relating to BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

360.15    Section 1. Minnesota Statutes 2012, section 144.051, is amended by adding a
360.16subdivision to read:
360.17    Subd. 3. Data classification; private data. For providers regulated pursuant to
360.18sections 144A.43 to 144A.482, the following data collected, created, or maintained by the
360.19commissioner are classified as "private data" as defined in section 13.02, subdivision 12:
360.20(1) data submitted by or on behalf of applicants for licenses prior to issuance of
360.21the license;
360.22(2) the identity of complainants who have made reports concerning licensees or
360.23applicants unless the complainant consents to the disclosure;
360.24(3) the identity of individuals who provide information as part of surveys and
360.25investigations;
360.26(4) Social Security numbers; and
360.27(5) health record data.

360.28    Sec. 2. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
360.29to read:
360.30    Subd. 4. Data classification; public data. For providers regulated pursuant to
360.31sections 144A.43 to 144A.482, the following data collected, created, or maintained by the
360.32commissioner are classified as "public data" as defined in section 13.02, subdivision 15:
360.33(1) all application data on licensees, license numbers, license status;
360.34(2) licensing information about licenses previously held under this chapter;
361.1(3) correction orders, including information about compliance with the order and
361.2whether the fine was paid;
361.3(4) final enforcement actions pursuant to chapter 14;
361.4(5) orders for hearing, findings of fact and conclusions of law; and
361.5(6) when the licensee and department agree to resolve the matter without a hearing,
361.6the agreement and specific reasons for the agreement are public data.

361.7    Sec. 3. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
361.8to read:
361.9    Subd. 5. Data classification; confidential data. For providers regulated pursuant to
361.10sections 144A.43 to 144A.482, the following data collected, created, or maintained by
361.11the Department of Health are classified as "confidential data" as defined in section 13.02,
361.12subdivision 3: active investigative data relating to the investigation of potential violations
361.13of law by licensee including data from the survey process before the correction order is
361.14issued by the department.

361.15    Sec. 4. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
361.16to read:
361.17    Subd. 6. Release of private or confidential data. For providers regulated pursuant
361.18to sections 144A.43 to 144A.482, the department may release private or confidential
361.19data, except Social Security numbers, to the appropriate state, federal, or local agency
361.20and law enforcement office to enhance investigative or enforcement efforts or further
361.21public health protective process. Types of offices include, but are not limited to, Adult
361.22Protective Services, Office of the Ombudsmen for Long-Term Care and Office of the
361.23Ombudsmen for Mental Health and Developmental Disabilities, the health licensing
361.24boards, Department of Human Services, county or city attorney's offices, police, and local
361.25or county public health offices.

361.26    Sec. 5. Minnesota Statutes 2012, section 144A.43, is amended to read:
361.27144A.43 DEFINITIONS.
361.28    Subdivision 1. Applicability. The definitions in this section apply to sections
361.29144.699, subdivision 2 , and 144A.43 to 144A.47 144A.482.
361.30    Subd. 1a. Agent. "Agent" means the person upon whom all notices and orders shall
361.31be served and who is authorized to accept service of notices and orders on behalf of
361.32the home care provider.
362.1    Subd. 1b. Applicant. "Applicant" means an individual, organization, association,
362.2corporation, unit of government, or other entity that applies for a temporary license,
362.3license, or renewal of their home care provider license under section 144A.472.
362.4    Subd. 1c. Client. "Client" means a person to whom home care services are provided.
362.5    Subd. 1d. Client record. "Client record" means all records that document
362.6information about the home care services provided to the client by the home care provider.
362.7    Subd. 1e. Client representative. "Client representative" means a person who,
362.8because of the client's needs, makes decisions about the client's care on behalf of the
362.9client. A client representative may be a guardian, health care agent, family member, or
362.10other agent of the client. Nothing in this section expands or diminishes the rights of
362.11persons to act on behalf of clients under other law.
362.12    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
362.13    Subd. 2a. Controlled substance. "Controlled substance" has the meaning given
362.14in section 152.01, subdivision 4.
362.15    Subd. 2b. Department. "Department" means the Minnesota Department of Health.
362.16    Subd. 2c. Dietary supplement. "Dietary supplement" means a product taken by
362.17mouth that contains a "dietary ingredient" intended to supplement the diet. Dietary
362.18ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and
362.19substances such as enzymes, organ tissue, glandulars, or metabolites.
362.20    Subd. 2d. Dietician. "Dietitian" is a person licensed under sections 148.621 to
362.21148.633.
362.22    Subd. 2e. Dietetics or nutrition practice. "Dietetics or nutrition practice" is
362.23performed by a licensed dietician or licensed nutritionist and includes the activities of
362.24assessment, setting priorities and objectives, providing nutrition counseling, developing
362.25and implementing nutrition care services, and evaluating and maintaining appropriate
362.26standards of quality of nutrition care under sections 148.621 to 148.633.
362.27    Subd. 3. Home care service. "Home care service" means any of the following
362.28services when delivered in a place of residence to the home of a person whose illness,
362.29disability, or physical condition creates a need for the service:
362.30(1) nursing services, including the services of a home health aide;
362.31(2) personal care services not included under sections 148.171 to 148.285;
362.32(3) physical therapy;
362.33(4) speech therapy;
362.34(5) respiratory therapy;
362.35(6) occupational therapy;
362.36(7) nutritional services;
363.1(8) home management services when provided to a person who is unable to perform
363.2these activities due to illness, disability, or physical condition. Home management
363.3services include at least two of the following services: housekeeping, meal preparation,
363.4and shopping;
363.5(9) medical social services;
363.6(10) the provision of medical supplies and equipment when accompanied by the
363.7provision of a home care service; and
363.8(11) other similar medical services and health-related support services identified by
363.9the commissioner in rule.
363.10"Home care service" does not include the following activities conducted by the
363.11commissioner of health or a board of health as defined in section 145A.02, subdivision 2:
363.12communicable disease investigations or testing; administering or monitoring a prescribed
363.13therapy necessary to control or prevent a communicable disease; or the monitoring
363.14of an individual's compliance with a health directive as defined in section 144.4172,
363.15subdivision 6 .
363.16(1) assistive tasks as defined in section 144A.471, subdivision 6, provided by
363.17unlicensed personnel;
363.18(2) services provided by a registered nurse or licensed practical nurse, physical
363.19therapist, respiratory therapist, occupational therapist, speech-language pathologist,
363.20dietitian or nutritionist, or social worker;
363.21(3) medication and treatment management services; or
363.22(4) the provision of durable medical equipment services when provided with any of
363.23the home care services listed in clauses (1) to (3).
363.24    Subd. 3a. Hands-on-assistance. "Hands-on-assistance" means physical help by
363.25another person without which the client is not able to perform the activity.
363.26    Subd. 3b. Home. "Home" means the client's temporary or permanent place of
363.27residence.
363.28    Subd. 4. Home care provider. "Home care provider" means an individual,
363.29organization, association, corporation, unit of government, or other entity that is regularly
363.30engaged in the delivery of at least one home care service, directly or by contractual
363.31arrangement, of home care services in a client's home for a fee and who has a valid current
363.32temporary license or license issued under sections 144A.43 to 144A.482. At least one
363.33home care service must be provided directly, although additional home care services may
363.34be provided by contractual arrangements. "Home care provider" does not include:
364.1(1) any home care or nursing services conducted by and for the adherents of any
364.2recognized church or religious denomination for the purpose of providing care and
364.3services for those who depend upon spiritual means, through prayer alone, for healing;
364.4(2) an individual who only provides services to a relative;
364.5(3) an individual not connected with a home care provider who provides assistance
364.6with home management services or personal care needs if the assistance is provided
364.7primarily as a contribution and not as a business;
364.8(4) an individual not connected with a home care provider who shares housing with
364.9and provides primarily housekeeping or homemaking services to an elderly or disabled
364.10person in return for free or reduced-cost housing;
364.11(5) an individual or agency providing home-delivered meal services;
364.12(6) an agency providing senior companion services and other older American
364.13volunteer programs established under the Domestic Volunteer Service Act of 1973,
364.14Public Law 98-288;
364.15(7) an employee of a nursing home licensed under this chapter or an employee of a
364.16boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
364.17emergency calls from individuals residing in a residential setting that is attached to or
364.18located on property contiguous to the nursing home or boarding care home;
364.19(8) a member of a professional corporation organized under chapter 319B that does
364.20not regularly offer or provide home care services as defined in subdivision 3;
364.21(9) the following organizations established to provide medical or surgical services
364.22that do not regularly offer or provide home care services as defined in subdivision 3:
364.23a business trust organized under sections 318.01 to 318.04, a nonprofit corporation
364.24organized under chapter 317A, a partnership organized under chapter 323, or any other
364.25entity determined by the commissioner;
364.26(10) an individual or agency that provides medical supplies or durable medical
364.27equipment, except when the provision of supplies or equipment is accompanied by a
364.28home care service;
364.29(11) an individual licensed under chapter 147; or
364.30(12) an individual who provides home care services to a person with a developmental
364.31disability who lives in a place of residence with a family, foster family, or primary caregiver.
364.32    Subd. 5. Medication reminder. "Medication reminder" means providing a verbal
364.33or visual reminder to a client to take medication. This includes bringing the medication
364.34to the client and providing liquids or nutrition to accompany medication that a client is
364.35self-administering.
365.1    Subd. 6. License. "License" means a basic or comprehensive home care license
365.2issued by the commissioner to a home care provider.
365.3    Subd. 7. Licensed health professional. "Licensed health professional" means a
365.4person, other than a registered nurse or licensed practical nurse, who provides home care
365.5services within the scope of practice of the person's health occupation license, registration,
365.6or certification as regulated and who is licensed by the appropriate Minnesota state board
365.7or agency.
365.8    Subd. 8. Licensee. "Licensee" means a home care provider that is licensed under
365.9this chapter.
365.10    Subd. 9. Managerial official. "Managerial official" means an administrator,
365.11director, officer, trustee, or employee of a home care provider, however designated, who
365.12has the authority to establish or control business policy.
365.13    Subd. 10. Medication. "Medication" means a prescription or over-the-counter drug.
365.14For purposes of this chapter only, medication includes dietary supplements.
365.15    Subd. 11. Medication administration. "Medication administration" means
365.16performing a set of tasks to ensure a client takes medications, and includes the following:
365.17(1) checking the client's medication record;
365.18(2) preparing the medication as necessary;
365.19(3) administering the medication to the client;
365.20(4) documenting the administration or reason for not administering the medication;
365.21and
365.22(5) reporting to a nurse any concerns about the medication, the client, or the client's
365.23refusal to take the medication.
365.24    Subd. 12. Medication management. "Medication management" means the
365.25provision of any of the following medication-related services to a client:
365.26(1) performing medication setup;
365.27(2) administering medication;
365.28(3) storing and securing medications;
365.29(4) documenting medication activities;
365.30(5) verifying and monitoring effectiveness of systems to ensure safe handling and
365.31administration;
365.32(6) coordinating refills;
365.33(7) handling and implementing changes to prescriptions;
365.34(8) communicating with the pharmacy about the client's medications; and
365.35(9) coordinating and communicating with the prescriber.
366.1    Subd. 13. Medication setup. "Medication setup" means arranging medications by a
366.2nurse, pharmacy, or authorized prescriber for later administration by the client or by
366.3comprehensive home care staff.
366.4    Subd. 14. Nurse. "Nurse" means a person who is licensed under sections 148.171 to
366.5148.285.
366.6    Subd. 15. Occupational therapist. "Occupational therapist" means a person who is
366.7licensed under sections 148.6401 to 148.6450.
366.8    Subd. 16. Over-the-counter drug. "Over-the-counter drug" means a drug that is
366.9not required by federal law to bear the symbol "Rx only."
366.10    Subd. 17. Owner. "Owner" means a proprietor, general partner, limited partner who
366.11has five percent or more of equity interest in a limited partnership, a person who owns or
366.12controls voting stock in a corporation in an amount equal to or greater than five percent of
366.13the shares issued and outstanding, or a corporation that owns equity interest in a licensee
366.14or applicant for a license.
366.15    Subd. 18. Pharmacist. "Pharmacist" has the meaning given in section 151.01,
366.16subdivision 3.
366.17    Subd. 19. Physical therapist. "Physical therapist" means a person who is licensed
366.18under sections 148.65 to 148.78.
366.19    Subd. 20. Physician. "Physician" means a person who is licensed under chapter 147.
366.20    Subd. 21. Prescriber. "Prescriber" means a person who is authorized by sections
366.21148.235; 151.01, subdivision 23; and 151.37, to prescribe prescription drugs.
366.22    Subd. 22. Prescription. "Prescription" has the meaning given in section 151.01,
366.23subdivision 16.
366.24    Subd. 23. Regularly scheduled. "Regularly scheduled" means ordered or planned
366.25to be completed at predetermined times or according to a predetermined routine.
366.26    Subd. 24. Reminder. "Reminder" means providing a verbal or visual reminder
366.27to a client.
366.28    Subd. 25. Respiratory therapist. "Respiratory therapist" means a person who
366.29is licensed under chapter 147C.
366.30    Subd. 26. Revenues. "Revenues" means all money or the value of property or
366.31services received by a registrant and derived from the provision of home care services,
366.32including fees for services, grants, bequests, gifts, donations, appropriations of public
366.33money, and earned interest or dividends.
366.34    Subd. 27. Service plan. "Service plan" means the written plan between the client or
366.35client's representative and the temporary licensee or licensee about the services that will
366.36be provided to the client.
367.1    Subd. 28. Social worker. "Social worker" means a person who is licensed under
367.2chapter 148D or 148E.
367.3    Subd. 29. Speech language pathologist. "Speech language pathologist" has the
367.4meaning given in section 148.512.
367.5    Subd. 30. Standby assistance. "Standby assistance" means the presence of another
367.6person within arm's reach to minimize the risk of injury while performing daily activities
367.7through physical intervention or cuing.
367.8    Subd. 31. Substantial compliance. "Substantial compliance" means complying
367.9with the requirements in this chapter sufficiently to prevent unacceptable health or safety
367.10risks to the home care client.
367.11    Subd. 32. Survey. "Survey" means an inspection of a licensee or applicant for
367.12licensure for compliance with this chapter.
367.13    Subd. 33. Surveyor. "Surveyor" means a staff person of the department authorized
367.14to conduct surveys of home care providers and applicants.
367.15    Subd. 34. Temporary license. "Temporary license" means the initial basic or
367.16comprehensive home care license the department issues after approval of a complete
367.17written application and before the department completes the temporary license survey and
367.18determines that the temporary licensee is in substantial compliance.
367.19    Subd. 35. Treatment or therapy. "Treatment" or "therapy" means the provision
367.20of care, other than medications, ordered or prescribed by a licensed health professional
367.21provided to a client to cure, rehabilitate, or ease symptoms.
367.22    Subd. 36. Unit of government. "Unit of government" means every city, county,
367.23town, school district, other political subdivisions of the state, and any agency of the state
367.24or federal government, which includes any instrumentality of a unit of government.
367.25    Subd. 37. Unlicensed personnel. "Unlicensed personnel" are individuals not
367.26otherwise licensed or certified by a governmental health board or agency who provide
367.27home care services in the client's home.
367.28    Subd. 38. Verbal. "Verbal" means oral and not in writing.

