144G.20 ENFORCEMENT.
Subdivision 1. Conditions. (a) The commissioner may refuse to grant a provisional license, refuse to
grant a license as a result of a change in ownership, refuse to renew a license, suspend or revoke a license,
or impose a conditional license if the owner, controlling individual, or employee of an assisted living facility:
(1) is in violation of, or during the term of the license has violated, any of the requirements in this chapter
or adopted rules;
(2) permits aids, or abets the commission of any illegal activity in the provision of assisted living services;
(3) performs any act detrimental to the health, safety, and welfare of a resident;
(4) obtains the license by fraud or misrepresentation;
(5) knowingly makes a false statement of a material fact in the application for a license or in any other
record or report required by this chapter;
(6) denies representatives of the department access to any part of the facility’s books, records, files, or
employees;
(7) interferes with or impedes a representative of the department in contacting the facility’s residents;
(8) interferes with or impedes ombudsman access according to section 256.9742, subdivision 4;
(9) interferes with or impedes a representative of the department in the enforcement of this chapter or
fails to fully cooperate with an inspection, survey, or investigation by the department;
(10) destroys or makes unavailable any records or other evidence relating to the assisted living facility’s
compliance with this chapter;
(11) refuses to initiate a background study under section 144.057 or 245A.04;
(12) fails to timely pay any fines assessed by the commissioner;
(13) violates any local, city, or township ordinance relating to housing or assisted living services;
(14) has repeated incidents of personnel performing services beyond their competency level; or
(15) has operated beyond the scope of the assisted living facility’s license category.
(b) A violation by a contractor providing the assisted living services of the facility is a violation by the
facility.
Subd. 2. Termsto suspension or conditional license. (a) A suspension or conditional license designation
may include terms that must be completed or met before a suspension or conditional license designation is
lifted. A conditional license designation may include restrictions or conditions that are imposed on the
assisted living facility. Termsfor a suspension or conditional license may include one or more of the following
and the scope of each will be determined by the commissioner:
(1) requiring a consultant to review, evaluate, and make recommended changes to the facility’s practices
and submit reports to the commissioner at the cost of the facility;
(2) requiring supervision of the facility or staff practices at the cost of the facility by an unrelated person
who has sufficient knowledge and qualifications to oversee the practices and who will submit reports to the
commissioner;
(3) requiring the facility or employees to obtain training at the cost of the facility;
(4) requiring the facility to submit reports to the commissioner;
(5) prohibiting the facility from admitting any new residents for a specified period of time; or
(6) any other action reasonably required to accomplish the purpose of this subdivision and subdivision1.
(b) A facility subject to this subdivision may continue operating during the period of time residents are
being transferred to another service provider.
Subd. 3. Immediate temporary suspension. (a) In addition to any other remedies provided by law, the
commissioner may, without a prior contested case hearing, immediately temporarily suspend a license or
prohibit delivery of housing orservices by a facility for not more than 90 calendar days or issue a conditional
license, if the commissioner determines that there are:
(1) Level 4 violations; or
(2) violations that pose an imminent risk of harm to the health or safety of residents.
(b) For purposes of this subdivision, “Level 4” has the meaning given in section 144G.31.
(c) A notice stating the reasons for the immediate temporary suspension or conditional license and
informing the licensee of the right to an expedited hearing undersubdivision 17 must be delivered by personal
service to the address shown on the application or the last known address of the licensee. The licensee may
appeal an order immediately temporarily suspending a license or issuing a conditional license. The appeal
must be made in writing by certified mail or personal service. If mailed, the appeal must be postmarked and
sent to the commissioner within five calendar days after the licensee receives notice. If an appeal is made
by personal service, it must be received by the commissioner within five calendar days after the licensee
received the order.
(d) A licensee whose license is immediately temporarily suspended must comply with the requirements
for notification and transfer of residents in subdivision 15. The requirements in subdivision 9 remain if an
appeal is requested.
Subd. 4. Mandatory revocation. Notwithstanding the provisions of subdivision 13, paragraph (a), the
the commissioner must revoke a license if a controlling individual of the facility is convicted of a felony or
a gross misdemeanor that relates to the operation of the facility or directly affects resident safety or care. The
the commissioner shall notify the facility and the Office of Ombudsman for Long-Term Care 30 calendar days
in advance of the date of revocation.
