Assisted Living Resources & FAQs - Minnesota Department of Health

Assisted Living Resources & Frequently-Asked Questions (FAQs)

Application Process

All information related to the application process is available on the Application Materials page.

Assisted Living Contract

An "assisted living contract" means the legal agreement between a resident and an assisted living facility for housing and, if applicable, assisted living services.

The contract should include:

  • terms concerning provisions of housing
  • assisted living services
  • a service plan, if applicable
Related Statutes: 144G.08 Subd. 5, 144G.50

Refer to the above from statute 144G.50 for the required items of am assisted living contract.

No. Each provider will be responsible for crafting their own contract with all the required elements.

Yes. They will sign the assisted living contract for the housing piece. A service agreement may be added later as needed.

Yes. Please refer to the definition of resident in statute 144G.09, Subd. 59. A resident will have a contract for housing at the very least.

It is not required by the 144G law for providers to include that. There is, however, a statute (256.975) under the Minnesota Board on Aging that requires prospective residents to call the Senior Linkage Line (SLL) prior to making a “long term care” choice. MDH will have some language on the Disclosure of Services checklist for consumers to be made aware of this. The current statute is being updated to reflect the new license changes for August 1st, so this will continue when the assisted living licenses are in place. Therefore, providers should inform prospective residents that they need to call the SLL before they sign a lease and be offered objective counseling and support to make an informed decision. 

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Background Studies

Each application must include documentation of compliance with the background study requirements in section 144G.13 for the owner, controlling individuals, and managerial officials.

Prior to a license being issued, a managerial official or a natural person who is an owner with direct ownership interest is required to undergo a background study under section 144.057.

A license will not be issued if any controlling individual, including a managerial official, has been unsuccessful in having a background study disqualification set aside under section 144.057 and chapter 245C.

No person may be involved in the management, operation, or control of an assisted living facility if the person has been disqualified under chapter 245C.

Definitions:

144G.08 Subd. 48. Owner: means an individual or legal entity that has a direct or indirect ownership interest of five percent or more in a licensee. For purposes of this chapter, "owner of a nonprofit corporation" means the president and treasurer of the board of directors or, for an entity owned by an employee stock ownership plan, means the president and treasurer of the entity. A government entity that is issued a license under this chapter shall be designated the owner.

245A.02 Subd. 5a. Controlling individual: means an owner of a program or service provider licensed under this chapter and the following individuals, if applicable:

  • (1) each officer of the organization, including the chief executive officer and chief financial officer;
  • (2) the individual designated as the authorized agent under section 245A.04, subdivision 1, paragraph (b);
  • (3) the individual designated as the compliance officer under section 256B.04, subdivision 21, paragraph (g);
  • and
  • (4) each managerial official whose responsibilities include the direction of the management or policies of a program.
  • (5) For purposes of this subdivision, "managerial official" means an individual who has the decision-making authority related to the operation of the program, and the responsibility for the ongoing management of or direction of the policies, services, or employees of the program. A site director who has no ownership interest in the program is not considered to be a managerial official for purposes of this definition.

144G.08 Subd. 15. Controlling individual: means an owner and the following individuals and entities, if applicable:

  • (1) each officer of the organization, including the chief executive officer and chief financial officer;
  • (2) each managerial official;
  • and
  • (3) any entity with at least a five percent mortgage, deed of trust, or other security interest in the facility.

144G.08 Subd. 36. Managerial official: means an individual who has the decision-making authority related to the operation of the facility and the responsibility for the ongoing management or direction of the policies, services, or employees of the facility. Per 144G.13, for purposes of background studies, this only pertains to individuals who provide direct contact.

245C.02 Subd. 11. & 144G.08 Subd. 22 Direct contact: means providing face-to-face care, training, supervision, counseling, consultation, or medication assistance to persons served by the program.

Related Statutes: 144G.12 Subd. 1 (6), 144G.13, 144.057, 245C

No. If there is already a background check completed from the homecare ownership it simply needs to be “affiliated” with the 144G licensure via NetStudy 2.0 portal.

Providers will want to affiliate the controlling individual under that identification number. With that affiliation, a new background study request will not be needed. See the previous question and answer.

