2025 Legislative Update Book

CARE PROVIDERS OF MINNESOTA

A R E P O R T O N T H E F I R S T Y E A R O F T H E 9 4 T H L E G I S L AT I V E S E S S I O N

CARE PROVIDERS OF MINNESOTA

2025 LEGISLATIVE

UPDATE

#CPMADVOCATES | www.careproviders.org/advocacy

7851 Metro Parkway, Suite 200 Bloomington, MN 55425 952-854-2844 / 1-800-462-0024 www.careproviders.org

2025 LEGISLATIVE UPDATE A report to the membership on the second year of the 94th Legislative Session Toby Pearson, President/CEO Prepared by: Care Providers of Minnesota Advocacy staff

This report does not constitute legal analyses of the changes in law reported herein. For legal opinions on the application of new statutory language to specific fact situations, contact your organization’s legal counsel. This publication may not be reproduced in whole or in part in any form without the written permission of Care Providers of Minnesota. © Care Providers of Minnesota, Inc., 2025

July 24, 2025 Welcome to the 2025 Legislative Update Book! We hope you find the contents useful as a reference to help you understand the laws that passed this year during the 2025 Legislative Session and to help you prepare for implementation. We encourage you to use the information you find in these pages to talk with your own staff, elected officials, customers, family members, and community leaders about topics of concern for you. This legislative session featured fiscal deficits, cuts, and policy changes to a variety of areas with many new laws that will directly, as well as indirectly, impact your operations.

With the legislature no longer in session and now is the time to educate them on the policy and payment issues facing our profession, before they return for their next session.

It will take some time for the state agencies to fill staff positions to implement these new laws and to analyze some of the more complicated consequences of the laws passed. We have included as much information as we know now about the laws that passed but there are many questions that have been forwarded to the various state agencies and we are waiting for their responses. As we learn more about how some of the laws will be implemented, we will be sure to update you in our weekly newsletter. As you consider how to operationalize some of these new mandates/opportunities, don’t hesitate to ask us questions—there may be consequences we haven’t even thought about!

If you have any questions or need more information about anything you find in this book, do not hesitate to contact me at 952-851-2487. You may also access this book and/or individual pages in an electronic version on our website in the “Advocacy” section: www.careproviders.org/advocacy.

Sincerely,

Thomas (Toby) Pearson President/CEO tpearson@careproviders.org

Care Providers of Minnesota 7851 Metro Parkway, Suite 200 • Bloomington, MN 55425 • Phone 952/854-2844 • MN Toll-Free 800/462-0024 • Fax 952/854-6214 • www.careproviders.org Leading Members to Excellence

2025 Legislative Update Book Table of Contents

I. Session summary ............................................................................................................................................ 9 II. Assisted Living Payment .............................................................................................................................. 15 a. Disproportionate Share Extended to May 31, 2028 ...................................................................... 17 b. DWRS Compensation Threshold no Longer Applies to Assisted Living Facilities .................. 19 III. Assisted Living Policy .................................................................................................................................. 21 a. Survey and Investigation Changes-Assisted Living Facilities .................................................... 23 b. Agency Use of Fines ........................................................................................................................ 25 c. Home Care and Assisted Living Advisory Council ...................................................................... 27 d. Controlling Person – When No Individual has at Least 5% Ownership ..................................... 29 e. Nonrenewal: Termination Definition Change in 144G .................................................................. 31 f. Termination: Expedited Termination Changes ............................................................................. 33 g. Termination: Resident Resource Notification Change................................................................. 35 h. Termination: Duties of Facility and Writ of Recovery After Termination is Successful ........... 37 i. Case Management to help ALFs with Coordinated Moves .......................................................... 39 j. Attached Unlicensed Entity Fire Barrier ........................................................................................ 41 k. Licensing and Affiliation Requirement for Assisted Living Directors ........................................ 43 l. Protected Title: Restriction on Use “Assisted Living” ................................................................. 45 m. Provisional License Denial and One-Year Reapplication Moratorium for Assisted Living Facilities ............................................................................................................................................ 47 n. Change of Ownership; Existing Contracts .................................................................................... 49 o. Arbitration Changes ......................................................................................................................... 51 p. Private Pay to Public Assistance Resident Transition ................................................................. 53 q. LPN allowed to complete portions of resident reassessments in ALFs .................................... 57 r. Individualized Medication Management Plan ................................................................................ 59 IV. Nursing Facility Payment ............................................................................................................................. 61 a. Swing-Bed Limits Removed for One Critical Access Hospital .................................................... 63 b. Rate Increases for Minimum Wage Standards .............................................................................. 65 c. Capped Operating Rates Create Significant Reduction in Funding ........................................... 71 d. Long-term Services and Supports Loan Program Excludes Nursing Facilities ........................ 73 e. Nursing Home Bed Surcharge Increased ...................................................................................... 75 f. Annual Inflation Adjustment for Property Rate Removed ........................................................... 77 g. Nursing Facility Medicaid Rates Transition to PDPM Nursing Indices ...................................... 79 h. Single-Bed Incentive Rate from Closing Beds Phased-Out......................................................... 83 i. Grant Provided to Boundary Waters Care Center ........................................................................ 85 V. Nursing Facility Policy .................................................................................................................................. 87 a. Employer Definition Used by Nursing Home Workforce Standards Board Tied to Medicaid Participation ...................................................................................................................................... 89 b. Changes to Bed Layaway and Single Bed Election...................................................................... 91 c. Statute Repealed From 256R .......................................................................................................... 93 d. Nursing Home Controlling Person – When No Individual has at Least 5% Ownership ............ 95 e. Changes to Nursing Homes Resident Property Taxes/Rent Paid ............................................... 97 f. Nursing Facility Medicaid Case Mix Transition Policy Changes ................................................. 99 g. Consolidation Savings now Applied to Moratorium Project Costs .......................................... 101 h. MN-ITS Mailbox, Email may be Used to Notify Withholding due to Late Surcharge Payment .......................................................................................................................................... 103 i. Notice for Withholding for Annual Surcharge Nonpayment Changes ..................................... 105 VI. General Long-Term Care ............................................................................................................................ 109 a. License, Permit, and Survey Fees ................................................................................................ 111 Care Providers of Minnesota

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b. c. d. e. f. g. h. i.

Health Facilities Construction Plan Submittal and Fees............................................................ 113 Changes to DHS Licensing Enforcement Authority ................................................................... 115 LTC Consultation Assessments to Include an Estimated Date of Completion ....................... 117 Nonprofit Profit to Private NH and AL Conversion Regulations ............................................... 119 Human Services Licensed Provider Fee Increases .................................................................... 121 Changes to the Bill of Rights for Persons with Guardians or Conservators ........................... 123 Financial Exploitation of a Vulnerable Adult ............................................................................... 125 Designated Support Person .......................................................................................................... 127

VII. Workforce and Employment ...................................................................................................................... 131 a. Trained Medication Aide Training ................................................................................................ 133 b. Drive for Five .................................................................................................................................. 135 c. Workforce Development Funding Appropriations ...................................................................... 137 d. Meal and Rest Breaks .................................................................................................................... 139 e. Worker Misclassification ............................................................................................................... 141 f. Earned Sick and Safe Time ........................................................................................................... 143 g. Garnishment Forms; Execution of Judgments; Debt Collection .............................................. 145 h. Workers’ Compensation ................................................................................................................ 147 i. Background Studies ...................................................................................................................... 149 VIII. DHS/HCBS .................................................................................................................................................... 151 a. Verbal Attestation Instead of Signature Allowed for some Disability Waiver Client Reassessments .............................................................................................................................. 153 b. Dashboard on Assessment Completions to be Created ............................................................ 155 c. Limitations on Rate Exceptions for Residential Services Required ......................................... 157 d. Self-Directed Home Care Nursing Required Under Waiver Imagine Phase II .......................... 159 e. Long-Term Services and Supports Advisory Council to Provide Cost Growth Reduction Ideas ................................................................................................................................................ 161 f. DHS Discretionary Temporary Licensing Moratorium ............................................................... 163 IX. Miscellaneous .............................................................................................................................................. 165 a. Survey and Investigation Changes-Comprehensive Home Care .............................................. 167 b. Changes to SNSA Registration and License Fees ..................................................................... 169 c. Changes to Hospice Fees ............................................................................................................. 171 d. Spoken Language Health Care Interpreter Work Group ............................................................ 173 e. Occupational Therapy Changes ................................................................................................... 175 f. Nonemergency Medical Transportation Statewide or Regional Contracting Required .......... 177 g. Cannabis Changes Impacting Long-Term Care and Landlords ................................................ 179 h. Task Force on Homeowners and Commercial Property Insurance .......................................... 183 i. Part B Supplemental Coverage Premium Changes .................................................................... 185 j. Area Agency on Aging Nutrition Support Services .................................................................... 187 k. Promotion of Materials on Rights and Obligations of Landlords and Residential Tenants ... 189 l. Minimum Heat Code Changes ...................................................................................................... 191 m. Treatment of Information of Domestic Violence Victim in Rental Housing ............................. 193 n. Tenant Remedies Changes ........................................................................................................... 195 o. Missing Persons Endangered Definition Change ....................................................................... 197 p. Public Employees Retirement Association (PERA) Privatization ............................................. 199 q. SNSA Ownership Definitions Changes ........................................................................................ 201 r. Candidate Access .......................................................................................................................... 203 s. Certificates of Rent Paid Nonreporting Penalties ....................................................................... 205

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SESSION SUMMARY

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A Session Defined by Chaos, Crisis, and Compromise The 2025 Minnesota legislative session will be remembered not for what was accomplished, but for the chaos that defined it. A delicate political balance, unexpected tragedies, and ethical scandals collided with deep policy divisions, making it one of the most turbulent sessions in state history.

Minnesota voters told the legislature that they were tired of one-party control and voted in a Minnesota House split 67-67. This tie was quickly broken when a Ramsey County District Court judge ruled the Democratic candidate from District 40B was ineligible to take the oath of office. With a 67-66 majority, House Republicans attempted to elect a Speaker and start the legislative session while Democrats held out, staging a boycott.

Republicans attempted to operate until the Minnesota Supreme Court ruled that they needed 68 members to have a quorum and be considered duly organized. The decision ended all legislative activity until Democrats and Republicans reached an agreement.

After a 23-day holdout Democrats returned to the capitol providing for a Republican Speaker and a short-term Republican majority. The House returned to split control when Democrats won the new election in District 40B. All of the upheaval and chaos diminished the opportunity for meaningful policy work until the final weeks of the session.

The Minnesota Senate was not up for election in 2024 and maintained a one-seat DFL majority. That majority remained a point of contention as Senator Nicole Mitchell (DFLWoodbury), who was accused of felony burglary in April of 2024 (and ultimately would be convicted in July 2025), would continue to provide the 34th majority vote. Tragedy struck just before session started with the death of Senate Majority Leader Kari Dziedzic (DFL-Minneapolis), forcing another political reset and a special election. The upper chamber was further rocked when Senator Justin Eichorn (R-Grand Rapids) was arrested for solicitation of a minor. What followed was a political circus as nine Republican candidates filed to run, and the eventual winner was Keri Heintzeman (RNisswa), the spouse of Representative Josh Heintzeman (R-Nisswa). For the first time in Minnesota history, a husband and wife now represent the same Senate district.

Negotiations around the state budget were contentious. End-of-session talks between Senate leaders and the Governor’s office broke down repeatedly, particularly over funding for long-term care and disability services.

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Despite calls from providers and advocates warning of dangerous workforce shortages and facility closures, both the Senate and Governor’s budget proposals sought to reduce long-term care investments—branding these as efforts to "slow the growth" of spending rather than outright cuts. This framing did not consider that providers are already struggling under inflation, workforce shortages, and a fractured care economy.

Meanwhile, the controversial Nursing Home Workforce Standards Board continued to face scrutiny. The Board issued over $200 million in unfunded mandates to long-term care facilities with little consideration for the financial viability of individual providers or the availability of a trained workforce. There has been no meaningful attempt by the administration to reconcile the Board’s mandates with the harsh economic realities providers face daily, especially in rural and underserved communities. Attempts to rein in the board were opposed by Democratic lawmakers and the Governor.

Tensions within the Legislature were evident after the legislative leaders and Governor announced the global budget targets. Members of the DFL People of Color and Indigenous (POCI) Caucus disrupted a leadership press conference calling for the agreement to remove undocumented adults from MinnesotaCare. Their protest highlighted frustrations over their exclusion from major budget decisions. However, they were not the only ones unhappy with the legislative agreement. The global agreement included a plan to close the Stillwater Prison within four years. The decision stunned workers and lawmakers alike and reinforced the perception that major policy changes were being dictated from the top down without meaningful dialogue.

All of this played out against the backdrop of growing public disillusionment. As national political discourse grows increasingly toxic, Minnesota politics have proven no exception. Once seen as a model of pragmatic governance, the state’s legislative process is now marked by power struggles and policy decisions made behind closed doors.

For Minnesota’s long-term care community, the session left more questions than answers. Minnesota is unprepared to care for its aging population, and hope has become the state's primary plan.

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This legislative update book aims to document the decisions of the 2025 session, and outline what providers, workers, and the people they serve must brace for in the months ahead.

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ASSISTED LIVING PAYMENT

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Disproportionate Share Extended to May 31, 2028 2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Sections 25-30 Human Services Omnibus Bill Effective: January 1, 2026

Short description The Elderly Waiver (EW) Customized Living (CL) Disproportionate Share Program was extended for eligible providers to May 31, 2028.

Summary Created by the 2021 legislature, the Disproportionate Share Program provides a minimum base rate (or rate floor) to assisted living providers that serve a high proportion of EW-CL clients.

The 2024 legislature sunsetted the Disproportionate Share Program effective December 31, 2025, set the rate floor at $141, and only allowed existing participants to re-apply for participation during 2025.

The 2025 legislature extended the program for eligible providers to May 31, 2028.

According to statute, a facility determined eligible for the disproportionate share rate adjustment in application year 2023 and receiving payments in rate year 2024 is eligible to receive payments in rate years beginning on or after January 1, 2025, and has: (1) at least 83.5 percent of the residents of the facility are customized living residents; and (2) at least 70 percent of the customized living residents are elderly waiver participants.

The legislature also added new requirements to providers participating in the program.

• A facility must not pressure, coerce, entice, or otherwise unduly influence a resident to become an elderly waiver participant. Every six months, each designated disproportionate share facility must submit a written attestation to the commissioner affirming that neither the facility nor any of its owners, operators, or employees pressured, coerced, enticed, or otherwise unduly influenced a resident to become an elderly waiver participant.

• A provider receiving a rate floor must use a minimum of 66 percent of the incremental increase in revenue generated by the rate floor under this section for direct care staff compensation.

Implications To be in the Disproportionate Share Program on January 1, 2026, eligible providers will need to apply during September 2025 and be approved by the Minnesota Department of Human Services Care Providers of Minnesota will inform members when the application is available.

Bill language Chapter 9, Article 1, Sections 25-30: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.25.0#laws.1.25.0

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DWRS Compensation Threshold no Longer Applies to Assisted Living Facilities

2025 Regular Session SF 2443/HF 2115 Chapter 38, Article 1, Section 22 Human Services Policy Bill Effective: The day following enactment

Short description The disability waiver rate setting (DWRS) compensation threshold no longer applies to licensed assisted living facilities. For all other compensation thresholds and affected providers the requirements are now effective January 1, 2029.

Summary Several years ago, the legislature passed requirements that certain Medicaid DWRS providers needed to demonstrate that a specific percentage of payments received went to staff compensation. While the statute and requirements remain, the following changes were made: • The requirement no longer applies to providers licensed as an assisted living facility under chapter 144G. • For other providers, the requirement is now effective January 1, 2029, and applies to services provided on or after that date.

Implications Assisted living facilities that are enrolled as customized living providers under the CADI or BI waivers are required to submit cost reports once every five years.

This change means that the cost report submitted will no longer be used to determine if an ALF is meeting the 66% compensation threshold.

Bill language Chapter 38, Article 1, Section 22: https://www.revisor.mn.gov/laws/2025/0/38/laws.1.22.0#laws.1.22.0

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ASSISTED LIVING POLICY

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Survey and Investigation Changes-Assisted Living Facilities 2025 First Special Session HF 2 Chapter 3, Article 1, Section 68-75 Health Finance Omnibus Bill Effective: August 1, 2025

Short description Sections 68–75 revise the enforcement structure, fine amounts, and violation levels for assisted living facilities licensed under Minnesota Statutes Chapter 144G. The changes introduce a new “Level 5” violation category for the most serious cases (serious injury or death), authorize immediate fines, and strengthen the commissioner’s authority to take swift action (like suspensions or conditional licenses) without prior hearings.

Summary • New violation category: Level 5 o Defined in 144G.31, subd. 2 as violations resulting in serious injury or death. o Level 4 was revised to no longer include serious injury or death.

• Revised fine amounts o Level 3: Reduced from $3,000 → $1,000 o Level 4: Reduced from $5,000 → $3,000 o Level 5: $5,000 per violation (new) o Specific maltreatment fines up to $5,000 for abuse resulting in serious injury, death, or sexual assault.

• Immediate fines o Now authorized for Level 3, 4, and 5 violations. o Fines can be imposed without a chance to correct first. o Immediate fines do not preclude other enforcement actions.

• Follow-up surveys o Required within 90 days of violations for Levels 3, 4, or 5.

• Expanded suspension authority o The commissioner may immediately suspend a license or issue a conditional license if a level 5 violation or imminent risk is identified. o Hearing and appeal procedures clarified and expedited (e.g., hearings must occur within 30 or 90 days depending on type).

Implications The 2025 legislative updates introduce significant changes to the enforcement landscape for assisted living facilities. With the addition of a new Level 5 violation category, providers now face clearer and more stratified accountability for incidents that result in serious injury or death. This realignment ensures that enforcement actions more accurately reflect the severity of resident harm, creating a greater sense of urgency around high-risk events.

One of the most impactful changes is the commissioner’s expanded authority to issue immediate fines for level 3, 4, and 5 violations—without offering the facility an opportunity to correct the issue first. This shift increases both financial exposure and operational risk for providers. A single serious incident can now result in substantial fines—up to $5,000 per violation—in addition to any other enforcement measures such as conditional licenses or suspensions.

The changes also introduce stricter timelines for appeals and hearing processes, compressing the window in which providers must respond and prepare their defense. As a result, facilities will need to ensure their compliance infrastructure is robust and responsive. Strong documentation, internal oversight, and rapid corrective action will be more essential than ever.

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Moreover, the commissioner can now immediately suspend a license or prohibit service delivery when serious violations or imminent risks are identified. These actions can occur before a hearing, which significantly heightens the potential for disruption to business operations. Facilities could be forced to halt services or transfer residents with very little notice, even while pursuing an appeal.

Altogether, these statutory amendments demand a proactive compliance culture. Assisted living providers must reevaluate their policies, train staff on updated enforcement criteria, and maintain vigilant oversight to reduce the risk of escalated enforcement. The stakes for noncompliance— particularly in situations involving serious harm—are now considerably higher.

Bill language Chapter 3, Article 1, Section 68-75 https://www.revisor.mn.gov/laws/2025/1/3/laws.1.68.0#laws.1.68.0

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Agency Use of Fines

2025 First Special Session HF 3 Chapter 9, Article 8, Section 5 Human Services Omnibus Bill Effective: August 1, 2025 Short description Changes to the process for the use of assisted living fines to fund special projects or initiatives to improve resident quality of care and outcomes through a competitive grant program.

Summary Updated law establishes a competitive grant program for special projects or initiatives for assisted living facilities or other organizations for the purpose of improving resident quality of care and outcomes.

Aligns with the Home Care and Assisted Living Advisory Council requirements. Requires the balance as of January 1, 2026 be appropriated for grants within two years with a minimum grant size of $10,000.

Implications This new language should provide an avenue for the agency to more quickly distribute grants from these funds for member special projects.

Bill language Chapter 9, Article 8, Section 5: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.5.0#laws.8.5.0 Sec. 5. Minnesota Statutes 2024, section 144G.31, subdivision 8, is amended to read: Subd. 8. Deposit of fines. Fines collected under this section shall be deposited in a dedicated special revenue account. On an annual basis, The balance in the special revenue account shall be is appropriated to the commissioner for special projects to improve a competitive grant program for special projects or initiatives for assisted living facilities licensed under this chapter or other organizations or entities with experience in or knowledge of assisted living operations, compliance, resident needs, or best practices for the purpose of improving resident quality of care and outcomes in assisted living facilities licensed under this chapter in Minnesota as recommended by the advisory council established in section 144A.4799., including those projects consistent with criteria in section 144A.4799, subdivision 3, paragraph (c). A facility with a provisional license under this chapter is not eligible to apply. The balance in the special revenue account as of January 1, 2026, must be appropriated for grants within two years, provided there are enough grant requests totaling the sum in the account. Thereafter, money in the special revenue account must be appropriated annually. The minimum amount of a grant award is $10,000. The commissioner may retain up to ten percent of the amount available to cover costs to administer the grants under this section.

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Home Care and Assisted Living Advisory Council 2025 First Special Session HF 3 Chapter 9, Article 8, Section 3 Human Services Omnibus Bill Effective: July 1, 2025

Short description Renamed from the Dept of Health Licensed Home Care Provider Advisory Council, modifying structure.

Summary Membership is expanded from 13 to 14 individuals, expanding the two public members to four and recommending those appointed have lived experience. One public member having received within five years home care services, one public member being a family member of someone who received home care services, one public member having within five years been an assisted living resident, and one public member who is a family member at an assisted living facility.

The board reduces consumer advocacy organization representation from two members to one.

Provides that the advisory council shall make recommendations annually on how to appropriate funds, and the commissioner shall act upon them within one year, and expands the use of use of funds collected under 144A.474 subd 11 (j).

Implications This advisory group provides recommendations to the commissioner, but these recommendations are not binding. The authority on how to use these funds is the decision of the Commissioner. The process has been modified in statute and additional information about this process is available under “Agency Use of Fines”.

Bill language Chapter 9, Article 8, Section 3: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.3.0#laws.8.3.0

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Controlling Person – When No Individual has at Least 5% Ownership 2025 First Special Session HF 3 Chapter 9, Article 8, Section 4 Human Services Omnibus Bill Effective: August 1, 2025

Summary The new law changes the definition of a controlling individual for when no individual owns at least a five percent ownership interest; every individual is considered a controlling person. The law expands controlling individual to those with interest in the land or structure on which an assisted living is located.

Implications This change broadens the scope of individuals subject to the regulatory requirements outlined in Minnesota Statutes Chapter 144G. Controlling persons must submit comprehensive background information and comply with all licensing and quality standards. Providers and owners should: • • • •

Review ownership structures carefully to identify all individuals with any ownership interest, especially in facilities lacking a 5% individual owner.

Prepare to collect and submit detailed background and compliance documentation for all controlling persons, not just those with majority stakes.

Ensure internal policies and governance reflect the expanded regulatory scope, including individuals with interests in facility property or land.

Consult legal or compliance experts to confirm all controlling persons are properly disclosed and meet the required standards to avoid enforcement actions.

This change increases administrative and compliance responsibilities particularly for facilities with complex ownership or corporate structures. These requirements are expanded to include those who own the land or structure in which an assisted living is located. Proactive preparation will help avoid delays in licensing and ensure continuous regulatory compliance.