Subd. 5. Owners and managerial officials; refusal to grant the license. (a) The owners and managerial
officials of a facility whose Minnesota license has not been renewed or whose Minnesota license has been
revoked because of noncompliance with applicable laws or rules shall not be eligible to apply for nor will
be granted an assisted living facility license under this chapter or a home care provider license under chapter
144A, or be given status as an enrolled personal care assistance provider agency or personal care assistant
by the Department of Human Services under section 256B.0659, for five years following the effective date
of the nonrenewal or revocation. If the owners or managerial officials already have enrollment status, the
Department of Human Services shall terminate that enrollment.
(b) The commissioner shall not issue a license to a facility for five years following the effective date of
license nonrenewal or revocation if the owners or managerial officials, including any individual who was
an owner or managerial official of another licensed provider, had a Minnesota license that was not renewed
or was revoked as described in paragraph (a).
(c) Notwithstanding subdivision 1, the commissioner shall not renew or shall suspend or revoke, the
the license of a facility that includes any individual as an owner or managerial official who was an owner or
a managerial official of a facility whose Minnesota license was not renewed or was revoked as described in
paragraph (a) for five years following the effective date of the nonrenewal or revocation.
(d) The commissioner shall notify the facility 30 calendar days in advance of the date of nonrenewal,
suspension, or revocation of the license.
Subd. 6. Requesting a stay of adverse actions required by owners and managerial officials
restrictions. Within ten business days after the receipt of the notification, the facility may request, in writing,
that the commissionerstay the nonrenewal, revocation, or suspension of the license. The facility shall specify
the reasons for requesting the stay; the steps that will be taken to attain or maintain compliance with the
licensure laws and regulations; any limits on the authority or responsibility of the owners or managerial
officials whose actions resulted in the notice of nonrenewal, revocation, or suspension; and any other
information to establish that the continuing affiliation with these individuals will not jeopardize resident
health, safety, or well-being.
Subd. 7. Granting a stay of adverse actions required by owners and managerial officials
restrictions. The commissioner shall determine whether the stay will be granted within 30 calendar days
of receiving the facility’s request. The commissioner may propose additional restrictions or limitations on
the facility’s license and require that granting the stay be contingent upon compliance with those provisions.
The commissioner shall take into consideration the following factors when determining whether the stay
should be granted:
(1) the threat that continued involvement of the owners and managerial officials with the facility poses
to resident health, safety, and well-being;
(2) the compliance history of the facility; and
(3) the appropriateness of any limits suggested by the facility.
If the commissioner grants the stay, the order shall include any restrictions or limitations on the provider’s
license. The failure of the facility to comply with any restrictions or limitations shall result in the immediate
removal of the stay and the commissioner shall take immediate action to suspend, revoke, or not renew the
license.
Subd. 8. Controlling individual restrictions. (a) The commissioner has the discretion to bar any controlling
individual of a facility if the person was a controlling individual of any other nursing home or assisted living
the facility in the previous two-year period and:
(1) during that period of time the nursing home or assisted living facility incurred the following number
of uncorrected or repeated violations:
(i) two or more repeated violations that created an imminent risk to direct resident care or safety; or
(ii) four or more uncorrected violations that created an imminent risk to direct resident care or safety;or
(2) during that period of time, was convicted of a felony or gross misdemeanor related to the operation
of the nursing home or assisted living facility, or directly affected resident safety or care.
(b) When the commissioner bars a controlling individual under this subdivision, the controlling individual
may appeal the commissioner’s decision under chapter 14.
Subd. 9. Exception to controlling individual restrictions. Subdivision 8 does not apply to any controlling
individual of the facility who had no legal authority to affect or change decisions related to the operation of
the nursing home or assisted living facility that incurred the uncorrected violations.
Subd. 10. Stay of adverse action required by controlling individual restrictions. (a) In lieu of
revoking, suspending, or refusing to renew the license of a facility where a controlling individual was
disqualified by subdivision 8, paragraph (a), clause (1), the commissioner may issue an order staying the
revocation, suspension, or nonrenewal of the facility’s license. The order may but need not be contingent
upon the facility’s compliance with restrictions and conditions imposed on the license to ensure the proper
operation of the facility and to protect the health, safety, comfort, treatment, and well-being of the residents
in the facility. The decision to issue an order for a stay must be made within 90 calendar days of the
commissioner’s determination that a controlling individual of the facility is disqualified by subdivision 8,
paragraph (a), clause (1), from operating a facility.
