“**” means the summary reflects changes anticipated in an author’s amendment

Section 1 contains the short title (or popular name) of the act.

Section 2 (144.6501, subdivision 3) modifies the requirements for nursing facility contracts by requiring that the contract contain the name, address, and contact information of the current owner, manager, and license holder of the nursing facility.

Section 3 [144.6501, subdivision 3a] requires nursing facilities to inform residents and the legal representatives of residents with 30 days of a change in ownership, management, or of the license holder, and to include the name, address, and contact information of the new owner, manager, or license holder.

Section 4 [144.6502] establishes the conditions under which electronic motoring is a protected right of residents of a nursing facility, a boarding care home, or an assisted living setting.  This section is effective January 1, 2019.

Subdivision 1 provides definitions of “commissioner,” “electronic monitoring device,” “facility,” “legal representative,” and “resident.”

Paragraph (d) defines “facility” as including nursing facilities, boarding care facilities, and assisted living settings.

Paragraph (e) defines “legal representative” as a person with legal authority to make decisions about health care services for a resident, including (by cross-reference) a spouse, parent, adult child, adult sibling, or next of kin of the resident.

**Paragraph (f) requires a copy of the notification and consent form be given to the facility.

Subdivision 2 requires a nursing facility, a boarding care home, or an assisted living setting to permit a resident or a resident’s legal representative to conduct electronic monitoring of a resident’s room or private living space.

Subdivision 3, paragraphs (a) to (c), require the resident to consent in writing to electronic monitoring on a standard form provided by the commissioner of health. The resident may place conditions on monitoring. If the resident’s physician determines the resident cannot provide consent, the resident’s legal representative may consent on the resident’s behalf. 

Paragraphs (c) and (d) require a resident to obtain a roommate’s consent.  The same consent requirements that apply to resident apply to the roommate.

Paragraph (e) requires a resident to remove an electronic monitoring device if a resident gets a new roommate and the new roommate refuses to consent to electronic monitoring.  If the resident does not remove the electronic monitoring device, the facility must remove it.

Subdivision 4 allows a resident or roommate to withdraw consent at any time and contains requirements of residents and facilities when consent to electronic monitoring is denied or withdrawn.  If a roommate refuses or withdraws consent, the facility must make a reasonable attempt to accommodate the resident by finding another room or roommate.  A facility is not required to provide a private room unless the resident pays the private room rate.

Subdivision 5 specifies the requirements for the notification and consent form the commissioner of health is required to make available by January 1, 2019. The form must include information on how and where consent was obtained, the type of device, installation needs, proposed date, and any conditions or restrictions on use of the device.

Subdivision 6 specifies that the resident is responsible for the cost of installation and monitoring of an electronic monitoring device.

Subdivision 7 requires facilities, at their own expense, to post signage stating that electronic monitoring may be occurring in the facility.

Subdivision 8 prohibits anyone from knowingly and without permission interfering with an electronic monitoring device unless a facility does so because a resident or roommate withdrew consent.

Subdivision 9 prohibits a facility from accessing any recordings without permission and prohibits dissemination of recordings except to address the health, safety, or welfare of a resident.

Subdivision 10 provides a facility with immunity from civil or criminal liability arising from a resident disseminating a recording or for any violations of a resident’s right to privacy arising from the use of electronic monitoring in accordance with this section.

Subdivision 11 prohibits a facility from refusing to admit, discharging or evicting, or retaliating against a resident for the resident’s choices with respect to electronic monitoring.  A facility may not prevent or interfere with the installation of electronic monitoring provided the resident has satisfied the requirement that written consent be obtained.

Sections 5 to 15 modify the health care bill of rights, which covers residents of nursing facilities.  Many of the changes in these sections align the health care bill of rights with the home care bill of rights.

Section 5 (144.651, subdivision 1) modifies the health care bill of rights to clarify that health care facilities, such as nursing homes, cannot request that a resident waive any of the rights granted to the resident under the health care bill of rights. 