Bill language Chapter 9, Article 8, Section 4: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.4.0#laws.8.4.0 Sec. 4. Minnesota Statutes 2024, section 144G.08, subdivision 15, is amended to read: Subd. 15. Controlling individual. (a) "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.; and (4) if no individual has at least a five percent ownership interest, every individual with an ownership interest in a privately held corporation, limited liability company, or other business entity, including a business entity that is publicly traded or nonpublicly traded, that collects capital investments from individuals or entities. (b) Controlling individual also means any entity or natural person who has any direct or indirect ownership interest in: (1) any corporation, partnership, or other business association such as a limited liability company that is a controlling individual; (2) the land on which an assisted living facility is located; or (3) the structure in which an assisted living facility is located. (b) (c) Controlling individual does not include: Care Providers of Minnesota

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(1) a bank, savings bank, trust company, savings association, credit union, industrial loan and thrift company, investment banking firm, or insurance company unless the entity operates a program directly or through a subsidiary; (2) government and government-sponsored entities such as the U.S. Department of Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the Minnesota Housing Finance Agency which provide loans, financing, and insurance products for housing sites; (3) an individual who is a state or federal official, a state or federal employee, or a member or employee of the governing body of a political subdivision of the state or federal government that operates one or more facilities, unless the individual is also an officer, owner, or managerial official of the facility, receives remuneration from the facility, or owns any of the beneficial interests not excluded in this subdivision; ...

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Nonrenewal: Termination Definition Change in 144G 2025 First Special Session HF 3 Chapter 9, Article 8, Section 6 Human Services Omnibus Bill Effective: August 1, 2025

Short description Change to remove the concept of nonrenewal from the “termination” definition in 144G.52.

Summary The reference to nonrenewal was deleted from the “termination” definition in 144G.52. The revised definition clarifies that a termination is limited to either (1) a facility-initiated termination of a resident’s entire Assisted Living Contract (which covers both housing services and assisted living services) or (2) a facility-initiated termination of all assisted living services received by a resident pursuant to the resident’s Assisted Living Contract with the facility.

Implications This could make nonrenewal a more viable option for operators who look to end a contractual relationship with a resident. With the described change, the nonrenewal process is no longer subject to the terminations appeals statute (144G.54). Consult a legal professional if you are looking to not renew a resident’s Assisted Living Contract in order to ensure you follow the required process.

Bill language Chapter 9, Article 8, Section 6: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.6.0#laws.8.6.0 Sec. 6. Minnesota Statutes 2024, section 144G.52, subdivision 1, is amended to read: Subdivision 1. Definition. For purposes of sections 144G.52 to 144G.55, "termination" means: (1) a facility-initiated termination of housing provided to the resident under the contract an assisted living contract; or (2) a facility-initiated termination or nonrenewal of all assisted living services the resident receives from the facility under the assisted living contract.

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Termination: Expedited Termination Changes 2025 First Special Session HF 3 Chapter 9, Article 8, Sections 7 and 10 Human Services Finance Omnibus Bill Effective: August 1, 2025

Short description Changes to the expedited termination timeline.

Summary The termination statutes were altered to put expedited terminations on a separate timeline from regular terminations. The new timeline is as follows: - Expedited termination notices cannot be issued unless at least 5 days have passed since the pre-termination meeting (this is a reduction from a previous requirement of 7 days).

- Hearings to appeal an expedited termination must be scheduled as soon as practicable, but no later than 10 calendar days after the Office of Administrative Hearing receives a hearing request from the MN Dept. of Health (this is a reduction from a previous requirement of 14 days). The Office of Administrative Hearings has the discretion to order a continuance, which would result in the hearing occurring more than 10 days after it receives the hearing request.

- An Administrative Law Judge’s recommendation to the Commissioner of Health regarding whether the facility can proceed with the termination must be made as soon as practicable but in no event more than 5 business days after the hearing (this is a reduction from a previous requirement of 10 business days).

Implications For those seeking an expedited termination, the process may be faster than it was before, however, it remains a very slow process that can be extended by the Administrative Law Judge. Consult a legal professional if you are looking to use the termination process.

Bill language Chapter 9, Article 8, Sections 7 and 10: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.7.0#laws.8.7.0 https://www.revisor.mn.gov/laws/2025/1/9/laws.8.10.0#laws.8.10.0 Sec. 7. Minnesota Statutes 2024, section 144G.52, subdivision 2, is amended to read: Subd. 2. Prerequisite to termination of a contract. (a) Before issuing a notice of termination of an assisted living contract, a facility must schedule and participate in a meeting with the resident and the resident's legal representative and designated representative. The purposes of the meeting are to: (1) explain in detail the reasons for the proposed termination; and (2) identify and offer reasonable accommodations or modifications, interventions, or alternatives to avoid the termination or enable the resident to remain in the facility, including but not limited to securing services from another provider of the resident's choosing that may allow the resident to avoid the termination. A facility is not required to offer accommodations, modifications, interventions, or alternatives that fundamentally alter the nature of the operation of the facility. (b) For a termination pursuant to subdivision 3 or 4, the meeting must be scheduled to take place at least seven days before a notice of termination is issued. The facility must make reasonable efforts to ensure that the resident, legal representative, and designated representative are able to attend the meeting.

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(c) For a termination pursuant to subdivision 5, the meeting must be scheduled to take place at least five days before a notice of termination is issued. The facility must make reasonable efforts to ensure that the resident, legal representative, and designated representative are able to attend the meeting. (d) The facility must notify the resident that the resident may invite family members, relevant health professionals, a representative of the Office of Ombudsman for Long-Term Care, a representative of the Office of Ombudsman for Mental Health and Developmental Disabilities, or other persons of the resident's choosing to participate in the meeting. For residents who receive home and communitybased waiver services under chapter 256S and section 256B.49, the facility must notify the resident's case manager of the meeting. (d) (e) In the event of an emergency relocation under subdivision 9, where the facility intends to issue a notice of termination and an in-person meeting is impractical or impossible, the facility must use telephone, video, or other electronic means to conduct and participate in the meeting required under this subdivision and rules within Minnesota Rules, chapter 4659. https://www.revisor.mn.gov/laws/2025/1/9/laws.8.10.0#laws.8.10.0 Sec. 10. Minnesota Statutes 2024, section 144G.54, subdivision 3, is amended to read: Subd. 3. Appeals process. (a) The Office of Administrative Hearings must conduct an expedited hearing as soon as practicable under this section, but in no event later than 14 calendar days after the office receives the request, unless the parties agree otherwise or the chief administrative law judge deems the timing to be unreasonable, given the complexity of the issues presented. For terminations initiated pursuant to section 144G.52, subdivision 5, the Office of Administrative Hearings must conduct an expedited hearing as soon as practicable but in no event later than ten calendar days after the office receives the request, unless the parties agree otherwise. The Office of Administrative Hearings has discretion to order a continuance. (b) The hearing must be held at the facility where the resident lives, unless holding the hearing at that location is impractical, the parties agree to hold the hearing at a different location, or the chief administrative law judge grants a party's request to appear at another location or by telephone or interactive video. (c) The hearing is not a formal contested case proceeding, except when determined necessary by the chief administrative law judge. (d) Parties may but are not required to be represented by counsel. The appearance of a party without counsel does not constitute the unauthorized practice of law. (e) The hearing shall be limited to the amount of time necessary for the participants to expeditiously present the facts about the proposed termination. The administrative law judge shall issue a recommendation to the commissioner as soon as practicable, but in no event later than ten business days after the hearing related to a termination issued under section 144G.52, subdivision 3 or 4, or five business days for a hearing related to a termination issued under section 144G.52, subdivision 5.

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Termination: Resident Resource Notification Change

2025 First Special Session HF 3 Chapter 9, Article 8, Sections 8-9 Human Services Finance Omnibus Bill Effective: August 1, 2025

Short description The statute now requires termination notices to include information on how to contact either the Senior LinkAge Line under MN Stat. Sec. 256.975, subd. 7 or the Disability Hub under MN Stat. Sec. 256.01 subd 24, whichever is most appropriate for the resident. The language specifically requires an explanation that the Senior LinkAge Line and the Disability Hub may provide information about other available housing or service options – this is already required for nonpayment terminations.

Implications Be sure to include the required resources if you are attempting to terminate a resident's contract for nonpayment or termination for cause. Consult a legal professional if you are looking to use the termination process.

Bill language Chapter 9, Article 8, Sections 8 and 9: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.8.0#laws.8.8.0

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Termination: Duties of Facility and Writ of Recovery After Termination is Successful 2025 First Special Session HF 3 Chapter 9, Article 8, Sections 11-12 Human Services Finance Omnibus Bill Effective: August 1, 2025

Short description Changes to the termination statute on the duties of the facility in order to access a writ of recovery.

Summary The coordinated moves statute (144G.55) was amended to identify that a facility has met its obligations under the terminations statute (144G.52) if: - For residents of facilities in the seven-county metropolitan area: the facility identifies at least three other facilities that are willing and able to meet the individual's service needs, one of which is within the seven-county metropolitan area; or - For residents of facilities outside of the seven-county metropolitan area: the facility identifies at least two other facilities that are willing and able to meet the individual's service needs, and to the extent such facilities exist, one must be within two hours or 120 miles from the resident's current location.

- And the facility pursuing the termination has written documentation showing that the resident or the resident's designated representative, if any, has either consented to the move or has expressly refused to relocate to any of the facilities identified by the terminating facility pursuant to 144G.55, subd. 1.

A facility can receive a Writ of Recovery under 504B (the landlord-tenant law) if the termination is upheld by an Administrative Law Judge in a termination appeal hearing and the coordinated move obligations of the facility were fulfilled.

Implications These changes will make it harder for assisted living facilities to successfully pursue termination. This is because facilities must now identify a specific number of other facilities that are both willing and able to accept a resident. This will be especially true for those facilities trying to find placement for residents who may have complex health and/or behavior issues. It additionally is unclear if a facility within 120 miles must additionally be within a two-hour drive to meet the requirement. Consult a legal professional if you are looking to use the termination process.

Bill language Chapter 9, Article 8, Sections 11 and 12: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.11.0#laws.8.11.0 Sec. 11. Minnesota Statutes 2024, section 144G.54, subdivision 7, is amended to read: Subd. 7. Application of chapter 504B to appeals of terminations. A resident may not bring an action under chapter 504B to challenge a termination that has occurred and been upheld under this section. A facility is entitled to a writ of recovery of premises and order to vacate pursuant to section 504B.361 when a termination has been upheld under this section and the facility has met its obligation under section 144G.55.

Sec. 12. Minnesota Statutes 2024, section 144G.55, subdivision 1, is amended to read: Subdivision 1. Duties of facility. (a) If a facility terminates an assisted living contract, reduces services to the extent that a resident needs to move or obtain a new service provider or the facility has its Care Providers of Minnesota

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license restricted under section 144G.20, or the facility conducts a planned closure under section 144G.57, the facility: (1) must ensure, subject to paragraph (c), a coordinated move to a safe location that is appropriate for the resident and that is identified by the facility prior to any hearing under section 144G.54 and document the same; (2) must ensure a coordinated move of the resident to an appropriate service provider identified by the facility prior to any hearing under section 144G.54, provided services are still needed and desired by the resident; and (3) must consult and cooperate with the resident, legal representative, designated representative, case manager for a resident who receives home and community-based waiver services under chapter 256S and section 256B.49, relevant health professionals, and any other persons of the resident's choosing to make arrangements to move the resident, including consideration of the resident's goals and document the same. (b) A facility may satisfy the requirements of paragraph (a), clauses (1) and (2), by moving the resident to a different location within the same facility, if appropriate for the resident. (c) A resident may decline to move to the location the facility identifies or to accept services from a service provider the facility identifies, and may choose instead to move to a location of the resident's choosing or receive services from a service provider of the resident's choosing within the timeline prescribed in the termination notice. (d) A facility has met its obligations under this section, following a termination completed in accordance with section 144G.52 if: (1) for residents of facilities in the seven-county metropolitan area, the facility identifies at least three other facilities willing and able to meet the individual's service needs, one of which is within the sevencounty metropolitan area; (2) for residents of facilities outside of the seven-county metropolitan area, the facility identifies at least two other facilities willing and able to meet the individual's service needs, and to the extent such facilities exist, one must be within two hours or 120 miles from the resident's current location; and (3) the facility documents, in writing, the resident or the resident's designated representative has: (i) consented to move; or (ii) expressly refused to relocate to any of the facilities identified in accordance with this subdivision. (e) Sixty days before the facility plans to reduce or eliminate one or more services for a particular resident, the facility must provide written notice of the reduction that includes: (1) a detailed explanation of the reasons for the reduction and the date of the reduction; (2) the contact information for the Office of Ombudsman for Long-Term Care, the Office of Ombudsman for Mental Health and Developmental Disabilities, and the name and contact information of the person employed by the facility with whom the resident may discuss the reduction of services; (3) a statement that if the services being reduced are still needed by the resident, the resident may remain in the facility and seek services from another provider; and (4) a statement that if the reduction makes the resident need to move, the facility must participate in a coordinated move of the resident to another provider or caregiver, as required under this section. (e) (f) In the event of an unanticipated reduction in services caused by extraordinary circumstances, the facility must provide the notice required under paragraph (d) (e) as soon as possible. (f) (g) If the facility, a resident, a legal representative, or a designated representative determines that a reduction in services will make a resident need to move to a new location, the facility must ensure a coordinated move in accordance with this section, and must provide notice to the Office of Ombudsman for Long-Term Care. (g) (h) Nothing in this section affects a resident's right to remain in the facility and seek services from another provider.

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Case Management to help ALFs with Coordinated Moves 2025 First Special Session SF 7/HF 3 Chapter 9, Article 8, Sections 15-16 Human Services Omnibus Bill Effective: August 1, 2025

Short description Case management are statutorily directed to assist and cooperate with the obligations of licensed assisted living facilities during the coordinated move of a resident.

Summary The duties of a developmental disability waiver case manager include helping assisted living facilities meet their obligations to facilitate a coordinated move of a resident following an assisted living contract termination.

Implications See other articles regarding assisted living contract termination.

Bill language Chapter 9, Article 8, Sections 15-16: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.15.0#laws.8.15.0

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Attached Unlicensed Entity Fire Barrier 2025 Regular Session HF 2115 Chapter 38, Article 2, Section 15 Human Services Policy Omnibus Bill Effective: August 1, 2025.

Short description For an assisted living with a portion of the building utilized by an unlicensed entity, a two-hour vertical fire barrier is required.

Summary An assisted living seeking to use a portion of their building by an unlicensed entity or an entity with a different licensing type, must install a two-hour vertical fire barrier as defined by the National Fire Protection Association Standard 101, Life Safety Code between entities.

Implications The two-hour vertical fire barrier is an added cost but would allow facilities the ability to use under utilized portions of their buildings for other licensed or unlicensed purposes.

Bill language Chapter 38, Article 2, Section 15: https://www.revisor.mn.gov/laws/2025/0/38/laws.2.15.0#laws.2.15.0 (2) No facility or building on a campus may provide assisted living services until obtaining the required license under paragraphs (c) to (e). (b) The licensee is legally responsible for the management, control, and operation of the facility, regardless of the existence of a management agreement or subcontract. Nothing in this chapter shall in any way affect the rights and remedies available under other law. (c) Upon approving an application for an assisted living facility license, the commissioner shall issue a single license for each building that is operated by the licensee as an assisted living facility and is located at a separate address, except as provided under paragraph (d) or (e). If a portion of a licensed assisted living facility building is utilized by an unlicensed entity or an entity with a license type not granted under this chapter, the licensed assisted living facility must ensure there is at least a vertical two-hour fire barrier as defined by the National Fire Protection Association Standard 101, Life Safety Code, between any licensed assisted living facility areas and unlicensed entity areas of the building and between the licensed assisted living facility areas and any licensed areas subject to another license type.

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Licensing and Affiliation Requirement for Assisted Living Directors 2025 Regular Session HF 2115 Chapter 38, Article 2, Section 16 Human Services Policy Omnibus Bill Effective: August 1, 2025.

Short description This change clarifies the legal requirement that every licensed assisted living facility in Minnesota must employ a licensed or permitted assisted living director who is officially affiliated with the Board of Executives for Long-Term Services and Supports (BELTSS) as the facility’s director of record.

Summary Minnesota Statutes, section 144G.10, subdivision 1a, was amended to reinforce and clarify the regulatory requirement that all assisted living facilities must have a licensed (or permitted) assisted living director in place. The director must not only be credentialed by BELTSS but also formally affiliated as the director of record for the specific facility they oversee. This statutory update ensures alignment between licensure, professional accountability, and operational oversight at the facility level.

While the original statute already required a licensed director, this change closes any ambiguity by specifying that official affiliation with BELTSS is a necessary condition of compliance—not just possession of a license or permit.

Implications Facilities must ensure their appointed director is properly affiliated with BELTSS as the official director of record—not just licensed in general. A mismatch in affiliation could result in noncompliance. Directors and license holders should verify that their affiliation is up to date in BELTSS records to avoid administrative oversights or enforcement action. When facilities undergo leadership changes, it's critical to notify BELTSS and complete the necessary affiliation process to remain in compliance. This clarification eliminates potential confusion about interim leadership, shared directorship, or informal arrangements that are not reflected in BELTSS records.

Bill language Chapter 38, Article 2, Section 16: https://www.revisor.mn.gov/laws/2025/0/38/laws.2.16.0#laws.2.16.0 Minnesota Statutes 2024, section 144G.10, subdivision 1a, is amended to read: Subd. 1a. Assisted living director license required. Each assisted living facility must employ an assisted living director who is licensed or permitted by the Board of Executives for Long Term Services and Supports and affiliated as the director of record with the board.

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Protected Title: Restriction on Use “Assisted Living” 2025 Regular Session HF 2115 Chapter 38, Article 2, Section 17 Human Services Policy Omnibus Bill Effective: January 1, 2027

Description Effective January 1, 2027, no person or entity can use the phrase assisted living unless they are licensed as an assisted living. An assisted living facility may not include in their name the terms “home care” or “nursing home”. This is done to help avoid confusion among the Minnesota Department of Health license types.

Implications There is no ‘grandfathering’ of names of facilities. Therefore, facilities will have to update their name by January 1, 2027 to comply if they are in violation.

Bill language Chapter 38, Article 2, Section 17 https://www.revisor.mn.gov/laws/2025/0/38/laws.2.17.0#laws.2.17.0 Minnesota Statutes 2024, section 144G.10, subdivision 5, is amended to read: Subd. 5. Protected title; restriction on use. (a) Effective January 1, 2026 2027, no person or entity may use the phrase "assisted living," whether alone or in combination with other words and whether orally or in writing, to: advertise; market; or otherwise describe, offer, or promote itself, or any housing, service, service package, or program that it provides within this state, unless the person or entity is a licensed assisted living facility that meets the requirements of this chapter. A person or entity entitled to use the phrase "assisted living" shall use the phrase only in the context of its participation that meets the requirements of this chapter. (b) Effective January 1, 2026 2027, the licensee's name for a new an assisted living facility may not include the terms "home care" or "nursing home."

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Provisional License Denial and One-Year Reapplication Moratorium for Assisted Living Facilities 2025 Regular Session HF 2115 Chapter 38, Article 2, Section 18 Human Services Policy Omnibus Bill Effective: August 1, 2025 Short description If a provisional license for an assisted living facility is denied, the owners and managerial officials are prohibited from applying for a new assisted living facility license for one year following the facility’s closure.

Summary Under Minnesota Statutes 144G.16, subdivision 3, the commissioner evaluates provisional license holders based on compliance with an initial licensing survey. If the provisional licensee meets substantial compliance, a full facility license is issued. If not, the provisional license may be terminated or extended with conditions for correction. Should the license ultimately be denied, the facility must close, and the owners and managerial officials are barred from reapplying for a new assisted living facility license for one year from the closure date.

Implications This change heightens the importance of meeting compliance standards during the provisional licensing period for assisted living facilities. Providers must be diligent in preparing for and responding to initial licensing surveys to avoid license denial. Failure to achieve substantial compliance not only results in losing the license but also triggers a mandatory one-year waiting period before the owners and managerial officials can apply for a new license. This cooling-off period serves as a significant deterrent against rushed or inadequate preparation and encourages providers to establish strong operational and quality controls from the outset. As a result, providers should prioritize early compliance efforts and continuous quality improvement to prevent disruption of services and protect their ability to operate in the future.

Bill language Chapter 38, Article 2, Section 18: https://www.revisor.mn.gov/laws/2025/0/38/laws.2.18.0#laws.2.18.0 Minnesota Statutes 2024, section 144G.16, subdivision 3, is amended to read: Subd. 3. Licensure; termination or extension of provisional licenses. (a) If the provisional licensee is in substantial compliance with the survey, the commissioner shall issue a facility license. (b) If the provisional licensee is not in substantial compliance with the initial survey, the commissioner shall either: (1) not issue the facility license and terminate the provisional license; or (2) extend the provisional license for a period not to exceed 90 calendar days and apply

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conditions necessary to bring the facility into substantial compliance. If the provisional licensee is not in substantial compliance with the survey within the time period of the extension or if the provisional licensee does not satisfy the license conditions, the commissioner may deny the license. (c) The owners and managerial officials of a provisional licensee whose license is denied are ineligible to apply for an assisted living facility license under this chapter for one year following the facility's closure date.

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Change of Ownership; Existing Contracts 2025 Regular Session HF 2115 Chapter 38, Article 2, Section 19 Human Services Policy Omnibus Bill Effective: January 1, 2026

Short description State law now requires that when ownership of an assisted living facility changes, the new owner must honor all existing resident contracts until the end of the contract term.

Implications Prospective buyers and facility operators should carefully review existing resident contracts before completing a purchase, as they are legally obligated to comply with the terms of those contracts through their expiration date. Additionally, new owners should plan for the timeline required to implement any new contracts once existing agreements have concluded.

Bill language Chapter 38, Article 2, Section 19 https://www.revisor.mn.gov/laws/2025/0/38/laws.2.19.0#laws.2.19.0 Minnesota Statutes 2024, section 144G.19, is amended by adding a subdivision to read: Subd. 5. Change of ownership; existing contracts. Following a change of ownership, the new licensee must honor the terms of an assisted living contract in effect at the time of the change of ownership until the end of the contract term.

EFFECTIVE DATE. This section is effective January 1, 2026, and applies to all assisted living contracts executed on or after January 1, 2026.

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Arbitration Changes

2025 Regular Session HF 2115 Chapter 38, Article 2, Section 21 Human Services Policy Omnibus Bill Effective: August 1, 2025 Short description An assisted living is not allowed to require arbitration as a condition of admission or continued care.

Implications Members who have included an arbitration agreement in their operations will need to evaluate whether those agreements comply with this new law and if they wish to seek an arbitration, how that could be offered.

Bill language Chapter 38, Article 2, Section 21: https://www.revisor.mn.gov/laws/2025/0/38/laws.2.21.0#laws.2.21.0 Minnesota Statutes 2024, section 144G.51, is amended to read: 144G.51 ARBITRATION. (a) An assisted living facility must clearly and conspicuously disclose, in writing in an assisted living contract, any arbitration provision in the contract that precludes, limits, or delays the ability of a resident from taking a civil action. (b) An arbitration requirement provision must not include a choice of law or choice of venue provision. Assisted living contracts must adhere to Minnesota law and any other applicable federal or local law. (c) An assisted living facility must not require any resident or the resident's representative to sign an agreement for binding arbitration as a condition of admission to, or as a requirement to continue to receive care at, the facility.