Yes. Section 144G.13, subd. 1(b) makes it clear that a license cannot be issued if “any controlling individual, including a managerial official, has been unsuccessful in having a background study disqualification set aside under section 144.057 and chapter 245C.” This implies those individuals must have either a clear background study or be successful in having a disqualification set aside under the stated statutes.

Per the definition of “Owner” noted in Minn. Stat. § 144G.08, Subd. 48, “owner of a nonprofit corporation” means the president and treasurer of the board of directors. For the purpose of filling in ownership information for a nonprofit corporation on a Conversion or Provisional Assisted Living Facility License Application, applicants should list the nonprofit corporation as holding 100% of the ownership interest. The President of the Board of Directors and the Treasurer should be listed as owners with 0% ownership interest. The President and Treasurer will be subject to background study requirements.

Although not considered owners, other members of the board of directors may be controlling individuals under Minn. Stat. § 144G.08, Subd. 15; however, pursuant to Minn. Stat. § 144G.13, Subd 1 (a), only managerial officials who provide direct contact as defined by Minn. Stat. § 144G.08, Subd. 22, and owners, are subject to the background study requirements. Notwithstanding the individual background study requirements, no person may be involved in the management, operation, or control of an assisted living facility if the person has been disqualified under chapter 245C.

Please note that this response is specific to the background study requirements noted in Minn. Stat. § 144G.13 concerning ownership, managerial officials, and controlling individuals. Applicants are subject to all other background study requirements noted in statute, including those noted in Minn. Stat. Chapter 245C.

No. If there is already a background check completed it simply needs to be “affiliated” with the 144G licensure via NetStudy 2.0 portal.

Once MDH has receipt of payment, a notice is sent to DHS/NetStudy with the Applicant’s information so DHS can send the applicant information to onboard for Background Studies.

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Campus Definition

The definition for a campus is contained in the 7th Special Session language under 144G.08 Subd. 4a: "Assisted living facility campus" or "campus" means:

  1. a single building having two or more addresses, located on the same property with a single property identification number;
  2. two or more buildings, each with a separate address, located on the same property with a single property identification number; or
  3. two or more buildings at different addresses, located on properties with different property identification numbers, that share a portion of a legal property boundary.
Related Statutes: 144G.08 Subd. 4a

No. You can hold an assisted living license in one building and an assisted living with dementia care for another one.

Yes, unless you meet the campus definition as above.

No. Per definition you will be required to license each of these entities separately.

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Dementia Care Training

An assisted living facility with dementia care must provide residents with dementia-trained staff who have been instructed in the person-centered care approach. All direct care staff assigned to care for residents with dementia must be specially trained to work with residents with Alzheimer's disease and other dementias. The persons providing or overseeing staff training are required per statute to have experience and knowledge in the care of individuals with dementia, including:

  • two years of work experience related to Alzheimer's disease or other dementias, or in health care, gerontology, or another related field; and
  • completion of training equivalent to the requirements in this section and successfully passing a skills competency or knowledge test required by the commissioner per 144G.83 Subd. 3(2).

Related Statutes: 144G.83

Per 144G.83 Subd. 3 anyone providing or overseeing staff training pertaining to dementia care must pass a skills competency or knowledge test required by the commissioner. MDH recommends the essentiALZ® Exam from Alzheimer’s Association.

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Food Code Requirements

All assisted living facilities shall offer to provide or make available at least the following services to residents:

  • At least three nutritious meals daily, with snacks available seven days per week.
  • Food is prepared according to the recommended dietary allowances in the United States Department of Agriculture (USDA) guidelines.
  • Facilities must include seasonal fresh fruit and fresh vegetables.
  • Menus must be prepared at least one week in advance, and made available to all residents.
  • The facility must encourage residents' involvement in menu planning.
  • Meal substitutions must be of similar nutritional value if a resident refuses a food that is served.
  • Residents must be informed in advance of menu changes.
  • Food must be prepared and served according to the Minnesota Food Code, Minnesota Rules, chapter 4626.

Resources: Food Business Fact Sheets. Please note the following ones to view:

  • Minnesota Certified Food Protection Manager
  • Person in Charge
  • Specialized Processes in Retail Food Establishments
  • Cleaning & Sanitizing
  • Cooling time/Temperature Control for Safety Foods (TCS)
  • Date Marking
  • Employee Personal Hygiene
  • Equipment Requirements
  • Handwashing for Employees
  • Reheating Ready-to-Eat Foods
  • Temperature and Time Requirements for Food
  • Time/Temperature Control for Safety Foods

All assisted living facilities that prepare and serve food need a CFPM. Only those not preparing food will not require a CFPM.