Section 6 (144.651, subdivision 2, paragraphs (a) to (c)) modifies definitions for the purposes of the health care bill of rights. The changes are technical and editorial.

Paragraph (d) clarifies the meaning of health care facility for the purposes of the health care bill of rights. 

Paragraph (e) defines “interested person” for the purposes of the health care bill of rights, and includes (by cross-reference) a guardian or conservator, person designated in writing by the resident, health care agent, or spouse, parent, adult child, adult sibling, or next of kin of the resident.

Section 7 (144.651, subdivision 4) modifies the health care bill of rights to include a right to a plain language written explanation of the rights and to be provided with the name and contact information of a state or local agency to contact for additional information and assistance with understanding or exercising these rights.

Section 8 (144.651, subdivision 6) modifies the health care bill of rights to specify that a resident’s right to appropriate care includes a right to continuity of staff who are properly trained and competent.

Section 9 (144.651, subdivision 14) modifies the health care bill of rights to include by cross-reference a patient’s or resident’s right to various notifications regarding reports of maltreatment of vulnerable adults, which includes notice that a report has been made, disposition of a report, and appeal rights (see sections 48 and 49).

Section 10 (144.651, subdivision 16) modifies the health care bill of rights by including a right to confidential treatment of a patient’s or resident’s financial records, and a right to access records about them.

Section 11 (144.651, subdivision 17) modifies the health care bill of rights by adding a right to 30 days’ advanced notice of changes in services or charges and a right to have any nonrefundable deposit applied to the first month’s charges.

Section 12 (144.651, subdivision 20, paragraph (a)) modifies the health care bill of rights by adding that a patient or resident has the right to be free from retaliation for voicing grievances, asserting rights or recommending changes to facility policy.

Paragraph (b) establishes a right to complain, requires the facility to provide residents, patients and interested persons with the name of the individual who is responsible for handling grievances, and requires the facility to investigate grievances and attempt a resolution.

Paragraph (c) is slightly re-written language stricken from new paragraph (a).

Section 13 (144.651, subdivision 21) creates a right, at the patient’s or resident’s expense, to internet service.

**Section 14 [144.651, subdivision 34, paragraph (a)] prohibits a facility from retaliating against a patient or resident who files a grievance, submits a maltreatment report, advocates for improved care or enforcement of rights, or contracts to receive services from a provider of the resident’s choice.

Paragraph (b) establishes a rebuttable presumption of retaliation when a facility takes an adverse action within 90 days of a patient or resident filing a grievance, reporting maltreatment, or advocating on behalf of a patient or resident.

Paragraph (c) defines adverse action by cross-reference to an amended definition in the statute governing the reporting of maltreatment of vulnerable adults.  Adverse actions include discharge from a facility, restricting access to the facility, restrictions of rights, restrictions of access to services or amenities, and sudden increase in cost of services.

Section 15 [144.651, subdivision 35] modifies the health care bill of rights by adding a right to electronic monitoring.

Section 16 [144.6511, paragraph (a)] forbids a health care facility, as defined for the purposes of the health care bill of rights, to engage in deceptive marketing and business practices.

Paragraph (b) defines deceptive practices.

Section 17 (144A.10, subdivision 1) modifies the statute governing the commissioner of health’s authority to enforce nursing home licensing by clarifying that the commissioner may issue correction orders and issue fines and by specifying that a nursing home that fails to comply with a lawful request for information is subject to a correction order and a fine.

Section 18 (144A.44) modifies the home care bill of rights, which, as amended, covers persons receiving services from home care providers or services in an assisted living setting.

Subdivision 1, paragraph (a)  expands the definition of “provider” to include not only home care providers, but also housing with services establishments; expands the definition of “services” to include not only home care services, but also supportive services and health-related services offered by housing with services establishments; and expands the definition of “service plan” to include not only a home care service plan, but any contract or lease between a client and a housing with services establishment.

Paragraph (b) is rewritten language moved forward from subdivision 2 below.

