1.1.................... moves to amend H.F. No. 90, the fourth engrossment, as follows:
1.2Delete everything after the enacting clause and insert:

1.3"ARTICLE 1
1.4RESIDENT RIGHTS AND CONSUMER PROTECTIONS

1.5    Section 1. [144.6512] RETALIATION IN NURSING HOMES PROHIBITED.
1.6    Subdivision 1. Definitions. For the purposes of this section:
1.7(1) "nursing home" means a facility licensed as a nursing home under chapter 144A;
1.8and
1.9(2) "resident" means a person residing in a nursing home.
1.10    Subd. 2. Retaliation prohibited. A nursing home or agent of the nursing home may not
1.11retaliate against a resident or employee if the resident, employee, or any person acting on
1.12behalf of the resident:
1.13(1) files a complaint or grievance, makes an inquiry, or asserts any right;
1.14(2) indicates an intention to file a complaint or grievance, make an inquiry, or assert any
1.15right;
1.16(3) files or indicates an intention to file a maltreatment report, whether mandatory or
1.17voluntary, under section 626.557;
1.18(4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
1.19problems or concerns to the administrator or manager of the nursing home, the Office of
1.20Ombudsman for Long-Term Care, a regulatory or other government agency, or a legal or
1.21advocacy organization;
2.1(5) advocates or seeks advocacy assistance for necessary or improved care or services
2.2or enforcement of rights under this section or other law;
2.3(6) takes or indicates an intention to take civil action;
2.4(7) participates or indicates an intention to participate in any investigation or
2.5administrative or judicial proceeding;
2.6(8) contracts or indicates an intention to contract to receive services from a service
2.7provider of the resident's choice other than the nursing home; or
2.8(9) places or indicates an intention to place a camera or electronic monitoring device in
2.9the resident's private space as provided under section 144J.05.
2.10    Subd. 3. Retaliation against a resident. For purposes of this section, to retaliate against
2.11a resident includes but is not limited to any of the following actions taken or threatened by
2.12a nursing home or an agent of the nursing home against a resident, or any person with a
2.13familial, personal, legal, or professional relationship with the resident:
2.14(1) the discharge, eviction, transfer, or termination of services;
2.15(2) the imposition of discipline, punishment, or a sanction or penalty;
2.16(3) any form of discrimination;
2.17(4) restriction or prohibition of access:
2.18(i) of the resident to the nursing home or visitors; or
2.19(ii) to the resident by a family member or a person with a personal, legal, or professional
2.20relationship with the resident;
2.21(5) the imposition of involuntary seclusion or withholding food, care, or services;
2.22(6) restriction of any of the rights granted to residents under state or federal law;
2.23(7) restriction or reduction of access to or use of amenities, care, services, privileges, or
2.24living arrangements;
2.25(8) an arbitrary increase in charges or fees;
2.26(9) removing, tampering with, or deprivation of technology, communication, or electronic
2.27monitoring devices; or
2.28(10) any oral or written communication of false information about a person advocating
2.29on behalf of the resident.
3.1    Subd. 4. Retaliation against an employee. For purposes of this section, to retaliate
3.2against an employee includes but is not limited to any of the following actions taken or
3.3threatened by the nursing home or an agent of the nursing home against an employee:
3.4(1) discharge or transfer;
3.5(2) demotion or refusal to promote;
3.6(3) reduction in compensation, benefits, or privileges;
3.7(4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
3.8(5) any form of discrimination.
3.9    Subd. 5. Rebuttable presumption of retaliation. (a) Except as provided in paragraphs
3.10(b), (c), and (d), there is a rebuttable presumption that any action described in subdivision
3.113 or 4 and taken within 90 days of an initial action described in subdivision 2 is retaliatory.
3.12(b) The presumption does not apply to actions described in subdivision 3, clause (4), if
3.13a good faith report of maltreatment pursuant to section 626.557 is made by the nursing home
3.14or agent of the nursing home against the visitor, family member, or other person with a
3.15personal, legal, or professional relationship who is subject to the restriction or prohibition
3.16of access.
3.17(c) The presumption does not apply to any oral or written communication described in
3.18subdivision 3, clause (10), that is associated with a good faith report of maltreatment pursuant
3.19to section 626.557 made by the nursing home or agent of the nursing home against the
3.20person advocating on behalf of the resident.
3.21(d) The presumption does not apply to a termination of a contract of admission, as that
3.22term is defined under section 144.6501, subdivision 1, for a reason permitted under state
3.23or federal law.
3.24    Subd. 6. Remedy. A resident who meets the criteria under section 325F.71, subdivision
3.251, has a cause of action under section 325F.71, subdivision 4, for the violation of this section,
3.26unless the resident otherwise has a cause of action under section 626.557, subdivision 17.
3.27EFFECTIVE DATE.This section is effective August 1, 2019.

3.28    Sec. 2. [144G.07] RETALIATION PROHIBITED.
3.29    Subdivision 1. Definitions. For the purposes of this section and section 144G.08:
3.30(1) "facility" means a housing with services establishment registered under section
3.31144D.02 and operating under title protection under this chapter; and
4.1(2) "resident" means a resident of a facility.
4.2    Subd. 2. Retaliation prohibited. A facility or agent of the facility may not retaliate
4.3against a resident or employee if the resident, employee, or any person on behalf of the
4.4resident:
4.5(1) files a complaint or grievance, makes an inquiry, or asserts any right;
4.6(2) indicates an intention to file a complaint or grievance, make an inquiry, or assert any
4.7right;
4.8(3) files or indicates an intention to file a maltreatment report, whether mandatory or
4.9voluntary, under section 626.557;
4.10(4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
4.11problems or concerns to the administrator or manager of the facility, the Office of
4.12Ombudsman for Long-Term Care, a regulatory or other government agency, or a legal or
4.13advocacy organization;
4.14(5) advocates or seeks advocacy assistance for necessary or improved care or services
4.15or enforcement of rights under this section or other law;
4.16(6) takes or indicates an intention to take civil action;
4.17(7) participates or indicates an intention to participate in any investigation or
4.18administrative or judicial proceeding;
4.19(8) contracts or indicates an intention to contract to receive services from a service
4.20provider of the resident's choice other than the facility; or
4.21(9) places or indicates an intention to place a camera or electronic monitoring device in
4.22the resident's private space as provided under section 144J.05.
4.23    Subd. 3. Retaliation against a resident. For purposes of this section, to retaliate against
4.24a resident includes but is not limited to any of the following actions taken or threatened by
4.25a facility or an agent of the facility against a resident, or any person with a familial, personal,
4.26legal, or professional relationship with the resident:
4.27(1) the discharge, eviction, transfer, or termination of services;
4.28(2) the imposition of discipline, punishment, or a sanction or penalty;
4.29(3) any form of discrimination;
4.30(4) restriction or prohibition of access:
4.31(i) of the resident to the facility or visitors; or
5.1(ii) to the resident by a family member or a person with a personal, legal, or professional
5.2relationship with the resident;
5.3(5) the imposition of involuntary seclusion or withholding food, care, or services;
5.4(6) restriction of any of the rights granted to residents under state or federal law;
5.5(7) restriction or reduction of access to or use of amenities, care, services, privileges, or
5.6living arrangements;
5.7(8) an arbitrary increase in charges or fees;
5.8(9) removing, tampering with, or deprivation of technology, communication, or electronic
5.9monitoring devices; or
5.10(10) any oral or written communication of false information about a person advocating
5.11on behalf of the resident.
5.12    Subd. 4. Retaliation against an employee. For purposes of this section, to retaliate
5.13against an employee includes but is not limited to any of the following actions taken or
5.14threatened by the facility or an agent of the facility against an employee:
5.15(1) discharge or transfer;
5.16(2) demotion or refusal to promote;
5.17(3) reduction in compensation, benefits, or privileges;
5.18(4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
5.19(5) any form of discrimination.
5.20    Subd. 5. Rebuttable presumption of retaliation. (a) Except as provided in paragraphs
5.21(b), (c), and (d), there is a rebuttable presumption that any action described in subdivision
5.223 or 4 and taken within 90 days of an initial action described in subdivision 2 is retaliatory.
5.23(b) The presumption does not apply to actions described in subdivision 3, clause (4), if
5.24a good faith report of maltreatment pursuant to section 626.557 is made by the facility or
5.25agent of the facility against the visitor, family member, or other person with a personal,
5.26legal, or professional relationship who is subject to the restriction or prohibition of access.
5.27(c) The presumption does not apply to any oral or written communication described in
5.28subdivision 3, clause (10), that is associated with a good faith report of maltreatment pursuant
5.29to section 626.557 made by the facility or agent of the facility against the person advocating
5.30on behalf of the resident.
6.1(d) The presumption does not apply to a termination of a housing with services contract
6.2for a reason permitted under state or federal law.
6.3    Subd. 6. Remedy. A resident who meets the criteria under section 325F.71, subdivision
6.41, has a cause of action under section 325F.71, subdivision 4, for the violation of this section,
6.5unless the resident otherwise has a cause of action under section 626.557, subdivision 17.
6.6EFFECTIVE DATE.This section is effective August 1, 2019, and expires July 31,
6.72021.

6.8    Sec. 3. [144G.08] DECEPTIVE MARKETING AND BUSINESS PRACTICES
6.9PROHIBITED.
6.10    Subdivision 1. Prohibitions. (a) No employee or agent of any facility may make any
6.11false, fraudulent, deceptive, or misleading statements or representations or material omissions
6.12in marketing, advertising, or any other description or representation of care or services.
6.13(b) No housing with services contract as required under section 144D.04, subdivision
6.141, may include any provision that the facility knows or should know to be deceptive,
6.15unlawful, or unenforceable under state or federal law, nor include any provision that requires
6.16or implies a lesser standard of care or responsibility than is required by law.
6.17(c) No facility may advertise or represent that the facility has a dementia care unit without
6.18complying with disclosure requirements under section 325F.72 and all additional
6.19requirements in chapter 144I and in rule.
6.20    Subd. 2. Remedies. (a) A violation of this section constitutes a violation of section
6.21325F.69, subdivision 1. The attorney general or a county attorney may enforce this section
6.22using the remedies in section 325F.70.
6.23(b) A resident who meets the criteria under section 325F.71, subdivision 1, has a cause
6.24of action under section 325F.71, subdivision 4, for the violation of this section, unless the
6.25resident otherwise has a cause of action under section 626.557, subdivision 17.
6.26EFFECTIVE DATE.This section is effective August 1, 2019, and expires July 31,
6.272021.

6.28    Sec. 4. [144J.01] DEFINITIONS.
6.29    Subdivision 1. Applicability. For the purposes of this chapter, the following terms have
6.30the meanings given them unless the context clearly indicates otherwise.
7.1    Subd. 2. Assisted living contract. "Assisted living contract" means the legal agreement
7.2between a resident and an assisted living facility for housing and, if applicable, assisted
7.3living services.
7.4    Subd. 3. Assisted living facility. "Assisted living facility" has the meaning given in
7.5section 144I.01, subdivision 7.
7.6    Subd. 4. Assisted living facility with dementia care. "Assisted living facility with
7.7dementia care" has the meaning given in section 144I.01, subdivision 8.
7.8    Subd. 5. Assisted living services. "Assisted living services" has the meaning given in
7.9section 144I.01, subdivision 9.
7.10    Subd. 6. Attorney-in-fact. "Attorney-in-fact" means a person designated by a principal
7.11to exercise the powers granted by a written and valid power of attorney under chapter 523.
7.12    Subd. 7. Conservator. "Conservator" means a court-appointed conservator acting in
7.13accordance with the powers granted to the conservator under chapter 524.
7.14    Subd. 8. Designated representative. "Designated representative" means a person
7.15designated in writing by the resident in an assisted living contract and identified in the
7.16resident's records on file with the assisted living facility.
7.17    Subd. 9. Facility. "Facility" means an assisted living facility.
7.18    Subd. 10. Guardian. "Guardian" means a court-appointed guardian acting in accordance
7.19with the powers granted to the guardian under chapter 524.
7.20    Subd. 11. Health care agent. "Health care agent" has the meaning given in section
7.21145C.01, subdivision 2.
7.22    Subd. 12. Legal representative. "Legal representative" means one of the following in
7.23the order of priority listed, to the extent the person may reasonably be identified and located:
7.24(1) a guardian;
7.25(2) a conservator;
7.26(3) a health care agent; or
7.27(4) an attorney-in-fact.
7.28    Subd. 13. Licensed health professional. "Licensed health professional" means:
7.29(1) a physician licensed under chapter 147;
8.1(2) an advanced practice registered nurse, as that term is defined in section 148.171,
8.2subdivision 3;
8.3(3) a licensed practical nurse, as that term is defined in section 148.171, subdivision 8;
8.4or
8.5(4) a registered nurse, as that term is defined in section 148.171, subdivision 20.
8.6    Subd. 14. Resident. "Resident" means a person living in an assisted living facility.
8.7    Subd. 15. Resident record. "Resident record" has the meaning given in section 144I.01,
8.8subdivision 60.
8.9    Subd. 16. Service plan. "Service plan" has the meaning given in section 144I.01,
8.10subdivision 63.
8.11EFFECTIVE DATE.This section is effective August 1, 2021.

8.12    Section 1. [144J.02] ASSISTED LIVING BILL OF RIGHTS.
8.13    Subdivision 1. Applicability. This section applies to residents living in assisted living
8.14facilities.
8.15    Subd. 2. Legislative intent. The rights established under this section for the benefit of
8.16residents do not limit any other rights available under law. No facility may request or require
8.17that any resident waive any of these rights at any time for any reason, including as a condition
8.18of admission to the facility.
8.19    Subd. 3. Information about rights. Before receiving services, residents have the right
8.20to be informed by the facility of the rights granted under this section and the recourse
8.21residents have if rights are violated. The information must be in plain language and in terms
8.22residents can understand. The facility must make reasonable accommodations for residents
8.23who have communication disabilities and those who speak a language other than English.
8.24    Subd. 4. Appropriate care and services. (a) Residents have the right to care and assisted
8.25living services that are appropriate based on the resident's needs and according to an
8.26up-to-date service plan subject to accepted health care standards.
8.27(b) Residents have the right to receive health care and other assisted living services with
8.28continuity from people who are properly trained and competent to perform their duties and
8.29in sufficient numbers to adequately provide the services agreed to in the assisted living
8.30contract and the service plan.
9.1    Subd. 5. Refusal of care or services. Residents have the right to refuse care or assisted
9.2living services and to be informed by the facility of the medical, health-related, or
9.3psychological consequences of refusing care or services.
9.4    Subd. 6. Participation in care and service planning. Residents have the right to actively
9.5participate in the planning, modification, and evaluation of their care and services. This
9.6right includes:
9.7(1) the opportunity to discuss care, services, treatment, and alternatives with the
9.8appropriate caregivers;
9.9(2) the right to include a family member or the resident's health care agent and designated
9.10representative, or both; and
9.11(3) the right to be told in advance of, and take an active part in decisions regarding, any
9.12recommended changes in the service plan.
9.13    Subd. 7. Courteous treatment. Residents have the right to be treated with courtesy and
9.14respect, and to have the resident's property treated with respect.
9.15    Subd. 8. Freedom from maltreatment. Residents have the right to be free from physical,
9.16sexual, and emotional abuse; neglect; financial exploitation; and all forms of maltreatment
9.17covered under the Vulnerable Adults Act.
9.18    Subd. 9. Right to come and go freely. Residents have the right to enter and leave the
9.19facility as they choose. This right may be restricted only as allowed by other law and
9.20consistent with a resident's service plan.
9.21    Subd. 10. Individual autonomy. Residents have the right to individual autonomy,
9.22initiative, and independence in making life choices, including establishing a daily schedule
9.23and choosing with whom to interact.
9.24    Subd. 11. Right to control resources. Residents have the right to control personal
9.25resources.
9.26    Subd. 12. Visitors and social participation. (a) Residents have the right to meet with
9.27or receive visits at any time by the resident's family, guardian, conservator, health care
9.28agent, attorney, advocate, or religious or social work counselor, or any person of the resident's
9.29choosing. This right may be restricted in certain circumstances if necessary for the resident's
9.30health and safety and if documented in the resident's service plan.
9.31(b) Residents have the right to engage in community life and in activities of their choice.
9.32This includes the right to participate in commercial, religious, social, community, and
10.1political activities without interference and at their discretion if the activities do not infringe
10.2on the rights of other residents.
10.3    Subd. 13. Personal and treatment privacy. (a) Residents have the right to consideration
10.4of their privacy, individuality, and cultural identity as related to their social, religious, and
10.5psychological well-being. Staff must respect the privacy of a resident's space by knocking
10.6on the door and seeking consent before entering, except in an emergency or where clearly
10.7inadvisable or unless otherwise documented in the resident's service plan.
10.8(b) Residents have the right to have and use a lockable door to the resident's unit. The
10.9facility shall provide locks on the resident's unit. Only a staff member with a specific need
10.10to enter the unit shall have keys. This right may be restricted in certain circumstances if
10.11necessary for a resident's health and safety and documented in the resident's service plan.
10.12(c) Residents have the right to respect and privacy regarding the resident's service plan.
10.13Case discussion, consultation, examination, and treatment are confidential and must be
10.14conducted discreetly. Privacy must be respected during toileting, bathing, and other activities
10.15of personal hygiene, except as needed for resident safety or assistance.
10.16    Subd. 14. Communication privacy. (a) Residents have the right to communicate
10.17privately with persons of their choice.
10.18(b) If an assisted living facility is sending or receiving mail on behalf of residents, the
10.19assisted living facility must do so without interference.
10.20(c) Residents must be provided access to a telephone to make and receive calls.
10.21    Subd. 15. Confidentiality of records. (a) Residents have the right to have personal,
10.22financial, health, and medical information kept private, to approve or refuse release of
10.23information to any outside party, and to be advised of the assisted living facility's policies
10.24and procedures regarding disclosure of the information. Residents must be notified when
10.25personal records are requested by any outside party.
10.26(b) Residents have the right to access their own records.
10.27    Subd. 16. Right to furnish and decorate. Residents have the right to furnish and decorate
10.28the resident's unit within the terms of the assisted living contract.
10.29    Subd. 17. Right to choose roommate. Residents have the right to choose a roommate
10.30if sharing a unit.
11.1    Subd. 18. Right to access food. Residents have the right to access food at any time.
11.2This right may be restricted in certain circumstances if necessary for the resident's health
11.3and safety and if documented in the resident's service plan.
11.4    Subd. 19. Access to technology. Residents have the right to access Internet service at
11.5their expense.
11.6    Subd. 20. Grievances and inquiries. Residents have the right to make and receive a
11.7timely response to a complaint or inquiry, without limitation. Residents have the right to
11.8know and every facility must provide the name and contact information of the person
11.9representing the facility who is designated to handle and resolve complaints and inquiries.
11.10    Subd. 21. Access to counsel and advocacy services. Residents have the right to the
11.11immediate access by:
11.12(1) the resident's legal counsel;
11.13(2) any representative of the protection and advocacy system designated by the state
11.14under Code of Federal Regulations, title 45, section 1326.21; or
11.15(3) any representative of the Office of Ombudsman for Long-Term Care.
11.16    Subd. 22. Information about charges. Before services are initiated, residents have the
11.17right to be notified:
11.18(1) of all charges for housing and assisted living services;
11.19(2) of any limits on housing and assisted living services available;
11.20(3) if known, whether and what amount of payment may be expected from health
11.21insurance, public programs, or other sources; and
11.22(4) what charges the resident may be responsible for paying.
11.23    Subd. 23. Information about individuals providing services. Before receiving services
11.24identified in the service plan, residents have the right to be told the type and disciplines of
11.25staff who will be providing the services, the frequency of visits proposed to be furnished,
11.26and other choices that are available for addressing the resident's needs.
11.27    Subd. 24. Information about other providers and services. Residents have the right
11.28to be informed by the assisted living facility, prior to executing an assisted living contract,
11.29that other public and private services may be available and that the resident has the right to
11.30purchase, contract for, or obtain services from a provider other than the assisted living
11.31facility.
12.1    Subd. 25. Resident councils. Residents have the right to organize and participate in
12.2resident councils as described in section 144I.10, subdivision 5.
12.3    Subd. 26. Family councils. Residents have the right to participate in family councils
12.4formed by families or residents as described in section 144I.10, subdivision 6.

12.5    Sec. 6. [144J.03] RETALIATION PROHIBITED.
12.6    Subdivision 1. Retaliation prohibited. A facility or agent of a facility may not retaliate
12.7against a resident or employee if the resident, employee, or any person acting on behalf of
12.8the resident:
12.9(1) files a complaint or grievance, makes an inquiry, or asserts any right;
12.10(2) indicates an intention to file a complaint or grievance, make an inquiry, or assert any
12.11right;
12.12(3) files or indicates an intention to file a maltreatment report, whether mandatory or
12.13voluntary, under section 626.557;
12.14(4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
12.15problems or concerns to the director or manager of the facility, the Office of Ombudsman
12.16for Long-Term Care, a regulatory or other government agency, or a legal or advocacy
12.17organization;
12.18(5) advocates or seeks advocacy assistance for necessary or improved care or services
12.19or enforcement of rights under this section or other law;
12.20(6) takes or indicates an intention to take civil action;
12.21(7) participates or indicates an intention to participate in any investigation or
12.22administrative or judicial proceeding;
12.23(8) contracts or indicates an intention to contract to receive services from a service
12.24provider of the resident's choice other than the facility; or
12.25(9) places or indicates an intention to place a camera or electronic monitoring device in
12.26the resident's private space as provided under section 144J.05.
12.27    Subd. 2. Retaliation against a resident. For purposes of this section, to retaliate against
12.28a resident includes but is not limited to any of the following actions taken or threatened by
12.29a facility or an agent of the facility against a resident, or any person with a familial, personal,
12.30legal, or professional relationship with the resident:
12.31(1) the discharge, eviction, transfer, or termination of services;
13.1(2) the imposition of discipline, punishment, or a sanction or penalty;
13.2(3) any form of discrimination;
13.3(4) restriction or prohibition of access:
13.4(i) of the resident to the facility or visitors; or
13.5(ii) to the resident by a family member or a person with a personal, legal, or professional
13.6relationship with the resident;
13.7(5) the imposition of involuntary seclusion or withholding food, care, or services;
13.8(6) restriction of any of the rights granted to residents under state or federal law;
13.9(7) restriction or reduction of access to or use of amenities, care, services, privileges, or
13.10living arrangements;
13.11(8) an arbitrary increase in charges or fees;
13.12(9) removing, tampering with, or deprivation of technology, communication, or electronic
13.13monitoring devices; or
13.14(10) any oral or written communication of false information about a person advocating
13.15on behalf of the resident.
13.16    Subd. 3. Retaliation against an employee. For purposes of this section, to retaliate
13.17against an employee includes but is not limited to any of the following actions taken or
13.18threatened by the facility or an agent of the facility against an employee:
13.19(1) discharge or transfer;
13.20(2) demotion or refusal to promote;
13.21(3) reduction in compensation, benefits, or privileges;
13.22(4) the unwarranted imposition of discipline, punishment, or a sanction or penalty; or
13.23(5) any form of discrimination.
13.24    Subd. 4. Rebuttable presumption of retaliation. (a) Except as provided in paragraphs
13.25(b), (c), and (d), there is a rebuttable presumption that any action described in subdivision
13.262 or 3 and taken within 90 days of an initial action described in subdivision 1 is retaliatory.
13.27(b) The presumption does not apply to actions described in subdivision 2, clause (4), if
13.28a good faith report of maltreatment pursuant to section 626.557 is made by the facility or
13.29agent of the facility against the visitor, family member, or other person with a personal,
13.30legal, or professional relationship who is subject to the restriction or prohibition of access.
14.1(c) The presumption does not apply to any oral or written communication described in
14.2subdivision 2, clause (10), that is associated with a good faith report of maltreatment pursuant
14.3to section 626.557 made by the facility or agent of the facility against the person advocating
14.4on behalf of the resident.
14.5(d) The presumption does not apply to a discharge, eviction, transfer, or termination of
14.6services that occurs for a reason permitted under section 144J.08, subdivision 3 or 6, provided
14.7the assisted living facility has complied with the applicable requirements in sections 144J.08
14.8and 144.10.
14.9    Subd. 5. Other laws. Nothing in this section affects the rights available to a resident
14.10under section 626.557.
14.11EFFECTIVE DATE.This section is effective August 1, 2021.

14.12    Sec. 7. [144J.04] DECEPTIVE MARKETING AND BUSINESS PRACTICES
14.13PROHIBITED.
14.14(a) No employee or agent of any facility may make any false, fraudulent, deceptive, or
14.15misleading statements or representations or material omissions in marketing, advertising,
14.16or any other description or representation of care or services.
14.17(b) No assisted living contract may include any provision that the facility knows or
14.18should know to be deceptive, unlawful, or unenforceable under state or federal law, nor
14.19include any provision that requires or implies a lesser standard of care or responsibility than
14.20is required by law.
14.21(c) No facility may advertise or represent that it is licensed as an assisted living facility
14.22with dementia care without complying with disclosure requirements under section 325F.72
14.23and all additional requirements in chapter 144I and in rule.
14.24(d) A violation of this section constitutes a violation of section 325F.69, subdivision 1.
14.25The attorney general or a county attorney may enforce this section using the remedies in
14.26section 325F.70.
14.27EFFECTIVE DATE.This section is effective August 1, 2021.

14.28    Sec. 8. [144J.05] ELECTRONIC MONITORING IN CERTAIN FACILITIES.
14.29    Subdivision 1. Definitions. (a) For the purposes of this section, the terms defined in this
14.30subdivision have the meanings given.
14.31(b) "Commissioner" means the commissioner of health.
15.1(c) "Department" means the Department of Health.
15.2(d) "Electronic monitoring" means the placement and use of an electronic monitoring
15.3device by a resident in the resident's room or private living unit in accordance with this
15.4section.
15.5(e) "Electronic monitoring device" means a camera or other device that captures, records,
15.6or broadcasts audio, video, or both, that is placed in a resident's room or private living unit
15.7and is used to monitor the resident or activities in the room or private living unit.
15.8(f) "Facility" means a facility that is:
15.9(1) licensed as a nursing home under chapter 144A;
15.10(2) licensed as a boarding care home under sections 144.50 to 144.56;
15.11(3) until August 1, 2021, a housing with services establishment registered under chapter
15.12144D that is either subject to chapter 144G or has a disclosed special unit under section
15.13325F.72; or
15.14(4) on or after August 1, 2021, an assisted living facility.
15.15(g) "Resident" means a person 18 years of age or older residing in a facility.
15.16(h) "Resident representative" means one of the following in the order of priority listed,
15.17to the extent the person may reasonably be identified and located:
15.18(1) a court-appointed guardian;
15.19(2) a health care agent as defined in section 145C.01, subdivision 2; or
15.20(3) a person who is not an agent of a facility or of a home care provider designated in
15.21writing by the resident and maintained in the resident's records on file with the facility or
15.22with the resident's executed housing with services contract or nursing home contract.
15.23    Subd. 2. Electronic monitoring authorized. (a) A resident or a resident representative
15.24may conduct electronic monitoring of the resident's room or private living unit through the
15.25use of electronic monitoring devices placed in the resident's room or private living unit as
15.26provided in this section.
15.27(b) Nothing in this section precludes the use of electronic monitoring of health care
15.28allowed under other law.
15.29(c) Electronic monitoring authorized under this section is not a covered service under
15.30home and community-based waivers under sections 256B.0913, 256B.0915, 256B.092, and
15.31256B.49.
16.1(d) This section does not apply to monitoring technology authorized as a home and
16.2community-based service under section 256B.0913, 256B.0915, 256B.092, or 256B.49.
16.3    Subd. 3. Consent to electronic monitoring. (a) Except as otherwise provided in this
16.4subdivision, a resident must consent to electronic monitoring in the resident's room or private
16.5living unit in writing on a notification and consent form. If the resident has not affirmatively
16.6objected to electronic monitoring and the resident's medical professional determines that
16.7the resident currently lacks the ability to understand and appreciate the nature and
16.8consequences of electronic monitoring, the resident representative may consent on behalf
16.9of the resident. For purposes of this subdivision, a resident affirmatively objects when the
16.10resident orally, visually, or through the use of auxiliary aids or services declines electronic
16.11monitoring. The resident's response must be documented on the notification and consent
16.12form.
16.13(b) Prior to a resident representative consenting on behalf of a resident, the resident must
16.14be asked if the resident wants electronic monitoring to be conducted. The resident
16.15representative must explain to the resident:
16.16(1) the type of electronic monitoring device to be used;
16.17(2) the standard conditions that may be placed on the electronic monitoring device's use,
16.18including those listed in subdivision 6;
16.19(3) with whom the recording may be shared under subdivision 10 or 11; and
16.20(4) the resident's ability to decline all recording.
16.21(c) A resident, or resident representative when consenting on behalf of the resident, may
16.22consent to electronic monitoring with any conditions of the resident's or resident
16.23representative's choosing, including the list of standard conditions provided in subdivision
16.246. A resident, or resident representative when consenting on behalf of the resident, may
16.25request that the electronic monitoring device be turned off or the visual or audio recording
16.26component of the electronic monitoring device be blocked at any time.
16.27(d) Prior to implementing electronic monitoring, a resident, or resident representative
16.28when acting on behalf of the resident, must obtain the written consent on the notification
16.29and consent form of any other resident residing in the shared room or shared private living
16.30unit. A roommate's or roommate's resident representative's written consent must comply
16.31with the requirements of paragraphs (a) to (c). Consent by a roommate or a roommate's
16.32resident representative under this paragraph authorizes the resident's use of any recording
16.33obtained under this section, as provided under subdivision 10 or 11.
17.1(e) Any resident conducting electronic monitoring must immediately remove or disable
17.2an electronic monitoring device prior to a new roommate moving into a shared room or
17.3shared private living unit, unless the resident obtains the roommate's or roommate's resident
17.4representative's written consent as provided under paragraph (d) prior to the roommate
17.5moving into the shared room or shared private living unit. Upon obtaining the new
17.6roommate's signed notification and consent form and submitting the form to the facility as
17.7required under subdivision 5, the resident may resume electronic monitoring.
17.8(f) The resident or roommate, or the resident representative or roommate's resident
17.9representative if the representative is consenting on behalf of the resident or roommate, may
17.10withdraw consent at any time and the withdrawal of consent must be documented on the
17.11original consent form as provided under subdivision 5, paragraph (d).
17.12    Subd. 4. Refusal of roommate to consent. If a resident of a facility who is residing in
17.13a shared room or shared living unit, or the resident representative of such a resident when
17.14acting on behalf of the resident, wants to conduct electronic monitoring and another resident
17.15living in or moving into the same shared room or shared living unit refuses to consent to
17.16the use of an electronic monitoring device, the facility shall make a reasonable attempt to
17.17accommodate the resident who wants to conduct electronic monitoring. A facility has met
17.18the requirement to make a reasonable attempt to accommodate a resident or resident
17.19representative who wants to conduct electronic monitoring when, upon notification that a
17.20roommate has not consented to the use of an electronic monitoring device in the resident's
17.21room, the facility offers to move the resident to another shared room or shared living unit
17.22that is available at the time of the request. If a resident chooses to reside in a private room
17.23or private living unit in a facility in order to accommodate the use of an electronic monitoring
17.24device, the resident must pay either the private room rate in a nursing home setting, or the
17.25applicable rent in a housing with services establishment or assisted living facility. If a facility
17.26is unable to accommodate a resident due to lack of space, the facility must reevaluate the
17.27request every two weeks until the request is fulfilled. A facility is not required to provide
17.28a private room, a single-bed room, or a private living unit to a resident who is unable to
17.29pay.
17.30    Subd. 5. Notice to facility; exceptions. (a) Electronic monitoring may begin only after
17.31the resident or resident representative who intends to place an electronic monitoring device
17.32and any roommate or roommate's resident representative completes the notification and
17.33consent form and submits the form to the facility.
18.1(b) Notwithstanding paragraph (a), the resident or resident representative who intends
18.2to place an electronic monitoring device may do so without submitting a notification and
18.3consent form to the facility for up to 30 days:
18.4(1) if the resident or the resident representative reasonably fears retaliation against the
18.5resident by the facility, timely submits the completed notification and consent form to the
18.6Office of Ombudsman for Long-Term Care, and timely submits a Minnesota Adult Abuse
18.7Reporting Center report or police report, or both, upon evidence from the electronic
18.8monitoring device that suspected maltreatment has occurred;
18.9(2) if there has not been a timely written response from the facility to a written
18.10communication from the resident or resident representative expressing a concern prompting
18.11the desire for placement of an electronic monitoring device and if the resident or a resident
18.12representative timely submits a completed notification and consent form to the Office of
18.13Ombudsman for Long-Term Care; or
18.14(3) if the resident or resident representative has already submitted a Minnesota Adult
18.15Abuse Reporting Center report or police report regarding the resident's concerns prompting
18.16the desire for placement and if the resident or a resident representative timely submits a
18.17completed notification and consent form to the Office of Ombudsman for Long-Term Care.
18.18(c) Upon receipt of any completed notification and consent form, the facility must place
18.19the original form in the resident's file or file the original form with the resident's housing
18.20with services contract. The facility must provide a copy to the resident and the resident's
18.21roommate, if applicable.
18.22(d) In the event that a resident or roommate, or the resident representative or roommate's
18.23resident representative if the representative is consenting on behalf of the resident or
18.24roommate, chooses to alter the conditions under which consent to electronic monitoring is
18.25given or chooses to withdraw consent to electronic monitoring, the facility must make
18.26available the original notification and consent form so that it may be updated. Upon receipt
18.27of the updated form, the facility must place the updated form in the resident's file or file the
18.28original form with the resident's signed housing with services contract. The facility must
18.29provide a copy of the updated form to the resident and the resident's roommate, if applicable.
18.30(e) If a new roommate, or the new roommate's resident representative when consenting
18.31on behalf of the new roommate, does not submit to the facility a completed notification and
18.32consent form and the resident conducting the electronic monitoring does not remove or
18.33disable the electronic monitoring device, the facility must remove the electronic monitoring
18.34device.
19.1(f) If a roommate, or the roommate's resident representative when withdrawing consent
19.2on behalf of the roommate, submits an updated notification and consent form withdrawing
19.3consent and the resident conducting electronic monitoring does not remove or disable the
19.4electronic monitoring device, the facility must remove the electronic monitoring device.
19.5    Subd. 6. Form requirements. (a) The notification and consent form completed by the
19.6resident must include, at a minimum, the following information:
19.7(1) the resident's signed consent to electronic monitoring or the signature of the resident
19.8representative, if applicable. If a person other than the resident signs the consent form, the
19.9form must document the following:
19.10(i) the date the resident was asked if the resident wants electronic monitoring to be
19.11conducted;
19.12(ii) who was present when the resident was asked;
19.13(iii) an acknowledgment that the resident did not affirmatively object; and
19.14(iv) the source of authority allowing the resident representative to sign the notification
19.15and consent form on the resident's behalf;
19.16(2) the resident's roommate's signed consent or the signature of the roommate's resident
19.17representative, if applicable. If a roommate's resident representative signs the consent form,
19.18the form must document the following:
19.19(i) the date the roommate was asked if the roommate wants electronic monitoring to be
19.20conducted;
19.21(ii) who was present when the roommate was asked;
19.22(iii) an acknowledgment that the roommate did not affirmatively object; and
19.23(iv) the source of authority allowing the resident representative to sign the notification
19.24and consent form on the roommate's behalf;
19.25(3) the type of electronic monitoring device to be used;
19.26(4) a list of standard conditions or restrictions that the resident or a roommate may elect
19.27to place on the use of the electronic monitoring device, including but not limited to:
19.28(i) prohibiting audio recording;
19.29(ii) prohibiting video recording;
19.30(iii) prohibiting broadcasting of audio or video;
20.1(iv) turning off the electronic monitoring device or blocking the visual recording
20.2component of the electronic monitoring device for the duration of an exam or procedure by
20.3a health care professional;
20.4(v) turning off the electronic monitoring device or blocking the visual recording
20.5component of the electronic monitoring device while dressing or bathing is performed; and
20.6(vi) turning off the electronic monitoring device for the duration of a visit with a spiritual
20.7adviser, ombudsman, attorney, financial planner, intimate partner, or other visitor;
20.8(5) any other condition or restriction elected by the resident or roommate on the use of
20.9an electronic monitoring device;
20.10(6) a statement of the circumstances under which a recording may be disseminated under
20.11subdivision 10;
20.12(7) a signature box for documenting that the resident or roommate has withdrawn consent;
20.13and
20.14(8) an acknowledgment that the resident, in accordance with subdivision 3, consents to
20.15the Office of Ombudsman for Long-Term Care and its representatives disclosing information
20.16about the form. Disclosure under this clause shall be limited to:
20.17(i) the fact that the form was received from the resident or resident representative;
20.18(ii) if signed by a resident representative, the name of the resident representative and
20.19the source of authority allowing the resident representative to sign the notification and
20.20consent form on the resident's behalf; and
20.21(iii) the type of electronic monitoring device placed.
20.22(b) Facilities must make the notification and consent form available to the residents and
20.23inform residents of their option to conduct electronic monitoring of their rooms or private
20.24living unit.
20.25(c) Notification and consent forms received by the Office of Ombudsman for Long-Term
20.26Care are classified under section 256.9744.
20.27    Subd. 7. Costs and installation. (a) A resident or resident representative choosing to
20.28conduct electronic monitoring must do so at the resident's own expense, including paying
20.29purchase, installation, maintenance, and removal costs.
20.30(b) If a resident chooses to place an electronic monitoring device that uses Internet
20.31technology for visual or audio monitoring, the resident may be responsible for contracting
20.32with an Internet service provider.
21.1(c) The facility shall make a reasonable attempt to accommodate the resident's installation
21.2needs, including allowing access to the facility's public-use Internet or Wi-Fi systems when
21.3available for other public uses. A facility has the burden of proving that a requested
21.4accommodation is not reasonable.
21.5(d) All electronic monitoring device installations and supporting services must be
21.6UL-listed.
21.7    Subd. 8. Notice to visitors. (a) A facility must post a sign at each facility entrance
21.8accessible to visitors that states: "Electronic monitoring devices, including security cameras
21.9and audio devices, may be present to record persons and activities."
21.10(b) The facility is responsible for installing and maintaining the signage required in this
21.11subdivision.
21.12    Subd. 9. Obstruction of electronic monitoring devices. (a) A person must not knowingly
21.13hamper, obstruct, tamper with, or destroy an electronic monitoring device placed in a
21.14resident's room or private living unit without the permission of the resident or resident
21.15representative.
21.16(b) It is not a violation of paragraph (a) if a person turns off the electronic monitoring
21.17device or blocks the visual recording component of the electronic monitoring device at the
21.18direction of the resident or resident representative, or if consent has been withdrawn.
21.19    Subd. 10. Dissemination of recordings. (a) No person may access any video or audio
21.20recording created through authorized electronic monitoring without the written consent of
21.21the resident or resident representative.
21.22(b) Except as required under other law, a recording or copy of a recording made as
21.23provided in this section may only be disseminated for the purpose of addressing health,
21.24safety, or welfare concerns of one or more residents.
21.25(c) A person disseminating a recording or copy of a recording made as provided in this
21.26section in violation of paragraph (b) may be civilly or criminally liable.
21.27    Subd. 11. Admissibility of evidence. Subject to applicable rules of evidence and
21.28procedure, any video or audio recording created through electronic monitoring under this
21.29section may be admitted into evidence in a civil, criminal, or administrative proceeding.
21.30    Subd. 12. Liability. (a) For the purposes of state law, the mere presence of an electronic
21.31monitoring device in a resident's room or private living unit is not a violation of the resident's
21.32right to privacy under section 144.651 or 144A.44.
22.1(b) For the purposes of state law, a facility or home care provider is not civilly or
22.2criminally liable for the mere disclosure by a resident or a resident representative of a
22.3recording.
22.4    Subd. 13. Immunity from liability. The Office of Ombudsman for Long-Term Care
22.5and representatives of the office are immune from liability for conduct described in section
22.6256.9742, subdivision 2.
22.7    Subd. 14. Resident protections. (a) A facility must not:
22.8(1) refuse to admit a potential resident or remove a resident because the facility disagrees
22.9with the decision of the potential resident, the resident, or a resident representative acting
22.10on behalf of the resident regarding electronic monitoring;
22.11(2) retaliate or discriminate against any resident for consenting or refusing to consent
22.12to electronic monitoring, as provided in section 144.6512, 144G.07, or 144J.03; or
22.13(3) prevent the placement or use of an electronic monitoring device by a resident who
22.14has provided the facility or the Office of Ombudsman for Long-Term Care with notice and
22.15consent as required under this section.
22.16(b) Any contractual provision prohibiting, limiting, or otherwise modifying the rights
22.17and obligations in this section is contrary to public policy and is void and unenforceable.
22.18    Subd. 15. Employee discipline. (a) An employee of the facility or an employee of a
22.19contractor providing services at the facility who is the subject of proposed corrective or
22.20disciplinary action based upon evidence obtained by electronic monitoring must be given
22.21access to that evidence for purposes of defending against the proposed action.
22.22(b) An employee who obtains a recording or a copy of the recording must treat the
22.23recording or copy confidentially and must not further disseminate it to any other person
22.24except as required under law. Any copy of the recording must be returned to the facility or
22.25resident who provided the copy when it is no longer needed for purposes of defending
22.26against a proposed action.
22.27    Subd. 16. Penalties. (a) The commissioner may issue a correction order as provided
22.28under section 144A.10, 144A.45, or 144A.474, upon a finding that the facility has failed to
22.29comply with:
22.30(1) subdivision 5, paragraphs (c) to (f);
22.31(2) subdivision 6, paragraph (b);
22.32(3) subdivision 7, paragraph (c); or
23.1(4) subdivision 8, 9, 10, or 14.
23.2(b) The commissioner may exercise the commissioner's authority under section 144D.05
23.3to compel a housing with services establishment to meet the requirements of this section.
23.4EFFECTIVE DATE.This section is effective August 1, 2019, and applies to all contracts
23.5in effect, entered into, or renewed on or after that date.