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Private Pay to Public Assistance Resident Transition

2025 Regular Session HF 2115 Chapter 38, Article 2, Sections 22-23 Human Services Policy Omnibus Bill Effective: January 1, 2026 for contracts entered into on or after that date Short description New law prohibits assisted living facilities from terminating or nonrenewing a resident’s contract solely because the resident transitions from private pay to public funding for housing or services when the facility has indicated it accepts public assistance.

Summary The new law prevents assisted living facilities from terminating or choosing not to renew a resident’s contract if the facility has represented through advertising, or other communication, that it accepts public funding (such as Elderly Waiver or housing assistance) to pay for housing or services, or that a resident may remain in the facility once private funds are exhausted.

It requires that a resident has to notify the facility of their intention to apply for public assistance and requires that they make a timely application for such assistance. Facilities are required to inform residents at move-in and annually thereafter of their policies regarding transitions from private pay to public assistance. Importantly, this law does not amend existing law that allows for termination for nonpayment or violations of the assisted living contract.

In cases where a resident's application for public assistance is not processed within 30 days, the resident may contact the Office of the Ombudsman for Long-Term Care to request assistance in facilitating timely completion of enrollment.

The new policy is silent on the ability to move residents to a less costly unit.

Implications Facilities will need to revise policies and practices to ensure compliance with the new requirements. Specifically, providers appear to no longer be able to restrict or limit the number of residents allowed to participate at one time in public assistance programs within a facility. The new statute does not require a change in admissions practices for a facility based on the resident's use of public assistance.

Facilities must clearly and consistently communicate, on an annual basis, their policies on payment transitions to residents and families.

Facilities should also review marketing materials, websites, and admissions policies to ensure representations about whether or not they accept public funds are clear.

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Bill language Chapter 38, Article 2, Sections 22-23: https://www.revisor.mn.gov/laws/2025/0/38/laws.2.22.0#laws.2.22.0

Minnesota Statutes 2024, section 144G.52, is amended by adding a subdivision to read: Subd. 5a. Impermissible ground for termination. (a) A facility must not terminate an assisted living contract on the ground that the resident changes from using private funds to using public funds to pay for housing or services if the facility has represented or advertised that the facility accepts public funds to cover the costs of housing or services or makes any similar representation regarding the ability of the resident to remain in the facility when the resident's private funds are exhausted. (b) A resident must notify the facility of the resident's intention to apply for public assistance to pay for housing or services, or both, and must make a timely application to the appropriate government agency or agencies. The facility must inform the resident at the time the resident moves into the facility and once annually of the facility's policy regarding converting from using private funds to public funds to pay for housing or services, or both, and of the resident's obligation to notify the facility of the resident's intent to apply for public assistance and to make a timely application for public assistance. (c) This subdivision does not prohibit a facility from terminating an assisted living contract for nonpayment according to subdivision 3, or for a violation of the assisted living contract according to subdivision 4. (d) If a resident's application for public funds is not processed within 30 days, the resident may contact the Office of Ombudsman for Long-Term Care to facilitate timely completion of enrollment with the appropriate lead agency.

EFFECTIVE DATE. This section is effective January 1, 2026, and applies to all assisted living contracts executed on or after January 1, 2026.

Minnesota Statutes 2024, section 144G.53, is amended to read: 144G.53 NONRENEWAL OF HOUSING. Subdivision 1. Notice or termination procedure. (a) If a facility decides to not renew a resident's housing under a contract, the facility must either (1) provide the resident with 60 calendar days' notice of the nonrenewal and assistance with relocation planning, or (2) follow the termination procedure under section 144G.52.

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(b) The notice must include the reason for the nonrenewal and contact information of the Office of Ombudsman for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental Disabilities. (c) A facility must: (1) provide notice of the nonrenewal to the Office of Ombudsman for Long-Term Care; and (2) for residents who receive home and community-based waiver services under chapter 256S and section 256B.49, provide notice to the resident's case manager;.

Subd. 2. Prohibited ground for nonrenewal. (a) A facility must not decline to renew a resident's housing under an assisted living contract on the ground that the resident changes from using private funds to using public funds to pay for housing if the facility has represented or advertised that the facility accepts public funds to cover the costs of housing or makes any similar representation regarding the ability of the resident to remain in the facility when the resident's private funds are exhausted. (b) A resident must notify the facility of the resident's intention to apply for public assistance to pay for housing or services, or both, and must make a timely application to the appropriate government agency or agencies. The facility must inform the resident at the time the resident moves into the facility and once annually of the facility's policy regarding converting from using private funds to public funds to pay for housing or services, or both, and of the resident's obligation to notify the facility of the resident's intent to apply for public assistance and to make a timely application for public assistance. (c) This subdivision does not prohibit a facility from terminating an assisted living contract for nonpayment according to section 144G.52, subdivision 3, or for a violation of the assisted living contract according to section 144G.52, subdivision 4. (d) If a resident's application for public funds is not processed within 30 days, the resident may contact the Office of Ombudsman for Long-Term Care to facilitate timely completion of enrollment with the appropriate lead agency.

Subd. 3. Requirements following notice.

If a facility provides notice of nonrenewal according to subdivision 1, the facility must: (3) (1) ensure a coordinated move to a safe location, as defined in section 144G.55, subdivision 2, that is appropriate for the resident; (4) (2) ensure a coordinated move to an appropriate service provider identified by the facility, if services are still needed and desired by the resident;

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(5) (3) consult and cooperate with the resident, legal representative, designated representative, case manager for a resident who receives home and community-based waiver services under chapter 256S and section 256B.49, relevant health professionals, and any other persons of the resident's choosing to make arrangements to move the resident, including consideration of the resident's goals; and (6) (4) prepare a written plan to prepare for the move.

Subd. 4. Right to move to location of resident's choosing or to use provider of resident's choosing. (d) A resident may decline to move to the location the facility identifies or to accept services from a service provider the facility identifies, and may instead choose to move to a location of the resident's choosing or receive services from a service provider of the resident's choosing within the timeline prescribed in the nonrenewal notice.

EFFECTIVE DATE. This section is effective January 1, 2026, and applies to all assisted living contracts executed on or after January 1, 2026.

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LPN allowed to complete portions of resident reassessments in ALFs 2025 Regular Session HF 2115 Chapter 38, Article 2, Section 24 Human Service Policy Omnibus Bill Effective: August 1, 2025

Short description The new statute allows Licensed Practical Nurses (LPNs) to complete portions of resident reassessments and monitoring, under the Minnesota Nurse Practice Act. This change provides important flexibility to better manage staffing and meet required assessment timelines.

However, a Registered Nurse must still review and approve all reassessment findings to ensure high-quality, person-centered care.

Summary Previously, only Registered Nurses (RNs) could conduct the full resident reassessment and monitoring. Now, portions of these reassessments can be performed by Licensed Practical Nurses (LPNs) — as allowed under Minnesota’s Nurse Practice Act — but the RN must review the findings as part of the resident’s reassessment.

Implications Licensed Practical Nurses (LPNs) can now perform parts of the resident reassessment and monitoring within the limits of their professional scope, as defined by Minnesota’s Nurse Practice Act. This means: • • •

LPNs can actively contribute to clinical assessments they are trained and authorized to do.

Their skills are fully utilized to support timely, effective resident care.

RNs maintain clinical oversight by reviewing and approving LPN work, ensuring quality and compliance.

Bill language Chapter 38, Article 2, Section 24: https://www.revisor.mn.gov/laws/2025/0/38/laws.2.24.0#laws.2.24.0 Subd. 2. Initial reviews, assessments, and monitoring. (a) Residents who are not receiving any assisted living services shall not be required to undergo an initial nursing assessment. (b) An assisted living facility shall conduct a nursing assessment by a registered nurse of the physical and cognitive needs of the prospective resident and propose a temporary service plan prior to the date on which a prospective resident executes a contract with a facility or the date on which a prospective resident moves in, whichever is earlier. If necessitated by either the geographic distance between the prospective resident and the facility, or urgent or unexpected circumstances, the assessment may be conducted using telecommunication methods based on

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practice standards that meet the resident's needs and reflect person-centered planning and care delivery. (c) Resident reassessment and monitoring must be conducted no more than 14 calendar days after initiation of services. Ongoing resident reassessment and monitoring must be conducted as needed based on changes in the needs of the resident and cannot exceed 90 calendar days from the last date of the assessment. by a registered nurse: (1) no more than 14 calendar days after initiation of services; (2) as needed based on changes in the resident's needs; and (3) at least every 90 calendar days. (d) Sections of the reassessment and monitoring in paragraph (c) may be completed by a licensed practical nurse as allowed under the Nurse Practice Act in sections 148.171 to 148.285. A registered nurse must review the findings as part of the resident's reassessment. (d) (e) For residents only receiving assisted living services specified in section 144G.08, subdivision 9, clauses (1) to (5), the facility shall complete an individualized initial review of the resident's needs and preferences. The initial review must be completed within 30 calendar days of the start of services. Resident monitoring and review must be conducted as needed based on changes in the needs of the resident and cannot exceed 90 calendar days from the date of the last review. (e) (f) A facility must inform the prospective resident of the availability of and contact information for long-term care consultation services under section 256B.0911, prior to the date on which a prospective resident executes a contract with a facility or the date on which a prospective resident moves in, whichever is earlier.

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Individualized Medication Management Plan

2025 Regular Session HF 2115 Chapter 38, Article 2, Sections 25 and 26, Subdivisions 3 and 5 Human Services Policy Bill Effective: August 1, 2025 Short description Sections 25 and 26 amend Minnesota Statutes 144G.71, subdivisions 3 and 5, to clarify who is responsible for medication monitoring, reassessment, and management planning in assisted living settings. The changes shift the language from general facility responsibilities to specifying that a registered nurse (RN), advanced practice registered nurse (APRN), or delegated qualified staff must perform or oversee these tasks.

Summary Subdivision 3 now requires an RN, APRN, or delegated staff to monitor and reassess residents' medication management services as needed (such as when symptoms arise) and at least annually.

Subdivision 5 designates licensed nursing staff (or delegated personnel) to prepare and maintain an individualized medication management plan, which must be included in the resident’s service plan and updated when changes occur.

The amended statute clarifies that an RN, APRN, or delegated staff must prepare and maintain the individualized medication management plan, which includes specific elements (such as storage procedures, delegation responsibilities, and notification protocols) that were already required but now fall under clearly defined clinical oversight.

Additionally, a new provision requires medication reconciliation to be performed when a licensed nurse, health professional, or prescriber is providing medication management—this formalizes a best practice into law.

Implications Facilities must ensure that licensed nurses or delegated staff are clearly assigned to medication-related tasks, including reassessments and documentation.

Policies and procedures should be updated to reflect the new requirements for maintaining a current medication management record, especially after any change in a resident’s condition or medication regimen.

Medication reconciliation is now a required practice when medication management is provided by licensed professionals—facilities must ensure staff know when and how to perform and document this process.

Surveyors may place greater emphasis on documentation accuracy, RN oversight, and the timeliness of medication plan updates during compliance reviews.

Bill language Chapter 38, Article 2, Sections 25 and 26 https://www.revisor.mn.gov/laws/2025/0/38/laws.2.25.0#laws.2.25.0

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NURSING FACILITY PAYMENT

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Swing-Bed Limits Removed for One Critical Access Hospital 2025 First Special Session SF 6/HF 2 Chapter 3, Article 1, Sections 52-55, 85, 86 Health Finance Omnibus Bill Effective: January 1, 2026

Short description A critical access hospital is allowed an unlimited number of days of swing bed use per year.

Summary A critical access hospital in Cook County is no longer limited by the annual resident days cap. In addition, the following policies no longer apply to the critical access hospital in Cook County. (See paragraph (a), clauses (3) and (5), and paragraph (c). Bolded).

Minnesota statute 256B.0625 Subdivision 2b now states: (a) Medical assistance must not be used to pay the costs of nursing care provided to a patient in a swing bed as defined in section 144.562, unless: (1) the facility in which the swing bed is located is eligible as a sole community provider, as defined in Code of Federal Regulations, title 42, section 412.92, or the facility is a public hospital owned by a governmental entity with 25 or fewer licensed acute care beds; (2) the Centers for Medicare and Medicaid Services approves the necessary state plan amendments; (3) the patient was screened as provided by law; (4) the patient no longer requires acute care services; and (5) no nursing home beds are available within 25 miles of the facility. (b) The commissioner shall exempt a facility from compliance with the sole community provider requirement in paragraph (a), clause (1), if, as of January 1, 2004, the facility had an agreement with the commissioner to provide medical assistance swing bed services. (c) Medical assistance also covers up to ten days of nursing care provided to a patient in a swing bed if: (1) the patient's physician, advanced practice registered nurse, or physician assistant certifies that the patient has a terminal illness or condition that is likely to result in death within 30 days and that moving the patient would not be in the best interests of the patient and patient's family; (2) no open nursing home beds are available within 25 miles of the facility; and (3) no open beds are available in any Medicare hospice program within 50 miles of the facility.

Implications With Lake Superior, the Boundary Waters Canoe Area, and the Canadien border, Cook County is likely the most isolated county in the state. While the changes made for the one hospital in Cook County were supported by an access need, the concern moving forward is that this language will allow other critical access hospitals to seek the same designation.

Bill language Chapter 3, Article 1, Sections 52-55, 85, 86: https://www.revisor.mn.gov/laws/2025/1/3/laws.1.52.0#laws.1.52.0

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Rate Increases for Minimum Wage Standards

2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Sections 1, 2, 3, 17, 23 Human Services Omnibus Bill Effective: July 1, 2025, or upon federal approval, whichever is later Short description Funding, via application process, is available for nursing facilities to pay for the cost of implementing the Nursing Home Workforce Standards Board’s minimum wages standards.

Summary The legislature provided funding for the minimum wage standards for nursing home workers that were promulgated by the Nursing Home Workforce Standards Board (Board) using Minnesota’s expedited rule making process.

As issued by the Board, the minimum wage standards assumed no upfront cost to nursing facilities.

According to statute, to become effective, only the cost to the State of Minnesota requires funding. As a result, the Governor’s budget proposed additional funding for the 3rd and 4th years of the 4-year budget cycle. However, the January 1, 2026 and January 1, 2027 standards have immediate costs to nursing facilities.

Funding was appropriated for the standards beginning January 1, 2026.

Minimum Base Wage Standards January 1, (These are not funded) 2026

January 1, 2027

Certified Nursing Assistants

$22.50

$24.00

Trained Medication Aides

$23.50

$25.00

Licensed Practical Nurses

$27.00

$28.50

Other - Dietary, Laundry, Housekeeping, contracted workers etc. (or any employee earning less than $19.00 per hour)

$19.00

$20.50

Below are the estimated state share budget expenditures for the minimum wage standards.

State Share (dollars in thousands) FY 2026 FY 2027 FY 2028 FY 2029 Implement Nursing Home Workforce $4,328 $13,748 $17,523 $16,385 Standards Board Rules According to statute, the Minnesota Department of Human Services (DHS) will develop an application for nursing facilities to submit their estimated costs associated with complying with the minimum wage standards.

• For the January 1, 2026 rate year, the application is due October 1, 2025.

• For the January 1, 2027 rate year, the application is due October 1, 2026.

DHS is expected to publish the application during August 2025. Nursing facilities will need to quickly respond to meet the tight timeframe.

Implications While the standards are funded “upfront,” there remain several issues.

First, the funding does not address the cost of wage compression. Nursing facilities will have staff that are at or just above the standards. There is no funding available to address these staff, who will, presumably, want to receive a raise as well.

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Second, DHS is directed to ensure that the funding distributed does not exceed the amount appropriated. As a result, it is possible that nursing facilities will have their funding request prorated.

Third, the minimum wage standards are just one of several consequential changes to rate setting, including the new rate caps and case mix transition. How these changes interact with each other will likely depend on the facility.

Bill language Chapter 9, Article 1, Sections 1, 2, 3, 17, 23: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.1.0#laws.1.1.0 Section 1.

Minnesota Statutes 2024, section 181.213, subdivision 2, is amended to read: Subd. 2. Investigation of market conditions. (a) The board must investigate market conditions and the existing wages, benefits, and working conditions of nursing home workers for specific geographic areas of the state and specific nursing home occupations. Based on this information, the board must seek to adopt minimum nursing home employment standards that meet or exceed existing industry conditions for a majority of nursing home workers in the relevant geographic area and nursing home occupation. Except for standards exceeding the threshold determined in paragraph (d), initial employment standards established by the board are effective beginning January 1, 2025, and shall remain in effect until any subsequent standards are adopted by rules. (b) The board must consider the following types of information in making determinations that employment standards are reasonably necessary to protect the health and welfare of nursing home workers: (1) wage rate and benefit data collected by or submitted to the board for nursing home workers in the relevant geographic area and nursing home occupations; (2) statements showing wage rates and benefits paid to nursing home workers in the relevant geographic area and nursing home occupations; (3) signed collective bargaining agreements applicable to nursing home workers in the relevant geographic area and nursing home occupations; (4) testimony and information from current and former nursing home workers, worker organizations, nursing home employers, and employer organizations; (5) local minimum nursing home employment standards; (6) information submitted by or obtained from state and local government entities; and (7) any other information pertinent to establishing minimum nursing home employment standards. (c) In considering wage and benefit increases, the board must determine the impact of the proposed standards on nursing home operating payment rates determined pursuant to section 256R.21, subdivision 3, and the employee benefits portion of the external fixed costs payment rate determined pursuant to section 256R.25. If the board, in consultation with the commissioner of human services, determines the operating payment rate and employee benefits portion of the external fixed costs payment rate will increase to comply with the new employment standards, the board shall report to the legislature the increase in funding needed to increase payment rates to comply with the new employment standards and must make implementation of any new nursing home employment standards contingent upon an appropriation, as determined by sections 256R.21 and 256R.25, to fund the rate increase necessary to comply with the new employment standards. (d) In evaluating the impact of the employment standards on payment rates determined by sections 256R.21 and 256R.25, the board, in consultation with the commissioner of human services, must consider the following: (1) the statewide average wage rates for employees pursuant to section 256R.10, subdivision 5, and benefit rates pursuant to section 256R.02, subdivisions 18 and 22, as determined by the annual Medicaid cost report used to determine the operating payment rate and the employee Care Providers of Minnesota

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benefits portion of the external fixed costs payment rate for the first day of the calendar year immediately following the date the board has established minimum wage and benefit levels; (2) compare the results of clause (1) to the operating payment rate and employee benefits portion of the external fixed costs payment rate increase for the first day of the second calendar year after the adoption of any nursing home employment standards included in the most recent budget and economic forecast completed under section 16A.103; and (3) if the established nursing home employment standards result in an increase in costs that exceed the operating payment rate and external fixed costs payment rate increase included in the most recent budget and economic forecast completed under section 16A.103, effective on the proposed implementation date of the new nursing home employment standards, the board must determine if the rates will need to be increased to meet the new employment standards and the standards must not be effective until an appropriation sufficient to cover the rate increase and federal approval of the rate increase is obtained. (e) The budget and economic forecasts completed under section 16A.103 shall not assume an increase in payment rates determined under chapter 256R resulting from the new employment standards until the board certifies the rates will need to be increased and the legislature appropriates funding for the increase in payment rates.

Sec. 2.

Minnesota Statutes 2024, section 181.213, is amended by adding a subdivision to read: Subd. 2a. Effective dates of new employment standards. (a) New employment standards that do not meet the threshold determined in subdivision 2, paragraph (c) or (d), are effective on the date determined by the board in rules. (b) New employment standards that exceed the threshold determined in subdivision 2, paragraph (c) or (d), are effective upon federal approval or the following date, whichever is later: (1) if subdivision 2b is in effect, the date the applicable rate adjustment under section 256R.495 is effective; or (2) if subdivision 2b is not in effect, the effective date of an enacted appropriation sufficient to cover the rate increase.

Sec. 3.

Minnesota Statutes 2024, section 181.213, is amended by adding a subdivision to read: Subd. 2b. Implementation of rate increases. (a) This paragraph is effective only for those rate years, as defined in section 256R.02, during which both the CPI-U inflation limits and the percentage increase limits under sections 256R.23, subdivisions 7 and 8, and 256R.24, subdivision 3, are in effect. (b) For an increase in rates the board has determined under subdivision 2, paragraph (c) or (d), is needed to cover the increased cost of compliance with new nursing home employment standards, the appropriation sufficient to cover the rate increase must be made in the form of a rate adjustment under section 256R.495.

Sec. 23.

[256R.495] RATE ADJUSTMENT FOR NURSING HOME EMPLOYMENT STANDARDS. Subdivision 1. Nursing home employment standards rate adjustment.

For each rate year for which section 181.213, subdivision 2b, is in effect, and for which the legislature appropriates money to fund a rate increase necessary to meet new employment standards established under section 181.213, a nursing facility's rate under this chapter must include a rate adjustment to pay for the nursing home employment standards promulgated by the Nursing Home Workforce Standards Board if the facility complies with the requirements in subdivision 2. To receive a rate adjustment under this section, a nursing facility must report to the commissioner the wage rate for every worker and

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contracted worker below a new minimum employment standard established by the board under section 181.213.

Subd. 2. Application for rate adjustments.

To receive a rate adjustment under this section, a nursing facility must submit to the commissioner in a form and manner determined by the commissioner an application for each rate year in which a rate adjustment is available. The application must include data for a period beginning with the first pay period after June 1 of the year prior to the rate year in which the rate adjustment takes effect, including at least two months of worker-compensated hours by wage rate and a spending plan that describes how the money from the rate adjustment will be allocated for compensation to workers as defined by Minnesota Rules, part 5200.2060, who are paid less than the general wage standards defined in Minnesota Rules, part 5200.2080, and the wage standards for certain positions defined by Minnesota Rules, part 5200.2090. A nursing facility must submit the application by October 1 of the year prior to the rate year in which the rate adjustment takes effect. The commissioner may request any additional information needed to determine the rate adjustment. The nursing facility must provide any additional information requested by the commissioner within 20 calendar days of receiving a request from the commissioner for additional information. The commissioner may waive the deadlines in this subdivision under extraordinary circumstances.

Subd. 3. Rate adjustment timeline.

Based on an approved application submitted under subdivision 2, the commissioner must calculate the amount of the rate adjustment based on the facility's approved application under subdivision 2 and include that amount in the facility's external fixed cost payment rate under section 256R.25. For each rate year for which a nursing facility receives approval of the application under subdivision 2, the facility must receive a final rate adjustment according to the applicable subdivision of this section. The final rate adjustment must be included in the external fixed costs payment rate under section 256R.25 for two rate years.

Subd. 4. January 1, 2026, rate adjustment calculation. (a) For the rate year beginning January 1, 2026, the commissioner must calculate the annualized compensation costs by adding the totals of clauses (1) to (5). The result must be divided by the total resident days from the most recently available cost report to determine the preliminary rate adjustment for the nursing home employment standards: (1) for certified nursing assistants, the sum of the difference between $22.50 and any hourly wage rate of less than $22.50 multiplied by the number of compensated hours at that wage rate; (2) for trained medication aides, the sum of the difference between $23.50 and any hourly wage rate of less than $23.50 multiplied by the number of compensated hours at that wage rate; (3) for licensed practical nurses, the sum of the difference between $27 and any hourly wage rate of less than $27 multiplied by the number of compensated hours at that wage rate; (4) for all nursing home workers not included in clauses (1) to (3) who are subject to the minimum wage standards established by the board under section 181.213, the sum of the difference between $19 and any hourly wage rate less than $19 multiplied by the number of compensated hours at that wage rate; and (5) the sum of the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, pensions, and contributions to employee retirement accounts attributable to the amounts in clauses (1) to (4).

