HF3935

Purpose

The bill would revise how assisted living facilities operate in Minnesota by updating policies, procedures, and training related to resident care, staffing, and oversight. It also adds or strengthens enforcement provisions for violations.

Key changes to law

• Adds enforcement options and higher penalties for violations, including recovering investigation costs and increasing fines when harm (serious injury or death) occurs and the conduct is egregious.
• Updates required minimum standards for assisted living facilities, including alignment with the Nurse Practice Act and the Assisted Living Bill of Rights.
• Expands requirements around who can provide health care tasks (delegation by a registered nurse to unlicensed personnel) and how those tasks must be supervised and evaluated.
• Establishes more comprehensive staffing and on-site emergency coverage expectations (24/7 availability of staff and an on-site trained emergency responder, plus on-call RN coverage).

Main provisions and what the bill seeks to accomplish

• Clarifies penalties: The commissioner may assess investigation costs and increase fines for egregious conduct or when a serious injury or death results from a violation.
• Minimum requirements for facilities: Facilities must distribute the assisted living bill of rights, comply with the Nurse Practice Act, use person-centered planning, have a health care delegation system overseen by RNs, and ensure 24/7 health and safety support for residents.
• Resident rights and autonomy: Residents have rights related to decorating their unit, accessing food at any time, choosing visitors and visit times, choosing a roommate, and having a lockable door (with controlled access by staff and advance notice before entry). Facilities must not lock residents in their units.
• Staffing and emergency readiness: Facilities must develop staffing plans with biannual evaluations, maintain 24/7 on-site responses to resident requests, ensure availability of on-call RNs, and have an immediate plan to address emergencies.
• Policies and procedures: Each facility must have updated policies on maltreatment reporting, background checks, staff orientation and evaluation, complaint handling, resident needs assessments, nurse supervision, infection control, TB screening, license verification, delegation and supervision of tasks, and emergency procedures. Policies must be provided to residents or their representatives and shared with prospective residents before admission.
• Training and competency for unlicensed personnel: The bill adds extensive training requirements for unlicensed staff, including documentation, reporting changes in resident condition, infection control, hygiene and grooming, fall prevention, safe transfer techniques, medication and treatment reminders, nutrition and modified diets, confidentiality, privacy, boundaries, communication, emergency procedures, and knowledge of health technology and assistive devices. It also requires competency evaluations and ongoing observation and documentation of resident status.

Specific changes to statutes

• 144G.31 Subd. 7: Allows penalties to include investigation costs and potential increases in fines for egregious conduct or severe harm.
• 144G.41 Subdivisions 1-2: Sets minimum facility requirements (resident rights, nurse practice act compliance, delegation and supervision, 24/7 health/safety response, resident rights to decorate and access essentials, staffing plans, and on-site emergency readiness); requires comprehensive policies and procedures and annual or ongoing updates.
• 144G.61 Subdivision 2: Expands training and evaluation requirements for unlicensed personnel, outlining specific content areas and competency expectations.

Significant changes for residents and staff

• Residents gain stronger rights and more predictable access to food, visitors, and their living space, including a lockable door with controlled access.
• Facilities must ensure more robust staffing and 24/7 access to assistance and on-site emergency readiness.
• Unlicensed staff receive more structured and comprehensive training and ongoing competency evaluations, with emphasis on safety, communication, and appropriate handling of emergencies.

Implementation notes

• The bill would require facilities to implement the new policies and training standards and to provide updated materials to residents and prospective residents before admission and at relevant nursing assessments.

Relevant Terms assisted living facilities; unlicensed personnel; registered nurse; Nurse Practice Act; delegation of health care activities; supervision and evaluation; on-call registered nurse; 24 hours per day seven days per week; resident rights; assisted living bill of rights; lockable door; staffing plan; emergencies; on-site emergency responder; emergency procedures; infection control; TB screening; maltreatment reporting; background studies; orientation training; competency evaluations; documentation; communication; privacy; boundaries; health care services; medications; modified diets; body functioning; vital signs; safe transfer; range of motion; resident status; health technology; assistive devices; egregious conduct; investigation costs; fines.