367.29    Sec. 6. Minnesota Statutes 2012, section 144A.44, is amended to read:
367.30144A.44 HOME CARE BILL OF RIGHTS.
367.31    Subdivision 1. Statement of rights. A person who receives home care services
367.32has these rights:
367.33(1) the right to receive written information about rights in advance of before
367.34receiving care or during the initial evaluation visit before the initiation of treatment
367.35 services, including what to do if rights are violated;
368.1(2) the right to receive care and services according to a suitable and up-to-date plan,
368.2and subject to accepted health care, medical or nursing standards, to take an active part
368.3in creating and changing the plan developing, modifying, and evaluating care the plan
368.4 and services;
368.5(3) the right to be told in advance of before receiving care about the services that will
368.6be provided, the disciplines that will furnish care the type and disciplines of staff who will
368.7be providing the services, the frequency of visits proposed to be furnished, other choices
368.8that are available for addressing home care needs, and the consequences of these choices
368.9including the potential consequences of refusing these services;
368.10(4) the right to be told in advance of any change recommended changes by the
368.11provider in the service plan of care and to take an active part in any change decisions
368.12about changes to the service plan;
368.13(5) the right to refuse services or treatment;
368.14(6) the right to know, in advance before receiving services or during the initial
368.15visit, any limits to the services available from a home care provider, and the provider's
368.16grounds for a termination of services;
368.17(7) the right to know in advance of receiving care whether the services are covered
368.18by health insurance, medical assistance, or other health programs, the charges for services
368.19that will not be covered by Medicare, and the charges that the individual may have to pay;
368.20(8) (7) the right to know be told before services are initiated what the provider
368.21charges are for the services, no matter who will be paying the bill and if known to what
368.22extent payment may be expected from health insurance, public programs or other sources,
368.23and what charges the client may be responsible for paying;
368.24(9) (8) the right to know that there may be other services available in the community,
368.25including other home care services and providers, and to know where to go for find
368.26 information about these services;
368.27(10) (9) the right to choose freely among available providers and to change providers
368.28after services have begun, within the limits of health insurance, long-term care insurance,
368.29medical assistance, or other health programs;
368.30(11) (10) the right to have personal, financial, and medical information kept private,
368.31and to be advised of the provider's policies and procedures regarding disclosure of such
368.32information;
368.33(12) (11) the right to be allowed access to the client's own records and written
368.34information from those records in accordance with sections 144.291 to 144.298;
368.35(13) (12) the right to be served by people who are properly trained and competent
368.36to perform their duties;
369.1(14) (13) the right to be treated with courtesy and respect, and to have the patient's
369.2 client's property treated with respect;
369.3(15) (14) the right to be free from physical and verbal abuse, neglect, financial
369.4exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and
369.5the Maltreatment of Minors Act;
369.6(16) (15) the right to reasonable, advance notice of changes in services or charges,
369.7including;
369.8(16) the right to know the provider's reason for termination of services;
369.9(17) the right to at least ten days' advance notice of the termination of a service by a
369.10provider, except in cases where:
369.11(i) the recipient of services client engages in conduct that significantly alters the
369.12conditions of employment as specified in the employment contract between terms of
369.13the service plan with the home care provider and the individual providing home care
369.14services, or creates;
369.15(ii) the client, person who lives with the client, or others create an abusive or unsafe
369.16work environment for the individual person providing home care services; or
369.17(ii) (iii) an emergency for the informal caregiver or a significant change in the
369.18recipient's client's condition has resulted in service needs that exceed the current service
369.19provider agreement plan and that cannot be safely met by the home care provider;
369.20(17) (18) the right to a coordinated transfer when there will be a change in the
369.21provider of services;
369.22(18) (19) the right to voice grievances regarding treatment or care that is complain
369.23about services that are provided, or fails to be, furnished, or regarding fail to be provided,
369.24and the lack of courtesy or respect to the patient client or the patient's client's property;
369.25(19) (20) the right to know how to contact an individual associated with the home
369.26care provider who is responsible for handling problems and to have the home care provider
369.27investigate and attempt to resolve the grievance or complaint;
369.28(20) (21) the right to know the name and address of the state or county agency to
369.29contact for additional information or assistance; and
369.30(21) (22) the right to assert these rights personally, or have them asserted by
369.31the patient's family or guardian when the patient has been judged incompetent, client's
369.32representative or by anyone on behalf of the client, without retaliation.
369.33    Subd. 2. Interpretation and enforcement of rights. These rights are established
369.34for the benefit of persons clients who receive home care services. "Home care services"
369.35means home care services as defined in section 144A.43, subdivision 3, and unlicensed
369.36personal care assistance services, including services covered by medical assistance under
370.1section 256B.0625, subdivision 19a. All home care providers, including those exempted
370.2under section 144A.471, must comply with this section. The commissioner shall enforce
370.3this section and the home care bill of rights requirement against home care providers
370.4exempt from licensure in the same manner as for licensees. A home care provider may
370.5not request or require a person client to surrender any of these rights as a condition of
370.6receiving services. A guardian or conservator or, when there is no guardian or conservator,
370.7a designated person, may seek to enforce these rights. This statement of rights does not
370.8replace or diminish other rights and liberties that may exist relative to persons clients
370.9 receiving home care services, persons providing home care services, or providers licensed
370.10under Laws 1987, chapter 378. A copy of these rights must be provided to an individual
370.11at the time home care services, including personal care assistance services, are initiated.
370.12The copy shall also contain the address and phone number of the Office of Health Facility
370.13Complaints and the Office of Ombudsman for Long-Term Care and a brief statement
370.14describing how to file a complaint with these offices. Information about how to contact
370.15the Office of Ombudsman for Long-Term Care shall be included in notices of change in
370.16client fees and in notices where home care providers initiate transfer or discontinuation of
370.17services sections 144A.43 to 144A.482.

370.18    Sec. 7. Minnesota Statutes 2012, section 144A.45, is amended to read:
370.19144A.45 REGULATION OF HOME CARE SERVICES.
370.20    Subdivision 1. Rules Regulations. The commissioner shall adopt rules for the
370.21regulation of regulate home care providers pursuant to sections 144A.43 to 144A.47
370.22 144A.482. The rules regulations shall include the following:
370.23    (1) provisions to assure, to the extent possible, the health, safety and well-being,
370.24and appropriate treatment of persons who receive home care services while respecting
370.25clients' autonomy and choice;
370.26    (2) requirements that home care providers furnish the commissioner with specified
370.27information necessary to implement sections 144A.43 to 144A.47 144A.482;
370.28    (3) standards of training of home care provider personnel, which may vary according
370.29to the nature of the services provided or the health status of the consumer;
370.30(4) standards for provision of home care services;
370.31    (4) (5) standards for medication management which may vary according to the
370.32nature of the services provided, the setting in which the services are provided, or the
370.33status of the consumer. Medication management includes the central storage, handling,
370.34distribution, and administration of medications;
371.1    (5) (6) standards for supervision of home care services requiring supervision by a
371.2registered nurse or other appropriate health care professional which must occur on site
371.3at least every 62 days, or more frequently if indicated by a clinical assessment, and in
371.4accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that a
371.5person performing home care aide tasks for a class B licensee providing paraprofessional
371.6services does not require nursing supervision;
371.7    (6) (7) standards for client evaluation or assessment which may vary according to
371.8the nature of the services provided or the status of the consumer;
371.9    (7) (8) requirements for the involvement of a consumer's physician client's health
371.10care provider, the documentation of physicians' health care providers' orders, if required,
371.11and the consumer's treatment client's service plan, and;
371.12(9) the maintenance of accurate, current clinical client records;
371.13    (8) (10) the establishment of different classes basic and comprehensive levels of
371.14licenses for different types of providers and different standards and requirements for
371.15different kinds of home care based on services provided; and
371.16    (9) operating procedures required to implement (11) provisions to enforce these
371.17regulations and the home care bill of rights.
371.18    Subd. 1a. Home care aide tasks. Notwithstanding the provisions of Minnesota
371.19Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting
371.20toileting, transfers, and ambulation if the client is ambulatory and if the client has no
371.21serious acute illness or infectious disease.
371.22    Subd. 1b. Home health aide qualifications. Notwithstanding the provisions of
371.23Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks
371.24if the person maintains current registration as a nursing assistant on the Minnesota nursing
371.25assistant registry. Maintaining current registration on the Minnesota nursing assistant
371.26registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110,
371.27subpart 3.
371.28    Subd. 2. Regulatory functions. (a) The commissioner shall:
371.29(1) evaluate, monitor, and license, survey, and monitor without advance notice, home
371.30care providers in accordance with sections 144A.45 to 144A.47 144A.43 to 144A.482;
371.31(2) inspect the office and records of a provider during regular business hours without
371.32advance notice to the home care provider;
371.33(2) survey every temporary licensee within one year of the temporary license issuance
371.34date subject to the temporary licensee providing home care services to a client or clients;
371.35(3) survey all licensed home care providers on an interval that will promote the
371.36health and safety of clients;
372.1(3) (4) with the consent of the consumer client, visit the home where services are
372.2being provided;
372.3(4) (5) issue correction orders and assess civil penalties in accordance with section
372.4144.653, subdivisions 5 to 8 , for violations of sections 144A.43 to 144A.47 or the rules
372.5adopted under those sections 144A.482;
372.6(5) (6) take action as authorized in section 144A.46, subdivision 3 144A.475; and
372.7(6) (7) take other action reasonably required to accomplish the purposes of sections
372.8144A.43 to 144A.47 144A.482.
372.9(b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the
372.10commissioner shall comply with the applicable requirements of section 144.122, the
372.11Government Data Practices Act, and the Administrative Procedure Act.
372.12    Subd. 4. Medicaid reimbursement. Notwithstanding the provisions of section
372.13256B.37 or state plan requirements to the contrary, certification by the federal Medicare
372.14program must not be a requirement of Medicaid payment for services delivered under
372.15section 144A.4605.
372.16    Subd. 5. Home care providers; services for Alzheimer's disease or related
372.17disorder. (a) If a home care provider licensed under section 144A.46 or 144A.4605 markets
372.18or otherwise promotes services for persons with Alzheimer's disease or related disorders,
372.19the facility's direct care staff and their supervisors must be trained in dementia care.
372.20(b) Areas of required training include:
372.21(1) an explanation of Alzheimer's disease and related disorders;
372.22(2) assistance with activities of daily living;
372.23(3) problem solving with challenging behaviors; and
372.24(4) communication skills.
372.25(c) The licensee shall provide to consumers in written or electronic form a
372.26description of the training program, the categories of employees trained, the frequency
372.27of training, and the basic topics covered.

372.28    Sec. 8. [144A.471] HOME CARE PROVIDER AND HOME CARE SERVICES.
372.29    Subdivision 1. License required. A home care provider may not open, operate,
372.30manage, conduct, maintain, or advertise itself as a home care provider or provide home
372.31care services in Minnesota without a temporary or current home care provider license
372.32issued by the commissioner of health.
372.33    Subd. 2. Determination of direct home care service. "Direct home care service"
372.34means a home care service provided to a client by the home care provider or its employees,
372.35and not by contract. Factors that must be considered in determining whether an individual
373.1or a business entity provides at least one home care service directly include, but are not
373.2limited to, whether the individual or business entity:
373.3    (1) has the right to control, and does control, the types of services provided;
373.4(2) has the right to control, and does control, when and how the services are provided;
373.5    (3) establishes the charges;
373.6(4) collects fees from the clients or receives payment from third-party payers on
373.7the clients' behalf;
373.8(5) pays individuals providing services compensation on an hourly, weekly, or
373.9similar basis;
373.10(6) treats the individuals providing services as employees for the purposes of payroll
373.11taxes and workers' compensation insurance; and
373.12(7) holds itself out as a provider of home care services or acts in a manner that
373.13leads clients or potential clients to believe that it is a home care provider providing home
373.14care services.
373.15    None of the factors listed in this subdivision is solely determinative.
373.16    Subd. 3. Determination of regularly engaged. "Regularly engaged" means
373.17providing, or offering to provide, home care services as a regular part of a business. The
373.18following factors must be considered by the commissioner in determining whether an
373.19individual or a business entity is regularly engaged in providing home care services:
373.20    (1) whether the individual or business entity states or otherwise promotes that the
373.21individual or business entity provides home care services;
373.22    (2) whether persons receiving home care services constitute a substantial part of the
373.23individual's or the business entity's clientele; and
373.24(3) whether the home care services provided are other than occasional or incidental
373.25to the provision of services other than home care services.
373.26    None of the factors listed in this subdivision is solely determinative.
373.27    Subd. 4. Penalties for operating without license. A person involved in the
373.28management, operation, or control of a home care provider that operates without an
373.29appropriate license is guilty of a misdemeanor. This section does not apply to a person
373.30who has no legal authority to affect or change decisions related to the management,
373.31operation, or control of a home care provider.
373.32    Subd. 5. Basic and comprehensive levels of licensure. An applicant seeking
373.33to become a home care provider must apply for either a basic or comprehensive home
373.34care license.
374.1    Subd. 6. Basic home care license provider. Home care services that can be
374.2provided with a basic home care license are assistive tasks provided by licensed or
374.3unlicensed personnel that include:
374.4(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting,
374.5and bathing;
374.6(2) providing standby assistance;
374.7(3) providing verbal or visual reminders to the client to take regularly scheduled
374.8medication which includes bringing the client previously set-up medication, medication in
374.9original containers, or liquid or food to accompany the medication;
374.10(4) providing verbal or visual reminders to the client to perform regularly scheduled
374.11treatments and exercises;
374.12(5) preparing modified diets ordered by a licensed health professional; and
374.13(6) assisting with laundry, housekeeping, meal preparation, shopping, or other
374.14household chores and services if the provider is also providing at least one of the activities
374.15in clauses (1) to (5)
374.16    Subd. 7. Comprehensive home care license provider. Home care services that
374.17may be provided with a comprehensive home care license include any of the basic home
374.18care services listed in subdivision 6, and one or more of the following:
374.19(1) services of an advanced practice nurse, registered nurse, licensed practical
374.20nurse, physical therapist, respiratory therapist, occupational therapist, speech-language
374.21pathologist, dietician or nutritionist, or social worker;
374.22(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a
374.23licensed health professional within the person's scope of practice;
374.24(3) medication management services;
374.25(4) hands-on assistance with transfers and mobility;
374.26(5) assisting clients with eating when the clients have complicating eating problems
374.27as identified in the client record or through an assessment such as difficulty swallowing,
374.28recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
374.29instruments to be fed; or
374.30(6) providing other complex or specialty health care services.
374.31    Subd. 8. Exemptions from home care services licensure. (a) Except as otherwise
374.32provided in this chapter, home care services that are provided by the state, counties, or
374.33other units of government must be licensed under this chapter.
374.34(b) An exemption under this subdivision does not excuse the exempted individual or
374.35organization from complying with applicable provisions of the home care bill of rights
375.1in section 144A.44. The following individuals or organizations are exempt from the
375.2requirement to obtain a home care provider license:
375.3(1) an individual or organization that offers, provides, or arranges for personal care
375.4assistance services under the medical assistance program as authorized under sections
375.5256B.04, subdivision 16; 256B.0625, subdivision 19a; and 256B.0659;
375.6(2) a provider that is licensed by the commissioner of human services to provide
375.7semi-independent living services for persons with developmental disabilities under section
375.8252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
375.9(3) a provider that is licensed by the commissioner of human services to provide
375.10home and community-based services for persons with developmental disabilities under
375.11section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
375.12(4) an individual or organization that provides only home management services, if
375.13the individual or organization is registered under section 144A.482; or
375.14(5) an individual who is licensed in this state as a nurse, dietitian, social worker,
375.15occupational therapist, physical therapist, or speech-language pathologist who provides
375.16health care services in the home independently and not through any contractual or
375.17employment relationship with a home care provider or other organization.
375.18    Subd. 9. Exclusions from home care licensure. The following are excluded from
375.19home care licensure and are not required to provide the home care bill of rights:
375.20(1) an individual or business entity providing only coordination of home care that
375.21includes one or more of the following:
375.22(i) determination of whether a client needs home care services, or assisting a client
375.23in determining what services are needed;
375.24(ii) referral of clients to a home care provider;
375.25(iii) administration of payments for home care services; or
375.26(iv) administration of a health care home established under section 256B.0751;
375.27(2) an individual who is not an employee of a licensed home care provider if the
375.28individual:
375.29(i) only provides services as an independent contractor to one or more licensed
375.30home care providers;
375.31(ii) provides no services under direct agreements or contracts with clients; and
375.32(iii) is contractually bound to perform services in compliance with the contracting
375.33home care provider's policies and service plans;
375.34(3) a business that provides staff to home care providers, such as a temporary
375.35employment agency, if the business:
375.36(i) only provides staff under contract to licensed or exempt providers;
376.1(ii) provides no services under direct agreements with clients; and
376.2(iii) is contractually bound to perform services under the contracting home care
376.3provider's direction and supervision;
376.4(4) any home care services conducted by and for the adherents of any recognized
376.5church or religious denomination for its members through spiritual means, or by prayer
376.6for healing;
376.7(5) an individual who only provides home care services to a relative;
376.8(6) an individual not connected with a home care provider that provides assistance
376.9with basic home care needs if the assistance is provided primarily as a contribution and
376.10not as a business;
376.11(7) an individual not connected with a home care provider that shares housing with
376.12and provides primarily housekeeping or homemaking services to an elderly or disabled
376.13person in return for free or reduced-cost housing;
376.14(8) an individual or provider providing home-delivered meal services;
376.15(9) an individual providing senior companion services and other Older American
376.16Volunteer Programs (OAVP) established under the Domestic Volunteer Service Act of
376.171973, United States Code, title 42, chapter 66;
376.18(10) an employee of a nursing home licensed under this chapter or an employee of a
376.19boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
376.20emergency calls from individuals residing in a residential setting that is attached to or
376.21located on property contiguous to the nursing home or boarding care home;
376.22(11) a member of a professional corporation organized under chapter 319B that
376.23does not regularly offer or provide home care services as defined in section 144A.43,
376.24subdivision 3;
376.25(12) the following organizations established to provide medical or surgical services
376.26that do not regularly offer or provide home care services as defined in section 144A.43,
376.27subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit
376.28corporation organized under chapter 317A, a partnership organized under chapter 323, or
376.29any other entity determined by the commissioner;
376.30(13) an individual or agency that provides medical supplies or durable medical
376.31equipment, except when the provision of supplies or equipment is accompanied by a
376.32home care service;
376.33(14) a physician licensed under chapter 147;
376.34(15) an individual who provides home care services to a person with a developmental
376.35disability who lives in a place of residence with a family, foster family, or primary caregiver;
377.1(16) a business that only provides services that are primarily instructional and not
377.2medical services or health-related support services;
377.3(17) an individual who performs basic home care services for no more than 14 hours
377.4each calendar week to no more than one client;
377.5(18) an individual or business licensed as hospice as defined in sections 144A.75 to
377.6144A.755 who is not providing home care services independent of hospice service;
377.7(19) activities conducted by the commissioner of health or a board of health as
377.8defined in section 145A.02, subdivision 2, including communicable disease investigations
377.9or testing; or
377.10(20) administering or monitoring a prescribed therapy necessary to control or
377.11prevent a communicable disease, or the monitoring of an individual's compliance with a
377.12health directive as defined in section 144.4172, subdivision 6.

