144G.80 ADDITIONAL LICENSING REQUIREMENTS FOR ASSISTED LIVING FACILITIES
WITH DEMENTIA CARE.
Subdivision 1. Applicability. This section applies only to assisted living facilities with dementia care.
Subd. 2. Demonstrated capacity. (a) An applicant for licensure as an assisted living facility with
dementia care must have the ability to provide services in a manner that is consistent with the requirements
in this section. The commissioner shall consider the following criteria, including, but not limited to:
(1) the experience of the applicant in managing residents with dementia or previous long-term care
(2) the compliance history of the applicant in the operation of any care facility licensed, certified, or
registered under federal or state law.
(b) If the applicant does not have experience in managing residents with dementia, the applicant must
employ a consultant for at least the first six months of operation. The consultant must meet the requirements
in paragraph (a), clause (1), and make recommendations on providing dementia care services consistent
with the requirements of this chapter. The consultant must (1) have two years of work experience related to
dementia, health care, gerontology, or a related field, and (2) have completed at least the minimum core
training requirements in section 144G.64. The applicant must document an acceptable plan to address the
consultant’s identified concerns and must either implement the recommendations or document in the plan
any consultant recommendations that the applicant chooses not to implement. The commissioner must review
the applicant’s plan upon request.
(c) The commissioner shall conduct an on-site inspection prior to the issuance of an assisted living
facility with a dementia care license to ensure compliance with the physical environment requirements.
(d) The label “Assisted Living Facility with Dementia Care” must be identified on the license.
Subd. 3. Relinquishing license. (a) The licensee must notify the commissioner and the Office of
Ombudsman for Long-Term Care in writing at least 60 calendar days prior to the voluntary relinquishment
of an assisted living facility with a dementia care license. For voluntary relinquishment, the facility must at
(1) give all residents and they’re designated and legal representatives 60 calendar days’ notice. The notice
must include at a minimum:
(i) the proposed effective date of the relinquishment;
(ii) changes in staffing;
(iii) changes in services including the elimination or addition of services;
(iv) staff training that shall occur when the relinquishment becomes effective; and
(v) contact information for the Office of Ombudsman for Long-Term Care;
(2) submit a transitional plan to the commissioner demonstrating how the current residents shall be
evaluated and assessed to reside in other housing settings that are not an assisted living facility with dementia
care, that are physically unsecured, or that would require move-out or transfer to other settings;
(3) change service or care plans as appropriate to address any needs the residents may have with the
(4) notify the commissioner when the relinquishment process has been completed; and
(5) revise advertising materials and disclosure information to remove any reference that the facility is
an assisted living facility with dementia care.
(b) Nothing in this section alters obligations under section 144G.57.
144G.81 ADDITIONAL REQUIREMENTS FOR ASSISTED LIVINGFACILITIESWITHSECURED
DEMENTIA CARE UNITS.
Subdivision 1. Fire protection and physical environment. An assisted living facility with dementia
care that has a secured dementia care unit must meet the requirements of section 144G.45 and the following
(1) a hazard vulnerability assessment or safety risk must be performed on and around the property. The
hazards indicated on the assessment must be assessed and mitigated to protect the residents from harm; and
(2) the facility shall be protected throughout by an approved supervised automatic sprinkler system by
August 1, 2029.
Subd. 2. Fire drills. Fire drills in secured dementia care units in assisted living facilities with dementia
care shall be conducted in accordance with the NFPA Standard 101, Life Safety Code, Healthcare (limited
Subd. 3. Assisted living facilities with dementia care and secured dementia care unit; Life Safety
Code. (a) All assisted living facilities with dementia care and a secured dementia care unit must meet the
applicable provisions of the most current edition of the NFPA Standard 101, Life Safety Code, Healthcare
(limited care) chapter. The minimum design standards shall be met for all new licenses, new construction,
modifications, renovations, alterations, changes of use, or additions.
(b) If the commissioner decides to update the Life Safety Code for purposes of this subdivision, the
commissioner must notify the chairs and ranking minority members of the legislative committees and
divisions with jurisdiction over health care and public safety of the planned update by January 15 of the year
in which the new Life Safety Code will become effective. Following notice from the commissioner, the new
edition shall become effective for assisted living facilities with dementia care and a secured dementia care
unit beginning August 1 of that year, unless provided otherwise in law. The commissionershall, by publication
in the State Register,specify a date by which these facilities must comply with the updated Life Safety Code.
The date by which these facilities must comply shall not be sooner than six months after publication of the
commissioner’s notice in the State Register.
Subd. 4. Awake staff requirement. An assisted living facility with dementia care providing services
in a secured dementia care unit must have an awake person who is physically present in the secured dementia
care unit 24 hours per day, seven days per week, who is responsible for responding to the requests of residents
for assistance with health and safety needs, and who meets the requirements of section 144G.41,subdivision
1, clause (12).
Subd. 5. Variance or waiver. A facility may request under section 144G.45, subdivision 7, that the
commissioner grants a variance or waiver from the provisions of this section, except subdivision 4.
144G.82 ADDITIONAL RESPONSIBILITIES OF ADMINISTRATION FOR ASSISTED LIVING
FACILITIES WITH DEMENTIA CARE.
Subdivision 1. General. The licensee of an assisted living facility with dementia care is responsible for
the care and housing of the persons with dementia and the provision of person-centered care that promotes
Official Publication of the State of Minnesota each resident’s dignity, independence, and comfort.
This includes the supervision, training, and overall conduct of the staff.
Subd. 2. Additional requirements. (a) The licensee must follow the assisted living license requirements
and the criteria in this section.
