget RS Limit may be changed at any time, but the total of all services may never exceed the Conversion Budget Cap. If the Conversion Budget Cap is new, begin by providing the NF daily rate. Next complete the CL Plan with necessary services and times. If the Error Report indicates the RS service limit or the EW Community Budget Cap is exceeded, return here to complete this form and request a Conversion Budget Cap. If the application is for a renewal and last year’s Conversion Budget Cap is blank, enter the largest Conversion Budget Cap approved in the past. Use last year’s value if that is all that is known. (This is imported from version 8.1.1 or later CL Tools.) If services will be paid by a Health Plan, follow their process for getting or reauthorizing the higher limits. Except for South County, use the ‘Validate Plan Approval’ button to approve the CL Tool for submission to DHS. Provide the Health Plan approved Conversion Budget Cap and the Budget CL Limit if given. If the entered limits are exceeded, you will need to adjust the RS Tool to stay within limits. Submit the RS Plan as usual. Once any submission errors have been corrected, the higher rate may be authorized. If the limits are to be approved by DHS, complete this page. You must complete the EW Services Authorized page in the Tool. You should provide justification for all RS services on the Audit Report, especially those indicating a warning. Once complete, submit the RS Tool in the standard way. There may be other documentation required beyond this RS Tool. Submit as you have in the past. The approved limits will be entered into the RS Tool and the Tool returned to you. If the approved limits are less than the rates developed, you will need to adjust the RS Tool to get the rates below the limits. Finally, verify the approved rate on the Error Report and re-submit the RS Plan for final acceptance.
Enter the NF Daily Rate at discharge
Current maximum combined CL and EW Services authorized Conversion Budget Cap
-$1,003.00
Date of Discharge
Maximum Non- CL EW Services to Authorize
-$1,003.00
Conversion Limit is Authorized
FALSE
Actual Non- CL Services Authorized
$0.00
Maximum CL Services to Authorize
-$1,003.00
Actual CL Services Authorized
$0.00
Total of all Authorized Services
$0.00
CL Services or Non- CL Services Over Maximum
$1,003.00
Community Case-mix EW Budget Cap (Conversion Budget Cap) Request Section Is Client making a new request to exceed the Case-mix Budget Cap?
Planned CL Rate is below the normal CL Limits for this Case Mix
`
CL Rate + EW Services are below the normal Budget Cap for this Case Mix
Is Client requesting an annual review to renew a previously approved Conversion Limit that exceeds the Case-mix Budget Cap?
Original approved Conversion EW Services Case-Mix Budget Cap limit
DHS Approval Required?
N/A
Health Plan Approval Required?
N/A
DHS Approved?
N/A
Health Plan Approval Status
no
DHS Approved CL Rate
N/A
Health Plan Approved CL Rate
N/A
Do Not Approve
DHS Approved EW Cap Submit to DHS along with other necessary documentation documentation for approval
Most Recent Health Plan Approved EW Cap
N/A
N/A
DHS Use Only Validate Plan
Confidential
2/26/2020 Not Valid for Rates or Plan
Page 9
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
Monthly Rate Guide Printed February 26, 2020 DHS 02/11/2020
Ver. 11.1.9
EW - Customized Living Services Rate Summary by Effective Date Monthly Rate
Daily Rate $
Full monthly CL Rate on: ############# Max Prior Rate is $N/A
First month Current Rates
Prior Period Rate Start Date
From Date
To Date
2/1/2020
#############
Current Period Portion
1/0/1900
1/0/1900
Total Rate For First Month
1/0/1900
1/0/1900
Prior Period Portion
-
Authorize Rate
$0.00 $0.00 $
$0.00 Monthly $ ‐
-
$
-
Monthly
This is the CL Service Rate valid for payment during the authorization period. In all cases, Providers are required to bill ONLY for the days of actual service.
Client: Provider Name:
PMI:
Provider NPI: 0 Housing with Services Establishment Address: County/Tribe: Case Manager:
,MN Health Plan:
0
Recipient Health Plan ID: 0
0
Date: Rate Guide was Mailed/Given On:
Note: Monthly and Daily ratesRates shown here. You must authorize the monthly rate shown on this Rate Guide. In all cases, Providers are required to bill ONLY for the days of actual service. You may notice that the rates shown here may be a few cents different than the rate calculated taking an old tool's rate and multiplying by the COLA factor. This is due to rounding issues with the component rates. If slightly different rates are shown here, they are correct and may be authorized.
Copyright © 2009 - 2020 Minnesota Department of Human Services (DHS). All Rights Reserved
Page 17 of 34 Valid for Rate
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 VII. Budget Worksheet
DHS 02/11/2020
Ver. 11.1.9
Client: PMI: Service Adult Day Care Adult Day Care FADS Adult Day Care Bath Family Caregiver Coaching/Counseling (plus assessment)
Unit
Provider Name and Number
Start Date
End Date
# of Units/ Month
15 minutes 15 minutes 15 minutes 15 minutes
15 minutes Family Caregiver Training and Ed 15 minutes Family Caregiver Fam Memory Care 15 minutes Case Management 15 minutes Case Management 15 minutes Case Mgt - Paraprofessional Monthly Customized Living Services (planned for a month of service) 15 minutes Companion Services 15 minutes Home Health Aide Extended Visit Home Health Telehomecare Per Waiver Yr Envir Accessibility Adapts -Home Install Per Waiver Yr Envir Accessibility Adapts -Vehicle Install Per Assess Envir Accessibility Adapts -Vehicle Assess 15 minutes Personal Care Assistant - RN Supervision 15 minutes Personal Care Assistant 1:1 15 minutes Personal Care Assistant - Shared 1:2 15 minutes Personal Care Assistant - Shared 1:3 15 minutes LPN Complex Extended 15 minutes LPN Regular Extended 15 minutes LPN shared 1:2 Extended 15 minutes RN Complex Extended 15 minutes RN Regular Extended 15 minutes RN shared 1:2 Extended Total/Month Supplies and Equipment Total/Month Supplies and Equipment Total/Month Supplies and Equipment Total/Month Supplies and Equipment Total/Month Supplies and Equipment Per Occurs Transitional Services 1-way trip Transportation Per Mile Transportation, Non-commercial Notice: Any First Month Rate is subject to change once this RS Tool is submitted if the Prior Rate on file does not match the Prior Rate provided in this RS Tool.
Page 18 of 34 Valid for Rate and Plan
1
Unit Rate $ $ $ $ -
Cost Per Month $ $ $ $ -
$ $ $ $ $ $
$ $ $ $ $ $
-
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
-
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
-
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 Total Cost Per Month From October 01, 2010 IX. Choosing Community Long Term Care
$
-
In all cases Providers are required to bill ONLY for the days of actual service Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
You can choose to receive services in the community (your home) or in a nursing facility. Were you offered this choice? You can choose the provider you prefer for services. Did the person who helped you with this plan give you a list of providers, or tell you about different providers that you could choose for services in the plan? Did you have the chance to help develop this plan, including the kinds of services you want to receive? After reading the plan, do you agree with the services, and providers, as written? You have the right to apply for Minnesota Health Care Programs (MHCP) that may help pay for services planned here, including programs such as the Elderly Waiver Program, and the Alternative Care Program. Do you wish to apply for Minnesota Health Care Programs? Client signature:
Date
Date
Signature of Person Completing this Plan
Printed: February 26, 2020
Date
Date
Yes Application for MHCP Submitted?
Support Plan was Mailed/Given On: Note: A copy of the RS Plan must be attached to the CSSP and must be provided to the Client for this to constitute a complete plan. Copyright © 2009 - 2020 Minnesota Department of Human Services (DHS). All Rights Reserved
Page 19 of 34 Valid for Rate and Plan
No
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 Individualized EW - Customized Living Customized Living Plan
DHS 02/11/2020
Client
Ver 11.1.9
Home Care Provider Name
PMI
Provider NPI 0 Housing with Services Address
County/Tribes
0
Health Plan 0
0
Case Manager
Primary Diagnosis 00000000
Case Manager Phone# -
, MN
Recipient 0
Case Manager Email Start Date for CL 1/0/1900
In CL Plan?
Score
Light housekeeping Heavy housekeeping
no no
N/A N/A
Total Hours/ Month 0.00 0.00
Laundry - personal
no
N/A
0.00
Laundry-linens
no
N/A
0.00
Shopping
no
N/A
0.00
In CL Plan?
Score
no
N/A
In CL Plan?
Score
Homemaking
Estimation of Time for Purposes of Rate Computation
HwS Consultation Verif. Code
Breakfast prep and serve
no
N/A
0.00
Lunch prep and serve
no
N/A
0.00
Supper prep and serve
no
N/A
0.00
Snack prep and serve
no
N/A
0.00
Food Preparation
Individual Assistance w Meal Prep in Own Apartment
Food Preparation and Service
Service Description
Client
Client
Service Description
Total Hours/ Month 0.00
Service Description
Client
Page 20 of 34 Valid for Rate and Plan
# of Meals/ Snacks Month
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
In CL Plan?
Score
Making appts
no
N/A
0.00
Arrange Non-medical Transportation
no
N/A
0.00
Money Mgt
no
N/A
0.00
Socialization - Individual
no
N/A
0.00
Group Socialization: 1 Staff to 25 Residents
no
N/A
0.00
Group Socialization: 1 Staff to 6 12 Residents
no
N/A
0.00
Group Socialization: 1 Staff to 13 20 Residents
no
N/A
0.00
Group Socialization: 1 Staff to over 20 Residents
no
N/A
0.00
In CL Plan?