377.13    Sec. 9. [144A.472] HOME CARE PROVIDER LICENSE; APPLICATION AND
377.14RENEWAL.
377.15    Subdivision 1. License applications. Each application for a home care provider
377.16license must include information sufficient to show that the applicant meets the
377.17requirements of licensure, including:
377.18    (1) the applicant's name, e-mail address, physical address, and mailing address,
377.19including the name of the county in which the applicant resides and has a principal
377.20place of business;
377.21(2) the initial license fee in the amount specified in subdivision 7;
377.22(3) e-mail address, physical address, mailing address, and telephone number of the
377.23principal administrative office;
377.24(4) e-mail address, physical address, mailing address, and telephone number of
377.25each branch office, if any;
377.26(5) names, e-mail and mailing addresses, and telephone numbers of all owners
377.27and managerial officials;
377.28(6) documentation of compliance with the background study requirements of section
377.29144A.476 for all persons involved in the management, operation, or control of the home
377.30care provider;
377.31(7) documentation of a background study as required by section 144.057 for any
377.32individual seeking employment, paid or volunteer, with the home care provider;
377.33(8) evidence of workers' compensation coverage as required by sections 176.181
377.34and 176.182;
377.35(9) documentation of liability coverage, if the provider has it;
378.1(10) identification of the license level the provider is seeking;
378.2(11) documentation that identifies the managerial official who is in charge of
378.3day-to-day operations and attestation that the person has reviewed and understands the
378.4home care provider regulations;
378.5(12) documentation that the applicant has designated one or more owners,
378.6managerial officials, or employees as an agent or agents, which shall not affect the legal
378.7responsibility of any other owner or managerial official under this chapter;
378.8(13) the signature of the officer or managing agent on behalf of an entity, corporation,
378.9association, or unit of government;
378.10(14) verification that the applicant has the following policies and procedures in place
378.11so that if a license is issued, the applicant will implement the policies and procedures
378.12and keep them current:
378.13    (i) requirements in sections 626.556, reporting of maltreatment of minors, and
378.14626.557, reporting of maltreatment of vulnerable adults;
378.15(ii) conducting and handling background studies on employees;
378.16(iii) orientation, training, and competency evaluations of home care staff, and a
378.17process for evaluating staff performance;
378.18(iv) handling complaints from clients, family members, or client representatives
378.19regarding staff or services provided by staff;
378.20(v) conducting initial evaluation of clients' needs and the providers' ability to provide
378.21those services;
378.22(vi) conducting initial and ongoing client evaluations and assessments and how
378.23changes in a client's condition are identified, managed, and communicated to staff and
378.24other health care providers as appropriate;
378.25(vii) orientation to and implementation of the home care client bill of rights;
378.26(viii) infection control practices;
378.27(ix) reminders for medications, treatments, or exercises, if provided; and
378.28(x) conducting appropriate screenings, or documentation of prior screenings, to
378.29show that staff are free of tuberculosis, consistent with current United States Centers for
378.30Disease Control standards; and
378.31(15) other information required by the department.
378.32    Subd. 2. Comprehensive home care license applications. In addition to the
378.33information and fee required in subdivision 1, applicants applying for a comprehensive
378.34home care license must also provide verification that the applicant has the following
378.35policies and procedures in place so that if a license is issued, the applicant will implement
378.36the policies and procedures in this subdivision and keep them current:
379.1(1) conducting initial and ongoing assessments of the client's needs by a registered
379.2nurse or appropriate licensed health professional, including how changes in the client's
379.3conditions are identified, managed, and communicated to staff and other health care
379.4providers, as appropriate;
379.5(2) ensuring that nurses and licensed health professionals have current and valid
379.6licenses to practice;
379.7(3) medication and treatment management;
379.8(4) delegation of home care tasks by registered nurses or licensed health professionals;
379.9(5) supervision of registered nurses and licensed health professionals; and
379.10(6) supervision of unlicensed personnel performing delegated home care tasks.
379.11    Subd. 3. License renewal. (a) Except as provided in section 144A.475, a license
379.12may be renewed for a period of one year if the licensee satisfies the following:
379.13(1) submits an application for renewal in the format provided by the commissioner
379.14at least 30 days before expiration of the license;
379.15(2) submits the renewal fee in the amount specified in subdivision 7;
379.16(3) has provided home care services within the past 12 months;
379.17(4) complies with sections 144A.43 to 144A.4799;
379.18(5) provides information sufficient to show that the applicant meets the requirements
379.19of licensure, including items required under subdivision 1;
379.20(6) provides verification that all policies under subdivision 1, are current; and
379.21(7) provides any other information deemed necessary by the commissioner.
379.22(b) A renewal applicant who holds a comprehensive home care license must also
379.23provide verification that policies listed under subdivision 2 are current.
379.24    Subd. 4. Multiple units. Multiple units or branches of a licensee must be separately
379.25licensed if the commissioner determines that the units cannot adequately share supervision
379.26and administration of services from the main office.
379.27    Subd. 5. Transfers prohibited; changes in ownership. Any home care license
379.28issued by the commissioner may not be transferred to another party. Before acquiring
379.29ownership of a home care provider business, a prospective applicant must apply for a
379.30new temporary license. A change of ownership is a transfer of operational control to
379.31a different business entity, and includes:
379.32(1) transfer of the business to a different or new corporation;
379.33(2) in the case of a partnership, the dissolution or termination of the partnership under
379.34chapter 323A, with the business continuing by a successor partnership or other entity;
379.35(3) relinquishment of control of the provider to another party, including to a contract
379.36management firm that is not under the control of the owner of the business' assets;
380.1(4) transfer of the business by a sole proprietor to another party or entity; or
380.2(5) in the case of a privately held corporation, the change in ownership or control of
380.350 percent or more of the outstanding voting stock.
380.4    Subd. 6. Notification of changes of information. The temporary licensee or
380.5licensee shall notify the commissioner in writing within ten working days after any
380.6change in the information required in subdivision 1, except the information required in
380.7subdivision 1, clause (5), is required at the time of license renewal.
380.8    Subd. 7. Fees; application, change of ownership, and renewal. (a) An initial
380.9applicant seeking a temporary home care licensure must submit the following application
380.10fee to the commissioner along with a completed application:
380.11(1) basic home care provider, $2,100; or
380.12(2) comprehensive home care provider, $4,200.
380.13(b) A home care provider who is filing a change of ownership as required under
380.14subdivision 5 must submit the following application fee to the commissioner, along with
380.15the documentation required for the change of ownership:
380.16(1) basic home care provider, $2,100; or
380.17(2) comprehensive home care provider, $4,200.
380.18(c) A home care provider who is seeking to renew the provider's license shall pay a
380.19fee to the commissioner based on revenues derived from the provision of home care
380.20services during the calendar year prior to the year in which the application is submitted,
380.21according to the following schedule:
380.22License Renewal Fee

380.23	Provider Annual Revenue		Fee
380.24	greater than $1,500,000		$6,625
380.25 380.26	greater than $1,275,000 and no more than $1,500,000		$5,797
380.27 380.28	greater than $1,100,000 and no more than $1,275,000		$4,969
380.29 380.30	greater than $950,000 and no more than $1,100,000		$4,141
380.31 380.32	greater than $850,000 and no more than $950,000		$3,727
380.33 380.34	greater than $750,000 and no more than $850,000		$3,313
380.35 380.36	greater than $650,000 and no more than $750,000		$2,898
380.37 380.38	greater than $550,000 and no more than $650,000		$2,485
380.39 380.40	greater than $450,000 and no more than $550,000		$2,070
381.1 381.2	greater than $350,000 and no more than $450,000		$1,656
381.3 381.4	greater than $250,000 and no more than $350,000		$1,242
381.5 381.6	greater than $100,000 and no more than $250,000		$828
381.7 381.8	greater than $50,000 and no more than $100,000		$500
381.9 381.10	greater than $25,000 and no more than $50,000		$400
381.11	no more than $25,000		$200

381.12(d) If requested, the home care provider shall provide the commissioner information
381.13to verify the provider's annual revenues or other information as needed, including copies
381.14of documents submitted to the Department of Revenue.
381.15(e) At each annual renewal, a home care provider may elect to pay the highest
381.16renewal fee for its license category, and not provide annual revenue information to the
381.17commissioner.
381.18(f) A temporary license or license applicant, or temporary licensee or licensee that
381.19knowingly provides the commissioner incorrect revenue amounts for the purpose of
381.20paying a lower license fee, shall be subject to a civil penalty in the amount of double the
381.21fee the provider should have paid.
381.22(g) Fees and penalties collected under this section shall be deposited in the state
381.23treasury and credited to the special state government revenue fund.

381.24    Sec. 10. [144A.473] ISSUANCE OF TEMPORARY LICENSE AND LICENSE
381.25RENEWAL.
381.26    Subdivision 1. Temporary license and renewal of license. (a) The department
381.27shall review each application to determine the applicant's knowledge of and compliance
381.28with Minnesota home care regulations. Before granting a temporary license or renewing a
381.29license, the commissioner may further evaluate the applicant or licensee by requesting
381.30additional information or documentation or by conducting an on-site survey of the
381.31applicant to determine compliance with sections 144A.43 to 144A.482.
381.32(b) Within 14 calendar days after receiving an application for a license,
381.33the commissioner shall acknowledge receipt of the application in writing. The
381.34acknowledgment must indicate whether the application appears to be complete or whether
381.35additional information is required before the application will be considered complete.
381.36(c) Within 90 days after receiving a complete application, the commissioner shall
381.37issue a temporary license, renew the license, or deny the license.
382.1(d) The commissioner shall issue a license that contains the home care provider's
382.2name, address, license level, expiration date of the license, and unique license number. All
382.3licenses are valid for one year from the date of issuance.
382.4    Subd. 2. Temporary license. (a) For new license applicants, the commissioner
382.5shall issue a temporary license for either the basic or comprehensive home care level. A
382.6temporary license is effective for one year from the date of issuance. Temporary licensees
382.7must comply with sections 144A.43 to 144A.482.
382.8(b) During the temporary license year, the commissioner shall survey the temporary
382.9licensee after the commissioner is notified or has evidence that the temporary licensee
382.10is providing home care services.
382.11(c) Within five days of beginning the provision of services, the temporary
382.12licensee must notify the commissioner that it is serving clients. The notification to the
382.13commissioner may be mailed or e-mailed to the commissioner at the address provided by
382.14the commissioner. If the temporary licensee does not provide home care services during
382.15the temporary license year, then the temporary license expires at the end of the year and
382.16the applicant must reapply for a temporary home care license.
382.17(d) A temporary licensee may request a change in the level of licensure prior to
382.18being surveyed and granted a license by notifying the commissioner in writing and
382.19providing additional documentation or materials required to update or complete the
382.20changed temporary license application. The applicant must pay the difference between the
382.21application fees when changing from the basic to the comprehensive level of licensure.
382.22No refund will be made if the provider chooses to change the license application to the
382.23basic level.
382.24(e) If the temporary licensee notifies the commissioner that the licensee has clients
382.25within 45 days prior to the temporary license expiration, the commissioner may extend the
382.26temporary license for up to 60 days in order to allow the commissioner to complete the
382.27on-site survey required under this section and follow-up survey visits.
382.28    Subd. 3. Temporary licensee survey. (a) If the temporary licensee is in substantial
382.29compliance with the survey, the commissioner shall issue either a basic or comprehensive
382.30home care license. If the temporary licensee is not in substantial compliance with the
382.31survey, the commissioner shall not issue a basic or comprehensive license and there will
382.32be no contested hearing right under chapter 14.
382.33(b) If the temporary licensee whose basic or comprehensive license has been denied
382.34disagrees with the conclusions of the commissioner, then the licensee may request a
382.35reconsideration by the commissioner or commissioner's designee. The reconsideration
383.1request process will be conducted internally by the commissioner or commissioner's
383.2designee, and chapter 14 does not apply.
383.3(c) The temporary licensee requesting reconsideration must make the request in
383.4writing and must list and describe the reasons why the licensee disagrees with the decision
383.5to deny the basic or comprehensive home care license.
383.6(d) A temporary licensee whose license is denied must comply with the requirements
383.7for notification and transfer of clients in section 144A.475, subdivision 5.