(b) The assisted living director of an assisted living facility with dementia care must complete and
a document that at least ten hours of the required annual continuing education requirements relate to the
care of individuals with dementia. The training must include medical management of dementia, creating
and maintaining supportive and therapeutic environments for residents with dementia, and transitioning and
coordinating services for residents with dementia. Continuing education credits may include college courses,
preceptor credits, self-directed activities, course instructor credits, corporate training, in-service training,
professional association training, web-based training, correspondence courses, telecourses, seminars, and
Subd. 3. Policies. (a) In addition to the policies and procedures required in the licensing of all facilities,
the assisted living facility with dementia care licensee must develop and implement policies and procedures
that address the:
(1) philosophy of how services are provided based upon the assisted living facility licensee’s values,
mission, and promotion of person-centered care and how the philosophy shall be implemented;
(2) evaluation of behavioral symptoms and design of supports for intervention plans, including
nonpharmacological practices that are person-centered and evidence-informed;
(3) wandering and egress prevention that provides detailed instructions to staff in the event a resident
(4) medication management, including an assessment of residents for the use and effects of medications,
including psychotropic medications;
(5) staff training specific to dementia care;
(6) description of life enrichment programs and how activities are implemented;
(7) description of family support programs and efforts to keep the family engaged;
(8) limiting the use of public address and intercom systems for emergencies and evacuation drills only;
(9) transportation coordination and assistance to and from outside medical appointments; and
(10) safekeeping of residents’ possessions.
(b) The policies and procedures must be provided to residents and the residents’ legal and designated
representatives at the time of move-in.
144G.83 ADDITIONAL TRAINING REQUIREMENTS FOR ASSISTED LIVING FACILITIES
WITH DEMENTIA CARE.
Subdivision 1. General. (a) An assisted living facility with dementia care must provide residents with
dementia-trained staff who have been instructed in the person-centered care approach. All direct care staff
assigned to care for residents with dementia must be specially trained to work with residents with Alzheimer’s
disease and other dementias.
(b) Only staff trained as specified in subdivisions 2 and 3 shall be assigned to care for dementia residents.
(c) Staffing levels must be sufficient to meet the scheduled and unscheduled needs of residents. Staffing
levels during nighttime hours shall be based on the sleep patterns and needs of residents.
(d) In an emergency situation when trained staff are not available to provide services, the facility may
assign staff who have not completed the required training. The particular emergency situation must be
documented and must address:
(1) the nature of the emergency;
(2) how long the emergency lasted; and
(3) the names and positions of staff that provided coverage.
Subd. 2. Staffing requirements. (a) The licensee must ensure that staff who provide support to residents
with dementia can demonstrate a basic understanding and ability to apply dementia training to the residents’
emotional and unique health care needs using person-centered planning delivery. Direct care dementia-trained
staff and other staff must be trained on the topics identified during the expedited rulemaking process. These
requirements are in addition to the licensing requirements for training.
(b) Failure to comply with paragraph (a) or subdivision 1 shall result in a fine under section 144G.31.
Subd. 3. Supervising staff training. Persons providing or overseeing staff training must have experience
and knowledge in the care of individuals with dementia, including:
(1) two years of work experience related to Alzheimer’s disease or other dementias, or in health care,
gerontology, or another related field; and
(2) completion of training equivalent to the requirements in this section and successfully passing a skills
competency or knowledge test required by the commissioner.
Subd. 4. Preservice and in-service training. Preservice and in-service training may include various
methods of instruction, such as classroom style, web-based training, video, or one-to-one training. The
licensee must have a method for determining and documenting each staff person’s knowledge and
understanding of the training provided. All training must be documented.
144G.84 SERVICES FOR RESIDENTS WITH DEMENTIA.
(a) In addition to the minimum services required in section 144G.41, an assisted living facility with
dementia care must also provide the following services:
(1) assistance with activities of daily living that address the needs of each resident with dementia due
to cognitive or physical limitations. These services must meet or be in addition to the requirements in the
licensing rules for the facility. Services must be provided in a person-centered manner that promotes resident
choice, dignity, and sustains the resident’s abilities;
(2) nonpharmacological practices that are person-centered and evidence-informed;
(3) services to prepare and educate persons living with dementia and their legal and designated
representatives about transitions in care and ensuring complete, timely communication between, across, and
within settings; and
(4) services that provide residents with choices for meaningful engagement with other facility residents
and the broader community.
(b) Each resident must be evaluated for activities according to the licensing rules of the facility. In
addition, the evaluation must address the following:
(1) past and current interests;
(2) current abilities and skills;
(3) emotional and social needs and patterns;
(4) physical abilities and limitations;
(5) adaptations necessary for the resident to participate; and
(6) identification of activities for behavioral interventions.
(c) An individualized activity plan must be developed for each resident based on their activity evaluation.
The plan must reflect the resident’s activity preferences and needs.
(d) A selection of daily structured and non-structured activities must be provided and included on the
resident’s activity service or care plan as appropriate. Daily activity options based on resident evaluation
may include but are not limited to:
(1) occupation or chore related tasks;
(2) scheduled and planned events such as entertainment or outings;
(3) spontaneous activities for enjoyment or those that may help defuse a behavior;
(4) one-to-one activities that encourage positive relationships between residents and staff such as telling
a life story, reminiscing, or playing music;
(5) spiritual, creative, and intellectual activities;
(6) sensory stimulation activities;
(7) physical activities that enhance or maintain a resident’s ability to ambulate or move; and
(8) outdoor activities.
(e) Behavioral symptoms that negatively impact the resident and others in the assisted living facility
with dementia care must be evaluated and included in the service or care plan. The staff must initiate and
coordinate outside consultation or acute care when indicated.
(f) Support must be offered to family and other significant relationships on a regularly scheduled basis
but not less than quarterly.
(g) Access to secured outdoor space and walkways that allow residents to enter and return without staff
assistance must be provided.