The food code does not give an exception for a CFPM based on the size of the facility. The exceptions are based on the risk of the practice being done. If food is being prepared, a CFPM is required.

No, a CFPM is not required to be on site at all times food is being prepared and served, however there does need to be someone that has been trained in food safety present at all times.

HACCP plans are required when specialized processes are being done, such as vacuum packaging foods.

A person in charge is someone that has been trained to prevent foodborne disease prevention. The Certified Food Protection Manager (CFPM) can train individuals designated as the PIC. The PIC is responsible for ensuring safe food handling practices at all times.

No, the requirement is for one full-time CFPM at each licensed facility.

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Licensed Assisted Living Director (LALD)

All licensed assisted living facilities require a Licensed Assisted Living Director (LALD). Requirements can be found at the BELTSS Assisted Living Director website. Any questions regarding the licensed assisted living director can be emailed directly to beltss.hlb@state.mn.us.

Related Statutes: 144G.08 Subd. 6 144G.12 Subd. 1 (2), (13), and (14) 144G.82 Subd. 2

Yes, each Minnesota licensed assisted living facility must employ an assisted living director licensed by the Minnesota Board of Executives for Long Term Services and Supports (BELTSS) under Minn. Stat. 144G.08 Subd. 6. Under Minn. Stat. 144G.10 Subd. 1a, each assisted living facility must employ an assisted living director licensed or permitted by the BELTSS.

All health care professional licenses indicate that a credential holder has met the minimum knowledge, skills, and abilities of an entry level practitioner. The legislature establishes those minimums in statute and rules are created by the assigned agency to provide greater detail to the law’s framework. A Registered Nurse, Medical Doctor, Social Worker, Alcohol Drug Counselor, plus 13 other professions in Minnesota, have met the minimum education and prior experience requirements to obtain a professional individual license. The ongoing practice standards are established by the Professional Practice Analysis of the National Association of Long Term Care Administrator Boards (NAB) every five years to assure a contemporary community standard developed from a practitioner perspective.

Licensees who serve as directors for two or more facilities must obtain approval for a secondary license(s) from the board. You can find the Shared Director form required to apply for a secondary license on the Forms and Tutorials page of the BELTSS website.

Leadership of organizations and management of daily operations continues to evolve. BELTSS intentionally does not identify a minimum number of hours for the Licensed Assisted Living Director but expects that the LALD has assessed how to communicate, interact, monitor for quality control, delegate, investigate, monitor safety and environment controls while being the Director of Record.

You are required to notify BELTSS within five (5) days of a change of LALD in the facility per 6400.7050C. You can find information about how to update your Director of Record on the Forms & Tutorials page of the BELTSS website.

Yes. The individual would be required to possess both licenses.

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Licensed Resident Capacity

Per 144G.08 Subd. 31, "licensed resident capacity" means the resident occupancy level requested by a licensee and approved by the commissioner.

The total licensed resident capacity is what is or could be the number of residents you will be or plan to be serving in the license period without going over. Or in other words, your census (or desired census).

Related Statutes: 144G.08, 144G.12

You will not be penalized if you pick a number too high to be licensed for and do not fill to that number, but fines will be issued if you indicate your capacity is lower than what your census truly is at any point.

Yes, during your license renewal period is when you will have the opportunity to increase (or decrease) that number to fit your business plans more adequately for the next license period.

No. Please refer to the campus definition in 144G.08 Subd. 4a: "a single building having two or more addresses, located on the same property."

There are three criteria that must be met if a provider has an independent living unit under the same roofline as the rest of the building.

  • Must have a separate entrance to the outdoors.
  • Must have a separate address for the above-mentioned door.
  • Must have a firewall/door between the independent living unit and the rest of the building.