(b) If the aggregate net general fund spending under this subdivision does not exceed the increase in funding needed to increase payment rates to comply with the new employment standards as reported to the legislature by the Nursing Home Workforce Standards Board under section 181.213, the preliminary rate adjustment calculated under paragraph (a) is the final rate adjustment for the nursing home employment standards.

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(c) If the aggregate net general fund spending under this subdivision exceeds the increase in funding needed to increase payment rates necessary to comply with the new employment standards as reported to the legislature by the Nursing Home Workforce Standards Board under section 181.213, the commissioner must determine the final rate adjustment by reducing all preliminary rate adjustments calculated under paragraph (a) by an equal proportion such that the aggregate net general fund spending under this subdivision is equal to the amount reported to the legislature by the Nursing Home Workforce Standards Board.

Subd. 5. January 1, 2027, rate adjustment calculation. (a) For the rate year beginning January 1, 2027, the commissioner must calculate the annualized compensation costs by adding the totals of clauses (1) to (5). The result must be divided by the total resident days from the most recently available cost report to determine the final rate adjustment for the nursing home employment standards: (1) for certified nursing assistants, the sum of the difference between $24 and any hourly wage rate of less than $24 multiplied by the number of compensated hours at that wage rate; (2) for trained medication aides, the sum of the difference between $25 and any hourly wage rate of less than $25 multiplied by the number of compensated hours at that wage rate; (3) for licensed practical nurses, the sum of the difference between $28.50 and any hourly wage rate of less than $28.50 multiplied by the number of compensated hours at that wage rate; (4) for all nursing home workers not included in clauses (1) to (3) who are subject to the minimum wage standards established by the board under section 181.213, the sum of the difference between $20.50 and any hourly wage rate of less than $20.50 multiplied by the number of compensated hours at that wage rate; and (5) the sum of the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, pensions, and contributions to employee retirement accounts attributable to the amounts in clauses (1) to (4). (b) If the aggregate net general fund spending under this subdivision does not exceed the increase in funding needed to increase payment rates necessary to comply with the new employment standards as reported to the legislature by the Nursing Home Workforce Standards Board under section 181.213, the preliminary rate adjustment calculated under paragraph (a) is the final rate adjustment for the nursing home employment standards. (c) If the aggregate net general fund spending under this subdivision exceeds the increase in funding needed to increase payment rates necessary to comply with the new employment standards as reported to the legislature by the Nursing Home Workforce Standards Board under section 181.213, the commissioner must determine the final rate adjustment by reducing all preliminary rate adjustments calculated under paragraph (a) by an equal proportion such that the aggregate net general fund spending under this subdivision is equal to the amount reported to the legislature by the Nursing Home Workforce Standards Board.

EFFECTIVE DATE. This section is effective July 1, 2025, or upon federal approval, whichever is later.

The commissioner of human services shall notify the revisor of statutes when federal approval is obtained.

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Capped Operating Rates Create Significant Reduction in Funding 2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Sections 1, 14-16 Human Services Omnibus Bill Effective: January 1, 2026

Short description Beginning January 1, 2026 the annual increase to each nursing facility’s operating rates is capped.

Summary The 2025 legislature and Governor Walz considered several proposals to cut nursing facility rates.

While the Governor’s budget proposed a two percent cap on operating rates, the Senate proposed to utilize a punitive quality formula to reduce rates. With the House initially not including any operating rate reductions, the three elected bodies and DHS ultimately agreed to capping operating rates based on a nursing facility’s direct care, other care-related, and other operating rates being limited to the lessor of: • • •

CPI-U, or 4-percent, or facility’s actual cost per day (for direct care and other care-related).

The CPI-U factor used will be based on the 12-month period ending with the midpoint of the cost report period used for establishing the January 1 rates.

Below are the estimated state share budget savings derived from capping nursing facility operating rates.

State Share (dollars in thousands) FY 2026 FY 2027 FY 2028 FY 2029 Payment Operating Cap to CPI-U with ($11,300) ($33,369) ($45,556) ($56,419) 4% Annual Cap Implications The adoption of operating rate caps has profound implications for residents and families, employees, and nursing facility organizations.

• The cap removes the mediating impact of using total paid days as the divisor of cost centers. When total paid days for a cost report period fall, Minnesota’s Medicaid rate setting system (VBR) establishes per diems that increase, in part, due to the fall in census and fixed costs. This important feature is negated by capping operating rates.

• Nursing facilities that made investments in staff wages during the 2024 cost report (YE 9-30-24) with the expectation of receiving a rate increase on January 1, 2026, will see these investments limited if they exceed the cap.

Bill language Chapter 9, Article 1, Sections 1, 14-16: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.1.0#laws.1.1.0 Sec. 11. Minnesota Statutes 2024, section 256R.02, is amended by adding a subdivision to read: Subd. 14a. CPI-U inflation. "CPI-U inflation" means the percentage change in the Consumer Price Index-All Items (United States City average) (CPI-U) provided by the Reports and Forecasts Division of the Department of Human Services in the fourth quarter of the calendar year preceding the rate year based on the 12-month period ending with the midpoint of the reporting period for which CPI-U inflation is being applied to determine the rates and beginning with the midpoint of the previous reporting period.

EFFECTIVE DATE. This section is effective the day following final enactment.

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Sec. 14. Minnesota Statutes 2024, section 256R.23, subdivision 7, is amended to read: Subd. 7. Determination of direct care payment rates. A facility's direct care payment rate equals the lesser of (1) the facility's direct care costs per standardized day, or (2) the facility's direct care costs per standardized day divided by its cost to limit ratio, (3) the previous year's direct care payment rate times one plus CPI-U inflation, or (4) 104 percent of the previous year's direct care payment rate.

EFFECTIVE DATE. This section is effective January 1, 2026.

Sec. 15. Minnesota Statutes 2024, section 256R.23, subdivision 8, is amended to read: Subd. 8. Determination of other care-related payment rates. A facility's other care-related payment rate equals the lesser of (1) the facility's other care-related cost per resident day, or (2) the facility's other care-related cost per resident day divided by its cost to limit ratio, (3) the previous year's other care-related rate times one plus CPI-U inflation, or (4) 104 percent of the previous year's other care-related payment rate.

EFFECTIVE DATE. This section is effective January 1, 2026.

Sec. 16. Minnesota Statutes 2024, section 256R.24, subdivision 3, is amended to read: Subd. 3. Determination of the other operating payment rate. A facility's other operating payment rate equals the lesser of (1) 105 percent of the median other operating cost per day, (2) the previous year's other operating payment rate times one plus CPI-U inflation, or (3) 104 percent of the previous year's other operating payment rate.

EFFECTIVE DATE. This section is effective January 1, 2026.

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Long-term Services and Supports Loan Program Excludes Nursing Facilities 2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Section 4 Human Services Omnibus Bill Effective: August 1, 2025

Short description Nursing facilities are no longer eligible to participate in the $100 million interest free loan program for financially distressed settings that was passed by the 2023 legislature and expanded in 2024 to include Home and Community Based Service (HCBS) providers.

Summary With the removal of nursing facilities, only the following HCBS providers are eligible to apply for loans under the program: • Home and community-based services under chapter 245D • Personal care assistance services under section 256B.0659 • Community first services and supports under section 256B.85 • Early intensive developmental and behavioral intervention services under section 256B.0949 • Home care services as defined under section 256B.0651, subdivision 1, paragraph (d) • Customized living services as defined in section 256S.02 The following criteria are used by DHS to evaluate HCBS provider loan applications.

The loans are to be used for additional operating revenue needed to: • Preserve access to services within the community, • Expand services to people within the community, • Expand services to new communities, or • Support people with complex, high-acuity support needs The terms remain the same: • Interest free • Disbursement may be made as a lump sum or over defined schedule • Repayment must not begin until 18-months after disbursement • Repayment term must not exceed 72 months • The state may withhold payment for Medicaid services if provider is delinquent by 60 calendar days • Subject to DHS audit • The language places the State of Minnesota at the front of the line with regard to creditors and repayment.

Implications Nursing facilities are no longer eligible for the loan program. Likewise, there is no formal application process for HCBS providers.

However, for the 40 or so nursing facilities that were provided with loans, the legislature added the following language: (a) All loans disbursed to nursing facilities under this section prior to August 1, 2025, must follow the criteria and repayment terms outlined in their executed loan agreements. (b) In the event of a facility's closure prior to repayment, the commissioner must attempt to recover the unpaid amounts owed by the facility.

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Bill language Chapter 9, Article 1, Section 4: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.4.0#laws.1.4.0

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Nursing Home Bed Surcharge Increased 2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Sections 5, 17 Human Services Omnibus Bill Effective: January 1, 2026

Short description On January 1, 2026 the nursing home license surcharge will increase from $2,815 to $5,900 per bed.

The Medicaid and private pay rate paid to nursing homes will increase from $8.86 to $19.02 per bed.

Summary The nursing home bed surcharge program allows the State of Minnesota to increase general fund revenue by taxing nursing home beds, reimbursing nursing homes via the Medicaid and private pay rates and drawing down the associated federal match.

According to the fiscal note, the increase from $2,815 to $5,900 per bed will generate $136 million in additional revenue over 4-years for the State of Minnesota.

State Share (dollars in thousands) FY 2026 FY 2027 FY 2028 FY 2029 Nursing Home Surcharge

$16,441

$40,148

$40,546

$40,298

Implications There are several important implications for nursing homes.

First, the nursing home bed surcharge and the associated payback, often creates a net loss for nursing homes. This is due to empty beds as well as payers like Medicare, commercial, and LTC insurance not assuming the associated payback that Medicaid and private pay do. As a result, nursing homes will want to assess their bed capacity to determine if beds should be placed on layaway.

Second, the increase is the associated payback is a tax on private pay residents. Nursing homes should expect some residents and families to be upset by the increase.

Finally, additional language was inserted that calls for the associated payback to be reduced if state receipts are estimated to be 15% less than forecasted. It is not clear why this language was included or whether it contemplates how the program functions.

Bill language Chapter 9, Article 1, Sections 5, 17: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.5.0#laws.1.5.0

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Annual Inflation Adjustment for Property Rate Removed 2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Section 9 Human Services Omnibus Bill Effective: January 1, 2026

Short description Beginning January 1, 2026, a nursing facility’s property rate will no longer be adjusted annually by the CPI-U. Summary The 2025 legislature removed statutory language requiring a nursing facility’s property rate to be annually adjusted by the CPI-U. During previous budget deficits the adjustment was typically suspended for 2 or 4 years. By eliminating statutory language, an appropriation is now required to resume this rate increase. Below are the estimated state share budget savings accrued from eliminating the property rate adjustment.

State Share (dollars in thousands) APS Inflation

FY 2026 ($627)

FY 2027 ($1,964)

FY 2028 ($2,982)

FY 2029 ($4,015)

Note this change does not affect the property rates of nursing facilities that have completed a moratorium exceptions project under the fair rental value system adopted in 2019.

Implications Nursing facilities will need to adjust budget projections downward. The reduction also disincentivizes nursing facilities from keeping up with general maintenance and upkeep.

Bill language Chapter 9, Article 1, Section 9: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.9.0#laws.1.9.0

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Nursing Facility Medicaid Rates Transition to PDPM Nursing Indices 2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Sections 12, 13, and 24 Human Services Omnibus Bill Effective: October 1, 2025

Short description On October 1, 2025 Minnesota will begin using the nursing indices from the Medicare PDPM payment system to establish the rates and resident payment classifications for Medicaid and private pay. Due to the differences between the RUG-IV 48-Classification indices currently used and the PDPM 25Classification nursing indices, the case mix adjusted direct care payment rate will be phased-in beginning October 1, 2025 and conclude on January 1, 2029.

Summary The Minimum Data Set (MDS) is part of the federally mandated process for clinical assessment of all residents in Medicare and Medicaid certified nursing homes.

When implementing a new Medicare payment system on October 1, 2019, the Centers for Medicare and Medicaid Services (CMS) decided to no longer support the composition of the MDS needed by many states to administer their Medicaid nursing facility programs. Since Minnesota uses the MDS to establish the rates paid by Medicaid and Private Pay residents with the RUG-IV Medicaid-48 classification System, Minnesota will begin using the nursing indices from Medicare’s PDPM system.

For the 9-30-2023 and 9-30-2024 Medicaid cost reports, nursing facilities provided the Minnesota Department of Human Services (DHS) with census days by payer for the RUGS-IV and PDPM. • The 9-30-2023 data will be used to establish the 10-1-2025 case mix adjusted direct care payment rates.

• The 9-30-2024 data will be used to establish the 1-1-2026 case mix adjusted direct care payment rates.

DHS has not provided providers or the associations with an estimate of how this change will impact nursing facility reimbursement rates.

However, the PDPM nursing indices will increase payment to most nursing facilities.

Below is the estimated state share funding appropriated by the legislature for the PDPM case mix transition.

State Share (dollars in thousands) FY 2026 FY 2027 FY 2028 FY 2029 PDPM Phase-In $2,071 $4,553 $8,046 $11,779 Here is the phase-in schedule for the transition: Rate Year PDPM Percentage RUG-IV Percentage 10-1-2025

25%

75%

1-1-2026

25%

75%

1-1-2027

50%

50%

1-1-2028

75%

25%

1-1-2029

100%

0%

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Implications The transition to PDPM nursing indices will require nursing facilities to closely monitor the change in Medicaid and private pay rates and revenue on October 1, 2025. Likewise, the January 1, 2026 rates will use a different set of census data from the 9-30-2024 cost report. This also may create differences in expected Medicaid and private pay rates and revenue. Note there are other changes to the rates on January 1, 2026.

Finally, for both 10-1-2025 and 1-1-2026, nursing facilities will need to provide 30-day notice to private pay residents. According to statute, DHS will provide the rate notices 45-days before the effective date.

Bill language Chapter 9, Article 1, Sections 12, 13, and 24: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.12.0#laws.1.12.0 Sec. 12.

Minnesota Statutes 2024, section 256R.02, is amended by adding a subdivision to read: Subd. 36a. Patient driven payment model or PDPM. "Patient driven payment model" or "PDPM" has the meaning given in section 144.0724, subdivision 2.

EFFECTIVE DATE. This section is effective the day following final enactment.

Sec. 13.

Minnesota Statutes 2024, section 256R.02, is amended by adding a subdivision to read: Subd. 45a. Resource utilization group or RUG. "Resource utilization group" or "RUG" has the meaning given in section 144.0724, subdivision 2.

Sec. 24.

[256R.531] PATIENT DRIVEN PAYMENT MODEL PHASE-IN. Subdivision 1. PDPM phase-in.

Effective October 1, 2025, through December 31, 2028, for each facility, the commissioner must determine an adjustment to its total payment rate as determined under sections 256R.21 and 256R.27 to phase in the transition from the RUG-IV case mix classification system to the patient driven payment model (PDPM) case mix classification system.

Subd. 1a. Definition.

"Medical assistance facility average case mix index" means the facility average case mix index for the subset of a facility's residents that includes only medical assistance recipients.

Subd. 2. PDPM phase-in rate adjustment.

A facility's PDPM phase-in rate adjustment to its total payment rate is equal to: (1) the blended medical assistance case mix adjusted direct care payment rate determined in subdivision 6; minus (2) the PDPM medical assistance case mix adjusted direct care payment rate determined in section 256R.23, subdivision 7.

Subd. 3. RUG-IV standardized days and RUG-IV facility case mix index. (a) Effective October 1, 2025, through December 31, 2027, for each facility, the commissioner must determine the RUG-IV standardized days and RUG-IV medical assistance facility average case mix index. (b) For the rate year beginning January 1, 2028, only: (1) for each facility, the commissioner must determine both the RUG-IV facility average case mix index and the RUG-IV medical assistance facility average case mix index using resident days by the case mix classification on the facility's September 30, 2025, Minnesota Statistical and Cost Report; and

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(2) for each facility, the commissioner must determine the RUG-IV standardized days by multiplying the facility's resident days on the facility's September 30, 2026, Minnesota Statistical and Cost Report by the facility's RUG-IV facility average case mix index determined under clause (1).

Subd. 4. RUG-IV medical assistance case mix adjusted direct care payment rate.

The commissioner must determine a facility's RUG-IV medical assistance case mix adjusted direct care payment rate as the product of: (1) the facility's RUG-IV direct care payment rate determined in section 256R.23, subdivision 7, using the RUG-IV standardized days determined in subdivision 3; and (2) the corresponding RUG-IV medical assistance facility average case mix index determined in subdivision 3.

Subd. 5. PDPM medical assistance case mix adjusted direct care payment rate.

The commissioner must determine a facility's PDPM case mix adjusted direct care payment rate as the product of: (1) the facility's direct care payment rate determined in section 256R.23, subdivision 7; and (2) the corresponding medical assistance facility average case mix index.

Subd. 6. Blended medical assistance case mix adjusted direct care payment rate.

The commissioner must determine a facility's blended medical assistance case mix adjusted direct care payment rate as the sum of: (1) the RUG-IV medical assistance case mix adjusted direct care payment rate determined in subdivision 4 multiplied by the following percentages: (i) October 1, 2025, through December 31, 2026, 75 percent; (ii) January 1, 2027, through December 31, 2027, 50 percent; and (iii) January 1, 2028, through December 31, 2028, 25 percent; and (2) the PDPM medical assistance case mix adjusted direct care payment rate determined in subdivision 5 multiplied by the following percentages: (i) October 1, 2025, through December 31, 2026, 25 percent; (ii) January 1, 2027, through December 31, 2027, 50 percent; and (iii) January 1, 2028, through December 31, 2028, 75 percent.

Subd. 7. Expiration. This section expires January 1, 2029.

EFFECTIVE DATE. This section is effective October 1, 2025.

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Single-Bed Incentive Rate from Closing Beds Phased-Out 2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Section 21 Human Services Omnibus Bill Effective: The day following enactment

Short description The single-bed incentive rate will be phased out between January 1, 2027 to December 31, 2030.

Summary Between 2004 and present, nursing facilities received a single bed incentive rate add-on when the nursing facility closed beds and created single rooms.

The single bed incentive rates will be phased out by 20% a year beginning January 1, 2027 and ending January 1, 2031 (a 20% per year reduction until zero).

Below are the estimated state share budget savings accrued from eliminating sunsetting the single bed incentive.

State Share (dollars in thousands) SBI Phase Out (includes the elimination of future bed layaway adjustments to the property rate)

FY 2026

FY 2027

FY 2028

FY 2029

$0

($484)

($1,661)

($2,855)

Implications Nursing facilities will still be able to create single rooms by closing beds and receive a rate adjustment.

However, any adjustment received will be prorated according to the scheduled phase-out.

Nursing facilities will be able to receive a single room rate adjustment through June 30, 2030, which would be reduced to 20% of original amount and then removed on January 1, 2031.

Bill language Chapter 9, Article 1, Section 21: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.21.0#laws.1.21.0 256R.41 SINGLE-BED ROOM INCENTIVE. Subdivision 1. Single-bed incentive. (a) Beginning July 1, 2005, The operating payment rate for nursing facilities reimbursed under this chapter shall be increased by 20 percent multiplied by the ratio of the number of new single-bed rooms created divided by the number of active beds on July 1, 2005, for each bed closure that results in the creation of a single-bed room after July 1, 2005. The commissioner may implement rate adjustments for up to 3,000 new single-bed rooms each year through June 30, 2030. For eligible bed closures for which the commissioner receives a notice from a facility that a bed has been delicensed and a new single-bed room has been established, the rate adjustment in this paragraph shall be effective on either the first day of the month of January or July, whichever occurs first following the date of the bed delicensure.

Subd. 2. Single-bed incentive phase-out. (a) Beginning January 1, 2027, the commissioner shall reduce the value of the single-bed incentive calculated under subdivision 1 as follows: (1) January 1, 2027, through December 31, 2027, the single-bed incentive is 80 percent of the value calculated under subdivision 1;

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(2) January 1, 2028, through December 31, 2028, the single-bed incentive is 60 percent of the value calculated under subdivision 1; (3) January 1, 2029, through December 31, 2029, the single-bed incentive is 40 percent of the value calculated under subdivision 1; (4) January 1, 2030, through December 31, 2030, the single-bed incentive is 20 percent of the value calculated under subdivision 1; and (5) on or after January 1, 2031, the single-bed incentive is zero. (b) The phase-out schedule in this subdivision applies to all existing and new rate adjustment amounts determined under subdivision 1.

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Grant Provided to Boundary Waters Care Center 2025 First Special Session SF 7/HF 3 Chapter 9, Article 12, Section 10 Human Services Omnibus Bill Effective: July 1, 2025

Short description Boundary Waters Care Center in Ely received a $250,000 grant for fiscal year 2026.

Summary A one-time, state share only grant of $250,000 was provided to Boundary Waters Care Center in Ely for SFY2026.

Implications Since the appropriation is a grant, the funding will not be built into the nursing facility’s rate structure and will be offset.

Bill language Chapter 9, Article 12, Section 10: https://www.revisor.mn.gov/laws/2025/1/9/laws.12.10.0#laws.12.10.0

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NURSING FACILITY POLICY

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Employer Definition Used by Nursing Home Workforce Standards Board Tied to Medicaid Participation 2025 First Special Session SF 17/HF 15 Chapter 6, Article 5, Sections 7-8 Jobs and Labor Omnibus Effective: August 1, 2025

Short description The statutory definition used by Nursing Home Workforce Standards Board (Board) for nursing home and nursing home employers was amended to apply exclusively to those facilities that receive Medicaid reimbursement under Minnesota Statute 256R. Summary The authorizing statue for the Board passed the 2023 legislature with many poorly conceived definitions and references. One specific issue was that the statute both proposes to estimate the cost of any proposed standard to the state’s Medicaid program and definitionally apply to all nursing facilities and their employees in Minnesota. As a result, the standards issued by the Board had, until the change made by the 2025 legislature, applied to private pay only nursing facilities, the state forensic nursing facility, and those operated by the Veterans Administration.

Implications Standards issued by the Board only apply to nursing facilities reimbursed by Medicaid under Minnesota Statute 256R. Bill language Chapter 6, Article 5, Sections 7-8: https://www.revisor.mn.gov/laws/2025/1/6/laws.5.7.0#laws.5.7.0 Sec. 7. Minnesota Statutes 2024, section 181.211, subdivision 7, is amended to read: Subd. 7. Nursing home. "Nursing home" means a nursing home licensed under chapter 144A and reimbursed under chapter 256R, or a boarding care home licensed under sections 144.50 to 144.56 and reimbursed under chapter 256R. Sec. 8. Minnesota Statutes 2024, section 181.211, subdivision 8, is amended to read: Subd. 8. Nursing home employer. "Nursing home employer" means an employer of nursing home workers in a licensed, Medicaid-certified facility that is reimbursed under chapter 256R nursing home as defined under subdivision 7. .

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Changes to Bed Layaway and Single Bed Election 2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Section 8 Human Services Omnibus Bill Effective: July 1, 2025 with delayed implementation

Short description Effective January 1, 2027: 1) Property payment rates will no longer be adjusted when beds are placed in or removed from layaway on or after.