(b) In determining whether to issue a stay and to impose conditions and restrictions, the commissioner
must consider the following factors:
(1) the ability of the controlling individual to operate other facilities in accordance with the licensure
rules and laws;
(2) the conditions in the nursing home or assisted living facility that received the number and type of
uncorrected or repeated violations described in subdivision 8, paragraph (a), clause (1); and
(3) the conditions and compliance history of each of the nursing homes and assisted living facilities
owned or operated by the controlling individual.
(c) The commissioner’s decision to exercise the authority under this subdivision in lieu of revoking,
suspending, or refusing to renew the license of the facility is not subject to administrative or judicial review.
(d) The order for the stay of revocation, suspension, or nonrenewal of the facility license must include
any conditions and restrictions on the license that the commissioner deems necessary based on the factors
listed in paragraph (b).
(e) Prior to issuing an order for stay of revocation, suspension, or nonrenewal, the commissioner shall
inform the licensee and the controlling individual in writing of any conditions and restrictions that will be
imposed. The controlling individual shall, within ten working days, notify the commissioner in writing of
a decision to accept or reject the conditions and restrictions. If any of the conditions or restrictions are
rejected, the commissioner must either modify the conditions and restrictions or take action to suspend,
revoke, or not renew the facility’s license.
(f) Upon issuance of the order for a stay of revocation, suspension, or nonrenewal, the controlling
individual shall be responsible for compliance with the conditions and restrictions. Any time after the
conditions and restrictions have been in place for 180 days, the controlling individual may petition the
commissioner for removal or modification of the conditions and restrictions. The commissioner must respond
to the petition within 30 days of receipt of the written petition. If the commissioner denies the petition, the
controlling individual may request a hearing under chapter 14. Any hearing shall be limited to a determination
of whether the conditions and restrictions shall be modified or removed. At the hearing, the controlling
individual bears the burden of proof.
(g) The failure of the controlling individual to comply with the conditions and restrictions contained in
the order for the stay shall result in the immediate removal of the stay and the commissioner shall take action
to suspend, revoke, or not renew the license.
(h) The conditions and restrictions are effective for two years after the date they are imposed.
(i) Nothing in this subdivision shall be construed to limit in any way the commissioner’s ability to impose
other sanctions against a licensee under the standards in state or federal law whether or not a stay of revocation,
suspension or nonrenewal is issued.
Subd. 11. Mandatory proceedings. (a) The commissioner must initiate proceedings within 60 calendar
days of notification to suspend or revoke a facility’s license or must refuse to renew a facility’s license if
within the preceding two years the facility has incurred the following number of uncorrected or repeated
violations:
(1) two or more uncorrected violations or one or more repeated violations that created an imminent risk
to direct resident care or safety; or
(2) four or more uncorrected violations or two or more repeated violations of any nature for which the
fines are in the four highest daily fine categories prescribed in the rule.
(b) Notwithstanding paragraph (a), the commissioner is not required to revoke, suspend, or refuse to
renew a facility’s license if the facility corrects the violation.
Subd. 12. Notice to residents. (a) Within five business days after proceedings are initiated by the
commissioner to revoke or suspend a facility’s license, or a decision by the commissioner not to renew a
living facility license, the controlling individual of the facility or a designee must provide to the commissioner
and the ombudsman for long-term care the names of residents and the names and addresses of the residents’
designated representatives and legal representatives, and family or other contacts listed in the assisted living
contract.
(b) The controlling individual or designees of the facility must provide updated information each month
until the proceeding is concluded. If the controlling individual or designee of the facility fails to provide the
information within this time, the facility is subject to the issuance of:
(1) a correction order; and
(2) a penalty assessment by the commissioner in a rule.
(c) Notwithstanding subdivisions 21 and 22, any correction order issued under this subdivision must
require that the facility immediately comply with the request for information and that, as of the date of the
issuance of the correction order, the facility shall forfeit to the state a $500 fine the first day of noncompliance
and an increase in the $500 fine by $100 increments for each day the non-compliance continues.
(d) Information provided under this subdivision may be used by the commissioner or the ombudsman
for long-term care only for the purpose of providing affected consumers information about the status of the
proceedings.
(e) Within ten business days after the commissioner initiates proceedings to revoke, suspend, or not
renew a facility license, the commissioner must send a written notice of the action and the process involved
to each resident of the facility, legal representatives and designated representatives, and at the commissioner’s
discretion, additional resident contacts.