Score
Driver 1:1 Non-medical Transportation
no
N/A
0.00
Group Transportation: 2 riders
no
N/A
0.00
Group Transportation: 3 - 5 riders
no
N/A
0.00
Group Transportation: 6 - 10 riders
no
N/A
0.00
Group Transportation: Over 10 riders
no
N/A
0.00
In CL Plan?
Score
Supportive Services
Non-Medical Transportation
Mileage
1:1 mileage Group Mileage 2 riders Group Mileage 3 - 5 riders Group Mileage 6 - 10 riders Group Mileage over 10 riders
no no no no no
Service Description
Client
Service Description
Client
Service Description
Client
Total Hours/ Month
Total Hours/ Month
Total Hours/ Month
N/A
0.00
N/A
0.00
N/A
0.00
N/A
0.00
N/A
0.00
Page 21 of 34 Valid for Rate and Plan
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
In CL Plan?
Score
Dressing
no
N/A
Grooming
no
N/A
Bathing
no
N/A
0.00
Eating
no
N/A
0.00
Continence Care
no
N/A
0.00
Walking
no
N/A
0.00
Assistance With Use of Wheelchair
no
N/A
0.00
Transferring
no
N/A
0.00
Positioning
no
N/A
0.00
In CL Plan?
Score
Personal Care
Med Administration or assistance with self-administration
no
N/A
0.00
Verbal or Visual Medication Reminders
no
N/A
0.00
no
N/A
0.00
no
N/A
0.00
no
N/A
0.00
no
N/A
0.00
no
N/A
0.00
no
N/A
0.00
no
N/A
0.00
no
N/A
0.00
no
N/A
0.00
Other Delegated Health Services
Insulin Injections Therapeutic Exercises Delegated clinical monitoring Delegated nursing tasks
Service Description
Client
Total Hours/ Month 0.00
Service Description
Client
Page 22 of 34 Valid for Rate and Plan
Total Hours/ Month
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
In CL Plan?
Score
Medication Mgt by Licensed Nurse
Med Set Ups and Monitoring
no
N/A
0.00
Insulin Draws
no
N/A
0.00
In CL Plan?
Score
Sensory and Communication Status Hearing
N/A
0
Vision
N/A
0
Communication
N/A
0
Service Description
Total Hours/ Month
Client
Service Description
Client
Personal Security
Client
Awareness of need for assistance Will the person summon assistance when necessary?
If yes, how will they summon help?
0
What mechanism will they use?
no no
0
no If no, how will staff know when the person needs assistance?
Self-Preservation Can the person evacuate in an emergency?
0
If no, what is the emergency plan?
Emergency Backup Planning Hospital Name Physician Name Emergency Contact Name
Hospital Phone Physician Phone ER Contact Phone
Emergency Contact Relationship ER Backup Plan Details
If Client needs emergency medical or psychiatric services, call 911, admit to the Hospital listed, notify the emergency contact listed, and if necessary, the listed physician. In addition:
Page 23 of 34 Valid for Rate and Plan
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 Active Cognitive or Behavioral Support
In CL Plan?
Score
Implementation of written individual plan to address:
no
N/A
no
N/A
no
N/A
no
N/A
no
N/A
no
N/A
no
N/A
no
N/A
no
N/A
:
no
N/A
0.00
:
no
N/A
0.00
:
no
N/A
0.00
Wandering: Orientation issues : Anxiety: Verbal aggression: Physical aggression: Repetitive behavior: Agitation: Self-injurious behavior: Property destruction:
Service Description
Client
Total Hours/ Month 0.00
0.00
Summary of Supervisory Support Service Description
Client
Frequency of contact. Indicate expected minimum as well as frequency at different times during the day/night.
Mode of contact : Include description of how resident will summon assistance or how staff will know when assistance is required.
Competencies of Staff Implementing Active Cognitive and/or Behavioral Support
Training and Supervision of Staff Implementing Active Cognitive and/or Behavioral Support
Page 24 of 34 Valid for Rate and Plan
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
Summary of Estimated Monthly Hours of Service Column1 By Type
24 Hour Support Needed for: Toileting Dependency
no
Transferring Dependency
no
Positioning Dependency
no
Active Behavioral Support Dependency
no
Orientation Dependency
no
Clinical Monitoring Dependency
no
Med Admin + 50 hrs/mo of service
no
Column2
Column3 Per Month
Per Week
$
-
$
-
$
-
Home Care Aide Services:
$
-
$
-
$
-
Home Health Aide Services: Medication Setups by Licensed Nurse: Estimated combined hours of customized living services:
$ $
-
$ $
-
$ $
-
$
-
$
-
$
-
Notice: Any First Month Rate is subject to change once this RS Tool is submitted if the Prior Rate on file does not match the Prior Rate provided in this RS Tool.
Cost of Customized Living Services per mo.
From 01/00/00 To 01/00/00
End Date
$
1/0/1900
-
Monthly Cost of Non- CL EW Services
$
-
In all cases, Providers are required to bill based on the amounts in the Rate Guide and ONLY for the days of actual service provided. Client Notes
Printed: February 26, 2020
Per Day
Home Management / Homemaking and Support Services:
Date
Customized Living Plan was Mailed/Given On:
Copyright © 2009 - 2020 Minnesota Department of Human Services (DHS). All Rights Reserved
Page 25 of 34 Valid for Rate and Plan
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
DHS 02/11/2020 Ver. 11.1.9
EW Residential Monthly Services Rate Limits Service Limit Effective Dates:
Case Mix A B C D E F G H I J K L L* V
Community Budget Cap as of $3,457 $3,931 $4,614 $4,763 $5,255 $5,415 $5,587 $6,302 $6,469 $6,897 $8,036 $3,457 $2,662 $29,237 Based on Assessment Change Date
24 Hr CL Rate Limit $2,872 $3,315 $3,899 $4,070 $4,528 $4,696 $4,884 $5,486 $5,640 $6,032 $7,046 $2,872 N/A $25,625
Wednesday, January 01, 2020
Customized Living (Not 24 Hr) Rate Limits Statewide $1,543 $1,754 $2,058 $2,261 $2,347 $2,420 $2,497 $2,815 $2,903 $3,080 $3,592 $1,543 $1,158 $13,871
Group 1 Group 2 $1,412 $1,446 $1,563 $1,612 $1,780 $1,865 $1,918 $1,967 $2,084 $2,122 $2,168 $2,168 $2,250 $2,305 $2,524 $2,571 $2,594 $2,664 $2,733 $2,804 $3,166 $3,199 $1,412 $1,446 $1,058 $1,086 $11,934 $12,231 Based on CL Start Date
Group 3 $1,683 $1,850 $2,222 $2,347 $2,566 $2,607 $2,746 $3,100 $3,184 $3,410 $3,890 $1,683 $1,263 $14,462
New/Assessed > 08/31/11 New/Assessed > 06/30/13
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
EW Residential Daily Services Rate Limits
Case Mix A B C D E F G H I J K L L* V
Wednesday, January 01, 2020 y Service Limit Effective Dates: Budget Cap 24 Hr CL Customized Living (Not 24 Hr) Rate Limits as of Rate Limit 02/26/2020 Statewide Group 1 Group 2 Group 3 $113.58 $94.36 $50.69 $46.39 $47.51 $55.29 $129.15 $108.91 $57.63 $51.35 $52.96 $60.78 $151.59 $128.10 $67.61 $58.48 $61.27 $73.00 $156.48 $133.72 $74.28 $63.01 $64.62 $77.11 $172.65 $148.76 $77.11 $68.47 $69.72 $84.30 $177.91 $154.28 $79.51 $71.23 $71.23 $85.65 $183.56 $160.46 $82.04 $73.92 $75.73 $90.22 $207.05 $180.24 $92.48 $82.92 $84.47 $101.85 $212.53 $185.30 $95.38 $85.22 $87.52 $104.61 $226.60 $198.18 $101.19 $89.79 $92.12 $112.03 $264.02 $231.49 $118.01 $104.02 $105.10 $127.80 $113.58 $94.36 $50.69 $46.39 $47.51 $55.29 $87.46 N/A $38.05 $34.76 $35.68 $41.49 $960.56 $841.89 $455.72 $392.08 $401.84 $475.14 Based on Based on CL Start Date Assessment Change Date
New/Assessed > 08/31/11 New/Assessed > 06/30/13
Copyright © 2009 - 2020 Minnesota Department of Human Services (DHS). All Rights Reserved
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
Service Component Rates DHS 02/11/2020 Effective Date
Service Category
January 1, 2020
Ver. 11.1.9
Hourly Unit
Home Management/Homemaking and Support Services
$17.8400
Home Care Aide Services including Active Behavioral Support.