23.6    Sec. 9. [144J.06] NO DISCRIMINATION BASED ON SOURCE OF PAYMENT.
23.7All facilities must, regardless of the source of payment and for all persons seeking to
23.8reside or residing in the facility:
23.9(1) provide equal access to quality care; and
23.10(2) establish, maintain, and implement identical policies and practices regarding residency,
23.11transfer, and provision and termination of services.
23.12EFFECTIVE DATE.This section is effective August 1, 2021.

23.13    Sec. 10. [144J.07] CONSUMER ADVOCACY AND LEGAL SERVICES.
23.14Upon execution of an assisted living contract, every facility must provide the resident
23.15and the resident's legal and designated representatives with the names and contact
23.16information, including telephone numbers and e-mail addresses, of:
23.17(1) nonprofit organizations that provide advocacy or legal services to residents including
23.18but not limited to the designated protection and advocacy organization in Minnesota that
23.19provides advice and representation to individuals with disabilities; and
23.20(2) the Office of Ombudsman for Long-Term Care, including both the state and regional
23.21contact information.
23.22EFFECTIVE DATE.This section is effective August 1, 2021.

23.23    Sec. 11. [144J.08] INVOLUNTARY DISCHARGES AND SERVICE
23.24TERMINATIONS.
23.25    Subdivision 1. Definitions. (a) For the purposes of this section and sections 144J.09 and
23.26144J.10, the following terms have the meanings given them.
23.27(b) "Facility" means:
23.28(1) a housing with services establishment registered under section 144D.02 and operating
23.29under title protection provided under chapter 144G; or
24.1(2) on or after August 1, 2021, an assisted living facility.
24.2(c) "Refusal to readmit" means a refusal by an assisted living facility, upon a request
24.3from a resident or an agent of the resident, to allow the resident to return to the facility,
24.4whether or not a notice of termination of housing or services has been issued.
24.5(d) "Termination of housing or services" or "termination" means an involuntary
24.6facility-initiated discharge, eviction, transfer, or service termination not initiated at the oral
24.7or written request of the resident or to which the resident objects.
24.8    Subd. 2. Prerequisite to termination of housing or services. Before issuing a notice
24.9of termination, a facility must explain in person and in detail the reasons for the termination,
24.10and must convene a conference with the resident, the resident's legal representatives, the
24.11resident's designated representative, the resident's family, applicable state and social services
24.12agencies, and relevant health professionals to identify and offer reasonable accommodations
24.13and modifications, interventions, or alternatives to avoid the termination.
24.14    Subd. 3. Permissible reasons to terminate housing or services. (a) A facility is
24.15prohibited from terminating housing or services for grounds other than those specified in
24.16paragraphs (b) and (c). A facility initiating a termination under paragraph (b) or (c) must
24.17comply with subdivision 2.
24.18(b) A facility may not initiate a termination unless the termination is necessary and the
24.19facility produces a written determination, supported by documentation, of the necessity of
24.20the termination. A termination is necessary only if:
24.21(1) the resident has engaged in documented conduct that substantially interferes with
24.22the rights, health, or safety of other residents;
24.23(2) the resident has committed any of the acts enumerated under section 504B.171 that
24.24substantially interfere with the rights, health, or safety of other residents; or
24.25(3) the facility can demonstrate that the resident's needs exceed the scope of services for
24.26which the resident contracted or which are included in the resident's service plan.
24.27(c) A facility may initiate a termination for nonpayment, provided the facility:
24.28(1) makes reasonable efforts to accommodate temporary financial hardship;
24.29(2) informs the resident of private subsidies and public benefits options that may be
24.30available, including but not limited to benefits available under sections 256B.0915 and
24.31256B.49; and
25.1(3) if the resident applies for public benefits, timely responds to state or county agency
25.2questions regarding the application.
25.3(d) A facility may not initiate a termination of housing or services to a resident receiving
25.4public benefits in the event of a temporary interruption in benefits. A temporary interruption
25.5of benefits does not constitute nonpayment.
25.6    Subd. 4. Notice of termination required. (a) A facility initiating a termination of housing
25.7or services must issue a written notice that complies with subdivision 5 at least 30 days
25.8prior to the effective date of the termination to the resident, to the resident's legal
25.9representative and designated representative, or if none, to a family member if known, and
25.10to the Ombudsman for Long-Term Care.
25.11(b) A facility may relocate a resident with less than 30 days' notice only in the event of
25.12emergencies, as provided in subdivision 6.
25.13(c) The notice requirements in paragraph (a) do not apply if the facility's license is
25.14restricted by the commissioner or the facility ceases operations. In the event of a license
25.15restriction or cessation of operations, the facility must follow the commissioner's directions
25.16for resident relocations contained in section 144J.10.
25.17    Subd. 5. Content of notice. The notice required under subdivision 4 must contain, at a
25.18minimum:
25.19(1) the effective date of the termination;
25.20(2) a detailed explanation of the basis for the termination, including, but not limited to,
25.21clinical or other supporting rationale;
25.22(3) contact information for, and a statement that the resident has the right to appeal the
25.23termination to, the Office of Administrative Hearings;
25.24(4) contact information for the Ombudsman for Long-Term Care;
25.25(5) the name and contact information of a person employed by the facility with whom
25.26the resident may discuss the notice of termination of housing or services;
25.27(6) if the termination is for services, a statement that the notice of termination of services
25.28does not constitute a termination of housing or an eviction from the resident's home, and
25.29that the resident has the right to remain in the facility if the resident can secure necessary
25.30services from another provider of the resident's choosing; and
25.31(7) if the resident must relocate:
26.1(i) a statement that the facility must actively participate in a coordinated transfer of the
26.2resident's care to a safe and appropriate service provider; and
26.3(ii) the name of and contact information for the new location or provider, or a statement
26.4that the location or provider must be identified prior to the effective date of the termination.
26.5    Subd. 6. Exception for emergencies. (a) A facility may relocate a resident from a facility
26.6with less than 30 days' notice if relocation is required:
26.7(1) due to a resident's urgent medical needs and is ordered by a licensed health care
26.8professional; or
26.9(2) because of an imminent risk to the health or safety of another resident or a staff
26.10member of the facility.
26.11(b) A facility relocating a resident under this subdivision must:
26.12(1) remove the resident to an appropriate location. A private home where the occupant
26.13is unwilling or unable to care for the resident, a homeless shelter, a hotel, or a motel is not
26.14an appropriate location; and
26.15(2) provide notice of the contact information for and location to which the resident has
26.16been relocated, contact information for any new service provider and for the Ombudsman
26.17for Long-Term Care, the reason for the relocation, a statement that, if the resident is refused
26.18readmission to the facility, the resident has the right to appeal any refusal to readmit to the
26.19Office of Administrative Hearings, and, if ascertainable, the approximate date or range of
26.20dates when the resident is expected to return to the facility or a statement that such date is
26.21not currently ascertainable, to:
26.22(i) the resident, the resident's legal representative and designated representative, or if
26.23none, a family member if known immediately upon relocation of the resident; and
26.24(ii) the Office of Ombudsman for Long-Term Care as soon as practicable if the resident
26.25has been relocated from the facility for more than 48 hours.
26.26(c) The resident has the right to return to the facility if the conditions under paragraph
26.27(a) no longer exist.
26.28(d) If the facility determines that the resident cannot return to the facility or the facility
26.29cannot provide the necessary services to the resident upon return, the facility must as soon
26.30as practicable but in no event later than 24 hours after the refusal or determination, comply
26.31with subdivision 4, and section 144J.10.
27.1EFFECTIVE DATE.(a) This section is effective August 1, 2019, and expires July 31,
27.22021, for housing with services establishments registered under section 144D.02 and
27.3operating under title protection provided by and subject to chapter 144G.
27.4(b) This section is effective for assisted living facilities August 1, 2021.

27.5    Sec. 12. [144J.09] APPEAL OF TERMINATION OF HOUSING OR SERVICES.
27.6    Subdivision 1. Right to appeal termination of housing or services. A resident, the
27.7resident's legal representative or designated representative, or a family member, has the
27.8right to appeal a termination of housing or services or a facility's refusal to readmit the
27.9resident after an emergency relocation and to request a contested case hearing with the
27.10Office of Administrative Hearings.
27.11    Subd. 2. Appeals process. (a) An appeal and request for a contested case hearing must
27.12be filed in writing or electronically as authorized by the chief administrative law judge.
27.13(b) The Office of Administrative Hearings must conduct an expedited hearing as soon
27.14as practicable, and in any event no later than 14 calendar days after the office receives the
27.15request and within three business days in the event of an appeal of a refusal to readmit. The
27.16hearing must be held at the facility where the resident lives, unless it is impractical or the
27.17parties agree to a different place. The hearing is not a formal evidentiary hearing. The hearing
27.18may also be attended by telephone as allowed by the administrative law judge, after
27.19considering how a telephonic hearing will affect the resident's ability to participate. The
27.20hearing shall be limited to the amount of time necessary for the participants to expeditiously
27.21present the facts about the proposed termination or refusal to readmit. The administrative
27.22law judge shall issue a recommendation to the commissioner as soon as practicable, and in
27.23any event no later than ten calendar days after the hearing or within two calendar days after
27.24the hearing in the case of a refusal to readmit.
27.25(c) The facility bears the burden of proof to establish by a preponderance of the evidence
27.26that the termination of housing or services or the refusal to readmit is permissible under law
27.27and does not constitute retaliation under section 144G.07 or 144J.03.
27.28(d) Appeals from final determinations issued by the Office of Administrative Hearings
27.29shall be as provided in sections 14.63 to 14.68.
27.30(e) The Office of Administrative Hearings must grant the appeal and the commissioner
27.31of health may order the assisted living facility to rescind the termination of housing and
27.32services or readmit the resident if:
27.33(1) the termination or refusal to readmit was in violation of state or federal law;
28.1(2) the resident cures or demonstrates the ability to cure the reason for the termination
28.2or refusal to readmit, or has identified any reasonable accommodation or modification,
28.3intervention, or alternative to the termination;
28.4(3) termination would result in great harm or potential great harm to the resident as
28.5determined by a totality of the circumstances; or
28.6(4) the facility has failed to identify a safe and appropriate location to which the resident
28.7is to be relocated as required under section 144J.10.
28.8(f) The Office of Administrative Hearings has the authority to make any other
28.9determinations or orders regarding any conditions that may be placed upon the resident's
28.10readmission or continued residency, including but not limited to changes to the service plan
28.11or required increases in services.
28.12(g) Nothing in this section limits the right of a resident or the resident's designated
28.13representative to request or receive assistance from the Office of Ombudsman for Long-Term
28.14Care and the protection and advocacy agency protection and advocacy system designated
28.15by the state under Code of Federal Regulations, title 45, section 1326.21, concerning the
28.16termination of housing or services.
28.17    Subd. 3. Representation at the hearing. Parties may, but are not required to, be
28.18represented by counsel at a contested case hearing on an appeal. The appearance of a party
28.19without counsel does not constitute the unauthorized practice of law.
28.20    Subd. 4. Service provision while appeal pending. Housing or services may not be
28.21terminated during the pendency of an appeal and until a final determination is made by the
28.22Office of Administrative Hearings.
28.23EFFECTIVE DATE.(a) This section is effective August 1, 2019, and expires July 31,
28.242021, for housing with services establishments registered under section 144D.02 and
28.25operating under title protection provided by and subject to chapter 144G.
28.26(b) This section is effective for assisted living facilities August 1, 2021.

28.27    Sec. 13. [144J.10] HOUSING AND SERVICE TERMINATION; RELOCATION
28.28PLANNING.
28.29    Subdivision 1. Duties of the facility. If a facility terminates housing or services, if a
28.30facility intends to cease operations, or if a facility's license is restricted by the commissioner
28.31requiring termination of housing or services to residents, the facility:
29.1(1) in the event of a termination of housing, has an affirmative duty to ensure a
29.2coordinated and orderly transfer of the resident to a safe location that is appropriate for the
29.3resident. The facility must identify that location prior to any appeal hearing;
29.4(2) in the event of a termination of services, has an affirmative duty to ensure a
29.5coordinated and orderly transfer of the resident to an appropriate service provider, if services
29.6are still needed and desired by the resident. The facility must identify the provider prior to
29.7any appeal hearing; and
29.8(3) must consult and cooperate with the resident; the resident's legal representatives,
29.9designated representative, and family members; any interested professionals, including case
29.10managers; and applicable agencies to consider the resident's goals and make arrangements
29.11to relocate the resident.
29.12    Subd. 2. Safe location. A safe location is not a private home where the occupant is
29.13unwilling or unable to care for the resident, a homeless shelter, a hotel, or a motel. A facility
29.14may not terminate a resident's housing or services if the resident will, as a result of the
29.15termination, become homeless, as that term is defined in section 116L.361, subdivision 5,
29.16or if an adequate and safe discharge location or adequate and needed service provider has
29.17not been identified.
29.18    Subd. 3. Written relocation plan required. The facility must prepare a written relocation
29.19plan for a resident being relocated. The plan must:
29.20(1) contain all the necessary steps to be taken to reduce transfer trauma; and
29.21(2) specify the measures needed until relocation that protect the resident and meet the
29.22resident's health and safety needs.
29.23    Subd. 4. No relocation without receiving setting accepting. A facility may not relocate
29.24the resident unless the place to which the resident will be relocated indicates acceptance of
29.25the resident.
29.26    Subd. 5. No termination of services without another provider. If a resident continues
29.27to need and desire the services provided by the facility, the facility may not terminate services
29.28unless another service provider has indicated that it will provide those services.
29.29    Subd. 6. Information that must be conveyed. If a resident is relocated to another facility
29.30or to a nursing home, or if care is transferred to another provider, the facility must timely
29.31convey to that facility, nursing home, or provider:
29.32(1) the resident's full name, date of birth, and insurance information;
30.1(2) the name, telephone number, and address of the resident's designated representatives
30.2and legal representatives, if any;
30.3(3) the resident's current documented diagnoses that are relevant to the services being
30.4provided;
30.5(4) the resident's known allergies that are relevant to the services being provided;
30.6(5) the name and telephone number of the resident's physician, if known, and the current
30.7physician orders that are relevant to the services being provided;
30.8(6) all medication administration records that are relevant to the services being provided;
30.9(7) the most recent resident assessment, if relevant to the services being provided; and
30.10(8) copies of health care directives, "do not resuscitate" orders, and any guardianship
30.11orders or powers of attorney.
30.12    Subd. 7. Final accounting; return of money and property. (a) Within 30 days of the
30.13effective date of the termination of housing or services, the facility must:
30.14(1) provide to the resident, resident's legal representatives, and the resident's designated
30.15representative a final statement of account;
30.16(2) provide any refunds due;
30.17(3) return any money, property, or valuables held in trust or custody by the facility; and
30.18(4) as required under section 504B.178, refund the resident's security deposit unless it
30.19is applied to the first month's charges.
30.20EFFECTIVE DATE.(a) This section is effective August 1, 2019, and expires July 31,
30.212021, for housing with services establishments registered under section 144D.02 and
30.22operating under title protection provided by and subject to chapter 144G.
30.23(b) This section is effective for assisted living facilities August 1, 2021.

30.24    Sec. 14. [144J.11] FORCED ARBITRATION.
30.25(a) An assisted living facility must affirmatively disclose, orally and conspicuously in
30.26writing in an assisted living contract, any arbitration provision in the contract that precludes,
30.27limits, or delays the ability of a resident from taking a civil action.
30.28(b) A forced arbitration requirement must not include a choice of law or choice of venue
30.29provision. Assisted living contracts must adhere to Minnesota law and any other applicable
31.1federal or local law. Any civil actions by any litigant must be taken in Minnesota judicial
31.2or administrative courts.
31.3(c) A forced arbitration provision must not be unconscionable. All or the portion of a
31.4forced arbitration provision found by a court to be unconscionable shall have no effect on
31.5the remaining provisions, terms, or conditions of the contract.
31.6EFFECTIVE DATE.This section is effective August 1, 2019, for contracts entered
31.7into on or after that date.

31.8    Sec. 15. [144J.12] VIOLATION OF RIGHTS.
31.9(a) A resident who meets the criteria under section 325F.71, subdivision 1, has a cause
31.10of action under section 325F.71, subdivision 4, for the violation of section 144J.02,
31.11subdivision 8, 15, or 21, or section 144J.04.
31.12(b) A resident who meets the criteria under section 325F.71, subdivision 1, has a cause
31.13of action under section 325F.71, subdivision 4, for the violation of section 144J.03, unless
31.14the resident otherwise has a cause of action under section 626.557, subdivision 17.
31.15EFFECTIVE DATE.This section is effective August 1, 2021.

31.16    Sec. 16. [144J.13] APPLICABILITY OF OTHER LAWS.
31.17Assisted living facilities:
31.18(1) are subject to and must comply with chapter 504B;
31.19(2) must comply with section 325F.72; and
31.20(3) are not required to obtain a lodging license under chapter 157 and related rules.
31.21EFFECTIVE DATE.This section is effective August 1, 2021.

31.22    Sec. 17. Minnesota Statutes 2018, section 325F.72, subdivision 4, is amended to read:
31.23    Subd. 4. Remedy. The attorney general may seek the remedies set forth in section 8.31
31.24for repeated and intentional violations of this section. However, no private right of action
31.25may be maintained as provided under section 8.31, subdivision 3a.

32.1ARTICLE 2
32.2INDEPENDENT SENIOR LIVING FACILITIES

32.3    Section 1. [144K.01] DEFINITIONS.
32.4    Subdivision 1. Applicability. For the purposes of this chapter, the definitions in this
32.5section have the meanings given.
32.6    Subd. 2. Dementia. "Dementia" has the meaning given in section 144I.01, subdivision
32.716.
32.8    Subd. 3. Designated representative. "Designated representative" means a person
32.9designated in writing by the resident in a residency and services contract and identified in
32.10the resident's records on file with the independent senior living facility.
32.11    Subd. 4. Facility. "Facility" means an independent senior living facility.
32.12    Subd. 5. "I'm okay" check services. ""I'm okay" check services" means having,
32.13maintaining, and documenting a system to, by any means, check on the health, safety, and
32.14well-being of a resident a minimum of once daily or more frequently according to the
32.15residency and services contract.
32.16    Subd. 6. Independent senior living facility. "Independent senior living facility" means
32.17a facility that for a fee provides sleeping accommodations to one or more adults and offers
32.18or provides one or more supportive services directly or through a related supportive services
32.19provider. An independent senior living facility may also provide "I'm okay" check services
32.20directly or through a related supportive services provider. For purposes of this chapter,
32.21independent senior living facility does not include:
32.22(1) emergency shelter, transitional housing, or any other residential units serving
32.23exclusively or primarily homeless individuals, as defined under section 116L.361;
32.24(2) a nursing home licensed under chapter 144A;
32.25(3) a hospital, certified boarding care home, or supervised living facility licensed under
32.26sections 144.50 to 144.56;
32.27(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
32.289520.0500 to 9520.0670, or under chapter 245D or 245G;
32.29(5) a lodging establishment serving as a shelter for individuals fleeing domestic violence;
32.30(6) services and residential settings licensed under chapter 245A, including adult foster
32.31care and services and settings governed under the standards in chapter 245D;
33.1(7) private homes where the residents own or rent the home and control all aspects of
33.2the property and building;
33.3(8) a duly organized condominium, cooperative, and common interest community, or
33.4owners' association of the condominium, cooperative, and common interest community
33.5where at least 80 percent of the units that comprise the condominium, cooperative, or
33.6common interest community are occupied by individuals who are the owners, members, or
33.7shareholders of the units;
33.8(9) temporary family health care dwellings as defined in sections 394.307 and 462.3593;
33.9(10) settings offering services conducted by and for the adherents of any recognized
33.10church or religious denomination for its members through spiritual means or by prayer for
33.11healing;
33.12(11) housing financed pursuant to sections 462A.37 and 462A.375, units financed with
33.13low-income housing tax credits pursuant to United States Code, title 26, section 42, and
33.14units financed by the Minnesota Housing Finance Agency that are intended to serve
33.15individuals with disabilities or individuals who are homeless;
33.16(12) rental housing developed under United States Code, title 42, section 1437, or United
33.17States Code, title 12, section 1701q;
33.18(13) rental housing designated for occupancy by only elderly or elderly and disabled
33.19residents under United States Code, title 42, section 1437e, or rental housing for qualifying
33.20families under Code of Federal Regulations, title 24, section 983.56;
33.21(14) rental housing funded under United States Code, title 42, chapter 89, or United
33.22States Code, title 42, section 8011; or
33.23(15) an assisted living facility or assisted living facility with dementia care licensed
33.24under chapter 144I.
33.25    Subd. 7. Manager. "Manager" means a manager of an independent senior living facility.
33.26    Subd. 8. Residency and services contract or contract. "Residency and services contract"
33.27or "contract" means the legal agreement between an independent senior living facility and
33.28a resident for the provision of housing, supportive services, and "I'm okay" check services.
33.29    Subd. 9. Related supportive services provider. "Related supportive services provider"
33.30means a service provider that provides supportive services or "I'm okay" check services to
33.31a resident under a business relationship or other affiliation with the independent senior living
33.32facility.
34.1    Subd. 10. Resident. "Resident" means a person residing in an independent senior living
34.2facility.
34.3    Subd. 11. Supportive services. "Supportive services" means:
34.4(1) assistance with laundry, shopping, and household chores;
34.5(2) housekeeping services;
34.6(3) provision of meals or assistance with meals or food preparation;
34.7(4) help with arranging, or arranging transportation to, medical, social, recreational,
34.8personal, or social services appointments; or
34.9(5) provision of social or recreational services.
34.10Arranging for services does not include making referrals or contacting a service provider
34.11in an emergency.

34.12    Sec. 2. [144K.02] DECEPTIVE MARKETING AND BUSINESS PRACTICES
34.13PROHIBITED.
34.14(a) No employee or agent of any independent senior living facility may make any false,
34.15fraudulent, deceptive, or misleading statements or representations or material omissions in
34.16marketing, advertising, or any other description or representation of care or services.
34.17(b) No residency and services contract required under section 144K.03, subdivision 1,
34.18may include any provision that the facility knows or should know to be deceptive, unlawful,
34.19or unenforceable under state or federal law.
34.20(c) No facility may advertise or represent that the facility is an assisted living facility as
34.21defined in section 144I.01, subdivision 7, or an assisted living facility with dementia care
34.22as defined in section 144I.01, subdivision 8.

34.23    Sec. 3. [144K.025] REQUIRED DISCLOSURE BY FACILITY.
34.24An independent senior living facility must disclose to prospective residents and residents
34.25that the facility is not licensed as an assisted living facility and is not permitted to provide
34.26assisted living services, as defined in section 144I.01, subdivision 9, either directly or through
34.27a provider under a business relationship or other affiliation with the facility.

34.28    Sec. 4. [144K.03] RESIDENCY AND SERVICES CONTRACT.
34.29    Subdivision 1. Contract required. (a) No independent senior living facility may operate
34.30in this state unless a written contract that meets the requirements of subdivision 2 is executed
35.1between the facility and each resident and unless the establishment operates in accordance
35.2with the terms of the contract.
35.3(b) The facility must give a complete copy of any signed contract and any addendums,
35.4and all supporting documents and attachments, to the resident promptly after a contract and
35.5any addendums have been signed by the resident.
35.6(c) The contract must contain all the terms concerning the provision of housing,
35.7supportive services, and "I'm okay" check services whether the services are provided directly
35.8or through a related supportive services provider.
35.9    Subd. 2. Contents of contract. A residency and services contract must include at least
35.10the following elements in itself or through supporting documents or attachments:
35.11(1) the name, telephone number, and physical mailing address, which may not be a
35.12public or private post office box, of:
35.13(i) the facility and, where applicable, the related supportive services provider;
35.14(ii) the managing agent of the facility, if applicable; and
35.15(iii) at least one natural person who is authorized to accept service of process on behalf
35.16of the facility;
35.17(2) the term of the contract;
35.18(3) a description of all the terms and conditions of the contract, including a description
35.19of the services to be provided and any limitations to the services provided to the resident
35.20for the contracted amount;
35.21(4) a delineation of the grounds under which the resident may be evicted or have services
35.22terminated;
35.23(5) billing and payment procedures and requirements;
35.24(6) a statement regarding the ability of a resident to receive services from service
35.25providers with whom the facility does not have a business relationship;
35.26(7) a description of the facility's complaint resolution process available to residents,
35.27including the name and contact information of the person representing the facility who is
35.28designated to handle and resolve complaints;
35.29(8) the toll-free complaint line for the Office of Ombudsman for Long-Term Care; and
35.30(9) a statement regarding the availability of and contact information for long-term care
35.31consultation services under section 256B.0911 in the county in which the facility is located.
36.1    Subd. 3. Designation of representative. (a) Before or at the time of execution of a
36.2residency and services contract, every facility must offer the resident the opportunity to
36.3identify a designated representative in writing in the contract and provide the following
36.4verbatim notice on a document separate from the contract:
36.5RIGHT TO DESIGNATE A REPRESENTATIVE FOR CERTAIN PURPOSES.
36.6You have the right to name anyone as your "Designated Representative" to assist you
36.7or, if you are unable, advocate on your behalf. A "Designated Representative" does not take
36.8the place of your guardian, conservator, power of attorney ("attorney-in-fact"), or health
36.9care power of attorney ("health care agent").
36.10(b) The contract must contain a page or space for the name and contact information of
36.11the designated representative and a box the resident must initial if the resident declines to
36.12name a designated representative. Notwithstanding subdivision 5, the resident has the right
36.13at any time to add or change the name and contact information of the designated
36.14representative.
36.15    Subd. 4. Contracts are consumer contracts. A contract under this section is a consumer
36.16contract under sections 325G.29 to 325G.37.
36.17    Subd. 5. Additions and amendments to contract. The resident must agree in writing
36.18to any additions or amendments to the contract. Upon agreement between the resident or
36.19resident's designated representative and the facility, a new contract or an addendum to the
36.20existing contract must be executed and signed and provided to the resident and the resident's
36.21legal representative.
36.22    Subd. 6. Contracts in permanent files. Residency and services contracts and related
36.23documents executed by each resident must be maintained by the facility in files from the
36.24date of execution until three years after the contract is terminated.
36.25    Subd. 7. Waivers of liability prohibited. The contract must not include a waiver of
36.26facility liability for the health and safety or personal property of a resident. The contract
36.27must not include any provision that the facility knows or should know to be deceptive,
36.28unlawful, or unenforceable under state or federal law, and must not include any provision
36.29that requires or implies a lesser standard of responsibility than is required by law.

36.30    Sec. 5. [144K.04] TERMINATION OF RESIDENCY AND SERVICES CONTRACT.
36.31    Subdivision 1. Notice required. An independent senior living facility must provide at
36.32least 30 days prior notice of a termination of the residency and services contract.
37.1    Subd. 2. Content of notice. The notice required under subdivision 1 must contain, at a
37.2minimum:
37.3(1) the effective date of termination of the contract;
37.4(2) a detailed explanation of the basis for the termination;
37.5(3) a list of known facilities in the immediate geographic area;
37.6(4) information on how to contact the Office of Ombudsman for Long-Term Care and
37.7the Ombudsman for Mental Health and Developmental Disabilities;
37.8(6) a statement of any steps the resident can take to avoid termination;
37.9(7) the name and contact information of a person employed by the facility with whom
37.10the resident may discuss the notice of termination and, without extending the termination
37.11notice period, an affirmative offer to meet with the resident and any person or persons of
37.12the resident's choosing to discuss the termination;
37.13(8) a statement that, with respect to the notice of termination, reasonable accommodation
37.14is available for a resident with a disability; and
37.15(9) an explanation that:
37.16(i) the resident must vacate the apartment, along with all personal possessions, on or
37.17before the effective date of termination;
37.18(ii) failure to vacate the apartment by the date of termination may result in the filing of
37.19an eviction action in court by the facility, and that the resident may present a defense, if
37.20any, to the court at that time; and
37.21(iii) the resident may seek legal counsel in connection with the notice of termination.

37.22    Sec. 6. [144K.05] MANAGER REQUIREMENTS.
37.23(a) The manager of an independent senior living facility must obtain at least 30 hours
37.24of continuing education every two years of employment as the manager in topics relevant
37.25to the operations of the facility and the needs of its residents. Continuing education earned
37.26to maintain a professional license, such as a nursing home administrator license, nursing
37.27license, social worker license, or real estate license, may be used to satisfy this requirement.
37.28The continuing education must include at least four hours of documented training on dementia
37.29and related disorders, activities of daily living, problem solving with challenging behaviors,
37.30and communication skills within 160 working hours of hire and two hours of training on
37.31these topics for each 12 months of employment thereafter.
38.1(b) The facility must maintain records for at least three years demonstrating that the
38.2manager has attended educational programs as required by this section. New managers may
38.3satisfy the initial dementia training requirements by producing written proof of having
38.4previously completed required training within the past 18 months.

38.5    Sec. 7. [144K.06] FIRE PROTECTION AND PHYSICAL ENVIRONMENT.
38.6    Subdivision 1. Comprehensive fire protection system required. Every independent
38.7senior living facility must have a comprehensive fire protection system that includes:
38.8(1) protection throughout the facility by an approved supervised automatic sprinkler
38.9system according to building code requirements established in Minnesota Rules, part
38.101305.0903, or smoke detectors in each occupied room installed and maintained in accordance
38.11with the National Fire Protection Association (NFPA) Standard 72;
38.12(2) portable fire extinguishers installed and tested in accordance with the NFPA Standard
38.1310; and
38.14(3) the physical environment, including walls, floors, ceiling, all furnishings, grounds,
38.15systems, and equipment kept in a continuous state of good repair and operation with regard
38.16to the health, safety, comfort, and well-being of the residents in accordance with a
38.17maintenance and repair program.
38.18    Subd. 2. Fire drills. Fire drills shall be conducted in accordance with the residential
38.19board and care requirements in the Life Safety Code.

38.20    Sec. 8. [144K.07] EMERGENCY PLANNING.
38.21    Subdivision 1. Requirements. Each independent senior living facility must meet the
38.22following requirements:
38.23(1) have a written emergency disaster plan that contains a plan for evacuation, addresses
38.24elements of sheltering in-place, identifies temporary relocation sites, and details staff
38.25assignments in the event of a disaster or an emergency;
38.26(2) post an emergency disaster plan prominently;
38.27(3) provide building emergency exit diagrams to all residents upon signing a residency
38.28and services contract;
38.29(4) post emergency exit diagrams on each floor; and
38.30(5) have a written policy and procedure regarding missing residents.
39.1    Subd. 2. Emergency and disaster training. Each independent senior living facility
39.2must provide emergency and disaster training to all staff during the initial staff orientation
39.3and annually thereafter and must make emergency and disaster training available to all
39.4residents annually. Staff who have not received emergency and disaster training are allowed
39.5to work only when trained staff are also working on site.

39.6    Sec. 9. [144K.08] OTHER LAWS.
39.7An independent senior living facility must comply with chapter 504B and must obtain
39.8and maintain all other licenses, permits, registrations, or other governmental approvals
39.9required of it.
39.10EFFECTIVE DATE.This section is effective August 1, 2021.

39.11    Sec. 10. [144K.09] ENFORCEMENT.
39.12(a) A violation of this chapter constitutes a violation of section 325F.69, subdivision 1.
39.13The attorney general may enforce this section using the remedies in section 325F.70.
39.14(b) A resident who meets the criteria in section 325F.71, subdivision 1, has a cause of
39.15action under section 325F.71, subdivision 4, for a violation of this chapter.
39.16EFFECTIVE DATE.This section is effective August 1, 2021.

39.17ARTICLE 3
39.18ASSISTED LIVING LICENSURE

39.19    Section 1. Minnesota Statutes 2018, section 144.122, is amended to read:
39.20144.122 LICENSE, PERMIT, AND SURVEY FEES.
39.21    (a) The state commissioner of health, by rule, may prescribe procedures and fees for
39.22filing with the commissioner as prescribed by statute and for the issuance of original and
39.23renewal permits, licenses, registrations, and certifications issued under authority of the
39.24commissioner. The expiration dates of the various licenses, permits, registrations, and
39.25certifications as prescribed by the rules shall be plainly marked thereon. Fees may include
39.26application and examination fees and a penalty fee for renewal applications submitted after
39.27the expiration date of the previously issued permit, license, registration, and certification.
39.28The commissioner may also prescribe, by rule, reduced fees for permits, licenses,
39.29registrations, and certifications when the application therefor is submitted during the last
39.30three months of the permit, license, registration, or certification period. Fees proposed to
39.31be prescribed in the rules shall be first approved by the Department of Management and
40.1Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
40.2in an amount so that the total fees collected by the commissioner will, where practical,
40.3approximate the cost to the commissioner in administering the program. All fees collected
40.4shall be deposited in the state treasury and credited to the state government special revenue
40.5fund unless otherwise specifically appropriated by law for specific purposes.
40.6    (b) The commissioner may charge a fee for voluntary certification of medical laboratories
40.7and environmental laboratories, and for environmental and medical laboratory services
40.8provided by the department, without complying with paragraph (a) or chapter 14. Fees
40.9charged for environment and medical laboratory services provided by the department must
40.10be approximately equal to the costs of providing the services.
40.11    (c) The commissioner may develop a schedule of fees for diagnostic evaluations
40.12conducted at clinics held by the services for children with disabilities program. All receipts
40.13generated by the program are annually appropriated to the commissioner for use in the
40.14maternal and child health program.
40.15    (d) The commissioner shall set license fees for hospitals and nursing homes that are not
40.16boarding care homes at the following levels:
40.17
40.18
40.19
40.20
Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) and
American Osteopathic Association (AOA)
hospitals
$7,655 plus $16 per bed
40.21
Non-JCAHO and non-AOA hospitals
$5,280 plus $250 per bed
40.22
40.23
40.24
40.25
Nursing home
$183 plus $91 per bed until June 30, 2018.
$183 plus $100 per bed between July 1, 2018,
and June 30, 2020. $183 plus $105 per bed
beginning July 1, 2020.
40.26    The commissioner shall set license fees for outpatient surgical centers, boarding care
40.27homes, and supervised living facilities, assisted living facilities, and assisted living facilities
40.28with dementia care at the following levels:
40.29
Outpatient surgical centers
$3,712
40.30
Boarding care homes
$183 plus $91 per bed
40.31
Supervised living facilities
$183 plus $91 per bed.
40.32
Assisted living facilities with dementia care
$....... plus $....... per bed.
40.33
Assisted living facilities
$....... plus $....... per bed.
40.34Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if
40.35received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017,
40.36or later.
41.1    (e) Unless prohibited by federal law, the commissioner of health shall charge applicants
41.2the following fees to cover the cost of any initial certification surveys required to determine
41.3a provider's eligibility to participate in the Medicare or Medicaid program:
41.4
Prospective payment surveys for hospitals
$
900
41.5
Swing bed surveys for nursing homes
$
1,200
41.6
Psychiatric hospitals
$
1,400
41.7
Rural health facilities
$
1,100
41.8
Portable x-ray providers
$
500
41.9
Home health agencies
$
1,800
41.10
Outpatient therapy agencies
$
800
41.11
End stage renal dialysis providers
$
2,100
41.12
Independent therapists
$
800
41.13
Comprehensive rehabilitation outpatient facilities
$
1,200
41.14
Hospice providers
$
1,700
41.15
Ambulatory surgical providers
$
1,800
41.16
Hospitals
$
4,200
41.17
41.18
41.19
Other provider categories or additional
resurveys required to complete initial
certification
Actual surveyor costs: average
surveyor cost x number of hours for
the survey process.
41.20    These fees shall be submitted at the time of the application for federal certification and
41.21shall not be refunded. All fees collected after the date that the imposition of fees is not
41.22prohibited by federal law shall be deposited in the state treasury and credited to the state
41.23government special revenue fund.
41.24EFFECTIVE DATE.This section is effective August 1, 2021.

