SF4418 (Legislative Session 94 (2025-2026))
Certain information access authorization provision, Chapter 144D references removal provision, patient restraints usage documentation requirement provision, and change of ownership provisions modifications
Related bill: HF4212
AI Generated Summary
Purpose
This bill aims to strengthen health-care oversight and safety in Minnesota by: - improving access to certain facility records for the Health Commissioner; - updating and clarifying rules about electronic monitoring and the use of resident information; - clarifying change-of-ownership and related regulatory requirements for housing and care facilities; - tightening and standardizing discharge planning and the use of restraints in hospitals and other health-care settings.
Main Provisions (What the bill seeks to accomplish)
Access to records and enforcement
- The Health Commissioner may require facilities to provide relevant information, records, incident reports, and other documents for verification purposes.
- Violations related to these access requirements can lead to enforcement actions, including revocation or nonrenewal of a facility’s registration.
- Fines for violations of certain sections can be set at 200% of the amount billed or received in excess of the allowed maximum.
Updating references and definitions
- Clarifies that certain boarding care homes can provide nursing or home-care services without being in conflict with state rules.
- Expands definitions to include electronic monitoring and devices, and clarifies who is considered a resident and who may act as a resident representative.
- Updates ownership/change provisions and registration requirements for housing with services establishments (including those under chapter 144D).
Coverage of housing with services and related facilities
- Establishes registration requirements for boarding and lodging establishments and housing-with-services establishments, and aligns background check requirements.
- Sets rules on which services may or may not be provided in boarding and lodging establishments unless they are registered under 144D.
Health care provider definitions and patient services
- Broadens the definition of what constitutes a health care provider for purposes of state law, including various professionals, facilities, and entities that deliver patient services.
- Adds explicit exclusions (e.g., certain hospitals, nursing homes, wholesale distributors, transportation providers) from the broader health-care provider definition.
- Defines “patient services” and specifies items included and excluded from that concept (e.g., inpatient/outpatient services, drugs, equipment, and certain program services).
Use of patient restraints
- Requires hospitals to follow discharge-planning standards that assess post-hospital care needs and ensure timely and proper transfer arrangements.
- Hospitals must document and communicate the restraint use (type, duration, frequency) when patients are discharged or transferred.
- Discharge planning must include providing a list of available Medicare-eligible home care agencies or skilled-nursing facilities, and hospitals must not limit the patient’s choice of providers.
- Adds an imminent-risk standard to constraints used in care settings, clarifying when restraints pose immediate health, safety, or rights concerns.
Imminent risk
- Adds a new subdivision defining “imminent risk” as an immediate and impending threat to a patient’s health, safety, or rights.
Article-by-Article Overview (What changes in practice or law)
Article 1: Access to Records
- Expands the authority to request and review facility records and incident reports.
- Establishes penalties and enforcement mechanisms for noncompliance with access requirements.
Article 2: Updating References
- Updates rules to avoid restricting certain types of care in boarding care or housing-with-services settings.
- Revises definitions for electronic monitoring, residents, and resident representatives.
- Strengthens registration and background-check requirements for housing-with-services and related establishments.
- Clarifies services that may not be provided in boarding and lodging establishments unless under 144D.
Article 3: Use of Patient Restraints
- Strengthens discharge-planning requirements for hospitals to ensure safe, timely postacute care.
- Mandates documentation and notification related to restraint use at discharge or transfer.
- Introduces an official definition and recognition of imminent risk in restraint-related sections.
Significant Changes to Existing Law
- Expanded enforcement and penalties for failing to provide required access to records.
- Broadened definitions to include electronic monitoring, resident representations, and a wider array of facilities within the health-care oversight framework.
- Revisions to registration, ownership-transfer provisions, and background-check requirements for housing-with-services and boarding/lodging establishments.
- Expanded scope of “health care provider,” with explicit exclusions for certain entities and services.
- New requirements around the use of restraints, including discharge-planning obligations and reporting, plus a formal definition of imminent risk.
Potential Impacts and Considerations
- Facilities may face higher compliance requirements for record-keeping, reporting, and restraint documentation.
- Residents and families could see more transparent processes around restraints, discharge planning, and provider options.