$23.7200
Home Health Care Aide Services/Delegated Nursing Services
$27.0400
Medication Setups by Licensed Nurse
$33.9700
Mileage rate
Per Mile $0.5200
Summoning Device
$29.0000
Breakfast
$3.6700
Lunch
$4.5700
Supper
$4.5700
Snack
$0.4500 Socialization Hourly Rate $5.1000
Shared Services Socialization 1 Staff to 2-5 Residents Socialization 1 Staff to 6 - 12 Residents
$1.9900
Socialization 1 Staff to 13 - 20 Residents
$1.0900
Socialization 1 Staff to over 20 Residents
$0.5900 Driver Hourly Rate $8.9200
/Month
Group Mileage Rate $0.2700
Group Transportation
# of Riders 2
Group Transportation
# of Riders 3 - 5
$4.4600
$0.1300
Group Transportation
# of Riders 6 - 10
$2.2400
$0.0800
Group Transportation
# of Riders - More than 10
$1.1900
$0.0400
Copyright © 2009 - 2020 Minnesota Department of Human Services (DHS). All Rights Reserved
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
DHS 02/11/2020
EW Service Name
Unit Adult Day Care 15 minutes Adult Day Care FADS 15 minutes Adult Day Care Daily Adult Day Care FADS Daily Adult Day Care Bath 15 minutes Caregiver Training and Ed 15 minutes Family Caregiver Coaching/Counseling (plus asses15 minutes Family Caregiver Training and Ed 15 minutes Family Caregiver Fam Memory Care 15 minutes Case Management 15 minutes Case Mgt - Paraprofessional 15 minutes CDCS Background Checks One print CDCS Mandatory Case Mgt 15 minutes Chore Services 15 minutes Companion Services 15 minutes CDCS Per Service Customized Living Services (planned for a month oMonthly Home Delivered Meal 1Meal/Day Home Health Aide Visit Home Health Aide Extended 15 minutes Home Health - Skilled Nursing Visit Home Health Telehomecare Visit Homemaker 15 minutes Homemaker Per Diem Per Waiver Yr Envir Accessibility Adapts -Home Install Per Assess Envir Accessibility Adapts -Home Assess Per Waiver Yr Envir Accessibility Adapts -Vehicle Install Per Assess Envir Accessibility Adapts -Vehicle Assess Personal Care Assistant - RN Supervision 15 minutes Personal Care Assistant 1:1 15 minutes Personal Care Assistant - Shared 1:2 15 minutes Personal Care Assistant - Shared 1:3 15 minutes LPN Complex Extended 15 minutes LPN Regular Extended 15 minutes LPN shared 1:2 Extended 15 minutes RN Complex Extended 15 minutes RN Regular Extended 15 minutes RN shared 1:2 Extended 15 minutes Respite Certified Facility Per Diem Per Diem Respite, Hospital Respite, In-home 15 minutes Respite, In-home Per Diem Respite, Out of home 15 minutes Respite, Out of home Per Diem Supplies and Equipment Total/Month Transitional Services Per Occurs Transportation 1-way trip Transportation, Non-commercial Per Mile
EW Service Information Proc Code S5100 S5100 S5102 S5102 S5100 S5116 S5115 S5115 S5115 T1016 T1016 T2040 T2041 S5120 S5135 T2028 T2030/ S5170 T1021 T1004 T1030 T1030 S5130 S5131 S5165 T1028 T2039 T2039 T1019 T1019 T1019 T1019 T1003 T1003 T1003 T1002 T1002 T1002 H0045 H0045 S5150 S5151 S5150 H0045 T2029 T2038 T2003 S0215
Mod Mod 1 2 U7 U7 TF TF TG UC TF
GT
UD UA UC TT HQ TG UC TT TG UC TT
UB
UC UC
Up To Rate Limit as of 02/26/2020 $ 3.45 $ 3.45 N/A N/A $ 7.65 N/A $ 18.11 $ 18.11 $ 18.11 $ 25.46 UC $ 9.39 $ 25.00 Up to Required Case MGT C $ 4.15 $ 2.57 Up to CDCS Cap Case Mix C See CL Service Limits $ 7.06 N/A $ 8.01 N/A N/A $ 4.84 N/A EAA Services <= $20,0000 EAA Services <= $20,0000 EAA Services <= $20,0000 EAA Services <= $20,0000 N/A $ 4.45 UC $ 3.34 UC $ 2.93 UC $ 7.84 0 $ 6.69 UC $ 5.02 UC $ 10.44 $ 8.71 UC $ 6.53 NF's Per diem for the Recipie $ 147.85 $ 5.77 $ 103.85 $ 5.77 $ 103.85 Up to Budget Cap Up to Budget Cap $ 20.21 $ 0.58
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020
Estimated Hours of CL Services per Month
Ver. 11.1.9
DHS 02/11/2020 Client PMI 00000000
HM/SS Tasks housekeeping
RS Plan Form Ref 40
laundry
43
shopping
44
indiv meal prep
47
making appointments
55
arranging transportation
56
money management
57
congregate breakfast
49
congregate lunch
50
congregate supper
51
congregate snack
52
socialization
59-63
transportation
67-71
Confidential
Rate
Total Hours
Hours/Mo
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Home Health Aide-Like Tasks eating
RS Plan Form Ref Hours/Mo 84 0.00
continence care
85
walking
86
transferring
88
positioning
89
medication administration
92
insulin injections
94
therapeutic exercises
95
delegated clinical monitoring
96
other delegated tasks
97
other delegated tasks
98
other delegated tasks
99
other delegated tasks
100
other delegated tasks
101
other delegated tasks
102
2/26/2020 Not Valid for Rates or Plan
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
HM/SS
0.00
$17.84
HCA
0.00
$23.72
HHA Med Setup
0.00 0.00
$27.04 $33.97
Total Hrs
0.00
Page 33
Selected Pages from EW Residential Services - Workbook - Version 11.1.9 (XLSM) – Released 2/11/2020 Home management hours/month:
Home Care Tasks dressing, bathing and gro wheeling
RS Plan Form Ref 81-83 87
medication reminders 93 Active Behavioral or Cognitive Support Wandering 129 Orientation issues 130 Anxiety
131
Verbal aggression
132
Physical aggression
133
Repetitive behavior
134
Agitation
135
Self-injurious behavior
136
Property destruction
137
Other
139
Other
140
Other
141
Confidential
0.00
Home health aide-like hours/month: Med setups by licensed nurse Ref
Hours/Mo
Med set ups
105
0.00 0.00 0.00
Insulin draws
106
Med setup hours/month:
0.00 Hrs/Mo
0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2/26/2020 Not Valid for Rates or Plan
Page 34
2021 NURSE MANAGERS’ EDUCATION SERIES
2019 Updates to Comprehensive Home Care Statutes The 2019 Minnesota legislature passed several “tweaks” to the comprehensive home care statutes. Most of the changes were made to improve the functionality of home care regulations. All these changes except one (noted below) go into effect on August 1, 2019. They then will be carried over and applied to the Assisted Living Licensure law that goes into effect on August 1, 2021. The new language affects 28 areas of home care regulations: 1. The definition of Medication Administration has been revised. The new definition is: "Medication administration" means performing a set of tasks to ensure a client takes medications, and includes that include the following: i. checking the client's medication record; ii. preparing the medication as necessary; iii. administering the medication to the client; iv. documenting the administration or reason for not administering the medication; and v. reporting to a registered nurse or appropriate licensed health professional any concerns about the medication, the client, or the client's refusal to take the medication. Implication: Verify your policy and procedure include this new definition. 2. There is a new definition of Medication Reconciliation: "Medication reconciliation" means the process of identifying the most accurate list of all medications the client is taking, including the name, dosage, frequency, and route by comparing the client record to an external list of medications obtained from the client, hospital, prescriber, or other provider. Implication: Create a Medication Reconciliation policy that includes this new definition. Medication Reconciliation is a new step required as part of any medication management that is conducted (see #20). 3. The definition of Standby Assistance has been modified: "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 cuing to assist a client with an assistive task by providing cues, oversight, and minimal physical assistance. Implication: Modify your definition of standby assistance that is included in any policy or procedure. This change will help Basic Home Care licenses to continue caring for certain clients who would fall under this expanded definition. 4. Clarification that an approved Change of Ownership (CHOW) results in the receipt of a full home care license, not a temporary home care license (unless the selling entity only had a temporary license at the time of the CHOW). Implication: None – this is what has been occurring but was not clear in current language. 5. Clarification that when a CHOW occurs, the new owner can treat the employees acquired as if nothing had changed, in respect to orientation, training, tuberculosis testing, background
studies, and competency testing and training on applicable home care policies, except for policies that differ from the prior license owner. Changes in policy must be trained and tested within 90 days after the date of the change in ownership. In other words, a CHOW includes the employee records such records are considered current for the new owner. Implication: None – This is what has been occurring but representatives from MDH gave varying answers at times, so we memorialized the correct answer in the update statute. 6. A new fine of $1,000 will be assessed if a temporary home care licensee fails to notify MDH within 5 days after they begin providing home care services to their first client. This is effective May 31, 2019. Implication: If you start a new home care agency, and you fail to inform MDH within 5 days after admitting your first home care client, you can expect to receive a $1,000 fine from MDH. The notification requirement is the same, but the fine is new. NOTE – in effect on 5-31-19. 7. Permits temporary licenses to be extended beyond one year under certain circumstances. Implication: Current language gave MDH few options if they determined that substantial compliance did not exist at the time of the initial survey. This permits MDH to extend the temporary license if a reconsideration is filed, conditions are applied, or other actions are taken. 8. Permits MDH to extend temporary licenses with conditions for up to 90 days when substantial compliance is not determined on the temporary license survey. Implication: Current language gave MDH few options if they determined that substantial compliance did not exist at the time of the initial survey. This permits MDH to extend the temporary license if a reconsideration is filed, conditions are applied, or other actions are taken. 9. Allows temporary licenses to submit reconsideration requests regarding licensing orders identified on the temporary license survey. Implication: Current language gave MDH few options if they determined that substantial compliance did not exist at the time of the initial survey. This allows providers caught in that situation to request a reconsideration of the survey findings. 10. Clarifies that when a temporary license has their “full” license denied, they are permitted to continue operating as a home care provider when (1) a reconsideration request is in process, (2) an extension of the temporary licenses is being negotiated, (3) the placement of conditions on the temporary license are being negotiated, or (4) the transfer of home care clients from the temporary license to a new home care provider is in progress. Implication: Current language gave MDH few options if they determined that substantial compliance did not exist at the time of the initial survey. This permits MDH to extend the temporary license if a reconsideration is filed, conditions are applied, or other actions are taken.
