HF4338

Purpose

• Update who can be considered a party in state-related court or administrative proceedings.
• Improve requirements for assisted living facilities to ensure residents can request help with health and safety needs.
• Exempt assisted living facilities from the provider tax.
• Clarify who counts as a health care provider for statutory purposes.

Main Provisions

• Party definition changes in proceedings involving the state

  • Expands who can be a party to include entities such as partnerships, corporations, associations, or organizations with specific size or revenue limits.
  • Includes partners, officers, shareholders, members, or owners of those entities.
  • Excludes certain health care service providers when the matter involves licensing or reimbursement rates, to prevent those providers from being treated as parties in those specific disputes.

• Assisted living facility requirements (Minnesota Statutes 144G.41 and related sections)

  • Require facilities to distribute the assisted living bill of rights to residents.
  • Ensure services are delivered in a manner that complies with the Nurse Practice Act.
  • Use a person-centered planning and service delivery process.
  • Maintain a system to delegate health care activities to unlicensed personnel under RN supervision and evaluation.
  • Provide a means for residents to request assistance for health and safety needs 24/7, with possible use of technology to request assistance.
  • Allow residents to decorate their units, access food anytime, and choose visitors and roommates.
  • Require locks and a process to ensure only authorized entry, with advance notice to residents when possible; facilities must not lock residents in their units.
  • Develop and implement a staffing plan with biannual evaluations of staffing levels, ensuring adequacy to meet resident needs and emergencies.
  • Ensure there is always at least one person available 24/7 who can respond to resident requests, who is awake, in or near the building, capable of communicating and providing or summoning help, and able to follow directions.
  • Provide staff with access to an on-call registered nurse 24/7.

• Exception to the assistance-request requirement

  • No 24/7 requirement to provide a means to request assistance for residents with moderate to severe cognitive impairment (e.g., dementia) who cannot reliably use bells, call lights, pendants, or other alerting devices, based on nursing assessment.

• Health care provider definitions and tax-related changes

  • Expands the definition of “health care provider” to cover many licensed health care occupations and entities that provide patient services, with specific examples (e.g., medical, nursing, therapies, home health, ambulance services, certain providers that employ or contract with health care providers).
  • Lists numerous exclusions from being a health care provider for tax purposes, including hospitals, nursing homes, pharmacies, certain transportation providers, and various types of custodial or non-medical providers.
  • Defines “patient services” to include inpatient and outpatient care and related items and services, while excluding certain services (e.g., some services in nursing homes and other specified programs).
  • Applies these definitions to determine what counts for the provider tax and related provisions.

• Clarifications on provider tax scope

  • Intended to clarify which entities are subject to or exempt from the provider tax, with specific references to health care-related activities and services.

Significant Changes to Existing Law

• Revisions to who can be considered a party in state-related proceedings, potentially changing who can initiate or participate in cases involving the state.
• New or expanded requirements for assisted living facilities to ensure resident rights, health care delivery, and 24/7 assistance capabilities.
• Introduction of a robust exception for certain residents with cognitive impairments, affecting how the 24/7 assistance requirement is applied.
• Redefinition and expansion of what counts as a health care provider for tax and regulatory purposes, including detailed exclusions and inclusions.
• Explicit move to exempt assisted living facilities from the provider tax, aligning tax treatment with the new definitions and service provisions.

Implications for Residents and Providers

• Residents in assisted living facilities may experience stronger rights to request help, more predictable staffing, and clearer emergency response expectations.
• Facilities must invest in staffing, training, and systems to meet 24/7 assistance and on-call nurse requirements, with attention to resident privacy and autonomy.
• Some entities and individuals that previously might have been treated as parties in certain state proceedings may no longer be eligible to be named as parties, depending on size, revenue, and the nature of the proceeding.
• The provider tax landscape for health care-related services could change, potentially affecting billing, reimbursement, and which entities are taxed or exempt.

Relevant Terms - assisted living facilities - assisted living bill of rights - health care activities - unlicensed personnel - registered nurse (RN) supervision - person-centered planning - 24 hours per day, seven days per week (24/7) - on-call registered nurse - health care provider - provider tax - party (in court or contested case proceedings) - licensure and reimbursement rates - cognitive impairment (e.g., dementia) - patient services - staffing plan - emergency response - facility staffing levels