41.25    Sec. 2. [144I.01] DEFINITIONS.
41.26    Subdivision 1. Applicability. For the purposes of this chapter, the definitions in this
41.27section have the meanings given.
41.28    Subd. 2. Adult. "Adult" means a natural person who has attained the age of 18 years.
41.29    Subd. 3. Advanced practice registered nurse. "Advanced practice registered nurse"
41.30has the meaning given in section 148.171, subdivision 3.
41.31    Subd. 4. Applicant. "Applicant" means an individual, legal entity, or other organization
41.32that has applied for licensure under this chapter.
42.1    Subd. 5. Assisted living contract. "Assisted living contract" means the legal agreement
42.2between a resident and an assisted living facility for housing and, if applicable, assisted
42.3living services.
42.4    Subd. 6. Assisted living director. "Assisted living director" means a person who
42.5administers, manages, supervises, or is in general administrative charge of an assisted living
42.6facility, whether or not the individual has an ownership interest in the facility, and whether
42.7or not the person's functions or duties are shared with one or more individuals and who is
42.8licensed by the Board of Executives for Long Term Services and Supports pursuant to
42.9section 144A.20.
42.10    Subd. 7. Assisted living facility. "Assisted living facility" means a licensed facility that
42.11provides sleeping accommodations and assisted living services to one or more adults.
42.12Assisted living facility includes assisted living facility with dementia care, and does not
42.13include:
42.14(1) emergency shelter, transitional housing, or any other residential units serving
42.15exclusively or primarily homeless individuals, as defined under section 116L.361;
42.16(2) a nursing home licensed under chapter 144A;
42.17(3) a hospital, certified boarding care, or supervised living facility licensed under sections
42.18144.50 to 144.56;
42.19(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
42.209520.0500 to 9520.0670, or under chapter 245D or 245G;
42.21(5) services and residential settings licensed under chapter 245A, including adult foster
42.22care and services and settings governed under the standards in chapter 245D;
42.23(6) a private home in which the residents are related by kinship, law, or affinity with the
42.24provider of services;
42.25(7) a duly organized condominium, cooperative, and common interest community, or
42.26owners' association of the condominium, cooperative, and common interest community
42.27where at least 80 percent of the units that comprise the condominium, cooperative, or
42.28common interest community are occupied by individuals who are the owners, members, or
42.29shareholders of the units;
42.30(8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;
43.1(9) a setting offering services conducted by and for the adherents of any recognized
43.2church or religious denomination for its members exclusively through spiritual means or
43.3by prayer for healing;
43.4(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with
43.5low-income housing tax credits pursuant to United States Code, title 26, section 42, and
43.6units financed by the Minnesota Housing Finance Agency that are intended to serve
43.7individuals with disabilities or individuals who are homeless, except for those developments
43.8that market or hold themselves out as assisted living facilities and provide assisted living
43.9services;
43.10(11) rental housing developed under United States Code, title 42, section 1437, or United
43.11States Code, title 12, section 1701q;
43.12(12) rental housing designated for occupancy by only elderly or elderly and disabled
43.13residents under United States Code, title 42, section 1437e, or rental housing for qualifying
43.14families under Code of Federal Regulations, title 24, section 983.56;
43.15(13) rental housing funded under United States Code, title 42, chapter 89, or United
43.16States Code, title 42, section 8011; or
43.17(14) an independent senior living facility governed by chapter 144K.
43.18    Subd. 8. Assisted living facility with dementia care. "Assisted living facility with
43.19dementia care" means a licensed assisted living facility that is advertised, marketed, or
43.20otherwise promoted as providing specialized care for individuals with Alzheimer's disease
43.21or other dementias. An assisted living facility with a secured dementia care unit must be
43.22licensed as an assisted living facility with dementia care.
43.23    Subd. 9. Assisted living services. "Assisted living services" includes one or more of
43.24the following:
43.25(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, and bathing;
43.26(2) providing standby assistance;
43.27(3) providing verbal or visual reminders to the resident to take regularly scheduled
43.28medication, which includes bringing the resident previously set up medication, medication
43.29in original containers, or liquid or food to accompany the medication;
43.30(4) providing verbal or visual reminders to the resident to perform regularly scheduled
43.31treatments and exercises;
43.32(5) preparing modified diets ordered by a licensed health professional;
44.1(6) services of an advanced practice registered nurse, registered nurse, licensed practical
44.2nurse, physical therapist, respiratory therapist, occupational therapist, speech-language
44.3pathologist, dietitian or nutritionist, or social worker;
44.4(7) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed
44.5health professional within the person's scope of practice;
44.6(8) medication management services;
44.7(9) hands-on assistance with transfers and mobility;
44.8(10) treatment and therapies;
44.9(11) assisting residents with eating when the residents have complicated eating problems
44.10as identified in the resident record or through an assessment such as difficulty swallowing,
44.11recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
44.12instruments to be fed;
44.13(12) providing other complex or specialty health care services;
44.14(13) "I'm okay" check services; and
44.15(14) supportive services in addition to the provision of at least one of the services listed
44.16in clauses (1) to (12).
44.17    Subd. 10. Authority having jurisdiction. "Authority having jurisdiction" means an
44.18organization, office, or individual responsible for enforcing the requirements of a code or
44.19standard, or for approving equipment, materials, an installation, or a procedure.
44.20    Subd. 11. Authorized agent. "Authorized agent" means the person who is authorized
44.21to accept service of notices and orders on behalf of the licensee.
44.22    Subd. 12. Change of ownership. "Change of ownership" means a change in the licensee
44.23that is responsible for the management, control, and operation of a facility.
44.24    Subd. 13. Commissioner. "Commissioner" means the commissioner of health.
44.25    Subd. 14. Controlled substance. "Controlled substance" has the meaning given in
44.26section 152.01, subdivision 4.
44.27    Subd. 15. Controlling individual. (a) "Controlling individual" means an owner and the
44.28following individuals and entities, if applicable:
44.29(1) each officer of the organization, including the chief executive officer and chief
44.30financial officer;
44.31(2) each managerial official; and
45.1(3) any entity with at least a five percent mortgage, deed of trust, or other security interest
45.2in the facility.
45.3(b) Controlling individual does not include:
45.4(1) a bank, savings bank, trust company, savings association, credit union, industrial
45.5loan and thrift company, investment banking firm, or insurance company unless the entity
45.6operates a program directly or through a subsidiary;
45.7(2) government and government-sponsored entities such as the U.S. Department of
45.8Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the Minnesota
45.9Housing Finance Agency which provide loans, financing, and insurance products for housing
45.10sites;
45.11(3) an individual who is a state or federal official, a state or federal employee, or a
45.12member or employee of the governing body of a political subdivision of the state or federal
45.13government that operates one or more facilities, unless the individual is also an officer,
45.14owner, or managerial official of the facility, receives remuneration from the facility, or
45.15owns any of the beneficial interests not excluded in this subdivision;
45.16(4) an individual who owns less than five percent of the outstanding common shares of
45.17a corporation:
45.18(i) whose securities are exempt under section 80A.45, clause (6); or
45.19(ii) whose transactions are exempt under section 80A.46, clause (2);
45.20(5) an individual who is a member of an organization exempt from taxation under section
45.21290.05, unless the individual is also an officer, owner, or managerial official of the license
45.22or owns any of the beneficial interests not excluded in this subdivision. This clause does
45.23not exclude from the definition of controlling individual an organization that is exempt from
45.24taxation; or
45.25(6) an employee stock ownership plan trust, or a participant or board member of an
45.26employee stock ownership plan, unless the participant or board member is a controlling
45.27individual.
45.28    Subd. 16. Dementia. "Dementia" means the loss of cognitive function, including the
45.29ability to think, remember, problem solve, or reason, of sufficient severity to interfere with
45.30an individual's daily functioning. Dementia is caused by different diseases and conditions,
45.31including but not limited to Alzheimer's disease, vascular dementia, neurodegenerative
45.32conditions, Creutzfeldt-Jakob disease, and Huntington's disease.
46.1    Subd. 17. Dementia care services. "Dementia care services" means ongoing care for
46.2behavioral and psychological symptoms of dementia, including planned group and individual
46.3programming and person-centered care practices provided according to section 144I.40 to
46.4support activities of daily living for people living with dementia.
46.5    Subd. 18. Dementia-trained staff. "Dementia-trained staff" means any employee who
46.6has completed the minimum training required under sections 144I.21 and 144I.39 and has
46.7demonstrated knowledge and the ability to support individuals with dementia.
46.8    Subd. 19. Designated representative. "Designated representative" means a person
46.9designated in writing by the resident in an assisted living contract and identified in the
46.10resident record on file with the facility.
46.11    Subd. 20. Dietary supplement. "Dietary supplement" means a product taken by mouth
46.12that contains a dietary ingredient intended to supplement the diet. Dietary ingredients may
46.13include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as
46.14enzymes, organ tissue, glandulars, or metabolites.
46.15    Subd. 21. Dietitian. "Dietitian" means a person licensed as a dietitian under section
46.16148.624.
46.17    Subd. 22. Direct contact. "Direct contact" means providing face-to-face care, training,
46.18supervision, counseling, consultation, or medication assistance to residents of a facility.
46.19    Subd. 23. Direct ownership interest. "Direct ownership interest" means an individual
46.20or organization with the possession of at least five percent equity in capital, stock, or profits
46.21of the licensee, or who is a member of a limited liability company of the licensee.
46.22    Subd. 24. Facility. "Facility" means an assisted living facility.
46.23    Subd. 25. Hands-on assistance. "Hands-on assistance" means physical help by another
46.24person without which the resident is not able to perform the activity.
46.25    Subd. 26. "I'm okay" check services. ""I'm okay" check services" means having,
46.26maintaining, and documenting a system to, by any means, check on the health, safety, and
46.27well-being of a resident a minimum of once daily or more frequently according to the assisted
46.28living contract.
46.29    Subd. 27. Indirect ownership interest. "Indirect ownership interest" means an individual
46.30or legal entity with a direct ownership interest in an entity that has a direct or indirect
46.31ownership interest of at least five percent in an entity that is a licensee.
47.1    Subd. 28. Legal representative. "Legal representative" means one of the following in
47.2the order of priority listed, to the extent the person may reasonably be identified and located:
47.3(1) a court-appointed guardian acting in accordance with the powers granted to the
47.4guardian under chapter 524;
47.5(2) a conservator acting in accordance with the powers granted to the conservator under
47.6chapter 524;
47.7(3) a health care agent acting in accordance with the powers granted to the health care
47.8agent under chapter 145C; or
47.9(4) an attorney-in-fact acting in accordance with the powers granted to the attorney-in-fact
47.10by a written power of attorney under chapter 523.
47.11    Subd. 29. Licensed health professional. "Licensed health professional" means a person
47.12licensed in Minnesota to practice a profession described in section 214.01, subdivision 2.
47.13    Subd. 30. Licensed practical nurse. "Licensed practical nurse" has the meaning given
47.14in section 148.171, subdivision 8.
47.15    Subd. 31. Licensed resident capacity. "Licensed resident capacity" means the resident
47.16occupancy level requested by a licensee and approved by the commissioner.
47.17    Subd. 32. Licensee. "Licensee" means a person or legal entity to whom the commissioner
47.18issues a license for an assisted living facility and who is responsible for the management,
47.19control, and operation of a facility.
47.20    Subd. 33. Maltreatment. "Maltreatment" means conduct described in section 626.5572,
47.21subdivision 15.
47.22    Subd. 34. Management agreement. "Management agreement" means a written, executed
47.23agreement between a licensee and manager regarding the provision of certain services on
47.24behalf of the licensee.
47.25    Subd. 35. Manager. "Manager" means an individual or legal entity designated by the
47.26licensee through a management agreement to act on behalf of the licensee in the on-site
47.27management of the assisted living facility.
47.28    Subd. 36. Managerial official. "Managerial official" means an individual who has the
47.29decision-making authority related to the operation of the facility and the responsibility for
47.30the ongoing management or direction of the policies, services, or employees of the facility.
47.31    Subd. 37. Medication. "Medication" means a prescription or over-the-counter drug. For
47.32purposes of this chapter only, medication includes dietary supplements.
48.1    Subd. 38. Medication administration. "Medication administration" means performing
48.2a set of tasks that includes the following:
48.3(1) checking the resident's medication record;
48.4(2) preparing the medication as necessary;
48.5(3) administering the medication to the resident;
48.6(4) documenting the administration or reason for not administering the medication; and
48.7(5) reporting to a registered nurse or appropriate licensed health professional any concerns
48.8about the medication, the resident, or the resident's refusal to take the medication.
48.9    Subd. 39. Medication management. "Medication management" means the provision
48.10of any of the following medication-related services to a resident:
48.11(1) performing medication setup;
48.12(2) administering medications;
48.13(3) storing and securing medications;
48.14(4) documenting medication activities;
48.15(5) verifying and monitoring the effectiveness of systems to ensure safe handling and
48.16administration;
48.17(6) coordinating refills;
48.18(7) handling and implementing changes to prescriptions;
48.19(8) communicating with the pharmacy about the resident's medications; and
48.20(9) coordinating and communicating with the prescriber.
48.21    Subd. 40. Medication reconciliation. "Medication reconciliation" means the process
48.22of identifying the most accurate list of all medications the resident is taking, including the
48.23name, dosage, frequency, and route, by comparing the resident record to an external list of
48.24medications obtained from the resident, hospital, prescriber, or other provider.
48.25    Subd. 41. Medication setup. "Medication setup" means arranging medications by a
48.26nurse, pharmacy, or authorized prescriber for later administration by the resident or by
48.27facility staff.
48.28    Subd. 42. New construction. "New construction" means a new building, renovation,
48.29modification, reconstruction, physical changes altering the use of occupancy, or addition
48.30to a building.
49.1    Subd. 43. Nurse. "Nurse" means a person who is licensed under sections 148.171 to
49.2148.285.
49.3    Subd. 44. Nutritionist. "Nutritionist" means a person licensed as a nutritionist under
49.4section 148.624.
49.5    Subd. 45. Occupational therapist. "Occupational therapist" means a person who is
49.6licensed under sections 148.6401 to 148.6449.
49.7    Subd. 46. Ombudsman. "Ombudsman" means the ombudsman for long-term care.
49.8    Subd. 47. Over-the-counter drug. "Over-the-counter drug" means a drug that is not
49.9required by federal law to bear the symbol "Rx only."
49.10    Subd. 48. Owner. "Owner" means an individual or legal entity that has a direct or indirect
49.11ownership interest of five percent or more in a licensee. For purposes of this chapter, "owner
49.12of a nonprofit corporation" means the president and treasurer of the board of directors or,
49.13for an entity owned by an employee stock ownership plan, means the president and treasurer
49.14of the entity. A government entity that is issued a license under this chapter shall be
49.15designated the owner.
49.16    Subd. 49. Person-centered planning and service delivery. "Person-centered planning
49.17and service delivery" means services as defined in section 245D.07, subdivision 1a, paragraph
49.18(b).
49.19    Subd. 50. Pharmacist. "Pharmacist" has the meaning given in section 151.01, subdivision
49.203.
49.21    Subd. 51. Physical therapist. "Physical therapist" means a person who is licensed under
49.22sections 148.65 to 148.78.
49.23    Subd. 52. Physician. "Physician" means a person who is licensed under chapter 147.
49.24    Subd. 53. Prescriber. "Prescriber" means a person who is authorized by section 148.235;
49.25151.01, subdivision 23; or 151.37 to prescribe prescription drugs.
49.26    Subd. 54. Prescription. "Prescription" has the meaning given in section 151.01,
49.27subdivision 16a.
49.28    Subd. 55. Provisional license. "Provisional license" means the initial license the
49.29commissioner issues after approval of a complete written application and before the
49.30commissioner completes the provisional license survey and determines that the provisional
49.31licensee is in substantial compliance.
50.1    Subd. 56. Regularly scheduled. "Regularly scheduled" means ordered or planned to be
50.2completed at predetermined times or according to a predetermined routine.
50.3    Subd. 57. Reminder. "Reminder" means providing a verbal or visual reminder to a
50.4resident.
50.5    Subd. 58. Repeat violation. "Repeat violation" means the issuance of two or more
50.6correction orders within a 12-month period for a violation of the same provision of a statute
50.7or rule.
50.8    Subd. 59. Resident. "Resident" means a person living in an assisted living facility who
50.9has executed an assisted living contract.
50.10    Subd. 60. Resident record. "Resident record" means all records that document
50.11information about the services provided to the resident.
50.12    Subd. 61. Respiratory therapist. "Respiratory therapist" means a person who is licensed
50.13under chapter 147C.
50.14    Subd. 62. Secured dementia care unit. "Secured dementia care unit" means a designated
50.15area or setting designed for individuals with dementia that is locked or secured to prevent
50.16a resident from exiting, or to limit a resident's ability to exit, the secured area or setting. A
50.17secured dementia care unit is not solely an individual resident's living area.
50.18    Subd. 63. Service plan. "Service plan" means the written plan between the resident or
50.19the resident's representative and the provisional licensee or licensee about the services that
50.20will be provided to the resident.
50.21    Subd. 64. Social worker. "Social worker" means a person who is licensed under chapter
50.22148D or 148E.
50.23    Subd. 65. Speech-language pathologist. "Speech-language pathologist" has the meaning
50.24given in section 148.512, subdivision 17.
50.25    Subd. 66. Standby assistance. "Standby assistance" means the presence of another
50.26person within arm's reach to minimize the risk of injury while performing daily activities
50.27through physical intervention or cueing to assist a resident with an assistive task by providing
50.28cues, oversight, and minimal physical assistance.
50.29    Subd. 67. Substantial compliance. "Substantial compliance" means complying with
50.30the requirements in this chapter sufficiently to prevent unacceptable health or safety risks
50.31to residents.
50.32    Subd. 68. Supportive services. "Supportive services" means:
51.1(1) assistance with laundry, shopping, and household chores;
51.2(2) housekeeping services;
51.3(3) provision or assistance with meals or food preparation;
51.4(4) help with arranging for, or arranging transportation to, medical, social, recreational,
51.5personal, or social services appointments; or
51.6(5) provision of social or recreational services.
51.7Arranging for services does not include making referrals, or contacting a service provider
51.8in an emergency.
51.9    Subd. 69. Survey. "Survey" means an inspection of a licensee or applicant for licensure
51.10for compliance with this chapter and applicable rules.
51.11    Subd. 70. Surveyor. "Surveyor" means a staff person of the department who is authorized
51.12to conduct surveys of assisted living facilities.
51.13    Subd. 71. Termination of housing or services. "Termination of housing or services"
51.14means a discharge, eviction, transfer, or service termination initiated by the facility. A
51.15facility-initiated termination is one to which the resident objects and which did not originate
51.16through a resident's verbal or written request. A resident-initiated termination is one where
51.17a resident or, if appropriate, a designated representative provided a verbal or written notice
51.18of intent to leave the facility. A resident-initiated termination does not include the general
51.19expression of a desire to return home or the elopement of a resident with cognitive
51.20impairment.
51.21    Subd. 72. Treatment or therapy. "Treatment" or "therapy" means the provision of care,
51.22other than medications, ordered or prescribed by a licensed health professional and provided
51.23to a resident to cure, rehabilitate, or ease symptoms.
51.24    Subd. 73. Unit of government. "Unit of government" means a city, county, town, school
51.25district, other political subdivision of the state, or agency of the state or federal government,
51.26that includes any instrumentality of a unit of government.
51.27    Subd. 74. Unlicensed personnel. "Unlicensed personnel" means individuals not otherwise
51.28licensed or certified by a governmental health board or agency who provide services to a
51.29resident.
51.30    Subd. 75. Verbal. "Verbal" means oral and not in writing.
51.31EFFECTIVE DATE.This section is effective August 1, 2021.

52.1    Sec. 3. [144I.02] ASSISTED LIVING FACILITY LICENSE.
52.2    Subdivision 1. License required. Beginning August 1, 2021, no assisted living facility
52.3may operate in Minnesota unless it is licensed under this chapter. The licensee is legally
52.4responsible for the management, control, and operation of the facility, regardless of the
52.5existence of a management agreement or subcontract. Nothing in this chapter shall in any
52.6way affect the rights and remedies available under other law.
52.7    Subd. 2. Licensure categories. (a) The categories in this subdivision are established for
52.8assisted living facility licensure.
52.9(b) The assisted living facility category is for assisted living facilities that only provide
52.10assisted living services.
52.11(c) The assisted living facility with dementia care category is for assisted living facilities
52.12that provide assisted living services and dementia care services. An assisted living facility
52.13with dementia care may also provide dementia care services in a secured dementia care
52.14unit.
52.15(d) An assisted living facility that has a secured dementia care unit must be licensed as
52.16an assisted living facility with dementia care.
52.17    Subd. 3. Licensure under other law. An assisted living facility licensed under this
52.18chapter is not required to also be licensed as a boarding establishment, food and beverage
52.19service establishment, hotel, motel, lodging establishment, resort, or restaurant under chapter
52.20157.
52.21    Subd. 4. Violations; penalty. (a) Operating an assisted living facility without a license
52.22is a misdemeanor punishable by a fine imposed by the commissioner.
52.23(b) A controlling individual of the facility in violation of this section is guilty of a
52.24misdemeanor. This paragraph shall not apply to any controlling individual who had no legal
52.25authority to affect or change decisions related to the operation of the facility.
52.26(c) The sanctions in this section do not restrict other available sanctions in law.
52.27EFFECTIVE DATE.This section is effective August 1, 2021.

52.28    Sec. 4. [144I.03] PROVISIONAL LICENSE.
52.29    Subdivision 1. Provisional license. Beginning August 1, 2021, for new assisted living
52.30facility license applicants, the commissioner shall issue a provisional license from one of
52.31the licensure categories specified in section 144I.02, subdivision 2. A provisional license
53.1is effective for up to one year from the initial effective date of the license, except that a
53.2provisional license may be extended according to subdivision 2, paragraphs (c) and (d).
53.3    Subd. 2. Initial survey; licensure. (a) During the provisional license period, the
53.4commissioner shall survey the provisional licensee after the commissioner is notified or
53.5has evidence that the provisional licensee is providing assisted living services to at least
53.6one resident.
53.7(b) Within two days of beginning to provide assisted living services, the provisional
53.8licensee must provide notice to the commissioner that it is providing assisted living services
53.9by sending an e-mail to the e-mail address provided by the commissioner. If the provisional
53.10licensee does not provide services during the provisional license period, the provisional
53.11license shall expire at the end of the period and the applicant must reapply.
53.12(c) If the provisional licensee notifies the commissioner that the licensee is providing
53.13assisted living services within 45 calendar days prior to expiration of the provisional license,
53.14the commissioner may extend the provisional license for up to 60 calendar days in order to
53.15allow the commissioner to complete the on-site survey required under this section and
53.16follow-up survey visits.
53.17(d) If the provisional licensee is in substantial compliance with the survey, the
53.18commissioner shall issue a facility license. If the provisional licensee is not in substantial
53.19compliance with the initial survey, the commissioner shall either: (1) not issue the facility
53.20license and terminate the provisional license; or (2) extend the provisional license for a
53.21period not to exceed 90 calendar days and apply conditions necessary to bring the facility
53.22into substantial compliance. If the provisional licensee is not in substantial compliance with
53.23the survey within the time period of the extension or if the provisional licensee does not
53.24satisfy the license conditions, the commissioner may deny the license.
53.25    Subd. 3. Reconsideration. (a) If a provisional licensee whose assisted living facility
53.26license has been denied or extended with conditions disagrees with the conclusions of the
53.27commissioner, then the provisional licensee may request a reconsideration by the
53.28commissioner. The reconsideration request process must be conducted internally by the
53.29commissioner and chapter 14 does not apply.
53.30(b) The provisional licensee requesting the reconsideration must make the request in
53.31writing and must list and describe the reasons why the provisional licensee disagrees with
53.32the decision to deny the facility license or the decision to extend the provisional license
53.33with conditions.
54.1(c) The reconsideration request and supporting documentation must be received by the
54.2commissioner within 15 calendar days after the date the provisional licensee receives the
54.3denial or provisional license with conditions.
54.4    Subd. 4. Continued operation. A provisional licensee whose license is denied is
54.5permitted to continue operating during the period of time when:
54.6(1) a reconsideration is in process;
54.7(2) an extension of the provisional license and terms associated with it is in active
54.8negotiation between the commissioner and the licensee and the commissioner confirms the
54.9negotiation is active; or
54.10(3) a transfer of residents to a new facility is underway and not all of the residents have
54.11relocated.
54.12    Subd. 5. Requirements for notice and transfer. A provisional licensee whose license
54.13is denied must comply with the requirements for notification and transfer of residents in
54.14section 144J.08.
54.15    Subd. 6. Fines. The fee for failure to comply with the notification requirements in section
54.16144J.08, subdivision 6, paragraph (b), is $1,000.
54.17EFFECTIVE DATE.This section is effective August 1, 2021.

54.18    Sec. 5. [144I.04] APPLICATION FOR LICENSURE.
54.19    Subdivision 1. License applications. (a) Each application for an assisted living facility
54.20license, including provisional and renewal applications, must include information sufficient
54.21to show that the applicant meets the requirements of licensure, including:
54.22(1) the business name and legal entity name of the licensee, and the street address and
54.23mailing address of the facility;
54.24(2) the names, e-mail addresses, telephone numbers, and mailing addresses of all owners,
54.25controlling individuals, managerial officials, and the assisted living director;
54.26(3) the name and e-mail address of the managing agent and manager, if applicable;
54.27(4) the licensed resident capacity and the license category;
54.28(5) the license fee in the amount specified in section 144.122;
54.29(6) documentation of compliance with the background study requirements in section
54.30144I.06 for the owner, controlling individuals, and managerial officials. Each application
55.1for a new license must include documentation for the applicant and for each individual with
55.2five percent or more direct or indirect ownership in the applicant;
55.3(7) evidence of workers' compensation coverage as required by sections 176.181 and
55.4176.182;
55.5    (8) documentation that the facility has liability coverage;
55.6    (9) a copy of the executed lease agreement between the landlord and the licensee, if
55.7applicable;
55.8    (10) a copy of the management agreement, if applicable;
55.9    (11) a copy of the operations transfer agreement or similar agreement, if applicable;
55.10    (12) an organizational chart that identifies all organizations and individuals with an
55.11ownership interest in the licensee of five percent or greater and that specifies their relationship
55.12with the licensee and with each other;
55.13(13) whether the applicant, owner, controlling individual, managerial official, or assisted
55.14living director of the facility has ever been convicted of:
55.15(i) a crime or found civilly liable for a federal or state felony level offense that was
55.16detrimental to the best interests of the facility and its resident within the last ten years
55.17preceding submission of the license application. Offenses include: felony crimes against
55.18persons and other similar crimes for which the individual was convicted, including guilty
55.19pleas and adjudicated pretrial diversions; financial crimes such as extortion, embezzlement,
55.20income tax evasion,, insurance fraud, and other similar crimes for which the individual was
55.21convicted, including guilty pleas and adjudicated pretrial diversions; any felonies involving
55.22malpractice that resulted in a conviction of criminal neglect or misconduct; and any felonies
55.23that would result in a mandatory exclusion under section 1128(a) of the Social Security
55.24Act;.
55.25(ii) any misdemeanor conviction, under federal or state law, related to: the delivery of
55.26an item or service under Medicaid or a state health care program, or the abuse or neglect of
55.27a patient in connection with the delivery of a health care item or service;
55.28(iii) any misdemeanor conviction, under federal or state law, related to theft, fraud,
55.29embezzlement, breach of fiduciary duty, or other financial misconduct in connection with
55.30the delivery of a health care item or service;
56.1(iv) any felony or misdemeanor conviction, under federal or state law, relating to the
56.2interference with or obstruction of any investigation into any criminal offense described in
56.3Code of Federal Regulations, title 42, section 1001.101 or 1001.201;
56.4(v) any felony or misdemeanor conviction, under federal or state law, relating to the
56.5unlawful manufacture, distribution, prescription, or dispensing of a controlled substance;
56.6(vi) any felony or gross misdemeanor that relates to the operation of a a nursing home
56.7or assisted living facility or directly affects resident safety or care during that period;
56.8(vii) any revocation or suspension of a license to provide health care by any state licensing
56.9authority. This includes the surrender of such a license while a formal disciplinary proceeding
56.10was pending before a state licensing authority;
56.11(viii) any revocation or suspension of accreditation; or
56.12(ix) any suspension or exclusion from participation in, or any sanction imposed by, a
56.13federal or state health care program, or any debarment from participation in any federal
56.14executive branch procurement or non-procurement program;
56.15    (14) whether, in the preceding three years, the applicant or any owner, controlling
56.16individual, managerial official, or assisted living director of the facility has a record of
56.17defaulting in the payment of money collected for others, including the discharge of debts
56.18through bankruptcy proceedings;
56.19    (15) the signature of the owner of the licensee, or an authorized agent of the licensee;
56.20(16) identification of all states where the applicant or individual having a five percent
56.21or more ownership, currently or previously has been licensed as an owner or operator of a
56.22long-term care, community-based, or health care facility or agency where its license or
56.23federal certification has been denied, suspended, restricted, conditioned, refused, not renewed,
56.24or revoked under a private or state-controlled receivership, or where these same actions are
56.25pending under the laws of any state or federal authority;
56.26(17) statistical information required by the commissioner; and
56.27(18) any other information required by the commissioner.
56.28    Subd. 2. Authorized agents. (a) An application for an assisted living facility license or
56.29for renewal of a facility license must specify one or more owners, controlling individuals,
56.30or employees as authorized agents who can accept service on behalf of the licensee in
56.31proceedings under this chapter.
57.1(b) Notwithstanding any law to the contrary, personal service on the authorized agent
57.2named in the application is deemed to be service on all of the controlling individuals or
57.3managerial officials of the facility, and it is not a defense to any action arising under this
57.4chapter that personal service was not made on each controlling individual or managerial
57.5official of the facility. The designation of one or more controlling individuals or managerial
57.6officials under this subdivision shall not affect the legal responsibility of any other controlling
57.7individual or managerial official under this chapter.
57.8    Subd. 3. Fees. (a) An initial applicant, renewal applicant, or applicant filing a change
57.9of ownership for assisted living facility licensure must submit the application fee required
57.10in section 144.122 to the commissioner along with a completed application.
57.11(b) The penalty for late submission of the renewal application less than 30 days before
57.12the expiration date of the license or after expiration of the license is $200. The penalty for
57.13operating a facility after expiration of the license and before a renewal license is issued, is
57.14$250 each day after expiration of the license until the renewal license issuance date. The
57.15facility is still subject to the misdemeanor penalties for operating after license expiration.
57.16(c) Fees collected under this section shall be deposited in the state treasury and credited
57.17to the state government special revenue fund. All fees are nonrefundable.
57.18(d) Fines collected under this subdivision shall be deposited in a dedicated special revenue
57.19account. On an annual basis, the balance in the special revenue account shall be appropriated
57.20to the commissioner to implement the recommendations of the advisory council established
57.21in section 144A.4799.
57.22EFFECTIVE DATE.This section is effective August 1, 2021.

57.23    Sec. 6. [144I.05] TRANSFER OF LICENSE PROHIBITED.
57.24    Subdivision 1. Transfers prohibited. An assisted living facility license may not be
57.25transferred to another party.
57.26    Subd. 2. New license required. (a) A prospective licensee must apply for a license prior
57.27to operating a currently licensed assisted living facility. The new license, if issued, shall
57.28not be a provisional license. The licensee must change whenever one of the following events
57.29occur:
57.30(1) the form of the licensee's legal entity structure is converted or changed to a different
57.31type of legal entity structure;
58.1(2) the licensee dissolves, consolidates, or merges with another legal organization and
58.2the licensee's legal organization does not survive;
58.3(3) within the previous 24 months, 50 percent or more of the licensee is transferred,
58.4whether by a single transaction or multiple transactions, to:
58.5(i) a different person; or
58.6(ii) a person who had less than a five percent ownership interest in the facility at the
58.7time of the first transaction; or
58.8(4) any other event or combination of events that results in a substitution, elimination,
58.9or withdrawal of the licensee's responsibility for the facility.
58.10(b) The prospective licensee must provide written notice to the department at least 60
58.11calendar days prior to the anticipated date of the change of licensee.
58.12    Subd. 3. Survey required. For all new licensees after a change of ownership, the
58.13commissioner shall complete a survey within six months after the new license is issued.
58.14EFFECTIVE DATE.This section is effective August 1, 2021.

58.15    Sec. 7. [144I.06] BACKGROUND STUDIES.
58.16    Subdivision 1. Background studies required. (a) Before the commissioner issues a
58.17provisional license, issues a license as a result of an approved change of ownership, or
58.18renews a license, a managerial official or a natural person who is an owner with direct
58.19ownership interest is required to undergo a background study under section 144.057. No
58.20person may be involved in the management, operation, or control of an assisted living facility
58.21if the person has been disqualified under chapter 245C. For the purposes of this section,
58.22managerial officials subject to the background study requirement are individuals who provide
58.23direct contact.
58.24(b) The commissioner shall not issue a license if any controlling individual, including
58.25a managerial official, has been unsuccessful in having a background study disqualification
58.26set aside under section 144.057 and chapter 245C.
58.27(c) Employees, contractors, and regularly-scheduled volunteers of the facility are subject
58.28to the background study required by section 144.057 and may be disqualified under chapter
58.29245C. Nothing in this section shall be construed to prohibit the facility from requiring
58.30self-disclosure of criminal conviction information.
58.31    Subd. 2. Reconsideration. If an individual is disqualified under section 144.057 or
58.32chapter 245C, the individual may request reconsideration of the disqualification. If the
59.1individual requests reconsideration and the commissioner sets aside or rescinds the
59.2disqualification, the individual is eligible to be involved in the management, operation, or
59.3control of the facility. If an individual has a disqualification under section 245C.15,
59.4subdivision 1, and the disqualification is affirmed, the individual's disqualification is barred
59.5from a set aside, and the individual must not be involved in the management, operation, or
59.6control of the facility.
59.7    Subd. 3. Data classification. Data collected under this section shall be classified as
59.8private data on individuals under section 13.02, subdivision 12.
59.9    Subd. 4. Termination in good faith. Termination of an employee in good faith reliance
59.10on information or records obtained under this section regarding a confirmed conviction does
59.11not subject the assisted living facility to civil liability or liability for unemployment benefits.
59.12EFFECTIVE DATE.This section is effective August 1, 2021.

59.13    Sec. 8. [144I.07] LICENSE RENEWAL.
59.14A license that is not a provisional license may be renewed for a period of up to one year
59.15if the licensee:
59.16(1) submits an application for renewal in the format provided by the commissioner at
59.17least 60 calendar days before expiration of the license;
59.18(2) submits the renewal fee under section 144I.04, subdivision 3;
59.19(3) submits the late fee under section 144I.04, subdivision 3, if the renewal application
59.20is received less than 30 days before the expiration date of the license or after the expiration
59.21of the license;
59.22(4) provides information sufficient to show that the applicant meets the requirements of
59.23licensure, including items required under section 144I.04, subdivision 1; and
59.24(5) provides any other information deemed necessary by the commissioner.
59.25EFFECTIVE DATE.This section is effective August 1, 2021.

59.26    Sec. 9. [144I.08] NOTIFICATION OF CHANGES IN INFORMATION.
59.27A provisional licensee or licensee shall notify the commissioner in writing prior to a
59.28change in the manager or authorized agent and within 60 calendar days after any change in
59.29the information required in section 144I.04, subdivision 1, paragraph (a), clause (1), (3),
59.30(4), (17), or (18).
60.1EFFECTIVE DATE.This section is effective August 1, 2021.

60.2    Sec. 10. [144I.09] CONSIDERATION OF APPLICATIONS.
60.3(a) Before issuing a provisional license or license or renewing a license, the commissioner
60.4shall consider an applicant's compliance history in providing care in a facility that provides
60.5care to children, the elderly, ill individuals, or individuals with disabilities.
60.6(b) The applicant's compliance history shall include repeat violation, rule violations, and
60.7any license or certification involuntarily suspended ot terminated during an enforcement
60.8process.
60.9(c) The commissioner may deny, revoke, suspend, restrict, or refuse to renew the license
60.10or impose conditions if:
60.11(1) the applicant fails to provide complete and accurate information on the application
60.12and the commissioner concludes that the missing or corrected information is needed to
60.13determine if a license shall be granted;
60.14(2) the applicant, knowingly or with reason to know, made a false statement of a material
60.15fact in an application for the license or any data attached to the application or in any matter
60.16under investigation by the department;
60.17(3) the applicant refused to allow agents of the commissioner to inspect its books, records,
60.18and files related to the license application, or any portion of the premises;
60.19(4) the applicant willfully prevented, interfered with, or attempted to impede in any way:
60.20(i) the work of any authorized representative of the commissioner, the ombudsman for
60.21long-term care, or the ombudsman for mental health and developmental disabilities; or (ii)
60.22the duties of the commissioner, local law enforcement, city or county attorneys, adult
60.23protection, county case managers, or other local government personnel;
60.24(5) the applicant has a history of noncompliance with federal or state regulations that
60.25were detrimental to the health, welfare, or safety of a resident or a client; or
60.26(6) the applicant violates any requirement in this chapter.
60.27(e) If a license is denied, the applicant has the reconsideration rights available under
60.28section 144I.03, subdivision 3.
60.29EFFECTIVE DATE.This section is effective August 1, 2021.

61.1    Sec. 11. [144I.10] MINIMUM ASSISTED LIVING FACILITY REQUIREMENTS.
61.2    Subdivision 1. Minimum requirements. (a) All assisted living facilities shall:
61.3(1) distribute to residents, families, and resident representatives the assisted living bill
61.4of rights;
61.5(2) provide services in a manner that complies with the Nurse Practice Act in sections
61.6148.171 to 148.285;
61.7(3) utilize a person-centered planning and service delivery process;
61.8(4) have and maintain a system for delegation of health care activities to unlicensed
61.9personnel by a registered nurse, including supervision and evaluation of the delegated
61.10activities as required by the Nurse Practice Act in sections 148.171 to 148.285;
61.11(5) provide a means for residents to request assistance for health and safety needs 24
61.12hours per day, seven days per week;
61.13(6) allow residents the ability to furnish and decorate the resident's unit within the terms
61.14of the assisted living contract;
61.15(7) permit residents access to food at any time;
61.16(8) allow residents to choose the resident's visitors and times of visits;
61.17(9) allow the resident the right to choose a roommate if sharing a unit;
61.18(10) notify the resident of the resident's right to have and use a lockable door to the
61.19resident's unit. The licensee shall provide the locks on the unit. Only a staff member with
61.20a specific need to enter the unit shall have keys, and advance notice must be given to the
61.21resident before entrance, when possible. An assisted living facility must not lock a resident
61.22in the resident's unit;
61.23(11) develop and implement a staffing plan for determining its staffing level that:
61.24(i) includes an evaluation, to be conducted at least twice a year, of the appropriateness
61.25of staffing levels in the facility;
61.26(ii) ensures sufficient staffing at all times to meet the scheduled and reasonably
61.27foreseeable unscheduled needs of each resident as required by the residents' assessments
61.28and service plans on a 24-hour per day basis; and
61.29(iii) ensures that the facility can respond promptly and effectively to individual resident
61.30emergencies and to emergency, life safety, and disaster situations affecting staff or residents
61.31in the facility;
62.1(12) ensures that one or more persons are available 24 hours per day, seven days per
62.2week, who are responsible for responding to the requests of residents for assistance with
62.3health or safety needs. Such persons must be:
62.4(i) awake;
62.5(ii) located in the same building, in an attached building, or on a contiguous campus
62.6with the facility in order to respond within a reasonable amount of time;
62.7(iii) capable of communicating with residents;
62.8(iv) capable of providing or summoning the appropriate assistance;
62.9(v) capable of following directions; and
62.10(vi) for an assisted living facility with dementia care providing services in a secured
62.11dementia care unit, an awake person must be physically present in the secured dementia
62.12care unit;
62.13(13) offer to provide or make available at least the following services to residents:
62.14(i) at least three nutritious meals daily with snacks available seven days per week,
62.15according to the recommended dietary allowances in the United States Department of
62.16Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables. The
62.17following apply:
62.18(A) menus must be prepared at least one week in advance, and made available to all
62.19residents. The facility must encourage residents' involvement in menu planning. Meal
62.20substitutions must be of similar nutritional value if a resident refuses a food that is served.
62.21Residents must be informed in advance of menu changes;
62.22(B) food must be prepared and served according to the Minnesota Food Code, Minnesota
62.23Rules, chapter 4626; and
62.24(C) the facility cannot require a resident to include and pay for meals in their contract;
62.25(ii) weekly housekeeping;
62.26(iii) weekly laundry service;
62.27(iv) upon the request of the resident, provide direct or reasonable assistance with arranging
62.28for transportation to medical and social services appointments, shopping, and other recreation,
62.29and provide the name of or other identifying information about the persons responsible for
62.30providing this assistance;
63.1(v) upon the request of the resident, provide reasonable assistance with accessing
63.2community resources and social services available in the community, and provide the name
63.3of or other identifying information about persons responsible for providing this assistance;
63.4(vi) provide culturally sensitive programs; and
63.5(vii) have a daily program of social and recreational activities that are based upon
63.6individual and group interests, physical, mental, and psychosocial needs, and that creates
63.7opportunities for active participation in the community at large.
63.8(b) The resident's rights in section 144I.101, subdivisions 12, 13, and 18, may be restricted
63.9for an individual resident only if determined necessary for health and safety reasons identified
63.10by the facility through an initial assessment or reassessment under section 144I.16,
63.11subdivision 2, and documented in the written service plan under section 144I.16, subdivision
63.124. Any restrictions of those rights for people served under sections 256B.0915 and 256B.49
63.13must be documented by the case manager in the resident's coordinated service and support
63.14plan (CSSP), as defined in sections 256B.0915, subdivision 6, and 256B.49, subdivision
63.1515. Nothing in this section affects other laws applicable to or prohibiting restrictions on the
63.16resident's rights in section 144I.101, subdivisions 12, 13, and 18.
63.17    Subd. 2. Policies and procedures. (a) Each assisted living facility must have policies
63.18and procedures in place to address the following and keep them current:
63.19(1) requirements in section 626.557, reporting of maltreatment of vulnerable adults;
63.20(2) conducting and handling background studies on employees;
63.21(3) orientation, training, and competency evaluations of staff, and a process for evaluating
63.22staff performance;
63.23(4) handling complaints from residents, family members, or designated representatives
63.24regarding staff or services provided by staff;
63.25(5) conducting initial evaluations of residents' needs and the providers' ability to provide
63.26those services;
63.27(6) conducting initial and ongoing resident evaluations and assessments of resident
63.28needs, including assessments by a registered nurse or appropriate licensed health professional,
63.29and how changes in a resident's condition are identified, managed, and communicated to
63.30staff and other health care providers as appropriate;
63.31(7) orientation to and implementation of the assisted living bill of rights;
63.32(8) infection control practices;
64.1(9) reminders for medications, treatments, or exercises, if provided;
64.2(10) conducting appropriate screenings, or documentation of prior screenings, to show
64.3that staff are free of tuberculosis, consistent with current United States Centers for Disease
64.4Control and Prevention standards;
64.5(11) ensuring that nurses and licensed health professionals have current and valid licenses
64.6to practice;
64.7(12) medication and treatment management;
64.8(13) delegation of tasks by registered nurses or licensed health professionals;
64.9(14) supervision of registered nurses and licensed health professionals; and
64.10(15) supervision of unlicensed personnel performing delegated tasks.
64.11    Subd. 3. Infection control program. All assisted living facilities must establish and
64.12maintain an infection control program.
64.13    Subd. 4. Clinical nurse supervision. All assisted living facilities must have a clinical
64.14nurse supervisor who is a registered nurse licensed in Minnesota.
64.15    Subd. 5. Resident councils. The facility must provide a resident council with space and
64.16privacy for meetings, where doing so is reasonably achievable. Staff, visitors, and other
64.17guests may attend a resident council meeting only at the council's invitation. The facility
64.18must designate a staff person who is approved by the resident council to be responsible for
64.19providing assistance and responding to written requests that result from meetings. The
64.20facility must consider the views of the resident council and must respond promptly to the
64.21grievances and recommendations of the council, but a facility is not required to implement
64.22as recommended every request of the council. The facility shall, with the approval of the
64.23resident council, take reasonably achievable steps to make residents aware of upcoming
64.24meetings in a timely manner.
64.25    Subd. 6. Family councils. The facility must provide a family council with space and
64.26privacy for meetings, where doing so is reasonably achievable. The facility must designate
64.27a staff person who is approved by the family council to be responsible for providing
64.28assistance and responding to written requests that result from meetings. The facility must
64.29consider the views of the family council and must respond promptly to the grievances and
64.30recommendations of the council, but a facility is not required to implement as recommended
64.31every request of the council. The facility shall, with the approval of the family council, take
64.32reasonably achievable steps to make residents and family members aware of upcoming
64.33meetings in a timely manner.
65.1    Subd. 7. Resident grievances; reporting maltreatment. All facilities must post in a
65.2conspicuous place information about the facilities' grievance procedure, and the name,
65.3telephone number, and e-mail contact information for the individuals who are responsible
65.4for handling resident grievances. The notice must also have the contact information for the
65.5state and applicable regional Office of Ombudsman for Long-Term Care and the Office of
65.6Ombudsman for Mental Health and Developmental Disabilities, and must have information
65.7for reporting suspected maltreatment to the Minnesota Adult Abuse Reporting Center.
65.8    Subd. 8. Protecting resident rights. All facilities shall ensure that every resident has
65.9access to consumer advocacy or legal services by:
65.10(1) providing names and contact information, including telephone numbers and e-mail
65.11addresses of at least three organizations that provide advocacy or legal services to residents;
65.12(2) providing the name and contact information for the Minnesota Office of Ombudsman
65.13for Long-Term Care and the Office of the Ombudsman for Mental Health and Developmental
65.14Disabilities, including both the state and regional contact information;
65.15(3) assisting residents in obtaining information on whether Medicare or medical assistance
65.16under chapter 256B will pay for services;
65.17(4) making reasonable accommodations for people who have communication disabilities
65.18and those who speak a language other than English; and
65.19(5) providing all information and notices in plain language and in terms the residents
65.20can understand.
65.21    Subd. 9. Payment for services under disability waivers. For new assisted living
65.22facilities that did not operate as registered housing with services establishments prior to
65.23August 1, 2021, home and community-based services under section 256B.49 are not available
65.24when the new facility setting is adjoined to, or on the same property as, an institution as
65.25defined in Code of Federal Regulations, title 42, section 441.301(c).
65.26EFFECTIVE DATE.This section is effective August 1, 2021.