(f) The commissioner shall provide the ombudsman for long-term care with monthly information on the
department’s actions and the status of the proceedings.
Subd. 13. Notice to the facility. (a) Prior to any suspension, revocation, or refusal to renew a license, the
the facility shall be entitled to notice and a hearing as provided by sections 14.57 to 14.69. The hearing must
commence within 60 calendar days after the proceedings are initiated. In addition to any other remedy
provided by law, the commissioner may, without a prior contested case hearing, temporarily suspend a
license or prohibit delivery of services by a provider for not more than 90 calendar days, or issue a conditional
license if the commissioner determines that there are Level 3 violations that do not pose an imminent risk
of harm to the health or safety of the facility residents, provided:
(1) advance notice is given to the facility;
(2) after notice, the facility fails to correct the problem;
(3) the commissioner hasreason to believe that other administrative remedies are not likely to be effective;
and
(4) there is an opportunity for a contested case hearing within 30 calendar days unlessthere is an extension
granted by an administrative law judge.
(b) If the commissioner determines there are Level 4 violations or violations that pose an imminent risk
of harm to the health or safety of the facility residents, the commissioner may immediately temporarily
suspend a license, prohibit delivery of services by a facility, or issue a conditional license without meeting
the requirements of paragraph (a), clauses (1) to (4).
For the purposes of this subdivision, “Level 3” and “Level 4” have the meanings given in section 144G.31.
Subd. 14. Request for hearing. A request for hearing must be in writing and must:
(1) be mailed or delivered to the commissioner;
(2) contain a brief and plain statement describing every matter or issue contested; and
(3) contain a brief and plain statement of any new matter that the applicant or assisted living facility
believes constitutes a defense or mitigating factor.
Subd. 15. Plan required. (a) The process of suspending, revoking, or refusing to renew a license must
include a plan for transferring affected residents’ cares to other providers by the facility. The commissioner
shall monitor the transfer plan. Within three calendar days of being notified of the final revocation, refusal
to renew, or suspension, the licensee shall provide the commissioner, the lead agencies as defined in section
256B.0911, county adult protection and case managers, and the ombudsman for long-term care with the
following information:
(1) a list of all residents, including full names and all contact information on file;
(2) a list of the resident’s legal representatives and designated representatives and family or other contacts
listed in the assisted living contract, including full names and all contact information on file;
(3) the location or current residence of each resident;
(4) the payor sources for each resident, including payor source identification numbers; and
(5) for each resident, a copy of the resident service plan and a list of the types of services being provided.
(b) The revocation, refusal to renew or suspension notification requirement is satisfied by mailing the
notice to the address in the license record. The licensee shall cooperate with the commissioner and the lead
agencies, county adult protection and case managers, and the ombudsman for long-term care during the
process of transferring care of residents to qualified providers. Within three calendar days of being notified
of the final revocation, refusal to renew, or suspension action, the facility must notify and disclose to each
of the residents, or the resident’s legal and designated representatives or emergency contact persons, that the
commissioner is taking action against the facility’s license by providing a copy of the revocation, refusal to
renew, or suspension notice issued by the commissioner. If the facility does not comply with the disclosure
requirements in this section, the commissioner shall notify the residents, legal and designated representatives,
or emergency contact persons about the actions being taken. Lead agencies, county adult protection, and
case managers, and the Office of Ombudsman for Long-Term Care may also provide this information. The
revocation, refusal to renew, or suspension notice is public data except for any private data contained therein.
(c) A facility subject to this subdivision may continue operating while residents are being transferred
to other service providers.
Subd. 16. Hearing. Within 15 business days of receipt of the licensee’stimely appeal of a sanction under
this section, other than for a temporary suspension, the commissioner shall request the assignment of an
administrative law judge. The commissioner’s request must include a proposed date, time, and place of
hearing. A hearing must be conducted by an administrative law judge pursuant to Minnesota Rules, parts
1400.8505 to 1400.8612, within 90 calendar days of the request for assignment, unless an extension is
requested by either party and granted by the administrative law judge for good cause or for purposes of
discussing settlement. In no case shall one or more extensions be granted for a total of more than 90 calendar
days unless there is a criminal action pending against the licensee. If, while a licensee continues to operate
pending an appeal of an order for revocation, suspension, or refusal to renew a license, the commissioner
identifies one or more new violations of law that meet the requirements of Level 3 or Level 4 violations as
defined in section 144G.31, the commissioner shall act immediately to temporarily suspend the license.