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License Fees

The fee structure for the new license will be:

  • Assisted Living Facility License: $2,000 plus $75 per planned resident capacity.
  • Assisted Living Facility with Dementia Care License: $3,000 plus $100 per planned resident capacity.
Related Statutes: 144G.12 144.122

It is the number of residents a facility chooses to be licensed for. Please refer to the definition of "resident." "Resident" means a person living in an assisted living facility who has executed an assisted living contract (related statute: 144G.08 Subd. 59). Therefore, any individual residing in the facility will be counted in the planned resident capacity.

Facilities are required to license to the highest denominator as there is only one license allowed per building. In this scenario, the building would be required to hold the assisted living with dementia care license. Referring to the top then, the fee would be the $3,000 plus $100 per planned resident capacity.

Current comprehensive home care providers who do not intend to provide home care services under 144A on or after August 1, 2021:

  • Shall be issued a comprehensive home care license for a prorated license period upon renewal, effective for license renewals beginning on or after September 1, 2020.
  • The prorated license period shall be effective from the provider’s current comprehensive home care license renewal date through July 31, 2021.
  • Comprehensive home care providers with prorated license periods shall pay a prorated fee based on the number of months the comprehensive home care license was in effect.
  • Comprehensive home care providers using the prorated license or who otherwise do not intend to provide home care services after August 1, 2021, must notify the recipients of changes to their home care services in writing at least 60 days before the expiration of the provider’s home care license, or no later than May 31, 2021, whichever is earlier.
Please see Minn. Stat. § 144G.191, Subd. 3(c)(1)-(5) for the specific information you must include in the notice.

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License Options

There are two license options for assisted living facilities:

  • Assisted living facility (144g.08 Subd. 7): a licensed facility that provides sleeping accommodations and assisted living services to one or more adults.
  • Assisted living facility with dementia care (144G.08 Subd. 8): a licensed assisted living facility that is advertised, marketed, or otherwise promoted as providing specialized care for individuals with Alzheimer's disease or other dementias. An assisted living facility with a secured dementia care unit must be licensed as an assisted living facility with dementia care.
Related Statute: 144G.80-84

In statute definition 144G.08 Subd. 8, "Assisted living facility with dementia care" means a licensed assisted living facility that is advertised, marketed, or otherwise promoted as providing specialized care for individuals with Alzheimer's disease or other dementias. An assisted living facility with a secured dementia care unit must be licensed as an assisted living facility with dementia care.

If you do not plan to market or promote providing specialized care for dementia, and will not have a secured unit, then you will apply for the Assisted Living License. If your "dementia unit" is secured in any way, then the entire building will need to be licensed as an Assisted Living with Dementia Care license.

Facilities are required to license to the highest denominator as there is only one license allowed per building. In this scenario, the building would be required to hold the assisted living with dementia Care license.

In statute definition 144G.08 Subd. 8: "Assisted living facility with dementia care" means a licensed assisted living facility that is advertised, marketed, or otherwise promoted as providing specialized care for individuals with Alzheimer's disease or other dementias. An assisted living facility with a secured dementia care unit must be licensed as an assisted living facility with dementia care.

In statute definition 144G.08 Subd. 62: "Secured dementia care unit" means a designated area or setting designed for individuals with dementia that is locked or secured to prevent a resident from exiting, or to limit a resident's ability to exit, the secured area or setting. A secured dementia care unit is not solely an individual resident's living area.

In conclusion, if the 4–5-bedroom house meets the above two definitions, then yes. The determining factor is, does the resident have the freedom to leave the "unit" of their own volition.

In statute definition 144G.08 Subd. 62: "Secured dementia care unit" means a designated area or setting designed for individuals with dementia that is locked or secured to prevent a resident from exiting, or to limit a resident's ability to exit, the secured area or setting. A secured dementia care unit is not solely an individual resident's living area.

Please use the definition to determine the unique specifications for your facility.

In statute definition 144G.08 Subd. 8: "Assisted living facility with dementia care" means a licensed assisted living facility that is advertised, marketed, or otherwise promoted as providing specialized care for individuals with Alzheimer's disease or other dementias. An assisted living facility with a secured dementia care unit must be licensed as an assisted living facility with dementia care.

Based on the above definition, if the plan is to market the facility as "providing specialized care for individuals" with dementias, then yes.

The new assisted living licensure law impacts all customized living services funded by Elderly Waiver (EW), Brain Injury Waiver (BI) and Community Access for Disability Inclusion (CADI) Waivers. If you want to continue to receive payment, you must be licensed as an assisted living facility.