2) A facility is not allowed to change the facility's single bed election when placing a bed on layaway.

Summary The elimination of the incremental property rate adjustment resulted in budgetary savings for Minnesota. Most of the estimated savings below are presumably from the phase out of the single bed incentive (SBI).

State Share (dollars in thousands) SBI Phase Out (includes the elimination of future bed layaway adjustments to the property rate)

FY 2026

FY 2027

FY 2028

FY 2029

$0

($484)

($1,661)

($2,855)

Implications Importantly, these changes do not alter the bed layaway program. Nursing facility beds may still placed and removed from layaway.

While not effective until January 1, 2027, nursing facilities placing (or removing) a bed on layaway on or after July 1, 2026 will not have their property rate adjusted.

Similarly, nursing facilities that want to change their single room election by laying away a bed, will no longer be able to after January 1, 2027.

Bill language Chapter 9, Article 1, Section 8: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.8.0#laws.1.8.0

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Statute Repealed From 256R

2025 First Special Session SF 7/HF 3 Chapter 9, Article 1, Section 32 Human Services Omnibus Bill Effective: See bill language below Short description The 2025 legislature repealed several sections of Minnesota Statute 256R. Summary See below for language repealed from 256R. Implications Typically, repealed language is no longer needed.

Bill language Chapter 9, Article 1, Section 32: https://www.revisor.mn.gov/laws/2025/1/9/laws.1.32.0#laws.1.32.0 256R.02 DEFINITIONS. Subd. 38.Prior system operating cost payment rate. "Prior system operating cost payment rate" means the operating cost payment rate in effect on December 31, 2015, under Minnesota Rules and Minnesota Statutes, inclusive of health insurance, plus property insurance costs from external fixed costs, minus any rate increases allowed under Minnesota Statutes 2015 Supplement, section 256B.441, subdivision 55a.

256R.12 COST ALLOCATION. Subd. 10.Allocation of self-insurance costs. For the rate year beginning on July 1, 1998, a group of nursing facilities related by common ownership that self-insures group health, dental, or life insurance may allocate its directly identified costs of self-insuring its Minnesota nursing facility workers among those nursing facilities in the group that are reimbursed under this chapter. The method of cost allocation shall be based on the ratio of each nursing facility's total allowable salaries and wages to that of the nursing facility group's total allowable salaries and wages, then similarly allocated within each nursing facility's operating cost categories. The costs associated with the administration of the group's self-insurance plan must remain classified in the nursing facility's administrative cost category. A written request of the nursing facility group's election to use this alternate method of allocation of selfinsurance costs must be received by the commissioner no later than May 1, 1998, to take effect July 1, 1998, or those self-insurance costs shall continue to be allocated under the existing cost allocation methods. Once a nursing facility group elects this method of cost allocation for its group health, dental, or life insurance self-insurance costs, it shall remain in effect until such time as the group no longer selfinsures these costs.

256R.23 TOTAL CARE-RELATED PAYMENT RATES. Subd. 6.Payment rate limit reduction. No facility shall be subject in any rate year to a care-related payment rate limit reduction greater than five percent of the median determined in subdivision 4.

256R.36 HOLD HARMLESS. No nursing facility's operating payment rate, plus its employer health insurance costs portion of the external fixed costs payment rate, will be less than its prior system operating cost payment rate.

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Nursing Home Controlling Person – When No Individual has at Least 5% Ownership

2025 Regular Session HF 3 Chapter 9, Article 8, Section 1 Human Services Omnibus Bill Effective: August 1, 2025

Short description Changes the definition of a controlling individual of a nursing home, when no individual owns at least a five percent ownership interest; every individual is considered a controlling person.

Implications This change broadens the scope of individuals subject to the regulatory requirements outlined in Minnesota Statutes Chapter 144A. Controlling persons must submit comprehensive background information and comply with all licensing and quality standards. Providers and owners should: • • • •

Review ownership structures carefully to identify all individuals with any ownership interest, especially in facilities lacking a 5% individual owner.

Prepare to collect and submit detailed background and compliance documentation for all controlling persons, not just those with majority stakes.

Ensure internal policies and governance reflect the expanded regulatory scope, including individuals with interests in facility property or land.

Consult legal or compliance experts to confirm all controlling persons are properly disclosed and meet the required standards to avoid enforcement actions.

This change increases administrative and compliance responsibilities, particularly for facilities with complex ownership or corporate structures. Proactive preparation will help avoid delays in licensing and ensure continuous regulatory compliance.

Bill language Chapter 9, Article 8, Section 1: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.1.0#laws.8.1.0 Section 1. Minnesota Statutes 2024, section 144A.01, subdivision 4, is amended to read: Subd. 4. Controlling person. (a) "Controlling person" means an owner and the following individuals and entities, if applicable: (1) each officer of the organization, including the chief executive officer and the chief financial officer; (2) the nursing home administrator; and (3) any managerial official.; and (4) if no individual has at least a five percent ownership interest, every individual with an ownership interest in a privately held corporation, limited liability company, or other business entity, including a business entity that is publicly traded or nonpublicly traded, that collects capital investments from individuals or entities. (b) "Controlling person" also means any entity or natural person who has any direct or indirect ownership interest in: (1) any corporation, partnership or other business association which is a controlling person; (2) the land on which a nursing home is located; (3) the structure in which a nursing home is located; (4) any entity with at least a five percent mortgage, contract for deed, deed of trust, or other security interest in the land or structure comprising a nursing home; or (5) any lease or sublease of the land, structure, or facilities comprising a nursing home. ...

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Changes to Nursing Homes Resident Property Taxes/Rent Paid 2025 First Special Session HF 9 Chapter 13, Article 9, Section 6 Taxes Omnibus Bill Effective: Taxable years beginning after December 31, 2024 Short description Resident income changes to CRP program.

Summary If a resident is paying a portion of the rent they are eligible for a credit, but that credit calculation has been modified to no longer allow a reduction in AGI by the other sources including SSI, MSA, Housing Supports and Medical Assistance.

Implications Residents in assisted living who pay some portion of their rent out-of-pocket and receive partial support through programs like Housing Support or Medical Assistance, may now be more likely to qualify for and receive a larger Renters’ Credit. Residents will no longer have their income reduced by public program sources when computing eligibility. This results in a larger allowable fraction of the Renters’ Credit under the revised formula.

Bill language Chapter 13, Article 9, Section 6: https://www.revisor.mn.gov/laws/2025/1/13/laws.9.6.0#laws.9.6.0 Sec. 6. Minnesota Statutes 2024, section 290.0693, subdivision 6, is amended to read: Subd. 6. Residents of nursing homes, intermediate care facilities, long-term care facilities, or facilities accepting housing support payments. (a) A taxpayer must not claim a credit under this section if the taxpayer is a resident of a nursing home, intermediate care facility, long-term residential facility, or a facility that accepts housing support payments whose rent constituting property taxes is paid pursuant to the Supplemental Security Income program under title XVI of the Social Security Act, the Minnesota supplemental aid program under sections 256D.35 to 256D.54, the medical assistance program pursuant to title XIX of the Social Security Act, or the housing support program under chapter 256I. (b) If only a portion of the rent constituting property taxes is paid by these programs, the resident is eligible for a credit, but the credit calculated must be multiplied by a fraction, the numerator of which is adjusted gross income, reduced by the total amount of income from the above sources other than vendor payments under the medical assistance program and the denominator of which is adjusted gross income, plus vendor payments under the medical assistance program, to determine the allowable credit. (c) Notwithstanding paragraphs (a) and (b), if the taxpayer was a resident of the nursing home, intermediate care facility, long-term residential facility, or facility for which the rent was paid for the claimant by the housing support program for only a portion of the taxable year covered by the claim, the taxpayer may compute rent constituting property taxes by disregarding the rent constituting property taxes from the nursing home or facility and may use only that amount of rent constituting property taxes or property taxes payable relating to that portion of the year when the taxpayer was not in the facility.

The taxpayer's household income is the income for the entire taxable year covered by the claim.

EFFECTIVE DATE. This section is effective for taxable years beginning after December 31, 2024.

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Nursing Facility Medicaid Case Mix Transition Policy Changes

2025 Regular Session SF 2443/HF 2115 Chapter 38, Article 1, Sections 1-2 Human Services Policy Bill Effective: October 1, 2025, and applies to assessments conducted on or after that date.

Short description Minnesota will begin using the Medicare PDPM nursing indices for the state Medicaid nursing facility payment system.

Summary In addition to adding several definitions, changes were made to the policies governing the resident assessments and use of assessments under PDPM. • Effective October 1, Minnesota nursing facilities will transition to the nursing indices used by Medicare’s PDPM system.

• Effective October 1, the Optional State Assessment (OSA) will no longer be required as a standalone assessment after all therapy or isolation is completed or with any Omnibus Budget Reconciliation Act (OBRA) assessment.

• If the most recent assessment completed prior to October 1 is a standalone OSA, an OBRA assessment will need to be completed, submitted and accepted into the Centers for Medicare and Medicaid Services (CMS) database on or before September 30 to calculate a PDPM Nursing Component classification effective October 1.

• Effective October 1, a Significant Change in Status assessment will need to be completed on day 15, after isolation services have ended.

Two definitions were added: "Patient Driven Payment Model" or "PDPM" means the case mix reimbursement classification system for residents in nursing facilities based on the resident's condition, diagnosis, and the care the resident received at the time of the MDS assessment with an ARD on or after October 1, 2025.

"Resource utilization group" or "RUG" means the case mix reimbursement classification system for residents in nursing facilities according to the resident's clinical and functional status as reflected in data supplied by the facility's MDS with an ARD on or before September 30, 2025.

Implications Nursing facilities should prepare for the October 1, 2025 transition. Issues including notice to private pay, assessment schedules, how Medicaid and private pay residents are classified, and change in revenue will require staff education, extra work, and monitoring Bill language Chapter 38, Article 1, Sections 1-2: https://www.revisor.mn.gov/laws/2025/0/38/laws.1.1.0#laws.1.1.0

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Consolidation Savings now Applied to Moratorium Project Costs 2025 Regular Session SF 2443/HF 2115 Chapter 38, Article 1, Section 3 Human Services Policy Bill Effective: The day following enactment

Short description Rather than receiving the savings estimated from the consolidation of two or more nursing facilities in the form of an add-on rate, the savings will now be used to lower the cost of a moratorium project.

Summary Minnesota nursing facilities seeking to consolidate two or more facilities were able to receive an add-on based on 65% of the estimated savings. The 2025 legislature changed the program in two ways.

First, consolidation savings will now be applied to the cost of a moratorium proposal. If there are savings greater than cost of the moratorium proposal, then the additional savings will be assigned to the moratorium fund.

Second, a new subdivision is created that identifies the nursing facilities that have consolidation rates and the per patient day amount. When a nursing facility completes a moratorium exception project and receives a rate as calculated by the fair rental value system, the consolidation rate will expire.

Implications Two or more nursing facilities that have decided to consolidate buildings will no longer be eligible for a consolidation rate.

Bill language Chapter 38, Article 1, Section 3: https://www.revisor.mn.gov/laws/2025/0/38/laws.1.3.0#laws.1.3.0

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MN-ITS Mailbox, Email may be Used to Notify Withholding due to Late Surcharge Payment 2025 Regular Session SF 2443/HF 2115 Chapter 38, Article 1, Section 14 Human Services Policy Bill Effective: The day following enactment

Short description Providers that are delinquent in paying a provider tax or surcharge may now be notified by email and MN-ITS mailbox that the Minnesota Department of Human Services is withholding payment.

Summary Statute now directs DHS provide notice of department's intention to withhold by mailing or emailing a written notice to the provider at the address to which remittance advices are mailed, placing the notice in the provider's MN-ITS mailbox, or faxing a copy of the notice to the provider at least ten business days before the date of the first payment period for which the withholding begins.

The notice may be sent by ordinary or certified mail, email, MN-ITS mailbox, or facsimile, and shall be deemed received as of the date of mailing or receipt issuance of the facsimile, email, MN-ITS mailbox, or distribution.

Implications Nursing facilities should make sure their policies reflect the need for routinely checking the MN-ITS mailbox as well as tracking provider bed tax payments.

Bill language Chapter 38, Article 1, Section 14: https://www.revisor.mn.gov/laws/2025/0/38/laws.1.14.0#laws.1.14.0

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Notice for Withholding for Annual Surcharge Nonpayment Changes 2025 Regular Session HF 2115 Chapter 38, Article 1, Section 15 Human Services Policy Omnibus Bill Effective: August 1, 2025.

Short description Allows DHS to provide notice of their intention to withholding for nonpayment of annual surcharge through electronic methods.

Summary The changes maintain the current timeline for withholding practices by DHS. Currently, the agency can only give notice through traditional mail or faxing a copy. The law is now expanded to include email or adding the notice to the provider’s MN-ITS mailbox.

Implications Members who do not pay their annual surcharge in a timely manner may receive notice through electronic communication at the discretion of DHS. Bill language Chapter 38, Article 1, Section 15: https://www.revisor.mn.gov/laws/2025/0/38/laws.1.15.0#laws.1.15.0

Sec. 15. Minnesota Statutes 2024, section 256.9657, subdivision 7a, is amended to read: Subd. 7a. Withholding. If any provider obligated to pay an annual surcharge under this section is more than two months delinquent in the timely payment of a monthly surcharge installment payment, the provisions in paragraphs (a) to (f) apply. (a) The department may withhold some or all of the amount of the delinquent surcharge, together with any interest and penalties due and owing on those amounts, from any money the department owes to the provider. The department may, at its discretion, also withhold future surcharge installment payments from any money the department owes the provider as those installments become due and owing. The department may continue this withholding until the department determines there is no longer any need to do so. (b) The department shall give prior notice of the department's intention to withhold by mailing or emailing a written notice to the provider at the address to which remittance advices are mailed, placing the notice in the provider's MN-ITS mailbox, or faxing a copy of the notice to the provider at least ten business days before the date of the first payment period for which the withholding begins. The notice may be sent by ordinary or certified

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mail, email, MN-ITS mailbox, or facsimile, and shall be deemed received as of the date of mailing or receipt issuance of the facsimile, email, MN-ITS mailbox, or distribution. The notice shall: (1) state the amount of the delinquent surcharge; (2) state the amount of the withholding per payment period; (3) state the date on which the withholding is to begin; (4) state whether the department intends to withhold future installments of the provider's surcharge payments; (5) inform the provider of their rights to informally object to the proposed withholding and to appeal the withholding as provided for in this subdivision; (6) state that the provider may prevent the withholding during the pendency of their appeal by posting a bond; and (7) state other contents as the department deems appropriate. (c) The provider may informally object to the withholding in writing anytime before the withholding begins. An informal objection shall not stay or delay the commencement of the withholding. The department may postpone the commencement of the withholding as deemed appropriate and shall not be required to give another notice at the end of the postponement and before commencing the withholding. The provider shall have the right to appeal any withholding from remittances by filing an appeal with Ramsey County District Court and serving notice of the appeal on the department within 30 days of the date of the written notice of the withholding. Notice shall be given and the appeal shall be heard no later than 45 days after the appeal is filed. In a hearing of the appeal, the department's action shall be sustained if the department proves the amount of the delinquent surcharges or overpayment the provider owes, plus any accrued interest and penalties, has not been repaid. The department may continue withholding for delinquent and current surcharge installment payments during the pendency of an appeal unless the provider posts a bond from a surety company licensed to do business in Minnesota in favor of the department in an amount equal to two times the provider's total annual surcharge payment for the fiscal year in which the appeal is filed with the department. (d) The department shall refund any amounts due to the provider under any final administrative or judicial order or decree which fully and finally resolves the appeal together with interest on those amounts at the rate of three percent per annum simple

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interest computed from the date of each withholding, as soon as practical after entry of the order or decree. (e) The commissioner, or the commissioner's designee, may enter into written settlement agreements with a provider to resolve disputes and other matters involving unpaid surcharge installment payments or future surcharge installment payments. (f) Notwithstanding any law to the contrary, all unpaid surcharges, plus any accrued interest and penalties, shall be overpayments for purposes of section 256B.0641.

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General Long-Term Care

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License, Permit, and Survey Fees

2025 First Special Session HF 2 Chapter 3, Article 1, Section 43 Health Finance Omnibus Bill Effective: August 1, 2025

Short description This modification to Minnesota Statute § 144.122 increases the per-resident license fees for assisted living providers, including those with dementia care.

Summary Per-resident fees increased: $75 → $125 for assisted living; $100 → $150 for dementia-care.

Implications Providers should anticipate the fee change in fiscal planning for 2025. Larger facilities stand to see a more substantial increase in annual licensing costs following implementation.

Bill language Chapter 3, Article 1, Section 43 https://www.revisor.mn.gov/laws/2025/1/3/laws.1.43.0#laws.1.43.0

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Health Facilities Construction Plan Submittal and Fees

2025 First Special Session HF 2 Chapter 3, Article 1, Section 51 and 76 Subdivision, 6 Health Finance Omnibus Bill Effective: July 1, 2025

Short description Recent legislative changes increase construction plan review fees for health care facilities and clarify that licensed assisted living facilities must follow the statewide construction plan submission process and associated fees under Minnesota Statutes 144.554.

Summary Section 51 – Plan Review Fees (Minn. Stat. 144.554) •

Increases plan review fees across all tiers of estimated project cost for health facilities, including assisted living facilities.

For example:  $0–$10,000: increased from $30 to $45  $950,001–1,000,000: increased from $3,000 to $4,500  $1.5M–$2M: increased from $4,800 to $7,200  Projects over $50 million: new fee of $9,900 Fee structure and submission timing remain unchanged: plans and fees are due before construction begins and are nonrefundable. o

•

Section 76 – Assisted Living Facility Construction (Minn. Stat. 144G.45, Subd. 6) • • • •

Clarifies and aligns assisted living facility plan submission requirements with the broader statute under section 144.554.

Effective July 1, 2025, assisted living licensees must: o Submit construction plans and specifications to the commissioner under 144.554. o Pay the associated plan review fees as laid out in the updated fee schedule.

Continues to require detailed architectural, mechanical, and electrical plans and life safety drawings.

Adds administrative accountability: licensees must notify the commissioner 30 days before construction completion for final inspection.

Implications • • • • •

Assisted living providers are now explicitly required to follow the same plan review and fee process as hospitals, nursing homes, and other health facilities.

Budget impact: Increased review fees may raise upfront costs for facility construction, remodeling, or expansion.

Operational planning: Providers must ensure compliance with the submission timelines, fee payments, and plan content requirements to avoid delays.

Inspection readiness: A 30-day notice before construction completion is now mandated for state inspection scheduling.

Recordkeeping: Facilities must retain updated life safety plans reflecting changes due to remodeling or alteration.

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Bill language Chapter 3, Article 1, Section 51 and 76 Subdivision, 6 https://www.revisor.mn.gov/laws/2025/1/3/laws.1.51.0#laws.1.51.0 https://www.revisor.mn.gov/laws/2025/1/3/laws.1.76.0#laws.1.76.0

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Changes to DHS Licensing Enforcement Authority 2025 First Special Session HF 2 Chapter 3, Article 17, Section 5 and 6 Health Finance Omnibus Bill Effective: August 1, 2025

Short description The 2025 Legislature expanded the Minnesota Department of Human Services' (DHS) authority to immediately suspend or deny licenses when applicants or controlling individuals are involved in pending investigations or legal actions related to fraud or safety risks. The law also modernizes how DHS communicates licensing actions and processes appeals.

Summary Under this statutory amendment to Minnesota Statutes, Chapter 245A, DHS can deny or suspend a provider license without a final finding if the licensee or controlling individual is under investigation or charged with fraud or other program-related violations.

This includes: • • • •

Civil, criminal, or administrative investigations—even if no findings are finalized Criminal charges of fraud or theft against state/federal programs New violations discovered during an ongoing appeal Immediate suspensions without prior notice when health or safety is at risk

DHS is also authorized to deliver licensing decisions electronically via its Provider Licensing and Reporting Hub, and deadlines for appeals now begin from electronic notice.

Implications The Minnesota Department of Human Services (DHS), under authority granted in Minnesota Statutes, section 245A, now holds broader power to act swiftly when program integrity or client safety is in question. This means that home and community-based services (HCBS) providers, adult day services, foster care providers, and others licensed by DHS can have applications denied or licenses suspended based solely on pending investigations or charges—not just substantiated findings.

For providers with dual licensure—such as those operating both DHS-licensed waiver programs and MDH-regulated assisted living or home care—this expanded DHS authority can have cross-licensure consequences, especially if the same controlling individuals are involved in both licenses.

Providers must stay hyper-aware of their compliance status across all program areas and take steps to screen leadership and ownership for risks that could trigger DHS action. This includes conducting internal audits, reinforcing anti-fraud training, and developing clear documentation protocols.

Finally, because electronic notices via DHS’s Provider Hub are now legally valid and trigger the appeal timeline, it is critical for providers to monitor the portal regularly and respond immediately to any enforcement communications.

Bill language Chapter 3, Article 17, Section 5 and 6 https://www.revisor.mn.gov/laws/2025/1/3/laws.17.5.0#laws.17.5.0

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LTC Consultation Assessments to Include an Estimated Date of Completion 2025 First Special Session SF 7/HF 3 Chapter 9, Article 2, Section 16 Human Services Omnibus Bill Effective: August 1, 2025

Short description Long-term care consultation teams must begin a long-term care consultation within 20-days of the request and include an estimated date of completion.

Summary 256B.0911, subdivision 17 now states that a long-term care consultation team must begin an assessment of a person requesting long-term care consultation services or for whom long-term care consultation services were recommended, including an estimated timeline to full completion of the assessment, within 20 working days after the date on which an assessment was requested or recommended.

Implications The legislature, the Minnesota Departments of Human Services, and stakeholders continue to make attempts to improve MnCHOICES. Bill language Chapter 9, Article 2, Section 16: https://www.revisor.mn.gov/laws/2025/1/9/laws.2.16.0#laws.2.16.0

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Nonprofit Profit to Private NH and AL Conversion Regulations

2025 First Special Session HF 3 Chapter 9, Article 8, Sections 13-14 Human Services Finance Omnibus Bill Effective: July 1, 2025 and applies to transfers of ownership or control occurring on or after that date.

Short description New regulations require additional ownership disclosure, separate from the CHOW process, during transfers of ownership or control of a nonprofit assisted living or a nonprofit nursing home to for-profit entity.

Summary The change in law applies exclusively to nonprofit providers who are planning to sell or transfer control of their facility to a for-profit entity. Under the new law, 120 days prior to the transfer of ownership or control of a nonprofit nursing home or nonprofit assisted living, the provider must submit written notice to the Commissioner of Health and Commissioner of Human Services of its intent to transfer ownership or control to a for-profit entity.

Additionally, the for-profit entity seeking ownership or control must provide to the Attorney General, Commissioner of Health and Commissioner of Human Services: • The name of each individual with an ownership interest in the for-profit entity.

• The percentage of ownership held by each individual.

Implications Nonprofit facilities face an additional barrier when looking to sell their facility, potentially limiting market options. For profit entities are required to have their legal structuring and ownership stakes organized at least 120 days before closing. Some care providers may find the disclosure too invasive, reducing their interest in acquiring nonprofit providers.

Bill language Chapter 9, Article 8, Sections 13-14: https://www.revisor.mn.gov/laws/2025/1/9/laws.8.13.0#laws.8.13.0 Sec. 13. [145D.40] DEFINITIONS. Subdivision 1. Application. For purposes of sections 145D.40 to 145D.41, the following terms have the meanings given.