383.8    Sec. 11. [144A.474] SURVEYS AND INVESTIGATIONS.
383.9    Subdivision 1. Surveys. The commissioner shall conduct surveys of each home
383.10care provider. By June 30, 2016, the commissioner shall conduct a survey of home care
383.11providers on a frequency of at least once every three years. Survey frequency may be
383.12based on the license level, the provider's compliance history, number of clients served,
383.13or other factors as determined by the department deemed necessary to ensure the health,
383.14safety, and welfare of clients and compliance with the law.
383.15    Subd. 2. Types of home care surveys. (a) "Initial full survey" is the survey
383.16conducted of a new temporary licensee after the department is notified or has evidence that
383.17the licensee is providing home care services to determine if the provider is in compliance
383.18with home care requirements. Initial surveys must be completed within 14 months after
383.19the department's issuance of a temporary basic or comprehensive license.
383.20(b) "Core survey" means periodic inspection of home care providers to determine
383.21ongoing compliance with the home care requirements focusing on the essential health and
383.22safety requirements. Core surveys are available to licensed home care providers who have
383.23been licensed for three years, and been surveyed at least once in the past three years,
383.24with the latest survey having no widespread violation or violations beyond Level 1 as
383.25provided in subdivision 11. Providers must also have not had any substantiated licensing
383.26complaints, substantiated complaints against the agency under the Vulnerable Adults
383.27Act or Maltreatment of Minors Act, or an enforcement action as authorized in section
383.28144A.475 in the past three years. The core survey for Basic license level providers will
383.29review compliance in the following areas:
383.30(1) reporting of maltreatment;
383.31(2) orientation to and implementation of home care client bill of rights;
383.32(3) statement of home care services;
383.33(4) initial evaluation of clients and initiation of services;
383.34(5) basic license level client review and monitoring;
383.35(6) service plan implementation and changes to the service plan;
384.1(7) client complaint and investigative process;
384.2(8) competency of unlicensed personnel; and
384.3(9) infection control.
384.4For comprehensive license level providers, the core survey will include everything
384.5in the basic license level core survey plus these areas:
384.6(1) assessment, monitoring, and reassessments of clients; and
384.7(2) medication, treatment, and therapy management.
384.8(c) "Full survey" means the periodic inspection of home care providers to determine
384.9ongoing compliance with the home care requirements that cover the core survey areas and
384.10all the legal requirements for home care providers. A full survey will be conducted for
384.11all temporary licensees, providers who do not meet the requirements needed for a core
384.12survey, and when a surveyor identifies unacceptable client health or safety risks during a
384.13core survey. A full survey will include all the tasks identified as part of the core survey
384.14and any additional review deemed necessary by the department, including additional
384.15observation, interviewing, or records review of additional clients and staff.
384.16(d) "Follow-up surveys" are conducted to determine if a home care provider has
384.17corrected deficient issues and systems identified during a core survey, full survey, or
384.18complaint investigation. Follow-up surveys may be conducted via phone, e-mail, fax,
384.19mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be
384.20concluded with an exit conference and written information provided on the process for
384.21requesting a reconsideration of the survey results.
384.22(e) Upon receiving information alleging that a home care provider has violated or
384.23is currently violating a requirement of sections 144A.43 to 144A.482, the commissioner
384.24shall investigate the complaint according to sections 144A.51 to 144A.54.
384.25    Subd. 3. Survey process. The survey process for core surveys shall include the
384.26following as applicable to the particular licensee and setting surveyed:
384.27(1) presurvey review of pertinent documents and notification to the ombudsman
384.28for long-term care;
384.29(2) an entrance conference with available staff;
384.30(3) communication with managerial officials or the RN in charge, if available, and
384.31ongoing communication with key staff throughout the survey regarding information
384.32needed by the surveyor, clarifications regarding home care requirements, and applicable
384.33standards of practice;
384.34(4) presentation of written contact information to the provider about the survey staff
384.35conducting the survey, the supervisor, and the process for requesting a reconsideration of
384.36the survey results;
385.1(5) a brief tour of a sampling of the housing with services establishments in which
385.2the provider is providing home care services;
385.3(6) a sample selection of home care clients;
385.4(7) information gathering through client and staff observations, client and staff
385.5interviews, and reviews of records, policies, procedures, practices, and other agency
385.6information;
385.7(8) interviews of client's family members, if available, with client's consent when the
385.8client can legally give consent;
385.9(9) except for complaint surveys conducted by the Office of Health Facilities
385.10Complaints, an exit conference with preliminary findings shared and discussed with the
385.11provider, and written information on the process for requesting a reconsideration of the
385.12survey results; and
385.13(10) postsurvey analysis of findings and formulation of survey results, including
385.14correction orders when applicable.
385.15    Subd. 4. Scheduling surveys. Surveys and investigations shall be conducted
385.16without advance notice to home care providers. Surveyors may contact the home care
385.17provider on the day of a survey to arrange for someone to be available at the survey site.
385.18The contact does not constitute advance notice.
385.19    Subd. 5. Information provided by home care provider. The home care provider
385.20shall provide accurate and truthful information to the department during a survey,
385.21investigation, or other licensing activities.
385.22    Subd. 6. Providing client records. Upon request of a surveyor, home care providers
385.23shall provide a list of current and past clients or client representatives that includes
385.24addresses and telephone numbers and any other information requested about the services
385.25to clients within a reasonable period of time.
385.26    Subd. 7. Contacting and visiting clients. Surveyors may contact or visit a home
385.27care provider's clients to gather information without notice to the home care provider.
385.28Before visiting a client, a surveyor shall obtain the client's or client's representative's
385.29permission by telephone, mail, or in person. Surveyors shall inform all clients or client's
385.30representatives of their right to decline permission for a visit.
385.31    Subd. 8. Correction orders. (a) A correction order may be issued whenever the
385.32commissioner finds upon survey or during a complaint investigation that a home care
385.33provider, managerial official, or an employee of the provider is not in compliance with
385.34sections 144A.43 to 144A.482. The correction order shall cite the specific statute and
385.35document areas of noncompliance and the time allowed for correction.
386.1(b) The commissioner shall mail copies of any correction order to the last known
386.2address of the home care provider. A copy of each correction order and copies of any
386.3documentation supplied to the commissioner shall be kept on file by the home care
386.4provider, and public documents shall be made available for viewing by any person upon
386.5request. Copies may be kept electronically.
386.6(c) By the correction order date, the home care provider must document in the
386.7provider's records any action taken to comply with the correction order. The commissioner
386.8may request a copy of this documentation and the home care provider's action to respond
386.9to the correction order in future surveys, upon a complaint investigation, and as otherwise
386.10needed.
386.11    Subd. 9. Follow-up surveys. For providers that have Level 3 or Level 4 violations
386.12or any violations determined to be widespread, the department shall conduct a follow-up
386.13survey within 90 calendar days of the survey. When conducting a follow-up survey, the
386.14surveyor will focus on whether the previous violations have been corrected and may also
386.15address any new violations that are observed while evaluating the corrections that have
386.16been made. If a new violation is identified on a follow-up survey, no fine will be imposed
386.17unless it is not corrected on the next follow-up survey.
386.18    Subd. 10. Performance incentive. A licensee is eligible for a performance
386.19incentive if there are no violations identified in a core or full survey. The performance
386.20incentive is a ten percent discount on the licensee's next home care renewal license fee.
386.21    Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be
386.22assessed based on the level and scope of the violations described in paragraph (c) as follows:
386.23(1) Level 1, no fines or enforcement;
386.24(2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement
386.25mechanisms authorized in section 144A.475 for widespread violations;
386.26(3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement
386.27mechanisms authorized in section 144A.475; and
386.28(4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the
386.29enforcement mechanisms authorized in section 144A.475.
386.30(b) Correction orders for violations will be categorized by both level and scope as
386.31follows, and fines will be assessed accordingly:
386.32(1) level of violation:
386.33(i) Level 1, a violation that has no potential to cause more than a minimal impact on
386.34the client and does not affect health or safety;
387.1(ii) Level 2, a violation that did not harm the client's health or safety, but had the
387.2potential to have harmed a client's health or safety, but not likely to cause serious injury,
387.3impairment, or death;
387.4(iii) Level 3, a violation that harmed a client's health or safety, not including serious
387.5injury, impairment, or death, or a violation that has the potential to lead to serious injury,
387.6impairment, or death; and
387.7(iv) Level 4, a violation that results in serious injury, impairment or death.
387.8 (2) scope of violation:
387.9(i) isolated, when one or a limited number of clients are affected, or one or a limited
387.10number of staff are involved, or the situation has occurred only occasionally;
387.11(ii) pattern, when more than a limited number of clients are affected, more than a
387.12limited number of staff are involved, or the situation has had repeated occurrences but
387.13is not found to be pervasive; or
387.14(iii) widespread; when problems are pervasive or represent a systemic failure that
387.15has affected or has the potential to affect a large portion or all of the clients.
387.16(c) If the commissioner finds that the applicant or a home care provider required
387.17to be licensed under sections 144A.43 to 144A.482 has not corrected violations by the
387.18date specified in the correction order or conditional license resulting from a survey or
387.19complaint investigation, the commissioner may impose a fine. A notice of noncompliance
387.20with a correction order must be mailed to the applicant's or provider's last known address.
387.21The noncompliance notice must list the violations not corrected.
387.22(d) Fines under this subdivision may be assessed according to paragraph (b), or
387.23the commissioner may assess a fine other than those identified in paragraph (b), from
387.24$500 to $2,000 per violation when the provider has failed to correct an order relating to
387.25violation of state licensing laws.
387.26(e) The license holder must pay the fines assessed on or before the payment date
387.27specified. If the license holder fails to fully comply with the order, the commissioner
387.28may issue a second fine or suspend the license until the license holder complies by
387.29paying the fine. A timely appeal shall stay payment of the fine until the commissioner
387.30issues a final order.
387.31(f) A license holder shall promptly notify the commissioner in writing when a
387.32violation specified in the order is corrected. If upon reinspection, the commissioner
387.33determines that a violation has not been corrected as indicated by the order, the
387.34commissioner may issue a second fine. The commissioner shall notify the license holder by
387.35mail to the last known address in the licensing record that a second fine has been assessed.
387.36The license holder may appeal the second fine as provided under this subdivision.
388.1(g) A home care provider that has been assessed a fine under this subdivision has a
388.2right to a reconsideration or a hearing under this section and chapter 14.
388.3(h) When a fine has been assessed, the license holder may not avoid payment by
388.4closing, selling, or otherwise transferring the licensed program to a third party. In such an
388.5event, the license holder shall be liable for payment of the fine.
388.6(i) In addition to any fine imposed under this section, the commissioner may assess
388.7costs related to an investigation that results in a final order assessing a fine or other
388.8enforcement action authorized by this chapter.
388.9(j) Fines collected under this subdivision shall be deposited in the state government
388.10special revenue fund and credited to an account separate from the revenue collected under
388.11section 144A.472. Subject to an appropriation by the legislature, the revenue from the
388.12fines collected may be used by the commissioner for special projects to improve home care
388.13in Minnesota as recommended by the advisory council established in section 144A.4799.
388.14    Subd. 12. Reconsideration. (a) The commissioner shall make available to home
388.15care providers a correction order reconsideration process. This process may be used
388.16to challenge the correction order issued, including the level and scope described in
388.17subdivision 11, and any fine assessed. During the correction order reconsideration
388.18request, the issuance of the correction orders under reconsideration are not stayed, but
388.19the department will post information on the Web site with the correction order that the
388.20licensee has requested a reconsideration review and that the review is pending.
388.21(b) A licensed home care provider may request from the commissioner, in writing,
388.22a correction order reconsideration regarding any correction order issued to the provider.
388.23The correction order reconsideration shall not be reviewed by any surveyor, investigator,
388.24or supervisor that participated in the writing or reviewing of the correction order being
388.25disputed. The correction order reconsiderations may be conducted in person by telephone,
388.26by another electronic form, or in writing, as determined by the commissioner. The
388.27commissioner shall respond in writing to the request from a home care provider for
388.28a correction order reconsideration within 60 days of the date the provider requests a
388.29reconsideration. The commissioner's response shall identify the commissioner's decision
388.30regarding each citation challenged by the home care provider
388.31The findings of a correction order reconsideration process shall be one or more of
388.32the following:
388.33(1) supported in full: the correction order is supported in full, with no deletion of
388.34findings to the citation;
388.35(2) supported in substance: the correction order is supported, but one or more
388.36findings are deleted or modified without any change in the citation;
389.1 (3) correction order cited an incorrect home care licensing requirement: the correction
389.2order is amended by changing the correction order to the appropriate statutory reference;
389.3(4) correction order was issued under an incorrect citation: the correction order is
389.4amended to be issued under the more appropriate correction order citation;
389.5(5) the correction order is rescinded;
389.6(6) fine is amended: it is determined the fine assigned to the correction order was
389.7applied incorrectly; and
389.8(7) the level or scope of the citation is modified based on the reconsideration.
389.9(c) If the correction order findings are changed by the commissioner, the
389.10commissioner shall update the correction order Web site accordingly.
389.11    Subd. 13. Home care surveyor training. Before conducting a home care survey,
389.12each home care surveyor must receive training on the following topics:
389.13(1) Minnesota home care licensure requirements;
389.14(2) Minnesota home care client bill of rights;
389.15(3) Minnesota Vulnerable Adults Act and Reporting of Maltreatment of Minors;
389.16(4) principles of documentation;
389.17(5) survey protocol and processes;
389.18(6) Offices of the Ombudsman roles;
389.19(7) Office of Health Facility Complaints;
389.20(8) Minnesota landlord and tenant, and housing with services laws;
389.21(9) types of payors for home care services; and
389.22(10) Minnesota Nurse Practice Act for nurse surveyors.
389.23Materials used for this training will be posted on the Minnesota Department of
389.24Health Web site. Requisite understanding of these topics will be reviewed as part of the
389.25quality improvement plan in section 26.

389.26    Sec. 12. [144A.475] ENFORCEMENT.
389.27    Subdivision 1. Conditions. (a) The commissioner may refuse to grant a temporary
389.28license, renew a license, suspend or revoke a license, or impose a conditional license if the
389.29home care provider or owner or managerial official of the home care provider:
389.30(1) is in violation of, or during the term of the license has violated, any of the
389.31requirements in sections 144A.471 to 144A.482;
389.32(2) permits, aids, or abets the commission of any illegal act in the provision of
389.33home care;
389.34(3) performs any act detrimental to the health, safety, and welfare of a client;
389.35(4) obtains the license by fraud or misrepresentation;
390.1(5) knowingly made or makes a false statement of a material fact in the application
390.2for a license or in any other record or report required by this chapter;
390.3(6) denies representatives of the department access to any part of the home care
390.4provider's books, records, files, or employees;
390.5(7) interferes with or impedes a representative of the department in contacting the
390.6home care provider's clients;
390.7(8) interferes with or impedes a representative of the department in the enforcement
390.8of this chapter or has failed to fully cooperate with an inspection, survey, or investigation
390.9by the department;
390.10(9) destroys or makes unavailable any records or other evidence relating to the home
390.11care provider's compliance with this chapter;
390.12(10) refuses to initiate a background study under section 144.057 or 245A.04;
390.13(11) fails to timely pay any fines assessed by the department;
390.14(12) violates any local, city, or township ordinance relating to home care services;
390.15(13) has repeated incidents of personnel performing services beyond their
390.16competency level; or
390.17(14) has operated beyond the scope of the home care provider's license level.
390.18    (b) A violation by a contractor providing the home care services of the home care
390.19provider is a violation by the home care provider.
390.20    Subd. 2. Terms to suspension or conditional license. A suspension or conditional
390.21license designation may include terms that must be completed or met before a suspension
390.22or conditional license designation is lifted. A conditional license designation may include
390.23restrictions or conditions that are imposed on the provider. Terms for a suspension or
390.24conditional license may include one or more of the following and the scope of each will be
390.25determined by the commissioner:
390.26(1) requiring a consultant to review, evaluate, and make recommended changes to
390.27the home care provider's practices and submit reports to the commissioner at the cost of
390.28the home care provider;
390.29(2) requiring supervision of the home care provider or staff practices at the cost
390.30of the home care provider by an unrelated person who has sufficient knowledge and
390.31qualifications to oversee the practices and who will submit reports to the commissioner;
390.32(3) requiring the home care provider or employees to obtain training at the cost of
390.33the home care provider;
390.34(4) requiring the home care provider to submit reports to the commissioner;
390.35(5) prohibiting the home care provider from taking any new clients for a period
390.36of time; or
391.1(6) any other action reasonably required to accomplish the purpose of this
391.2subdivision and section 144A.45, subdivision 2.
391.3    Subd. 3. Notice. Prior to any suspension, revocation, or refusal to renew a license,
391.4the home care provider shall be entitled to notice and a hearing as provided by sections
391.514.57 to 14.69. In addition to any other remedy provided by law, the commissioner may,
391.6without a prior contested case hearing, temporarily suspend a license or prohibit delivery
391.7of services by a provider for not more than 90 days if the commissioner determines that
391.8the health or safety of a consumer is in imminent danger, provided:
391.9(1) advance notice is given to the home care provider;
391.10(2) after notice, the home care provider fails to correct the problem;
391.11(3) the commissioner has reason to believe that other administrative remedies are not
391.12likely to be effective; and
391.13(4) there is an opportunity for a contested case hearing within the 90 days.
391.14    Subd. 4. Time limits for appeals. To appeal the assessment of civil penalties
391.15under section 144A.45, subdivision 2, clause (5), and an action against a license under
391.16this section, a provider must request a hearing no later than 15 days after the provider
391.17receives notice of the action.
391.18    Subd. 5. Plan required. (a) The process of suspending or revoking a license
391.19must include a plan for transferring affected clients to other providers by the home care
391.20provider, which will be monitored by the commissioner. Within three business days of
391.21being notified of the final revocation or suspension action, the home care provider shall
391.22provide the commissioner, the lead agencies as defined in section 256B.0911, and the
391.23ombudsman for long-term care with the following information:
391.24(1) a list of all clients, including full names and all contact information on file;
391.25(2) a list of each client's representative or emergency contact person, including full
391.26names and all contact information on file;
391.27(3) the location or current residence of each client;
391.28(4) the payor sources for each client, including payor source identification numbers;
391.29and
391.30(5) for each client, a copy of the client's service plan, and a list of the types of
391.31services being provided.
391.32(b) The revocation or suspension notification requirement is satisfied by mailing the
391.33notice to the address in the license record. The home care provider shall cooperate with
391.34the commissioner and the lead agencies during the process of transferring care of clients to
391.35qualified providers. Within three business days of being notified of the final revocation or
391.36suspension action, the home care provider must notify and disclose to each of the home
392.1care provider's clients, or the client's representative or emergency contact persons, that
392.2the commissioner is taking action against the home care provider's license by providing a
392.3copy of the revocation or suspension notice issued by the commissioner.
392.4    Subd. 6. Owners and managerial officials; refusal to grant license. (a) The
392.5owner and managerial officials of a home care provider whose Minnesota license has not
392.6been renewed or that has been revoked because of noncompliance with applicable laws or
392.7rules shall not be eligible to apply for nor will be granted a home care license, including
392.8other licenses under this chapter, or be given status as an enrolled personal care assistance
392.9provider agency or personal care assistant by the Department of Human Services under
392.10section 256B.0659 for five years following the effective date of the nonrenewal or
392.11revocation. If the owner and managerial officials already have enrollment status, their
392.12enrollment will be terminated by the Department of Human Services.
392.13(b) The commissioner shall not issue a license to a home care provider for five
392.14years following the effective date of license nonrenewal or revocation if the owner or
392.15managerial official, including any individual who was an owner or managerial official
392.16of another home care provider, had a Minnesota license that was not renewed or was
392.17revoked as described in paragraph (a).
392.18(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall
392.19suspend or revoke, the license of any home care provider that includes any individual
392.20as an owner or managerial official who was an owner or managerial official of a home
392.21care provider whose Minnesota license was not renewed or was revoked as described in
392.22paragraph (a) for five years following the effective date of the nonrenewal or revocation.
392.23(d) The commissioner shall notify the home care provider 30 days in advance of
392.24the date of nonrenewal, suspension, or revocation of the license. Within ten days after
392.25the receipt of the notification, the home care provider may request, in writing, that the
392.26commissioner stay the nonrenewal, revocation, or suspension of the license. The home
392.27care provider shall specify the reasons for requesting the stay; the steps that will be taken
392.28to attain or maintain compliance with the licensure laws and regulations; any limits on the
392.29authority or responsibility of the owners or managerial officials whose actions resulted in
392.30the notice of nonrenewal, revocation, or suspension; and any other information to establish
392.31that the continuing affiliation with these individuals will not jeopardize client health, safety,
392.32or well-being. The commissioner shall determine whether the stay will be granted within
392.3330 days of receiving the provider's request. The commissioner may propose additional
392.34restrictions or limitations on the provider's license and require that the granting of the stay
392.35be contingent upon compliance with those provisions. The commissioner shall take into
392.36consideration the following factors when determining whether the stay should be granted:
393.1(1) the threat that continued involvement of the owners and managerial officials with
393.2the home care provider poses to client health, safety, and well-being;
393.3(2) the compliance history of the home care provider; and
393.4(3) the appropriateness of any limits suggested by the home care provider.
393.5    If the commissioner grants the stay, the order shall include any restrictions or
393.6limitation on the provider's license. The failure of the provider to comply with any
393.7restrictions or limitations shall result in the immediate removal of the stay and the
393.8commissioner shall take immediate action to suspend, revoke, or not renew the license.
393.9    Subd. 7. Request for hearing. A request for a hearing must be in writing and must:
393.10(1) be mailed or delivered to the department or the commissioner's designee;
393.11(2) contain a brief and plain statement describing every matter or issue contested; and
393.12(3) contain a brief and plain statement of any new matter that the applicant or home
393.13care provider believes constitutes a defense or mitigating factor.
393.14    Subd. 8. Informal conference. At any time, the applicant or home care provider
393.15and the commissioner may hold an informal conference to exchange information, clarify
393.16issues, or resolve issues.
393.17    Subd. 9. Injunctive relief. In addition to any other remedy provided by law, the
393.18commissioner may bring an action in district court to enjoin a person who is involved in
393.19the management, operation, or control of a home care provider or an employee of the
393.20home care provider from illegally engaging in activities regulated by sections 144A.43 to
393.21144A.482. The commissioner may bring an action under this subdivision in the district
393.22court in Ramsey County or in the district in which a home care provider is providing
393.23services. The court may grant a temporary restraining order in the proceeding if continued
393.24activity by the person who is involved in the management, operation, or control of a home
393.25care provider, or by an employee of the home care provider, would create an imminent
393.26risk of harm to a recipient of home care services.
393.27    Subd. 10. Subpoena. In matters pending before the commissioner under sections
393.28144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance
393.29of witnesses and the production of all necessary papers, books, records, documents, and
393.30other evidentiary material. If a person fails or refuses to comply with a subpoena or
393.31order of the commissioner to appear or testify regarding any matter about which the
393.32person may be lawfully questioned or to produce any papers, books, records, documents,
393.33or evidentiary materials in the matter to be heard, the commissioner may apply to the
393.34district court in any district, and the court shall order the person to comply with the
393.35commissioner's order or subpoena. The commissioner of health may administer oaths to
393.36witnesses or take their affirmation. Depositions may be taken in or outside the state in the
394.1manner provided by law for the taking of depositions in civil actions. A subpoena or other
394.2process or paper may be served on a named person anywhere in the state by an officer
394.3authorized to serve subpoenas in civil actions, with the same fees and mileage and in the
394.4same manner as prescribed by law for a process issued out of a district court. A person
394.5subpoenaed under this subdivision shall receive the same fees, mileage, and other costs
394.6that are paid in proceedings in district court.