It also permits the provider to continue operating if the license has been revoked while clients are being moved or a new home care licensee is being brought in to take over the service plans. 11. Requires that MDH conduct a full home care survey within six months after the issuance of a new license resulting from a change of ownership (CHOW). Implication: Current language did not require any survey after a CHOW was executed. MDH had enough examples of sales resulting in substantial decreases in regulatory compliance that this language was added. 12. Clarifies that when a home care license has conditions applied to the license, or the license is being suspended or revoked, the licensee may continue operating during the period home care clients are being transferred to other providers. Implication: Permits continuity of care during these situations. 13. Requires that TB screening results are included in employee records. Implication: Providers may have these records in separate employee medical/health files. Surveyors are permitted to review for TB compliance but are not permitted to request employee medical or health files. 14. Throughout the home care regulations, replaces terms such as “initiation of” with “date that services are first provided to the client”. Examples include: notice of the bill of rights, statement of home care services, 30-day time limit to conduct supervision of new staff (after first performing delegated tasks for clients), 5 and 14-day deadlines for assessments, 14-day deadline for finalization of a written service plan, etc. Implication: None. This has been the communicated position of MDH, but at times surveyors were confused and tried to apply the date admission agreements were signed as the trigger for counting days. 15. Clarifies that if home care services are provided to a client prior to an assessment conducted by an RN, an RN must complete a temporary plan and orientate staff assigned to deliver the services identified in the temporary plan. Implication: None. This was not address in current statutes but has been the expectation of both providers and regulators. 16. Makes the following changes to elements required to be in the written service plan: Replaces: “the frequency of sessions of supervision of staff and type of personnel who will supervise staff” with “the schedule and methods of monitoring staff providing home care services”. The concept is the same, but the language is clearer.
Implication: You may need to change your policy and procedure, and possibly the description on your service plan. Provides additional clarify of what is required. 17. Eliminates the requirement to include “identification of and information as to who has authority to sign for the client in an emergency.” Note – The service plan must still include “names and contact information of persons the client wishes to have notified in an emergency or if there is a significant adverse change in the client's condition.” Implication: Current language was very confusing and resulted in a significant number of correction orders during surveys. Therefore, the requirement was eliminated. Policies and procedures may need to be updated, as well as the format for service plans. 18. Clarifies that the requirement for the comprehensive home care provider to identify how it will ensure security and accountability for the overall management, control, and disposition of medications in compliance with state and federal regulations applies only to those medications that are being managed, stored, and secured by the comprehensive home care provider. Implication: Clarifies that this requirement only applies to those medications you have accepted responsibility for. 19. Adds a requirement that the comprehensive home care provider provide instructions to the client or client's representative on interventions to manage the client's medications and prevent diversion of medications. Implication: Documentation on the medication assessment or medication administration form, or similar, will need to indicate that you communicated to the client/family how controlled substances will be stored to prevent diversion. 20. Adds a requirement that for each client receiving medication management services from a comprehensive home care provider, a medication reconciliation must be completed when a licensed nurse, licensed health professional, or authorized prescriber is providing medication management. Implication: Policy and procedures for medication management services will need to be modified to include medication reconciliation (see definition in #2). Nurses will need to be trained on conducting and documenting medication reconciliation. 21. Expands the timeframe to provide medications for clients who will be away from home from 120 hours to seven calendar days. Implication: Extends the time from 5 days to 7 days. Uses days instead of hours for clarity. Policy and procedures will need to be updated.
22. Adds a new requirement for clients who will be away from home. The policy and procedure must now include how the unlicensed staff must document in the client's record any unused medications that are returned to the provider, including the name of each medication and the doses of each returned medication. Implication: You will need to update your policy and procedures. This was an identified weakness in current regulations. 23. Clarifies that treatment and therapy orders must be renewed every 12 months. Implication: You will need to update your policy and procedures. This was an identified weakness in current regulations. 24. Clarifies that orientation of new staff to the provider's policies and procedures related to the provision of home care services is limited to those policies and procedures that are applicable to the new staff person. No need to train in areas outside the scope of the new employees’ position! Implications: Clarifies the obvious. No need to train on policies and procedures that are not applicable to a new employee. 25. Creates a new section (144A.4798) titled Disease Prevention and Infection Control. This new section bundles the following topics that were previously spread out within the home care statues: i. TB infection control program ii. Reporting of communicable diseases iii. Establishing and maintaining an effective infection control program Implication: Consider creating a new Disease Prevention and Infection control binder that has all the applicable policies and procedures in it. None of the three elements are new – they are now being bundled together for clarify and accuracy of survey reports. 26. Clarifies that public members of the Home Care and Assisted Living Program Advisory Council may include persons who have received home care services within five years of the application date. Implication: Expands the scope of who can be a member of this advisory council. 27. Deletes the transition period for establishing integrated licenses (the period ended June 30, 2015). Implication: This transition period has expired, so we removed it from the statutes.
28. Deletes the home care license transition period that was in place between October 1, 2013 and June 30, 2015. Implication: This transition period has expired, so we removed it from the statutes.
2019 ASSISTED LIVING LICENSURE & OLDER ADULT PROTECTIONS LEGISLATION
SENIORS AT THE CENTER OF THE
SOLUTIONS SAFETY
Seniors and their families should have confidence in the care they receive and the laws in place to protect older & vulnerable adults.
CHOICE
Seniors should be able to choose settings that promote independence and best meet their needs, interests, and lifestyles.
ACCESS
Seniors need access to senior services in all places they call home to remain connected to family and community.
GOALS
Together, with a broad coalition of consumer advocates, regulators, and senior living providers, we have worked to develop solutions that will lead to great TRANSPARENCY, ACCOUNTABILITY, AND CONFIDENCE THAT SENIORS ARE RECEIVING SAFE, QUALITY CARE.
WHAT’S NEXT The Minnesota Legislature has adjourned. Assuming that Governor Walz signs the bills into law, the implications of the 2020-2021 biennial budget and policy bills adopted this year are numerous. There will be many opportunities for you to find out more: June Region Forums (seven locations across the state) | www.careproviders.org/regions Legislative update webinar on June 19, 2019 | www.careproviders.org/learning Electronic monitoring webinar, Fall 2019 | www.careproviders.org/learning Care Providers of Minnesota 2019 Convention and Exposition | www.careproviders.org/convention
CARE PROVIDERS OF MINNESOTA | 2019 ASSISTED LIVING LICENSURE & OLDER ADULT PROTECTIONS LEGISLATION
ASSISTED LIVING LICENSURE
SUMMARY
ASSISTED LIVING LICENSURE FRAMEWORK
The licensure framework will apply to all assisted living settings; there are specific exemptions from this licensure such as transitional housing, residential settings under 245A, and privately-owned communities such as co-ops. There will be two levels of licensure: assisted living and assisted living with dementia care. The license will cover all services, unit lease, and physical plant requirements. Residents will still have the option to receive services from an outside provider. New licensure fees will begin in 2021 and are set at a level to support surveys every other year. Assisted living fees will be $2,000 per building plus $75.00 per resident. Assisted living with dementia care fees will be $3,000 plus $100.00 per resident. There will be a rule-making process starting on July 1, 2019 to detail out some of the specific provisions.
MIN NIMUM ASSISTEDD LIVING FACILITY QUIREMENTS REQ
AUGUST 1, 2021: ASSISTEDD LIVING LICENSSURE
The 150-page assisted living licensure bill is a compilation of current and new laws intended to establish clarity of expectations for assisted living facilities and guidance to the state agency responsible to license such entities and survey for compliance. Knowing all of the requirements will be essential prior to August 1, 2021, however, included are some key areas of change for your review— details about each of the sections and resources for compliance will be available long before implementation.
careproviders.org/advocacy
This section sets out general expectations of all assisted living facilities such as: distributing the bill of rights; providing service in compliance with the Nurse Practice Act; developing and implementing a staffing plan; ensuring one or more persons are available 24 hours/day who are awake; a listing of services that must be provided or made available such as food, housekeeping, and laundry; a list of policies and procedures; requiring an infection control program; requiring resident and family councils; and delineating a resident grievance procedure. It should be noted that many of these requirements are already in place under the comprehensive home care license law.
ASSISTED LIVING BILL OF RIGHTS
The comprehensive home care bill of rights was used as the base for the new assisted living bill of rights with a few additions/edits. For example, the right to organize and participate in resident and/or family councils was inserted as a right.
