MDH to Convene Assisted Living Licensure Rules Advisory Committee to Consider Proposed Rules

Posted on November 4, 2020 by Kari Thurlow

MDH has released Proposed Rules for Assisted Living Licensure. It is important to note that these rules are not yet final, and changes may be made through the rulemaking process.

The Assisted Living Rulemaking Advisory Committee will be meeting on November 5, 2:30-4:30 p.m. to discuss the proposed Assisted Living Licensure Rules. Kari Thurlow from LeadingAge MN staff serves on this committee on behalf of our members. This is a public meeting, and if you wish to attend, click here.

Last week, LeadingAge MN shared initial comments related to the rule with MDH. We remain hopeful that our comments will be considered and incorporated into the proposed rule. We will continue to advocate for a better balance between resident autonomy and safety; and will oppose rules that reflect an institutional model that will be expensive, operationally challenging and diminish choice and access to services. At the same time, we are pleased that the proposed rule does not contain strict staffing ratios, which has been a significant point of advocacy. Here are a couple of the issues we are most concerned with:

• Licensing in General:  LeadingAge MN is seeking to preserve flexibility in business models to meet the obligations under an assisted living license. The proposed rules appear to require that any person or entity that manages an assisted living must hold a license. This is different than what is reflected in statute under 144G.10, subd. 1, which explicitly permits management contracts and other duties under the license to be contracted out. 
• Emergency/Disaster Planning: LeadingAge MN is very concerned with the general approach MDH has taken in these proposed rules to incorporate federal nursing home standards, as well as blindly incorporating successor requirements or model code updates and the like. CMS did not have assisted living settings in mind when they wrote the nursing facility rules, did not seek public comment on their applicability to assisted living settings, nor will they have assisted living settings in mind when they update the rules over time. While we support emergency and disaster planning rules, we were disappointed that the proposed rules did not reflect work done by the Rules Advisory Committee earlier this year.
• Staffing Plans: While we are grateful that there are no hard staffing ratios incorporated into the proposed rules, we are concerned that the rules propose a public posting of daily staffing plans.  This raises privacy concerns as well as safety concerns for staff working in these settings. There is also an arbitrary requirement that staff respond to client calls within 10 minutes, rather than a more flexible standard of “reasonable response” time.
• Pre-Termination Procedures and Coordinated Move Requirements: Minn. Stat. 144G requires providers to conduct pre-termination meetings and to assist in coordinated moves upon termination of an assisted living contract. However, the proposed rules impose process and procedures that are overly burdensome and could prevent necessary contract terminations. We will continue to advocate for a more streamlined approach.

We will continue to keep members up to date on the development of these proposed rules. We expect these rules to be published later this year, beginning the formal comment period.