65.27    Section 1. [144I.101] ASSISTED LIVING BILL OF RIGHTS.
65.28    Subdivision 1. Applicability. This section applies to residents living in assisted living
65.29facilities.
65.30    Subd. 2. Legislative intent. The rights established under this section for the benefit of
65.31residents do not limit any other rights available under law. No facility may request or require
66.1that any resident waive any of these rights at any time for any reason, including as a condition
66.2of admission to the facility.
66.3    Subd. 3. Information about rights. Before receiving services, residents have the right
66.4to be informed by the facility of the rights granted under this section and the recourse
66.5residents have if rights are violated. The information must be in plain language and in terms
66.6residents can understand. The facility must make reasonable accommodations for residents
66.7who have communication disabilities and those who speak a language other than English.
66.8    Subd. 4. Appropriate care and services. (a) Residents have the right to care and assisted
66.9living services that are appropriate based on the resident's needs and according to an
66.10up-to-date service plan subject to accepted health care standards.
66.11(b) Residents have the right to receive health care and other assisted living services with
66.12continuity from people who are properly trained and competent to perform their duties and
66.13in sufficient numbers to adequately provide the services agreed to in the assisted living
66.14contract and the service plan.
66.15    Subd. 5. Refusal of care or services. Residents have the right to refuse care or assisted
66.16living services and to be informed by the facility of the medical, health-related, or
66.17psychological consequences of refusing care or services.
66.18    Subd. 6. Participation in care and service planning. Residents have the right to actively
66.19participate in the planning, modification, and evaluation of their care and services. This
66.20right includes:
66.21(1) the opportunity to discuss care, services, treatment, and alternatives with the
66.22appropriate caregivers;
66.23(2) the right to include a family member or the resident's health care agent and designated
66.24representative, or both; and
66.25(3) the right to be told in advance of, and take an active part in decisions regarding, any
66.26recommended changes in the service plan.
66.27    Subd. 7. Courteous treatment. Residents have the right to be treated with courtesy and
66.28respect, and to have the resident's property treated with respect.
66.29    Subd. 8. Freedom from maltreatment. Residents have the right to be free from physical,
66.30sexual, and emotional abuse; neglect; financial exploitation; and all forms of maltreatment
66.31covered under the Vulnerable Adults Act.
67.1    Subd. 9. Right to come and go freely. Residents have the right to enter and leave the
67.2facility as they choose. This right may be restricted only as allowed by other law and
67.3consistent with a resident's service plan.
67.4    Subd. 10. Individual autonomy. Residents have the right to individual autonomy,
67.5initiative, and independence in making life choices, including establishing a daily schedule
67.6and choosing with whom to interact.
67.7    Subd. 11. Right to control resources. Residents have the right to control personal
67.8resources.
67.9    Subd. 12. Visitors and social participation. (a) Residents have the right to meet with
67.10or receive visits at any time by the resident's family, guardian, conservator, health care
67.11agent, attorney, advocate, or religious or social work counselor, or any person of the resident's
67.12choosing. This right may be restricted in certain circumstances if necessary for the resident's
67.13health and safety and if documented in the resident's service plan.
67.14(b) Residents have the right to engage in community life and in activities of their choice.
67.15This includes the right to participate in commercial, religious, social, community, and
67.16political activities without interference and at their discretion if the activities do not infringe
67.17on the rights of other residents.
67.18    Subd. 13. Personal and treatment privacy. (a) Residents have the right to consideration
67.19of their privacy, individuality, and cultural identity as related to their social, religious, and
67.20psychological well-being. Staff must respect the privacy of a resident's space by knocking
67.21on the door and seeking consent before entering, except in an emergency or where clearly
67.22inadvisable or unless otherwise documented in the resident's service plan.
67.23(b) Residents have the right to have and use a lockable door to the resident's unit. The
67.24facility shall provide locks on the resident's unit. Only a staff member with a specific need
67.25to enter the unit shall have keys. This right may be restricted in certain circumstances if
67.26necessary for a resident's health and safety and documented in the resident's service plan.
67.27(c) Residents have the right to respect and privacy regarding the resident's service plan.
67.28Case discussion, consultation, examination, and treatment are confidential and must be
67.29conducted discreetly. Privacy must be respected during toileting, bathing, and other activities
67.30of personal hygiene, except as needed for resident safety or assistance.
67.31    Subd. 14. Communication privacy. (a) Residents have the right to communicate
67.32privately with persons of their choice.
68.1(b) If an assisted living facility is sending or receiving mail on behalf of residents, the
68.2assisted living facility must do so without interference.
68.3(c) Residents must be provided access to a telephone to make and receive calls.
68.4    Subd. 15. Confidentiality of records. (a) Residents have the right to have personal,
68.5financial, health, and medical information kept private, to approve or refuse release of
68.6information to any outside party, and to be advised of the assisted living facility's policies
68.7and procedures regarding disclosure of the information. Residents must be notified when
68.8personal records are requested by any outside party.
68.9(b) Residents have the right to access their own records.
68.10    Subd. 16. Right to furnish and decorate. Residents have the right to furnish and decorate
68.11the resident's unit within the terms of the assisted living contract.
68.12    Subd. 17. Right to choose roommate. Residents have the right to choose a roommate
68.13if sharing a unit.
68.14    Subd. 18. Right to access food. Residents have the right to access food at any time.
68.15This right may be restricted in certain circumstances if necessary for the resident's health
68.16and safety and if documented in the resident's service plan.
68.17    Subd. 19. Access to technology. Residents have the right to access Internet service at
68.18their expense.
68.19    Subd. 20. Grievances and inquiries. Residents have the right to make and receive a
68.20timely response to a complaint or inquiry, without limitation. Residents have the right to
68.21know and every facility must provide the name and contact information of the person
68.22representing the facility who is designated to handle and resolve complaints and inquiries.
68.23    Subd. 21. Access to counsel and advocacy services. Residents have the right to the
68.24immediate access by:
68.25(1) the resident's legal counsel;
68.26(2) any representative of the protection and advocacy system designated by the state
68.27under Code of Federal Regulations, title 45, section 1326.21; or
68.28(3) any representative of the Office of Ombudsman for Long-Term Care.
68.29    Subd. 22. Information about charges. Before services are initiated, residents have the
68.30right to be notified:
68.31(1) of all charges for housing and assisted living services;
69.1(2) of any limits on housing and assisted living services available;
69.2(3) if known, whether and what amount of payment may be expected from health
69.3insurance, public programs, or other sources; and
69.4(4) what charges the resident may be responsible for paying.
69.5    Subd. 23. Information about individuals providing services. Before receiving services
69.6identified in the service plan, residents have the right to be told the type and disciplines of
69.7staff who will be providing the services, the frequency of visits proposed to be furnished,
69.8and other choices that are available for addressing the resident's needs.
69.9    Subd. 24. Information about other providers and services. Residents have the right
69.10to be informed by the assisted living facility, prior to executing an assisted living contract,
69.11that other public and private services may be available and that the resident has the right to
69.12purchase, contract for, or obtain services from a provider other than the assisted living
69.13facility.
69.14    Subd. 25. Resident councils. Residents have the right to organize and participate in
69.15resident councils as described in section 144I.10, subdivision 5.
69.16    Subd. 26. Family councils. Residents have the right to participate in family councils
69.17formed by families or residents as described in section 144I.10, subdivision 6.
69.18EFFECTIVE DATE.This section is effective August 1, 2021.

69.19    Sec. 13. [144I.11] HOUSING AND SERVICES.
69.20    Subdivision 1. Responsibility for housing and services. The facility is directly
69.21responsible to the resident for all housing and service-related matters provided, irrespective
69.22of a management contract. Housing and service-related matters include but are not limited
69.23to the handling of complaints, the provision of notices, and the initiation of any adverse
69.24action against the resident involving housing or services provided by the facility.
69.25    Subd. 2. Uniform checklist disclosure of services. (a) On and after August 1, 2021, all
69.26assisted living facilities must provide to prospective residents, the prospective resident's
69.27legal and designated representatives, and any other person or persons the resident chooses:
69.28(1) a disclosure of the categories of assisted living licenses available and the category
69.29of license held by the facility;
69.30(2) a written checklist listing all services permitted under the facility's license, identifying
69.31all services the facility offers to provide under the assisted living facility contract, and
69.32identifying all services allowed under the license that the facility does not provide; and
70.1(2) an oral explanation of the services offered under the contract.
70.2(b) The requirements of paragraph (a) must be completed prior to the execution of the
70.3assisted living contract.
70.4(c) The commissioner must, in consultation with all interested stakeholders, design the
70.5uniform checklist disclosure form for use as provided under paragraph (a).
70.6    Subd. 3. Reservation of rights. Nothing in this chapter:
70.7(1) requires a resident to utilize any service provided by or through, or made available
70.8in, a facility;
70.9(2) prevents a facility from requiring, as a condition of the contract, that the resident pay
70.10for a package of services even if the resident does not choose to use all or some of the
70.11services in the package. For residents who are eligible for home and community-based
70.12waiver services under sections 256B.0915 and 256B.49, payment for services will follow
70.13the policies of those programs;
70.14(3) requires a facility to fundamentally alter the nature of the operations of the facility
70.15in order to accommodate a resident's request; or
70.16(4) affects the duty of a facility to grant a resident's request for reasonable
70.17accommodations.
70.18EFFECTIVE DATE.This section is effective August 1, 2021.

70.19    Sec. 14. [144I.12] TRANSFER OF RESIDENTS WITHIN FACILITY.
70.20    Subdivision 1. Transfers. (a) All assisted living facilities must provide for the safe,
70.21orderly, and appropriate transfer of residents within the facility.
70.22(b) If an assisted living contract permits resident transfers within a facility, the facility
70.23must comply with the notice requirements in subdivision 2.
70.24(c) In situations where there is a curtailment, reduction, capital improvement, or change
70.25in operations within a facility, the facility must minimize the number of transfers needed
70.26to complete the project or change in operations, consider individual resident needs and
70.27preferences, and provide reasonable accommodation for individual resident requests regarding
70.28the room transfer. The facility must provide notice to the Office of Ombudsman for
70.29Long-Term Care and, when appropriate, the Office of Ombudsman for Mental Health and
70.30Developmental Disabilities in advance of any notice to residents, residents' legal and
70.31designated representatives, and families when all of the following circumstances apply:
71.1(1) the transfers of residents within the facility are being proposed due to curtailment,
71.2reduction, capital improvements, or change in operations;
71.3(2) the transfers of residents within the facility are not temporary moves to accommodate
71.4physical plan upgrades or renovation; and
71.5(3) the transfers involve multiple residents being moved simultaneously.
71.6    Subd. 2. Notice required before transfer within facility. (a) A facility must:
71.7(1) notify a resident and the resident's legal and designated representatives, if any, at
71.8least 30 calendar days prior to a proposed nonemergency transfer within the facility; and
71.9(2) obtain consent from the resident or the resident's legal or designated representative,
71.10if any.
71.11    (b) A resident must be allowed to stay in the resident's room. If a resident consents to a
71.12move, any needed reasonable modifications must be made to the new room to accommodate
71.13the resident's disabilities.
71.14    Subd. 3. Evaluation. A facility shall evaluate the resident's individual needs before
71.15deciding whether the room to which the resident will be moved fits the resident's
71.16psychological, cognitive, and health care needs, including the accessibility of the bathroom.
71.17    Subd. 4. Restriction on transfer. A person who has been a private-pay resident for at
71.18least one year and resides in a private room, and whose payments subsequently will be made
71.19under the medical assistance program under chapter 256B, may not be relocated to a shared
71.20room without the consent of the resident or the resident's legal or designated representative,
71.21if any.
71.22EFFECTIVE DATE.This section is effective August 1, 2021.

71.23    Sec. 15. [144I.13] BUSINESS OPERATION.
71.24    Subdivision 1. Display of license. The original current license must be displayed at the
71.25main entrance of each assisted living facility. The facility must provide a copy of the license
71.26to any person who requests it.
71.27    Subd. 2. Quality management. The facility shall engage in quality management
71.28appropriate to the size of the facility and relevant to the type of services provided. The
71.29quality management activity means evaluating the quality of care by periodically reviewing
71.30resident services, complaints made, and other issues that have occurred and determining
71.31whether changes in services, staffing, or other procedures need to be made in order to ensure
71.32safe and competent services to residents. Documentation about quality management activity
72.1must be available for two years. Information about quality management must be available
72.2to the commissioner at the time of the survey, investigation, or renewal.
72.3    Subd. 3. Facility restrictions. (a) This subdivision does not apply to licensees that are
72.4Minnesota counties or other units of government.
72.5(b) A facility or staff person may not:
72.6(1) accept a power-of-attorney from residents for any purpose, and may not accept
72.7appointments as guardians or conservators of residents; or
72.8(2) borrow a resident's funds or personal or real property, nor in any way convert a
72.9resident's property to the possession of the facility or staff person.
72.10(c) A facility may not serve as a resident's legal, designated, or other representative.
72.11(d) Nothing in this subdivision precludes a facility or staff person from accepting gifts
72.12of minimal value or precludes acceptance of donations or bequests made to a facility that
72.13are exempt from section 501(c)(3) of the Internal Revenue Code.
72.14    Subd. 4. Handling residents' finances and property. (a) A facility may assist residents
72.15with household budgeting, including paying bills and purchasing household goods, but may
72.16not otherwise manage a resident's property.
72.17(b) Where funds are deposited with the facility by the resident, the licensee:
72.18(1) retains fiduciary and custodial responsibility for the funds;
72.19(2) is directly accountable to the resident for the funds; and
72.20(3) must maintain records of and provide a resident with receipts for all transactions and
72.21purchases made with the resident's funds. When receipts are not available, the transaction
72.22or purchase must be documented.
72.23(c) Subject to paragraph (d), if responsibilities for day-to-day management of the resident
72.24funds are delegated to the manager, the manager must:
72.25(1) provide the licensee with a monthly accounting of the resident funds; and
72.26(2) meet all legal requirements related to holding and accounting for resident funds.
72.27(d) The facility must ensure any party responsible for holding or managing residents'
72.28personal funds is bonded or obtains insurance in sufficient amounts to specifically cover
72.29losses of resident funds and provides proof of the bond or insurance.
73.1    Subd. 5. Final accounting; return of money and property. Within 30 days of the
73.2effective date of a facility-initiated or resident-initiated termination of housing or services
73.3or the death of the resident, the facility must:
73.4(1) provide to the resident, resident's legal representative, and resident's designated
73.5representative a final statement of account;
73.6(2) provide any refunds due;
73.7(3) return any money, property, or valuables held in trust or custody by the facility; and
73.8(4) as required under section 504B.178, refund the resident's security deposit unless it
73.9is applied to the first month's charges.
73.10    Subd. 6. Compliance with requirements for reporting maltreatment of vulnerable
73.11adults; abuse prevention plan. (a) The assisted living facility must comply with the
73.12requirements for the reporting of maltreatment of vulnerable adults in section 626.557. The
73.13facility must establish and implement a written procedure to ensure that all cases of suspected
73.14maltreatment are reported.
73.15(b) The facility must develop and implement an individual abuse prevention plan for
73.16each vulnerable adult. The plan shall contain an individualized review or assessment of the
73.17person's susceptibility to abuse by another individual, including other vulnerable adults; the
73.18person's risk of abusing other vulnerable adults; and statements of the specific measures to
73.19be taken to minimize the risk of abuse to that person and other vulnerable adults. For purposes
73.20of the abuse prevention plan, abuse includes self-abuse.
73.21    Subd. 7. Posting information for reporting suspected crime and maltreatment. The
73.22facility shall support protection and safety through access to the state's systems for reporting
73.23suspected criminal activity and suspected vulnerable adult maltreatment by:
73.24(1) posting the 911 emergency number in common areas and near telephones provided
73.25by the assisted living facility;
73.26(2) posting information and the reporting number for the Minnesota Adult Abuse
73.27Reporting Center to report suspected maltreatment of a vulnerable adult under section
73.28626.557; and
73.29(3) providing reasonable accommodations with information and notices in plain language.
73.30    Subd. 8. Employee records. (a) The facility must maintain current records of each paid
73.31employee, each regularly scheduled volunteer providing services, and each individual
73.32contractor providing services. The records must include the following information:
74.1(1) evidence of current professional licensure, registration, or certification if licensure,
74.2registration, or certification is required by this chapter or rules;
74.3(2) records of orientation, required annual training and infection control training, and
74.4competency evaluations;
74.5(3) current job description, including qualifications, responsibilities, and identification
74.6of staff persons providing supervision;
74.7(4) documentation of annual performance reviews that identify areas of improvement
74.8needed and training needs;
74.9(5) for individuals providing assisted living services, verification that required health
74.10screenings under subdivision 9, have taken place and the dates of those screenings; and
74.11(6) documentation of the background study as required under section 144.057.
74.12    (b) Each employee record must be retained for at least three years after a paid employee,
74.13volunteer, or contractor ceases to be employed by, provide services at, or be under contract
74.14with the facility. If a facility ceases operation, employee records must be maintained for
74.15three years after facility operations cease.
74.16    Subd. 9. Tuberculosis prevention and control. The facility must establish and maintain
74.17a comprehensive tuberculosis infection control program according to the most current
74.18tuberculosis infection control guidelines issued by the United States Centers for Disease
74.19Control and Prevention (CDC), Division of Tuberculosis Elimination, as published in the
74.20CDC's Morbidity and Mortality Weekly Report (MMWR). The program must include a
74.21tuberculosis infection control plan that covers all paid and unpaid employees, contractors,
74.22students, and regularly scheduled volunteers. The commissioner shall provide technical
74.23assistance regarding implementation of the guidelines.
74.24    Subd. 10. Disaster planning and emergency preparedness plan. (a) The facility must
74.25meet the following requirements:
74.26(1) have a written emergency disaster plan that contains a plan for evacuation, addresses
74.27elements of sheltering in place, identifies temporary relocation sites, and details staff
74.28assignments in the event of a disaster or an emergency;
74.29(2) post an emergency disaster plan prominently;
74.30(3) provide building emergency exit diagrams to all residents;
74.31(4) post emergency exit diagrams on each floor; and
74.32(5) have a written policy and procedure regarding missing tenant residents.
75.1(b) The facility must provide emergency and disaster training to all staff during the initial
75.2staff orientation and annually thereafter and must make emergency and disaster training
75.3annually available to all residents. Staff who have not received emergency and disaster
75.4training are allowed to work only when trained staff are also working on site.
75.5(c) The facility must meet any additional requirements adopted in rule.
75.6EFFECTIVE DATE.This section is effective August 1, 2021.

75.7    Sec. 16. [144I.14] STAFFING AND SUPERVISORY REQUIREMENTS.
75.8    Subdivision 1. Qualifications, training, and competency. All staff persons providing
75.9assisted living services must be trained and competent in the provision of services consistent
75.10with current practice standards appropriate to the resident's needs, and promote and be
75.11trained to support the assisted living bill of rights.
75.12    Subd. 2. Licensed health professionals and nurses. (a) Licensed health professionals
75.13and nurses providing services as employees of a licensed facility must possess a current
75.14Minnesota license or registration to practice.
75.15(b) Licensed health professionals and registered nurses must be competent in assessing
75.16resident needs, planning appropriate services to meet resident needs, implementing services,
75.17and supervising staff if assigned.
75.18(c) Nothing in this section limits or expands the rights of nurses or licensed health
75.19professionals to provide services within the scope of their licenses or registrations, as
75.20provided by law.
75.21    Subd. 3. Unlicensed personnel. (a) Unlicensed personnel providing assisted living
75.22services must have:
75.23(1) successfully completed a training and competency evaluation appropriate to the
75.24services provided by the facility and the topics listed in subdivision 10, paragraph (b); or
75.25(2) demonstrated competency by satisfactorily completing a written or oral test on the
75.26tasks the unlicensed personnel will perform and on the topics listed in subdivision 10,
75.27paragraph (b); and successfully demonstrated competency of topics in subdivision 10,
75.28paragraph (b), clauses (5), (7), and (8), by a practical skills test.
75.29Unlicensed personnel who only provide assisted living services listed in section 144I.01,
75.30subdivision 9, clauses (1) to (5), shall not perform delegated nursing or therapy tasks.
75.31    (b) Unlicensed personnel performing delegated nursing tasks in an assisted living facility
75.32must:
76.1    (1) have successfully completed training and demonstrated competency by successfully
76.2completing a written or oral test of the topics in subdivision 10, paragraphs (b) and (c), and
76.3a practical skills test on tasks listed in subdivision 10, paragraphs (b), clauses (5) and (7),
76.4and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform;
76.5    (2) satisfy the current requirements of Medicare for training or competency of home
76.6health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
76.7section 483 or 484.36; or
76.8    (3) have, before April 19, 1993, completed a training course for nursing assistants that
76.9was approved by the commissioner.
76.10    (c) Unlicensed personnel performing therapy or treatment tasks delegated or assigned
76.11by a licensed health professional must meet the requirements for delegated tasks in
76.12subdivision 7 and any other training or competency requirements within the licensed health
76.13professional's scope of practice relating to delegation or assignment of tasks to unlicensed
76.14personnel.
76.15    Subd. 4. Availability of contact person to staff. (a) Assisted living facilities must have
76.16a registered nurse available for consultation to staff performing delegated nursing tasks and
76.17must have an appropriate licensed health professional available if performing other delegated
76.18services such as therapies.
76.19(b) The appropriate contact person must be readily available either in person, by
76.20telephone, or by other means to the staff at times when the staff is providing services.
76.21    Subd. 5. Supervision of staff. (a) Staff who only provide assisted living services specified
76.22in section 144I.01, subdivision 9, clauses (1) to (5) must be supervised periodically where
76.23the services are being provided to verify that the work is being performed competently and
76.24to identify problems and solutions to address issues relating to the staff's ability to provide
76.25the services. The supervision of the unlicensed personnel must be done by staff of the facility
76.26having the authority, skills, and ability to provide the supervision of unlicensed personnel
76.27and who can implement changes as needed, and train staff.
76.28(b) Supervision includes direct observation of unlicensed personnel while the unlicensed
76.29personnel are providing the services and may also include indirect methods of gaining input
76.30such as gathering feedback from the resident. Supervisory review of staff must be provided
76.31at a frequency based on the staff person's competency and performance.
76.32    Subd. 6. Supervision of staff providing delegated nursing or therapy tasks. (a) Staff
76.33who perform delegated nursing or therapy tasks must be supervised by an appropriate
77.1licensed health professional or a registered nurse according to the assisted living facility's
77.2policy where the services are being provided to verify that the work is being performed
77.3competently and to identify problems and solutions related to the staff person's ability to
77.4perform the tasks. Supervision of staff performing medication or treatment administration
77.5shall be provided by a registered nurse or appropriate licensed health professional and must
77.6include observation of the staff administering the medication or treatment and the interaction
77.7with the resident.
77.8(b) The direct supervision of staff performing delegated tasks must be provided within
77.930 calendar days after the date on which the individual begins working for the facility and
77.10first performs the delegated tasks for residents and thereafter as needed based on performance.
77.11This requirement also applies to staff who have not performed delegated tasks for one year
77.12or longer.
77.13    Subd. 7. Delegation of assisted living services. A registered nurse or licensed health
77.14professional may delegate tasks only to staff who are competent and possess the knowledge
77.15and skills consistent with the complexity of the tasks and according to the appropriate
77.16Minnesota practice act. The assisted living facility must establish and implement a system
77.17to communicate up-to-date information to the registered nurse or licensed health professional
77.18regarding the current available staff and their competency so the registered nurse or licensed
77.19health professional has sufficient information to determine the appropriateness of delegating
77.20tasks to meet individual resident needs and preferences.
77.21    Subd. 8. Documentation. A facility must retain documentation of supervision activities
77.22in the personnel records.
77.23    Subd. 9. Temporary staff. When a facility contracts with a temporary staffing agency,
77.24those individuals must meet the same requirements required by this section for personnel
77.25employed by the facility and shall be treated as if they are staff of the facility.
77.26    Subd. 10. Instructor and competency evaluation requirements; training for
77.27unlicensed personnel. (a) Instructors and competency evaluators must meet the following
77.28requirements:
77.29(1) training and competency evaluations of unlicensed personnel who only provide
77.30assisted living services specified in section 144I.01, subdivision 9, clauses (1) to (5) must
77.31be conducted by individuals with work experience and training in providing these services;
77.32and
78.1(2) training and competency evaluations of unlicensed personnel providing assisted
78.2living services must be conducted by a registered nurse, or another instructor may provide
78.3training in conjunction with the registered nurse.
78.4(b) Training and competency evaluations for all unlicensed personnel must include the
78.5following:
78.6(1) documentation requirements for all services provided;
78.7(2) reports of changes in the resident's condition to the supervisor designated by the
78.8facility;
78.9(3) basic infection control, including blood-borne pathogens;
78.10(4) maintenance of a clean and safe environment;
78.11(5) appropriate and safe techniques in personal hygiene and grooming, including:
78.12(i) hair care and bathing;
78.13(ii) care of teeth, gums, and oral prosthetic devices;
78.14(iii) care and use of hearing aids; and
78.15(iv) dressing and assisting with toileting;
78.16(6) training on the prevention of falls;
78.17(7) standby assistance techniques and how to perform them;
78.18(8) medication, exercise, and treatment reminders;
78.19(9) basic nutrition, meal preparation, food safety, and assistance with eating;
78.20(10) preparation of modified diets as ordered by a licensed health professional;
78.21(11) communication skills that include preserving the dignity of the resident and showing
78.22respect for the resident and the resident's preferences, cultural background, and family;
78.23(12) awareness of confidentiality and privacy;
78.24(13) understanding appropriate boundaries between staff and residents and the resident's
78.25family;
78.26(14) procedures to use in handling various emergency situations; and
78.27(15) awareness of commonly used health technology equipment and assistive devices.
78.28(c) In addition to paragraph (b), training and competency evaluation for unlicensed
78.29personnel providing assisted living services must include:
79.1(1) observing, reporting, and documenting resident status;
79.2(2) basic knowledge of body functioning and changes in body functioning, injuries, or
79.3other observed changes that must be reported to appropriate personnel;
79.4(3) reading and recording temperature, pulse, and respirations of the resident;
79.5(4) recognizing physical, emotional, cognitive, and developmental needs of the resident;
79.6(5) safe transfer techniques and ambulation;
79.7(6) range of motioning and positioning; and
79.8(7) administering medications or treatments as required.
79.9(d) When the registered nurse or licensed health professional delegates tasks, that person
79.10must ensure that prior to the delegation the unlicensed personnel is trained in the proper
79.11methods to perform the tasks or procedures for each resident and are able to demonstrate
79.12the ability to competently follow the procedures and perform the tasks. If an unlicensed
79.13personnel has not regularly performed the delegated assisted living task for a period of 24
79.14consecutive months, the unlicensed personnel must demonstrate competency in the task to
79.15the registered nurse or appropriate licensed health professional. The registered nurse or
79.16licensed health professional must document instructions for the delegated tasks in the
79.17resident's record.
79.18EFFECTIVE DATE.This section is effective August 1, 2021.

79.19    Sec. 17. [144I.15] REQUIRED NOTICES.
79.20    Subdivision 1. Assisted living bill of rights; notification to resident. (a) An assisted
79.21living facility must provide the resident, legal representative, and designated representative
79.22a written notice of the rights under section 144I.101 before the initiation of services to that
79.23resident. The facility shall make all reasonable efforts to provide notice of the rights to the
79.24resident and the legal and designated representatives in a language the resident and legal
79.25and designated representatives can understand.
79.26(b) In addition to the text of the assisted living bill of rights in section 144I.101, the
79.27notice shall also contain the following statement describing how to file a complaint or report
79.28suspected abuse.
79.29"If you want to report suspected abuse, neglect, or financial exploitation, you may contact
79.30the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about
79.31the facility or person providing your services, you may contact the Office of Health Facility
79.32Complaints, Minnesota Department of Health. You may also contact the Office of
80.1Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health and
80.2Developmental Disabilities."
80.3    (c) The statement must include contact information for the Minnesota Adult Abuse
80.4Reporting Center and the telephone number, website address, e-mail address, mailing
80.5address, and street address of the Office of Health Facility Complaints at the Minnesota
80.6Department of Health, the Office of Ombudsman for Long-Term Care, and the Office of
80.7Ombudsman for Mental Health and Developmental Disabilities. The statement must include
80.8the facility's name, address, e-mail, telephone number, and name or title of the person at
80.9the facility to whom problems or complaints may be directed. It must also include a statement
80.10that the facility will not retaliate because of a complaint.
80.11    (d) A facility must obtain written acknowledgment of the resident's receipt of the assisted
80.12living bill of rights or shall document why an acknowledgment cannot be obtained. The
80.13acknowledgment may be obtained from the resident, legal representative, or designated
80.14representative. Acknowledgment of receipt shall be retained in the resident's record.
80.15    Subd. 2. Notices in plain language; language accommodations. A facility must provide
80.16all notices in plain language that residents can understand and make reasonable
80.17accommodations for residents who have communication disabilities and those whose primary
80.18language is a language other than English.
80.19    Subd. 3. Notice of dementia training. An assisted living facility with dementia care
80.20shall make available in written or electronic form, to residents and families or other persons
80.21who request it, a description of the training program and related training it provides, including
80.22the categories of employees trained, the frequency of training, and the basic topics covered.
80.23A hard copy of this notice must be provided upon request.
80.24    Subd. 4. Notice of available assistance. A facility shall provide each resident with
80.25identifying and contact information about the persons who can assist with health care or
80.26supportive services being provided. A facility shall keep each resident informed of changes
80.27in the personnel referenced in this subdivision.
80.28    Subd. 5. Notice to residents; change in ownership or management. (a) A facility must
80.29provide written notice to the resident, legal representative, or designated representative of
80.30a change of ownership within seven calendar days after the facility receives a new license.
80.31(b) A facility must provide prompt written notice to the resident and, as applicable, legal
80.32representative or designated representative, of any change of legal name, telephone number,
80.33and physical mailing address, which may not be a public or private post office box, of:
81.1(1) the manager of the facility, if applicable; and
81.2(2) the authorized agent.
81.3EFFECTIVE DATE.This section is effective August 1, 2021.

81.4    Sec. 18. [144I.16] SERVICES.
81.5    Subdivision 1. Acceptance of residents. An assisted living facility may not accept a
81.6person as a resident unless the facility has staff, sufficient in qualifications, competency,
81.7and numbers, to adequately provide the services agreed to in the assisted living contract.
81.8    Subd. 2. Initial reviews, assessments, and monitoring. (a) Residents who are not
81.9receiving any services shall not be required to undergo an initial nursing assessment.
81.10(b) An assisted living facility shall conduct a nursing assessment by a registered nurse
81.11of the physical and cognitive needs of the prospective resident and propose a temporary
81.12service plan prior to the date on which a prospective resident executes a contract with a
81.13facility or the date on which a prospective resident moves in, whichever is earlier. If
81.14necessitated by either the geographic distance between the prospective resident and the
81.15facility, or urgent or unexpected circumstances, the assessment may be conducted using
81.16telecommunication methods based on practice standards that meet the resident's needs and
81.17reflect person-centered planning and care delivery.
81.18(c) Resident reassessment and monitoring must be conducted no more than 14 calendar
81.19days after initiation of services. Ongoing resident reassessment and monitoring must be
81.20conducted as needed based on changes in the needs of the resident and cannot exceed 90
81.21calendar days from the last date of the assessment.
81.22(d) For residents only receiving assisted living services specified in section 144I.01,
81.23subdivision 9, clauses (1) to (5), the facility shall complete an individualized initial review
81.24of the resident's needs and preferences. The initial review must be completed within 30
81.25calendar days of the start of services. Resident monitoring and review must be conducted
81.26as needed based on changes in the needs of the resident and cannot exceed 90 calendar days
81.27from the date of the last review.
81.28(e) A facility must inform the prospective resident of the availability of and contact
81.29information for long-term care consultation services under section 256B.0911, prior to the
81.30date on which a prospective resident executes a contract with a facility or the date on which
81.31a prospective resident moves in, whichever is earlier.
82.1    Subd. 3. Temporary service plan. When a facility initiates services and the
82.2individualized assessment required in subdivision 2 has not been completed, the facility
82.3must complete a temporary plan and agreement with the resident for services. A temporary
82.4service plan shall not be effective for more than 72 hours.
82.5    Subd. 4. Service plan, implementation, and revisions to service plan. (a) No later
82.6than 14 calendar days after the date that services are first provided, an assisted living facility
82.7shall finalize a current written service plan.
82.8(b) The service plan and any revisions must include a signature or other authentication
82.9by the facility and by the resident documenting agreement on the services to be provided.
82.10The service plan must be revised, if needed, based on resident reassessment under subdivision
82.112. The facility must provide information to the resident about changes to the facility's fee
82.12for services and how to contact the Office of Ombudsman for Long-Term Care.
82.13(c) The facility must implement and provide all services required by the current service
82.14plan.
82.15(d) The service plan and the revised service plan must be entered into the resident record,
82.16including notice of a change in a resident's fees when applicable.
82.17(e) Staff providing services must be informed of the current written service plan.
82.18(f) The service plan must include:
82.19(1) a description of the services to be provided, the fees for services, and the frequency
82.20of each service, according to the resident's current assessment and resident preferences;
82.21(2) the identification of staff or categories of staff who will provide the services;
82.22(3) the schedule and methods of monitoring assessments of the resident;
82.23(4) the schedule and methods of monitoring staff providing services; and
82.24(5) a contingency plan that includes:
82.25(i) the action to be taken by the facility and by the resident and the designated
82.26representative if the scheduled service cannot be provided;
82.27(ii) information and a method for a resident to contact the facility;
82.28(iii) the names and contact information of persons the resident wishes to have notified
82.29in an emergency or if there is a significant adverse change in the resident's condition,
82.30including identification of and information as to who has authority to sign for the resident
82.31in an emergency; and
83.1(iv) the circumstances in which emergency medical services are not to be summoned
83.2consistent with chapters 145B and 145C, and declarations made by the resident under those
83.3chapters.
83.4    Subd. 5. Referrals. If a facility reasonably believes that a resident is in need of another
83.5medical or health service, including a licensed health professional, or social service provider,
83.6the facility shall:
83.7(1) determine the resident's preferences with respect to obtaining the service; and
83.8(2) inform the resident of the resources available, if known, to assist the resident in
83.9obtaining services.
83.10    Subd. 6. Medical cannabis. Assisted living facilities may exercise the authority and are
83.11subject to the protections in section 152.34.
83.12    Subd. 7. Request for discontinuation of life-sustaining treatment. (a) If a resident,
83.13family member, or other caregiver of the resident requests that an employee or other agent
83.14of the facility discontinue a life-sustaining treatment, the employee or agent receiving the
83.15request:
83.16(1) shall take no action to discontinue the treatment; and
83.17(2) shall promptly inform the supervisor or other agent of the facility of the resident's
83.18request.
83.19(b) Upon being informed of a request for discontinuance of treatment, the facility shall
83.20promptly:
83.21(1) inform the resident that the request will be made known to the physician or advanced
83.22practice registered nurse who ordered the resident's treatment;
83.23(2) inform the physician or advanced practice registered nurse of the resident's request;
83.24and
83.25(3) work with the resident and the resident's physician or advanced practice registered
83.26nurse to comply with chapter 145C.
83.27(c) This section does not require the facility to discontinue treatment, except as may be
83.28required by law or court order.
83.29(d) This section does not diminish the rights of residents to control their treatments,
83.30refuse services, or terminate their relationships with the facility.
84.1(e) This section shall be construed in a manner consistent with chapter 145B or 145C,
84.2whichever applies, and declarations made by residents under those chapters.
84.3    Subd. 8. Applicability of other law. Assisted living facilities are subject to and must
84.4comply with chapter 504B.
84.5EFFECTIVE DATE.This section is effective August 1, 2021.