394.7    Sec. 13. [144A.476] BACKGROUND STUDIES.
394.8    Subdivision 1. Prior criminal convictions; owner and managerial officials. (a)
394.9Before the commissioner issues a temporary license or renews a license, an owner or
394.10managerial official is required to complete a background study under section 144.057. No
394.11person may be involved in the management, operation, or control of a home care provider
394.12if the person has been disqualified under chapter 245C. If an individual is disqualified
394.13under section 144.057 or chapter 245C, the individual may request reconsideration of
394.14the disqualification. If the individual requests reconsideration and the commissioner
394.15sets aside or rescinds the disqualification, the individual is eligible to be involved in the
394.16management, operation, or control of the provider. If an individual has a disqualification
394.17under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's
394.18disqualification is barred from a set aside, and the individual must not be involved in the
394.19management, operation, or control of the provider.
394.20(b) For purposes of this section, owners of a home care provider subject to the
394.21background check requirement are those individuals whose ownership interest provides
394.22sufficient authority or control to affect or change decisions related to the operation of the
394.23home care provider. An owner includes a sole proprietor, a general partner, or any other
394.24individual whose individual ownership interest can affect the management and direction
394.25of the policies of the home care provider.
394.26(c) For the purposes of this section, managerial officials subject to the background
394.27check requirement are individuals who provide direct contact as defined in section 245C.02,
394.28subdivision 11, or individuals who have the responsibility for the ongoing management or
394.29direction of the policies, services, or employees of the home care provider. Data collected
394.30under this subdivision shall be classified as private data under section 13.02, subdivision 12.
394.31(d) The department shall not issue any license if the applicant or owner or managerial
394.32official has been unsuccessful in having a background study disqualification set aside
394.33under section 144.057 and chapter 245C; if the owner or managerial official, as an owner
394.34or managerial official of another home care provider, was substantially responsible for
394.35the other home care provider's failure to substantially comply with sections 144A.43 to
395.1144A.482; or if an owner that has ceased doing business, either individually or as an
395.2owner of a home care provider, was issued a correction order for failing to assist clients in
395.3violation of this chapter.
395.4    Subd. 2. Employees, contractors, and volunteers. (a) Employees, contractors,
395.5and volunteers of a home care provider are subject to the background study required by
395.6section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall
395.7be construed to prohibit a home care provider from requiring self-disclosure of criminal
395.8conviction information.
395.9(b) Termination of an employee in good faith reliance on information or records
395.10obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not
395.11subject the home care provider to civil liability or liability for unemployment benefits.

395.12    Sec. 14. [144A.477] COMPLIANCE.
395.13    Subdivision 1. Medicare-certified providers; coordination of surveys. If feasible,
395.14the commissioner shall survey licensees to determine compliance with this chapter at the
395.15same time as surveys for certification for Medicare if Medicare certification is based on
395.16compliance with the federal conditions of participation and on survey and enforcement
395.17by the Department of Health as agent for the United States Department of Health and
395.18Human Services.
395.19    Subd. 2. Medicare-certified providers; equivalent requirements. For home care
395.20providers licensed to provide comprehensive home care services that are also certified for
395.21participation in Medicare as a home health agency under Code of Federal Regulations,
395.22title 42, part 484, the following state licensure regulations are considered equivalent to
395.23the federal requirements:
395.24(1) quality management, section 144A.479, subdivision 3;
395.25(2) personnel records, section 144A.479, subdivision 7;
395.26(3) acceptance of clients, section 144A.4791, subdivision 4;
395.27(4) referrals, section 144A.4791, subdivision 5;
395.28(5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792,
395.29subdivisions 2 and 3;
395.30(6) individualized monitoring and reassessment, sections 144A.4791, subdivision
395.318, and 144A.4792, subdivisions 2 and 3;
395.32(7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792,
395.33subdivision 5, and 144A.4793, subdivision 3;
395.34(8) client complaint and investigation process, section 144A.4791, subdivision 11;
395.35(9) prescription orders, section 144A.4792, subdivisions 13 to 16;
396.1(10) client records, section 144A.4794, subdivisions 1 to 3;
396.2(11) qualifications for unlicensed personnel performing delegated tasks, section
396.3144A.4795;
396.4(12) training and competency staff, section 144A.4795;
396.5(13) training and competency for unlicensed personnel, section 144A.4795,
396.6subdivision 7;
396.7(14) delegation of home care services, section 144A.4795, subdivision 4;
396.8(15) availability of contact person, section 144A.4797, subdivision 1; and
396.9(16) supervision of staff, section 144A.4797, subdivisions 2 and 3.
396.10Violations of requirements in clauses (1) to (16) may lead to enforcement actions
396.11under section 144A.474.

396.12    Sec. 15. [144A.478] INNOVATION VARIANCE.
396.13    Subdivision 1. Definition. For purposes of this section, "innovation variance"
396.14means a specified alternative to a requirement of this chapter. An innovation variance
396.15may be granted to allow a home care provider to offer home care services of a type or
396.16in a manner that is innovative, will not impair the services provided, will not adversely
396.17affect the health, safety, or welfare of the clients, and is likely to improve the services
396.18provided. The innovative variance cannot change any of the client's rights under section
396.19144A.44, home care bill of rights.
396.20    Subd. 2. Conditions. The commissioner may impose conditions on the granting of
396.21an innovation variance that the commissioner considers necessary.
396.22    Subd. 3. Duration and renewal. The commissioner may limit the duration of any
396.23innovation variance and may renew a limited innovation variance.
396.24    Subd. 4. Applications; innovation variance. An application for innovation
396.25variance from the requirements of this chapter may be made at any time, must be made in
396.26writing to the commissioner, and must specify the following:
396.27(1) the statute or law from which the innovation variance is requested;
396.28(2) the time period for which the innovation variance is requested;
396.29(3) the specific alternative action that the licensee proposes;
396.30(4) the reasons for the request; and
396.31(5) justification that an innovation variance will not impair the services provided,
396.32will not adversely affect the health, safety, or welfare of clients, and is likely to improve
396.33the services provided.
396.34The commissioner may require additional information from the home care provider before
396.35acting on the request.
397.1    Subd. 5. Grants and denials. The commissioner shall grant or deny each request
397.2for an innovation variance in writing within 45 days of receipt of a complete request.
397.3Notice of a denial shall contain the reasons for the denial. The terms of a requested
397.4innovation variance may be modified upon agreement between the commissioner and
397.5the home care provider.
397.6    Subd. 6. Violation of innovation variances. A failure to comply with the terms of
397.7an innovation variance shall be deemed to be a violation of this chapter.
397.8    Subd. 7. Revocation or denial of renewal. The commissioner shall revoke or
397.9deny renewal of an innovation variance if:
397.10(1) it is determined that the innovation variance is adversely affecting the health,
397.11safety, or welfare of the licensee's clients;
397.12(2) the home care provider has failed to comply with the terms of the innovation
397.13variance;
397.14(3) the home care provider notifies the commissioner in writing that it wishes to
397.15relinquish the innovation variance and be subject to the statute previously varied; or
397.16(4) the revocation or denial is required by a change in law.

397.17    Sec. 16. [144A.479] HOME CARE PROVIDER RESPONSIBILITIES;
397.18BUSINESS OPERATION.
397.19    Subdivision 1. Display of license. The original current license must be displayed
397.20in the home care providers' principal business office and copies must be displayed in
397.21any branch office. The home care provider must provide a copy of the license to any
397.22person who requests it.
397.23    Subd. 2. Advertising. Home care providers shall not use false, fraudulent,
397.24or misleading advertising in the marketing of services. For purposes of this section,
397.25advertising includes any verbal, written, or electronic means of communicating to
397.26potential clients about the availability, nature, or terms of home care services.
397.27    Subd. 3. Quality management. The home care provider shall engage in quality
397.28management appropriate to the size of the home care provider and relevant to the type
397.29of services the home care provider provides. The quality management activity means
397.30evaluating the quality of care by periodically reviewing client services, complaints made,
397.31and other issues that have occurred and determining whether changes in services, staffing,
397.32or other procedures need to be made in order to ensure safe and competent services to
397.33clients. Documentation about quality management activity must be available for two
397.34years. Information about quality management must be available to the commissioner at
397.35the time of the survey, investigation, or renewal.
398.1    Subd. 4. Provider restrictions. (a) This subdivision does not apply to licensees
398.2that are Minnesota counties or other units of government.
398.3(b) A home care provider or staff cannot accept powers-of-attorney from clients for
398.4any purpose, and may not accept appointments as guardians or conservators of clients.
398.5(c) A home care provider cannot serve as a client's representative.
398.6    Subd. 5. Handling of client's finances and property. (a) A home care provider
398.7may assist clients with household budgeting, including paying bills and purchasing
398.8household goods, but may not otherwise manage a client's property. A home care provider
398.9must provide a client with receipts for all transactions and purchases paid with the clients'
398.10funds. When receipts are not available, the transaction or purchase must be documented.
398.11A home care provider must maintain records of all such transactions.
398.12(b) A home care provider or staff may not borrow a client's funds or personal or
398.13real property, nor in any way convert a client's property to the home care provider's or
398.14staff's possession.
398.15(c) Nothing in this section precludes a home care provider or staff from accepting
398.16gifts of minimal value, or precludes the acceptance of donations or bequests made to a
398.17home care provider that are exempt from income tax under section 501(c) of the Internal
398.18Revenue Code of 1986.
398.19    Subd. 6. Reporting maltreatment of vulnerable adults and minors. (a) All
398.20home care providers must comply with requirements for the reporting of maltreatment
398.21of minors in section 626.556 and the requirements for the reporting of maltreatment
398.22of vulnerable adults in section 626.557. Home care providers must report suspected
398.23maltreatment of minors and vulnerable adults to the common entry point. Each home
398.24care provider must establish and implement a written procedure to ensure that all cases
398.25of suspected maltreatment are reported.
398.26(b) Each home care provider must develop and implement an individual abuse
398.27prevention plan for each vulnerable minor or adult for whom home care services are
398.28provided by a home care provider. The plan shall contain an individualized review or
398.29assessment of the person's susceptibility to abuse by another individual, including other
398.30vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors;
398.31and statements of the specific measures to be taken to minimize the risk of abuse to that
398.32person and other vulnerable adults or minors. For purposes of the abuse prevention plan,
398.33the term abuse includes self-abuse.
398.34    Subd. 7. Employee records. The home care provider must maintain current records
398.35of each paid employee, regularly scheduled volunteers providing home care services, and
399.1of each individual contractor providing home care services. The records must include
399.2the following information:
399.3(1) evidence of current professional licensure, registration, or certification, if
399.4licensure, registration, or certification is required by this statute, or other rules;
399.5(2) records of orientation, required annual training and infection control training,
399.6and competency evaluations;
399.7(3) current job description, including qualifications, responsibilities, and
399.8identification of staff providing supervision;
399.9(4) documentation of annual performance reviews which identify areas of
399.10improvement needed and training needs;
399.11(5) for individuals providing home care services, verification that required health
399.12screenings under section 144A.4798 have taken place and the dates of those screenings; and
399.13(6) documentation of the background study as required under section 144.057.
399.14Each employee record must be retained for at least three years after a paid employee,
399.15home care volunteer, or contractor ceases to be employed by or under contract with the
399.16home care provider. If a home care provider ceases operation, employee records must be
399.17maintained for three years.