BUSINESS OPERATIONS
Several requirements can be found under this section of law. • Several provisions related to handling resident finances and property, including a requirement to provide a final statement and funds within 30 days of a termination or death • Facility must develop and implement an individualized abuse prevention plan for each resident • Specific employee records must be maintained • Facility must establish and maintain a comprehensive tuberculosis (TB) infection control program • Written emergency disaster plan and emergency disaster training for all staff
CARE PROVIDERS OF MINNESOTA | 2019 ASSISTED LIVING LICENSURE & OLDER ADULT PROTECTIONS LEGISLATION
MEDICATION MANAGGEMENT
Much of the language regarding medication management for comprehensive home care settings was moved into the assisted living law. An assisted living facility that provides medication management services must develop, implement, and maintain specific medication management policies and procedures. The law specifies: who can delegate medication administration and how; documentation requirements; medication management for residents who will be away from home; and storage and disposition of medications.
ASSISTED LIVING LICENSURE
SUMMARY
LICEN NSE APPLICATIONS & CONTROLLING INDIVIDUAL RESTTRICTIONS
The new law gives the commissioner of health authorization to deny licensure—initial or renewal—under certain circumstances such as prior history with nursing facilities or other assisted living facilities; and establishes stays of revocations or non-renewals under certain conditions.
PHYSICAL PLANT
On or after August 21, 2021, MDH engineering will be reviewing & must approve architectural & engineering plans for new AL construction; MDH engineering will be conducting on-site inspections of each licensed AL building, on a frequency of at least once every two years. It is our assumption this building inspection will coincide with the survey of the licensed AL facility. On or after August 21, 2021, each licensed AL facility must have a comprehensive fire protection system to include the following: • Approved sprinkler system or smoke detectors in each occupied room • Portable fire extinguishers • Physical environment kept in a “continuous state of good repair and operation” • A maintenance & repair program must be in place • Fire drills conducted in accordance with Life Safety Code (one every two months, with two being at night) • Existing buildings must be maintained in a manner that does not constitute a distinct hazard to life • New construction must meeting the following requirements: • Facilities with six or more residents must meet the AL requirements in the Facility Guidelines Institute (FGI) “Guidelines for Design & Construction of Residential Health, Care & Support Facilities” • Facilities with six or more residents must comply with the Residential Board & Care Occupancy chapter of the NFPA 101 (Life Safety Code) • Licensed AL with dementia care facilities that have a secured unit have the following additional requirements: • Compliance with the Healthcare (limited care) chapter of the NFPA 101 • A hazard vulnerability analysis or safety risk assessment must be completed to identify property & ground risks for residents & mitigation strategies to protect residents from harm • Be fully sprinkled by August 1, 2029
ASSISTTED LIVING CONTRACT REQUIREMENTS
All current contracts with residents will need to be revised to take into account a singular license (rather than a separate lease and service agreement), as well as the specific provisions that must be included in the contract included in this law. The language in the bill does not preclude a facility from creating a two-part contract with one part describing the lease expectations and the other part delineating the services.
RESIDEN NT ASSESSM MENT & SERVICCES Key to ensuring we minimize the numbers of involuntary terminations or nonrenewals of housing is making sure those moving into our assisted living facilities can be served; that there is an awareness of service needs; and that there is a process in place for reassessments and communication as needs change. Each resident moving in who will be receiving services from the assisted living facility must have an assessment conducted by a registered nurse prior to the move-in date, or contract execution date, whichever is earlier. Resident reassessment needs to be conducted within two weeks after initiation of services and a written service plan developed.
CARE PROVIDERS OF MINNESOTA | 2019 ASSISTED LIVING LICENSURE & OLDER ADULT PROTECTIONS LEGISLATION
SURVEYSS & FINES
Surveys will be conducted at least once every two years, with details on when follow-up surveys will be required/optional. The law delineates the fines associated with non-compliance at each level and defines the level and scope of violations. The commissioner MAY issue immediate fines for level 3 and level 4 correction orders or findings of maltreatment. The law further specifies a reconsideration of correction orders and fines process and the various remedies available to the commissioner for enforcement.
ASSISTED LIVING LICENSURE
SUMMARY
NEW W PROCEDURES FOR CO ONTRACT TERMINATIONS & CONSUMER APPEAL RIGHTS There are new notice and discharge planning requirements for situations that require a contract termination and a new appeals process with the Office of Administrative Hearings for consumers wishing to contest a contract termination. There are separate terms and processes for termination for nonpayment, termination for violations of the contract, and expedited termination where there are health and safety issues involving other residents or facility staff. Emergency relocations are allowed with specific notice requirements; however, a facility shall not refuse to allow a resident to return if a termination of housing has not been effectuated. For situations where a facility just decides not to renew a resident’s housing under a contract, there are requirements that the facility either give 60 days’ notice of the nonrenewal and help with relocation planning or follow the termination procedure. Regardless of how a resident is moved from the facility (termination, service reduction, planned closure), there are requirements for facilities to help coordinate the move, including development of a relocation plan that includes a “safe location.”
RETALIATION PROHIBITED
Retaliation against residents/families/employees was an important issue for the consumer advocates as there were many examples provided where the families felt they were being retaliated against if they complained formally or informally; or placed an electronic monitoring device in a resident’s room. This new law states that an assisted living facility or agent of the facility may not retaliate against a resident, or employee if the resident, employee, or person acting on behalf of the resident files a good faith complaint; grievance; maltreatment report; or places an electronic monitoring device in the room. What constitutes retaliation against a resident is further defined and includes actions such as: discharges or transfers; restrictions or prohibition of access; restriction of rights; unauthorized removal or tampering of electronic monitoring devices. Retaliation against an employee for reporting complaints/grievances includes unwarranted discharge or transfer; demotions or refusal to promote; reduction in compensation; imposition of discipline. The commissioner can take enforcement action if it was determined that a retaliatory action took place within 30 days of a complaint or related activity happening.
RESIDENT QUALIITY OF CARE & OUTCO OMES IMPROVEMENT TAASK FORCE
The task force is to be established by July 1, 2020, with specified members and the goal of periodically providing recommendations on changes needed to promote safety and quality improvement practices in long-term care settings and with long-term care providers.
DEMENTIA CARE
Additional requirements are identified for assisted living facilities that advertise, market, or otherwise promote 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. Facilities with this designation must demonstrate the capacity to manage residents with dementia, comply with the additional staffing and staff training requirements, and provide some specific services as needed by each resident.
careproviders.org/advocacy CARE PROVIDERS OF MINNESOTA | 2019 ASSISTED LIVING LICENSURE & OLDER ADULT PROTECTIONS LEGISLATION
ASSISTED LIVING LICENSURE
SUMMARY
“I’M OKAY” CHECKS
Concerns about independent living settings providing services without accountability and transparency for consumers led to a section of law titled “I’m okay” check services. Unlicensed settings—which provide sleeping accommodations to one or more adults, at least 80 percent of whom are 55 years of age or older, and offering or providing for a fee any supportive services (like housekeeping, meals, or laundry)—must disclose in a written contract whether they will or will not offer “I’m okay” checks. If the resident contracts for “I’m okay” check services in this otherwise independent living setting, there must be details on the nature, extent, and frequency in the contract.
NEW QUALIFICATIONS FOR ASSISTED LIVING DIREECTORS
Assisted living directors will be ultimately in charge of the assisted living facility, so the law builds in initial requirements and ongoing training for this position. The examination and continuing education will be monitored by the Board of Executives for Long-Term Services and Supports (formerly the nursing home examiner board). In order to be qualified to serve as an assisted living director, an individual must: 1. have completed an approved training course and passed an examination approved by the board that is designed to test for competence and that includes assisted living facility laws in Minnesota; 2. (i) currently be licensed as a nursing home administrator or have been validated as a qualified health services executive by the National Association of Long-Term Care Administrator Boards; and (ii) have core knowledge of assisted living facility laws; or 3. apply for licensure by July 1, 2021, and satisfy one of the following: • have a higher education degree in nursing, social services, or mental health, or another professional degree with training specific to management and regulatory compliance; • have at least three years of supervisory, management, or operational experience and higher education training applicable to an assisted living facility; • have completed at least 1,000 hours of an executive-in-training program provided by an assisted living director licensed under this subdivision; or • have managed a housing with services establishment operating under assisted living title protection for at least three years.
Together, we developed solutions. Seniors should be able to live independently for as long as they are able, with access to the safe, quality care options they need, in the communities they call home. Protection of vulnerable adults lies at the very core of our work and is best accomplished through partnerships. We have worked to ensure that we have a system that balances the values of independence and choice with the values of safety and protection.
CARE PROVIDERS OF MINNESOTA | 2019 ASSISTED LIVING LICENSURE & OLDER ADULT PROTECTIONS LEGISLATION
CARE PROVIDERS OF MINNESOTA’S
ADVOCACY TEAM
Toby Pearson
Vice President of Advocacy tpearson@careproviders.org 952-851-2480
Nicole Mattson
Vice President of Strategic Initiatives nmattson@careproviders.org 952-851-2482
Patti Cullen, CAE
Todd Bergstrom
Doug Beardsley
Jill Schewe
President/CEO pcullen@careproviders.org 952-851-2487
Vice President of Member Services pdbeardsl@careproviders.org 952-851-2489
facebook.com/CPofMN twitter.com/CPofMN
CARE PROVIDERS OF MINNESOTA 7851 Metro Parkway, Suite 200 Bloomington, MN 55425
Director of Research & Data Analysis tbergstrom@careproviders.org 952-851-2486
Director of Assisted Living, Housing & Home Care jschewe@careproviders.org 952-851-2484
Kaila May
Communications & Website Specialist kmay@careproviders.org 952-851-2495
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December 30, 2019
www.careproviders.org 1-952-854-2844 MN Toll-Free 1-800-462-0024
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Retaliation Prohibited in Registered Housing with Services Establishments with Assisted Living Title Protection Effective August 1, 2019, and expires July 31, 2021 [144G.07] RETALIATION PROHIBITED. Subdivision 1. Definitions. For the purposes of this section: (1) "facility" means a housing with services establishment registered under section 144D.02 and operating under title protection under this chapter; and (2) "resident" means a resident of a facility. Subd. 2. Retaliation prohibited. A facility or agent of a facility may not retaliate against a resident or employee if the resident, employee, or any person 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 administrator 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 (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. 3. 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; (7) an arbitrary increase in charges or fees;
(8) unauthorized removal, tampering with, or deprivation of technology, communication, or electronic monitoring devices; or (9) any oral or written communication of false information about a person advocating on behalf of the resident. Subd. 4. Retaliation against an employee. For purposes of this section, to retaliate against an employee means any of the following actions taken 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. 5. 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 3 within 30 days of an initial action described in subdivision 2, 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.