Subd. 2. Assisted living facility. "Assisted living facility" has the meaning given in section 144G.08, subdivision 7. Assisted living facility includes an assisted living facility with dementia care as defined in section 144G.08, subdivision 8.

Subd. 3. Nursing home. "Nursing home" means a facility licensed as a nursing home under chapter 144A. Subd. 4. Ownership or control. "Ownership or control" means the assumption of governance or the acquisition of an ownership interest or direct or indirect control by a for-profit entity over the operations of a nonprofit nursing home or a nonprofit assisted living facility through any means, including but not limited to a purchase, lease, transfer, exchange, option, conveyance, creation of a joint venture, or other manner of acquisition of assets, governance, an ownership interest, or direct or indirect control of a nonprofit nursing home or a nonprofit assisted living facility.

Sec. 14. [145D.41] NOTICE OF CERTAIN ACQUISITIONS OF NURSING HOMES AND ASSISTED LIVING FACILITIES.

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Subdivision 1. Notice. At least 120 days prior to the transfer of ownership or control of a nonprofit nursing home or nonprofit assisted living facility to a for-profit entity, the nursing home or assisted living facility must provide written notice to the commissioner of health and the commissioner of human services of its intent to transfer ownership or control to a for-profit entity.

Subd. 2. Information. Together with the notice, the for-profit entity seeking to acquire ownership or control of the nonprofit nursing home or nonprofit assisted living facility must provide to the attorney general, commissioner of health, and commissioner of human services the names of each individual with an interest in the for-profit entity and the percentage of interest each individual holds in the forprofit entity.

EFFECTIVE DATE. This section is effective July 1, 2025, and applies to transfers of ownership or control occurring on or after July 1, 2025.

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Human Services Licensed Provider Fee Increases

2025 First Special Session HF 3 Chapter 9, Article 10, Sections 4-8 Human Services Omnibus Bill Effective: January 1, 2026

Short description Changes in fees for Department of Human Services licensed providers.

Summary • Amends 245A.10, subdivision 1 - which eliminates the licensing fee exemption for child foster care, adult foster care, and community residential settings.

• Amends 245A.10, subdivision 2 by eliminating the authority of counties to charge licensing fees and provide license fee exceptions; by requiring the commissioner to charge licensing fees for programs overseen by counties; and by increasing the licensing fee from a discretionary maximum of $500 annually to $2,100 annually. In this instance, applicable to community residential settings, residential services facilities, adult day or adult foster care.

• Amends 245A.10, subdivision 3 -which increases the initial licensing fee for all 245D services to $4,200, and imposes a $500 initial licensing fee for children’s residential facilities and mental health clinics.

• Adds 245A.10, subdivision 3a - which imposes new fees, $4200, for licensing activities associated with changes of ownership.

• Amends § 245A.10, subd. 4. Increases annual license fees for home and community based services and supports, substance use disorder treatment programs, detoxification programs, and specified residential mental health programs. Requires an additional $500 annual fee for any satellite facilities.

• Amends 245A.10, subdivision 4 - by increasing licensing fees for 245D service providers, substance use disorder treatment providers, detoxification programs, residential facilities serving people with mental illness, adult day care centers, Implications Increased costs for 245D providers and others licensed by the Department of Human Services.

Bill language Chapter 9, Article 10, Sections 4-8: https://www.revisor.mn.gov/laws/2025/1/9/laws.10.4.0#laws.10.4.0

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Changes to the Bill of Rights for Persons with Guardians or Conservators 2025 Regular Session HF 2432 Chapter 35, Article 11, Section 13-15 Judiciary Omnibus Bill Effective: August 1, 2025

Short description Expands social and communication rights for those under guardianship or conservatorship.

Summary Individuals subject to guardian or conservatorships retain the right to all forms of communication, including electronic, such as email and social media, unless a guardian can show good cause for substantial risk. Guardians must first try limited restrictions and assess their effectiveness.

Additionally, this regulation requires the guardian to make specific notifications within 48 hours of implementing restrictions.

Implications Members may see increased notifications or engagement with guardians and conservators as they work to comply with these changes.

Bill language Chapter 35, Article 11, Section 13-15 https://www.revisor.mn.gov/laws/2025/0/35/laws.11.13.0#laws.11.13.0

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Financial Exploitation of a Vulnerable Adult 2025 Regular Session HF 2432 Chapter 35, Article 11, Section 16 Judiciary Omnibus Bill Effective: January 1, 2026

Short description Establishes a legal process for the court to issue an order of protection in cases of financial exploitation of a vulnerable adult.

Summary Provides measures for the court to protect vulnerable adults who may be victims of financial exploitation including freezing accounts, restraining contact and an expedited process for emergent situations.

Implications Members may have residents who may be victims of financial exploitation.

Bill language Chapter 35, Article 11, Section 16 https://www.revisor.mn.gov/laws/2025/0/35/laws.11.16.0#laws.11.16.0

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Designated Support Person

2025 Regular Session HF 2115 Chapter 38, Article 2, Section 6 and 28 Human Service Policy Omnibus Bill Effective: August 1, 2025 Short description Provides language aligned with the Assisted Living and Nursing Home Resident Rights to allow a designated support person to stay with resident aligning with residents' rights under the law.

Summary The changes to the statute provide clarity that the resident has the ability to have a designated support person with them at the time of the resident’s choosing.

The language includes a provision which allows restrictions of a designated support person to the extent necessary to ensure the designated support person is not living at the facility on a short-term or long-term basis. It also includes an ability to restrict access to a designated support person if they are violent or if restrictions are necessary to meet the appropriate standard of care. If a facility restricts or prohibits access to a designated support person, the resident may file an inquiry or complaint with the Ombudsman's office.

Implications Providers committed to person-centered care already prioritize resident preferences and rights.

This statute can serve as a valuable tool in navigating complex situations, and providers should understand its intent.

Bill language Chapter 38, Article 2, Section 6: https://www.revisor.mn.gov/laws/2025/0/38/laws.2.6.0#laws.2.6.0

Sec. 6. Minnesota Statutes 2024, section 144.651, subdivision 10a, is amended to read: Subd. 10a. Designated support person for pregnant patient or other patient. (a) Subject to paragraph (c), a health care provider and a health care facility must allow, at a minimum, one designated support person chosen by a patient, including but not limited to a pregnant patient, to be physically present while the patient is receiving health care services including during a hospital stay. Subject to paragraph (c), a facility must allow, at a minimum, one designated support person chosen by the resident to be physically present with the resident at times of the resident's choosing while the resident resides at the facility.

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(b) For purposes of this subdivision, "designated support person" means any person chosen by the patient or resident to provide comfort to the patient or resident, including but not limited to the patient's or resident's spouse, partner, family member, or another person related by affinity. Certified doulas and traditional midwives may not be counted toward the limit of one designated support person. (c) A facility may restrict or prohibit the presence of a designated support person in treatment rooms, procedure rooms, and operating rooms when such a restriction or prohibition is strictly necessary to meet the appropriate standard of care. A facility may also restrict or prohibit the presence of a designated support person if the designated support person is acting in a violent or threatening manner toward others. A facility may restrict the presence of a resident's designated support person to the extent necessary to ensure a designated support person who is not a facility resident is not living at the facility on a short-term or long-term basis. Any restriction or prohibition of a designated support person by the facility is subject to the facility's written internal grievance procedure required by subdivision 20. (d) This subdivision does not apply to a patient or resident at a state-operated treatment program as defined in section 253B.02, subdivision 18d.

https://www.revisor.mn.gov/laws/2025/0/38/laws.2.28.0#laws.2.28.0

Sec. 28. Minnesota Statutes 2024, section 144G.91, is amended by adding a subdivision to read: Subd. 6a. Designated support person. (a) Subject to paragraph (c), an assisted living facility must allow, at a minimum, one designated support person chosen by the resident to be physically present with the resident at times of the resident's choosing while the resident resides at the facility. (b) For purposes of this subdivision, "designated support person" means any person chosen by the resident to provide comfort to the resident, including but not limited to the resident's spouse, partner, family member, or another person related by affinity. (c) A facility may restrict or prohibit the presence of a designated support person if the designated support person is acting in a violent or threatening manner toward others. A facility may restrict the presence of a resident's designated support person to the extent necessary to ensure a designated support person who is not a facility resident is not living at the facility on a short-term or long-term basis. If the facility restricts or prohibits a

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resident's designated support person from being present, the resident may file a complaint or inquiry with the facility according to subdivision 20, the Office of Ombudsman for LongTerm Care, or the Office of Ombudsman for Mental Health and Developmental Disabilities.

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WORKFORCE AND EMPLOYMENT

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Trained Medication Aide Training

2025 Regular Session HF 2115 Chapter 38, Article 2, Sections 7-8 Human Services Policy Omnibus Bill Effective: August 1, 2025 but rulemaking is necessary.

Short description Allows the Minnesota Department of Health (MDH) to approve and maintain curriculum for Medication Aide certification programs for nursing facilities, similar to Certified Nursing Assistant.

Summary Minnesota Department of Health controls the curricula approval for training and this will open the training beyond Minnesota State. While the effective date is August 1, 2025, additional changes are needed to Minnesota Rule 4658.1360 to allow nursing facilities to use Medication Aides trained outside of the MN State College system to dispense medication in their settings.

Implications Expands access to medication aide training. Members may be able to conduct their own TMA training in the future, similar to CNA training programs.

Bill language Chapter 38, Article 2, Sections 7-8: https://www.revisor.mn.gov/laws/2025/0/38/laws.2.7.0#laws.2.7.0

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Drive for Five

2025 First Special Session SF 17 Chapter 6, Article 1, Section 2, Subdivision 3 Jobs and Labor Omnibus Bill Effective: August 1, 2025 Short description Money appropriated for existing workforce development initiative focused on key industries, including the caring profession.

Summary To grow the workforce and address a tight labor market, skills mismatch, geographic mismatch and other barriers to employment, the Drive for Five workforce initiative will prepare a workforce to enter five of the most critical occupational four categories in the state with high-growth jobs and family-sustaining wages: Technology, Caring Professions, Education, Manufacturing, and Trades. The Drive for Five Workforce Fund will create a pipeline of workers who are skilled and prepared to enter high-growth and high-wage employment and begin to address Minnesota’s high job vacancy rate. The Drive for Five Workforce Fund invests in populations that face the biggest barriers to employment: people of color, people with disabilities, and those with other systemic barriers. Funding $6,000,000 per year. $3,375,000 each year available through a competitive request for proposal process of which $1,500,000 each year must be awarded through competitive grants made to trade associations Implications Opportunity for employers to benefit from enhanced training and job placement into our sector. Association grants for training and employer engagement strategies.

Bill language Chapter 6, Article 1, Section 2, Subdivision 3 : https://www.revisor.mn.gov/laws/2025/1/6/laws.1.2.0#laws.1.2.0 (fff) $6,000,000 each year is from the workforce development fund for the Drive for Five Initiative to conduct outreach and provide job skills training, career counseling, case management, and supportive services for careers in technology, labor, the caring professions, manufacturing, and educational and professional services. This is a onetime appropriation. (ggg) Of the amount appropriated in paragraph (fff), the commissioner must make $3,375,000 each year available through a competitive request for proposal process. The grant awards must be used to provide education and training in the five industries identified in paragraph (fff). Education and training may include: (1) student tutoring and testing support services; (2) training and employment placement in high-wage and high-growth employment; (3) assistance in obtaining industry-specific certifications; (4) remedial training leading to enrollment in employment training programs or services; (5) real-time work experience;

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(6) career and educational counseling; (7) work experience and internships; and (8) supportive services. (hhh) Of the amount appropriated in paragraph (fff), $1,500,000 each year must be awarded through competitive grants made to trade associations or chambers of commerce for job placement services.

Grant awards must be used to encourage workforce training efforts to ensure that efforts are aligned with employer demands and that graduates are connected with employers that are currently hiring.

Trade associations or chambers of commerce must partner with employers with current or anticipated employment opportunities and nonprofit workforce training partners participating in this program. The trade associations or chambers of commerce must work closely with the industry sector training providers in the five industries identified in paragraph (fff). Grant awards may be used for: (1) employer engagement strategies to align employment opportunities for individuals exiting workforce development training programs. Strategies may include business recruitment, job opening development, employee recruitment, and job matching. Trade associations must utilize the state's labor exchange system; (2) diversity, inclusion, and retention training of their members to increase the business' understanding of welcoming and retaining a diverse workforce; and (3) industry-specific training. (iii) Of the amount appropriated in paragraph (fff), $1,125,000 each year is to hire, train, and deploy business services representatives in local workforce development areas throughout the state. Business services representatives must work with an assigned local workforce development area to address the hiring needs of Minnesota's businesses by connecting job seekers and program participants in the CareerForce system. Business services representatives serve in the classified service of the state and operate as part of the agency's Employment and Training Office. The commissioner shall develop and implement training materials and reporting and evaluation procedures for the activities of the business services representatives. The business services representatives must: (1) serve as the primary contact for businesses in that area; (2) actively engage employers by assisting with matching employers to job seekers by referring candidates, convening job fairs, and assisting with job announcements; (3) work with the local area board and its partners to identify candidates for openings in small and midsize companies in the local area; and (4) engage in workforce innovation solutions. (jjj)(1) $150,000 the first year is for conducting a comprehensive review of the department's programs and competitive grant processes, including how grants are announced, reviewed, awarded, and administered, and how those processes impact how services are delivered. This review must include input from past applicants and potential applicants. This appropriation is onetime and is available until June 30, 2027.

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Workforce Development Funding Appropriations 2025 First Special Session SF 17 Chapter 6, Article 1, Section 2, various subdivisions Jobs and Labor Omnibus Bill Effective: Various dates

Short description Funding of workforce development, several initiatives that may have an impact on the long-term care sector, including direct appropriations to community-based organizations that do nursing assistant training.

Summary This includes, but is not limited to: • Office of New Americans at the Department of Employment and Economic Development for $750,000 per year.

• Comunidades Organizando el Poder y la Acción Latina (COPAL) $250,000 each year.

• Al Maa'uun, $250,000 each year.

• HIRED $400,000 each year.

• Workforce Development Inc, of Southeast MN workforce development area $275,000 per year.

• International Institute of Minnesota $500,000 per year.

• Emerge $225,000 per year.

• Workforce Development Inc, Bridges to Healthcare $375,000 per year.

• Aspirus Lake View Hospital for new Nursing Assistant training $42,000 one time appropriation.

Implications Opportunities for long-term care employers to partner with community based organizations that are providing skills training for nursing assistants, caregivers and other roles in our sector.

Bill language Chapter 6, Article 1, Section 2: https://www.revisor.mn.gov/laws/2025/1/6/laws.1.2.0#laws.1.2.0

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Meal and Rest Breaks

2025 First Special Session SF 17 Chapter 6, Article 5, Sections 1-6 Jobs and Labor Omnibus Bill Effective: January 1, 2026 Short description Defines rest and meal breaks with specific durations.

Summary Changes the definition of a rest break to specify it be at least 15 minutes or enough time to utilize the nearest convenient restroom, whichever is longer, for each four hours of consecutive work. Changes the definition of a meal break to specify at least 30 minutes of time be allowed for every six consecutive hours worked. Adds a provision to seek remedies, including liquidated damages, for employers who are found not to be following the rule.

Implications Employers should reconsider the use of automatic deductions for meal breaks, as these policies may increase compliance risks. It is important to review meal and break policies, assess whether additional documentation is necessary, and ensure staff are properly educated.

Bill language Chapter 6, Article 5, Sections 1-6: https://www.revisor.mn.gov/laws/2025/1/6/laws.5.1.0#laws.5.1.0 Section 1.

Minnesota Statutes 2024, section 177.253, subdivision 1, is amended to read: Subdivision 1.

Rest breaks.

An employer must allow each employee adequate time from work a rest break of at least 15 minutes or enough time to utilize the nearest convenient restroom, whichever is longer, within each four consecutive hours of work to utilize the nearest convenient restroom.

EFFECTIVE DATE. This section is effective January 1, 2026.

Sec. 2.

Minnesota Statutes 2024, section 177.253, is amended by adding a subdivision to read: Subd. 3.

Remedies.

If an employer does not allow an employee rest breaks as required by this section and related rules, the employer is liable to the employee for the rest break time that should have been allowed at the employee's regular rate of pay, plus an additional equal amount as liquidated damages.

EFFECTIVE DATE. This section is effective January 1, 2026.

Sec. 3.

Minnesota Statutes 2024, section 177.254, subdivision 1, is amended to read: Subdivision 1.

Meal break.

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An employer must permit allow each employee who is working for eight six or more consecutive hours sufficient time to eat a meal break of at least 30 minutes.

EFFECTIVE DATE. This section is effective January 1, 2026.

Sec. 4.

Minnesota Statutes 2024, section 177.254, subdivision 2, is amended to read: Subd. 2.

Payment not required.

Except for subdivision 4, nothing in this section requires the employer to pay the employee during the meal break.

EFFECTIVE DATE. This section is effective January 1, 2026.

Sec. 5.

Minnesota Statutes 2024, section 177.254, is amended by adding a subdivision to read: Subd. 4.

Remedies.

If an employer does not allow an employee meal breaks as required by this section and related rules, the employer is liable to the employee for the meal break time that should have been allowed at the employee's regular rate of pay, plus an additional equal amount as liquidated damages.

EFFECTIVE DATE. This section is effective January 1, 2026.

Sec. 6.

Minnesota Statutes 2024, section 177.27, subdivision 5, is amended to read: Subd. 5.

Civil actions.

The commissioner may bring an action in the district court where an employer resides or where the commissioner maintains an office to enforce or require compliance with orders issued under subdivision 4. In addition to any other remedy provided by law, the commissioner may also apply in the district court where an employer resides or where the commissioner maintains an office for an order enjoining and restraining violations of any statute or rule listed in subdivision 4.

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Worker Misclassification

2025 First Special Session SF 17 Chapter 6, Article 5, Section 9 and others Jobs and Labor Omnibus Bill Effective: August 1, 2025 Summary Provisions to increase funding, staffing, and enforcement efforts relating to the existing worker misclassification statute including: increasing the penalty for intentional misrepresentation with regard to unemployment benefits; allowing the Department of Labor and Industry(DLI) commissioner to apply in the district court for an order enjoining and restraining violations of DLI’s statutes; and authorizing a “misclassification fraud impact” report.

Implications Employers should be aware of penalties associated with misclassifying their workers as independent contractors versus employees.

Bill language Chapter 6, Article 5, Section 9 : https://www.revisor.mn.gov/laws/2025/1/6/laws.5.9.0#laws.5.9.0

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Earned Sick and Safe Time

2025 First Special Session SF 17 Chapter 6, Article 5, Sections 10-13 Jobs and Labor Omnibus Bill Effective: August 1, 2025 and January 1, 2026 as noted Short description Administrative modifications made to the existing Earned Sick and Safe Time program.

Summary • Changes to the notice requirements wording-employers may require employee to give notices of the need for earned sick and safe time as “reasonably required by the employer”.

• Changes to the documentation requirements o Employers can now request reasonable documentation if an employee uses more than two (previously three) consecutive scheduled workdays of ESST. o The amendments broaden acceptable forms of documentation, allowing employeewritten statements when documentation from healthcare providers or others cannot be obtained timely or without added expense. o Written statements from employees do not need to be notarized and can be written in any language.

• Employers cannot require employees to find a replacement worker as a condition for using ESST, though employees may do so voluntarily.

• Interaction with More Generous Policies (Section 181.9448)—changes below are effective January 1, 2026 o Clarifies that employers with existing leave policies that meet or exceed ESST requirements are not required to provide additional ESST. o Outlines that pre-2024 leave balances can follow existing employer policies, avoiding retroactive application of the new ESST rules. o Provides flexibility for collective bargaining agreements to waive certain ESST provisions. o Allows individual providers of certain home- and community-based services to waive ESST for the remainder of a service plan year, with funds returned to the participant’s budget. o Confirms that employers may permit employees to donate unused ESST or advance ESST to employees before accrual.

Implications Employers will want to review these changes and adjust their policies if applicable.

Bill language Chapter 6, Article 5, Sections 10-13: https://www.revisor.mn.gov/laws/2025/1/6/laws.5.10.0#laws.5.10

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Garnishment Forms; Execution of Judgments; Debt Collection 2025 Regular Session SF 2847 Chapter 18 Garnishments Forms Modification Bill Effective: June 1, 2025

Short description/summary Makes changes to various statutory forms pertaining to garnishments.

Summary This bill amends the statutory forms used to garnish the wages and bank accounts of a person who has a court ordered judgement against them. Chapter 550 covers the enforcement of judgments and contains numerous forms that are sent to a debtor prior to garnishing their wages or assets. The forms are also used to claim exemptions, such as wages or money in the bank that cannot be garnished including Social Security benefits or public assistance payments like MFIP. A 2024 law directed the Attorney General to update the statutory forms.

The forms are being updated to conform with the changes to the garnishment laws (chapter 571) that were passed in 2024 (Laws 2024, chapter 114). Those changes include the percentage of income that can be garnished for a debt (between 0-25% depending on the income of the debtor), and the limits for the value of exempt assets and household items. Some of the changes took effect on August 1, 2024.

Because the law on garnishment and exemptions changed, all the forms used to execute a judgment needed to be updated to reflect those changes. The form updates include clarifying, grammatical, and technical changes to the forms as well.

The bill amends the effective date of the garnishment law passed in 2024 and makes that law and the new forms effective on June 1, 2025 Implications Employers should be mindful of changes to forms as they process employee garnishments.

Bill language Chapter 18: https://www.revisor.mn.gov/laws/2025/0/18/laws.1.1.0#laws.1.1.0

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Workers’ Compensation

2025 Regular Session HF 3228 Chapter 27 Workers’ Compensation Bill Effective: Following enactment and October 1, 2025 Short description This bill is a collection of recommendations from the Workers’ Compensation Advisory Council, most of which are technical in nature.

Summary • Section 1 Employee: Changes the definition of “employee” for the purposes of workers’ compensation to clarify the inclusion of workers performing direct support services under several specific types of arrangements. Effective date: This section is effective the day following final enactment.

• Section 2 Executive officer of a corporation: Adds a citation to the definition of an “executive officer of a corporation.” Effective date: This section is effective the day following final enactment.

• Section 3 Employments excluded: Adds citations to references to “an executive officer.” Effective date: This section is effective the day following final enactment.

• Section 4 Medical, psychological, chiropractic, podiatric, surgical, hospital: Requires the employer to pay for the reasonable value of nursing services provided by a member of the employee’s household, not just the employee’s family, in cases of permanent total disability.

Effective date: This section is effective the day following final enactment.

• Section 5 Time limitations: Clarifies that the time limit for actions or proceedings by an injured employee to determine or recover compensation is three years after a written report of the injury is made to the commissioner of labor and industry, but not to exceed six years from the date of the accident. Effective date: This section is effective the day following final enactment • Section 6 Nonassignability: Raises the amount of a claim for compensation owed to an injured employee or dependents that is exempt from seizure or sale for the payment of any debt or liability from $1,000,000 per claim or award to $10,000,000. Effective date: This section is effective for dates of injury on or after October 1, 2025.

• Section 7 Written motion: Creates an exception to interventor interests being extinguished if a motion to intervene is not timely filed, for when a member of the employee’s family or household is supplying nursing services in a case of permanent total disability. Effective date: This section is effective the day following final enactment.