399.18    Sec. 17. [144A.4791] HOME CARE PROVIDER RESPONSIBILITIES WITH
399.19RESPECT TO CLIENTS.
399.20    Subdivision 1. Home care bill of rights; notification to client. (a) The home
399.21care provider shall provide the client or the client's representative a written notice of the
399.22rights under section 144A.44 in a language that the client or the client's representative
399.23can understand before the initiation of services to that client. If a written version is not
399.24available, the home care bill of rights must be communicated to the client or client's
399.25representative in a language they can understand.
399.26(b) In addition to the text of the home care bill of rights in section 144A.44,
399.27subdivision 1, the notice shall also contain the following statement describing how to file
399.28a complaint with these offices.
399.29"If you have a complaint about the provider or the person providing your
399.30home care services, you may call, write, or visit the Office of Health Facility
399.31Complaints, Minnesota Department of Health. You may also contact the Office of
399.32Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health
399.33and Developmental Disabilities."
399.34The statement should include the telephone number, Web site address, e-mail
399.35address, mailing address, and street address of the Office of Health Facility Complaints at
400.1the Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care,
400.2and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The
400.3statement should also include the home care provider's name, address, e-mail, telephone
400.4number, and name or title of the person at the provider to whom problems or complaints
400.5may be directed. It must also include a statement that the home care provider will not
400.6retaliate because of a complaint.
400.7(c) The home care provider shall obtain written acknowledgment of the client's
400.8receipt of the home care bill of rights or shall document why an acknowledgment cannot
400.9be obtained. The acknowledgment may be obtained from the client or the client's
400.10representative. Acknowledgment of receipt shall be retained in the client's record.
400.11    Subd. 2. Notice of services for dementia, Alzheimer's disease, or related
400.12disorders. The home care provider that provides services to clients with dementia shall
400.13provide in written or electronic form, to clients and families or other persons who request
400.14it, a description of the training program and related training it provides, including the
400.15categories of employees trained, the frequency of training, and the basic topics covered.
400.16This information satisfies the disclosure requirements in section 325F.72, subdivision
400.172, clause (4).
400.18    Subd. 3. Statement of home care services. Prior to the initiation of services,
400.19a home care provider must provide to the client or the client's representative a written
400.20statement which identifies if they have a basic or comprehensive home care license, the
400.21services they are authorized to provide, and which services they cannot provide under the
400.22scope of their license. The home care provider shall obtain written acknowledgment
400.23from the clients that they have provided the statement or must document why they could
400.24not obtain the acknowledgment.
400.25    Subd. 4. Acceptance of clients. No home care provider may accept a person as a
400.26client unless the home care provider has staff, sufficient in qualifications, competency,
400.27and numbers, to adequately provide the services agreed to in the service plan and that
400.28are within the provider's scope of practice.
400.29    Subd. 5. Referrals. If a home care provider reasonably believes that a client is in
400.30need of another medical or health service, including a licensed health professional, or
400.31social service provider, the home care provider shall:
400.32(1) determine the client's preferences with respect to obtaining the service; and
400.33(2) inform the client of resources available, if known, to assist the client in obtaining
400.34services.
400.35    Subd. 6. Initiation of services. When a provider initiates services and the
400.36individualized review or assessment required in subdivisions 7 and 8 has not been
401.1completed, the provider must complete a temporary plan and agreement with the client for
401.2services.
401.3    Subd. 7. Basic individualized client review and monitoring. (a) When services
401.4being provided are basic home care services, an individualized initial review of the client's
401.5needs and preferences must be conducted at the client's residence with the client or client's
401.6representative. This initial review must be completed within 30 days after the initiation of
401.7the home care services.
401.8(b) Client monitoring and review must be conducted as needed based on changes
401.9in the needs of the client and cannot exceed 90 days from the date of the last review.
401.10The monitoring and review may be conducted at the client's residence or through the
401.11utilization of telecommunication methods based on practice standards that meet the
401.12individual client's needs.
401.13    Subd. 8. Comprehensive assessment, monitoring, and reassessment. (a) When
401.14the services being provided are comprehensive home care services, an individualized
401.15initial assessment must be conducted in-person by a registered nurse. When the services
401.16are provided by other licensed health professionals, the assessment must be conducted by
401.17the appropriate health professional. This initial assessment must be completed within five
401.18days after initiation of home care services.
401.19(b) Client monitoring and reassessment must be conducted in the client's home no
401.20more than 14 days after initiation of services.
401.21(c) Ongoing client monitoring and reassessment must be conducted as needed based
401.22on changes in the needs of the client and cannot exceed 90 days from the last date of the
401.23assessment. The monitoring and reassessment may be conducted at the client's residence
401.24or through the utilization of telecommunication methods based on practice standards that
401.25meet the individual client's needs.
401.26    Subd. 9. Service plan, implementation, and revisions to service plan. (a) No later
401.27than 14 days after the initiation of services, a home care provider shall finalize a current
401.28written service plan.
401.29(b) The service plan and any revisions must include a signature or other
401.30authentication by the home care provider and by the client or the client's representative
401.31documenting agreement on the services to be provided. The service plan must be revised,
401.32if needed, based on client review or reassessment under subdivisions 7 and 8. The provider
401.33must provide information to the client about changes to the provider's fee for services and
401.34how to contact the Office of the Ombudsman for Long-Term Care.
401.35(c) The home care provider must implement and provide all services required by
401.36the current service plan.
402.1(d) The service plan and revised service plan must be entered into the client's record,
402.2including notice of a change in a client's fees when applicable.
402.3(e) Staff providing home care services must be informed of the current written
402.4service plan.
402.5(f) The service plan must include:
402.6(1) a description of the home care services to be provided, the fees for services, and
402.7the frequency of each service, according to the client's current review or assessment and
402.8client preferences;
402.9(2) the identification of the staff or categories of staff who will provide the services;
402.10(3) the schedule and methods of monitoring reviews or assessments of the client;
402.11(4) the frequency of sessions of supervision of staff and type of personnel who
402.12will supervise staff; and
402.13(5) a contingency plan that includes:
402.14(i) the action to be taken by the home care provider and by the client or client's
402.15representative if the scheduled service cannot be provided;
402.16(ii) information and method for a client or client's representative to contact the
402.17home care provider;
402.18(iii) names and contact information of persons the client wishes to have notified
402.19in an emergency or if there is a significant adverse change in the client's condition,
402.20including identification of and information as to who has authority to sign for the client in
402.21an emergency; and
402.22(iv) the circumstances in which emergency medical services are not to be summoned
402.23consistent with chapters 145B and 145C, and declarations made by the client under those
402.24chapters.
402.25    Subd. 10. Termination of service plan. (a) If a home care provider terminates a
402.26service plan with a client, and the client continues to need home care services, the home
402.27care provider shall provide the client and the client's representative, if any, with a written
402.28notice of termination which includes the following information:
402.29(1) the effective date of termination;
402.30(2) the reason for termination;
402.31(3) a list of known licensed home care providers in the client's immediate geographic
402.32area;
402.33(4) a statement that the home care provider will participate in a coordinated transfer
402.34of care of the client to another home care provider, health care provider, or caregiver, as
402.35required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);
403.1(5) the name and contact information of a person employed by the home care
403.2provider with whom the client may discuss the notice of termination; and
403.3(6) if applicable, a statement that the notice of termination of home care services
403.4does not constitute notice of termination of the housing with services contract with a
403.5housing with services establishment.
403.6(b) When the home care provider voluntarily discontinues services to all clients, the
403.7home care provider must notify the commissioner, lead agencies, and the ombudsman for
403.8long-term care about its clients and comply with the requirements in this subdivision.
403.9    Subd. 11. Client complaint and investigative process. (a) The home care
403.10provider must have a written policy and system for receiving, investigating, reporting,
403.11and attempting to resolve complaints from its clients or clients' representatives. The
403.12policy should clearly identify the process by which clients may file a complaint or concern
403.13about home care services and an explicit statement that the home care provider will not
403.14discriminate or retaliate against a client for expressing concerns or complaints. A home
403.15care provider must have a process in place to conduct investigations of complaints made
403.16by the client or the client's representative about the services in the client's plan that are or
403.17are not being provided or other items covered in the client's home care bill of rights. This
403.18complaint system must provide reasonable accommodations for any special needs of the
403.19client or client's representative if requested.
403.20(b) The home care provider must document the complaint, name of the client,
403.21investigation, and resolution of each complaint filed. The home care provider must
403.22maintain a record of all activities regarding complaints received, including the date the
403.23complaint was received, and the home care provider's investigation and resolution of the
403.24complaint. This complaint record must be kept for each event for at least two years after
403.25the date of entry and must be available to the commissioner for review.
403.26(c) The required complaint system must provide for written notice to each client or
403.27client's representative that includes:
403.28(1) the client's right to complain to the home care provider about the services received;
403.29(2) the name or title of the person or persons with the home care provider to contact
403.30with complaints;
403.31(3) the method of submitting a complaint to the home care provider; and
403.32(4) a statement that the provider is prohibited against retaliation according to
403.33paragraph (d).
403.34(d) A home care provider must not take any action that negatively affects a client
403.35in retaliation for a complaint made or a concern expressed by the client or the client's
403.36representative.
404.1    Subd. 12. Disaster planning and emergency preparedness plan. The home care
404.2provider must have a written plan of action to facilitate the management of the client's care
404.3and services in response to a natural disaster, such as flood and storms, or other emergencies
404.4that may disrupt the home care provider's ability to provide care or services. The licensee
404.5must provide adequate orientation and training of staff on emergency preparedness.
404.6    Subd. 13. Request for discontinuation of life-sustaining treatment. (a) If a
404.7client, family member, or other caregiver of the client requests that an employee or other
404.8agent of the home care provider discontinue a life-sustaining treatment, the employee or
404.9agent receiving the request:
404.10(1) shall take no action to discontinue the treatment; and
404.11(2) shall promptly inform their supervisor or other agent of the home care provider
404.12of the client's request.
404.13(b) Upon being informed of a request for termination of treatment, the home care
404.14provider shall promptly:
404.15(1) inform the client that the request will be made known to the physician who
404.16ordered the client's treatment;
404.17(2) inform the physician of the client's request; and
404.18(3) work with the client and the client's physician to comply with the provisions of
404.19the Health Care Directive Act in chapter 145C.
404.20(c) This section does not require the home care provider to discontinue treatment,
404.21except as may be required by law or court order.
404.22(d) This section does not diminish the rights of clients to control their treatments,
404.23refuse services, or terminate their relationships with the home care provider.
404.24(e) This section shall be construed in a manner consistent with chapter 145B or
404.25145C, whichever applies, and declarations made by clients under those chapters.

404.26    Sec. 18. [144A.4792] MEDICATION MANAGEMENT.
404.27    Subdivision 1. Medication management services; comprehensive home care
404.28license. (a) This subdivision applies only to home care providers with a comprehensive
404.29home care license that provides medication management services to clients. Medication
404.30management services may not be provided by a home care provider that has a basic
404.31home care license.
404.32(b) A comprehensive home care provider who provides medication management
404.33services must develop, implement, and maintain current written medication management
404.34policies and procedures. The policies and procedures must be developed under the
405.1supervision and direction of a registered nurse, licensed health professional, or pharmacist
405.2consistent with current practice standards and guidelines.
405.3(c) The written policies and procedures must address requesting and receiving
405.4prescriptions for medications; preparing and giving medications; verifying that
405.5prescription drugs are administered as prescribed; documenting medication management
405.6activities; controlling and storing medications; monitoring and evaluating medication use;
405.7resolving medication errors; communicating with the prescriber, pharmacist, and client
405.8and client representative, if any; disposing of unused medications; and educating clients
405.9and client representatives about medications. When controlled substances are being
405.10managed, the policies and procedures must also identify how the provider will ensure
405.11security and accountability for the overall management, control, and disposition of those
405.12substances in compliance with state and federal regulations and with subdivision 22.
405.13    Subd. 2. Provision of medication management services. (a) For each client who
405.14requests medication management services, the comprehensive home care provider shall,
405.15prior to providing medication management services, have a registered nurse, licensed
405.16health professional, or authorized prescriber under section 151.37 conduct an assessment
405.17to determine what mediation management services will be provided and how the services
405.18will be provided. This assessment must be conducted face-to-face with the client. The
405.19assessment must include an identification and review of all medications the client is known
405.20to be taking. The review and identification must include indications for medications, side
405.21effects, contraindications, allergic or adverse reactions, and actions to address these issues.
405.22(b) The assessment must identify interventions needed in management of
405.23medications to prevent diversion of medication by the client or others who may have
405.24access to the medications. Diversion of medications means the misuse, theft, or illegal
405.25or improper disposition of medications.
405.26    Subd. 3. Individualized medication monitoring and reassessment. The
405.27comprehensive home care provider must monitor and reassess the client's medication
405.28management services as needed under subdivision 14 when the client presents with
405.29symptoms or other issues that may be medication-related and, at a minimum, annually.
405.30    Subd. 4. Client refusal. The home care provider must document in the client's
405.31record any refusal for an assessment for medication management by the client. The
405.32provider must discuss with the client the possible consequences of the client's refusal and
405.33document the discussion in the client's record.
405.34    Subd. 5. Individualized medication management plan. (a) For each client
405.35receiving medication management services, the comprehensive home care provider must
405.36prepare and include in the service plan a written statement of the medication management
406.1services that will be provided to the client. The provider must develop and maintain a
406.2current individualized medication management record for each client based on the client's
406.3assessment that contains the following:
406.4(1) a statement describing the medication management services that will be provided;
406.5(2) a description of storage of medications based on the client's needs and
406.6preferences, risk of diversion, and consistent with the manufacturer's directions;
406.7(3) documentation of specific client instructions relating to the administration
406.8of medications;
406.9(4) identification of persons responsible for monitoring medication supplies and
406.10ensuring that medication refills are ordered on a timely basis;
406.11(5) identification of medication management tasks that may be delegated to
406.12unlicensed personnel;
406.13(6) procedures for staff notifying a registered nurse or appropriate licensed health
406.14professional when a problem arises with medication management services; and
406.15(7) any client-specific requirements relating to documenting medication
406.16administration, verification that all medications are administered as prescribed, and
406.17monitoring of medication use to prevent possible complications or adverse reactions.
406.18(b) The medication management record must be current and updated when there are
406.19any changes.
406.20    Subd. 6. Administration of medication. Medications may be administered by a
406.21nurse, physician, or other licensed health practitioner authorized to administer medications
406.22or by unlicensed personnel who have been delegated medication administration tasks by
406.23a registered nurse.
406.24    Subd. 7. Delegation of medication administration. When administration of
406.25medications is delegated to unlicensed personnel, the comprehensive home care provider
406.26must ensure that the registered nurse has:
406.27(1) instructed the unlicensed personnel in the proper methods to administer the
406.28medications, and the unlicensed personnel has demonstrated ability to competently follow
406.29the procedures;
406.30(2) specified, in writing, specific instructions for each client and documented those
406.31instructions in the client's records; and
406.32(3) communicated with the unlicensed personnel about the individual needs of
406.33the client.
406.34    Subd. 8. Documentation of administration of medications. Each medication
406.35administered by comprehensive home care provider staff must be documented in the
406.36client's record. The documentation must include the signature and title of the person
407.1who administered the medication. The documentation must include the medication
407.2name, dosage, date and time administered, and method and route of administration. The
407.3staff must document the reason why medication administration was not completed as
407.4prescribed and document any follow-up procedures that were provided to meet the client's
407.5needs when medication was not administered as prescribed and in compliance with the
407.6client's medication management plan.
407.7    Subd. 9. Documentation of medication set up. Documentation of dates of
407.8medication set up, name of medication, quantity of dose, times to be administered, route
407.9of administration, and name of person completing medication set up must be done at
407.10time of set up.
407.11    Subd. 10. Medications management for clients who will be away from home.
407.12(a) A home care provider that is providing medication management services to the client
407.13and controls the client's access to the medications must develop and implement policies
407.14and procedures for giving accurate and current medications to clients for planned or
407.15unplanned times away from home according to the client's individualized medication
407.16management plan.
407.17The policy and procedures must state that:
407.18(1) for planned time away, the medications must be obtained from the pharmacy or
407.19set up by the registered nurse according to appropriate state and federal laws and nursing
407.20standards of practice;
407.21(2) for unplanned time away, when the pharmacy is not able to provide the
407.22medications, a licensed nurse or unlicensed personnel shall give the client or the client's
407.23representative medications in amounts and dosages needed for the length of the anticipated
407.24absence, not to exceed 120 hours;
407.25(3) the client, or the client's representative, must be provided written information
407.26on medications, including any special instructions for administering or handling the
407.27medications, including controlled substances;
407.28(4) the medications must be placed in a medication container or containers
407.29appropriate to the provider's medication system and must be labeled with the client's name
407.30and the dates and times that the medications are scheduled; and
407.31(5) the client or client's representative must be provided in writing the home care
407.32provider's name and information on how to contact them.
407.33(b) For unplanned time away when the licensed nurse is not available, the registered
407.34nurse may delegate this task to unlicensed personnel if:
407.35(1) the registered nurse has trained and determined the unlicensed staff to be
407.36competent to follow the procedures for giving medications to clients;
408.1(2) the registered nurse has developed written procedures for the unlicensed
408.2personnel, including any special instructions or procedures regarding controlled substances
408.3that are prescribed for the client. The procedures must address:
408.4(i) the type of container or containers to be used for the medications appropriate to
408.5the provider's medication system;
408.6(ii) how the container or containers must be labeled;
408.7(iii) the written information about the medications to be given to the client or the
408.8client' s representative;
408.9(iv) how the unlicensed staff will document in the client's record that medications
408.10have been given to the client or the client's responsible person, including documenting the
408.11date the medications were given to the client or the client's responsible person and who
408.12received the medications, the person who gave the medications to the client, the number of
408.13medications that were given to the client, and other required information;
408.14(v) how the RN will be notified that medications have been given to the client or
408.15the client's responsible person and whether the RN needs to be contacted before the
408.16medications are given to the client or the client's responsible person; and
408.17(vi) a review by the RN of the completion of this task to verify that this task was
408.18completed accurately by the unlicensed personnel.
408.19    Subd. 11. Prescribed and nonprescribed medication. The comprehensive home
408.20care provider must determine whether it will require a prescription for all medications it
408.21manages. The comprehensive home care provider must inform the client or the client's
408.22representative whether the comprehensive home care provider requires a prescription
408.23for all over-the-counter and dietary supplements before the comprehensive home care
408.24provider will agree to manage those medications.
408.25    Subd. 12. Medications; over-the-counter; dietary supplements not prescribed.
408.26A comprehensive home care provider providing medication management services for
408.27over-the-counter drugs or dietary supplements must retain those items in the original labeled
408.28container with directions for use prior to setting up for immediate or later administration.
408.29The provider must verify that the medications are up-to-date and stored as appropriate.
408.30    Subd. 13. Prescriptions. There must be a current written or electronically recorded
408.31prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a, for all prescribed
408.32medications that the comprehensive home care provider is managing for the client.
408.33    Subd. 14. Renewal of prescriptions. Prescriptions must be renewed at least
408.34every 12 months or more frequently as indicated by the assessment in subdivision 2.
408.35Prescriptions for controlled substances must comply with chapter 152.
409.1    Subd. 15. Verbal prescription orders. Verbal prescription orders from an
409.2authorized prescriber must be received by a nurse or pharmacist. The order must be
409.3handled according to Minnesota Rules, part 6800.6200.
409.4    Subd. 16. Written or electronic prescription. When a written or electronic
409.5prescription is received, it must be communicated to the registered nurse in charge and
409.6recorded or placed in the client's record.
409.7    Subd. 17. Records confidential. A prescription or order received verbally, in
409.8writing, or electronically must be kept confidential according to sections 144.291 to
409.9144.298 and 144A.44.
409.10    Subd. 18. Medications provided by client or family members. When the
409.11comprehensive home care provider is aware of any medications or dietary supplements
409.12that are being used by the client and are not included in the assessment for medication
409.13management services, the staff must advise the registered nurse and document that in
409.14the client's record.
409.15    Subd. 19. Storage of drugs. A comprehensive home care provider providing
409.16storage of medications outside of the client's private living space must store all prescription
409.17drugs in securely locked and substantially constructed compartments according to the
409.18manufacturer's directions and permit only authorized personnel to have access.
409.19    Subd. 20. Prescription drugs. A prescription drug, prior to being set up for
409.20immediate or later administration, must be kept in the original container in which it was
409.21dispensed by the pharmacy bearing the original prescription label with legible information
409.22including the expiration or beyond-use date of a time-dated drug.
409.23    Subd. 21. Prohibitions. No prescription drug supply for one client may be used or
409.24saved for use by anyone other than the client.
409.25    Subd. 22. Disposition of drugs. (a) Any current medications being managed by the
409.26comprehensive home care provider must be given to the client or the client's representative
409.27when the client's service plan ends or medication management services are no longer part
409.28of the service plan. Medications that have been stored in the client's private living space
409.29for a client that is deceased or that have been discontinued or that have expired may be
409.30given to the client or the client's representative for disposal.
409.31(b) The comprehensive home care provider will dispose of any medications
409.32remaining with the comprehensive home care provider that are discontinued or expired or
409.33upon the termination of the service contract or the client's death according to state and
409.34federal regulations for disposition of drugs and controlled substances.
409.35(c) Upon disposition, the comprehensive home care provider must document in the
409.36client's record the disposition of the medications including the medication's name, strength,
410.1prescription number as applicable, quantity, to whom the medications were given, date of
410.2disposition, and names of staff and other individuals involved in the disposition.
410.3    Subd. 23. Loss or spillage. (a) Comprehensive home care providers providing
410.4medication management must develop and implement procedures for loss or spillage of all
410.5controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must
410.6require that when a spillage of a controlled substance occurs, a notation must be made
410.7in the client's record explaining the spillage and the actions taken. The notation must
410.8be signed by the person responsible for the spillage and include verification that any
410.9contaminated substance was disposed of according to state or federal regulations.
410.10(b) The procedures must require the comprehensive home care provider of
410.11medication management to investigate any known loss or unaccounted for prescription
410.12drugs and take appropriate action required under state or federal regulations and document
410.13the investigation in required records.