POLICY: RETALIATION PROHIBITED DATE ENACTED/REVIEWED: August 1, 2019 DATE WITHDRWAWN: July 31, 2021 AUTHORIZED SIGNATURE:___________________________________
It is the policy of XXXXXX to not retaliate against a resident or employee if the resident, employee, or any person acting on behalf of the client or tenant: 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 4. seeks assistance from or reports a reasonable suspicion of a crime or systemic problems or concerns to the administrator 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; 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 client’s or tenant’s choice other than the facility; or 9. places or indicates an intention to place a camera or electronic monitoring device in the client’s private space as provided under section 144.6502. Retaliation against a client or tenant 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 client or tenant, or any person with a familial, personal, legal, or professional relationship with the client or tenant: 1. termination of a contract; 2. any form of discrimination; 3. restriction or prohibition of access: i. of the client or tenant to the facility or visitors; or ii. of a family member or a person with a personal, legal, or professional relationship with the client or tenant to the client or tenant, 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 7. arrangements; 8. unauthorized removal, tampering with, or deprivation of technology, communication, or electronic monitoring devices; or 9. any oral or written communication of false information about a person advocating on behalf of the client or tenant. Retaliation against an employee means any of the following actions taken by the facility or an agent of the facility against an employee: 1. unwarranted discharge or transfer;
2. 3. 4. 5.
unwarranted demotion or refusal to promote; unwarranted reduction in compensation, benefits, or privileges; the unwarranted imposition of discipline, punishment, or a sanction or penalty; or any form of unwarranted discrimination.
Complaints of suspected retaliation should be brought to the attention of the community’s Director, Compliance Officer, or the Minnesota Commissioner of Health.
Do I need an Assisted Living Facility License or an Assisted Living Facility with Dementia Care License? YES
NO
Are you a facility that provides sleeping accommodations to one or more adults
Are you any of the following? An emergency shelter, transitional housing, or any other residential units serving exclusively or primarily homeless individuals (see 116L.361) A nursing home (144A), or a hospital , boarding care home, or licensed supervised living facility (144.50-144.56) A licensed lodging establishment Residential settings licensed under 245A, or adult foster care (245D) A private home in which the residents are related by kinship, law, or affinity with the providers of services A duly organized condominium, cooperative, or common interest community where at least 80% of the units are owners, members, or shareholders of the units A temporary family health care dwelling (394.307 & 426.3593) 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 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 Rental housing developed under United States Code, title 42, section 1437, or United States Code, title 12, section 1701q 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 Rental housing funded under United States Code, title 42, chapter 89, or United States Code, title 42, section 8011
NO
You are not required to have an AL License
YES
Do you provide one or more of the following Assistance with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, and bathing Standby assistance Verbal or visual reminders to residents to take regularly scheduled medication(s), which includes bring the resident previously set-up medication(s), medication(s) in original containers, or liquid or food to accompany the medication(s) Verbal or visual reminders to the resident to perform regularly scheduled treatments and/or exercises The preparation of modified diets ordered by a licensed health professional The services of an advanced practice registered nurse, registered nurse, licensed practical nurse, physical therapist, respiratory therapist, occupational therapist, speech-language pathologist, dietitian or nutritionist, or social worker Tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed health professional within the person’s scope of practice Medication management services Hands-on assistance with transfers and mobility Treatments and therapies Assistance for residents with eating when the residents have complicated eating problems Complex or specialty health care services
YES You need an AL
NO
license
Does either of the following apply to your facility? You are required to have an Assisted Living Facility with Dementia Care license
You advertise, market, or otherwise promote yourself an assisted living as providing specialized care for dementia or related disorders.
YES
You have a secured dementia care unit, meaning 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.
NO
You are required to have an Assisted Living Facility License. You have the option to have an Assisted Living Facility with Dementia Care license.
© Care Providers of Minnesota 5/19 1.3
Assisted Living Director Licensure By August 1, 2021, each Licensed Assisted Living Facility in Minnesota must be managed by a Licensed Assisted Living Director. There are three “routes” available to become a Licensed Assisted Living Director:
OPTION 1 (to be developed)
Has completed an approved training course and passed an examination approved by the Board of Executives for Long Term Services and Supports (formally BENHA) that is designed to test for competence and that includes assisted living facility laws in Minnesota
OPTION 2
Is a Licensed Nursing Home Administrator or has been validated as a Qualified Health Services Executive by the National Association of LongTerm Care Administrator Boards (NAB) and has a core knowledge of Minnesota Assisted Living laws (how to define and measure core knowledge is still to be determined)
OPTION 3
(“grandfathering” options)
Apply for licensure by July 1, 2021 AND satisfy at least ONE of the following requirements
Has a higher education degree in nursing, social services, or mental health, or another professional degree with training specific to management and regulatory compliance
Has completed at least 1,000 hours of a director/ executive in training program provided by a licensed assisted living director
Has managed a registered housing with services establishment under assisted living title protection for at least three years
Has at least three years of supervisory, management, or operational experience and higher education training applicable to an assisted living facility
Assisted Living Director licenses will be managed by the Minnesota Board of Executives for Long Term Services and Supports (formerly the Board of Examiners for Nursing Home Administrators/BENHA). Each Licensed Assisted Living Director must receive at least 30 hours of training every two years on topics relevant to the operation of a Licensed Assisted Living Facility and the needs to its residents. If the Licensed Assisted Living Director is managing a Licensed Assisted Living with Dementia Care, the Director must complete and document that at least 10 hours of the required 30 hours of training relate to the care of individuals with dementia. Care Providers of Minnesota 8/19
Compliance with Minnesota’s §325F.721 “I’m okay” Check Services Statue Are you an unlicensed setting providing sleeping accommodations to one or more adult residents, at least 80% which are 55 years of age or older
YES
NO
Do you, for a fee, offer any of the following supportive services? Assistance with laundry Assistance with shopping Assistance with household chores Housekeeping services Provision or assistance with meals or food preparation Help with arranging for, on arranging transportation to, medical, social, recreational, personal, or social services appointments Provision of social or recreational services
YES
The “I’m okay” statute does not apply to you.
NO
Are you any of the following? Emergency shelter, transitional housing, or any other residential units serving exclusively or primarily homeless individuals (see 116L.361) A nursing home A hospital A certified boarding care home A licensed supervised living facility A licensed lodging establishment Residential settings licensed under 245A Adult foster care An assisted living facility licensed under chapter 144I A setting governed by the standards of 245D A private home in which the residents are related by kinship, law, or affinity with the providers of services A duly organized condominium, cooperative, or common interest community where at least 80% of the units are owners, members, or shareholders of the units A temporary family health care dwelling (394.307 & 426.3593) 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 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 Rental housing developed under United States Code, title 42, section 1437, or United States Code, title 12, section 1701q 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 Rental housing funded under United States Code, title 42, chapter 89, or United States Code, title 42, section 8011
The “I’m okay” statute does not apply to you.
YES
NO
Effective with contracts entered into on or after August 21, 2021, you must comply with the following three requirements:
You must disclose to prospective residents that the facility is not licensed as an assisted living facility under chapter 144I and, notwithstanding any contract for "I'm okay" check services, is not permitted to provide assisted living services, as defined in section 144I.01, subdivision 9, either directly or through a provider under a business relationship or other affiliation with the covered setting. You must prominently disclose in a written contract whether or not your setting itself or through a provider with which the your setting has a business agreement offers "I'm okay" check services. 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. © Care Providers of Minnesota 5/19
2021 NURSE MANAGERS’ EDUCATION SERIES
FAQs ELECTRONIC MONITORING THE BASICS 1
When will this new law go into effect? January 1, 2020.
2
What type of facilities are covered by this new law? • Nursing facilities licensed under chapter 144A • Boarding care homes licensed under sections 144.50 to 144.56 • Between January 1, 2020, and August 1, 2021, a registered (144D) housing with services establishment that is either subject to 144G (assisted living title protection) or has disclosed a special care unit under section 325F.72 • Beginning August 1, 2021, licensed assisted living facilities
3
Can my facility prohibit electronic monitoring? Effective January 1, 2020—No.
4
Can my facility refuse to admit or initiate the discharge of a resident or client who intends to, or is, utilizing electronic monitoring? Effective January 1, 2020—No.