If you have questions for the Department of Human Services (DHS) regarding customized living services provider enrollment, please contact Samuel Acquaah at samuel.acquaah@state.mn.us.

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Meals and Dietary Requirements

Providers must offer to provide (or make available) the following services to residents:

  • At least three nutritious meals daily with snacks available seven days per week
  • Seasonal fresh fruit and fresh vegetables
  • Menus must be prepared at least one week in advance
  • Meals prepared according to the recommended dietary allowances in the United States Department of Agriculture (USDA) guidelines
  • Meal substitutions must be of similar nutritional value
  • Residents must be informed in advance of menu changes
  • Food must be prepared and served according to the Minnesota Food Code
Providers cannot require a resident to include and pay for meals in their contract (if they do not want to purchase them).

Related Statutes: 144G.41 Subd. 1 (13); Minnesota Food Code, Minnesota Rules, Chapter 4626

Statute indicates all assisted living facilities shall offer to provide or make available at least three nutritious meals daily. As a provider you are required to have the availability to provide at least three meals per day. The provider cannot have a blanket "one size fits all" meal charge.

Statute indicates all assisted living facilities shall offer to provide or make available at least three nutritious meals daily. There is no language that indicates where the meals should be served.

Statute indicates all assisted living facilities shall offer to provide or make available at least three nutritious meals daily. Using "Mom’s Meals" would meet the "make available" option, but will not negate the menu requirement, nor the seasonal fresh fruit and vegetable requirement. A provider would still be responsible to ensure the entire statute is met.

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Physical Environment

Assisted living facilities shall comply with all applicable state and local governing laws, regulations, standards, ordinances, and codes for fire safety, building, and zoning requirements.

Related Statutes: 144G.45 144G.81 Subd. 1, 2, & 3

Fire protection for assisted living facilities must be met per 144G.45 Subd. 2, as amended. This subdivision does not reference a sprinkler mandate. However, the assisted living with dementia care license requires the building to be sprinklered by August 2029 (144G.81 Subd. 1 (2)). Please keep in mind that you must stay in compliance with all other local or state codes and standards.

In December of 2020, the legislature passed an amendment to 144G.45 Subd. 2, a law that added clarity to the assisted living licensure law that originally passed in the spring of 2019. This law defines the design requirements for assisted living construction. If the construction project applies for a building permit prior to August 1, 2021, then that project needs to comply with the construction requirements at that time, the 2020 Minnesota State Building Codes. If a construction project applies for a building permit on August 1 or later, the project must comply with the 2020 Minnesota State Building Codes and the design requirements in 144G (Life Safety Code and Facility Guidelines Institute).

The law requires the inclusion of at least one bath to allow residents the option of a bath. One possible design option would be to have a central bath that all residents are able to use. This requirement is in a subdivision for new construction or new licenses. Refer to statute 144G.45 Subd. 4 for more information.

Most (small) facilities do not have an extinguishing or alarm system and would not be expected to install a system to meet this requirement. If you do have one of those systems (larger facility), a general requirement of the Minnesota Fire Code is a backup system, and that system is usually a battery backup. A battery backup system meets this emergency preparedness requirement.

A generator is generally not required in any assisted living facility. Generators are usually installed when a loss of power would cause major injury or death. If your emergency plan calls for a generator, then that generator must be installed, maintained, and tested in accordance with codes.

No. If you have a fire alarm system and/or emergency lighting, then you most likely have a battery backup system in accordance with the Minnesota Fire Code. Typically, facilities with 1-5 residents (usually single-family home) or 6-16 residents (usually duplex, triplex or fourplex) do not have emergency lighting and would not require an alternate source of energy to maintain that system in the event of a power outage. If you have a generator then you must maintain, inspect, and test it in accordance with all codes and standards.

You need a plan to deal with a power outage if you have some sort of sewage pump that requires electricity. Some facilities may have toilets that flush and then are pumped to the sanitary sewer or septic system. These types of systems must have backup power. In most cases, the backup power used for this is battery.

The statute does not specify that a facility must have a generator that would support the operations of a “whole building.” The generator (if installed or required by the facility) must serve the building as described in the emergency plan. Portable generators may meet those requirements if written into the emergency plan.