• Section 8 Service and filing of notice; cost of transcript: Removes the requirement to file a copy of the original notice of appeal, with proof of service, with the commissioner of labor and industry. Effective date: This section is effective the day following final enactment.

• Section 9 Repealer: Repeals the penalty for failure to make payment or report to the special workers’ compensation fund. Effective date: This section is effective the day following final enactment.

Implications Employers should plan for expanded obligations related to permanent disability care costs, train HR and claims teams on updated filing deadlines and legal exceptions and update internal records retention and compensation protocols to remain compliant.

Bill language Chapter 27: https://www.revisor.mn.gov/laws/2025/0/Session+Law/Chapter/27/

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Background Studies

2025 Regular Session & 2025 First Special Session HF 2115 & HF 2 Chapter 38, Article 5, Section 9 and 31--- Chapter 3, Article 16, Section 12 and 15 Human Services Policy Bill--- Health Finance Omnibus Bill Effective: July 1, 2025 and August 1, 2025 Short description Various changes to 245C, the background study statute.

Summary Effective August 1, 2025 Electronic signatures may be used for documentation requiring a signature as defined in 245C. Exempts supportive housing 256I.03 and emergency shelter providers providing housing support from the requirement to initiate background studies for controlling individuals, managerial officials, and all employees and volunteers. (Note that there is subsequent 2025 special session legislation to require providers of housing stabilization services, as defined under 256B.051, to complete background studies on their controlling individuals, managerial officials, and all employees and volunteers.)

Effective July 1, 2025 Amends § 245C.14 by adding subd. 6. Requires the commissioner to disqualify an individual from any position of ownership, management, or control of a program or billing activities for a period of two years if a background study shows violations of human services and children, youth, and families statutes related to fraud, theft, and program misconduct.

Implications Electronic signatures can be used. Housing support providers are no longer required to submit background studies through NetStudy 2.0. And Individual background study subject disqualifications for program fraud, theft and misconduct.

Bill language Chapter 38, Article 5, Section 9 and 31 https://www.revisor.mn.gov/laws/2025/0/38/laws.5.9.0#laws.5.9.0 Chapter 3, Article 16, Section 12 & 15 https://www.revisor.mn.gov/laws/2025/1/3/laws.16.12.0#laws.16.12.0

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DHS/HCBS

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Verbal Attestation Instead of Signature Allowed for some Disability Waiver Client Reassessments 2025 First Special Session SF 7/HF 3 Chapter 9, Article 2, Sections 18-19 Human Services Omnibus Bill Effective: The day following final enactment

Short description Attesting to replace required reassessment signatures for disability waivers.

Summary Two areas of disability program statute were changed to allow for an attestation.

First, verbal attestation may be used instead of the required reassessment signatures. DHS is now required to accept verbal attestation in lieu of signatures on reassessments for the purposes of service initiation. But the certified assessor is required to seek a signature within 30 days following a reassessment.

Second, a person who is older than 21 but younger than 65 and who is receiving services under a disability waiver or under CFSS may make an informed choice for two consecutive years to attest that the person has no change in needs since the person’s last assessment. A certified assessor is required to review the prior assessment and confirm that the attestation is accurate.

Implications The struggles by lead agencies to perform the assessments required by the state Medicaid programs continue to negatively impact residents, families, and nursing facility and assisted living facility providers.

These changes were presumably made to create additional efficiencies.

Bill language Chapter 9, Article 2, Sections 18-19: https://www.revisor.mn.gov/laws/2025/1/9/laws.2.18.0#laws.2.18.0

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Dashboard on Assessment Completions to be Created 2025 First Special Session SF 7/HF 3 Chapter 9, Article 2, Section 21 Human Services Omnibus Bill Effective: January 1, 2026.

Short description The Minnesota Department of Human Services (DHS) is required to maintain a publicly accessible website with summary data on the status of MnCHOICES assessments throughout the state.

Summary DHS is required to create a public website containing summary data on the completion of assessments and update the dashboard at least twice per year. Statute requires the dashboard to include: • The total number of assessments performed since the previous reporting period, by lead agency.

• The total number of initial assessments performed since the previous reporting period, by lead agency.

• The total number of reassessments performed since the previous reporting period, by lead agency.

• The number and percentage of assessments completed within the required timeline, by lead agency.

• The average length of time to complete an assessment, by lead agency.

• Summary data of the location in which the assessments were performed, by lead agency. And• Other information the commissioner determines is valuable to assess the capacity of lead agencies to complete assessments within the timelines prescribed by law.

Implications The struggles by lead agencies to perform the assessments required by the state Medicaid programs continue to negatively impact residents, families, and nursing facility and assisted living facility providers.

The new dashboard will hopefully provide additional transparency.

Bill language Chapter 9, Article 2, Section 21: https://www.revisor.mn.gov/laws/2025/1/9/laws.2.21.0#laws.2.21.0

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Limitations on Rate Exceptions for Residential Services Required 2025 First Special Session SF 7/HF 3 Chapter 9, Article 2, Section 36 Human Services Omnibus Bill Effective: January 1, 2026, or upon federal approval, whichever is later.

Short description Limits and conditions for Disability Waiver Rate Setting (DWRS) rate exceptions and annual exception renewals are required for community residential services, customized living services, family residential services, and integrated community supports.

Summary One of several DWRS budgetary funding measures enacted by the 2025 legislature, the limits and conditions are: • Restrict rate exceptions to the absence and utilization factor ratio to people temporarily receiving hospital or crisis respite services.

• For rate exceptions related to behavioral needs, the lead agency must include: o a documented behavioral diagnosis; or o determined assessed needs for behavioral supports as identified in the person's most recent assessment or reassessment under section 256B.0911.

• Community residential services rate exceptions must not include positive support services costs.

• The Minnesota Department of Human Services (DHS) must not approve rate exception requests related to increased community time or transportation.

• If DHS does approve a rate exception at annual renewal, the person's most recent assessment must indicate continued extraordinary needs in the areas cited in the exception request. If a person's assessment continues to identify these extraordinary needs, lead agencies requesting an annual renewal of rate exceptions must submit documentation supporting the continuation of the exception. Documentation required includes: o Payroll records for direct care wages cited in the request. o Payment records or receipts for other costs cited in the request. o Documentation of expenses paid that were identified as necessary for the initial rate exception.

• DHS must not increase rate exception at annual renewals that requests an exception to direct care or supervision wages more than the most recently implemented base wage index.

• DHS is required to publish an annual report detailing the impact of the limitations on home and community-based services spending. o The number and percentage of rate exceptions granted and denied. o Total spending on community residential setting services and rate exceptions. o Trends in the percentage of spending attributable to rate exceptions. Ando An evaluation of the effectiveness of the limitations in controlling spending growth.

Implications While the number of CADI or BI Customized living recipients that receive rate exceptions is small, the changes make the approval of rate exceptions more difficult.

Bill language Chapter 9, Article 2, Section 36: https://www.revisor.mn.gov/laws/2025/1/9/laws.2.36.0#laws.2.36.0

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Self-Directed Home Care Nursing Required Under Waiver Imagine Phase II

2025 First Special Session SF 7/HF 3 Chapter 9, Article 2, Section 56 Human Services Omnibus Bill Effective: The day following final enactment

Short description The Minnesota Department of Human Services (DHS) is directed to develop an individual budget rate exception methodology to accommodate self-direction of home care nursing.

Summary In addition to developing an individual budget rate exception methodology to accommodate selfdirection of home care nursing, DHS is required to implement an online support planning and tracking tool for people with disabilities to track their individual budgets and service choices by July 1, 2026.

To access the self-directed home care nursing, the beneficiary must be assessed to need the level of care delivered in a hospital setting.

Implications A beneficiary receiving community residential services, family residential services, integrated community supports services, or customized living services is not eligible for self-directed home care nursing.

Bill language Chapter 9, Article 2, Section 56: https://www.revisor.mn.gov/laws/2025/1/Session+Law/Chapter/9/

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Long-Term Services and Supports Advisory Council to Provide Cost Growth Reduction Ideas 2025 First Special Session SF 7/HF 3 Chapter 9, Article 2, Section 58 Human Services Omnibus Bill Effective: July 1, 2025

Short description Establishes an advisory council to identify reforms to the provision of long-term care services and supports that will produce savings in the 2028/2029 biennium.

Summary The Minnesota Department of Human Services is required to establish a Long-Term Services and Supports Advisory Council.

By December 1, 2026, the advisory council must submit to the legislature and the governor recommendations to reduce cost growth in long-term services and supports, to build greater efficiencies into the long-term care services system, and to promote better outcomes for Minnesotans with longterm care needs.

If the 95th legislature does not enact reforms proposed by the advisory council that are estimated to produce $177.5 million in reduced general fund spending (or approximately 143.5 million if a bonding appropriation for the Miller Building replacement is not exacted) the commissioner must make up the difference by reducing DWRS rates and by imposing a county share for disability waiver residential services.

The advisory council consists of at least 30 members, including: • One provider of nursing facility services to older adults and people with disabilities, appointed by the Long-Term Care Imperative.

• One provider of home care services, appointed by the Minnesota Home Care Association.

• Three providers of home and community-based disability services, one appointed by MOHR, one appointed by Residential Providers Association of Minnesota, and one appointed by ARRM. Implications Care Providers of Minnesota will participate and advocate on behalf of members potentially impacted by any recommendations made by the advisory council.

Bill language Chapter 9, Article 2, Section 58: https://www.revisor.mn.gov/laws/2025/1/9/laws.2.58.0#laws.2.58.0

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DHS Discretionary Temporary Licensing Moratorium 2025 First Special Session HF 3 Chapter 9, Article 10, Section 1 Human Services Omnibus Bill Effective: August 1, 2025

Short description A new section which gives the Department of Human Services commissioner discretion to implement a licensing moratorium.

Summary Requires the commissioner of the Department of Human Services (DHS) to assess the need for new licenses for existing service types or for new license types, and temporarily prohibits the commissioner from issuing licenses if the commissioner determines that new licenses would exceed the needed licensed service capacity; requires the commissioner to provide public notice prior to imposing a temporary licensing moratorium; requires the commissioner to establish and make publicly available criteria, and a process for granting licensing exceptions during a temporary moratorium. Outlines refund, notice, and exception requirements.

Implications Potential limits for new DHS licensees in certain geographic areas or for certain licensure types.

Bill language Chapter 9, Article 10, Section 1 https://www.revisor.mn.gov/laws/2025/1/9/laws.10.1.0#laws.10.1.0 Subd. 7a. Discretionary temporary licensing moratorium. (a) The commissioner must not accept an application from or issue an initial license for an individual, organization, or government entity seeking licensure under this chapter and must not add a new service to an existing license when the commissioner determines that exceptional growth in applications for licensure or requests to add new services exceeds the determined need for service capacity. The determined need for service capacity may be limited to a specific region, service focus, or other factors as determined by the commissioner.

A temporary licensing moratorium issued under this subdivision is effective for a period of up to 24 months from the date the commissioner issues the moratorium. (b) Any applicant that will not receive a license due to a temporary licensing moratorium issued under paragraph (a) may apply for a refund of licensing application fees for up to one year from the date the commissioner issues the moratorium. (c) The commissioner must notify the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services at least 30 days prior to issuing a temporary moratorium under this subdivision and publish notice of the moratorium on the department's website. The notice must include: (1) a list of all license types to which the moratorium will apply; (2) the proposed start date of the moratorium; and (3) the anticipated duration of the moratorium. (d) The commissioner must establish and make publicly available the processes and criteria the commissioner will use to grant exceptions to a temporary moratorium issued under this subdivision.

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MISCELLANEOUS

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Survey and Investigation Changes-Comprehensive Home Care

2025 First Special Session HF 2 Chapter 3, Article 1, Section 59-65 Health Finance Omnibus Bill Effective: August 1, 2025

Short description Sections 59–65 revise enforcement and penalty structures for comprehensive home care providers licensed under Minnesota Statutes, Chapter 144A. The updates add a new “Level 5” violation category for the most serious offenses, revise fine amounts, expands the situations where immediate fines and suspensions may be imposed, and clarifies timelines for enforcement actions and appeals.

Summary • New level 5 violation category: o Applies to violations resulting in serious injury or death. o Fines: $5,000 per violation.

• Fine adjustments: o Level 3: Reduced from $3,000 to $1,000 per incident. o Level 4: Reduced from $5,000 to $3,000 per incident. o Level 5: New category, $5,000 per violation. o Clarified fines for substantiated maltreatment—$5,000 for sexual assault, death, or abuse resulting in serious injury.

• Follow-up surveys: o Required within 90 days for level 3, 4, and now Level 5 violations.

• Enforcement powers expanded: o Commissioner may impose immediate fines without correction opportunity. o Licensees cannot avoid fines by closing or transferring a license. o Investigation costs may be recovered from providers.

• Suspension & appeal process tightened: o More defined procedures and shorter timelines for expedited hearings and license actions. o Operations must cease during temporary suspensions, even if an appeal is pending.

Implications The recent statutory changes significantly raise the stakes for licensed providers by introducing stronger enforcement tools tied to the seriousness of client harm. With the addition of a new Level 5 violation category—defined as incidents that result in serious injury or death—accountability is now more closely aligned with the impact on the client. This demands greater vigilance from providers to proactively identify and address risks before harm occurs.

Financial exposure has also increased. Fines may now be issued immediately, without allowing time for correction, especially for violations categorized as level 3 and above. As a result, providers must have robust systems in place to ensure ongoing compliance, documentation, and early intervention. The threshold for enforcement has shifted—meaning even minor oversights could now lead to major penalties if left unaddressed.

To meet these new expectations, providers must invest in updated training, policies, and internal quality oversight mechanisms. Staff at all levels should understand the definitions of each violation level, what circumstances could trigger enforcement, and the steps needed to avoid escalation. A strong culture of compliance and continuous improvement is no longer optional—it is essential to protecting clients, sustaining operations, and maintaining licensure.

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Bill language Chapter 3, Article 1, Section 59-65 https://www.revisor.mn.gov/laws/2025/1/3/laws.1.59.0#laws.1.59.0

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Changes to SNSA Registration and License Fees

2025 First Special Session HF 2 Chapter 3, Article 1, Section 66 Health Finances Omnibus Budget Bill Effective: January 1, 2026

Short description Increases SNSA registration and licenses fees.

Summary Increases registration and licensing fees by 16.67%, this includes new licenses and renewals.

Bill language Chapter 3, Article 1, Section 66 https://www.revisor.mn.gov/laws/2025/1/3/laws.1.66.0#laws.1.66.0

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Changes to Hospice Fees

2025 First Special Session HF 2 Chapter 3, Article 1, Section 67 Health Finance Omnibus Bill Effective: January 1, 2026 Short description This language increases hospice licensing fees.

Summary Increases all registration and licensing fees by 16.67%. This includes all new licenses and license renewals.

Implications Providers now need to budget for increases in fees.

Bill language Chapter 3, Article 1, Section 67 https://www.revisor.mn.gov/laws/2025/1/3/laws.1.67.0#laws.1.67.0

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Spoken Language Health Care Interpreter Work Group

2025 First Special Session HF 2 Chapter 3, Article 1, Section 96 Health Finance Omnibus Bill Report due to legislature: November 1, 2026

Short description Establishes a spoken language health care interpreter work group. The work group is charged with compiling recommendations to support and improve access to health care interpreting services statewide.

Summary The commissioner of health administers a voluntary statewide roster for spoken language health care interpreters. This bill directs the commissioner to contract with a neutral consultant to consult with interpreter service providers by convening a spoken language health care interpreter work group, and requires the work group to develop recommendations to improve access to interpreter services to the state. The commissioner must provide recommendation and draft legislation to certain members of the legislature by November 1, 2026.

Implications Determine barriers to interpreter access and offer potential solutions.

Bill language Chapter 3, Article 1, Section 96: https://www.revisor.mn.gov/laws/2025/1/3/laws.1.96.0#laws.1.96.0

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Occupational Therapy Changes

2025 First Special Session HF 2 Chapter 3, Article 3 Health Finance Omnibus Bill Effective: August 1, 2025

Short description Health licensing board adds clarity to definitions, licensing and scope of practice for occupational therapists and occupational therapy assistants.

Summary Terminology Updates: • Aligns terminology with national standards: o Changes “credentialing examination” to “certification examination.” o Clarifies the use of titles: “occupational therapist” and “occupational therapy assistant” (OT and OTA).

• Incorporates references to ACOTE (Accreditation Council for Occupational Therapy Education) and NBCOT (National Board for Certification in Occupational Therapy).

Scope of Practice and Definitions: • Expands and clarifies the scope of occupational therapy practice including health promotion, community mobility, and wellness.

• Defines new terms like “continuing competence” and “face-to-face supervision.”

Licensure Requirements: • Introduces clearer pathways for: o Initial licensure o Licensure by equivalency (NBCOT certified individuals) o Licensure by reciprocity (from other jurisdictions) o Temporary licensure • Specifies education, examination, and supervised practice requirements, including refresher courses for applicants who have been out of practice.

Supervision & Delegation: • Clarifies supervision rules for occupational therapy assistants (OTAs), including: o Delegation of duties o Frequency of evaluations and interventions o Face-to-face supervision every 10 intervention days or 30 calendar days.

Licensure Maintenance: • Sets clearer rules for: o License renewal timelines o Lapsed license reactivation (within 1 year, 2 years, or more) o Permanent expiration after prolonged lapse (2 years+).

• Introduces biennial licensure periods tied to licensees’ birth months.

Continuing Education (CE) Requirements: • Updates CE requirements and allowable activities.

• Adds clearer guidelines for CE audits and documentation.

• Allows for deferrals (instead of waivers) for hardship cases.

Compact Licensure: • Adds provisions for interstate licensure compact privilege, allowing OTs and OTAs licensed in other compact states to practice in Minnesota.

• Establishes a $150 compact privilege fee.

Fees and Administrative Changes: • Updates fee structure including: o Fees for licensure, renewals, and mailing lists.

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• Allows the Board to require a jurisprudence exam on Minnesota laws and rules.

Disciplinary Authority: • Expands the Board’s authority to deny, discipline, or condition licensure for specific professional misconduct or non-compliance.

Implications These updates will make Minnesota’s occupational therapy regulations more consistent with national standards.They emphasize public protection, professional accountability, and facilitate workforce mobility through the interstate compact.

Bill language Chapter 3, Article 3: https://www.revisor.mn.gov/laws/2025/1/3/laws.3.1.0#laws.3.1.0

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Nonemergency Medical Transportation Statewide or Regional Contracting Required 2025 First Special Session SF 6 / HF 2 Chapter 3, Article 8, Section 14, Subd. 18i.

Health Finance Omnibus Bill Effective: This section is effective the day following final enactment.

Short description The Minnesota Department of Human Services (DHS) is directed to contract, either statewide or regionally, for the administration of the nonemergency medical transportation program.

Summary Beginning July 1, 2026, for medical assistance fee-for- service and January 1, 2027, for prepaid medical assistance, DHS must contract either statewide or regionally, for the administration of the nonemergency medical transportation program.

While Governor Walz proposed to save $22.364 million in the FY2026-2027 biennium and $102.904 million in the FY2028-2029 biennium with authorization of a uniform Non-emergency Medical Transportation (NEMT) program for all Medical Assistance and MinnesotaCare members, the provision passed by the legislature does not appear to have claimed the savings in the Governor’s proposal Implications The details of this proposal are unknown and important. Presumably, most long-term care Medicaid beneficiaries would fall under the proposal to contract for the administration of NEMT. Since access and reliability of NEMT remain central issues with the service, the proposed change could be positive, negative, or neither.

Bill language Chapter 3, Article 8, Section 14, Subd. 18i: https://www.revisor.mn.gov/laws/2025/1/3/laws.8.14.0#laws.8.14.0

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Cannabis Changes Impacting Long-Term Care and Landlords 2025 Regular Session SF 2370 Chapter 3, Section 93 and 94 Cannabis Omnibus Bill Effective: August 1, 2025

Short description Technical changes updating Cannabis terminology in statutes including the health care facilities language and expanding protections for registry program participants who are renters.

Summary Language is changed under the Health Care Facilities subdivision of Cannabis Law to reflect the updated terminology and include hemp-derived products. Additional language is added to clarify that the Cannabis statute is not intended to allow violations of the Minnesota Clean Indoor Air Act Language has also been changed in the Protections for Registry Program Participants to include that landlords may not refuse to lease a property or penalize a resident who is a participating in the medical cannabis program. If a landlord is looking to take action against a resident that is in violation of these standards, the facility must give a 14 day notice, cite specific federal law or regulation that the landlord believe would be violated if they failed to take action and provide the monetary or specific licensingrelated benefit they would lose if they did not take action. It also includes a new provision adding that retaliation is prohibited and expressly provides an ability of an individual to bring action for injunctive relief for violations under the Protections for Registry Program Participants sections of law.

Landlord definition in 504B.001 subd. 7: “’Landlord’ means an owner of real property, a contract for deed vendee, receiver, executor, trustee, lessee, agent, or other person directly or indirectly in control of rental property.”

Implications Health care facilities will see little change as they are limited to clarifications that are likely already acknowledged. Health care facilities are not required to assist residents with use of resident cannabis to avoid conflicts with federal law, as it has been since adoption in 2023.

Those identified as a landlord who have a registry program participant should be aware of the restrictions already established and expanded in 2025.

Bill language Chapter 3, Section 93:

https://www.revisor.mn.gov/laws/2025/0/31/laws.0.93.0#laws.0.93.0 Subd. 2. Health care facilities. (a) Health care facilities licensed under chapter 144A; hospice providers licensed under chapter 144A; boarding care homes or supervised living facilities licensed under section 144.50; assisted living facilities under chapter 144G; facilities owned, controlled, managed, or under common control with hospitals licensed under chapter 144; and other health care facilities licensed by the commissioner of health or the commissioner of human services may adopt reasonable restrictions on the use of medical cannabis flower or medical cannabinoid, cannabis products, lower-potency hemp edibles, hemp-derived consumer products, or hemp-derived topical products by a patient enrolled in the registry program who resides at or is actively receiving treatment or care at the facility. The restrictions may include a provision that the facility must not store or maintain a patient's supply of medical cannabis flower or medical cannabinoid cannabis products on behalf of

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the patient; that a patient store the patient's supply of medical cannabis flower or medicinal cannabinoid, cannabis products, lower-potency hemp edibles, hemp-derived consumer products, or hemp-derived topical products in a locked container accessible only to the patient, the patient's designated caregiver, or the patient's parent, legal guardian, or spouse; that the facility is not responsible for providing medical cannabis or hemp for patients; and that medical cannabis flower or medical cannabinoid, cannabis products, lower-potency hemp edibles, hemp-derived consumer products, or hemp-derived topical products are used only in a location specified by the facility or provider. Nothing in this subdivision requires facilities and providers listed in this subdivision to adopt such restrictions. (b) No facility or provider listed in this subdivision may unreasonably limit a patient's access to or use of medical cannabis flower or medical cannabinoid, cannabis products, lower-potency hemp edibles, hemp-derived consumer products, or hemp-derived topical products to the extent that such use is authorized under sections 342.51 to 342.59, or, in the case of a visiting patient, authorized to use cannabis under the laws of their state of residence. No facility or provider listed in this subdivision may prohibit a patient access to or use of medical cannabis flower or medical cannabinoid cannabis products due solely to the fact that cannabis is a controlled substance pursuant to the federal Uniform Controlled Substances Act. If a federal regulatory agency, the United States Department of Justice, or the federal Centers for Medicare and Medicaid Services takes one of the following actions, a facility or provider may suspend compliance with this paragraph until the regulatory agency, the United States Department of Justice, or the federal Centers for Medicare and Medicaid Services notifies the facility or provider that it may resume permitting the use of medical cannabis flower or medical cannabinoid, cannabis products, lower-potency hemp edibles, hemp-derived consumer products, or hemp-derived topical products within the facility or in the provider's service setting: (1) a federal regulatory agency or the United States Department of Justice initiates enforcement action against a facility or provider related to the facility's compliance with the medical cannabis program; or (2) a federal regulatory agency, the United States Department of Justice, or the federal Centers for Medicare and Medicaid Services issues a rule or otherwise provides notification to the facility or provider that expressly prohibits the use of medical cannabis in health care facilities or otherwise prohibits compliance with the medical cannabis program. (c) An employee or agent of a facility or provider listed in this subdivision or a person licensed under chapter 144E is not violating this chapter or chapter 152 for the possession of medical cannabis flower or medical cannabinoid cannabis products while carrying out employment duties, including providing or supervising care to a patient enrolled in the registry program, or distribution of medical cannabis flower or medical cannabinoid cannabis products to a patient enrolled in the registry program who resides at or is actively receiving treatment or care at the facility or from the provider with which the employee or agent is affiliated. (d) Nothing in this subdivision is intended to require a facility covered by this subdivision to permit violations of sections 144.411 to 144.417. (e) This subdivision does not apply to sober homes under section 254B.181, except that a resident of a sober home who is a patient enrolled in the registry program must have access to medical cannabis flower and medical cannabinoid products subject to the restrictions and requirements in paragraphs (a) and (b).