- Hospitals and care facilities may need to adjust policies to ensure timely, documented discharge planning and communication with receiving providers.
- The changes could increase regulatory oversight and accountability for care settings, especially those operating under housing-with-services and 144D registrations.
Relevant Terms - electronic monitoring - electronic monitoring device - boarding care home - housing with services establishment - resident - resident representative - discharge planning - restraint - imminent risk - Health Commissioner (commissioner of health) - enforcement action - 144D (housing with services) - 144G.08 (restraints definition/related provisions) - 144A.72 (records access/penalties) - 144A.74 (fines/overbilling) - 144.56 (boarding care home rules) - 144.6502 (definitions for monitoring in facilities) - 157.17 (boarding and lodging establishment registration) - 295.50 (definition of health care provider) - 144A.161 (change in ownership/closure provisions) - 144A.472 (facility reporting requirements) - 144A.161 (closure/reorganization provisions) - 144G.31 (subdivision changes) - Imminent risk (new subdivision)
Bill text versions
- Introduction PDF PDF file
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| March 12, 2026 | Senate | Action | Introduction and first reading | ||
| March 12, 2026 | Senate | Action | Referred to | Health and Human Services |
Citations
[
{
"analysis": {
"added": [
"Prohibits the commissioner from adopting or enforcing any rule that limits (1) a certified boarding care home from providing nursing services in accordance with the home's Medicaid certification, or (2) a noncertified boarding care home registered under chapter 144D from providing home care services in accordance with the home's registration."
],
"removed": [],
"summary": "Amends 144.56 to remove regulatory limits on nursing/home care services by boarding care homes and 144D-registered noncertified boarding care homes.",
"modified": [
"Loosens regulatory restrictions on service provision by boarding care homes and 144D-registered noncertified homes."
]
},
"citation": "144.56",
"subdivision": "2b"
},
{
"analysis": {
"added": [
"Requires discharge planning evaluation addressing likelihood of needing posthospital services, availability of those services, patient self-care capacity, and appropriate discharge environment.",
"Requires timely completion of discharge planning evaluation and inclusion in patient medical records.",
"Requires hospitals to provide a list of Medicare-eligible home care agencies or skilled nursing facilities and to assist patients in obtaining care within their plan or network."
],
"removed": [],
"summary": "Incorporates postacute discharge planning requirements consistent with federal standards into hospital discharge planning.",
"modified": [
"Codifies federal discharge planning requirements into state statute."
]
},
"citation": "144.586",
"subdivision": "2"
},
{
"analysis": {
"added": [
"Electronic monitoring means placement/use of an electronic monitoring device per this section.",
"Electronic monitoring device means a camera or device that records broadcasts and is used in a resident’s room/private unit.",
"Facility includes entities licensed as a nursing home (ch. 144A), boarding care home (chs. 144.50–144.56), housing with services establishments under 144D, and certain licensed facilities thereafter.",
"Resident and resident representative definitions (including order of priority for representatives)."
],
"removed": [],
"summary": "Adds definitions related to electronic monitoring and facilities.",
"modified": [
"Provides explicit definitions to govern electronic monitoring and related facility/resident terms."
]
},
"citation": "144.6502",
"subdivision": "1"
},
{
"analysis": {
"added": [
"Requires facilities undergoing closure, reduction, or operational change (or housing with services units closed due to space being replaced by a nursing facility bed) to comply with specified requirements."
],
"removed": [],
"summary": "Addresses closure/reduction/change in operations for housing with services units and related facilities.",
"modified": [
"Clarifies procedures during closure or operational changes affecting housing with services units."
]
},
"citation": "144A.161",
"subdivision": "1a"
},
{
"analysis": {
"added": [
"Imminent risk defined as an immediate and impending threat to health, safety, or rights of an individual."
],
"removed": [],
"summary": "Adds a new subdivision defining imminent risk for use in restraint decisions.",
"modified": [
"Introduces a formal definition of imminent risk to support restraint/clinical decision-making."
]
},
"citation": "144G.08",
"subdivision": "6a"
},
{
"analysis": {
"added": [
"Adds Subd.6 to 144G.31; content of the subdivision is not detailed in the excerpt."