Fire drills and staff training must comply with 144G.45 Subd. 2, as amended, and should be documented in the facility’s standard operating procedures. Staff training for fire drills and performing fire drills are two different things. Staff must be trained as indicated in statute and the fire drill requirements test the staff training. Staff will evaluate their performance on fire drills and update their training based on performance on the drills.

The law does not require a Fire Marshal to participate in assisted living facility fire drills. MDH recommends involving the local fire department, fire chief and or state fire marshal with fire drill planning. MDH believes it is very beneficial to introduce the responding fire official to your building.

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SS-4 Document

For applicants who have an existing Federal Employment Identification Number (FEIN), the preferred method of confirming the FEIN is via the 147C letter issued by the IRS. Applicants may request that the IRS search for their FEIN by calling the Business & Specialty Tax Line at 1-800-829-4933. The applicant should then receive the 147C letter via mail or fax with the FEIN number.

Assisted living facility license applicants who require a new FEIN should visit IRS.GOV for information concerning Employer ID numbers. A business may apply for an FEIN in various ways, and you may apply online. This is a free service offered by the Internal Revenue Service and you can get your FEIN immediately.

If the applicant is not able to provide a 147C letter with the Assisted Living Facility License Application, MDH will accept the below noted documentation as evidence of the FEIN. All documentation must be issued by the IRS and include information sufficient to confirm the identity of the business and the corresponding FEIN. Any confidential information should be redacted prior to submission.

All applicants should continue to request a 147C letter from the IRS and submit a copy of the letter to the Minnesota Department of Health as soon as possible.

The following are acceptable alternatives to submit with your application while you wait for the SS-4:

  • Computer-generated notice that was issued by the IRS when the applicant first applied for the FEIN. This notice is issued as a confirmation of the application for, and receipt of an FEIN.
  • If the applicant used the FEIN to open a bank account or apply for any type of state or local license, they may contact the bank or agency to secure the FEIN and send confirmation to MDH.
  • Appropriately redacted first page of an as-filed tax return (1120, 990, 1065, 941, 943, 1099-NEC, W-4, 5500).
  • IRS determination letter for tax-exempt organizations.
  • Printout/screenshot of search results showing the organization as listed in IRS Pub 78 for tax-exempt organizations (see https://www.irs.gov/charities-non-profits/search-for-tax-exempt-organizations)
  • Listing in an as-filed 990 group return.
  • S-Corp election confirmation.
  • Any other correspondence from the IRS that includes the organization’s name and FEIN (for example, an audit notice letter, a request for documents, a notice of late filing of a tax return, etc.) provided the documentation is issued by the IRS and include information sufficient to confirm the identity of the business and the corresponding FEIN.

You can email it to the health.assistedliving@state.mn.us email box and we will attach it to your application file.

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Staffing

All assisted living facilities must have a clinical nurse supervisor who is a registered nurse licensed in Minnesota. The positions of both the assisted living director and the clinical nurse supervisor may be held by the same individual if the individual holds both licenses.

The staffing plan must be evaluated at least twice per year and include sufficient staffing at all times to meet the scheduled and reasonably foreseeable needs of each resident

A facility may not accept a person as a resident unless the facility has staff, sufficient in qualifications, competency, and numbers, to adequately provide the services agreed to in the assisted living contract.

Related Statutes: 144G.41 Subd. 1 (11-12) 144G.81 Subd. 4 144G.83 Subd. 1 (c) 144G.70 144G.81 Subd. 4

Under the statute it does NOT give staff ratios that the facility must follow. They must be able to satisfy the requirement to meet the scheduled and reasonably foreseeable needs of each resident.

Statute does not address whether a nurse can have more than one place of employment. Statute does address a nurse and the services provided must comply with the Nurse Practice Act in 148.71 to 148.285. Statute also defines a clinical nurse supervisor as a Registered Nurse (RN) licensed in Minnesota. The statute dictates certain duties that must be completed by the RN:

  • Resident assessments
  • Delegation of nursing tasks
  • Training and competency testing of unlicensed personnel
  • Be available for consultation to staff performing delegated nursing tasks (either in person, by telephone, or by other means)
  • Supervision of staff based on statute requirements in 144G.62 Subd. 4
  • Certain policy development

Statute does not address whether unlicensed personnel can have more than one place of employment. If the “organization” is the “W-2 holder” and is responsible for the provision of such staff across several locations, the “organization’s” requirement is to ensure adequate staffing at all its facilities.