Chapter 3, Section 94:

https://www.revisor.mn.gov/laws/2025/0/31/laws.0.94.0#laws.0.94.0 Section 94 Subd. 3. School enrollment; rental property. (a) No school may refuse to enroll or otherwise penalize a patient or person enrolled in the registry program or a Tribal medical cannabis program as a pupil solely because the patient or person is enrolled in the registry program or a Tribal medical cannabis program, unless failing to do so would

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violate federal law or regulations or cause the school to lose a monetary or licensing-related benefit under federal law or regulations. (b) No landlord may refuse to lease to a patient or person enrolled in the registry program or a Tribal medical cannabis program or otherwise penalize a patient or person enrolled in the registry program or a Tribal medical cannabis program solely because the patient or person is enrolled in the registry program or a Tribal medical cannabis program, unless failing to do so would violate federal law or regulations or cause the landlord to lose a monetary or licensing-related benefit under federal law or regulations. (c) A school must not refuse to enroll a patient as a pupil solely because cannabis is a controlled substance according to the Uniform Controlled Substances Act, United States Code, title 21, section 812. (d) A school must not penalize a pupil who is a patient solely because cannabis is a controlled substance according to the Uniform Controlled Substances Act, United States Code, title 21, section 812. (e) A landlord must not refuse to lease a property to a patient solely because cannabis is a controlled substance according to the Uniform Controlled Substances Act, United States Code, title 21, section 812. (f) A landlord must not otherwise penalize a patient solely because cannabis is a controlled substance according to the Uniform Controlled Substances Act, United States Code, title 21, section 812. ...

Subd. 5a. Notice.

An employer, a school, or a landlord must provide written notice to a patient at least 14 days before the employer, school, or landlord takes an action against the patient that is prohibited under subdivision 3 or 5. The written notice must cite the specific federal law or regulation that the employer, school, or landlord believes would be violated if the employer, school, or landlord fails to take action. The notice must specify what monetary or licensing-related benefit under federal law or regulations that the employer, school, or landlord would lose if the employer, school, or landlord fails to take action. ...

Subd. 6a. Retaliation prohibited.

A school, a landlord, a health care facility, or an employer must not retaliate against a patient for asserting the patient's rights or seeking remedies under this section or section 152.32.

Subd. 7. Action for damages; injunctive relief.

In addition to any other remedy provided by law, a patient or person an individual enrolled in the registry program or a Tribal medical cannabis program may bring an action for damages against any person who violates subdivision 3, 4, or 5. A person who violates subdivision 3, 4, or 5 is liable to a patient or person an individual enrolled in the registry program or a Tribal medical cannabis program injured by the violation for the greater of the person's actual damages or a civil penalty of $100 $1,000 and reasonable attorney fees. A patient may bring an action for injunctive relief to prevent or end a violation of subdivisions 3 to 6a.

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Task Force on Homeowners and Commercial Property Insurance

2025 First Special Session HF 4 Chapter 4, Article 3, Section 20 Commerce Omnibus Bill Effective: June 15, 2025

Short description Task force to address property insurance issues.

Summary The task force will produce a report to the legislature by February 15, 2026. The task force will be made up with appointments from multiple organizations where they will consider what is contributing to the escalating property insurance costs in Minnesota and suggestions for how to solve it.

Implications This task force could provide draft legislation to address escalating property insurance rates.

Bill language Chapter 4, Article 3, Section 20: https://www.revisor.mn.gov/laws/2025/1/4/laws.3.20.0#laws.3.20.0 Sec. 20. TASK FORCE ON HOMEOWNERS AND COMMERCIAL PROPERTY INSURANCE. Subdivision 1. Establishment. A task force is established to evaluate issues and provide recommendations relating to insurance affordability of single-family housing, common interest communities, and multifamily rental housing and for preventing disruptions or loss to the development, preservation, and long-term sustainability of Minnesota's housing infrastructure.

Subd. 2. Membership. (a) The task force consists of the following: (1) one member appointed by the commissioner of commerce; (2) one member appointed jointly by the speaker of the house and the speaker emerita of the house; (3) one member appointed jointly by the senate majority leader and the senate minority leader; (4) one member appointed by the Minnesota Consortium of Community Developers; (5) two members appointed by the Insurance Federation of Minnesota, including one member with expertise in homeowners insurance and one member with expertise in commercial insurance; (6) one member appointed by Big I Minnesota; (7) one member appointed by the Minnesota Association of Farm Mutual Insurance Companies; (8) one member appointed by the Community Associations Institute; (9) one member appointed by the Contractors Association of Minnesota; (10) one member appointed by the Minnesota Multi Housing Association; (11) one member appointed by the Housing Justice Center; and (12) one member appointed by Ceres with expertise in climate risk mitigation and insurance markets. (b) The appointing authorities must make the appointments by August 15, 2025.

Subd. 3. Duties. (a) The task force must identify recommendations to strengthen and stabilize the homeowners and commercial property insurance industry. (b) The task force must consult with the commissioner of the Housing Finance Agency, the commissioner of employment and economic development, other relevant state and local agencies, and key stakeholders in the insurance and housing industries. (c) The task force must review: (1) risk mitigation and property resilience to natural hazards, and the effect on insurance costs; (2) the effect of liability laws on insurance costs and whether tort reform could reduce costs; (3) minimum notice for coverage changes, including enforcement and oversight; (4) public reporting of aggregated data relating to insurance plan costs and coverage; Care Providers of Minnesota

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(5) the reinsurance market for homeowners and commercial property insurance; (6) the current state-supported insurance program and the potential to expand the program to include a catastrophic reinsurance fund and a self-insured pool; (7) factors that increase claim costs, including but not limited to post-loss contractors, fraudulent claims, climate, inflation, and discontinued building materials; (8) regulatory factors that increase insurance costs or decrease access to insurance products; and (9) other areas that would strengthen and stabilize the homeowners and commercial property insurance industry.

Subd. 4. Administration. The Legislative Coordinating Commission must provide administrative support to the task force. Upon request of the task force, the commissioners of commerce, the Housing Finance Agency, and employment and economic development must provide technical support and expertise.

Subd. 5. Meetings. (a) The Legislative Coordinating Commission must ensure the first meeting of the task force convenes no later than September 15, 2025, and must provide accessible physical or virtual meeting space as necessary for the task force to conduct work. (b) At the first meeting, the task force must elect a chair or cochairs from the members appointed by the house and senate by a majority vote of those members present and may elect a vice-chair as necessary. (c) The task force must establish a schedule for meetings and must meet as necessary to accomplish the duties under subdivision 3. (d) The task force is subject to Minnesota Statutes, chapter 13D. Subd. 6. Report required. (a) The task force must submit a report to the commissioners of commerce, the Housing Finance Agency, and employment and economic development and the chairs and ranking minority members of the legislative committees having jurisdiction over the agencies listed in this paragraph by February 15, 2026. (b) The report must: (1) summarize the activities of the task force; (2) provide findings and recommendations adopted by the task force; (3) make recommendations related to tort reform that could reduce insurance costs; (4) include any draft legislation required to implement recommendations; and (5) include other information the task force believes is necessary to report.

Subd. 7. Expiration. The task force expires upon submission of the report required under subdivision 6.

EFFECTIVE DATE. This section is effective the day following final enactment.

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Part B Supplemental Coverage Premium Changes 2025 First Special Session HF 4 Chapter 4, Article 5, Section 5 Human Services Omnibus Bill Effective: August 1, 2026

Short description Changes to Part B supplemental coverage rates based on age and delayed signing up.

Summary Plans can charge differently for supplemental coverage when there are different benefits or provider networks, the Geographic area being served (if approved by the state), and allowing discounts for healthy behaviors (like not smoking, if approved by the state). New law allows charging a higher premium to residents if they enroll late — outside their initial eligibility period — but only if they are 65– 70 years old for as long as they have coverage. These additional premiums are on top of changes to the community care rate.

• • • • • •

For an individual who enrolls during the 2026 open enrollment period, 15 percent; For an individual who enrolls during the 2027 open enrollment period, 20 percent; For an individual who enrolls during the 2028 open enrollment period, 25 percent; For an individual who enrolls during the 2029 open enrollment period, 30 percent; For an individual who enrolls during the 2030 open enrollment period, 35 percent; and For an individual who enrolls during an open enrollment period after 2029, 35 percent.

Implications This does not directly impact long-term care facilities but they may notice residents who delay enrolling in Part B services will pay more for insurance, which could strain their ability to afford private-pay LTC services and increase reliance on Medicaid.

Bill language Chapter 4, Article 5, Section 5: https://www.revisor.mn.gov/laws/2025/1/4/laws.5.5.0#laws.5.5.0

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Area Agency on Aging Nutrition Support Services 2025 First Special Session HF 3 Chapter 9, Article 1, Section 7 Health & Human Services Omnibus Bill Effective: August 1, 2025

Short description Creates Opportunity for Innovation and Partnerships for Senior Nutrition Services.

Summary Creates a new category of funding for an area agency on aging to explore ‘Innovative models of providing healthy and nutritious meals to seniors, including through partnerships with schools, restaurants, and other community partners’.

Adds clarifying language that all funding under this section is subject to federal requirements according to the Agency’s intrastate formula.

Implications May open opportunities to partner with regional area agency on aging groups to provide community based senior nutrition programs.

Bill language Chapter 9, Article 1, Section 7 https://www.revisor.mn.gov/laws/2025/1/9/laws.1.7.0#laws.1.7.0

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Promotion of Materials on Rights and Obligations of Landlords and Residential Tenants

2025 Regular Session SF 2298 Chapter 32, Article 3, Section 3.

Housing Omnibus Bill Effective: August 1, 2025

Short description The Minnesota Housing Finance Agency (Minnesota Housing) must publish information on landlordtenant law and prominently display information on the agency website.

Chapter 32, Article 3, Section 3: https://www.revisor.mn.gov/laws/2025/0/32/laws.3.3.0#laws.3.3.0

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Minimum Heat Code Changes

2025 Regular Session and 2025 First Special Session SF2298 and SF 9 Chapter 32, Article 4, Section 4 and Chapter 11 Section 1 Housing Omnibus Bill and Revisor Clean Up Bill Effective: July 1, 2025 Short description Changes to 2023 legislation on minimum heat code under landlord-tenant law.

Summary The 2023 legislation which amended the covenants of habitability to require a 68 minimum temperature during winter months is amended. The changes specify that heating requirement is only for places intended for habitation.

Implications Members should be aware of the minimum heat code and the provided clarification that it applies to areas which are intended for habitation.

Bill language Chapter 32, Article 4, Section 4: https://www.revisor.mn.gov/laws/2025/0/32/laws.4.4.0#laws.4.4.0 Sec. 4. Minnesota Statutes 2024, section 504B.161, subdivision 1, is amended to read: Subdivision 1. Requirements. (a) In every lease or license of residential premises, the landlord or licensor covenants: ...

(5) to supply equip or furnish heat at a minimum temperature of 68 degrees Fahrenheit in all places intended for habitation including kitchens and bathrooms from October 1 through April 30, unless a utility company requires and instructs the heat to be reduced.

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Treatment of Information of Domestic Violence Victim in Rental Housing

2025 Regular Session SF 2298 Chapter 32, Article 4, Section 5.

Housing Omnibus Bill Effective: May 23, 2025

Short description Do not share domestic violence victims information.

Summary The treatment of domestic violence victims using 504B.206 to end a lease agreement supersedes any other document or form previously signed by the tenant, including but not limited to any release of information form.

Implications A facility where a resident has terminated their lease due to domestic violence should use extreme caution and avoid sharing any identifiable information about the resident who uses the lease termination provision. If you are unsure of when you are able to share information, consult a legal professional.

Bill language Chapter 32, Article 4, Section 5: https://www.revisor.mn.gov/laws/2025/0/32/laws.4.5.0#laws.4.5.0

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Tenant Remedies Changes

2025 Regular Session SF 2298 Chapter 32, Article 4, Sections 6-7 Housing Omnibus Bill Effective: August 1, 2025 Short description The violations allowing for tenant remedies statute to be used are expanded to include the new language added during the 2024 legislative session.

Summary The 2024 legislature expanded the definition of violation under 504B and allowed tenant remedies for violations of Minnesota Statutes 504B and any federal, state, county, or city laws protecting tenants from discrimination and adding: Any applicable tenant rights and landlord obligations for public and subsidized tenancies under local, state, or federal law; or A violation of an oral or written agreement, lease, or contract for the rental of a dwelling in a building.

The additions will allow the new violations to be included for a tenant to rent escrow action to remedy repairs under 504B. Implications Many of the violations were already covered by the statute and tenant remedy actions have a low utilization rate. However, due to the expansion to include city and county laws in 2023 which protect residents from discrimination, members should be aware that cities and counties may have additional ordinances that impact their operations.

Bill language Chapter 32, Article 4, Sections 6-7: https://www.revisor.mn.gov/laws/2025/0/32/laws.4.6.0#laws.4.6.0 Sec. 6. Minnesota Statutes 2024, section 504B.385, subdivision 1, is amended to read: Subdivision 1. Escrow of rent. (a) If a violation exists in a residential building, a residential tenant may deposit the amount of rent due to the landlord with the court administrator using the procedures described in paragraphs (b) to (d). (b) For a violation as defined in section 504B.001, subdivision 14, clause (1), the residential tenant may deposit with the court administrator the rent due to the landlord along with a copy of the written notice of the code violation as provided in section 504B.185, subdivision 2. The residential tenant may not deposit the rent or file the written notice of the code violation until the time granted to make repairs has expired without satisfactory repairs being made, unless the residential tenant alleges that the time granted is excessive. (c) For a violation as defined in section 504B.001, subdivision 14, clause (2) or, (3), (4), or (5), the residential tenant must give written notice to the landlord specifying the violation. The notice must be delivered personally or sent to the person or place where rent is normally paid. If the violation is not corrected within 14 days, the residential tenant may deposit the amount of rent due to the landlord with the court administrator along with an affidavit specifying the violation. The court must provide a simplified form affidavit for use under this paragraph. (d) The residential tenant need not deposit rent if none is due to the landlord at the time the residential tenant files the notice required by paragraph (b) or (c). All rent which becomes due to the landlord after that time but before the hearing under subdivision 6 must be deposited with the court administrator. As

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long as proceedings are pending under this section, the residential tenant must pay rent to the landlord or as directed by the court and may not withhold rent to remedy a violation.

Sec. 7. Minnesota Statutes 2024, section 504B.395, subdivision 4, is amended to read: Subd. 4. Landlord must be informed. A landlord must be informed in writing of an alleged violation at least 14 days before an action is brought by: (1) a residential tenant of a residential building in which a violation as defined in section 504B.001, subdivision 14, clause (2) or, (3), (4), or (5), is alleged to exist; or (2) a housing-related neighborhood organization, with the written permission of a residential tenant of a residential building in which a violation, as defined in section 504B.001, subdivision 14, clause (2), (3), (4), or (5), is alleged to exist. The notice requirement may be waived if the court finds that the landlord cannot be located despite diligent efforts.

504b.001 subd. 14 for background: Subd. 14.Violation. "Violation" means: (1) a violation of any state, county or city health, safety, housing, building, fire prevention, or housing maintenance code applicable to the building; (2) a violation of this chapter; (3) a violation of any federal, state, county, or city laws protecting tenants from discrimination; (4) a violation of any applicable tenant rights and landlord obligations for public and subsidized tenancies under local, state, or federal law; or (5) a violation of an oral or written agreement, lease, or contract for the rental of a dwelling in a building.

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Missing Persons Endangered Definition Change

2025 Regular Session HF2432 Chapter 35, Article 5, Section 10 Judiciary Omnibus Bill Effective: August 1, 2025

Short description Expands the endangered person's definition to include a person diagnosed with dementia, a traumatic brain injury, Alzheimer's, or other cognitive impairments as well as to persons diagnosed with autism.

Implications The changes might provide people with an opportunity to quickly alert police to, and have a response to, the elopement or disappearance of individuals with cognitive impairments from the community or from facilities.

Bill language Chapter 35, Article 5, Section 10: https://www.revisor.mn.gov/laws/2025/0/35/laws.5.10.0#laws.5.10.0

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Public Employees Retirement Association (PERA) Privatization

2025 Regular Session SF 2884 Chapter 37, Article 4 Pensions Bill Effective: July 1, 2027

Short description Reform of the process for when a governmental subdivision is privatized, requiring payment to cover the public employees' unfunded retirement liability by the privatized owner.

Summary PERA proposed these legislative changes to the process of public to private ownership during 2025 as they found these transfers were leaving PERA with unfunded liabilities. Prior to this change, there was no requirement to make PERA whole when withdrawing from the PERA program.

These changes will require a notification to PERA from the governmental subdivision of the intention to privatize; the governmental subdivision must reimburse PERA for the calculation of an actuarial study to provide the withdrawal liability and requires the payment of the withdrawal liability by the privatized owner. Allows for a payment plan of up to 10 years. PERA reports annually to its board of trustees, the legislative commission on pensions, and legislative committees with jurisdiction including details on the effective date of privatization and any amount still to be paid by privatized facilities.

Implications Those who are looking to purchase a government owned facility should add to their considerations whether a payment for these liabilities will be required when privatizing a facility after July 1, 2027.

PERA representatives stated that these liabilities are expected to be fully funded in 2027.

Bill language Chapter 37, Article 4: https://www.revisor.mn.gov/laws/2025/0/37/laws.4.0.0#laws.4.0.0

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SNSA Ownership Definitions Changes 2025 Regular Session HF 2115 Chapter 38, Article 2, Sections 9-11 Human Service Policy Omnibus Bill Effective: August 1, 2025.

Short description Several changes to the change of ownership statutes.

Summary Makes a change to the definition of a controlling person to align with newly added definitions of direct ownership interest and indirect ownership interest. Both are similarly formatted and recognize an interest if entities own over a five percent interest.

Implications Members will be required to provide disclosure in their licensing of any other interests which own over five percent of an interest in their facility regardless of whether it is direct or indirect ownership.

Bill language Chapter 38, Article 2, Section 9-11: https://www.revisor.mn.gov/laws/2025/0/38/laws.2.9.0#laws.2.9.0

Subd. 3. Controlling person. "Controlling person" means a business entity or entities, officer, program administrator, or director, whose responsibilities include the management and decision-making authority to establish or control business policy and all other policies of a supplemental nursing services agency. Controlling person also means an individual who, directly or indirectly, beneficially owns an has a direct ownership interest or indirect ownership interest in a corporation, partnership, or other business association that is a controlling person the registrant.

Subd. 3a. Direct ownership interest. "Direct ownership interest" means an individual or legal entity with at least five percent equity in capital, stock, or profits of the registrant or who is a member of a limited liability company of the registrant.

Subd. 4b. Indirect ownership interest. "Indirect ownership interest" means an individual or legal entity with a direct ownership interest in an entity that has a direct or indirect ownership interest of at least five percent in an entity that is a registrant.

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Candidate Access

2025 Regular Session SF 3045 Chapter 39, Article 8, Section 83 State and Local Gov – Elections Bill Effective: July 1, 2025 Description Minnesota law has long allowed political candidates access to multi-unit residential dwellings. Recent amendments clarify that: Candidate access must be permitted between 9:00 a.m. and 9:00 p.m.

Operators are “encouraged” to notify residents when a candidate provides advance notice of their intent to visit.

Implications Candidates for public office are potential future elected officials. Members should use these opportunities to inform potential lawmakers of the impact they have on the community.

These changes do not change the restrictions a facility can impose on a candidate, including limiting access specific rooms in an assisted living or nursing home based on health reasons, reasonable identification, requiring a prior appointment, or denying admittance for good cause.

Bill language Chapter 39, Article 8, Section 83: https://www.revisor.mn.gov/laws/2025/0/39/laws.8.83.0#laws.8.83.0 Sec. 83. Minnesota Statutes 2024, section 211B.20, subdivision 2, is amended to read: Subd. 2. Exceptions. Subdivision 1 does not prohibit: (1) denial of admittance into a particular apartment, room, manufactured home, or personal residential unit; (2) requiring reasonable and proper identification as a necessary prerequisite to admission to a multiple unit dwelling; (3) in the case of a nursing home or an assisted living facility under chapter 144G, denial of permission to visit certain persons for valid health reasons; (4) limiting visits by candidates or volunteers accompanied by the candidate to a reasonable number of persons or reasonable hours, provided that access must be permitted during the hours of 9:00 a.m. through 9:00 p.m. on any day, at a minimum; (5) requiring a prior appointment to gain access to the facility; or (6) denial of admittance to or expulsion from a multiple unit dwelling for good cause.

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Certificates of Rent Paid Nonreporting Penalties 2025 First Special Session HF 9 Chapter 13, Article 8, Sections 13-14 Taxes Omnibus Bill Effective: For rent paid after December 31, 2025

Short description The law adjusts the penalty for failing to provide a Certificate of Rent Paid (CRP) to a renter is a penalty of $50 (reduced from $100). Additionally, it creates a new penalty of $50 to the owner for each failure to file a CRP with the commissioner. The Revenue commissioner has authority to abate the penalty.

Implications The penalty was essentially maintained at the same level it had been historically – spreading it across the resident and agency when an owner is noncompliant. Facilities should continue to provide CRPs to residents and the Department of Revenue as they have become accustomed to doing.

More information on filing CRPs with the Department of Revenue, as has been required since 2024, can be found here: https://www.revenue.state.mn.us/faqs-crps-e-services and https://www.revenue.state.mn.us/crp-e-services-instructions Bill language Chapter 13, Article 8, Section 13 & 14: https://www.revisor.mn.gov/laws/2025/1/13/laws.8.13.0#laws.8.13.0

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