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Assisted living licensure agreement

Toby Pearson
Toby Pearson  |  May 17, 2019  |   All members

As the Minneapolis Star Tribune wrote in an opinion piece on Wednesday, May 15, 2019: “Minnesotans with aging loved ones owe a debt of gratitude to the senior citizen advocates, long-term care providers and state health officials who labored late into the night last weekend to finalize a landmark deal to modernize the state’s elder care regulations.” Care Providers of Minnesota staff, along with our partners in the Long-Term Care Imperative, worked long into the night and early hours of the day last weekend, to iron out the agreement in principal. Currently, we are finalizing the language that corresponds to the agreed upon concepts. 

The final key sticking points remained up through last weekend, with key disagreements on how to protect residents in the event of a housing or service termination, guard against “retaliation” if abuse or theft is reported, what assisted living licensure could look like, amount of the fees assessed, and what interim safeguards to put in place until assisted-living facility licensure would take effect in 2021.  

In a letter that stakeholders signed and sent to the governor and the leadership of the House and Senate, we stated, in part, the following:  

We, the undersigned, respectfully request that you pass comprehensive legislation in the 2019 Session to protect vulnerable adults and establish a licensure system for assisted living facilities. The consensus bill language that we have prepared with the Minnesota Department of Health and Minnesota Department of Human Services represents our best efforts and combined knowledge of how to address this issue from a technical, policy and budgetary perspective.  

None of us think it is perfect.   

All of us think it is necessary and urgent.

The compromise language must still find funding and pass the House and Senate with the exact same language, and get signed by the governor. Care Providers staff continues to monitor how the language is moving forward in the process and will provide updates as things continue to change. From an extremely high-level, the current language in the proposal includes the following:  
  • One license combining current housing with services and home care providers—licensee will choose which “level” of license to apply for: “regular” assisted living or assisted living with dementia care 
  • For AL with dementia care license: defined as an AL facility that also provides dementia care services; an AL with dementia care MAY also have a secured dementia unit 
  • No AL may advertise or represent that the facility has a dementia care unit without complying with disclosure and additional requirements (staffing, training, programming, etc.) 
  • All current housing with services (HWS) providers who meet the definition of what is assisted living will need to apply for a new license effective August 1, 2021 
  • Clear accountability for that licensee 
  • Qualifications for the assisted living administrator—licensed by the new Board of Executives for Long-Term Services and Supports 
  • Physical plant expectations—basic emergency preparedness & safety 
    • Effective December 31, 2019, each “assisted living” facility must have a comprehensive fire protection system to include:   
      • Approved sprinkler system or smoke detectors in each occupied room 
      • Portable fire extinguishers, physical environment kept in a “continuous state of good repair and operation” 
  • Enhanced expectations for terminations of lease/services includes language on notice timeframes, planning requirements, documentation requirements, “soft landing” (agreement on new location) requirements and appeals rights for the termination of services and lease under certain conditions deceptive marketing and business practices prohibited including making any false or misleading statements or representations or material omissions in marketing, advertising or any other description or representation of care or services (in writing); or failing to inform a resident of any limitations to services 
  • Uniform checklist disclosure of services: written checklist of all services permitted under the facility’s license, all services offered by the facility and all services allowed under the license that the facility does NOT provide 
  • Survey frequency/enforcement 
  • Assessments of residents: nursing assessment needs to be conducted prior to the date the prospective resident moves in or signed a contract, whichever is earlier, with a scheduled of reassessments and ongoing assessments and monitoring noted 
  • Retaliation prohibited—Applies to both nursing facilities and assisted living facilities 
    • Retaliation means any of these actions taken (with a good faith standard):   
      • Termination of a contract 
      • Any form of discrimination 
      • Restriction or prohibition of access 
      • Imposition of involuntary seclusion or the withholding of food, care or services 
      • Restriction of any of the rights granted to residents 
      • Restriction or reduction of access to or use of amenities, care services, privileges, or living arrangements 
      • Or, unauthorized removal, tampering with, or deprivation of technology, communication, or electronic monitoring devices 
  • Electronic monitoring: governs placement and use of an electronic monitoring device by a resident in the resident’s room or private living unit in a nursing facility, or assisted living facility 
    • Effective January 1, 2020 
    • Applies to nursing facilities, as well as current housing with services settings 
    • Outstanding issue continues to be notice to facility upon placement of the electronic monitoring device—allows no notice under certain conditions for xx days 

Toby Pearson  |  Vice President of Advocacy  |  |  952-851-2480

About Care Providers of Minnesota

Care Providers of Minnesota is a non-profit membership association with the mission to Empower Members to Performance Excellence. Our 900+ members across Minnesota represent non-profit and for-profit organizations providing services along the full spectrum of post-acute care and long-term services and support. We are the state affiliate for the American Health Care Association/National Center for Assisted Living, and with our national partners we provide solutions for quality care.

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