410.14    Sec. 19. [144A.4793] TREATMENT AND THERAPY MANAGEMENT
410.15SERVICES.
410.16    Subdivision 1. Providers with a comprehensive home care license. This section
410.17applies only to home care providers with a comprehensive home care license that provide
410.18treatment or therapy management services to clients. Treatment or therapy management
410.19services cannot be provided by a home care provider that has a basic home care license.
410.20    Subd. 2. Policies and procedures. (a) A comprehensive home care provider who
410.21provides treatment and therapy management services must develop, implement, and
410.22maintain up-to-date written treatment or therapy management policies and procedures.
410.23The policies and procedures must be developed under the supervision and direction of
410.24a registered nurse or appropriate licensed health professional consistent with current
410.25practice standards and guidelines.
410.26(b) The written policies and procedures must address requesting and receiving
410.27orders or prescriptions for treatments or therapies, providing the treatment or therapy,
410.28documenting of treatment or therapy activities, educating and communicating with clients
410.29about treatments or therapy they are receiving, monitoring and evaluating the treatment
410.30and therapy, and communicating with the prescriber.
410.31    Subd. 3. Individualized treatment or therapy management plan. For each
410.32client receiving management of ordered or prescribed treatments or therapy services, the
410.33comprehensive home care provider must prepare and include in the service plan a written
410.34statement of the treatment or therapy services that will be provided to the client. The
411.1provider must also develop and maintain a current individualized treatment and therapy
411.2management record for each client that contains at least the following:
411.3(1) a statement of the type of services that will be provided;
411.4(2) documentation of specific client instructions relating to the treatments or therapy
411.5administration;
411.6(3) identification of treatment or therapy tasks that will be delegated to unlicensed
411.7personnel;
411.8(4) procedures for notifying a registered nurse or appropriate licensed health
411.9professional when a problem arises with treatments or therapy services; and
411.10(5) any client-specific requirements relating to documentation of treatment and
411.11therapy received, verification that all treatments and therapy was administered as
411.12prescribed, and monitoring of treatment or therapy to prevent possible complications or
411.13adverse reactions. The treatment or therapy management record must be current and
411.14updated when there are any changes.
411.15    Subd. 4. Administration of treatments and therapy. Ordered or prescribed
411.16treatments or therapies must be administered by a nurse, physician, or other licensed health
411.17professional authorized to perform the treatment or therapy, or may be delegated or assigned
411.18to unlicensed personnel by the licensed health professional according to the appropriate
411.19practice standards for delegation or assignment. When administration of a treatment or
411.20therapy is delegated or assigned to unlicensed personnel, the home care provider must
411.21ensure that the registered nurse or authorized licensed health professional has:
411.22(1) instructed the unlicensed personnel in the proper methods with respect to each
411.23client and has demonstrated their ability to competently follow the procedures;
411.24(2) specified, in writing, specific instructions for each client and documented those
411.25instructions in the client's record; and
411.26(3) communicated with the unlicensed personnel about the individual needs of
411.27the client.
411.28    Subd. 5. Documentation of administration of treatments and therapies. Each
411.29treatment or therapy administered by a comprehensive home care provider must be
411.30documented in the client's record. The documentation must include the signature and title
411.31of the person who administered the treatment or therapy and must include the date and
411.32time of administration. When treatment or therapies are not administered as ordered or
411.33prescribed, the provider must document the reason why it was not administered and any
411.34follow-up procedures that were provided to meet the client's needs.
411.35    Subd. 6. Orders or prescriptions. There must be an up-to-date written or
411.36electronically recorded order or prescription for all treatments and therapies. The order
412.1must contain the name of the client, description of the treatment or therapy to be provided,
412.2and the frequency and other information needed to administer the treatment or therapy.

412.3    Sec. 20. [144A.4794] CLIENT RECORD REQUIREMENTS.
412.4    Subdivision 1. Client record. (a) The home care provider must maintain records
412.5for each client for whom it is providing services. Entries in the client records must be
412.6current, legible, permanently recorded, dated, and authenticated with the name and title
412.7of the person making the entry.
412.8(b) Client records, whether written or electronic, must be protected against loss,
412.9tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable
412.10relevant federal and state laws. The home care provider shall establish and implement
412.11written procedures to control use, storage, and security of client's records and establish
412.12criteria for release of client information.
412.13(c) The home care provider may not disclose to any other person any personal,
412.14financial, medical, or other information about the client, except:
412.15(1) as may be required by law;
412.16(2) to employees or contractors of the home care provider, another home care
412.17provider, other health care practitioner or provider, or inpatient facility needing
412.18information in order to provide services to the client, but only such information that
412.19is necessary for the provision of services;
412.20(3) to persons authorized in writing by the client or the client's representative to
412.21receive the information, including third-party payers; and
412.22(4) to representatives of the commissioner authorized to survey or investigate home
412.23care providers under this chapter or federal laws.
412.24    Subd. 2. Access to records. The home care provider must ensure that the
412.25appropriate records are readily available to employees or contractors authorized to access
412.26the records. Client records must be maintained in a manner that allows for timely access,
412.27printing, or transmission of the records.
412.28    Subd. 3. Contents of client record. Contents of a client record include the
412.29following for each client:
412.30(1) identifying information, including the client's name, date of birth, address, and
412.31telephone number;
412.32(2) the name, address, and telephone number of an emergency contact, family
412.33members, client's representative, if any, or others as identified;
412.34(3) names, addresses, and telephone numbers of the client's health and medical
412.35service providers and other home care providers, if known;
413.1(4) health information, including medical history, allergies, and when the provider
413.2is managing medications, treatments or therapies that require documentation, and other
413.3relevant health records;
413.4(5) client's advance directives, if any;
413.5(6) the home care provider's current and previous assessments and service plans;
413.6(7) all records of communications pertinent to the client's home care services;
413.7(8) documentation of significant changes in the client's status and actions taken in
413.8response to the needs of the client including reporting to the appropriate supervisor or
413.9health care professional;
413.10(9) documentation of incidents involving the client and actions taken in response
413.11to the needs of the client including reporting to the appropriate supervisor or health
413.12care professional;
413.13(10) documentation that services have been provided as identified in the service plan;
413.14(11) documentation that the client has received and reviewed the home care bill
413.15of rights;
413.16(12) documentation that the client has been provided the statement of disclosure on
413.17limitations of services under section 144A.4791, subdivision 3;
413.18(13) documentation of complaints received and resolution;
413.19(14) discharge summary, including service termination notice and related
413.20documentation, when applicable; and
413.21(15) other documentation required under this chapter and relevant to the client's
413.22services or status.
413.23    Subd. 4. Transfer of client records. If a client transfers to another home care
413.24provider or other health care practitioner or provider, or is admitted to an inpatient facility,
413.25the home care provider, upon request of the client or the client's representative, shall take
413.26steps to ensure a coordinated transfer including sending a copy or summary of the client's
413.27record to the new home care provider, facility, or the client, as appropriate.
413.28    Subd. 5. Record retention. Following the client's discharge or termination of
413.29services, a home care provider must retain a client's record for at least five years, or as
413.30otherwise required by state or federal regulations. Arrangements must be made for secure
413.31storage and retrieval of client records if the home care provider ceases business.

413.32    Sec. 21. [144A.4795] HOME CARE PROVIDER RESPONSIBILITIES; STAFF.
413.33    Subdivision 1. Qualifications, training, and competency. All staff providing
413.34home care services must be trained and competent in the provision of home care services
413.35consistent with current practice standards appropriate to the client's needs.
414.1    Subd. 2. Licensed health professionals and nurses. (a) Licensed health
414.2professionals and nurses providing home care services as an employee of a licensed home
414.3care provider must possess current Minnesota license or registration to practice.
414.4(b) Licensed health professionals and registered nurses must be competent in
414.5assessing client needs, planning appropriate home care services to meet client needs,
414.6implementing services, and supervising staff if assigned.
414.7(c) Nothing in this section limits or expands the rights of nurses or licensed health
414.8professionals to provide services within the scope of their licenses or registrations, as
414.9provided by law.
414.10    Subd. 3. Unlicensed personnel. (a) Unlicensed personnel providing basic home
414.11care services must have:
414.12(1) successfully completed a training and competency evaluation appropriate to
414.13the services provided by the home care provider and the topics listed in subdivision 7,
414.14paragraph (b); or
414.15(2) demonstrated competency by satisfactorily completing a written or oral test on
414.16the tasks the unlicensed personnel will perform and in the topics listed in subdivision
414.177, paragraph (b); and successfully demonstrate competency of topics in subdivision 7,
414.18paragraph (b), clauses (5), (7), and (8), by a practical skills test.
414.19Unlicensed personnel providing home care services for a basic home care provider may
414.20not perform delegated nursing or therapy tasks.
414.21(b) Unlicensed personnel performing delegated nursing tasks for a comprehensive
414.22home care provider must have:
414.23(1) successfully completed training and demonstrated competency by successfully
414.24completing a written or oral test of the topics in subdivision 7, paragraphs (b) and (c), and
414.25a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5) and (7),
414.26and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform; or
414.27(2) satisfy the current requirements of Medicare for training or competency of home
414.28health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
414.29section 483 or section 484.36; or
414.30(3) before April 19, 1993, completed a training course for nursing assistants that was
414.31approved by the commissioner.
414.32(c) Unlicensed personnel performing therapy or treatment tasks delegated or
414.33assigned by a licensed health professional must meet the requirements for delegated
414.34tasks in subdivision 4 and any other training or competency requirements within the
414.35licensed health professional scope of practice relating to delegation or assignment of tasks
414.36to unlicensed personnel.
415.1    Subd. 4. Delegation of home care tasks. A registered nurse or licensed health
415.2professional may delegate tasks only to staff that are competent and possess the knowledge
415.3and skills consistent with the complexity of the tasks and according to the appropriate
415.4Minnesota Practice Act. The comprehensive home care provider must establish and
415.5implement a system to communicate up-to-date information to the registered nurse or
415.6licensed health professional regarding the current available staff and their competency so
415.7the registered nurse or licensed health professional has sufficient information to determine
415.8the appropriateness of delegating tasks to meet individual client needs and preferences.
415.9    Subd. 5. Individual contractors. When a home care provider contracts with an
415.10individual contractor excluded from licensure under section 144A.471 to provide home
415.11care services, the contractor must meet the same requirements required by this section for
415.12personnel employed by the home care provider.
415.13    Subd. 6. Temporary staff. When a home care provider contracts with a temporary
415.14staffing agency excluded from licensure under section 144A.471, those individuals must
415.15meet the same requirements required by this section for personnel employed by the home
415.16care provider and shall be treated as if they are staff of the home care provider.
415.17    Subd. 7. Requirements for instructors, training content, and competency
415.18evaluations for unlicensed personnel. (a) Instructors and competency evaluators must
415.19meet the following requirements:
415.20(1) training and competency evaluations of unlicensed personnel providing basic
415.21home care services must be conducted by individuals with work experience and training in
415.22providing home care services listed in section 144A.471, subdivisions 6 and 7; and
415.23(2) training and competency evaluations of unlicensed personnel providing
415.24comprehensive home care services must be conducted by a registered nurse, or another
415.25instructor may provide training in conjunction with the registered nurse. If the home care
415.26provider is providing services by licensed health professionals only, then that specific
415.27training and competency evaluation may be conducted by the licensed health professionals
415.28as appropriate.
415.29(b) Training and competency evaluations for all unlicensed personnel must include
415.30the following:
415.31(1) documentation requirements for all services provided;
415.32(2) reports of changes in the client's condition to the supervisor designated by the
415.33home care provider;
415.34(3) basic infection control, including blood-borne pathogens;
415.35(4) maintenance of a clean and safe environment;
415.36(5) appropriate and safe techniques in personal hygiene and grooming, including:
416.1(i) hair care and bathing;
416.2(ii) care of teeth, gums, and oral prosthetic devices;
416.3(iii) care and use of hearing aids; and
416.4(iv) dressing and assisting with toileting;
416.5(6) training on the prevention of falls for providers working with the elderly or
416.6individuals at risk of falls;
416.7(7) standby assistance techniques and how to perform them;
416.8(8) medication, exercise, and treatment reminders;
416.9(9) basic nutrition, meal preparation, food safety, and assistance with eating;
416.10(10) preparation of modified diets as ordered by a licensed health professional;
416.11(11) communication skills that include preserving the dignity of the client and
416.12showing respect for the client and the client's preferences, cultural background, and family;
416.13(12) awareness of confidentiality and privacy;
416.14(13) understanding appropriate boundaries between staff and clients and the client's
416.15family;
416.16(14) procedures to utilize in handling various emergency situations; and
416.17(15) awareness of commonly used health technology equipment and assistive devices.
416.18(c) In addition to paragraph (b), training and competency evaluation for unlicensed
416.19personnel providing comprehensive home care services must include:
416.20(1) observation, reporting, and documenting of client status;
416.21(2) basic knowledge of body functioning and changes in body functioning, injuries,
416.22or other observed changes that must be reported to appropriate personnel;
416.23(3) reading and recording temperature, pulse, and respirations of the client;
416.24(4) recognizing physical, emotional, cognitive, and developmental needs of the client;
416.25(5) safe transfer techniques and ambulation;
416.26(6) range of motioning and positioning; and
416.27(7) administering medications or treatments as required.
416.28(d) When the registered nurse or licensed health professional delegates tasks, they
416.29must ensure that prior to the delegation the unlicensed personnel is trained in the proper
416.30methods to perform the tasks or procedures for each client and are able to demonstrate
416.31the ability to competently follow the procedures and perform the tasks. If an unlicensed
416.32personnel has not regularly performed the delegated home care task for a period of 24
416.33consecutive months, the unlicensed personnel must demonstrate competency in the task
416.34to the registered nurse or appropriate licensed health professional. The registered nurse
416.35or licensed health professional must document instructions for the delegated tasks in
416.36the client's record.