Paragraph (c) lists the rights protects under the home care bill of rights. To a large extent the changes to this paragraph align the home care bill of rights with the health care bill of rights.  Of particular note are:

Clause (17), which increases from 10 to 30 days the required advanced notice providers must give a client before terminating services or a lease;

Clause (23), which adds by cross-reference a client’s right to various notifications regarding reports of maltreatment of vulnerable adults;

Clause (24), which adds a right, at the client’s expense, to internet service; and

Clause (25), which adds a right to electronic monitoring.

Paragraph (d) specifies additional duties of providers to assist clients in the exercise of their rights and in finding accessing information to which they are entitled or have a need.

Subdivision 2 strikes language that was moved elsewhere in the section and rewrites for clarity the remaining language.

Subdivision 3, paragraph (a) contains language stricken from subdivision 2 that was moved, and requires the commissioner of health to enforce the home care bill of rights against housing with services establishments.

**Subdivision 4 contains a cross-reference to the retaliation language added to the health care bill of rights.

Section 19 (144A.441) modifies the assisted living addendum to the home care bill of rights by requiring that an arranged home care provider that provides services in a housing with services establishment be able to document that a recipient has created an unsafe or abusive work environment before terminating services with less than 30 days’ notice, and by requiring a health professional to document that an emergency or change in condition has occurred that cannot be safely met by the provider before a provider may terminate services with less than 30 days’ notice.

Section 20 (144A.442) is technical and editorial.

Section 21 (144A.45, subdivision 1) modifies the statute governing the commissioner of health’s authority to regulate home care providers by clarifying that the commissioner can impose correction orders and fines for a home care provider’s violation of the home care bill of rights.

Section 22 (144A.45, subdivision 2) modifies the statute governing the commissioner of health’s authority to regulate home care providers by clarifying that the commissioner can impose correction orders and fines for a home care provider’s violation of the home care licensing requirements.

Section 23 (144A.474, subdivision 1) modifies the home care licensing statute by increasing the minimum licensing survey frequency from 3 to 4 years for home care providers who qualify for a core survey.

Section 24 (144A.474, subdivision 2, paragraph (b)) modifies the home care licensing statute by limiting which home care providers are eligible for a core survey.  To be eligible for a core survey, a home care provider must:

• Have been in operation for more than three years;
• Not have had widespread violations greater than level 1 on the most recent survey; and
• Not have had any violations of level 3 or great on any past survey unless the provider has had three consecutive annual full surveys with no violations above level 1.

Paragraph (c) decreases the frequency of full licensing surveys from “periodic” to annual for any home care provider that fails to qualify for a core survey.

Paragraph (e) clarifies when a survey must conclude with an exit conference.

Section 25 (144A.474, subdivision 8, paragraph (a)) modifies the home care licensing statute by permitting the commissioner of health to impose immediate fines for licensing violations and by requiring home care providers to whom a correction order is issued to submit a correction plan to the commissioner.

Paragraph (b) requires a home care provider who is fined to keep a record of the fine and the provider’s correction plan on file and available for public inspection by any person upon request.

Paragraph (c) requires a home care provider to whom a correction order is issued to submit in writing to the commissioner a description of the actions taken by the cited home care provider to correct the licensing violations.

Section 26 (144A.474, subdivision 9) modifies the home care licensing statute by permitting the commissioner to issue new immediate fines for new violations discovered during a follow-up survey.

Section 27 (144A.474, subdivision 11, paragraphs (c) to (f)) modify and clarify the home care licensing statute by explicitly stating that the commissioner can assess additional immediate fines, in addition to any fine for the original licensing violation, for noncompliance with a prior correction order, noncompliance with a notice of noncompliance with a correction order, and for failure to pay fines on time.

**Section ## (144A.479, subdivision 2) subjects home care providers to the same prohibitions against deceptive practices to which health care facilities are subject.

Section 28 (144A.4791, subdivision 10) contains conforming and technical changes.

Section 29 (144A.53, subdivision 1) modifies the statute governing the powers of the Office of Health Facility Complaints (OHFC) by clarifying OHFC’s authority to issue fines for violations of the nursing home licensing statutes and home care licensing statutes, as well as for failures to cooperate with the OHFC.