84.6    Sec. 19. [144I.17] MEDICATION MANAGEMENT.
84.7    Subdivision 1. Medication management services. (a) This section applies only to
84.8assisted living facilities that provide medication management services.
84.9(b) An assisted living facility that provides medication management services must
84.10develop, implement, and maintain current written medication management policies and
84.11procedures. The policies and procedures must be developed under the supervision and
84.12direction of a registered nurse, licensed health professional, or pharmacist consistent with
84.13current practice standards and guidelines.
84.14(c) The written policies and procedures must address requesting and receiving
84.15prescriptions for medications; preparing and giving medications; verifying that prescription
84.16drugs are administered as prescribed; documenting medication management activities;
84.17controlling and storing medications; monitoring and evaluating medication use; resolving
84.18medication errors; communicating with the prescriber, pharmacist, and resident and legal
84.19and designated representatives; disposing of unused medications; and educating residents
84.20and legal and designated representatives about medications. When controlled substances
84.21are being managed, the policies and procedures must also identify how the provider will
84.22ensure security and accountability for the overall management, control, and disposition of
84.23those substances in compliance with state and federal regulations and with subdivision 23.
84.24    Subd. 2. Provision of medication management services. (a) For each resident who
84.25requests medication management services, the facility shall, prior to providing medication
84.26management services, have a registered nurse, licensed health professional, or authorized
84.27prescriber under section 151.37 conduct an assessment to determine what medication
84.28management services will be provided and how the services will be provided. This assessment
84.29must be conducted face-to-face with the resident. The assessment must include an
84.30identification and review of all medications the resident is known to be taking. The review
84.31and identification must include indications for medications, side effects, contraindications,
84.32allergic or adverse reactions, and actions to address these issues.
85.1(b) The assessment must identify interventions needed in management of medications
85.2to prevent diversion of medication by the resident or others who may have access to the
85.3medications and provide instructions to the resident and legal and designated representatives
85.4on interventions to manage the resident's medications and prevent diversion of medications.
85.5For purposes of this section, "diversion of medication" means misuse, theft, or illegal or
85.6improper disposition of medications.
85.7    Subd. 3. Individualized medication monitoring and reassessment. The assisted living
85.8facility must monitor and reassess the resident's medication management services as needed
85.9under subdivision 2 when the resident presents with symptoms or other issues that may be
85.10medication-related and, at a minimum, annually.
85.11    Subd. 4. Resident refusal. The assisted living facility must document in the resident's
85.12record any refusal for an assessment for medication management by the resident. The facility
85.13must discuss with the resident the possible consequences of the resident's refusal and
85.14document the discussion in the resident's record.
85.15    Subd. 5. Individualized medication management plan. (a) For each resident receiving
85.16medication management services, the assisted living facility must prepare and include in
85.17the service plan a written statement of the medication management services that will be
85.18provided to the resident. The facility must develop and maintain a current individualized
85.19medication management record for each resident based on the resident's assessment that
85.20must contain the following:
85.21(1) a statement describing the medication management services that will be provided;
85.22(2) a description of storage of medications based on the resident's needs and preferences,
85.23risk of diversion, and consistent with the manufacturer's directions;
85.24(3) documentation of specific resident instructions relating to the administration of
85.25medications;
85.26(4) identification of persons responsible for monitoring medication supplies and ensuring
85.27that medication refills are ordered on a timely basis;
85.28(5) identification of medication management tasks that may be delegated to unlicensed
85.29personnel;
85.30(6) procedures for staff notifying a registered nurse or appropriate licensed health
85.31professional when a problem arises with medication management services; and
86.1(7) any resident-specific requirements relating to documenting medication administration,
86.2verifications that all medications are administered as prescribed, and monitoring of
86.3medication use to prevent possible complications or adverse reactions.
86.4(b) The medication management record must be current and updated when there are any
86.5changes.
86.6(c) Medication reconciliation must be completed when a licensed nurse, licensed health
86.7professional, or authorized prescriber is providing medication management.
86.8    Subd. 6. Administration of medication. Medications may be administered by a nurse,
86.9physician, or other licensed health practitioner authorized to administer medications or by
86.10unlicensed personnel who have been delegated medication administration tasks by a
86.11registered nurse.
86.12    Subd. 7. Delegation of medication administration. When administration of medications
86.13is delegated to unlicensed personnel, the assisted living facility must ensure that the registered
86.14nurse has:
86.15(1) instructed the unlicensed personnel in the proper methods to administer the
86.16medications, and the unlicensed personnel has demonstrated the ability to competently
86.17follow the procedures;
86.18(2) specified, in writing, specific instructions for each resident and documented those
86.19instructions in the resident's records; and
86.20(3) communicated with the unlicensed personnel about the individual needs of the
86.21resident.
86.22    Subd. 8. Documentation of administration of medications. Each medication
86.23administered by the assisted living facility staff must be documented in the resident's record.
86.24The documentation must include the signature and title of the person who administered the
86.25medication. The documentation must include the medication name, dosage, date and time
86.26administered, and method and route of administration. The staff must document the reason
86.27why medication administration was not completed as prescribed and document any follow-up
86.28procedures that were provided to meet the resident's needs when medication was not
86.29administered as prescribed and in compliance with the resident's medication management
86.30plan.
86.31    Subd. 9. Documentation of medication setup. Documentation of dates of medication
86.32setup, name of medication, quantity of dose, times to be administered, route of administration,
86.33and name of person completing medication setup must be done at the time of setup.
87.1    Subd. 10. Medication management for residents who will be away from home. (a)
87.2An assisted living facility that is providing medication management services to the resident
87.3must develop and implement policies and procedures for giving accurate and current
87.4medications to residents for planned or unplanned times away from home according to the
87.5resident's individualized medication management plan. The policies and procedures must
87.6state that:
87.7(1) for planned time away, the medications must be obtained from the pharmacy or set
87.8up by the licensed nurse according to appropriate state and federal laws and nursing standards
87.9of practice;
87.10(2) for unplanned time away, when the pharmacy is not able to provide the medications,
87.11a licensed nurse or unlicensed personnel shall give the resident or a legal representative
87.12medications in amounts and dosages needed for the length of the anticipated absence, not
87.13to exceed seven calendar days;
87.14(3) the resident and a legal or designated representative must be provided written
87.15information on medications, including any special instructions for administering or handling
87.16the medications, including controlled substances;
87.17(4) the medications must be placed in a medication container or containers appropriate
87.18to the provider's medication system and must be labeled with the resident's name and the
87.19dates and times that the medications are scheduled; and
87.20(5) the resident and legal and designated representative must be provided in writing the
87.21facility's name and information on how to contact the facility.
87.22(b) For unplanned time away when the licensed nurse is not available, the registered
87.23nurse may delegate this task to unlicensed personnel if:
87.24(1) the registered nurse has trained the unlicensed staff and determined the unlicensed
87.25staff is competent to follow the procedures for giving medications to residents; and
87.26(2) the registered nurse has developed written procedures for the unlicensed personnel,
87.27including any special instructions or procedures regarding controlled substances that are
87.28prescribed for the resident. The procedures must address:
87.29(i) the type of container or containers to be used for the medications appropriate to the
87.30provider's medication system;
87.31(ii) how the container or containers must be labeled;
88.1(iii) written information about the medications to be given to the resident or designated
88.2representative;
88.3(iv) how the unlicensed staff must document in the resident's record that medications
88.4have been given to the resident and the designated representative, including documenting
88.5the date the medications were given to the resident or the designated representative and who
88.6received the medications, the person who gave the medications to the resident, the number
88.7of medications that were given to the resident, and other required information;
88.8(v) how the registered nurse shall be notified that medications have been given to the
88.9resident or designated representative and whether the registered nurse needs to be contacted
88.10before the medications are given to the resident or the designated representative;
88.11(vi) a review by the registered nurse of the completion of this task to verify that this task
88.12was completed accurately by the unlicensed personnel; and
88.13(vii) how the unlicensed personnel must document in the resident's record any unused
88.14medications that are returned to the facility, including the name of each medication and the
88.15doses of each returned medication.
88.16    Subd. 11. Prescribed and nonprescribed medication. The assisted living facility must
88.17determine whether the facility shall require a prescription for all medications the provider
88.18manages. The facility must inform the resident and the legal and designated representatives
88.19whether the facility requires a prescription for all over-the-counter and dietary supplements
88.20before the facility agrees to manage those medications.
88.21    Subd. 12. Medications; over-the-counter drugs; dietary supplements not
88.22prescribed. An assisted living facility providing medication management services for
88.23over-the-counter drugs or dietary supplements must retain those items in the original labeled
88.24container with directions for use prior to setting up for immediate or later administration.
88.25The facility must verify that the medications are up to date and stored as appropriate.
88.26    Subd. 13. Prescriptions. There must be a current written or electronically recorded
88.27prescription as defined in section 151.01, subdivision 16a, for all prescribed medications
88.28that the assisted living facility is managing for the resident.
88.29    Subd. 14. Renewal of prescriptions. Prescriptions must be renewed at least every 12
88.30months or more frequently as indicated by the assessment in subdivision 2. Prescriptions
88.31for controlled substances must comply with chapter 152.
89.1    Subd. 15. Verbal prescription orders. Verbal prescription orders from an authorized
89.2prescriber must be received by a nurse or pharmacist. The order must be handled according
89.3to Minnesota Rules, part 6800.6200.
89.4    Subd. 16. Written or electronic prescription. When a written or electronic prescription
89.5is received, it must be communicated to the registered nurse in charge and recorded or placed
89.6in the resident's record.
89.7    Subd. 17. Records confidential. A prescription or order received verbally, in writing,
89.8or electronically must be kept confidential according to sections 144.291 to 144.298 and
89.9144A.44.
89.10    Subd. 18. Medications provided by resident or family members. When the assisted
89.11living facility is aware of any medications or dietary supplements that are being used by
89.12the resident and are not included in the assessment for medication management services,
89.13the staff must advise the registered nurse and document that in the resident record.
89.14    Subd. 19. Storage of medications. An assisted living facility must store all prescription
89.15medications in securely locked and substantially constructed compartments according to
89.16the manufacturer's directions and permit only authorized personnel to have access.
89.17    Subd. 20. Prescription drugs. A prescription drug, prior to being set up for immediate
89.18or later administration, must be kept in the original container in which it was dispensed by
89.19the pharmacy bearing the original prescription label with legible information including the
89.20expiration or beyond-use date of a time-dated drug.
89.21    Subd. 21. Prohibitions. No prescription drug supply for one resident may be used or
89.22saved for use by anyone other than the resident.
89.23    Subd. 22. Disposition of medications. (a) Any current medications being managed by
89.24the assisted living facility must be given to the resident or the designated representative
89.25when the resident's service plan ends or medication management services are no longer part
89.26of the service plan. Medications for a resident who is deceased or that have been discontinued
89.27or have expired may be given to the resident or the designated representative for disposal.
89.28(b) The facility shall dispose of any medications remaining with the facility that are
89.29discontinued or expired or upon the termination of the service contract or the resident's
89.30death according to state and federal regulations for disposition of medications and controlled
89.31substances.
89.32(c) Upon disposition, the facility must document in the resident's record the disposition
89.33of the medication including the medication's name, strength, prescription number as
90.1applicable, quantity, to whom the medications were given, date of disposition, and names
90.2of staff and other individuals involved in the disposition.
90.3    Subd. 23. Loss or spillage. (a) Assisted living facilities providing medication
90.4management must develop and implement procedures for loss or spillage of all controlled
90.5substances defined in Minnesota Rules, part 6800.4220. These procedures must require that
90.6when a spillage of a controlled substance occurs, a notation must be made in the resident's
90.7record explaining the spillage and the actions taken. The notation must be signed by the
90.8person responsible for the spillage and include verification that any contaminated substance
90.9was disposed of according to state or federal regulations.
90.10(b) The procedures must require that the facility providing medication management
90.11investigate any known loss or unaccounted for prescription drugs and take appropriate action
90.12required under state or federal regulations and document the investigation in required records.
90.13EFFECTIVE DATE.This section is effective August 1, 2021.

90.14    Sec. 20. [144I.18] TREATMENT AND THERAPY MANAGEMENT SERVICES.
90.15    Subdivision 1. Treatment and therapy management services. This section applies
90.16only to assisted living facilities that provide treatment and therapy management services.
90.17    Subd. 2. Policies and procedures. (a) An assisted living facility that provides treatment
90.18and therapy management services must develop, implement, and maintain up-to-date written
90.19treatment or therapy management policies and procedures. The policies and procedures
90.20must be developed under the supervision and direction of a registered nurse or appropriate
90.21licensed health professional consistent with current practice standards and guidelines.
90.22(b) The written policies and procedures must address requesting and receiving orders
90.23or prescriptions for treatments or therapies, providing the treatment or therapy, documenting
90.24treatment or therapy activities, educating and communicating with residents about treatments
90.25or therapies they are receiving, monitoring and evaluating the treatment or therapy, and
90.26communicating with the prescriber.
90.27    Subd. 3. Individualized treatment or therapy management plan. For each resident
90.28receiving management of ordered or prescribed treatments or therapy services, the assisted
90.29living facility must prepare and include in the service plan a written statement of the treatment
90.30or therapy services that will be provided to the resident. The facility must also develop and
90.31maintain a current individualized treatment and therapy management record for each resident
90.32which must contain at least the following:
90.33(1) a statement of the type of services that will be provided;
91.1(2) documentation of specific resident instructions relating to the treatments or therapy
91.2administration;
91.3(3) identification of treatment or therapy tasks that will be delegated to unlicensed
91.4personnel;
91.5(4) procedures for notifying a registered nurse or appropriate licensed health professional
91.6when a problem arises with treatments or therapy services; and
91.7(5) any resident-specific requirements relating to documentation of treatment and therapy
91.8received, verification that all treatment and therapy was administered as prescribed, and
91.9monitoring of treatment or therapy to prevent possible complications or adverse reactions.
91.10The treatment or therapy management record must be current and updated when there are
91.11any changes.
91.12    Subd. 4. Administration of treatments and therapy. Ordered or prescribed treatments
91.13or therapies must be administered by a nurse, physician, or other licensed health professional
91.14authorized to perform the treatment or therapy, or may be delegated or assigned to unlicensed
91.15personnel by the licensed health professional according to the appropriate practice standards
91.16for delegation or assignment. When administration of a treatment or therapy is delegated
91.17or assigned to unlicensed personnel, the facility must ensure that the registered nurse or
91.18authorized licensed health professional has:
91.19(1) instructed the unlicensed personnel in the proper methods with respect to each resident
91.20and the unlicensed personnel has demonstrated the ability to competently follow the
91.21procedures;
91.22(2) specified, in writing, specific instructions for each resident and documented those
91.23instructions in the resident's record; and
91.24(3) communicated with the unlicensed personnel about the individual needs of the
91.25resident.
91.26    Subd. 5. Documentation of administration of treatments and therapies. Each treatment
91.27or therapy administered by an assisted living facility must be in the resident record. The
91.28documentation must include the signature and title of the person who administered the
91.29treatment or therapy and must include the date and time of administration. When treatment
91.30or therapies are not administered as ordered or prescribed, the provider must document the
91.31reason why it was not administered and any follow-up procedures that were provided to
91.32meet the resident's needs.
92.1    Subd. 6. Treatment and therapy orders. There must be an up-to-date written or
92.2electronically recorded order from an authorized prescriber for all treatments and therapies.
92.3The order must contain the name of the resident, a description of the treatment or therapy
92.4to be provided, and the frequency, duration, and other information needed to administer the
92.5treatment or therapy. Treatment and therapy orders must be renewed at least every 12
92.6months.
92.7    Subd. 7. Right to outside service provider; other payors. Under section 144I.101, a
92.8resident is free to retain therapy and treatment services from an off-site service provider.
92.9Assisted living facilities must make every effort to assist residents in obtaining information
92.10regarding whether the Medicare program, the medical assistance program under chapter
92.11256B, or another public program will pay for any or all of the services.
92.12EFFECTIVE DATE.This section is effective August 1, 2021.

92.13    Sec. 21. [144I.19] RESIDENT RECORD REQUIREMENTS.
92.14    Subdivision 1. Resident record. (a) Assisted living facilities must maintain records for
92.15each resident for whom it is providing services. Entries in the resident records must be
92.16current, legible, permanently recorded, dated, and authenticated with the name and title of
92.17the person making the entry.
92.18(b) Resident records, whether written or electronic, must be protected against loss,
92.19tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable
92.20relevant federal and state laws. The facility shall establish and implement written procedures
92.21to control use, storage, and security of resident records and establish criteria for release of
92.22resident information.
92.23(c) The facility may not disclose to any other person any personal, financial, or medical
92.24information about the resident, except:
92.25(1) as may be required by law;
92.26(2) to employees or contractors of the facility, another facility, other health care
92.27practitioner or provider, or inpatient facility needing information in order to provide services
92.28to the resident, but only the information that is necessary for the provision of services;
92.29(3) to persons authorized in writing by the resident or the legal representative to receive
92.30the information, including third-party payers; and
92.31(4) to representatives of the commissioner authorized to survey or investigate facilities
92.32under this chapter or federal laws.
93.1    Subd. 2. Access to records. The facility must ensure that the appropriate records are
93.2readily available to employees and contractors authorized to access the records. Resident
93.3records must be maintained in a manner that allows for timely access, printing, or
93.4transmission of the records. The records must be made readily available to the commissioner
93.5upon request.
93.6    Subd. 3. Contents of resident record. Contents of a resident record include the following
93.7for each resident:
93.8(1) identifying information, including the resident's name, date of birth, address, and
93.9telephone number;
93.10(2) the name, address, and telephone number of an emergency contact, family members,
93.11designated representative, if any, legal representative, if any, or others as identified;
93.12(3) names, addresses, and telephone numbers of the resident's health and medical service
93.13providers, if known;
93.14(4) health information, including medical history, allergies, and when the provider is
93.15managing medications, treatments or therapies that require documentation, and other relevant
93.16health records;
93.17(5) the resident's advance directives, if any;
93.18(6) copies of any health care directives, guardianships, powers of attorney, or
93.19conservatorships;
93.20(7) the facility's current and previous assessments and service plans;
93.21(8) all records of communications pertinent to the resident's services;
93.22(9) documentation of significant changes in the resident's status and actions taken in
93.23response to the needs of the resident, including reporting to the appropriate supervisor or
93.24health care professional;
93.25(10) documentation of incidents involving the resident and actions taken in response to
93.26the needs of the resident, including reporting to the appropriate supervisor or health care
93.27professional;
93.28(11) documentation that services have been provided as identified in the service plan;
93.29(12) documentation that the resident has received and reviewed the assisted living bill
93.30of rights;
93.31(13) documentation of complaints received and any resolution;
94.1(14) a discharge summary, including service termination notice and related
94.2documentation, when applicable; and
94.3(15) other documentation required under this chapter and relevant to the resident's
94.4services or status.
94.5    Subd. 4. Transfer of resident records. With the resident's knowledge and consent, if
94.6a resident is relocated to another facility or to a nursing home, or if care is transferred to
94.7another service provider, the facility must timely convey to the new facility, nursing home,
94.8or provider:
94.9(1) the resident's full name, date of birth, and insurance information;
94.10(2) the name, telephone number, and address of the resident's designated representatives
94.11and legal representatives, if any;
94.12(3) the resident's current documented diagnoses that are relevant to the services being
94.13provided;
94.14(4) the resident's known allergies that are relevant to the services being provided;
94.15(5) the name and telephone number of the resident's physician, if known, and the current
94.16physician orders that are relevant to the services being provided;
94.17(6) all medication administration records that are relevant to the services being provided;
94.18(7) the most recent resident assessment, if relevant to the services being provided; and
94.19(8) copies of health care directives, "do not resuscitate" orders, and any guardianship
94.20orders or powers of attorney.
94.21    Subd. 5. Record retention. Following the resident's discharge or termination of services,
94.22an assisted living facility must retain a resident's record for at least five years or as otherwise
94.23required by state or federal regulations. Arrangements must be made for secure storage and
94.24retrieval of resident records if the facility ceases to operate.
94.25EFFECTIVE DATE.This section is effective August 1, 2021.

94.26    Sec. 22. [144I.20] ORIENTATION AND ANNUAL TRAINING REQUIREMENTS.
94.27    Subdivision 1. Orientation of staff and supervisors. All staff providing and supervising
94.28direct services must complete an orientation to assisted living facility licensing requirements
94.29and regulations before providing assisted living services to residents. The orientation may
94.30be incorporated into the training required under subdivision 6. The orientation need only
94.31be completed once for each staff person and is not transferable to another facility.
95.1    Subd. 2. Content. (a) The orientation must contain the following topics:
95.2(1) an overview of this chapter;
95.3(2) an introduction and review of the facility's policies and procedures related to the
95.4provision of assisted living services by the individual staff person;
95.5(3) handling of emergencies and use of emergency services;
95.6(4) compliance with and reporting of the maltreatment of vulnerable adults under section
95.7626.557 to the Minnesota Adult Abuse Reporting Center (MAARC);
95.8(5) the assisted living bill of rights and staff responsibilities related to ensuring the
95.9exercise and protection of those rights;
95.10(6) the principles of person-centered planning and service delivery and how they apply
95.11to direct support services provided by the staff person;
95.12(7) handling of residents' complaints, reporting of complaints, and where to report
95.13complaints, including information on the Office of Health Facility Complaints;
95.14(8) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
95.15Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
95.16Ombudsman at the Department of Human Services, county-managed care advocates, or
95.17other relevant advocacy services; and
95.18(9) a review of the types of assisted living services the employee will be providing and
95.19the facility's category of licensure.
95.20(b) In addition to the topics in paragraph (a), orientation may also contain training on
95.21providing services to residents with hearing loss. Any training on hearing loss provided
95.22under this subdivision must be high quality and research based, may include online training,
95.23and must include training on one or more of the following topics:
95.24(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
95.25and the challenges it poses to communication;
95.26(2) health impacts related to untreated age-related hearing loss, such as increased
95.27incidence of dementia, falls, hospitalizations, isolation, and depression; or
95.28(3) information about strategies and technology that may enhance communication and
95.29involvement, including communication strategies, assistive listening devices, hearing aids,
95.30visual and tactile alerting devices, communication access in real time, and closed captions.
96.1    Subd. 3. Verification and documentation of orientation and training. The assisted
96.2living facility shall retain evidence in the employee record of each staff person having
96.3completed the orientation and training required by this section.
96.4    Subd. 4. Orientation to resident. Staff providing assisted living services must be oriented
96.5specifically to each individual resident and the services to be provided. This orientation
96.6may be provided in person, orally, in writing, or electronically.
96.7    Subd. 5. Training required relating to dementia. All direct care staff and supervisors
96.8providing direct services must demonstrate an understanding of the training specified in
96.9section 144I.21.
96.10    Subd. 6. Required annual training. (a) All staff that perform direct services must
96.11complete at least eight hours of annual training for each 12 months of employment. The
96.12training may be obtained from the facility or another source and must include topics relevant
96.13to the provision of assisted living services. The annual training must include:
96.14(1) training on reporting of maltreatment of vulnerable adults under section 626.557;
96.15(2) review of the assisted living bill of rights and staff responsibilities related to ensuring
96.16the exercise and protection of those rights;
96.17(3) review of infection control techniques used in the home and implementation of
96.18infection control standards including a review of hand washing techniques; the need for and
96.19use of protective gloves, gowns, and masks; appropriate disposal of contaminated materials
96.20and equipment, such as dressings, needles, syringes, and razor blades; disinfecting reusable
96.21equipment; disinfecting environmental surfaces; and reporting communicable diseases;
96.22(4) effective approaches to use to problem solve when working with a resident's
96.23challenging behaviors, and how to communicate with residents who have dementia,
96.24Alzheimer's disease, or related disorders;
96.25(5) review of the facility's policies and procedures relating to the provision of assisted
96.26living services and how to implement those policies and procedures; and
96.27(6) the principles of person-centered planning and service delivery and how they apply
96.28to direct support services provided by the staff person.
96.29(b) In addition to the topics in paragraph (a), annual training may also contain training
96.30on providing services to residents with hearing loss. Any training on hearing loss provided
96.31under this subdivision must be high quality and research based, may include online training,
96.32and must include training on one or more of the following topics:
97.1(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
97.2and challenges it poses to communication;
97.3(2) the health impacts related to untreated age-related hearing loss, such as increased
97.4incidence of dementia, falls, hospitalizations, isolation, and depression; or
97.5(3) information about strategies and technology that may enhance communication and
97.6involvement, including communication strategies, assistive listening devices, hearing aids,
97.7visual and tactile alerting devices, communication access in real time, and closed captions.
97.8    Subd. 7. Implementation. The assisted living facility must implement all orientation
97.9and training topics covered in this section.
97.10EFFECTIVE DATE.This section is effective August 1, 2021.

97.11    Sec. 23. [144I.21] TRAINING IN DEMENTIA CARE REQUIRED.
97.12(a) All assisted living facilities must meet the following training requirements:
97.13(1) supervisors of direct-care staff must have at least eight hours of initial training on
97.14topics specified under paragraph (b) within 120 working hours of the employment start
97.15date, and must have at least two hours of training on topics related to dementia care for each
97.1612 months of employment thereafter;
97.17(2) direct-care employees must have completed at least eight hours of initial training on
97.18topics specified under paragraph (b) within 160 working hours of the employment start
97.19date. Until this initial training is complete, an employee must not provide direct care unless
97.20there is another employee on site who has completed the initial eight hours of training on
97.21topics related to dementia care and who can act as a resource and assist if issues arise. A
97.22trainer of the requirements under paragraph (b) or a supervisor meeting the requirements
97.23in clause (1) must be available for consultation with the new employee until the training
97.24requirement is complete. Direct-care employees must have at least two hours of training on
97.25topics related to dementia for each 12 months of employment thereafter;
97.26(3) for assisted living facilities with dementia care, direct care employees must have
97.27completed at least eight hours of initial training on topics specified under paragraph (b)
97.28within 80 working hours of the employment start date. Until this initial training is complete,
97.29an employee must not provide direct care unless there is another employee on site who has
97.30completed the initial eight hours of training on topics related to dementia care and who can
97.31act as a resource and assist if issues arise. A trainer of the requirements under paragraph
97.32(b) or a supervisor meeting the requirements in clause (1) must be available for consultation
97.33with the new employee until the training requirement is complete. Direct-care employees
98.1must have at least two hours of training on topics related to dementia for each 12 months
98.2of employment thereafter;
98.3(4) staff who do not provide direct care, including maintenance, housekeeping, and food
98.4service staff, must have at least four hours of initial training on topics specified under
98.5paragraph (b) within 160 working hours of the employment start date, and must have at
98.6least two hours of training on topics related to dementia care for each 12 months of
98.7employment thereafter; and
98.8(5) new employees may satisfy the initial training requirements by producing written
98.9proof of previously completed required training within the past 18 months.
98.10(b) Areas of required training include:
98.11(1) an explanation of Alzheimer's disease and other dementias;
98.12(2) assistance with activities of daily living;
98.13(3) problem solving with challenging behaviors;
98.14(4) communication skills; and
98.15(5) person-centered planning and service delivery.
98.16(c) The facility shall provide to consumers in written or electronic form a description of
98.17the training program, the categories of employees trained, the frequency of training, and
98.18the basic topics covered.
98.19EFFECTIVE DATE.This section is effective August 1, 2021.

98.20    Sec. 24. [144I.22] CONTROLLING INDIVIDUAL RESTRICTIONS.
98.21    Subdivision 1. Restrictions. (a) The commissioner has discretion to bar any controlling
98.22individual of a facility if the person was a controlling individual of any other nursing home
98.23or assisted living facility in the previous two-year period and:
98.24(1) during that period of time the nursing home or assisted living facility incurred the
98.25following number of uncorrected or repeated violations:
98.26(i) two or more repeated violations that created an imminent risk to direct resident care
98.27or safety; or
98.28(ii) four or more uncorrected violations that created an imminent risk to direct resident
98.29care or safety; or
99.1(2) during that period of time, was convicted of a felony or gross misdemeanor that
99.2related to the operation of the nursing home or assisted living facility, or directly affected
99.3resident safety or care.
99.4(b) When the commissioner bars a controlling individual under this subdivision, the
99.5controlling individual may appeal the commissioner's decision under chapter 14.
99.6    Subd. 2. Exception. Subdivision 1 does not apply to any controlling individual of the
99.7facility who had no legal authority to affect or change decisions related to the operation of
99.8the nursing home or assisted living facility that incurred the uncorrected violations.
99.9    Subd. 3. Stay of adverse action required by controlling individual restrictions. (a)
99.10In lieu of revoking, suspending, or refusing to renew the license of a facility where a
99.11controlling individual was disqualified by subdivision 1, paragraph (a), clause (1), the
99.12commissioner may issue an order staying the revocation, suspension, or nonrenewal of the
99.13facility's license. The order may but need not be contingent upon the facility's compliance
99.14with restrictions and conditions imposed on the license to ensure the proper operation of
99.15the facility and to protect the health, safety, comfort, treatment, and well-being of the
99.16residents in the facility. The decision to issue an order for a stay must be made within 90
99.17calendar days of the commissioner's determination that a controlling individual of the facility
99.18is disqualified by subdivision 1, paragraph (a), clause (1), from operating a facility.
99.19(b) In determining whether to issue a stay and to impose conditions and restrictions, the
99.20commissioner must consider the following factors:
99.21(1) the ability of the controlling individual to operate other facilities in accordance with
99.22the licensure rules and laws;
99.23(2) the conditions in the nursing home or assisted living facility that received the number
99.24and type of uncorrected or repeated violations described in subdivision 1, paragraph (a),
99.25clause (1); and
99.26(3) the conditions and compliance history of each of the nursing homes and assisted
99.27living facilities owned or operated by the controlling individual.
99.28(c) The commissioner's decision to exercise the authority under this subdivision in lieu
99.29of revoking, suspending, or refusing to renew the license of the facility is not subject to
99.30administrative or judicial review.
99.31(d) The order for the stay of revocation, suspension, or nonrenewal of the facility license
99.32must include any conditions and restrictions on the license that the commissioner deems
99.33necessary based on the factors listed in paragraph (b).
100.1(e) Prior to issuing an order for stay of revocation, suspension, or nonrenewal, the
100.2commissioner shall inform the licensee and the controlling individual in writing of any
100.3conditions and restrictions that will be imposed. The controlling individual shall, within ten
100.4working days, notify the commissioner in writing of a decision to accept or reject the
100.5conditions and restrictions. If any of the conditions or restrictions are rejected, the
100.6commissioner must either modify the conditions and restrictions or take action to suspend,
100.7revoke, or not renew the facility's license.
100.8(f) Upon issuance of the order for a stay of revocation, suspension, or nonrenewal, the
100.9controlling individual shall be responsible for compliance with the conditions and restrictions.
100.10Any time after the conditions and restrictions have been in place for 180 days, the controlling
100.11individual may petition the commissioner for removal or modification of the conditions and
100.12restrictions. The commissioner must respond to the petition within 30 days of receipt of the
100.13written petition. If the commissioner denies the petition, the controlling individual may
100.14request a hearing under chapter 14. Any hearing shall be limited to a determination of
100.15whether the conditions and restrictions shall be modified or removed. At the hearing, the
100.16controlling individual bears the burden of proof.
100.17(g) The failure of the controlling individual to comply with the conditions and restrictions
100.18contained in the order for stay shall result in the immediate removal of the stay and the
100.19commissioner shall take action to suspend, revoke, or not renew the license.
100.20(h) The conditions and restrictions are effective for two years after the date they are
100.21imposed.
100.22(i) Nothing in this subdivision shall be construed to limit in any way the commissioner's
100.23ability to impose other sanctions against a licensee under the standards in state or federal
100.24law whether or not a stay of revocation, suspension, or nonrenewal is issued.
100.25EFFECTIVE DATE.This section is effective August 1, 2021.

100.26    Sec. 25. [144I.24] MINIMUM SITE, PHYSICAL ENVIRONMENT, AND FIRE
100.27SAFETY REQUIREMENTS.
100.28    Subdivision 1. Requirements. (a) The following are required for all assisted living
100.29facilities:
100.30(1) public utilities must be available, and working or inspected and approved water and
100.31septic systems must be in place;
100.32(2) the location must be publicly accessible to fire department services and emergency
100.33medical services;
101.1(3) the location's topography must provide sufficient natural drainage and is not subject
101.2to flooding;
101.3(4) all-weather roads and walks must be provided within the lot lines to the primary
101.4entrance and the service entrance, including employees' and visitors' parking at the site; and
101.5(5) the location must include space for outdoor activities for residents.
101.6(b) An assisted living facility with dementia care that has a secured dementia care unit
101.7must also meet the following requirements:
101.8(1) a hazard vulnerability assessment or safety risk must be performed on and around
101.9the property. The hazards indicated on the assessment must be assessed and mitigated to
101.10protect the residents from harm; and
101.11(2) the facility shall be protected throughout by an approved supervised automatic
101.12sprinkler system by August 1, 2029.
101.13    Subd. 2. Fire protection and physical environment. (a) Each assisted living facility
101.14must have a comprehensive fire protection system that includes:
101.15(1) protection throughout by an approved supervised automatic sprinkler system according
101.16to building code requirements established in Minnesota Rules, part 1305.0903, or smoke
101.17detectors in each occupied room installed and maintained in accordance with the National
101.18Fire Protection Association (NFPA) Standard 72;
101.19(2) portable fire extinguishers installed and tested in accordance with the NFPA Standard
101.2010; and
101.21(3) the physical environment, including walls, floors, ceiling, all furnishings, grounds,
101.22systems, and equipment that is kept in a continuous state of good repair and operation with
101.23regard to the health, safety, comfort, and well-being of the residents in accordance with a
101.24maintenance and repair program.
101.25(b) Fire drills in assisted living facilities shall be conducted in accordance with the
101.26residential board and care requirements in the Life Safety Code, except that fire drills in
101.27secured dementia care units shall be conducted in accordance with the healthcare (limited
101.28care) chapter of the Life Safety Code.
101.29(c) Existing construction or elements, including assisted living facilities that were
101.30registered as housing with services establishments under chapter 144D prior to August 1,
101.312021, shall be permitted to be continued in use provided such use does not constitute a
101.32distinct hazard to life. Any existing elements that an authority having jurisdiction deems a
102.1distinct hazard to life must be corrected. The facility must document in the facility's records
102.2any actions taken to comply with a correction order, and must submit to the commissioner
102.3for review and approval prior to correction.
102.4    Subd. 3. Local laws apply. Assisted living facilities shall comply with all applicable
102.5state and local governing laws, regulations, standards, ordinances, and codes for fire safety,
102.6building, and zoning requirements.
102.7    Subd. 4. Design requirements. (a) All assisted living facilities with six or more residents
102.8must meet the provisions relevant to assisted living facilities in the most current edition of
102.9the Facility Guidelines Institute "Guidelines for Design and Construction of Residential
102.10Health, Care and Support Facilities" and of adopted rules. This minimum design standard
102.11must be met for all new licenses, new construction, modifications, renovations, alterations,
102.12changes of use, or additions. In addition to the guidelines, assisted living facilities shall
102.13provide the option of a bath in addition to a shower for all residents.
102.14(b) If the commissioner decides to update the edition of the guidelines specified in
102.15paragraph (a) for purposes of this subdivision, the commissioner must notify the chairs and
102.16ranking minority members of the legislative committees and divisions with jurisdiction over
102.17health care and public safety of the planned update by January 15 of the year in which the
102.18new edition will become effective. Following notice from the commissioner, the new edition
102.19shall become effective for assisted living facilities beginning August 1 of that year, unless
102.20provided otherwise in law. The commissioner shall, by publication in the State Register,
102.21specify a date by which facilities must comply with the updated edition. The date by which
102.22facilities must comply shall not be sooner than six months after publication of the
102.23commissioner's notice in the State Register.
102.24    Subd. 5. Assisted living facilities; life safety code. (a) All assisted living facilities with
102.25six or more residents must meet the applicable provisions of the most current edition of the
102.26NFPA Standard 101, Life Safety Code, Residential Board and Care Occupancies chapter.
102.27The minimum design standard shall be met for all new licenses, new construction,
102.28modifications, renovations, alterations, changes of use, or additions.
102.29(b) If the commissioner decides to update the Life Safety Code for purposes of this
102.30subdivision, the commissioner must notify the chairs and ranking minority members of the
102.31legislative committees and divisions with jurisdiction over health care and public safety of
102.32the planned update by January 15 of the year in which the new Life Safety Code will become
102.33effective. Following notice from the commissioner, the new edition shall become effective
102.34for assisted living facilities beginning August 1 of that year, unless provided otherwise in
103.1law. The commissioner shall, by publication in the State Register, specify a date by which
103.2facilities must comply with the updated Life Safety Code. The date by which facilities must
103.3comply shall not be sooner than six months after publication of the commissioner's notice
103.4in the State Register.
103.5    Subd. 6. Assisted living facilities with dementia care and secured dementia care
103.6unit; Life Safety Code. (a) All assisted living facilities with dementia care and a secured
103.7dementia care unit must meet the applicable provisions of the most current edition of the
103.8NFPA Standard 101, Life Safety Code, Healthcare (limited care) chapter. The minimum
103.9design standards shall be met for all new licenses, new construction, modifications,
103.10renovations, alterations, changes of use, or additions.
103.11(b) If the commissioner decides to update the Life Safety Code for purposes of this
103.12subdivision, the commissioner must notify the chairs and ranking minority members of the
103.13legislative committees and divisions with jurisdiction over health care and public safety of
103.14the planned update by January 15 of the year in which the new Life Safety Code will become
103.15effective. Following notice from the commissioner, the new edition shall become effective
103.16for assisted living facilities with dementia care and a secured dementia care unit beginning
103.17August 1 of that year, unless provided otherwise in law. The commissioner shall, by
103.18publication in the State Register, specify a date by which these facilities must comply with
103.19the updated Life Safety Code. The date by which these facilities must comply shall not be
103.20sooner than six months after publication of the commissioner's notice in the State Register.
103.21    Subd. 7. New construction; plans. (a) For all new licensure and construction beginning
103.22on or after August 1, 2021, the following must be provided to the commissioner:
103.23(1) architectural and engineering plans and specifications for new construction must be
103.24prepared and signed by architects and engineers who are registered in Minnesota. Final
103.25working drawings and specifications for proposed construction must be submitted to the
103.26commissioner for review and approval;
103.27(2) final architectural plans and specifications must include elevations and sections
103.28through the building showing types of construction, and must indicate dimensions and
103.29assignments of rooms and areas, room finishes, door types and hardware, elevations and
103.30details of nurses' work areas, utility rooms, toilet and bathing areas, and large-scale layouts
103.31of dietary and laundry areas. Plans must show the location of fixed equipment and sections
103.32and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions
103.33must be indicated. The roof plan must show all mechanical installations. The site plan must
104.1indicate the proposed and existing buildings, topography, roadways, walks and utility service
104.2lines; and
104.3(3) final mechanical and electrical plans and specifications must address the complete
104.4layout and type of all installations, systems, and equipment to be provided. Heating plans
104.5must include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers,
104.6boilers, breeching, and accessories. Ventilation plans must include room air quantities,
104.7ducts, fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing
104.8plans must include the fixtures and equipment fixture schedule; water supply and circulating
104.9piping, pumps, tanks, riser diagrams, and building drains; the size, location, and elevation
104.10of water and sewer services; and the building fire protection systems. Electrical plans must
104.11include fixtures and equipment, receptacles, switches, power outlets, circuits, power and
104.12light panels, transformers, and service feeders. Plans must show location of nurse call signals,
104.13cable lines, fire alarm stations, and fire detectors and emergency lighting.
104.14(b) Unless construction is begun within one year after approval of the final working
104.15drawing and specifications, the drawings must be resubmitted for review and approval.
104.16(c) The commissioner must be notified within 30 days before completion of construction
104.17so that the commissioner can make arrangements for a final inspection by the commissioner.
104.18(d) At least one set of complete life safety plans, including changes resulting from
104.19remodeling or alterations, must be kept on file in the facility.
104.20    Subd. 8. Variances or waivers. (a) A facility may request that the commissioner grant
104.21a variance or waiver from the provisions of this section. A request for a waiver must be
104.22submitted to the commissioner in writing. Each request must contain:
104.23(1) the specific requirement for which the variance or waiver is requested;
104.24(2) the reasons for the request;
104.25(3) the alternative measures that will be taken if a variance or waiver is granted;
104.26(4) the length of time for which the variance or waiver is requested; and
104.27(5) other relevant information deemed necessary by the commissioner to properly evaluate
104.28the request for the waiver.
104.29(b) The decision to grant or deny a variance or waiver must be based on the
104.30commissioner's evaluation of the following criteria:
104.31(1) whether the waiver will adversely affect the health, treatment, comfort, safety, or
104.32well-being of a resident;
105.1(2) whether the alternative measures to be taken, if any, are equivalent to or superior to
105.2those prescribed in this section; and
105.3(3) whether compliance with the requirements would impose an undue burden on the
105.4facility.
105.5(c) The commissioner must notify the facility in writing of the decision. If a variance or
105.6waiver is granted, the notification must specify the period of time for which the variance
105.7or waiver is effective and the alternative measures or conditions, if any, to be met by the
105.8facility.
105.9(d) Alternative measures or conditions attached to a variance or waiver have the force
105.10and effect of this chapter and are subject to the issuance of correction orders and fines in
105.11accordance with sections 144I.30, subdivision 7, and 144I.31. The amount of fines for a
105.12violation of this subdivision is that specified for the specific requirement for which the
105.13variance or waiver was requested.
105.14(e) A request for renewal of a variance or waiver must be submitted in writing at least
105.1545 days before its expiration date. Renewal requests must contain the information specified
105.16in paragraph (b). A variance or waiver must be renewed by the commissioner if the facility
105.17continues to satisfy the criteria in paragraph (a) and demonstrates compliance with the
105.18alternative measures or conditions imposed at the time the original variance or waiver was
105.19granted.
105.20(f) The commissioner must deny, revoke, or refuse to renew a variance or waiver if it
105.21is determined that the criteria in paragraph (a) are not met. The facility must be notified in
105.22writing of the reasons for the decision and informed of the right to appeal the decision.
105.23(g) A facility may contest the denial, revocation, or refusal to renew a variance or waiver
105.24by requesting a contested case hearing under chapter 14. The facility must submit, within
105.2515 days of the receipt of the commissioner's decision, a written request for a hearing. The
105.26request for hearing must set forth in detail the reasons why the facility contends the decision
105.27of the commissioner should be reversed or modified. At the hearing, the facility has the
105.28burden of proving by a preponderance of the evidence that the facility satisfied the criteria
105.29specified in paragraph (b), except in a proceeding challenging the revocation of a variance
105.30or waiver.
105.31EFFECTIVE DATE.This section is effective August 1, 2021.