Subd. 17. Expedited hearing. (a) Within five business days of receipt of the licensee’s timely appeal
of a temporary suspension or issuance of a conditional license, the commissioner shall request assignment
of an administrative law judge. The request must include a proposed date, time, and place of a hearing. A
hearing must be conducted by an administrative law judge pursuant to Minnesota Rules, parts 1400.8505
to 1400.8612, within 30 calendar days of the request for assignment, unless an extension is requested by
either party and granted by the administrative law judge for good cause. The commissioner shall issue a
notice of hearing by certified mail or personal service at least ten business days before the hearing. Certified
mail to the last known address is sufficient. The scope of the hearing shall be limited solely to the issue of
whether the temporary suspension or issuance of a conditional license should remain in effect and whether
there is sufficient evidence to conclude that the licensee’s actions or failure to comply with applicable laws
are Level 3 or Level 4 violations as defined in section 144G.31, or that there were violations that posed an
imminent risk of harm to the resident’s health and safety.
(b) The administrative law judge shall issue findings of fact, conclusions, and a recommendation within
ten business days from the date of hearing. The parties shall have ten calendar days to submit exceptions to
the administrative law judge’s report. The record shall close at the end of the ten-day period for submission
of exceptions. The commissioner’s final order shall be issued within ten business days from the close of the
record. When an appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed,
the commissioner shall issue a final order affirming the temporary immediate suspension or conditional
license within ten calendar days of the commissioner’s receipt of the withdrawal or dismissal. The licensee
is prohibited from operation during the temporary suspension period.
(c) When the final order under paragraph (b) affirms an immediate suspension, and a final licensing
sanction is issued under subdivisions 1 and 2 and the licensee appealsthatsanction, the licensee is prohibited
from operation pending a final commissioner’s order after the contested case hearing conducted under chapter14.
(d) A licensee whose license is temporarily suspended must comply with the requirements for notification
and transfer of residents under subdivision 15. These requirements remain if an appeal is requested.
Subd. 18. Time limits for appeals. To appeal the assessment of civil penalties under section 144G.31,
and an action against a license under this section, a licensee must request a hearing no later than 15 business
days after the licensee receives notice of the action.
Subd. 19. Relicensing. If a facility license is revoked, a new application for a license may be considered
by the commissioner when the conditions upon which the revocation was based have been corrected and
satisfactory evidence of this fact has been furnished to the commissioner. A new license may be granted
after an inspection has been made and the facility has complied with all provisions of this chapter and adopted
rules.
Subd. 20. Informal conference. At any time, the commissioner and the applicant, licensee, manager if
applicable, or facility may hold an informal conference to exchange information, clarify issues, or resolve
issues.
Subd. 21. Injunctive relief. In addition to any other remedy provided by law, the commissioner may
bring an action in district court to enjoin a person who is involved in the management, operation, or control
of a facility or an employee of the facility from illegally engaging in activities regulated by this chapter. The
commissioner may bring an action under this subdivision in the district court in Ramsey County or in the
district in which the facility is located. The court may grant a temporary restraining order in the proceeding
if continued activity by the person who is involved in the management, operation, or control of a facility,
or by an employee of the facility, would create an imminent risk of harm to a resident.
Subd. 22. Subpoena. In matters pending before the commissioner under this chapter, the commissioner
may issue subpoenas and compel the attendance of witnesses and the production of all necessary papers,
books, records, documents, and other evidentiary material. If a person fails or refuses to comply with a
subpoena or order of the commissioner to appear or testify regarding any matter about which the person
may be lawfully questioned or to produce any papers, books, records, documents, or evidentiary materials
in the matter to be heard, the commissioner may apply to the district court in any district, and the court shall
order the person to comply with the commissioner’s order or subpoena. The commissioner may administer
oaths to witnesses or take their affirmation. Depositions may be taken in or outside the state in the manner
provided by law for taking depositions in civil actions. A subpoena or other process or paper may be served
on a named person anywhere in the state by an officer authorized to serve subpoenas in civil actions, with
the same fees and mileage and in the same manner as prescribed by law for a process issued out of a district
court. A person subpoenaed under this subdivision shall receive the same fees, mileage, and other costs that
are paid in proceedings in district court.