Section 30 (144A.53, subdivision 4, paragraph (a)) modifies the duties of OHFC by clarifying that OHFC is required to forward complaints or reports of maltreatment to law enforcement if the complaint or report falls within the jurisdiction of law enforcement.

Paragraph (c) requires OHFC to refer suspected criminal activity by a client or resident of a health care facility or home care provider to law enforcement.

Section 31 (144D.01, subdivision 1) contains a conforming change.

Section 32 (144D.02) contains a conforming change.

Section 33 (144D.04, subdivision 2) modifies the statute governing the content of contracts for housing with services establishments by requiring the contract to contain the physical mailing address of a natural person authorized to accept service of process, a statement that the resident has the right to request reasonable accommodations, and a statement describing the conditions under which the housing with services contract may be amended.

**Section 34 [144D.04, subdivision 2b] requires housing with services establishments to inform residents and the legal representatives of residents with 30 days of a change in ownership or management and to include the name, address and contact information of the new owner or manager.

**Section ## (144D.041) subjects housing with services to the same prohibitions against deceptive practices to which health care facilities are subject.

Section 35 [144D.095] clarifies the conditions under which home care services provided in a housing with services establishment can be terminated by placing a cross-reference in the statute governing housing with services establishments.

Section 36 [144G.01, subdivision 1] contains conforming changes.

**Section 37 [144G.07] clarifies the conditions under which an assisted living resident’s lease can be terminated by placing a cross-reference in the statute governing assisted living.

Section 38 [144G.08] clarifies the conditions under which an assisted living resident’s home care services can be terminated by placing a cross-reference in the statute governing assisted living.

Section 39 (256.045, subdivision 3) amends the state agency fair hearing process to allow a vulnerable adult who is the subject of a maltreatment investigation or an interested person to request a fair hearing.  Current law only applies to an individual or facility who has been determined to have maltreated a vulnerable adult.

Section 40 (256.045, subdivision 4) amends the procedure under the fair hearing process to modify notification requirements, consistent with the changes in section 39.

Section 41 (325F.71) expands the current law providing additional civil penalties for deceptive acts perpetrated against senior citizens or disabled persons to add vulnerable adults. Factors to be considered by the court in imposing a civil penalty are expanded to include whether the defendant provided or arranged for health care or services that are inferior to, substantially different than or substantially more expensive than offered, promised, marketed, or advertised.

Section 42 (609.2231, subdivision 8) amends the fourth-degree assault crime against vulnerable adults to eliminate a requirement that the assault inflicted demonstrable bodily harm.

Sections 43 to 56 amend the vulnerable adult maltreatment reporting law.

Section 43 (626.557, subdivision 3) requires mandated reporters to make reports as soon as possible, but in no event longer than 24 hours (current law requires a report to be made “immediately”).

Section 44 (626.557, subdivision 4) requires the common entry point to provide a method for a reporter to electronically submit evidence.  All reports must be directed to the common entry point.

Section 45 (626.557, subdivision 9) requires the common entry point to cross-reference multiple complaints concerning the same alleged perpetrator, facility, or licensee; the same vulnerable adult; or the same incident.

Section 46 (626.557, subdivision 9a) requires the common entry point to immediately notify the appropriate law enforcement agency if it determines that there is an immediate need for response by law enforcement.

Section 47 (626.557, subdivision 9b) provides that law enforcement must obtain the results of any investigation conducted by the lead investigative agency to determine if criminal action is warranted.

Section 48 (626.557, subdivision 9c) modifies the law governing lead investigative agency notification requirements, dispositions, and determinations.  Reporters would receive notice that a report had been received and provided information on the initial disposition in all cases, not just upon request.  Within five days of receipt of a report, specified information must be provided to the vulnerable adult or the vulnerable adult’s interested person regarding the report.  It would include the nature of the maltreatment allegations, name of the facility or other location where alleged maltreatment occurred, name of alleged perpetrator, protective measures that may be recommended or taken, contact information for the investigator, and confirmation of whether the lead investigative agency is investigating the matter.   Upon completing the investigation, a copy of the public investigation memorandum must be provided to law enforcement and a county attorney, as appropriate.  The notice to the vulnerable adult would include a reference to the fair hearing process discussed in sections 39 and 40, which replaces the vulnerable adult maltreatment review panel.

