Purpose

This bill amends Minnesota’s hospital construction moratorium to create numerous exceptions that allow new hospital beds, new hospitals, and relocations/redistributions of beds under specific conditions. It aims to expand capacity and access to health services in various regions while outlining required criteria, oversight, and timelines for these projects.

Main Provisions

• carve-outs to the moratorium:
  • The general prohibition on increasing hospital beds or establishing new hospitals has many specified exceptions, including projects that would add beds, relocate beds, or create new facilities under defined circumstances.
• certificate of need and approvals:
  • Several exceptions rely on prior or ongoing CON determinations, past denied CON decisions with timely appeals, or other established exemptions.
  • Some projects require compliance with public interest review processes (see “Public Interest Review and Conditions”).
• service and facility requirements:
  • For many new or expanded facilities, the bill requires specific inpatient services to be offered (e.g., medical/surgical, obstetrics, intensive care, pediatrics, behavior health, emergency services).
  • Some provisions require advanced infrastructure and staffing commitments (e.g., electronic medical records systems, workforce development, patient safety programs, uncompensated care commitments).
• specific project examples and geographic focus:
  • Maple Grove: a new hospital with up to 300 licensed beds, owned/controlled by not-for-profit hospitals or systems, with detailed service, staffing, and community commitment requirements; includes timing/plan milestones.
  • Other targeted expansions: various counties and settings (e.g., Cass County near AhGwahChing, Fergus Falls, Beltrami, Otter Tail, Carver, Itasca, Hennepin, Ramsey, etc.) with specified bed counts and conditions.
  • Pediatric, psychiatric, trauma, and regional safety net facilities are repeatedly highlighted with tailored bed addition or relocation allowances.
• special conditions and deadlines:
  • Some provisions impose deadlines for plan submissions and public interest reviews (e.g., deadlines tied to 2009, 2021, 2022, etc., and timelines for completing reviews).
  • Certain expansions require findings of public interest or specific health system configurations (e.g., nonprofit ownership, regional care integration, emergency and trauma service coordination).
• bed relocation and redistribution rules:
  • Numerous clauses govern how beds can be moved within a hospital campus, between buildings, within a hospital system, or across regions, with constraints such as limiting net increases in capacity, not expanding beyond existing boundaries, and prioritizing certain uses (e.g., mental health or indigent care) before other uses.
  • Some transfers are allowed only if they do not create a net increase and are designed to replace or repurpose beds in a controlled way (including consideration of regional health system boundaries and historical bed usage).
• post-construction monitoring:
  • After completion, some projects require ongoing monitoring of patient case mix, payer mix, transfers, and patient flows, as well as intake/assessment requirements and data reporting to the department.

Notable Changes to Existing Law

• Expands the hospital construction moratorium’s scope by enumerating numerous detailed exceptions that would permit new beds or new facilities under conditions tied to public interest, nonprofit ownership, specific service arrays, and regional health planning.
• Adds explicit service requirements (e.g., mental health/inpatient beds, emergency services, obstetrics, pediatrics, rehabilitation, EMR adoption) for eligible projects.
• Introduces or reinforces public interest review requirements and timelines for certain projects, with some projects allowed to proceed with plan submission deadlines before formal review completion.
• Establishes conditions for bed relocation/redistribution that aim to prevent net capacity growth in certain situations while enabling strategic reallocation to address service needs.

Relevant Terms

• hospital construction moratorium
• bed capacity
• certificate of need (CON)
• net increase in beds
• relocation of hospital beds
• redistribution of beds
• public interest review
• Minnesota Statutes 144.551
• private nonprofit ownership / not-for-profit hospitals
• indigent care / uncompensated care
• direct care and treatment (DCT) executive board
• critical access hospital
• psychiatric hospital / behavioral health
• pediatric beds / pediatric health services
• trauma center / Level I trauma center
• safety net hospital
• emergency medical services
• electronic medical records (EMR) with physician order entry
• plan submission deadlines
• plan monitoring and reporting
• regional health planning
• Maple Grove (city) hospital project
• AhGwahChing facility (Cass County reference)
• public interest review under section 144.552
• inpatient services (medical/surgical, obstetrics, ICU, etc.)
• intensive care / rehabilitation beds
• disability and mental health service needs (specialty pediatric/private/public considerations)