5
Does the electronic monitoring law apply to facility-installed cameras in public areas of the building or in areas of the building only accessible by facility staff ? No—The law applies to electronic monitoring initiated by the resident, client, or their representative, to be installed in the resident’s or client’s private living space.
6
Does this law apply to electronic monitoring outside of a resident’s private living space (e.g., meetings, conference rooms, etc.)? No—The law only applies to the resident’s or client’s private living space.
7
What is considered an “electronic monitoring device”? A camera or other device that captures, records, or broadcasts audio, video, or both, that is placed in a resident’s or client’s room or private living unit and is used to monitor the resident/client or activities in the room/private living unit.
8
Will my facility be required to purchase, install, or maintain an electronic monitoring device for a resident or client? No—It is the responsibility of the resident, client, or their representative to purchase, pay for installation, and pay for maintenance of an electronic monitoring device.
9
What are the consequences against a facility for not complying with this new electronic monitoring law? Failing to comply may result in a $500 fine.
10
Is a facility allowed to share with staff when electronic monitoring is installed? The law is silent in this area. However, if the consent form indicates any restrictions or conditions that the facility directs staff to accommodate, applicable staff would need to be notified of such restrictions or conditions.
11
What happens with electronic monitoring devices in-place prior to January 1, 2020? Effective January 1, 2020, such devices will need to have a consent and notification form consistent with the new law. Facilities should provide residents and/or resident representatives with the MDH-approved consent forms (http://bit.ly/EMconsentforms) and notify them that proper consent must be received or the device will be disabled.
FAQs | ELECTRONIC MONITORING THE BASICS CONTINUED... 12
What should I do if my staff comes across an electronic monitoring device in a private living space? First, they should always be acting in a manner under which they assume they are being monitored. Second, they should contact the administrator or manager, so leadership can confirm if a consent form has, or has not, been provided to the facility. If a consent form has not been received by the facility, leadership should contact the Office of Ombudsman for Long-Term Care (OOLTC) to determine if OOLTC was provided a signed consent form. If the OOLTC confirms a consent form has been received, the facility should verify the consent is not dated more than 14 days prior and compare information regarding the electronic monitoring device provided by the OOLTC with the device that was discovered, to verify it is the correct device and consent form on file. If no consent was received, the facility should contact the resident representative to have the device removed or proper consent provided. The facility may disable the device until proper consent and notification is received but should not remove the device as it does not belong to the facility.
13
Nursing facilities are required to pull privacy curtains to maintain the dignity of residents during personal cares. If pulling the privacy curtain would block the electronic monitoring field of view, what should staff do? Representatives from the Minnesota Department of Health (MDH) have indicated if a resident has consented to having personal cares monitored electronically, which means the privacy curtain would NOT be pulled if the electronic device would be blocked by the curtain, the facility will not be cited for failing to pull the privacy curtain due to the directed request of the resident (person-centered care).
14
If an electronic monitoring device is installed, can it have an extension cord or surge protector strip utilized to reach an outlet? Not in a nursing facility—That would violate requirements in the NFPA Life Safety Codes and required referenced codes.
15
The webinar mentioned the potential issue of a resident/client moving around in public areas of the building with an electronic monitoring device in a teddy bear on his or her lap. How should this situation be handled? The law does not address this scenario. The facility response may depend on what is being streamed from the device. Is it an event like a picnic or activity that the resident wants to share, or is it simply streaming everything and anything that is within the device’s recording range? The main concern would be that the device is streaming images and audio of other residents who have not consented to having their images or audio streamed or recorded by an outside entity or person. This scenario would need to be discussed with the resident or resident’s representative to limit unintended privacy breaches.
2
16
A family has installed an electronic device consistent with the law, and the family is calling the facility a lot to address issues captured by the device (the question was unclear regarding the type of issues). As a result, staff are spending significant amounts of time checking on the resident and speaking with the family. Can the facility charge extra for this additional staff time? In a nursing facility—no. In a housing with services/assisted living—maybe, if the result is acknowledged increased care/service needs of the resident that are added to the service plan relating to their assessed needs. Charging the resident more as a result of the facility’s frequent interaction with the family would most likely be viewed as retaliation, which is prohibited.
17
Does this law include swing beds in hospitals? No—The law does not apply to swing beds in hospitals.
18
Will this law mean a change to the Bill of Rights? The Assisted Living Bill of Rights (http://bit.ly/MDH_AL_BOR) was modified to include electronic monitoring. The Nursing Facility Bill of Rights was not modified.
19
Will Care Providers of Minnesota be providing members with a sample electronic monitoring policy? Yes, we will! Each facility will need to modify the sample to fit the approaches used by the facility.
©CARE PROVIDERS OF MINNESOTA | December 30, 2019
FAQs | ELECTRONIC MONITORING CONSENT 1
Does the resident or client need to consent to the placement of an electronic monitoring device that will be installed in the resident’s or client’s private living space? Yes—A resident or client must consent to electronic monitoring in the resident’s/client’s room or private living unit in writing on a standardized notice and consent form. The forms were developed by the Minnesota Department of Health and are available here: http://bit.ly/EMconsentforms. There are exceptions permitting those legally authorized to act on behalf of a resident or resident-identified resident representative when a resident is unable to consent on his or her behalf (such as issues surrounding capacity of residents; or clients lacking the ability to understand and appreciate the nature and consequences of electronic monitoring).
2
How are “cognitive issues” defined? The law does not define cognition or capacity. Instead, the law states the following: 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 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.
3
Must a resident, client, or their authorized representative provide the facility with a copy of the executed consent form? Yes—Notice of the consent to authorize electronic monitoring must be provided to the facility in advance of the installation of electronic monitoring. The facility must place the original consent form in the resident’s or client’s file.
4
Are there exceptions to requiring the consent form be provided to the facility in advance of the installation of electronic monitoring? Yes—If a resident, client, or authorized representative reasonably fears retaliation against them as a result of the planned installation of electronic monitoring, they can instead provide the executed consent form to the Office of Ombudsman for LongTerm Care instead of to the facility. However, this exception has two additional requirements: 1. A er 14 days using this exception, the resident, client, or authorized representative must provide a copy of the executed consent form to the facility. 2. During the 14-day period, if the resident, client, or authorized representative obtains evidence from the electronic monitoring device that suspected maltreatment occurred, they must timely submit their maltreatment concern to the Minnesota Adult Abuse Center (MAARC), the police, or both.
5
Are there other exceptions to requiring the consent form be provided to the facility in advance of the installation of electronic monitoring? Yes—Two other exceptions exist in the law: 1. If there has not been a timely, written response from the facility to a written communication from the resident, client, or their authorized representative expressing a concern, they can provide the executed consent form to the Office of Ombudsman for Long-Term Care instead of to the facility (the 14-day maximum period before providing notice to the facility still applies) 2. If the resident, client, or their authorized representative has already submitted a concern to MAARC or police, they can provide the executed consent form to the Ombudsman for Long-Term Care instead of to the facility (the 14-day maximum period before providing notice to the facility still applies)
6
Can the resident, client, or their authorized representative put restrictions on when the electronic monitoring device can and cannot be used? Yes—The consent form has a standard list of situations where electronic monitoring may be restricted or prohibited, such as during dressing, bathing, medical exams, etc.
7
3
Does a facility need to allow limitations or conditions to be placed on the use of electronic monitoring? Yes—The law requires the consent form to provide the option to place conditions on the use of electronic monitoring, therefore, the facility cannot prohibit such limitations or conditions. It remains unclear whose responsibility it is to accommodate any conditions—it is something a facility should consider discussing with the resident or resident’s representative when a consent form is received. A facility is not prohibited from forbidding staff or contractors to interact with the electronic monitoring device, even to accommodate conditions.
©CARE PROVIDERS OF MINNESOTA | December 30, 2019
FAQs | ELECTRONIC MONITORING CONSENT CONTINUED... 8
If neither the ombudsman or facility has an executed consent and notification form, how much time does the resident or authorized representative have in order to come and remove the device or comply with the law? If they live 4–5 hours away it won’t be same day, so then do we let the device remain on? That could be days. A er communicating with the resident or authorized representative that the device is not permitted because the requirements of the law are not being followed (and explaining how the device could be used with proper consent and notification), it is reasonable for the facility to disable the device, but not remove it. This may mean turning it off, unplugging it, or removing the battery.
9
What if the resident representative is also a member of the facility staff? Facility staff are not be permitted to act in the capacity of a resident’s representative.
10
Will there be a consent withdrawal form? An area to document withdrawal of the consent is a required element on the consent form.
11
When will the approved consent and notification form be available? On December 24, 2019, MDH published the approved consent and notification forms, which are available online here: http://bit.ly/EMconsentforms
ROOMMATES—SHARED PRIVATE LIVING SPACE 1
If a resident or client lives in a double room or shared living space that will be monitored by an electronic monitoring device, must the roommate also give consent? Yes—The same consent procedures are required for roommates.
2
What happens when a roommate objects to the placement of an electronic monitoring device? The resident, client, or authorized representative is prohibited from installing the electronic monitoring device. If requested, the facility must make a reasonable attempt to accommodate the resident or client who wants to conduct electronic monitoring—this includes offering the resident or client a move to another shared room with a roommate who gives consent for electronic monitoring or to a private room. The facility is not responsible to pay for the costs of the move or increased costs for the alternative room. The facility shall reevaluate the move request every two weeks until the request is fulfilled.