106.1    Sec. 26. [144I.25] ASSISTED LIVING CONTRACT REQUIREMENTS.
106.2    Subdivision 1. Contract required. (a) An assisted living facility may not offer or provide
106.3housing or assisted living services to a resident unless it has executed a written contract
106.4with the resident.
106.5(b) The contract must contain all the terms concerning the provision of:
106.6(1) housing;
106.7(2) assisted living services, whether provided directly by the facility or by management
106.8agreement or other agreement; and
106.9(3) the resident's service plan, if applicable.
106.10(c) A facility must:
106.11(1) offer to prospective residents and provide to the Office of Ombudsman for Long-Term
106.12Care a complete unsigned copy of its contract; and
106.13(2) give a complete copy of any signed contract and any addendums, and all supporting
106.14documents and attachments, to the resident or the designated representative promptly after
106.15a contract and any addendum has been signed by the resident and the legal representative.
106.16(d) A contract under this section is a consumer contract under sections 325G.29 to
106.17325G.37.
106.18(e) Before or at the time of execution of the contract, the facility must offer the resident
106.19the opportunity to identify a designated representative according to subdivision 3.
106.20(f) The resident must agree in writing to any additions or amendments to the contract.
106.21Upon agreement between the resident and the facility, a new contract or an addendum to
106.22the existing contract must be executed and signed.
106.23    Subd. 2. Contents and contract; contact information. (a) The contract must include
106.24in a conspicuous place and manner on the contract the legal name and the license number
106.25of the facility.
106.26(b) The contract must include the name, telephone number, and physical mailing address,
106.27which may not be a public or private post office box, of:
106.28(1) the facility and contracted service provider when applicable;
106.29(2) the licensee of the facility;
106.30(3) the managing agent of the facility, if applicable; and
107.1(4) the authorized agent for the facility.
107.2(c) The contract must include:
107.3(1) a disclosure of the category of assisted living facility license held by the facility and,
107.4if the facility is not an assisted living facility with dementia care, a disclosure that it does
107.5not hold an assisted living facility with dementia care license;
107.6(2) a description of all the terms and conditions of the contract, including a description
107.7of and any limitations to the housing or assisted living services to be provided for the
107.8contracted amount;
107.9(3) a delineation of the cost and nature of any other services to be provided for an
107.10additional fee;
107.11(4) a delineation and description of any additional fees the resident may be required to
107.12pay if the resident's condition changes during the term of the contract;
107.13(5) a delineation of the grounds under which the resident may be discharged, evicted,
107.14or transferred or have services terminated;
107.15(6) billing and payment procedures and requirements; and
107.16(7) disclosure of the facility's ability to provide specialized diets.
107.17(d) The contract must include a description of the facility's complaint resolution process
107.18available to residents, including the name and contact information of the person representing
107.19the facility who is designated to handle and resolve complaints.
107.20(e) The contract must include a clear and conspicuous notice of:
107.21(1) the right under section 144J.09 to challenge a discharge, eviction, refusal to readmit,
107.22or service termination;
107.23(2) the facility's policy regarding transfer of residents within the facility, under what
107.24circumstances a transfer may occur, and whether or not consent of the resident being asked
107.25to transfer is required;
107.26(3) contact information for the Office of Ombudsman for Long-Term Care, the
107.27Ombudsman for Mental Health and Developmental Disabilities, and the Office of Health
107.28Facility Complaints;
107.29(4) the resident's right to obtain services from an unaffiliated service provider;
108.1(5) a description of the facility's policies related to medical assistance waivers under
108.2sections 256B.0915 and 256B.49 and the housing support program under chapter 256I,
108.3including:
108.4(i) whether the facility is enrolled with the commissioner of human services to provide
108.5customized living services under medical assistance waivers;
108.6(ii) whether the facility has an agreement to provide housing support under section
108.7256I.04, subdivision 2, paragraph (b);
108.8(iii) whether there is a limit on the number of people residing at the facility who can
108.9receive customized living services or participate in the housing support program at any
108.10point in time. If so, the limit must be provided;
108.11(iv) whether the facility requires a resident to pay privately for a period of time prior to
108.12accepting payment under medical assistance waivers or the housing support program, and
108.13if so, the length of time that private payment is required;
108.14(v) a statement that medical assistance waivers provide payment for services, but do not
108.15cover the cost of rent;
108.16(vi) a statement that residents may be eligible for assistance with rent through the housing
108.17support program; and
108.18(vii) a description of the rent requirements for people who are eligible for medical
108.19assistance waivers but who are not eligible for assistance through the housing support
108.20program;
108.21(6) the contact information to obtain long-term care consulting services under section
108.22256B.0911; and
108.23(7) the toll-free phone number for the Minnesota Adult Abuse Reporting Center.
108.24(f) The contract must include a description of the facility's complaint resolution process
108.25available to residents, including the name and contact information of the person representing
108.26the facility who is designated to handle and resolve complaints.
108.27    Subd. 3. Designation of representative. (a) Before or at the time of execution of an
108.28assisted living contract, an assisted living facility must offer the resident the opportunity to
108.29identify a designated representative in writing in the contract and must provide the following
108.30verbatim notice on a document separate from the contract:
108.31RIGHT TO DESIGNATE A REPRESENTATIVE FOR CERTAIN PURPOSES.
109.1You have the right to name anyone as your "Designated Representative" to assist you
109.2or, if you are unable, advocate on your behalf. A "Designated Representative" does not take
109.3the place of your guardian, conservator, power of attorney ("attorney-in-fact"), or health
109.4care power of attorney ("health care agent"), if applicable.
109.5(b) The contract must contain a page or space for the name and contact information of
109.6the designated representative and a box the resident must initial if the resident declines to
109.7name a designated representative. Notwithstanding subdivision 1, paragraph (f), the resident
109.8has the right at any time to add or change the name and contact information of the designated
109.9representative.
109.10    Subd. 4. Filing. The contract and related documents must be maintained by the facility
109.11in files from the date of execution until five years after the contract is terminated or expires.
109.12The contracts and all associated documents must be available for on-site inspection by the
109.13commissioner at any time. The documents shall be available for viewing or copies shall be
109.14made available to the resident and the legal or designated representative at any time.
109.15    Subd. 5. Waivers of liability prohibited. The contract must not include a waiver of
109.16facility liability for the health and safety or personal property of a resident. The contract
109.17must not include any provision that the facility knows or should know to be deceptive,
109.18unlawful, or unenforceable under state or federal law, nor include any provision that requires
109.19or implies a lesser standard of care or responsibility than is required by law.
109.20EFFECTIVE DATE.This section is effective August 1, 2021.

109.21    Sec. 27. [144I.265] OFFICE OF OMBUDSMAN FOR LONG-TERM CARE.
109.22    Subdivision 1. Immunity from liability. The Office of Ombudsman for Long-Term
109.23Care and representatives of the office are immune from liability for conduct described in
109.24section 256.9742, subdivision 2.
109.25    Subd. 2. Data classification. All forms and notices received by the Office of Ombudsman
109.26for Long-Term Care under this chapter are classified under section 256.9744.
109.27EFFECTIVE DATE.This section is effective August 1, 2021.

109.28    Sec. 28. [144I.27] PLANNED CLOSURES.
109.29    Subdivision 1. Closure plan required. In the event that an assisted living facility elects
109.30to voluntarily close the facility, the facility must notify the commissioner and the Office of
109.31Ombudsman for Long-Term Care in writing by submitting a proposed closure plan.
110.1    Subd. 2. Content of closure plan. The facility's proposed closure plan must include:
110.2(1) the procedures and actions the facility will implement to notify residents of the
110.3closure, including a copy of the written notice to be given to residents, designated
110.4representatives, legal representatives, and family;
110.5(2) the procedures and actions the facility will implement to ensure all residents receive
110.6appropriate termination planning in accordance with section 144J.10, subdivisions 1 to 6,
110.7and final accountings and returns under section 144I.13, subdivision 5;
110.8(3) assessments of the needs and preferences of individual residents; and
110.9(4) procedures and actions the facility will implement to maintain compliance with this
110.10chapter until all residents have relocated.
110.11    Subd. 3. Commissioner's approval required prior to implementation. (a) The plan
110.12shall be subject to the commissioner's approval and subdivision 6. The facility shall take
110.13no action to close the residence prior to the commissioner's approval of the plan. The
110.14commissioner shall approve or otherwise respond to the plan as soon as practicable.
110.15(b) The commissioner may require the facility to work with a transitional team comprised
110.16of department staff, staff of the Office of Ombudsman for Long-Term Care, and other
110.17professionals the commissioner deems necessary to assist in the proper relocation of residents.
110.18    Subd. 4. Termination planning and final accounting requirements. Prior to
110.19termination, the facility must follow the termination planning requirements under section
110.20144J.10, subdivisions 1 to 6, and final accounting and return requirements under section
110.21144I.13, subdivision 5, for residents. The facility must implement the plan approved by the
110.22commissioner and ensure that arrangements for relocation and continued care that meet
110.23each resident's social, emotional, and health needs are effectuated prior to closure.
110.24    Subd. 5. Notice to residents. After the commissioner has approved the relocation plan
110.25and at least 60 calendar days before closing, except as provided under subdivision 6, the
110.26facility must notify residents, designated representatives, and legal representatives or, if a
110.27resident has no designated representative or legal representative, a family member, if known,
110.28of the closure, the proposed date of closure, the contact information of the ombudsman for
110.29long-term care, and that the facility will follow the termination planning requirements under
110.30section 144J.10, subdivisions 1 to 6, and final accounting and return requirements under
110.31section 144I.13, subdivision 5. For residents who receive home and community-based waiver
110.32services under sections 256B.0915 and 256B.49, the facility must also provide this
110.33information to the resident's case manager.
111.1    Subd. 6. Emergency closures. (a) In the event the facility must close because the
111.2commissioner deems the facility can no longer remain open, the facility must meet all
111.3requirements in subdivisions 1 to 5, except for any requirements the commissioner finds
111.4would endanger the health and safety of residents. In the event the commissioner determines
111.5a closure must occur with less than 60 calendar days' notice, the facility shall provide notice
111.6to residents as soon as practicable or as directed by the commissioner.
111.7(b) Upon request from the commissioner, the facility must provide the commissioner
111.8with any documentation related to the appropriateness of its relocation plan, or to any
111.9assertion that the facility lacks the funds to comply with subdivision 1 to 5, or that remaining
111.10open would otherwise endanger the health and safety of residents pursuant to paragraph
111.11(a).
111.12    Subd. 7. Other rights. Nothing in this section or section 144J.08, 144J.09, or 144J.10
111.13affects the rights and remedies available under chapter 504B.
111.14    Subd. 8. Fine. The commissioner may impose a fine for failure to follow the requirements
111.15of this section.
111.16EFFECTIVE DATE.This section is effective August 1, 2021.

111.17    Sec. 29. [144I.29] COMMISSIONER OVERSIGHT AND AUTHORITY.
111.18    Subdivision 1. Regulations. The commissioner shall regulate assisted living facilities
111.19pursuant to this chapter. The regulations shall include the following:
111.20(1) provisions to assure, to the extent possible, the health, safety, well-being, and
111.21appropriate treatment of residents while respecting individual autonomy and choice;
111.22(2) requirements that facilities furnish the commissioner with specified information
111.23necessary to implement this chapter;
111.24(3) standards of training of facility personnel;
111.25(4) standards for the provision of assisted living services;
111.26(5) standards for medication management;
111.27(6) standards for supervision of assisted living services;
111.28(7) standards for resident evaluation or assessment;
111.29(8) standards for treatments and therapies;
112.1(9) requirements for the involvement of a resident's health care provider, the
112.2documentation of the health care provider's orders, if required, and the resident's service
112.3plan;
112.4(10) standards for the maintenance of accurate, current resident records;
112.5(11) the establishment of levels of licenses based on services provided; and
112.6(12) provisions to enforce these regulations and the assisted living bill of rights.
112.7    Subd. 2. Regulatory functions. (a) The commissioner shall:
112.8(1) license, survey, and monitor without advance notice assisted living facilities in
112.9accordance with this chapter and rules;
112.10(2) survey every provisional licensee within one year of the provisional license issuance
112.11date subject to the provisional licensee providing assisted living services to residents;
112.12(3) survey assisted living facility licensees annually;
112.13(4) investigate complaints of assisted living facilities;
112.14(5) issue correction orders and assess civil penalties under sections 144I.30 and 144I.31;
112.15(6) take action as authorized in section 144I.33; and
112.16(7) take other action reasonably required to accomplish the purposes of this chapter.
112.17(b) The commissioner shall review blueprints for all new facility construction and must
112.18approve the plans before construction may be commenced.
112.19(c) The commissioner shall provide on-site review of the construction to ensure that all
112.20physical environment standards are met before the facility license is complete.
112.21EFFECTIVE DATE.This section is effective August 1, 2021.

112.22    Sec. 30. [144I.30] SURVEYS AND INVESTIGATIONS.
112.23    Subdivision 1. Regulatory powers. (a) The Department of Health is the exclusive state
112.24agency charged with the responsibility and duty of surveying and investigating all assisted
112.25living facilities required to be licensed under this chapter. The commissioner of health shall
112.26enforce all sections of this chapter and the rules adopted under this chapter.
112.27(b) The commissioner, upon request to the facility, must be given access to relevant
112.28information, records, incident reports, and other documents in the possession of the facility
112.29if the commissioner considers them necessary for the discharge of responsibilities. For
112.30purposes of surveys and investigations and securing information to determine compliance
113.1with licensure laws and rules, the commissioner need not present a release, waiver, or
113.2consent to the individual. The identities of residents must be kept private as defined in
113.3section 13.02, subdivision 12.
113.4    Subd. 2. Surveys. The commissioner shall conduct a survey of each assisted living
113.5facility on a frequency of at least once each year. The commissioner may conduct surveys
113.6more frequently than once a year based on the license category, the facility's compliance
113.7history, the number of residents served, or other factors as determined by the commissioner
113.8deemed necessary to ensure the health, safety, and welfare of residents and compliance with
113.9the law.
113.10    Subd. 3. Follow-up surveys. The commissioner may conduct follow-up surveys to
113.11determine if the facility has corrected deficient issues and systems identified during a survey
113.12or complaint investigation. Follow-up surveys may be conducted via phone, e-mail, fax,
113.13mail, or on-site reviews. Follow-up surveys, other than complaint investigations, shall be
113.14concluded with an exit conference and written information provided on the process for
113.15requesting a reconsideration of the survey results.
113.16    Subd. 4. Scheduling surveys. Surveys and investigations shall be conducted without
113.17advance notice to the facilities. Surveyors may contact the facility on the day of a survey
113.18to arrange for someone to be available at the survey site. The contact does not constitute
113.19advance notice. The surveyor must provide presurvey notification to the Office of
113.20Ombudsman for Long-Term Care.
113.21    Subd. 5. Information provided by facility. The assisted living facility shall provide
113.22accurate and truthful information to the department during a survey, investigation, or other
113.23licensing activities.
113.24    Subd. 6. Providing resident records. Upon request of a surveyor, assisted living facilities
113.25shall provide a list of current and past residents or designated representatives that includes
113.26addresses and telephone numbers and any other information requested about the services
113.27to residents within a reasonable period of time.
113.28    Subd. 7. Correction orders. (a) A correction order may be issued whenever the
113.29commissioner finds upon survey or during a complaint investigation that a facility, a
113.30managerial official, or an employee of the facility is not in compliance with this chapter.
113.31The correction order shall cite the specific statute and document areas of noncompliance
113.32and the time allowed for correction.
113.33(b) The commissioner shall mail or e-mail copies of any correction order to the facility
113.34within 30 calendar days after the survey exit date. A copy of each correction order and
114.1copies of any documentation supplied to the commissioner shall be kept on file by the
114.2facility and public documents shall be made available for viewing by any person upon
114.3request. Copies may be kept electronically.
114.4(c) By the correction order date, the facility must document in the facility's records any
114.5action taken to comply with the correction order. The commissioner may request a copy of
114.6this documentation and the facility's action to respond to the correction order in future
114.7surveys, upon a complaint investigation, and as otherwise needed.
114.8    Subd. 8. Required follow-up surveys. For assisted living facilities that have Level 3
114.9or Level 4 violations under section 144I.31, the commissioner shall conduct a follow-up
114.10survey within 90 calendar days of the survey. When conducting a follow-up survey, the
114.11surveyor shall focus on whether the previous violations have been corrected and may also
114.12address any new violations that are observed while evaluating the corrections that have been
114.13made.
114.14EFFECTIVE DATE.This section is effective August 1, 2021.

114.15    Sec. 31. [144I.31] VIOLATIONS AND FINES.
114.16    Subdivision 1. Fine amounts. (a) Fines and enforcement actions under this subdivision
114.17may be assessed based on the level and scope of the violations described in subdivision 2
114.18as follows and may be imposed immediately with no opportunity to correct the violation
114.19prior to imposition:
114.20(1) Level 1, no fines or enforcement;
114.21(2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism
114.22authorized in section 144I.33 for widespread violations;
114.23(3) Level 3, a fine of $3,000 per violation per incident, in addition to any enforcement
114.24mechanism authorized in section 144I.33;
114.25(4) Level 4, a fine of $5,000 per incident, in addition to any enforcement mechanism
114.26authorized in section 144I.33; and
114.27(5) for maltreatment violations for which the licensee was determined to be responsible
114.28for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000.
114.29A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible
114.30for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury.
115.1(b) When a fine is assessed against a facility for substantiated maltreatment, the
115.2commissioner shall not also impose an immediate fine under this chapter for the same
115.3circumstance.
115.4    Subd. 2. Level and scope of violation. Correction orders for violations are categorized
115.5by both level and scope:
115.6(1) level of violation:
115.7(i) Level 1 is a violation that has no potential to cause more than a minimal impact on
115.8the resident and does not affect health or safety;
115.9(ii) Level 2 is a violation that did not harm a resident's health or safety but had the
115.10potential to have harmed a resident's health or safety, but was not likely to cause serious
115.11injury, impairment, or death;
115.12(iii) Level 3 is a violation that harmed a resident's health or safety, not including serious
115.13injury, impairment, or death, or a violation that has the potential to lead to serious injury,
115.14impairment, or death; and
115.15(iv) Level 4 is a violation that results in serious injury, impairment, or death; and
115.16(2) scope of violation:
115.17(i) isolated, when one or a limited number of residents are affected or one or a limited
115.18number of staff are involved or the situation has occurred only occasionally;
115.19(ii) pattern, when more than a limited number of residents are affected, more than a
115.20limited number of staff are involved, or the situation has occurred repeatedly but is not
115.21found to be pervasive; and
115.22(iii) widespread, when problems are pervasive or represent a systemic failure that has
115.23affected or has the potential to affect a large portion or all of the residents.
115.24    Subd. 3. Notice of noncompliance. If the commissioner finds that the applicant or a
115.25facility has not corrected violations by the date specified in the correction order or conditional
115.26license resulting from a survey or complaint investigation, the commissioner shall provide
115.27a notice of noncompliance with a correction order by e-mailing the notice of noncompliance
115.28to the facility. The noncompliance notice must list the violations not corrected.
115.29    Subd. 4. Immediate fine; payment. (a) For every Level 3 or Level 4 violation, the
115.30commissioner may issue an immediate fine. The licensee must still correct the violation in
115.31the time specified. The issuance of an immediate fine may occur in addition to any
116.1enforcement mechanism authorized under section 144I.33. The immediate fine may be
116.2appealed as allowed under this section.
116.3(b) The licensee must pay the fines assessed on or before the payment date specified. If
116.4the licensee fails to fully comply with the order, the commissioner may issue a second fine
116.5or suspend the license until the licensee complies by paying the fine. A timely appeal shall
116.6stay payment of the fine until the commissioner issues a final order.
116.7(c) A licensee shall promptly notify the commissioner in writing when a violation
116.8specified in the order is corrected. If upon reinspection the commissioner determines that
116.9a violation has not been corrected as indicated by the order, the commissioner may issue
116.10an additional fine. The commissioner shall notify the licensee by mail to the last known
116.11address in the licensing record that a second fine has been assessed. The licensee may appeal
116.12the second fine as provided under this subdivision.
116.13(d) A facility that has been assessed a fine under this section has a right to a
116.14reconsideration or hearing under this section and chapter 14.
116.15    Subd. 5. Payment of fines required. When a fine has been assessed, the licensee may
116.16not avoid payment by closing, selling, or otherwise transferring the license to a third party.
116.17In such an event, the licensee shall be liable for payment of the fine.
116.18    Subd. 6. Additional penalties. In addition to any fine imposed under this section, the
116.19commissioner may assess a penalty amount based on costs related to an investigation that
116.20results in a final order assessing a fine or other enforcement action authorized by this chapter.
116.21    Subd. 7. Deposit of fines. Fines collected under this section shall be deposited in the
116.22state government special revenue fund and credited to an account separate from the revenue
116.23collected under section 144A.472. Subject to an appropriation by the legislature, the revenue
116.24from the fines collected must be used by the commissioner for special projects to improve
116.25home care in Minnesota as recommended by the advisory council established in section
116.26144A.4799.
116.27EFFECTIVE DATE.This section is effective August 1, 2021.

116.28    Sec. 32. [144I.32] RECONSIDERATION OF CORRECTION ORDERS AND FINES.
116.29    Subdivision 1. Reconsideration process required. The commissioner shall make
116.30available to assisted living facilities a correction order reconsideration process. This process
116.31may be used to challenge the correction order issued, including the level and scope described
116.32in section 144I.31, and any fine assessed. When a licensee requests reconsideration of a
116.33correction order, the correction order is not stayed while it is under reconsideration. The
117.1commissioner shall post information on its website that the licensee requested reconsideration
117.2of the correction order and that the review is pending.
117.3    Subd. 2. Reconsideration process. An assisted living facility may request from the
117.4commissioner, in writing, a correction order reconsideration regarding any correction order
117.5issued to the facility. The written request for reconsideration must be received by the
117.6commissioner within 15 calendar days of the correction order receipt date. The correction
117.7order reconsideration shall not be reviewed by any surveyor, investigator, or supervisor that
117.8participated in writing or reviewing the correction order being disputed. The correction
117.9order reconsiderations may be conducted in person, by telephone, by another electronic
117.10form, or in writing, as determined by the commissioner. The commissioner shall respond
117.11in writing to the request from a facility for a correction order reconsideration within 60 days
117.12of the date the facility requests a reconsideration. The commissioner's response shall identify
117.13the commissioner's decision regarding each citation challenged by the facility.
117.14    Subd. 3. Findings. The findings of a correction order reconsideration process shall be
117.15one or more of the following:
117.16(1) supported in full: the correction order is supported in full, with no deletion of findings
117.17to the citation;
117.18(2) supported in substance: the correction order is supported, but one or more findings
117.19are deleted or modified without any change in the citation;
117.20(3) correction order cited an incorrect licensing requirement: the correction order is
117.21amended by changing the correction order to the appropriate statute or rule;
117.22(4) correction order was issued under an incorrect citation: the correction order is amended
117.23to be issued under the more appropriate correction order citation;
117.24(5) the correction order is rescinded;
117.25(6) fine is amended: it is determined that the fine assigned to the correction order was
117.26applied incorrectly; or
117.27(7) the level or scope of the citation is modified based on the reconsideration.
117.28    Subd. 4. Updating the correction order website. If the correction order findings are
117.29changed by the commissioner, the commissioner shall update the correction order website.
117.30    Subd. 5. Provisional licensees. This section does not apply to provisional licensees.
117.31EFFECTIVE DATE.This section is effective August 1, 2021.

118.1    Sec. 33. [144I.33] ENFORCEMENT.
118.2    Subdivision 1. Conditions. (a) The commissioner may refuse to grant a provisional
118.3license, refuse to grant a license as a result of a change in ownership, refuse to renew a
118.4license, suspend or revoke a license, or impose a conditional license if the owner, controlling
118.5individual, or employee of an assisted living facility:
118.6(1) is in violation of, or during the term of the license has violated, any of the requirements
118.7in this chapter or adopted rules;
118.8(2) permits, aids, or abets the commission of any illegal act in the provision of assisted
118.9living services;
118.10(3) performs any act detrimental to the health, safety, and welfare of a resident;
118.11(4) obtains the license by fraud or misrepresentation;
118.12(5) knowingly makes a false statement of a material fact in the application for a license
118.13or in any other record or report required by this chapter;
118.14(6) denies representatives of the department access to any part of the facility's books,
118.15records, files, or employees;
118.16(7) interferes with or impedes a representative of the department in contacting the facility's
118.17residents;
118.18(8) interferes with or impedes ombudsman access according to section 256.9742,
118.19subdivision 4;
118.20(9) interferes with or impedes a representative of the department in the enforcement of
118.21this chapter or fails to fully cooperate with an inspection, survey, or investigation by the
118.22department;
118.23(10) destroys or makes unavailable any records or other evidence relating to the assisted
118.24living facility's compliance with this chapter;
118.25(11) refuses to initiate a background study under section 144.057 or 245A.04;
118.26(12) fails to timely pay any fines assessed by the commissioner;
118.27(13) violates any local, city, or township ordinance relating to housing or assisted living
118.28services;
118.29(14) has repeated incidents of personnel performing services beyond their competency
118.30level; or
118.31(15) has operated beyond the scope of the assisted living facility's license category.
119.1(b) A violation by a contractor providing the assisted living services of the facility is a
119.2violation by facility.
119.3    Subd. 2. Terms to suspension or conditional license. (a) A suspension or conditional
119.4license designation may include terms that must be completed or met before a suspension
119.5or conditional license designation is lifted. A conditional license designation may include
119.6restrictions or conditions that are imposed on the assisted living facility. Terms for a
119.7suspension or conditional license may include one or more of the following and the scope
119.8of each will be determined by the commissioner:
119.9(1) requiring a consultant to review, evaluate, and make recommended changes to the
119.10facility's practices and submit reports to the commissioner at the cost of the facility;
119.11(2) requiring supervision of the facility or staff practices at the cost of the facility by an
119.12unrelated person who has sufficient knowledge and qualifications to oversee the practices
119.13and who will submit reports to the commissioner;
119.14(3) requiring the facility or employees to obtain training at the cost of the facility;
119.15(4) requiring the facility to submit reports to the commissioner;
119.16(5) prohibiting the facility from admitting any new residents for a specified period of
119.17time; or
119.18(6) any other action reasonably required to accomplish the purpose of this subdivision
119.19and subdivision 1.
119.20(b) A facility subject to this subdivision may continue operating during the period of
119.21time residents are being transferred to another service provider.
119.22    Subd. 3. Immediate temporary suspension. (a) In addition to any other remedies
119.23provided by law, the commissioner may, without a prior contested case hearing, immediately
119.24temporarily suspend a license or prohibit delivery of housing or services by a facility for
119.25not more than 90 calendar days or issue a conditional license, if the commissioner determines
119.26that there are:
119.27(1) Level 4 violations; or
119.28(2) violations that pose an imminent risk of harm to the health or safety of residents.
119.29(b) For purposes of this subdivision, "Level 4" has the meaning given in section 144I.31.
119.30(c) A notice stating the reasons for the immediate temporary suspension or conditional
119.31license and informing the licensee of the right to an expedited hearing under subdivision
119.3211 must be delivered by personal service to the address shown on the application or the last
120.1known address of the licensee. The licensee may appeal an order immediately temporarily
120.2suspending a license or issuing a conditional license. The appeal must be made in writing
120.3by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
120.4the commissioner within five calendar days after the licensee receives notice. If an appeal
120.5is made by personal service, it must be received by the commissioner within five calendar
120.6days after the licensee received the order.
120.7(d) A licensee whose license is immediately temporarily suspended must comply with
120.8the requirements for notification and transfer of residents in subdivision 9. The requirements
120.9in subdivision 9 remain if an appeal is requested.
120.10    Subd. 4. Mandatory revocation. Notwithstanding the provisions of subdivision 7,
120.11paragraph (a), the commissioner must revoke a license if a controlling individual of the
120.12facility is convicted of a felony or gross misdemeanor that relates to operation of the facility
120.13or directly affects resident safety or care. The commissioner shall notify the facility and the
120.14Office of Ombudsman for Long-Term Care 30 calendar days in advance of the date of
120.15revocation.
120.16    Subd. 5. Mandatory proceedings. (a) The commissioner must initiate proceedings
120.17within 60 calendar days of notification to suspend or revoke a facility's license or must
120.18refuse to renew a facility's license if within the preceding two years the facility has incurred
120.19the following number of uncorrected or repeated violations:
120.20(1) two or more uncorrected violations or one or more repeated violations that created
120.21an imminent risk to direct resident care or safety; or
120.22(2) four or more uncorrected violations or two or more repeated violations of any nature
120.23for which the fines are in the four highest daily fine categories prescribed in rule.
120.24(b) Notwithstanding paragraph (a), the commissioner is not required to revoke, suspend,
120.25or refuse to renew a facility's license if the facility corrects the violation.
120.26    Subd. 6. Notice to residents. (a) Within five business days after proceedings are initiated
120.27by the commissioner to revoke or suspend a facility's license, or a decision by the
120.28commissioner not to renew a living facility's license, the controlling individual of the facility
120.29or a designee must provide to the commissioner and the ombudsman for long-term care the
120.30names of residents and the names and addresses of the residents' guardians, designated
120.31representatives, and family contacts.
120.32(b) The controlling individual or designees of the facility must provide updated
120.33information each month until the proceeding is concluded. If the controlling individual or
121.1designee of the facility fails to provide the information within this time, the facility is subject
121.2to the issuance of:
121.3(1) a correction order; and
121.4(2) a penalty assessment by the commissioner in rule.
121.5(c) Notwithstanding subdivisions 16 and 17, any correction order issued under this
121.6subdivision must require that the facility immediately comply with the request for information
121.7and that, as of the date of the issuance of the correction order, the facility shall forfeit to the
121.8state a $500 fine the first day of noncompliance and an increase in the $500 fine by $100
121.9increments for each day the noncompliance continues.
121.10(d) Information provided under this subdivision may be used by the commissioner or
121.11the ombudsman for long-term care only for the purpose of providing affected consumers
121.12information about the status of the proceedings.
121.13(e) Within ten business days after the commissioner initiates proceedings to revoke,
121.14suspend, or not renew a facility license, the commissioner must send a written notice of the
121.15action and the process involved to each resident of the facility and the resident's designated
121.16representative or, if there is no designated representative and if known, a family member
121.17or interested person.
121.18(f) The commissioner shall provide the ombudsman for long-term care with monthly
121.19information on the department's actions and the status of the proceedings.
121.20    Subd. 7. Notice to facility. (a) Prior to any suspension, revocation, or refusal to renew
121.21a license, the facility shall be entitled to notice and a hearing as provided by sections 14.57
121.22to 14.69. The hearing must commence within 60 calendar days after the proceedings are
121.23initiated. In addition to any other remedy provided by law, the commissioner may, without
121.24a prior contested case hearing, temporarily suspend a license or prohibit delivery of services
121.25by a provider for not more than 90 calendar days, or issue a conditional license if the
121.26commissioner determines that there are Level 3 violations that do not pose an imminent
121.27risk of harm to the health or safety of the facility residents, provided:
121.28(1) advance notice is given to the facility;
121.29(2) after notice, the facility fails to correct the problem;
121.30(3) the commissioner has reason to believe that other administrative remedies are not
121.31likely to be effective; and
122.1(4) there is an opportunity for a contested case hearing within 30 calendar days unless
122.2there is an extension granted by an administrative law judge.
122.3(b) If the commissioner determines there are Level 4 violations or violations that pose
122.4an imminent risk of harm to the health or safety of the facility residents, the commissioner
122.5may immediately temporarily suspend a license, prohibit delivery of services by a facility,
122.6or issue a conditional license without meeting the requirements of paragraph (a), clauses
122.7(1) to (4).
122.8For the purposes of this subdivision, "Level 3" and "Level 4" have the meanings given in
122.9section 144I.31.
122.10    Subd. 8. Request for hearing. A request for hearing must be in writing and must:
122.11(1) be mailed or delivered to the commissioner;
122.12(2) contain a brief and plain statement describing every matter or issue contested; and
122.13(3) contain a brief and plain statement of any new matter that the applicant or assisted
122.14living facility believes constitutes a defense or mitigating factor.
122.15    Subd. 9. Plan required. (a) The process of suspending, revoking, or refusing to renew
122.16a license must include a plan for transferring affected residents' cares to other providers by
122.17the facility. The commissioner shall monitor the transfer plan. Within three calendar days
122.18of being notified of the final revocation, refusal to renew, or suspension, the licensee shall
122.19provide the commissioner, the lead agencies as defined in section 256B.0911, county adult
122.20protection and case managers, and the ombudsman for long-term care with the following
122.21information:
122.22(1) a list of all residents, including full names and all contact information on file;
122.23(2) a list of each resident's legal and designated representatives or emergency contact
122.24person, including full names and all contact information on file;
122.25(3) the location or current residence of each resident;
122.26(4) the payor sources for each resident, including payor source identification numbers;
122.27and
122.28(5) for each resident, a copy of the resident's service plan and a list of the types of services
122.29being provided.
122.30(b) The revocation, refusal to renew, or suspension notification requirement is satisfied
122.31by mailing the notice to the address in the license record. The licensee shall cooperate with
122.32the commissioner and the lead agencies, county adult protection and county managers, and
123.1the ombudsman for long-term care during the process of transferring care of residents to
123.2qualified providers. Within three calendar days of being notified of the final revocation,
123.3refusal to renew, or suspension action, the facility must notify and disclose to each of the
123.4residents, or the resident's legal and designated representatives or emergency contact persons,
123.5that the commissioner is taking action against the facility's license by providing a copy of
123.6the revocation, refusal to renew, or suspension notice issued by the commissioner. If the
123.7facility does not comply with the disclosure requirements in this section, the commissioner
123.8shall notify the residents, legal and designated representatives, or emergency contact persons
123.9about the actions being taken. Lead agencies, county adult protection and county managers,
123.10and the Office of Ombudsman for Long-Term Care may also provide this information. The
123.11revocation, refusal to renew, or suspension notice is public data except for any private data
123.12contained therein.
123.13(c) A facility subject to this subdivision may continue operating while residents are being
123.14transferred to other service providers.
123.15    Subd. 10. Hearing. Within 15 business days of receipt of the licensee's timely appeal
123.16of a sanction under this section, other than for a temporary suspension, the commissioner
123.17shall request assignment of an administrative law judge. The commissioner's request must
123.18include a proposed date, time, and place of hearing. A hearing must be conducted by an
123.19administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
123.2090 calendar days of the request for assignment, unless an extension is requested by either
123.21party and granted by the administrative law judge for good cause or for purposes of discussing
123.22settlement. In no case shall one or more extensions be granted for a total of more than 90
123.23calendar days unless there is a criminal action pending against the licensee. If, while a
123.24licensee continues to operate pending an appeal of an order for revocation, suspension, or
123.25refusal to renew a license, the commissioner identifies one or more new violations of law
123.26that meet the requirements of Level 3 or Level 4 violations as defined in section 144I.31,
123.27the commissioner shall act immediately to temporarily suspend the license.
123.28    Subd. 11. Expedited hearing. (a) Within five business days of receipt of the licensee's
123.29timely appeal of a temporary suspension or issuance of a conditional license, the
123.30commissioner shall request assignment of an administrative law judge. The request must
123.31include a proposed date, time, and place of a hearing. A hearing must be conducted by an
123.32administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
123.3330 calendar days of the request for assignment, unless an extension is requested by either
123.34party and granted by the administrative law judge for good cause. The commissioner shall
123.35issue a notice of hearing by certified mail or personal service at least ten business days
124.1before the hearing. Certified mail to the last known address is sufficient. The scope of the
124.2hearing shall be limited solely to the issue of whether the temporary suspension or issuance
124.3of a conditional license should remain in effect and whether there is sufficient evidence to
124.4conclude that the licensee's actions or failure to comply with applicable laws are Level 3
124.5or Level 4 violations as defined in section 144I.31, or that there were violations that posed
124.6an imminent risk of harm to the resident's health and safety.
124.7(b) The administrative law judge shall issue findings of fact, conclusions, and a
124.8recommendation within ten business days from the date of hearing. The parties shall have
124.9ten calendar days to submit exceptions to the administrative law judge's report. The record
124.10shall close at the end of the ten-day period for submission of exceptions. The commissioner's
124.11final order shall be issued within ten business days from the close of the record. When an
124.12appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed,
124.13the commissioner shall issue a final order affirming the temporary immediate suspension
124.14or conditional license within ten calendar days of the commissioner's receipt of the
124.15withdrawal or dismissal. The licensee is prohibited from operation during the temporary
124.16suspension period.
124.17(c) When the final order under paragraph (b) affirms an immediate suspension, and a
124.18final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that
124.19sanction, the licensee is prohibited from operation pending a final commissioner's order
124.20after the contested case hearing conducted under chapter 14.
124.21(d) A licensee whose license is temporarily suspended must comply with the requirements
124.22for notification and transfer of residents under subdivision 9. These requirements remain if
124.23an appeal is requested.
124.24    Subd. 12. Time limits for appeals. To appeal the assessment of civil penalties under
124.25section 144I.31, and an action against a license under this section, a licensee must request
124.26a hearing no later than 15 business days after the licensee receives notice of the action.
124.27    Subd. 13. Owners and managerial officials; refusal to grant license. (a) The owner
124.28and managerial officials of a facility whose Minnesota license has not been renewed or
124.29whose Minnesota license has been revoked because of noncompliance with applicable laws
124.30or rules shall not be eligible to apply for nor will be granted an assisted living facility license
124.31under this chapter or a home care provider license under chapter 144A, or be given status
124.32as an enrolled personal care assistance provider agency or personal care assistant by the
124.33Department of Human Services under section 256B.0659, for five years following the
125.1effective date of the nonrenewal or revocation. If the owner or managerial officials already
125.2have enrollment status, the Department of Human Services shall terminate that enrollment.
125.3(b) The commissioner shall not issue a license to a facility for five years following the
125.4effective date of license nonrenewal or revocation if the owner or managerial official,
125.5including any individual who was an owner or managerial official of another licensed
125.6provider, had a Minnesota license that was not renewed or was revoked as described in
125.7paragraph (a).
125.8(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall suspend
125.9or revoke, the license of a facility that includes any individual as an owner or managerial
125.10official who was an owner or managerial official of a facility whose Minnesota license was
125.11not renewed or was revoked as described in paragraph (a) for five years following the
125.12effective date of the nonrenewal or revocation.
125.13(d) The commissioner shall notify the facility 30 calendar days in advance of the date
125.14of nonrenewal, suspension, or revocation of the license. Within ten business days after the
125.15receipt of the notification, the facility may request, in writing, that the commissioner stay
125.16the nonrenewal, revocation, or suspension of the license. The facility shall specify the
125.17reasons for requesting the stay; the steps that will be taken to attain or maintain compliance
125.18with the licensure laws and regulations; any limits on the authority or responsibility of the
125.19owners or managerial officials whose actions resulted in the notice of nonrenewal, revocation,
125.20or suspension; and any other information to establish that the continuing affiliation with
125.21these individuals will not jeopardize resident health, safety, or well-being. The commissioner
125.22shall determine whether the stay will be granted within 30 calendar days of receiving the
125.23facility's request. The commissioner may propose additional restrictions or limitations on
125.24the facility's license and require that granting the stay be contingent upon compliance with
125.25those provisions. The commissioner shall take into consideration the following factors when
125.26determining whether the stay should be granted:
125.27(1) the threat that continued involvement of the owners and managerial officials with
125.28the facility poses to resident health, safety, and well-being;
125.29(2) the compliance history of the facility; and
125.30(3) the appropriateness of any limits suggested by the facility.
125.31If the commissioner grants the stay, the order shall include any restrictions or limitation on
125.32the provider's license. The failure of the facility to comply with any restrictions or limitations
125.33shall result in the immediate removal of the stay and the commissioner shall take immediate
125.34action to suspend, revoke, or not renew the license.
126.1    Subd. 14. Relicensing. If a facility license is revoked, a new application for license may
126.2be considered by the commissioner when the conditions upon which the revocation was
126.3based have been corrected and satisfactory evidence of this fact has been furnished to the
126.4commissioner. A new license may be granted after an inspection has been made and the
126.5facility has complied with all provisions of this chapter and adopted rules.
126.6    Subd. 15. Informal conference. At any time, the commissioner and the applicant,
126.7licensee, manager if applicable, or facility may hold an informal conference to exchange
126.8information, clarify issues, or resolve issues.
126.9    Subd. 16. Injunctive relief. In addition to any other remedy provided by law, the
126.10commissioner may bring an action in district court to enjoin a person who is involved in
126.11the management, operation, or control of a facility or an employee of the facility from
126.12illegally engaging in activities regulated by this chapter. The commissioner may bring an
126.13action under this subdivision in the district court in Ramsey County or in the district in
126.14which the facility is located. The court may grant a temporary restraining order in the
126.15proceeding if continued activity by the person who is involved in the management, operation,
126.16or control of a facility, or by an employee of the facility, would create an imminent risk of
126.17harm to a resident.
126.18    Subd. 17. Subpoena. In matters pending before the commissioner under this chapter,
126.19the commissioner may issue subpoenas and compel the attendance of witnesses and the
126.20production of all necessary papers, books, records, documents, and other evidentiary material.
126.21If a person fails or refuses to comply with a subpoena or order of the commissioner to appear
126.22or testify regarding any matter about which the person may be lawfully questioned or to
126.23produce any papers, books, records, documents, or evidentiary materials in the matter to be
126.24heard, the commissioner may apply to the district court in any district, and the court shall
126.25order the person to comply with the commissioner's order or subpoena. The commissioner
126.26may administer oaths to witnesses or take their affirmation. Depositions may be taken in
126.27or outside the state in the manner provided by law for taking depositions in civil actions. A
126.28subpoena or other process or paper may be served on a named person anywhere in the state
126.29by an officer authorized to serve subpoenas in civil actions, with the same fees and mileage
126.30and in the same manner as prescribed by law for a process issued out of a district court. A
126.31person subpoenaed under this subdivision shall receive the same fees, mileage, and other
126.32costs that are paid in proceedings in district court.
126.33EFFECTIVE DATE.This section is effective August 1, 2021.