],
"removed": [],
"summary": "Adds subdivision 6 to section 144G.31 (content not shown in excerpt).",
"modified": []
},
"citation": "144G.31",
"subdivision": "6"
},
{
"analysis": {
"added": [
"Requires registration (with annual renewal) for boarding and lodging establishments and housing with services establishments; requires disclosure of name/address, operator, services, resident types, staff qualifications, and resident needs; commissioner to provide registration form."
],
"removed": [],
"summary": "Regulates registration of housing with services and related establishments; aligns with 144D requirements.",
"modified": [
"Establishes ongoing registration requirements and identifies information necessary to support resident needs."
]
},
"citation": "157.17",
"subdivision": "2"
},
{
"analysis": {
"added": [
"Specifies that, except those facilities registered under chapter 144D, boarding and lodging establishments may not admit or retain individuals who require certain advanced care (e.g., bowel incontinence, catheter care, wound/dressing changes, or level of care beyond supportive/health supervision)."
],
"removed": [],
"summary": "Defines restrictions on services that boarding and lodging establishments may provide.",
"modified": [
"Adds explicit admissions limitations to non-144D establishments."
]
},
"citation": "157.17",
"subdivision": "5"
},
{
"analysis": {
"added": [
"Broadens the definition of 'Health care provider' to include additional professionals and entities involved in direct patient services or reimburseable activities."
],
"removed": [],
"summary": "Expands the definition of health care provider and related categories.",
"modified": [
"Extends applicability of health care provider definitions across settings (e.g., housing with services, home care, etc.)."
]
},
"citation": "295.50",
"subdivision": "4"
},
{
"analysis": {
"added": [
"Criminal background check requirements apply to personnel providing home care services under 144A.43–144A.47 and personnel providing hospice care under 144A.75–144A.755."
],
"removed": [],
"summary": "Criminal background check requirements apply to specified personnel.",
"modified": [
"Extends background check requirements to additional home care and hospice contexts."
]
},
"citation": "299C.66 to 299C.71",
"subdivision": ""
},
{
"analysis": {
"added": [
"Criminal background check requirements in 144.057 apply specifically to personnel described in home care and hospice sections (144A.43–144A.47; 144A.75–144A.755)."
],
"removed": [],
"summary": "Cross-references and scope for criminal background checks in home care and hospice contexts.",
"modified": []
},
"citation": "144.057",
"subdivision": ""
},
{
"analysis": {
"added": [
"Serves as the scope for criminal background checks applied to home care personnel."
],
"removed": [],
"summary": "Referenced for background check applicability to home care personnel.",
"modified": []
},
"citation": "144A.43 to 144A.47",
"subdivision": ""
},
{
"analysis": {
"added": [
"Serves as the scope for criminal background checks applied to hospice care personnel."
],
"removed": [],
"summary": "Referenced for background check applicability to hospice personnel.",
"modified": []
},
"citation": "144A.75 to 144A.755",
"subdivision": ""
},
{
"analysis": {
"added": [
"Incorporates reference to 325F.72 when describing housing with services units and related regulatory contexts."
],
"removed": [],
"summary": "Mentions of 325F.72 in relation to housing with services and related units.",
"modified": []
},
"citation": "325F.72",
"subdivision": ""
},
{
"analysis": {
"added": [
"Adds or adjusts items within the patient services definition under 144A.474 Subd.11 (content not shown in excerpt)."
],
"removed": [],
"summary": "Updates to patient services enumeration under 144A.474 (as cited in 2025 Supplement).",
"modified": [
"Expands or clarifies the scope of patient services in the 144A.474 framework."
]
},
"citation": "144A.474",
"subdivision": "11"
},
{
"analysis": {
"added": [
"Defines/expands patient services to include a enumerated list of services (beds, nursing, facilities usage, drugs, etc.)."
],
"removed": [],
"summary": "Expands patient services within the health care provider framework.",
"modified": [
"Broadens the scope of patient services covered under 295.50 Subd.9b."
]
},
"citation": "295.50",
"subdivision": "9b"
}
]Progress through the legislative process
In Committee