3
Is a spouse considered a roommate under this statute? The law does not address this question. “Roommate” is described in the statue as “any other resident residing in the shared room or shared private living unit,” therefore, it is assumed the roommate restrictions would apply even if the roommate was the spouse of a resident.
4
Who verifies that the roommate has the capacity to consent if the consent is going to the ombudsman? The law is silent on this issue. However, a facility should use caution to avoid the perception of putting up roadblocks or barriers to implementation of electronic monitoring. It is unclear what the Office of Ombudsman for Long-Term Care (OOLTC) will do with the consent and notification forms they receive. If a facility verifies with the OOLTC that consent was provided by the resident/ authorized representative and, when applicable, the roommate/roommate’s authorized representative, and the facility has concerns about the capacity of either to provide consent, the facility should request the OOLTC look into the validity of such consent and notification.
5
How will this affect shared rooms? If by “shared rooms” you mean bedrooms or living spaces with a roommate, then all the requirements of consent and notification apply to both the resident and roommate. If you define two private rooms with a shared bathroom as a shared room, the requirements would apply independently to each of the residents in their own private rooms.
4
©CARE PROVIDERS OF MINNESOTA | December 30, 2019
FAQs | ELECTRONIC MONITORING WI-FI / INTERNET 1
Must I install or provide free internet access to residents or clients? No—However, if you do make internet access available to residents, tenants, clients, or visitors, you must also make it available for electronic monitoring purposes under the same terms.
2
Is a facility required to provide public Wi-Fi? No—The law states the following: • 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. • 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.
3
Do I need to make my “public” internet secure? No—Many facilities have a secure private/business internet service, and a separate unsecured public internet service. Note—If this is the case, persons who have access to the public internet service should be informed that the connection is not secure. If your public internet service is secure, you should follow and communicate standard best practices for secure sites—such as encrypting the secure connection by one or more security protocols (such as passwords and/or secure sockets layer/SSL) to ensure the security of data flowing between two or more nodes.
4
What if the facility’s public Wi-Fi is not secure? This should be disclosed in your resident handbook or however you communicate your information regarding your public Wi-Fi. When a consent and notification form is received, you may want to communicate that fact again to the resident or authorized representative (document such communication).
5
Are we allowed to limit the use of our public Wi-Fi to certain uses? If you have public Wi-Fi, and if a resident desires to utilize electronic monitoring within the terms of the law and wants to use the public Wi-Fi, the facility will have the burden of proving that allowing access to the facility’s public-use Wi-Fi is not a reasonable accommodation.
6
What does the word “reasonable” mean? The law does not define the term “reasonable” in this statute. Merriam-Webster® defines it as “not extreme or excessive.” Other definitions use statements such as “as much as is appropriate or fair,” or “fair and sensible.”
7
We provide free Wi-Fi for guests. We do not allow continued use of Wi-Fi for such things as Netflix® or streaming. We have made some exceptions for individuals on EW who cannot afford their own Wi-Fi. Is this problematic? All users of Wi-Fi should be treated the same. If there is public Wi-Fi that all can use, that should remain the same. If there is a fee for faster or non-public Wi-Fi, then all should be charged the fee.
SIGNAGE 1
What type of signage must be used for electronic monitoring? A sign outside of the resident’s/tenant’s/client’s private living space is not required. However, the facility must post a sign at each facility entrance accessible to visitors that states the following: “Electronic monitoring devices, including security cameras & audio devices, may be present to record persons & activities.”
2
Does the electronic monitoring law prohibit a facility from posting signs at the doorway to a resident’s private living space indicating that electronic monitoring is occurring in the space? The law does not require or prohibit such signage at the entrance to a resident’s private living space. The signage posting requirement pertains to facility entrances from the outside that are available for public access into the building. Note—It is unclear in a nursing facility environment if surveyors would consider a posting outside a resident’s private living space as violating a “home-like atmosphere” or whether there would be an issue with “resident dignity.”
5
©CARE PROVIDERS OF MINNESOTA | December 30, 2019
FAQs | ELECTRONIC MONITORING REPORTING 1
If a family puts an electronic monitoring device in a resident’s private living space against the resident’s wishes (or roommate’s wishes), should the facility report it under the Vulnerable Adults Act, call the police, or something else? The law does not address this situation. However, it sounds like a potentially volatile situation that should be addressed to protect the rights of the resident(s). Frankly, the police will not know what to do, so we would not advise calling them in as your first response. Same holds true for the VAA—while it may be appropriate for adult protection to be involved, they may determine that it is the facility’s responsibility to protect the resident(s) privacy rights in this situation. We would advise as your first step contacting the Office of Ombudsman for Long-Term Care and have them represent the interests of the resident(s).
2
If a resident with dementia wanders into a room where electronic monitoring is occurring, does the facility need to contact the wandering resident’s family because consent for audio or video recording had not been granted? The law does not address this scenario, but notification of such an event does not seem necessary.
3
When would a facility be required to report an electronic device to the Minnesota Adult Abuse Reporting Center (MAARC) or the Office of Health Facility Complaints (OHFC)? The law does not identify failure to follow the electronic monitoring requirements as potential maltreatment, abuse, neglect, or exploitation. If a facility feels that the county adult protective services needs to be involved, they should contact MAARC. It is suggested that a facility work with the resident’s authorized representative and the OOLTC first to get the issues resolved.
4
When would a facility be required to report an electronic device to law enforcement? The law identifies penalties against licensed providers for failing to comply with the law, but does not identify any legal ramifications for residents or authorized representatives, other than potential civil or criminal penalties for disseminating a recording or copy of a recording for purposes outside of addressing health, safety, or welfare concerns of one or more residents. It is suggested that a facility work with the resident’s authorized representative and the OOLTC first to get any issues resolved.
5
If the resident’s authorized representative witnesses maltreatment via the electronic monitoring device, are they required to report it? Yes—If it occurs during the 14-day period when the consent notice was provided to the Office of Ombudsman for Long-Term Care instead of to the facility.
MISCELLANEOUS 1
What happens to the recordings that are captured by electronic monitoring devices? The law is somewhat silent on this issue. However, the law does have the following restrictions in place: • No person may access any video or audio recording created through authorized electronic monitoring without the written consent of the resident or resident representative. • Except as required under other law, a recording or copy of a recording made as provided in the electronic monitoring law may only be disseminated for the purpose of addressing health, safety, or welfare concerns of one or more residents. A person disseminating a recording or copy of a recording made as provided in the electronic monitoring law may be civilly or criminally liable if it is disseminated for reasons other than the purpose of addressing health, safety, or welfare concerns of one or more residents. • Subject to applicable rules of evidence and procedure, any video or audio recording created through electronic monitoring may be admitted into evidence in a civil, criminal, or administrative proceeding. • 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. • 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.
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If a recording captured by an electronic monitoring device causes a facility to initiate employee disciplinary actions, who has access to the recorded images? An employee of the facility or an employee of a contractor providing services at the facility, including an arranged home care provider, 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. 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.
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©CARE PROVIDERS OF MINNESOTA | December 30, 2019
FAQs | ELECTRONIC MONITORING MISCELLANEOUS CONTINUED... 3
If a family member purchases something like a baby monitoring device, and asks the facility to monitor it to identify falls or activity, is that electronic monitoring, and how should the facility respond? Interesting question! First, it appears a baby-monitoring type of device would be considered electronic monitoring, as it is a device that broadcasts audio, video, or both; placed in a resident’s room or private living space; and used to monitor the resident or activities in the resident’s room or private living space. Therefore, all components of the new electronic monitoring law would need to be met. The facility clearly has no duty to accept this obligation to monitor. If the facility did accept this responsibility, the facility should consider the following: • Have all components of the electronic monitoring law been met? • Can the facility continuously monitor the broadcast, if that is the expectation? • Can the broadcast be kept private, so that others cannot see/hear it? In most instances the answers would be no, indicating the facility may want to decline the monitoring of the broadcast.
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Why would providers not want to be proactive and put cameras in the rooms or private living area for facility purposes and then market that to the public that the facility has nothing to hide? If a facility were to do this, the same consent notice and ability to elect restrictions would be applicable for all current and new residents/clients (and roommates). Having such recordings could place an additional regulatory or legal burden on the facility in terms of responsibility.
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If we know there is a camera in a room, and we know that and accidentally break it, I understand we may be responsible to replace that. What if it is a hidden camera in a tissue box and we move that for cleaning, and it breaks…is that our responsibility to replace that device? The law is silent on this issue. We assume when you are referring to “hidden camera” you mean an electronic monitoring device that complies with the new law. How does your facility handle the replacement of other resident personal items that staff unintentionally break?
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What is a facility’s responsibility to maintain a resident’s electronic monitoring device/camera? The facility is not responsible for the maintenance of such device—It is the responsibility of the resident or resident’s authorized representative choosing to conduct the electronic monitoring.
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Can we have rules about how devices are physically installed? The law is somewhat silent in this area, other than stating that installation costs are the responsibility of the resident. What limitations regarding the installation of other personal resident items, such as furnishings, pictures, TVs, mementos, or other belongings does your facility enforce?
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Can a resident’s authorized electronic monitoring device be placed in a manner that it is also recording/transmitting images of common areas outside of the resident’s private living space? The law is somewhat silent in this area, but the consent and notification form is designed to only cover electronic monitoring in the resident’s private living space.
©CARE PROVIDERS OF MINNESOTA | December 30, 2019
CARE PROVIDERS OF MINNESOTA’S
ADVOCACY TEAM
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December 30, 2019
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