127.1    Sec. 34. [144I.34] INNOVATION VARIANCE.
127.2    Subdivision 1. Definition; granting variances. (a) For purposes of this section,
127.3"innovation variance" means a specified alternative to a requirement of this chapter.
127.4(b) An innovation variance may be granted to allow an assisted living facility to offer
127.5services of a type or in a manner that is innovative, will not impair the services provided,
127.6will not adversely affect the health, safety, or welfare of the residents, and is likely to improve
127.7the services provided. The innovative variance cannot change any of the resident's rights
127.8under the assisted living bill of rights.
127.9    Subd. 2. Conditions. The commissioner may impose conditions on granting an innovation
127.10variance that the commissioner considers necessary.
127.11    Subd. 3. Duration and renewal. The commissioner may limit the duration of any
127.12innovation variance and may renew a limited innovation variance.
127.13    Subd. 4. Applications; innovation variance. An application for innovation variance
127.14from the requirements of this chapter may be made at any time, must be made in writing to
127.15the commissioner, and must specify the following:
127.16(1) the statute or rule from which the innovation variance is requested;
127.17(2) the time period for which the innovation variance is requested;
127.18(3) the specific alternative action that the licensee proposes;
127.19(4) the reasons for the request; and
127.20(5) justification that an innovation variance will not impair the services provided, will
127.21not adversely affect the health, safety, or welfare of residents, and is likely to improve the
127.22services provided.
127.23The commissioner may require additional information from the facility before acting on
127.24the request.
127.25    Subd. 5. Grants and denials. The commissioner shall grant or deny each request for
127.26an innovation variance in writing within 45 days of receipt of a complete request. Notice
127.27of a denial shall contain the reasons for the denial. The terms of a requested innovation
127.28variance may be modified upon agreement between the commissioner and the facility.
127.29    Subd. 6. Violation of innovation variances. A failure to comply with the terms of an
127.30innovation variance shall be deemed to be a violation of this chapter.
128.1    Subd. 7. Revocation or denial of renewal. The commissioner shall revoke or deny
128.2renewal of an innovation variance if:
128.3(1) it is determined that the innovation variance is adversely affecting the health, safety,
128.4or welfare of the residents;
128.5(2) the facility has failed to comply with the terms of the innovation variance;
128.6(3) the facility notifies the commissioner in writing that it wishes to relinquish the
128.7innovation variance and be subject to the statute previously varied; or
128.8(4) the revocation or denial is required by a change in law.
128.9EFFECTIVE DATE.This section is effective August 1, 2021.

128.10    Sec. 35. [144I.35] RESIDENT QUALITY OF CARE AND OUTCOMES
128.11IMPROVEMENT TASK FORCE.
128.12    Subdivision 1. Establishment. The commissioner shall establish a resident quality of
128.13care and outcomes improvement task force to examine and make recommendations, on an
128.14ongoing basis, on how to apply proven safety and quality improvement practices and
128.15infrastructure to settings and providers that provide long-term services and supports.
128.16    Subd. 2. Membership. The task force shall include representation from:
128.17(1) nonprofit Minnesota-based organizations dedicated to patient safety or innovation
128.18in health care safety and quality;
128.19(2) Department of Health staff with expertise in issues related to safety and adverse
128.20health events;
128.21(3) consumer organizations;
128.22(4) direct care providers or their representatives;
128.23(5) organizations representing long-term care providers and home care providers in
128.24Minnesota;
128.25(6) the ombudsman for long-term care or a designee;
128.26(7) national patient safety experts; and
128.27(8) other experts in the safety and quality improvement field.
128.28The task force shall have at least one public member who either is or has been a resident in
128.29an assisted living setting and one public member who has or had a family member living
129.1in an assisted living setting. The membership shall be voluntary except that public members
129.2may be reimbursed under section 15.059, subdivision 3.
129.3    Subd. 3. Recommendations. The task force shall periodically provide recommendations
129.4to the commissioner and the legislature on changes needed to promote safety and quality
129.5improvement practices in long-term care settings and with long-term care providers. The
129.6task force shall meet no fewer than four times per year. The task force shall be established
129.7by July 1, 2020.

129.8    Sec. 36. [144I.36] EXPEDITED RULEMAKING AUTHORIZED.
129.9(a) The commissioner shall adopt rules for all assisted living facilities that promote
129.10person-centered planning and service delivery and optimal quality of life, and that ensure
129.11resident rights are protected, resident choice is allowed, and public health and safety is
129.12ensured.
129.13    (b) On July 1, 2019, the commissioner shall begin expedited rulemaking using the process
129.14in section 14.389.
129.15    (c) The commissioner shall adopt rules that include but are not limited to the following:
129.16    (1) staffing appropriate for each licensure category to best protect the health and safety
129.17of residents no matter their vulnerability;
129.18    (2) training prerequisites and ongoing training, including dementia care training and
129.19standards for demonstrating competency;
129.20    (3) procedures for discharge planning and ensuring resident appeal rights;
129.21    (4) initial assessments, continuing assessments, and a uniform assessment tool;
129.22(5) emergency disaster and preparedness plans;
129.23(6) uniform checklist disclosure of services;
129.24(7) a definition of serious injury that results from maltreatment; and
129.25(8) conditions and fine amounts for planned closures.
129.26    (d) The commissioner shall publish the proposed rules by December 31, 2019, and shall
129.27publish final rules by December 31, 2020.

129.28    Sec. 37. TRANSITION PERIOD.
129.29(a) From July 1, 2019, to June 30, 2020, the commissioner shall engage in the expedited
129.30rulemaking process.
130.1(b) From July 1, 2020, to July 31, 2021, the commissioner shall prepare for the new
130.2assisted living facility and assisted living facility with dementia care licensure by hiring
130.3staff, developing forms, and communicating with stakeholders about the new facility
130.4licensing.
130.5(c) Effective August 1, 2021, all existing housing with services establishments providing
130.6home care services under Minnesota Statutes, chapter 144A, must convert their registration
130.7to licensure under Minnesota Statutes, chapter 144I.
130.8(d) Effective August 1, 2021, all new assisted living facilities and assisted living facilities
130.9with dementia care must be licensed by the commissioner.
130.10(e) Effective August 1, 2021, all assisted living facilities and assisted living facilities
130.11with dementia care must be licensed by the commissioner.

130.12    Sec. 38. REPEALER.
130.13Minnesota Statutes 2018, sections 144D.01; 144D.015; 144D.02; 144D.025; 144D.03;
130.14144D.04; 144D.045; 144D.05; 144D.06; 144D.065; 144D.066; 144D.07; 144D.08; 144D.09;
130.15144D.10; 144D.11; 144G.01; 144G.02; 144G.03; 144G.04; 144G.05; and 144G.06, are
130.16repealed effective August 1, 2021.

130.17ARTICLE 4
130.18DEMENTIA CARE SERVICES FOR ASSISTED LIVING FACILITIES WITH
130.19DEMENTIA CARE

130.20    Section 1. [144I.37] ADDITIONAL REQUIREMENTS FOR ASSISTED LIVING
130.21FACILITIES WITH DEMENTIA CARE.
130.22    Subdivision 1. Applicability. This section applies only to assisted living facilities with
130.23dementia care.
130.24    Subd. 2. Demonstrated capacity. (a) An applicant for licensure as an assisted living
130.25facility with dementia care must have the ability to provide services in a manner that is
130.26consistent with the requirements in this section. The commissioner shall consider the
130.27following criteria, including, but not limited to:
130.28(1) the experience of the applicant in managing residents with dementia or previous
130.29long-term care experience; and
130.30(2) the compliance history of the applicant in the operation of any care facility licensed,
130.31certified, or registered under federal or state law.
131.1(b) If the applicant does not have experience in managing residents with dementia, the
131.2applicant must employ a consultant for at least the first six months of operation. The
131.3consultant must meet the requirements in paragraph (a), clause (1), and make
131.4recommendations on providing dementia care services consistent with the requirements of
131.5this chapter. The consultant must (1) have two years of work experience related to dementia,
131.6health care, gerontology, or a related field, and (2) have completed at least the minimum
131.7core training requirements in section 144I.21. The applicant must document an acceptable
131.8plan to address the consultant's identified concerns and must either implement the
131.9recommendations or document in the plan any consultant recommendations that the applicant
131.10chooses not to implement. The commissioner must review the applicant's plan upon request.
131.11(c) The commissioner shall conduct an on-site inspection prior to the issuance of an
131.12assisted living facility with dementia care license to ensure compliance with the physical
131.13environment requirements.
131.14(d) The label "Assisted Living Facility with Dementia Care" must be identified on the
131.15license.
131.16    Subd. 3. Relinquishing license. (a) The licensee must notify the commissioner in writing
131.17at least 60 calendar days prior to the voluntary relinquishment of an assisted living facility
131.18with dementia care license. For voluntary relinquishment, the facility must:
131.19(1) give all residents and their designated representatives 60 calendar days' notice. The
131.20notice must include:
131.21(i) the proposed effective date of the relinquishment;
131.22(ii) changes in staffing;
131.23(iii) changes in services including the elimination or addition of services; and
131.24(iv) staff training that shall occur when the relinquishment becomes effective;
131.25(2) submit a transitional plan to the commissioner demonstrating how the current residents
131.26shall be evaluated and assessed to reside in other housing settings that are not an assisted
131.27living facility with dementia care, that are physically unsecured, or that would require
131.28move-out or transfer to other settings;
131.29(3) change service or care plans as appropriate to address any needs the residents may
131.30have with the transition;
131.31(4) notify the commissioner when the relinquishment process has been completed; and
132.1(5) revise advertising materials and disclosure information to remove any reference that
132.2the facility is an assisted living facility with dementia care.
132.3(b) Nothing in this section alters obligations under section 144I.27.
132.4EFFECTIVE DATE.This section is effective August 1, 2021.

132.5    Sec. 2. [144I.38] RESPONSIBILITIES OF ADMINISTRATION FOR ASSISTED
132.6LIVING FACILITIES WITH DEMENTIA CARE.
132.7    Subdivision 1. General. The licensee of an assisted living facility with dementia care
132.8is responsible for the care and housing of the persons with dementia and the provision of
132.9person-centered care that promotes each resident's dignity, independence, and comfort. This
132.10includes the supervision, training, and overall conduct of the staff.
132.11    Subd. 2. Additional requirements. (a) The licensee must follow the assisted living
132.12license requirements and the criteria in this section.
132.13(b) The assisted living director of an assisted living facility with dementia care must
132.14complete and document that at least ten hours of the required annual continuing educational
132.15requirements relate to the care of individuals with dementia. The training must include
132.16medical management of dementia, creating and maintaining supportive and therapeutic
132.17environments for residents with dementia, and transitioning and coordinating services for
132.18residents with dementia. Continuing education credits may include college courses, preceptor
132.19credits, self-directed activities, course instructor credits, corporate training, in-service
132.20training, professional association training, web-based training, correspondence courses,
132.21telecourses, seminars, and workshops.
132.22    Subd. 3. Policies. (a) In addition to the policies and procedures required in the licensing
132.23of all facilities, the assisted living facility with dementia care licensee must develop and
132.24implement policies and procedures that address the:
132.25(1) philosophy of how services are provided based upon the assisted living facility
132.26licensee's values, mission, and promotion of person-centered care and how the philosophy
132.27shall be implemented;
132.28(2) evaluation of behavioral symptoms and design of supports for intervention plans,
132.29including nonpharmacological practices that are person-centered and evidence-informed;
132.30(3) wandering and egress prevention that provides detailed instructions to staff in the
132.31event a resident elopes;
133.1(4) medication management, including an assessment of residents for the use and effects
133.2of medications, including psychotropic medications;
133.3(5) staff training specific to dementia care;
133.4(6) description of life enrichment programs and how activities are implemented;
133.5(7) description of family support programs and efforts to keep the family engaged;
133.6(8) limiting the use of public address and intercom systems for emergencies and
133.7evacuation drills only;
133.8(9) transportation coordination and assistance to and from outside medical appointments;
133.9and
133.10(10) safekeeping of resident's possessions.
133.11(b) The policies and procedures must be provided to residents and the resident's legal
133.12and designated representatives at the time of move-in.
133.13EFFECTIVE DATE.This section is effective August 1, 2021.

133.14    Sec. 3. [144I.39] STAFFING AND STAFF TRAINING.
133.15    Subdivision 1. General. (a) An assisted living facility with dementia care must provide
133.16residents with dementia-trained staff who have been instructed in the person-centered care
133.17approach. All direct care staff assigned to care for residents with dementia must be specially
133.18trained to work with residents with Alzheimer's disease and other dementias.
133.19(b) Only staff trained as specified in subdivisions 2 and 3 shall be assigned to care for
133.20dementia residents.
133.21(c) Staffing levels must be sufficient to meet the scheduled and unscheduled needs of
133.22residents. Staffing levels during nighttime hours shall be based on the sleep patterns and
133.23needs of residents.
133.24(d) In an emergency situation when trained staff are not available to provide services,
133.25the facility may assign staff who have not completed the required training. The particular
133.26emergency situation must be documented and must address:
133.27(1) the nature of the emergency;
133.28(2) how long the emergency lasted; and
133.29(3) the names and positions of staff that provided coverage.
134.1    Subd. 2. Staffing requirements. (a) The licensee must ensure that staff who provide
134.2support to residents with dementia can demonstrate a basic understanding and ability to
134.3apply dementia training to the residents' emotional and unique health care needs using
134.4person-centered planning delivery. Direct care dementia-trained staff and other staff must
134.5be trained on the topics identified during the expedited rulemaking process. These
134.6requirements are in addition to the licensing requirements for training.
134.7(b) Failure to comply with paragraph (a) or subdivision 1 shall result in a fine under
134.8section 144I.31.
134.9    Subd. 3. Supervising staff training. Persons providing or overseeing staff training must
134.10have experience and knowledge in the care of individuals with dementia, including:
134.11(1) two years of work experience related to Alzheimer's disease or other dementias, or
134.12in health care, gerontology, or another related field; and
134.13(2) completion of training equivalent to the requirements in this section and successfully
134.14passing a skills competency or knowledge test required by the commissioner.
134.15    Subd. 4. Preservice and in-service training. Preservice and in-service training may
134.16include various methods of instruction, such as classroom style, web-based training, video,
134.17or one-to-one training. The licensee must have a method for determining and documenting
134.18each staff person's knowledge and understanding of the training provided. All training must
134.19be documented.
134.20EFFECTIVE DATE.This section is effective August 1, 2021.

134.21    Sec. 4. [144I.40] SERVICES FOR RESIDENTS WITH DEMENTIA.
134.22(a) In addition to the minimum services required in section 144I.10, an assisted living
134.23facility with dementia care must also provide the following services:
134.24(1) assistance with activities of daily living that address the needs of each resident with
134.25dementia due to cognitive or physical limitations. These services must meet or be in addition
134.26to the requirements in the licensing rules for the facility. Services must be provided in a
134.27person-centered manner that promotes resident choice, dignity, and sustains the resident's
134.28abilities;
134.29(2) nonpharmacological practices that are person-centered and evidence-informed;
134.30(3) services to prepare and educate persons living with dementia and their legal and
134.31designated representatives about transitions in care and ensuring complete, timely
134.32communication between, across, and within settings; and
135.1(4) services that provide residents with choices for meaningful engagement with other
135.2facility residents and the broader community.
135.3(b) Each resident must be evaluated for activities according to the licensing rules of the
135.4facility. In addition, the evaluation must address the following:
135.5(1) past and current interests;
135.6(2) current abilities and skills;
135.7(3) emotional and social needs and patterns;
135.8(4) physical abilities and limitations;
135.9(5) adaptations necessary for the resident to participate; and
135.10(6) identification of activities for behavioral interventions.
135.11(c) An individualized activity plan must be developed for each resident based on their
135.12activity evaluation. The plan must reflect the resident's activity preferences and needs.
135.13(d) A selection of daily structured and non-structured activities must be provided and
135.14included on the resident's activity service or care plan as appropriate. Daily activity options
135.15based on resident evaluation may include but are not limited to:
135.16(1) occupation or chore related tasks;
135.17(2) scheduled and planned events such as entertainment or outings;
135.18(3) spontaneous activities for enjoyment or those that may help defuse a behavior;
135.19(4) one-to-one activities that encourage positive relationships between residents and
135.20staff such as telling a life story, reminiscing, or playing music;
135.21(5) spiritual, creative, and intellectual activities;
135.22(6) sensory stimulation activities;
135.23(7) physical activities that enhance or maintain a resident's ability to ambulate or move;
135.24and
135.25(8) outdoor activities.
135.26(e) Behavioral symptoms that negatively impact the resident and others in the assisted
135.27living facility with dementia care must be evaluated and included on the service or care
135.28plan. The staff must initiate and coordinate outside consultation or acute care when indicated.
135.29(f) Support must be offered to family and other significant relationships on a regularly
135.30scheduled basis but not less than quarterly.
136.1(g) Access to secured outdoor space and walkways that allow residents to enter and
136.2return without staff assistance must be provided.
136.3EFFECTIVE DATE.This section is effective August 1, 2021.

136.4ARTICLE 5
136.5ASSISTED LIVING LICENSURE CONFORMING CHANGES; DIRECTOR
136.6LICENSURE

136.7    Section 1. Minnesota Statutes 2018, section 144.051, subdivision 4, is amended to read:
136.8    Subd. 4. Data classification; public data. For providers regulated pursuant to sections
136.9144A.43 to 144A.482 and chapter 144I, the following data collected, created, or maintained
136.10by the commissioner are classified as public data as defined in section 13.02, subdivision
136.1115
:
136.12(1) all application data on licensees, license numbers, and license status;
136.13(2) licensing information about licenses previously held under this chapter;
136.14(3) correction orders, including information about compliance with the order and whether
136.15the fine was paid;
136.16(4) final enforcement actions pursuant to chapter 14;
136.17(5) orders for hearing, findings of fact, and conclusions of law; and
136.18(6) when the licensee and department agree to resolve the matter without a hearing, the
136.19agreement and specific reasons for the agreement are public data.
136.20EFFECTIVE DATE.This section is effective August 1, 2021.

136.21    Sec. 2. Minnesota Statutes 2018, section 144.051, subdivision 5, is amended to read:
136.22    Subd. 5. Data classification; confidential data. For providers regulated pursuant to
136.23sections 144A.43 to 144A.482 and chapter 144I, the following data collected, created, or
136.24maintained by the Department of Health are classified as confidential data on individuals
136.25as defined in section 13.02, subdivision 3: active investigative data relating to the
136.26investigation of potential violations of law by a licensee including data from the survey
136.27process before the correction order is issued by the department.
136.28EFFECTIVE DATE.This section is effective August 1, 2021.

137.1    Sec. 3. Minnesota Statutes 2018, section 144.051, subdivision 6, is amended to read:
137.2    Subd. 6. Release of private or confidential data. For providers regulated pursuant to
137.3sections 144A.43 to 144A.482 and chapter 144I, the department may release private or
137.4confidential data, except Social Security numbers, to the appropriate state, federal, or local
137.5agency and law enforcement office to enhance investigative or enforcement efforts or further
137.6a public health protective process. Types of offices include Adult Protective Services, Office
137.7of the Ombudsman for Long-Term Care and Office of the Ombudsman for Mental Health
137.8and Developmental Disabilities, the health licensing boards, Department of Human Services,
137.9county or city attorney's offices, police, and local or county public health offices.
137.10EFFECTIVE DATE.This section is effective August 1, 2021.

137.11    Sec. 4. Minnesota Statutes 2018, section 144.057, subdivision 1, is amended to read:
137.12    Subdivision 1. Background studies required. The commissioner of health shall contract
137.13with the commissioner of human services to conduct background studies of:
137.14(1) individuals providing services which that have direct contact, as defined under section
137.15245C.02, subdivision 11 , with patients and residents in hospitals, boarding care homes,
137.16outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
137.17home care agencies licensed under chapter 144A; residential care homes licensed under
137.18chapter 144B, assisted living facilities and assisted living facilities with dementia care
137.19licensed under chapter 144I; and board and lodging establishments that are registered to
137.20provide supportive or health supervision services under section 157.17;
137.21(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
137.22services in a nursing home or a home care agency licensed under chapter 144A; an assisted
137.23living facility or assisted living facility with dementia care licensed under chapter 144I; or
137.24a boarding care home licensed under sections 144.50 to 144.58. If the individual under study
137.25resides outside Minnesota, the study must include a check for substantiated findings of
137.26maltreatment of adults and children in the individual's state of residence when the information
137.27is made available by that state, and must include a check of the National Crime Information
137.28Center database;
137.29(3) beginning July 1, 1999, all other employees in assisted living facilities or assisted
137.30living facilities with dementia care licensed under chapter 144I, nursing homes licensed
137.31under chapter 144A, and boarding care homes licensed under sections 144.50 to 144.58. A
137.32disqualification of an individual in this section shall disqualify the individual from positions
137.33allowing direct contact or access to patients or residents receiving services. "Access" means
138.1physical access to a client or the client's personal property without continuous, direct
138.2supervision as defined in section 245C.02, subdivision 8, when the employee's employment
138.3responsibilities do not include providing direct contact services;
138.4(4) individuals employed by a supplemental nursing services agency, as defined under
138.5section 144A.70, who are providing services in health care facilities; and
138.6(5) controlling persons of a supplemental nursing services agency, as defined under
138.7section 144A.70.
138.8If a facility or program is licensed by the Department of Human Services and subject to
138.9the background study provisions of chapter 245C and is also licensed by the Department
138.10of Health, the Department of Human Services is solely responsible for the background
138.11studies of individuals in the jointly licensed programs.
138.12EFFECTIVE DATE.This section is effective August 1, 2021.

138.13    Sec. 5. Minnesota Statutes 2018, section 144A.04, subdivision 5, is amended to read:
138.14    Subd. 5. Administrators. (a) Each nursing home must employ an administrator who
138.15must be licensed or permitted as a nursing home administrator by the Board of Examiners
138.16for Nursing Home Administrators Executives for Long Term Services and Supports. The
138.17nursing home may share the services of a licensed administrator. The administrator must
138.18maintain a sufficient an on-site presence in the facility to effectively manage the facility in
138.19compliance with applicable rules and regulations. The administrator must establish procedures
138.20and delegate authority for on-site operations in the administrator's absence, but is ultimately
138.21responsible for the management of the facility. Each nursing home must have posted at all
138.22times the name of the administrator and the name of the person in charge on the premises
138.23in the absence of the licensed administrator.
138.24(b) Notwithstanding sections 144A.18 to 144A.27, a nursing home with a director of
138.25nursing serving as an unlicensed nursing home administrator as of March 1, 2001, may
138.26continue to have a director of nursing serve in that capacity, provided the director of nursing
138.27has passed the state law and rules examination administered by the Board of Examiners for
138.28Nursing Home Administrators and maintains evidence of completion of 20 hours of
138.29continuing education each year on topics pertinent to nursing home administration.

139.1    Sec. 6. Minnesota Statutes 2018, section 144A.19, subdivision 1, is amended to read:
139.2    Subdivision 1. Creation; membership. There is hereby created the Board of Examiners
139.3for Nursing Home Administrators Executives for Long Term Services and Supports which
139.4shall consist of the following members:
139.5(1) a designee of the commissioner of health who shall be a nonvoting member;
139.6(2) a designee of the commissioner of human services who shall be a nonvoting member;
139.7and
139.8(3) the following members appointed by the governor:
139.9(i) two members one licensed nursing home administrator member actively engaged in
139.10the management, operation, or ownership of proprietary nursing homes;
139.11(ii) one licensed nursing home administrator or health services executive member actively
139.12engaged in the management, operation, or ownership of proprietary nursing homes or assisted
139.13living facilities;
139.14(ii) two members (iii) two licensed nursing home administrator or health services
139.15executive members actively engaged in the management or operation of nonprofit nursing
139.16homes or assisted living facilities;
139.17(iv) one licensed assisted living facility director member actively engaged in the
139.18management, operation, or ownership of assisted living facilities;
139.19(iii) (v) one member actively engaged in the practice of medicine;
139.20(iv) one member (vi) two members actively engaged in the practice of professional
139.21nursing, one practicing in nursing homes and one practicing in assisted living facilities; and
139.22(v) (vii) three public members as defined in section 214.02. Public members may not
139.23be current health-related license holders.
139.24EFFECTIVE DATE.This section is effective July 1, 2020.

139.25    Sec. 7. Minnesota Statutes 2018, section 144A.20, subdivision 1, is amended to read:
139.26    Subdivision 1. Criteria. The Board of Examiners Executives may issue licenses to
139.27qualified persons as nursing home administrators or assisted living directors, and shall
139.28establish qualification criteria for nursing home administrators and assisted living directors.
139.29No license shall be issued to a person as a nursing home administrator unless that person:
139.30(1) is at least 21 years of age and otherwise suitably qualified;
140.1(2) has satisfactorily met standards set by the Board of Examiners, which standards shall
140.2be designed to assure that nursing home administrators will be individuals who, by training
140.3or experience are qualified to serve as nursing home administrators; and
140.4(3) has passed an examination approved by the board and designed to test for competence
140.5in the subject matters referred to in clause (2), or has been approved by the Board of
140.6Examiners through the development and application of other appropriate techniques.
140.7EFFECTIVE DATE.This section is effective July 1, 2020.

140.8    Sec. 8. Minnesota Statutes 2018, section 144A.20, is amended by adding a subdivision to
140.9read:
140.10    Subd. 3. Nursing home administrator qualifications. The Board of Executives may
140.11issue licenses to qualified persons as a nursing home administrator and shall approve training
140.12and examinations. No license shall be issued to a person as a nursing home administrator
140.13unless that person:
140.14(1) is at least 21 years of age and otherwise suitably qualified;
140.15(2) has satisfactorily met standards set by the Board of Executives. The standards shall
140.16be designed to assure that nursing home administrators are individuals who, by training or
140.17experience, are qualified to serve as nursing home administrators; and
140.18(3) has passed an examination approved by the board and designed to test for competence
140.19in the subject matters referred to in clause (2), or has been approved by the Board of
140.20Executives through the development and application of other appropriate techniques.
140.21EFFECTIVE DATE.This section is effective July 1, 2020.

140.22    Sec. 9. Minnesota Statutes 2018, section 144A.20, is amended by adding a subdivision to
140.23read:
140.24    Subd. 4. Assisted living director qualifications; ongoing training. (a) The Board of
140.25Executives may issue licenses to qualified persons as an assisted living director and shall
140.26approve training and examinations. No license shall be issued to a person as an assisted
140.27living director unless that person:
140.28(1) is eligible for licensure;
140.29(2) has applied for licensure under this subdivision within six months of hire; and
140.30(3) has satisfactorily met standards set by the board or is scheduled to complete the
140.31training in paragraph (b) within one year of hire. The standards shall be designed to assure
141.1that assisted living directors are individuals who, by training or experience, are qualified to
141.2serve as assisted living directors.
141.3(b) In order to be qualified to serve as an assisted living director, an individual must:
141.4(1) have completed an approved training course and passed an examination approved
141.5by the board that is designed to test for competence and that includes assisted living facility
141.6laws in Minnesota;
141.7(2)(i) currently be licensed as a nursing home administrator or have been validated as a
141.8qualified health services executive by the National Association of Long-Term Care
141.9Administrator Boards; and
141.10(ii) have core knowledge of assisted living facility laws; or
141.11(3) apply for licensure by July 1, 2021, and satisfy one of the following:
141.12(i) have a higher education degree in nursing, social services, or mental health, or another
141.13professional degree with training specific to management and regulatory compliance;
141.14(ii) have at least three years of supervisory, management, or operational experience and
141.15higher education training applicable to an assisted living facility;
141.16(iii) have completed at least 1,000 hours of an executive in training program provided
141.17by an assisted living director licensed under this subdivision; or
141.18(iv) have managed a housing with services establishment operating under assisted living
141.19title protection for at least three years.
141.20(c) An assisted living director must receive at least 30 hours of training every two years
141.21on topics relevant to the operation of an assisted living facility and the needs of its residents.
141.22An assisted living director must maintain records of the training required by this paragraph
141.23for at least the most recent three-year period and must provide these records to Department
141.24of Health surveyors upon request. Continuing education earned to maintain another
141.25professional license, such as a nursing home administrator license, nursing license, social
141.26worker license, mental health professional license, or real estate license, may be used to
141.27satisfy this requirement when the continuing education is relevant to the assisted living
141.28services offered and residents served at the assisted living facility.
141.29EFFECTIVE DATE.This section is effective July 1, 2020.

142.1    Sec. 10. Minnesota Statutes 2018, section 144A.21, is amended to read:
142.2144A.21 ADMINISTRATOR LICENSES.
142.3    Subdivision 1. Transferability. A nursing home administrator's license shall not be
142.4transferable. An assisted living director's license shall not be transferable.
142.5    Subd. 2. Rules; renewal. The Board of Examiners Executives by rule shall establish
142.6forms and procedures for the processing of license renewals. A nursing home administrator's
142.7license or an assisted living director's license may be renewed only in accordance with the
142.8standards adopted by the Board of Examiners Executives pursuant to section 144A.24.
142.9EFFECTIVE DATE.This section is effective July 1, 2020.

142.10    Sec. 11. Minnesota Statutes 2018, section 144A.23, is amended to read:
142.11144A.23 JURISDICTION OF BOARD.
142.12Except as provided in section 144A.04, subdivision 5, the Board of examiners Executives
142.13shall have exclusive authority to determine the qualifications, skill and fitness required of
142.14any person to serve as an administrator of a nursing home or an assisted living director. The
142.15holder of a license shall be deemed fully qualified to serve as the administrator of a nursing
142.16home or director of an assisted living facility.
142.17EFFECTIVE DATE.This section is effective July 1, 2020.

142.18    Sec. 12. Minnesota Statutes 2018, section 144A.24, is amended to read:
142.19144A.24 DUTIES OF THE BOARD.
142.20The Board of Examiners Executives shall:
142.21(1) develop and enforce standards for licensing of nursing home administrator licensing,
142.22which administrators and assisted living directors. The standards shall be designed to assure
142.23that nursing home administrators and assisted living directors will be individuals of good
142.24character who, by training or experience, are suitably qualified to serve as nursing home
142.25administrators or assisted living directors;
142.26(2) develop appropriate techniques, including examinations and investigations, for
142.27determining whether applicants and licensees meet the board's standards;
142.28(3) issue licenses and permits to those individuals who are found to meet the board's
142.29standards;
143.1(4) establish and implement procedures designed to assure that individuals licensed as
143.2nursing home administrators and assisted living directors will comply with the board's
143.3standards;
143.4(5) receive and investigate complaints and take appropriate action consistent with chapter
143.5214, to revoke or suspend the license or permit of a nursing home administrator or acting
143.6administrator or an assisted living director or acting director who fails to comply with
143.7sections 144A.18 to 144A.27 or the board's standards;
143.8(6) conduct a continuing study and investigation of nursing homes and assisted living
143.9facilities, and the administrators of nursing homes and assisted living directors within the
143.10state, with a view to the improvement of the standards imposed for the licensing of
143.11administrators and directors and improvement of the procedures and methods used for
143.12enforcement of the board's standards; and
143.13(7) approve or conduct courses of instruction or training designed to prepare individuals
143.14for licensing in accordance with the board's standards. Courses designed to meet license
143.15renewal requirements shall be designed solely to improve professional skills and shall not
143.16include classroom attendance requirements exceeding 50 hours per year. The board may
143.17approve courses conducted within or without this state.
143.18EFFECTIVE DATE.This section is effective July 1, 2020.

143.19    Sec. 13. Minnesota Statutes 2018, section 144A.251, is amended to read:
143.20144A.251 MANDATORY PROCEEDINGS.
143.21In addition to its discretionary authority to initiate proceedings under section 144A.24
143.22and chapter 214, the Board of Examiners Executives shall initiate proceedings to suspend
143.23or revoke a nursing home administrator or assisted living director license or shall refuse to
143.24renew a license if within the preceding two-year period the administrator or director was
143.25employed at a nursing home or assisted living facility which during the period of employment
143.26incurred the following number of uncorrected violations, which violations were in the
143.27jurisdiction and control of the administrator or director and for which a fine was assessed
143.28and allowed to be recovered:
143.29(1) two or more uncorrected violations which created an imminent risk of harm to a
143.30nursing home or assisted living facility resident; or
143.31(2) ten or more uncorrected violations of any nature.
143.32EFFECTIVE DATE.This section is effective August 1, 2021.

144.1    Sec. 14. Minnesota Statutes 2018, section 144A.2511, is amended to read:
144.2144A.2511 COSTS; PENALTIES.
144.3If the Board of Examiners Executives has initiated proceedings under section 144A.24
144.4or 144A.251 or chapter 214, and upon completion of the proceedings has found that a nursing
144.5home administrator or assisted living director has violated a provision or provisions of
144.6sections 144A.18 to 144A.27, it may impose a civil penalty not exceeding $10,000 for each
144.7separate violation, with all violations related to a single event or incident considered as one
144.8violation. The amount of the civil penalty shall be fixed so as to deprive the nursing home
144.9administrator or assisted living director of any economic advantage gained by reason of the
144.10violation charged or to reimburse the board for the cost of the investigation and proceeding.
144.11For purposes of this section, the cost of the investigation and proceeding may include, but
144.12is not limited to, fees paid for services provided by the Office of Administrative Hearings,
144.13legal and investigative services provided by the Office of the Attorney General, court
144.14reporters, witnesses, and reproduction of records.
144.15EFFECTIVE DATE.This section is effective August 1, 2021.

144.16    Sec. 15. Minnesota Statutes 2018, section 144A.26, is amended to read:
144.17144A.26 RECIPROCITY WITH OTHER STATES AND EQUIVALENCY OF
144.18HEALTH SERVICES EXECUTIVE.
144.19    Subdivision 1. Reciprocity. The Board of Examiners Executives may issue a nursing
144.20home administrator's license, without examination, to any person who holds a current license
144.21as a nursing home administrator from another jurisdiction if the board finds that the standards
144.22for licensure in the other jurisdiction are at least the substantial equivalent of those prevailing
144.23in this state and that the applicant is otherwise qualified.
144.24    Subd. 2. Health services executive license. The Board of Executives may issue a health
144.25services executive license to any person who (1) has been validated by the National
144.26Association of Long Term Care Administrator Boards as a health services executive, and
144.27(2) has met the education and practice requirements for the minimum qualifications of a
144.28nursing home administrator, assisted living administrator, and home and community-based
144.29service provider. Licensure decisions made by the board under this subdivision are final.

144.30    Sec. 16. [144A.291] FEES.
144.31    Subdivision 1. Payment types and nonrefundability. The fees imposed in this section
144.32shall be paid by cash, personal check, bank draft, cashier's check, or money order made
145.1payable to the Board of Executives for Long Term Services and Supports. All fees are
145.2nonrefundable.
145.3    Subd. 2. Amount. The amount of fees may be set by the board with the approval of
145.4Minnesota Management and Budget up to the limits provided in this section depending
145.5upon the total amount required to sustain board operations under section 16A.1285,
145.6subdivision 2. Information about fees in effect at any time is available from the board office.
145.7The maximum amounts of fees are:
145.8(1) application for licensure, $150;
145.9(2) for a prospective applicant for a review of education and experience advisory to the
145.10license application, $50, to be applied to the fee for application for licensure if the latter is
145.11submitted within one year of the request for review of education and experience;
145.12(3) state examination, $75;
145.13(4) licensed nursing home administrator initial license, $200 if issued between July 1
145.14and December 31, or $100 if issued between January 1 and June 30;
145.15(5) acting administrator permit, $250;
145.16(6) renewal license, $200;
145.17(7) duplicate license, $10;
145.18(8) fee to a sponsor for review of individual continuing education seminars, institutes,
145.19workshops, or home study courses:
145.20(i) for less than seven clock hours, $30; and
145.21(ii) for seven or more clock hours, $50;
145.22(9) fee to a licensee for review of continuing education seminars, institutes, workshops,
145.23or home study courses not previously approved for a sponsor and submitted with an
145.24application for license renewal:
145.25(i) for less than seven clock hours total, $30; and
145.26(ii) for seven or more clock hours total, $50;
145.27(10) late renewal fee, $50;
145.28(11) fee to a licensee for verification of licensure status and examination scores, $30;
145.29(12) registration as a registered continuing education sponsor, $1,000; and
146.1(13) health services executive initial license, $200 if issued between July 1 and December
146.231, or $100 if issued between January 1 and June 30.

146.3    Sec. 17. Minnesota Statutes 2018, section 144A.44, subdivision 1, is amended to read:
146.4    Subdivision 1. Statement of rights. (a) A person client who receives home care services
146.5in the community or in an assisted living facility licensed under chapter 144I has these
146.6rights:
146.7(1) the right to receive written information, in plain language, about rights before
146.8receiving services, including what to do if rights are violated;
146.9(2) the right to receive care and services according to a suitable and up-to-date plan, and
146.10subject to accepted health care, medical or nursing standards and person-centered care, to
146.11take an active part in developing, modifying, and evaluating the plan and services;
146.12(3) the right to be told before receiving services the type and disciplines of staff who
146.13will be providing the services, the frequency of visits proposed to be furnished, other choices
146.14that are available for addressing home care needs, and the potential consequences of refusing
146.15these services;
146.16(4) the right to be told in advance of any recommended changes by the provider in the
146.17service plan and to take an active part in any decisions about changes to the service plan;
146.18(5) the right to refuse services or treatment;
146.19(6) the right to know, before receiving services or during the initial visit, any limits to
146.20the services available from a home care provider;
146.21(7) the right to be told before services are initiated what the provider charges for the
146.22services; to what extent payment may be expected from health insurance, public programs,
146.23or other sources, if known; and what charges the client may be responsible for paying;
146.24(8) the right to know that there may be other services available in the community,
146.25including other home care services and providers, and to know where to find information
146.26about these services;
146.27(9) the right to choose freely among available providers and to change providers after
146.28services have begun, within the limits of health insurance, long-term care insurance, medical
146.29assistance, or other health programs, or public programs;
146.30(10) the right to have personal, financial, and medical information kept private, and to
146.31be advised of the provider's policies and procedures regarding disclosure of such information;
147.1(11) the right to access the client's own records and written information from those
147.2records in accordance with sections 144.291 to 144.298;
147.3(12) the right to be served by people who are properly trained and competent to perform
147.4their duties;
147.5(13) the right to be treated with courtesy and respect, and to have the client's property
147.6treated with respect;
147.7(14) the right to be free from physical and verbal abuse, neglect, financial exploitation,
147.8and all forms of maltreatment covered under the Vulnerable Adults Act and the Maltreatment
147.9of Minors Act;
147.10(15) the right to reasonable, advance notice of changes in services or charges;
147.11(16) the right to know the provider's reason for termination of services;
147.12(17) the right to at least ten 30 calendar days' advance notice of the termination of a
147.13service or housing by a provider, except in cases where:
147.14(i) the client engages in conduct that significantly alters the terms of the service plan
147.15with the home care provider;
147.16(ii) the client, person who lives with the client, or others create an abusive or unsafe
147.17work environment for the person providing home care services; or
147.18(iii) an emergency or a significant change in the client's condition has resulted in service
147.19needs that exceed the current service plan and that cannot be safely met by the home care
147.20provider;
147.21(18) the right to a coordinated transfer when there will be a change in the provider of
147.22services;
147.23(19) the right to complain to staff and others of the client's choice about services that
147.24are provided, or fail to be provided, and the lack of courtesy or respect to the client or the
147.25client's property and the right to recommend changes in policies and services, free from
147.26retaliation including the threat of termination of services;
147.27(20) the right to know how to contact an individual associated with the home care provider
147.28who is responsible for handling problems and to have the home care provider investigate
147.29and attempt to resolve the grievance or complaint;
147.30(21) the right to know the name and address of the state or county agency to contact for
147.31additional information or assistance; and
148.1(22) the right to assert these rights personally, or have them asserted by the client's
148.2representative or by anyone on behalf of the client, without retaliation.; and
148.3(23) place an electronic monitoring device in the client's or resident's space in compliance
148.4with state requirements.
148.5(b) When providers violate the rights in this section, they are subject to the fines and
148.6license actions in sections 144A.474, subdivision 11, and 144A.475.
148.7(c) Providers must do all of the following:
148.8(1) encourage and assist in the fullest possible exercise of these rights;
148.9(2) provide the names and telephone numbers of individuals and organizations that
148.10provide advocacy and legal services for clients and residents seeking to assert their rights;
148.11(3) make every effort to assist clients or residents in obtaining information regarding
148.12whether Medicare, medical assistance, other health programs, or public programs will pay
148.13for services;
148.14(4) make reasonable accommodations for people who have communication disabilities,
148.15or those who speak a language other than English; and
148.16(5) provide all information and notices in plain language and in terms the client or
148.17resident can understand.
148.18(d) No provider may require or request a client or resident to waive any of the rights
148.19listed in this section at any time or for any reasons, including as a condition of initiating
148.20services or entering into an assisted living contract.