For assisted living licensure, under 144G.41, subdivision 1 (12): ensure that one or more persons are available 24 hours per day, seven days per week, who are responsible for responding to the requests of residents for assistance with health or safety needs. Such persons must be:

  • awake;
  • located in the same building, in an attached building, or on a contiguous campus with the facility in order to respond within a reasonable amount of time;
  • capable of communicating with residents;
  • capable of providing or summoning the appropriate assistance; and
  • capable of following directions.
So at an assisted living licensed entity, the staff must be awake, however one staff member could be responsible for covering more than one unit.

For an assisted living with dementia care license, under 144G.81 Subd. 4. Awake staff requirement: An assisted living facility with dementia care providing services in a secured dementia care unit must have an awake person who is physically present in the secured dementia care unit 24 hours per day, seven days per week, who is responsible for responding to the requests of residents for assistance with health and safety needs, and who meets the requirements of section 144G.41 Subd. 1, clause (12).

None. See 144G.41 Subd. 1 (12): “ensure that one or more persons are available 24 hours per day, seven days per week, who are responsible for responding to the requests of residents for assistance with health or safety needs. Such persons must be:

  1. awake;
  2. located in the same building, in an attached building, or on a contiguous campus with the facility in order to respond within a reasonable amount of time…”
A nurse who is not on site but is available for consultation to staff performing delegated nursing tasks (either in person, by telephone, or by other means), may be asleep (at home) if the nurse is able to respond accordingly when summoned.

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Survey Process

The MN Department of Health (MDH) is the exclusive state agency charged with the responsibility and duty of surveying and investigating all facilities required to be licensed under Minnesota Statutes, chapter 144G. The commissioner shall conduct a survey of each assisted living facility on a frequency of at least once every two years. Surveys and investigations shall be conducted without advance notice to the facilities.

Related Statutes: 144G.16 Subd. 2 144G.19 Subd. 3 144G.30

Provisional applicants will be surveyed within one year of notifying the department they are providing services to a resident.

Immediately upon the new Assisted Living Licensure becoming effective on Aug. 1, 2021.

The survey process will be similar to the process for homecare surveys under 144A. You can learn more about the survey process and see example forms on the Assisted Living Forms and Self-Audit Tools page.

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Uniform Disclosure of Assisted Living Services and Amenities (UDALSA)

It is by statutory requirement that facilities provide any prospective resident a disclosure of their available services. This is a uniform document created by the commissioner in consultation with stakeholders. Every facility is required to utilize this document in lieu of creating their own. This is a fillable PDF and will be a required element of the application process. Because it is downloadable, a facility can print versions to hand out to prospective residents, and they can post it on their websites for consumers to view.

In addition to assisted living services that a provider can choose to provide, the form also lists several amenities that may be available. Consumer feedback indicated this is a highly valued tool allowing side by side comparison of facilities with similar structure.

An applicant or licensee shall submit a completed checklist with the license application or renewal. The form can be found in the Forms section of the Assisted Living Licensure Application Materials page.

Related Statutes and Rules: 144G.40 Subd.2, 4659.0090

Whenever a facility changes the services that the facility offers under the assisted living facility contract, the facility must submit an updated checklist to the commissioner within 30 calendar days of the change in services. You also need to provide an up-to-date checklist to each prospective resident and each prospective resident's representative who requests information about the facility.

144G.40, subdivision 2, states that an assisted living facility must provide the UDALSA to prospective residents before a contract is executed. As long as that condition is met, yes. The key is to make sure the language or date of signature indicates the UDALSA was received before the contract is signed. Another option could be to photocopy the signature page and place that in the resident record.

You will want to indicate in the comments section if there are any limits such as you will only do mechanical soft vs. a pureed diet.

Yes. In fact, it is highly recommended that you do have different ones if there is a large difference between care levels in different units or buildings within your entity.

Yes, make sure they are clearly labeled as to which building or unit they apply to.

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Updated Wednesday, 06-Oct-2021 13:10:48 CDT