Section 49 (626.557, subdivision 9d) strikes a reference to the vulnerable adult maltreatment review panel and replaces it with language specifying that the vulnerable adult or interested person may request a fair hearing. A definition of “interested person” is stricken as it is now defined under section 56.

Section 50 (626.557, subdivision 9e) requires the commissioners of health and human services to develop and maintain written guidance for facilities that explains the reporting requirements as well as specified requirements under federal law.

Section 51 (626.557, subdivision 10b) requires a lead investigator to contact the alleged victim, if known, or an interested person within five days after initiation of an investigation to provide the investigator’s name and contact information.  The investigator must also communicate approximately every three weeks over the course of the investigation.

Section 52 (626.557, subdivision 12b) amends data classifications.  Data maintained by the common entry point would be private data on individuals or nonpublic data, as opposed to confidential or protected nonpublic data.  The name of the reporter would remain confidential data on individuals.  New provisions would allow the sharing of data with a vulnerable adult or interested person if both the commissioners of health and human services determine that the sharing is needed to protect the vulnerable adult. A mandated reporter would be authorized to disclose that the individual was the reporter to support a claim of retaliation that might be made against them for making a report. Finally, a lead investigative agency is authorized to share common entry point or investigative data and notify other affected parties, including the vulnerable adult, if it determines that there is reason to believe maltreatment has occurred and the information will safeguard the well-being of the affected parties.

Section 53 (626.557, subdivision 14) gives the commissioner of health authority to issue a correction order and impose an immediate fine upon finding that a facility has failed to comply with abuse prevention plan requirements.

Section 54 (626.557, subdivision 17) amends the prohibition on retaliation for persons who make reports.  It would include a person who the facility believes reported suspected maltreatment. The definition of “adverse action” is expanded to include additional items.

Section 55 (626.5572, subdivision 6) expands the definition of facility for the purposes of the requirements governing the reporting of maltreatment of vulnerable adults by including all housing with services establishments, including assisted living settings, under the definition of facility.

Section 56 (626.5572, subdivision 12a) adds a definition of "interested person." It includes a guardian or conservator; health care agent, and specified family member of next of kin.

Section 57 (Assisted Living Licensure and Dementia Care Certification Task Force) establishes a task force to make recommendations and draft legislation by February 1, 2019, for an assisted living licensing structure and dementia care certification process.

Section 58 (Assisted Living Report Card Working Group) establishes a working group to make recommendations and draft legislation by January 15, 2019, for an assisted living report card.

Section 59 (Crimes Against Vulnerable Adults Advisory Task Force) establishes a task force to make recommendations and draft legislation by December 1, 2018, for changes to state statute involving crimes against vulnerable adults.

Section 60 (Direction to the Commissioner of Health) requires the commissioner to submit by March 1, 2019, a report to the legislature documenting the commissioner’s progress toward implementing the changes at the Office of Health Facility Complaints (OHFC) to which the commissioner committed in the commissioner’s letter responding to the Office of the Legislative Auditor’s report on the OHFC.

Section 61 (Direction to the Commissioner of Health) requires the commissioner to submit quarterly reports to the legislature containing measures and analysis of the Office of Health Facility Complaints’ response to reports of maltreatment of vulnerable adults.

**Section ## (Directions to the Commissioner) requires the commissioner to post all substantiated reports of maltreatment against vulnerable adults on the OHFC Web site.

Sections 62 and 63 (Appropriation) appropriate $75,000 for each of the task forces or working groups.

**Section ## (Appropriation) is a blank appropriation to the commissioner for technological upgrades at the OHFC.

Section 64 (Repealer) repeals the vulnerable adult maltreatment review panel since the bill permits the review panel’s current function to be carried out through the state agency hearing process.