148.21    Sec. 18. Minnesota Statutes 2018, section 144A.471, subdivision 7, is amended to read:
148.22    Subd. 7. Comprehensive home care license provider. Home care services that may
148.23be provided with a comprehensive home care license include any of the basic home care
148.24services listed in subdivision 6, and one or more of the following:
148.25(1) services of an advanced practice nurse, registered nurse, licensed practical nurse,
148.26physical therapist, respiratory therapist, occupational therapist, speech-language pathologist,
148.27dietitian or nutritionist, or social worker;
148.28(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed
148.29health professional within the person's scope of practice;
148.30(3) medication management services;
148.31(4) hands-on assistance with transfers and mobility;
149.1(5) treatment and therapies;
149.2(6) assisting clients with eating when the clients have complicating eating problems as
149.3identified in the client record or through an assessment such as difficulty swallowing,
149.4recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
149.5instruments to be fed; or
149.6(6) (7) providing other complex or specialty health care services.

149.7    Sec. 19. Minnesota Statutes 2018, section 144A.471, subdivision 9, is amended to read:
149.8    Subd. 9. Exclusions from home care licensure. The following are excluded from home
149.9care licensure and are not required to provide the home care bill of rights:
149.10(1) an individual or business entity providing only coordination of home care that includes
149.11one or more of the following:
149.12(i) determination of whether a client needs home care services, or assisting a client in
149.13determining what services are needed;
149.14(ii) referral of clients to a home care provider;
149.15(iii) administration of payments for home care services; or
149.16(iv) administration of a health care home established under section 256B.0751;
149.17(2) an individual who is not an employee of a licensed home care provider if the
149.18individual:
149.19(i) only provides services as an independent contractor to one or more licensed home
149.20care providers;
149.21(ii) provides no services under direct agreements or contracts with clients; and
149.22(iii) is contractually bound to perform services in compliance with the contracting home
149.23care provider's policies and service plans;
149.24(3) a business that provides staff to home care providers, such as a temporary employment
149.25agency, if the business:
149.26(i) only provides staff under contract to licensed or exempt providers;
149.27(ii) provides no services under direct agreements with clients; and
149.28(iii) is contractually bound to perform services under the contracting home care provider's
149.29direction and supervision;
150.1(4) any home care services conducted by and for the adherents of any recognized church
150.2or religious denomination for its members through spiritual means, or by prayer for healing;
150.3(5) an individual who only provides home care services to a relative;
150.4(6) an individual not connected with a home care provider that provides assistance with
150.5basic home care needs if the assistance is provided primarily as a contribution and not as a
150.6business;
150.7(7) an individual not connected with a home care provider that shares housing with and
150.8provides primarily housekeeping or homemaking services to an elderly or disabled person
150.9in return for free or reduced-cost housing;
150.10(8) an individual or provider providing home-delivered meal services;
150.11(9) an individual providing senior companion services and other older American volunteer
150.12programs (OAVP) established under the Domestic Volunteer Service Act of 1973, United
150.13States Code, title 42, chapter 66;
150.14(10) an employee of a nursing home or home care provider licensed under this chapter
150.15or an employee of a boarding care home licensed under sections 144.50 to 144.56 when
150.16responding to occasional emergency calls from individuals residing in a residential setting
150.17that is attached to or located on property contiguous to the nursing home, boarding care
150.18home, or location where home care services are also provided;
150.19(11) an employee of a nursing home or home care provider licensed under this chapter
150.20or an employee of a boarding care home licensed under sections 144.50 to 144.56 when
150.21providing occasional minor services free of charge to individuals residing in a residential
150.22setting that is attached to or located on property contiguous to the nursing home, boarding
150.23care home, or location where home care services are also provided;
150.24(12) a member of a professional corporation organized under chapter 319B that does
150.25not regularly offer or provide home care services as defined in section 144A.43, subdivision
150.263;
150.27(13) the following organizations established to provide medical or surgical services that
150.28do not regularly offer or provide home care services as defined in section 144A.43,
150.29subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit
150.30corporation organized under chapter 317A, a partnership organized under chapter 323, or
150.31any other entity determined by the commissioner;
150.32(14) an individual or agency that provides medical supplies or durable medical equipment,
150.33except when the provision of supplies or equipment is accompanied by a home care service;
151.1(15) a physician licensed under chapter 147;
151.2(16) an individual who provides home care services to a person with a developmental
151.3disability who lives in a place of residence with a family, foster family, or primary caregiver;
151.4(17) a business that only provides services that are primarily instructional and not medical
151.5services or health-related support services;
151.6(18) an individual who performs basic home care services for no more than 14 hours
151.7each calendar week to no more than one client;
151.8(19) an individual or business licensed as hospice as defined in sections 144A.75 to
151.9144A.755 who is not providing home care services independent of hospice service;
151.10(20) activities conducted by the commissioner of health or a community health board
151.11as defined in section 145A.02, subdivision 5, including communicable disease investigations
151.12or testing; or
151.13(21) administering or monitoring a prescribed therapy necessary to control or prevent a
151.14communicable disease, or the monitoring of an individual's compliance with a health directive
151.15as defined in section 144.4172, subdivision 6.
151.16EFFECTIVE DATE.The amendments to clauses (10) and (11) are effective July 1,
151.172021.

151.18    Sec. 20. Minnesota Statutes 2018, section 144A.472, subdivision 7, is amended to read:
151.19    Subd. 7. Fees; application, change of ownership, and renewal, and failure to
151.20notify. (a) An initial applicant seeking temporary home care licensure must submit the
151.21following application fee to the commissioner along with a completed application:
151.22(1) for a basic home care provider, $2,100; or
151.23(2) for a comprehensive home care provider, $4,200.
151.24(b) A home care provider who is filing a change of ownership as required under
151.25subdivision 5 must submit the following application fee to the commissioner, along with
151.26the documentation required for the change of ownership:
151.27(1) for a basic home care provider, $2,100; or
151.28(2) for a comprehensive home care provider, $4,200.
151.29(c) For the period ending June 30, 2018, a home care provider who is seeking to renew
151.30the provider's license shall pay a fee to the commissioner based on revenues derived from
152.1the provision of home care services during the calendar year prior to the year in which the
152.2application is submitted, according to the following schedule:
152.3License Renewal Fee
152.4
Provider Annual Revenue
Fee
152.5
greater than $1,500,000
$6,625
152.6
152.7
greater than $1,275,000 and no more than
$1,500,000
$5,797
152.8
152.9
greater than $1,100,000 and no more than
$1,275,000
$4,969
152.10
152.11
greater than $950,000 and no more than
$1,100,000
$4,141
152.12
greater than $850,000 and no more than $950,000
$3,727
152.13
greater than $750,000 and no more than $850,000
$3,313
152.14
greater than $650,000 and no more than $750,000
$2,898
152.15
greater than $550,000 and no more than $650,000
$2,485
152.16
greater than $450,000 and no more than $550,000
$2,070
152.17
greater than $350,000 and no more than $450,000
$1,656
152.18
greater than $250,000 and no more than $350,000
$1,242
152.19
greater than $100,000 and no more than $250,000
$828
152.20
greater than $50,000 and no more than $100,000
$500
152.21
greater than $25,000 and no more than $50,000
$400
152.22
no more than $25,000
$200
152.23(d) For the period between July 1, 2018, and June 30, 2020, a home care provider who
152.24is seeking to renew the provider's license shall pay a fee to the commissioner in an amount
152.25that is ten percent higher than the applicable fee in paragraph (c). A home care provider's
152.26fee shall be based on revenues derived from the provision of home care services during the
152.27calendar year prior to the year in which the application is submitted.
152.28(e) Beginning July 1, 2020, a home care provider who is seeking to renew the provider's
152.29license shall pay a fee to the commissioner based on revenues derived from the provision
152.30of home care services during the calendar year prior to the year in which the application is
152.31submitted, according to the following schedule:
152.32License Renewal Fee
152.33
Provider Annual Revenue
Fee
152.34
greater than $1,500,000
$7,651
152.35
152.36
greater than $1,275,000 and no more than
$1,500,000
$6,695
153.1
153.2
greater than $1,100,000 and no more than
$1,275,000
$5,739
153.3
153.4
greater than $950,000 and no more than
$1,100,000
$4,783
153.5
greater than $850,000 and no more than $950,000
$4,304
153.6
greater than $750,000 and no more than $850,000
$3,826
153.7
greater than $650,000 and no more than $750,000
$3,347
153.8
greater than $550,000 and no more than $650,000
$2,870
153.9
greater than $450,000 and no more than $550,000
$2,391
153.10
greater than $350,000 and no more than $450,000
$1,913
153.11
greater than $250,000 and no more than $350,000
$1,434
153.12
greater than $100,000 and no more than $250,000
$957
153.13
greater than $50,000 and no more than $100,000
$577
153.14
greater than $25,000 and no more than $50,000
$462
153.15
no more than $25,000
$231
153.16(f) If requested, the home care provider shall provide the commissioner information to
153.17verify the provider's annual revenues or other information as needed, including copies of
153.18documents submitted to the Department of Revenue.
153.19(g) At each annual renewal, a home care provider may elect to pay the highest renewal
153.20fee for its license category, and not provide annual revenue information to the commissioner.
153.21(h) A temporary license or license applicant, or temporary licensee or licensee that
153.22knowingly provides the commissioner incorrect revenue amounts for the purpose of paying
153.23a lower license fee, shall be subject to a civil penalty in the amount of double the fee the
153.24provider should have paid.
153.25(i) The fee for failure to comply with the notification requirements in section 144A.473,
153.26subdivision 2, paragraph (c), is $1,000.
153.27(i) (j) Fees and penalties collected under this section shall be deposited in the state
153.28treasury and credited to the state government special revenue fund. All fees are
153.29nonrefundable. Fees collected under paragraphs (c), (d), and (e) are nonrefundable even if
153.30received before July 1, 2017, for temporary licenses or licenses being issued effective July
153.311, 2017, or later.
153.32(k) Fines collected under this subdivision shall be deposited in a dedicated special revenue
153.33account. On an annual basis, the balance in the special revenue account shall be appropriated
153.34to the commissioner to implement the recommendations of the advisory council established
154.1in section 144A.4799. Fines collected in state fiscal year 2019 shall be deposited in the
154.2dedicated special revenue account as described in this section.
154.3EFFECTIVE DATE.This section is effective the day following final enactment.

154.4    Sec. 21. Minnesota Statutes 2018, section 144A.474, subdivision 9, is amended to read:
154.5    Subd. 9. Follow-up surveys. For providers that have Level 3 or Level 4 violations under
154.6subdivision 11, or any violations determined to be widespread, the department shall conduct
154.7a follow-up survey within 90 calendar days of the survey. When conducting a follow-up
154.8survey, the surveyor will focus on whether the previous violations have been corrected and
154.9may also address any new violations that are observed while evaluating the corrections that
154.10have been made. If a new violation is identified on a follow-up survey, no fine will be
154.11imposed unless it is not corrected on the next follow-up survey.

154.12    Sec. 22. Minnesota Statutes 2018, section 144A.474, subdivision 11, is amended to read:
154.13    Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be assessed
154.14based on the level and scope of the violations described in paragraph (c) (b) and imposed
154.15immediately with no opportunity to correct the violation first as follows:
154.16(1) Level 1, no fines or enforcement;
154.17(2) Level 2, fines ranging from $0 to a fine of $500 per violation, in addition to any of
154.18the enforcement mechanisms authorized in section 144A.475 for widespread violations;
154.19(3) Level 3, fines ranging from $500 to $1,000 a fine of $3,000 per incident plus $100
154.20for each resident affected by the violation, in addition to any of the enforcement mechanisms
154.21authorized in section 144A.475; and
154.22(4) Level 4, fines ranging from $1,000 to a fine of $5,000 per incident plus $200 for
154.23each resident affected by the violation, in addition to any of the enforcement mechanisms
154.24authorized in section 144A.475.;
154.25(5) for maltreatment violations as defined in section 626.557 including abuse, neglect,
154.26financial exploitation, and drug diversion, that are determined against the provider, an
154.27immediate fine shall be imposed of $5,000 per incident plus $200 for each resident affected
154.28by the violation; and
154.29(6) the fines in clauses (1) to (4) are increased and immediate fine imposition is authorized
154.30for both surveys and investigations conducted.
155.1(b) Correction orders for violations are categorized by both level and scope and fines
155.2shall be assessed as follows:
155.3(1) level of violation:
155.4(i) Level 1 is a violation that has no potential to cause more than a minimal impact on
155.5the client and does not affect health or safety;
155.6(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
155.7to have harmed a client's health or safety, but was not likely to cause serious injury,
155.8impairment, or death;
155.9(iii) Level 3 is a violation that harmed a client's health or safety, not including serious
155.10injury, impairment, or death, or a violation that has the potential to lead to serious injury,
155.11impairment, or death; and
155.12(iv) Level 4 is a violation that results in serious injury, impairment, or death;
155.13(2) scope of violation:
155.14(i) isolated, when one or a limited number of clients are affected or one or a limited
155.15number of staff are involved or the situation has occurred only occasionally;
155.16(ii) pattern, when more than a limited number of clients are affected, more than a limited
155.17number of staff are involved, or the situation has occurred repeatedly but is not found to be
155.18pervasive; and
155.19(iii) widespread, when problems are pervasive or represent a systemic failure that has
155.20affected or has the potential to affect a large portion or all of the clients.
155.21(c) If the commissioner finds that the applicant or a home care provider required to be
155.22licensed under sections 144A.43 to 144A.482 has not corrected violations by the date
155.23specified in the correction order or conditional license resulting from a survey or complaint
155.24investigation, the commissioner may impose a fine. A shall provide a notice of
155.25noncompliance with a correction order must be mailed by e-mail to the applicant's or
155.26provider's last known e-mail address. The noncompliance notice must list the violations not
155.27corrected.
155.28(d) For every violation identified by the commissioner, the commissioner shall issue an
155.29immediate fine pursuant to paragraph (a), clause (6). The license holder must still correct
155.30the violation in the time specified. The issuance of an immediate fine can occur in addition
155.31to any enforcement mechanism authorized under section 144A.475. The immediate fine
155.32may be appealed as allowed under this subdivision.
156.1(d) (e) The license holder must pay the fines assessed on or before the payment date
156.2specified. If the license holder fails to fully comply with the order, the commissioner may
156.3issue a second fine or suspend the license until the license holder complies by paying the
156.4fine. A timely appeal shall stay payment of the fine until the commissioner issues a final
156.5order.
156.6(e) (f) A license holder shall promptly notify the commissioner in writing when a violation
156.7specified in the order is corrected. If upon reinspection the commissioner determines that
156.8a violation has not been corrected as indicated by the order, the commissioner may issue a
156.9second fine. The commissioner shall notify the license holder by mail to the last known
156.10address in the licensing record that a second fine has been assessed. The license holder may
156.11appeal the second fine as provided under this subdivision.
156.12(f) (g) A home care provider that has been assessed a fine under this subdivision has a
156.13right to a reconsideration or a hearing under this section and chapter 14.
156.14(g) (h) When a fine has been assessed, the license holder may not avoid payment by
156.15closing, selling, or otherwise transferring the licensed program to a third party. In such an
156.16event, the license holder shall be liable for payment of the fine.
156.17(h) (i) In addition to any fine imposed under this section, the commissioner may assess
156.18a penalty amount based on costs related to an investigation that results in a final order
156.19assessing a fine or other enforcement action authorized by this chapter.
156.20(i) (j) Fines collected under this subdivision shall be deposited in the state government
156.21a dedicated special revenue fund and credited to an account separate from the revenue
156.22collected under section 144A.472. Subject to an appropriation by the legislature, the revenue
156.23from the fines collected must be used by the commissioner for special projects to improve
156.24home care in Minnesota as recommended by account. On an annual basis, the balance in
156.25the special revenue account shall be appropriated to the commissioner to implement the
156.26recommendations of the advisory council established in section 144A.4799. Fines collected
156.27in state fiscal year 2019 shall be deposited in the dedicated special revenue account as
156.28described in this section.
156.29EFFECTIVE DATE.This section is effective July 1, 2019.

156.30    Sec. 23. Minnesota Statutes 2018, section 144A.475, subdivision 3b, is amended to read:
156.31    Subd. 3b. Expedited hearing. (a) Within five business days of receipt of the license
156.32holder's timely appeal of a temporary suspension or issuance of a conditional license, the
156.33commissioner shall request assignment of an administrative law judge. The request must
157.1include a proposed date, time, and place of a hearing. A hearing must be conducted by an
157.2administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
157.330 calendar days of the request for assignment, unless an extension is requested by either
157.4party and granted by the administrative law judge for good cause. The commissioner shall
157.5issue a notice of hearing by certified mail or personal service at least ten business days
157.6before the hearing. Certified mail to the last known address is sufficient. The scope of the
157.7hearing shall be limited solely to the issue of whether the temporary suspension or issuance
157.8of a conditional license should remain in effect and whether there is sufficient evidence to
157.9conclude that the licensee's actions or failure to comply with applicable laws are level 3 or
157.104 violations as defined in section 144A.474, subdivision 11, paragraph (b), or that there
157.11were violations that posed an imminent risk of harm to the health and safety of persons in
157.12the provider's care.
157.13(b) The administrative law judge shall issue findings of fact, conclusions, and a
157.14recommendation within ten business days from the date of hearing. The parties shall have
157.15ten calendar days to submit exceptions to the administrative law judge's report. The record
157.16shall close at the end of the ten-day period for submission of exceptions. The commissioner's
157.17final order shall be issued within ten business days from the close of the record. When an
157.18appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed,
157.19the commissioner shall issue a final order affirming the temporary immediate suspension
157.20or conditional license within ten calendar days of the commissioner's receipt of the
157.21withdrawal or dismissal. The license holder is prohibited from operation during the temporary
157.22suspension period.
157.23(c) When the final order under paragraph (b) affirms an immediate suspension, and a
157.24final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that
157.25sanction, the licensee is prohibited from operation pending a final commissioner's order
157.26after the contested case hearing conducted under chapter 14.
157.27(d) A licensee whose license is temporarily suspended must comply with the requirements
157.28for notification and transfer of clients in subdivision 5. These requirements remain if an
157.29appeal is requested.

157.30    Sec. 24. Minnesota Statutes 2018, section 144A.475, subdivision 5, is amended to read:
157.31    Subd. 5. Plan required. (a) The process of suspending or, revoking, or refusing to renew
157.32a license must include a plan for transferring affected clients clients' care to other providers
157.33by the home care provider, which will be monitored by the commissioner. Within three
157.34business calendar days of being notified of the final revocation, refusal to renew, or
158.1suspension action, the home care provider shall provide the commissioner, the lead agencies
158.2as defined in section 256B.0911, county adult protection and case managers, and the
158.3ombudsman for long-term care with the following information:
158.4(1) a list of all clients, including full names and all contact information on file;
158.5(2) a list of each client's representative or emergency contact person, including full names
158.6and all contact information on file;
158.7(3) the location or current residence of each client;
158.8(4) the payor sources for each client, including payor source identification numbers; and
158.9(5) for each client, a copy of the client's service plan, and a list of the types of services
158.10being provided.
158.11(b) The revocation, refusal to renew, or suspension notification requirement is satisfied
158.12by mailing the notice to the address in the license record. The home care provider shall
158.13cooperate with the commissioner and the lead agencies, county adult protection and county
158.14managers, and the ombudsman for long term care during the process of transferring care of
158.15clients to qualified providers. Within three business calendar days of being notified of the
158.16final revocation, refusal to renew, or suspension action, the home care provider must notify
158.17and disclose to each of the home care provider's clients, or the client's representative or
158.18emergency contact persons, that the commissioner is taking action against the home care
158.19provider's license by providing a copy of the revocation, refusal to renew, or suspension
158.20notice issued by the commissioner. If the provider does not comply with the disclosure
158.21requirements in this section, the commissioner shall notify the clients, client representatives,
158.22or emergency contact persons, about the action being taken. Lead agencies, county adult
158.23protection and county managers, and the Office of Ombudsman for Long-Term Care may
158.24also provide this information. The revocation, refusal to renew, or suspension notice is
158.25public data except for any private data contained therein.
158.26(c) A home care provider subject to this subdivision may continue operating during the
158.27period of time home care clients are being transferred to other providers.

158.28    Sec. 25. Minnesota Statutes 2018, section 144A.476, subdivision 1, is amended to read:
158.29    Subdivision 1. Prior criminal convictions; owner and managerial officials. (a) Before
158.30the commissioner issues a temporary license, issues a license as a result of an approved
158.31change in ownership, or renews a license, an owner or managerial official is required to
158.32complete a background study under section 144.057. No person may be involved in the
158.33management, operation, or control of a home care provider if the person has been disqualified
159.1under chapter 245C. If an individual is disqualified under section 144.057 or chapter 245C,
159.2the individual may request reconsideration of the disqualification. If the individual requests
159.3reconsideration and the commissioner sets aside or rescinds the disqualification, the individual
159.4is eligible to be involved in the management, operation, or control of the provider. If an
159.5individual has a disqualification under section 245C.15, subdivision 1, and the disqualification
159.6is affirmed, the individual's disqualification is barred from a set aside, and the individual
159.7must not be involved in the management, operation, or control of the provider.
159.8(b) For purposes of this section, owners of a home care provider subject to the background
159.9check requirement are those individuals whose ownership interest provides sufficient
159.10authority or control to affect or change decisions related to the operation of the home care
159.11provider. An owner includes a sole proprietor, a general partner, or any other individual
159.12whose individual ownership interest can affect the management and direction of the policies
159.13of the home care provider.
159.14(c) For the purposes of this section, managerial officials subject to the background check
159.15requirement are individuals who provide direct contact as defined in section 245C.02,
159.16subdivision 11
, or individuals who have the responsibility for the ongoing management or
159.17direction of the policies, services, or employees of the home care provider. Data collected
159.18under this subdivision shall be classified as private data on individuals under section 13.02,
159.19subdivision 12
.
159.20(d) The department shall not issue any license if the applicant or owner or managerial
159.21official has been unsuccessful in having a background study disqualification set aside under
159.22section 144.057 and chapter 245C; if the owner or managerial official, as an owner or
159.23managerial official of another home care provider, was substantially responsible for the
159.24other home care provider's failure to substantially comply with sections 144A.43 to
159.25144A.482 ; or if an owner that has ceased doing business, either individually or as an owner
159.26of a home care provider, was issued a correction order for failing to assist clients in violation
159.27of this chapter.

159.28    Sec. 26. Minnesota Statutes 2018, section 144A.4791, subdivision 10, is amended to read:
159.29    Subd. 10. Termination of service plan. (a) If a home care provider terminates a service
159.30plan with a client, and the client continues to need home care services, the home care provider
159.31shall provide the client and the client's representative, if any, with a 30-day written notice
159.32of termination which includes the following information:
159.33(1) the effective date of termination;
160.1(2) the reason for termination;
160.2(3) a list of known licensed home care providers in the client's immediate geographic
160.3area;
160.4(4) a statement that the home care provider will participate in a coordinated transfer of
160.5care of the client to another home care provider, health care provider, or caregiver, as
160.6required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);
160.7(5) the name and contact information of a person employed by the home care provider
160.8with whom the client may discuss the notice of termination; and
160.9(6) if applicable, a statement that the notice of termination of home care services does
160.10not constitute notice of termination of the housing with services contract with a housing
160.11with services establishment.
160.12(b) When the home care provider voluntarily discontinues services to all clients, the
160.13home care provider must notify the commissioner, lead agencies, and ombudsman for
160.14long-term care about its clients and comply with the requirements in this subdivision.

160.15    Sec. 27. Minnesota Statutes 2018, section 144A.4799, is amended to read:
160.16144A.4799 DEPARTMENT OF HEALTH LICENSED HOME CARE PROVIDER
160.17ADVISORY COUNCIL.
160.18    Subdivision 1. Membership. The commissioner of health shall appoint eight persons
160.19to a home care and assisted living program advisory council consisting of the following:
160.20(1) three public members as defined in section 214.02 who shall be either persons who
160.21are currently receiving home care services or, persons who have received home care services
160.22within five years of the application date, persons who have family members receiving home
160.23care services, or persons who have family members who have received home care services
160.24within five years of the application date;
160.25(2) three Minnesota home care licensees representing basic and comprehensive levels
160.26of licensure who may be a managerial official, an administrator, a supervising registered
160.27nurse, or an unlicensed personnel performing home care tasks;
160.28(3) one member representing the Minnesota Board of Nursing; and
160.29(4) one member representing the office of ombudsman for long-term care.; and
160.30(5) beginning July 1, 2021, one member of a county health and human services or county
160.31adult protection office.
161.1    Subd. 2. Organizations and meetings. The advisory council shall be organized and
161.2administered under section 15.059 with per diems and costs paid within the limits of available
161.3appropriations. Meetings will be held quarterly and hosted by the department. Subcommittees
161.4may be developed as necessary by the commissioner. Advisory council meetings are subject
161.5to the Open Meeting Law under chapter 13D.
161.6    Subd. 3. Duties. (a) At the commissioner's request, the advisory council shall provide
161.7advice regarding regulations of Department of Health licensed home care providers in this
161.8chapter, including advice on the following:
161.9(1) community standards for home care practices;
161.10(2) enforcement of licensing standards and whether certain disciplinary actions are
161.11appropriate;
161.12(3) ways of distributing information to licensees and consumers of home care;
161.13(4) training standards;
161.14(5) identifying emerging issues and opportunities in the home care field, including;
161.15(6) identifying the use of technology in home and telehealth capabilities;
161.16(6) (7) allowable home care licensing modifications and exemptions, including a method
161.17for an integrated license with an existing license for rural licensed nursing homes to provide
161.18limited home care services in an adjacent independent living apartment building owned by
161.19the licensed nursing home; and
161.20(7) (8) recommendations for studies using the data in section 62U.04, subdivision 4,
161.21including but not limited to studies concerning costs related to dementia and chronic disease
161.22among an elderly population over 60 and additional long-term care costs, as described in
161.23section 62U.10, subdivision 6.
161.24(b) The advisory council shall perform other duties as directed by the commissioner.
161.25(c) The advisory council shall annually review the balance of the account in the state
161.26government special revenue fund described in section 144A.474, subdivision 11, paragraph
161.27(i), and make annual recommendations by January 15 directly to the chairs and ranking
161.28minority members of the legislative committees with jurisdiction over health and human
161.29services regarding appropriations to the commissioner for the purposes in section 144A.474,
161.30subdivision 11, paragraph (i). The recommendations shall address ways the commissioner
161.31may improve protection of the public under existing statutes and laws and include but are
161.32not limited to projects that create and administer training of licensees and their employees
162.1to improve residents lives, supporting ways that licensees can improve and enhance quality
162.2care, ways to provide technical assistance to licensees to improve compliance; information
162.3technology and data projects that analyze and communicate information about trends of
162.4violations or lead to ways of improving client care; communications strategies to licensees
162.5and the public; and other projects or pilots that benefit clients, families, and the public.

162.6    Sec. 28. Minnesota Statutes 2018, section 256.9741, subdivision 1, is amended to read:
162.7    Subdivision 1. Long-term care facility. "Long-term care facility" means a nursing home
162.8licensed under sections 144A.02 to 144A.10; a boarding care home licensed under sections
162.9144.50 to 144.56; an assisted living facility or an assisted living facility with dementia care
162.10licensed under chapter 144I; or a licensed or registered residential setting that provides or
162.11arranges for the provision of home care services.

162.12    Sec. 29. Minnesota Statutes 2018, section 256I.03, subdivision 15, is amended to read:
162.13    Subd. 15. Supportive housing. "Supportive housing" means housing with support
162.14services according to the continuum of care coordinated assessment system established
162.15under Code of Federal Regulations, title 24, section 578.3 that is not time-limited and
162.16provides or coordinates services necessary for a resident to maintain housing stability.

162.17    Sec. 30. Minnesota Statutes 2018, section 256I.04, subdivision 2a, is amended to read:
162.18    Subd. 2a. License required; staffing qualifications. (a) Except as provided in paragraph
162.19(b), an agency may not enter into an agreement with an establishment to provide housing
162.20support unless:
162.21(1) the establishment is licensed by the Department of Health as a hotel and restaurant;
162.22a board and lodging establishment; a boarding care home before March 1, 1985; or a
162.23supervised living facility, and the service provider for residents of the facility is licensed
162.24under chapter 245A. However, an establishment licensed by the Department of Health to
162.25provide lodging need not also be licensed to provide board if meals are being supplied to
162.26residents under a contract with a food vendor who is licensed by the Department of Health;
162.27(2) the residence is: (i) licensed by the commissioner of human services under Minnesota
162.28Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior
162.29to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265;
162.30(iii) licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120,
162.31with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02,
163.1subdivision 4a
, as a community residential setting by the commissioner of human services;
163.2or
163.3(3) the establishment facility is registered under chapter 144D or licensed under chapter
163.4144I and provides three meals a day.
163.5(b) The requirements under paragraph (a) do not apply to establishments exempt from
163.6state licensure because they are:
163.7(1) located on Indian reservations and subject to tribal health and safety requirements;
163.8or
163.9    (2) a supportive housing establishment that has an approved habitability inspection and
163.10an individual lease agreement and that serves people who have experienced long-term
163.11homelessness and were referred through a coordinated assessment in section 256I.03,
163.12subdivision 15 supportive housing establishments where an individual has an approved
163.13habitability inspection and an individual lease agreement.
163.14    (c) Supportive housing establishments that serve individuals who have experienced
163.15long-term homelessness and emergency shelters must participate in the homeless management
163.16information system and a coordinated assessment system as defined by the commissioner.
163.17    (d) Effective July 1, 2016, an agency shall not have an agreement with a provider of
163.18housing support unless all staff members who have direct contact with recipients:
163.19    (1) have skills and knowledge acquired through one or more of the following:
163.20    (i) a course of study in a health- or human services-related field leading to a bachelor
163.21of arts, bachelor of science, or associate's degree;
163.22    (ii) one year of experience with the target population served;
163.23    (iii) experience as a mental health certified peer specialist according to section 256B.0615;
163.24or
163.25    (iv) meeting the requirements for unlicensed personnel under sections 144A.43 to
163.26144A.483 ;
163.27    (2) hold a current driver's license appropriate to the vehicle driven if transporting
163.28recipients;
163.29    (3) complete training on vulnerable adults mandated reporting and child maltreatment
163.30mandated reporting, where applicable; and
163.31    (4) complete housing support orientation training offered by the commissioner.

164.1    Sec. 31. Minnesota Statutes 2018, section 325F.72, subdivision 1, is amended to read:
164.2    Subdivision 1. Persons to whom disclosure is required. Housing with services
164.3establishments, as defined in sections 144D.01 to 144D.07, that secure, segregate, or provide
164.4a special program or special unit for residents with a diagnosis of probable Alzheimer's
164.5disease or a related disorder or that advertise, market, or otherwise promote the establishment
164.6as providing specialized care for Alzheimer's disease or a related disorder are considered a
164.7"special care unit." All special care units Only assisted living facilities with dementia care
164.8licenses under chapter 144I may advertise, market, or otherwise promote the facility as
164.9providing specialized care for dementia or related disorders. All assisted living facilities
164.10with dementia care licenses shall provide a written disclosure to the following:
164.11(1) the commissioner of health, if requested;
164.12(2) the Office of Ombudsman for Long-Term Care; and
164.13(3) each person seeking placement within a residence, or the person's authorized
164.14representative legal and designated representatives, as those terms are defined in section
164.15144J.01, before an agreement to provide the care is entered into.

164.16    Sec. 32. Minnesota Statutes 2018, section 325F.72, subdivision 2, is amended to read:
164.17    Subd. 2. Content. Written disclosure shall include, but is not limited to, the following:
164.18(1) a statement of the overall philosophy and how it reflects the special needs of residents
164.19with Alzheimer's disease or other dementias;
164.20(2) the criteria for determining who may reside in the special care secured dementia care
164.21unit as defined in section 144I.01, subdivision 62;
164.22(3) the process used for assessment and establishment of the service plan or agreement,
164.23including how the plan is responsive to changes in the resident's condition;
164.24(4) staffing credentials, job descriptions, and staff duties and availability, including any
164.25training specific to dementia;
164.26(5) physical environment as well as design and security features that specifically address
164.27the needs of residents with Alzheimer's disease or other dementias;
164.28(6) frequency and type of programs and activities for residents of the special care unit
164.29assisted living facility with dementia care;
164.30(7) involvement of families in resident care and availability of family support programs;
165.1(8) fee schedules for additional services to the residents of the special secured dementia
165.2care unit; and
165.3(9) a statement that residents will be given a written notice 30 calendar days prior to
165.4changes in the fee schedule.

165.5    Sec. 33. Minnesota Statutes 2018, section 626.5572, subdivision 6, is amended to read:
165.6    Subd. 6. Facility. (a) "Facility" means a hospital or other entity required to be licensed
165.7under sections 144.50 to 144.58; a nursing home required to be licensed to serve adults
165.8under section 144A.02; a facility or service required to be licensed under chapter 245A; an
165.9assisted living facility required to be licensed under chapter 144I; a home care provider
165.10licensed or required to be licensed under sections 144A.43 to 144A.482; a hospice provider
165.11licensed under sections 144A.75 to 144A.755; or a person or organization that offers,
165.12provides, or arranges for personal care assistance services under the medical assistance
165.13program as authorized under sections 256B.0625, subdivision 19a, 256B.0651 to 256B.0654,
165.14256B.0659 , or 256B.85.
165.15(b) For services identified in paragraph (a) that are provided in the vulnerable adult's
165.16own home or in another unlicensed location, the term "facility" refers to the provider, person,
165.17or organization that offers, provides, or arranges for personal care services, and does not
165.18refer to the vulnerable adult's home or other location at which services are rendered.

165.19    Sec. 34. REVISOR INSTRUCTION.
165.20The revisor of statutes shall change the phrases "Board of Examiners for Nursing Home
165.21Administrators" to "Board of Executives for Long Term Services and Supports" and "Board
165.22of Examiners" to "Board of Executives" wherever the phrases appear in Minnesota Statutes
165.23and apply to the board established in Minnesota Statutes, section 144A.19.

165.24    Sec. 35. REPEALER.
165.25(a) Minnesota Statutes 2018, section 144A.472, subdivision 4, is repealed July 1, 2019.
165.26(b) Minnesota Statutes 2018, sections 144A.441; and 144A.442, are repealed August 1,
165.272021.

165.28ARTICLE 6
165.29APPROPRIATIONS

165.30
Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
166.1The sums shown in the columns marked "Appropriations" are appropriated to the agencies
166.2and for the purposes specified in this article. The appropriations are from the general fund,
166.3or another named fund, and are available for the fiscal years indicated for each purpose.
166.4The figures "2020" and "2021" used in this article mean that the appropriations listed under
166.5them are available for the fiscal year ending June 30, 2020, or June 30, 2021, respectively.
166.6"The first year" is fiscal year 2020. "The second year" is fiscal year 2021. "The biennium"
166.7is fiscal years 2020 and 2021.
166.8
APPROPRIATIONS
166.9
Available for the Year
166.10
Ending June 30
166.11
2020
2021

166.12
166.13
Sec. 2. COMMISSIONER OF HUMAN
SERVICES
166.14
Subdivision 1.Total Appropriation
$
7,793,000
$
4,088,000
166.15The amounts that may be spent for each
166.16purpose are specified in the following
166.17subdivisions.
166.18
Subd. 2.Central Office; Operations
2,654,000
740,000
166.19Base Level Adjustment. The general fund
166.20base for this appropriation is $711,000 in fiscal
166.21year 2022 and $711,000 in fiscal year 2023.
166.22
166.23
Subd. 3.Central Office; Continuing Care for
Older Adults
5,139,000
2,848,000
166.24(a) Assisted Living Survey. Beginning in
166.25fiscal year 2020, $2,500,000 in the even
166.26numbered year of each biennium is to fund a
166.27resident experience survey and family survey
166.28for all housing with services sites. This
166.29paragraph does not expire.
166.30(b) Information and Assistance Grant
166.31Transfer. $1,000,000 in fiscal year 2020 and
166.32$1,000,000 in fiscal year 2021 are transferred
167.1to the continuing care for older adults
167.2administration from the aging and adult
167.3services grants for developing the Home and
167.4Community-Based Report Card for assisted
167.5living. This transfer is ongoing.
167.6(c) Base Level Adjustment. The general fund
167.7base for this appropriation is $5,323,000 in
167.8fiscal year 2022 and $2,823,000 in fiscal year
167.92023.
167.10
167.11
Subd. 4.Grant Programs; Children and
Community Service Grants
1,000,000
1,500,000
167.12(a) Adult Protection Grants. $1,000,000 in
167.13fiscal year 2020 and $1,500,000 in fiscal year
167.142021 are for grant funding for adult abuse
167.15maltreatment investigations and adult
167.16protective services to counties and tribes as
167.17allocated and specified under Minnesota
167.18Statutes, section 256M.42.
167.19(b) Base Level Adjustment. The general fund
167.20base for this appropriation is $2,050,000 in
167.21fiscal year 2022 and $2,655,000 in fiscal year
167.222023.
167.23
167.24
Subd. 5.Grant Programs; Aging and Adult
Services Grants
(1,000,000)
(1,000,000)
167.25Base Level Adjustment. The general fund
167.26base for this appropriation is reduced by
167.27$1,000,000 in fiscal year 2022 and $1,000,000
167.28in fiscal year 2023.

167.29
Sec. 3. COMMISSIONER OF HEALTH
167.30
Subdivision 1.Total Appropriation
$
10,973,000
$
13,519,000
167.31
Appropriations by Fund
167.32
2020
2021
167.33
General
9,870,000
12,416,000
167.34
167.35
State Government
Special Revenue
1,103,000
1,103,000
168.1The amounts that may be spent for each
168.2purpose are specified in the following
168.3subdivision.
168.4
Subd. 2.Health Protection
168.5
Appropriations by Fund
168.6
General
9,870,000
12,416,000
168.7
168.8
State Government
Special Revenue
1,103,000
1,103,000
168.9(a) Vulnerable Adults Program
168.10Improvements. $7,438,000 in fiscal year 2020
168.11and $4,302,000 in fiscal year 2021 are from
168.12the general fund for the commissioner to
168.13continue necessary current operations
168.14improvements to the regulatory activities,
168.15systems, analysis, reporting, and
168.16communications that contribute to the health,
168.17safety, care quality, and abuse prevention for
168.18vulnerable adults in Minnesota. $1,103,000 in
168.19fiscal year 2020 and $1,103,000 in fiscal year
168.202021 are from the state government special
168.21revenue fund to improve the frequency of
168.22home care provider inspections. The state
168.23government special revenue appropriations
168.24under this paragraph are onetime
168.25appropriations.
168.26(b) Vulnerable Adults Regulatory Reform.
168.27$2,432,000 in fiscal year 2020 and $8,114,000
168.28in fiscal year 2021 are from the general fund
168.29for the commissioner to establish the assisted
168.30living licensure under Minnesota Statutes,
168.31section 144I.01. This is a onetime
168.32appropriation. The commissioner shall transfer
168.33fine revenue previously deposited to the state
168.34government special revenue fund under
168.35Minnesota Statutes, section 144A.474,
169.1subdivision 11, which is estimated to be
169.2$632,000, to a dedicated account in the state
169.3treasury.
169.4(c) Base Level Adjustment. The general fund
169.5base for this appropriation is $5,800,000 in
169.6fiscal year 2022 and $5,369,000 in fiscal year
169.72023. The state government special revenue
169.8fund base for this appropriation is $13,458,000
169.9in fiscal year 2022 and $13,458,000 in fiscal
169.10year 2023.

169.11    Sec. 4. APPROPRIATIONS OR TRANSFERS ENACTED MORE THAN ONCE;
169.12EFFECT.
169.13If an appropriation or transfer in this act is enacted more than once in the 2019 legislative
169.14session, the appropriation or transfer must be given effect only once."
169.15Amend the title accordingly