417.1    Sec. 22. [144A.4796] ORIENTATION AND ANNUAL TRAINING
417.2REQUIREMENTS.
417.3    Subdivision 1. Orientation of staff and supervisors to home care. All staff
417.4providing and supervising direct home care services must complete an orientation to home
417.5care licensing requirements and regulations before providing home care services to clients.
417.6The orientation may be incorporated into the training required under subdivision 6. The
417.7orientation need only be completed once for each staff person and is not transferable
417.8to another home care provider.
417.9    Subd. 2. Content. The orientation must contain the following topics:
417.10    (1) an overview of sections 144A.43 to 144A.4798;
417.11(2) introduction and review of all the provider's policies and procedures related to
417.12the provision of home care services;
417.13(3) handling of emergencies and use of emergency services;
417.14(4) compliance with and reporting the maltreatment of minors or vulnerable adults
417.15under sections 626.556 and 626.557;
417.16(5) home care bill of rights, under section 144A.44;
417.17(6) handling of clients' complaints; reporting of complaints and where to report
417.18complaints including information on the Office of Health Facility Complaints and the
417.19Common Entry Point;
417.20(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
417.21Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
417.22Ombudsman at the Department of Human Services, county managed care advocates,
417.23or other relevant advocacy services; and
417.24(8) review of the types of home care services the employee will be providing and
417.25the provider's scope of licensure.
417.26    Subd. 3. Verification and documentation of orientation. Each home care provider
417.27shall retain evidence in the employee record of each staff person having completed the
417.28orientation required by this section.
417.29    Subd. 4. Orientation to client. Staff providing home care services must be oriented
417.30specifically to each individual client and the services to be provided. This orientation may
417.31be provided in person, orally, in writing, or electronically.
417.32    Subd. 5. Training required relating to Alzheimer's disease and related disorders.
417.33For home care providers that provide services for persons with Alzheimer's or related
417.34disorders, all direct care staff and supervisors working with these clients must receive
417.35training that includes a current explanation of Alzheimer's disease and related disorders,
418.1effective approaches to use to problem solve when working with a client's challenging
418.2behaviors, and how to communicate with clients who have Alzheimer's or related disorders.
418.3    Subd. 6. Required annual training. All staff that perform direct home care
418.4services must complete at least eight hours of annual training for each 12 months of
418.5employment. The training may be obtained from the home care provider or another source
418.6and must include topics relevant to the provision of home care services. The annual
418.7training must include:
418.8(1) training on reporting of maltreatment of minors under section 626.556 and
418.9maltreatment of vulnerable adults under section 626.557, whichever is applicable to the
418.10services provided;
418.11(2) review of the home care bill of rights in section 144A.44;
418.12(3) review of infection control techniques used in the home and implementation of
418.13infection control standards including a review of hand washing techniques; the need for
418.14and use of protective gloves, gowns, and masks; appropriate disposal of contaminated
418.15materials and equipment, such as dressings, needles, syringes, and razor blades;
418.16disinfecting reusable equipment; disinfecting environmental surfaces; and reporting of
418.17communicable diseases; and
418.18(4) review of the provider's policies and procedures relating to the provision of home
418.19care services and how to implement those policies and procedures.
418.20    Subd. 7. Documentation. A home care provider must retain documentation in the
418.21employee records of the staff that have satisfied the orientation and training requirements
418.22of this section.

418.23    Sec. 23. [144A.4797] PROVISION OF SERVICES.
418.24    Subdivision 1. Availability of contact person to staff. (a) A home care provider
418.25with a basic home care license must have a person available to staff for consultation on
418.26items relating to the provision of services or about the client.
418.27(b) A home care provider with a comprehensive home care license must have a
418.28registered nurse available for consultation to staff performing delegated nursing tasks
418.29and must have an appropriate licensed health professional available if performing other
418.30delegated services such as therapies.
418.31(c) The appropriate contact person must be readily available either in person, by
418.32telephone, or by other means to the staff at times when the staff is providing services.
418.33    Subd. 2. Supervision of staff; basic home care services. (a) Staff who perform
418.34basic home care services must be supervised periodically where the services are being
418.35provided to verify that the work is being performed competently and to identify problems
419.1and solutions to address issues relating to the staff's ability to provide the services. The
419.2supervision of the unlicensed personnel must be done by staff of the home care provider
419.3having the authority, skills, and ability to provide the supervision of unlicensed personnel
419.4and who can implement changes as needed, and train staff.
419.5(b) Supervision includes direct observation of unlicensed personnel while they
419.6are providing the services and may also include indirect methods of gaining input such
419.7as gathering feedback from the client. Supervisory review of staff must be provided at a
419.8frequency based on the staff person's competency and performance.
419.9(c) For an individual who is licensed as a home care provider, this section does
419.10not apply.
419.11    Subd. 3. Supervision of staff providing delegated nursing or therapy home
419.12care tasks. (a) Staff who perform delegated nursing or therapy home care tasks must be
419.13supervised by an appropriate licensed health professional or a registered nurse periodically
419.14where the services are being provided to verify that the work is being performed
419.15competently and to identify problems and solutions related to the staff person's ability to
419.16perform the tasks. Supervision of staff performing medication or treatment administration
419.17shall be provided by a registered nurse or appropriate licensed health professional and
419.18must include observation of the staff administering the medication or treatment and the
419.19interaction with the client.
419.20(b) The direct supervision of staff performing delegated tasks must be provided
419.21within 30 days after the individual begins working for the home care provider and
419.22thereafter as needed based on performance. This requirement also applies to staff who
419.23have not performed delegated tasks for one year or longer.
419.24    Subd. 4. Documentation. A home care provider must retain documentation of
419.25supervision activities in the personnel records.
419.26    Subd. 5. Exemption. This section does not apply to an individual licensed under
419.27sections 144A.43 to 144A.4799.

419.28    Sec. 24. [144A.4798] EMPLOYEE HEALTH STATUS.
419.29    Subdivision 1. Tuberculosis (TB) prevention and control. A home care provider
419.30must establish and maintain a TB prevention and control program based on the most
419.31current guidelines issued by the Centers for Disease Control and Prevention (CDC).
419.32Components of a TB prevention and control program include screening all staff providing
419.33home care services, both paid and unpaid, at the time of hire for active TB disease and
419.34latent TB infection, and developing and implementing a written TB infection control plan.
420.1The commissioner shall make the most recent CDC standards available to home care
420.2providers on the department's Web site.
420.3    Subd. 2. Communicable diseases. A home care provider must follow
420.4current federal or state guidelines for prevention, control, and reporting of human
420.5immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other
420.6communicable diseases as defined in Minnesota Rules, part 4605.7040.

420.7    Sec. 25. [144A.4799] DEPARTMENT OF HEALTH LICENSED HOME CARE
420.8PROVIDER ADVISORY COUNCIL.
420.9    Subdivision 1. Membership. The commissioner of health shall appoint eight
420.10persons to a home care provider advisory council consisting of the following:
420.11(1) three public members as defined in section 214.02 who shall be either persons
420.12who are currently receiving home care services or have family members receiving home
420.13care services, or persons who have family members who have received home care services
420.14within five years of the application date;
420.15(2) three Minnesota home care licensees representing basic and comprehensive
420.16levels of licensure who may be a managerial official, an administrator, a supervising
420.17registered nurse, or an unlicensed personnel performing home care tasks;
420.18(3) one member representing the Minnesota Board of Nursing; and
420.19(4) one member representing the ombudsman for long-term care.
420.20    Subd. 2. Organizations and meetings. The advisory council shall be organized
420.21and administered under section 15.059 with per diems and costs paid within the limits of
420.22available appropriations. Meetings will be held quarterly and hosted by the department.
420.23Subcommittees may be developed as necessary by the commissioner. Advisory council
420.24meetings are subject to the Open Meeting Law under chapter 13D.
420.25    Subd. 3. Duties. At the commissioner's request, the advisory council shall provide
420.26advice regarding regulations of Department of Health licensed home care providers in
420.27this chapter such as:
420.28(1) advice to the commissioner regarding community standards for home care
420.29practices;
420.30(2) advice to the commissioner on enforcement of licensing standards and whether
420.31certain disciplinary actions are appropriate;
420.32(3) advice to the commissioner about ways of distributing information to licensees
420.33and consumers of home care;
420.34(4) advice to the commissioner about training standards;
421.1(5) identify emerging issues and opportunities in the home care field, including the
421.2use of technology in home and telehealth capabilities; and
421.3(6) perform other duties as directed by the commissioner.

421.4    Sec. 26. [144A.481] HOME CARE LICENSING IMPLEMENTATION FOR
421.5NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.
421.6    Subdivision 1. Temporary home care licenses and changes of ownership. (a)
421.7Beginning January 1, 2014, all temporary license applicants must apply for either a
421.8temporary basic or comprehensive home care license.
421.9(b) Temporary home care licenses issued beginning January 1, 2014, will be
421.10issued according to the provisions in sections 144A.43 to 144A.4799 and fees in section
421.11144A.472 and will be required to comply with this chapter.
421.12(c) No temporary licenses or initial licenses will be accepted or issued between
421.13October 1, 2013, and December 31, 2013.
421.14(d) Beginning October 1, 2013, changes in ownership applications will require
421.15payment of the new fees listed in section 144A.472.
421.16    Subd. 2. Current home care licensees with licenses prior to July 1, 2013. (a)
421.17Beginning July 1, 2014, department licensed home care providers must apply for either
421.18the basic or comprehensive home care license on their regularly scheduled renewal date.
421.19(b) By June 30, 2015, all home care providers must either have a basic or
421.20comprehensive home care license or temporary license.
421.21    Subd. 3. Renewal application of home care licensure during transition period.
421.22Renewal of home care licenses issued beginning July 1, 2014, will be issued according to
421.23sections 144A.43 to 144A.4799, and upon license renewal, providers must comply with
421.24sections 144A.43 to 144A.4799. Prior to renewal, providers must comply with the home
421.25care licensure law in effect on June 30, 2013.
421.26The fees charged for licenses renewed between July 1, 2014, and June 30, 2016,
421.27shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000
421.28increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625.
421.29For fiscal year 2014 only the fees for providers with revenues greater than $25,000
421.30and no more than $100,000 will be $313 and for providers with revenues no more than
421.31$25,000 the fee will be $125.
421.32The license renewal fee schedule in section 144A.472 will be effective July 1, 2016.

421.33    Sec. 27. [144A.482] REGISTRATION OF HOME MANAGEMENT
421.34PROVIDERS.
422.1(a) For purposes of this section, a home management provider is an individual or
422.2organization that provides at least two of the following services: housekeeping, meal
422.3preparation, and shopping, to a person who is unable to perform these activities due to
422.4illness, disability, or physical condition.
422.5(b) A person or organization that provides only home management services may not
422.6operate in the state without a current certificate of registration issued by the commissioner
422.7of health. To obtain a certificate of registration, the person or organization must annually
422.8submit to the commissioner the name, mailing and physical address, e-mail address, and
422.9telephone number of the individual or organization and a signed statement declaring that
422.10the individual or organization is aware that the home care bill of rights applies to their
422.11clients and that the person or organization will comply with the home care bill of rights
422.12provisions contained in section 144A.44. An individual or organization applying for a
422.13certificate must also provide the name, business address, and telephone number of each of
422.14the individuals responsible for the management or direction of the organization.
422.15(c) The commissioner shall charge an annual registration fee of $20 for individuals
422.16and $50 for organizations. The registration fee shall be deposited in the state treasury and
422.17credited to the state government special revenue fund.
422.18(d) A home care provider that provides home management services and other home
422.19care services must be licensed, but licensure requirements other than the home care bill of
422.20rights do not apply to those employees or volunteers who provide only home management
422.21services to clients who do not receive any other home care services from the provider.
422.22A licensed home care provider need not be registered as a home management service
422.23provider, but must provide an orientation on the home care bill of rights to its employees
422.24or volunteers who provide home management services.
422.25(e) An individual who provides home management services under this section must,
422.26within 120 days after beginning to provide services, attend an orientation session approved
422.27by the commissioner that provides training on the home care bill of rights and an orientation
422.28on the aging process and the needs and concerns of elderly and disabled persons.
422.29(f) The commissioner may suspend or revoke a provider's certificate of registration
422.30or assess fines for violation of the home care bill of rights. Any fine assessed for a
422.31violation of the home care bill of rights by a provider registered under this section shall be
422.32in the amount established in the licensure rules for home care providers. As a condition
422.33of registration, a provider must cooperate fully with any investigation conducted by the
422.34commissioner, including providing specific information requested by the commissioner on
422.35clients served and the employees and volunteers who provide services. Fines collected
423.1under this paragraph shall be deposited in the state treasury and credited to the fund
423.2specified in the statute or rule in which the penalty was established.
423.3(g) The commissioner may use any of the powers granted in sections 144A.43 to
423.4144A.4799 to administer the registration system and enforce the home care bill of rights
423.5under this section.

423.6    Sec. 28. AGENCY QUALITY IMPROVEMENT PROGRAM.
423.7    Subdivision 1. Annual legislative report on home care licensing. The
423.8commissioner shall establish a quality improvement program for the home care survey
423.9and home care complaint investigation processes. The commissioner shall submit to the
423.10legislature an annual report, beginning October 1, 2015, and each October 1 thereafter.
423.11Each report will review the previous state fiscal year of home care licensing and regulatory
423.12activities. The report must include, but is not limited to, an analysis of:
423.13(1) the number of FTE's in the Compliance Monitoring Division, including the
423.14Office of Health Facilities Complaint units assigned to home care licensing, survey,
423.15investigation, and enforcement process;
423.16(2) numbers of and descriptive information about licenses issued, complaints
423.17received and investigated, including allegations made and correction orders issued,
423.18surveys completed and timelines, correction order reconsiderations, and results;
423.19(3) descriptions of emerging trends in home care provision and areas of concern
423.20identified by the department in its regulation of home care providers;
423.21(4) information and data regarding performance improvement projects underway
423.22and planned by the commissioner in the area of home care surveys; and
423.23(5) work of the Department of Health Home Care Advisory Council.
423.24    Subd. 2. Study of correction order appeal process. Starting July 1, 2015, the
423.25commissioner shall study whether to add a correction order appeal process conducted by
423.26an independent reviewer, such as an administrative law judge or other office, and submit a
423.27report to the legislature by February 1, 2016. The commissioner shall review home care
423.28regulatory systems in other states as part of that study. The commissioner shall consult
423.29with the home care providers and representatives.

423.30    Sec. 29. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
423.31AND COMMUNITY-BASED SERVICES.
423.32(a) The Department of Health Compliance Monitoring Division and the Department
423.33of Human Services Licensing Division shall jointly develop an integrated licensing system
424.1for providers of both home care services subject to licensure under Minnesota Statutes,
424.2chapter 144A, and for home and community-based services subject to licensure under
424.3Minnesota Statutes, chapter 245D. The integrated licensing system shall:
424.4(1) require only one license of any provider of services under Minnesota Statutes,
424.5sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
424.6(2) promote quality services that recognize a person's individual needs and protect
424.7the person's health, safety, rights, and well-being;
424.8(3) promote provider accountability through application requirements, compliance
424.9inspections, investigations, and enforcement actions;
424.10(4) reference other applicable requirements in existing state and federal laws,
424.11including the federal Affordable Care Act;
424.12(5) establish internal procedures to facilitate ongoing communications between the
424.13agencies, and with providers and services recipients about the regulatory activities;
424.14(6) create a link between the agency Web sites so that providers and the public can
424.15access the same information regardless of which Web site is accessed initially; and
424.16(7) collect data on identified outcome measures as necessary for the agencies to
424.17report to the Centers for Medicare and Medicaid Services.
424.18(b) The joint recommendations for legislative changes to implement the integrated
424.19licensing system are due to the legislature by February 15, 2014.
424.20(c) Before implementation of the integrated licensing system, providers licensed as
424.21home care providers under Minnesota Statutes, chapter 144A, may also provide home
424.22and community-based services subject to licensure under Minnesota Statutes, chapter
424.23245D, without obtaining a home and community-based services license under Minnesota
424.24Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
424.25apply to these providers:
424.26(1) the provider must comply with all requirements under Minnesota Statutes, chapter
424.27245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
424.28(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
424.29enforced by the Department of Health under the enforcement authority set forth in
424.30Minnesota Statutes, section 144A.475; and
424.31(3) the Department of Health will provide information to the Department of Human
424.32Services about each provider licensed under this section, including the provider's license
424.33application, licensing documents, inspections, information about complaints received, and
424.34investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

424.35    Sec. 30. REPEALER.
425.1(a) Minnesota Statutes 2012, sections 144A.46; and 144A.461, are repealed.
425.2(b) Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
425.34668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040;
425.44668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
425.54668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170;
425.64668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240;
425.74668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830;
425.84668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
425.94669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; and 4669.0050, are repealed.

425.10    Sec. 31. EFFECTIVE DATE.
425.11Sections 1 to 30 are effective the day following final enactment.