1.1 A bill for an act 1.2 relating to health; modifying consent to electronic monitoring requirements; 1.3 modifying provisions related to retaliation in nursing homes and assisted living 1.4 facilities; expanding membership and duties of the home care and assisted living 1.5 program advisory council; modifying the hospice bill of rights; prohibiting required 1.6 binding arbitration agreements in assisted living contracts; modifying medication 1.7 management requirements; modifying authority of health care agents to restrict 1.8 visitation and communication; amending Minnesota Statutes 2024, sections 1.9 144.6502, subdivision 3; 144.6512, subdivision 3, by adding a subdivision; 1.10 144A.04, by adding a subdivision; 144A.474, subdivision 11; 144A.4799; 1.11 144A.751, subdivision 1; 144G.08, by adding a subdivision; 144G.31, subdivision 1.12 8; 144G.51; 144G.71, subdivisions 3, 5; 144G.92, subdivision 2, by adding a 1.13 subdivision; 145C.07, by adding a subdivision; 145C.10. 1.14BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.15 Section 1. Minnesota Statutes 2024, section 144.6502, subdivision 3, is amended to read: 1.16 Subd. 3.Consent to electronic monitoring.(a) Except as otherwise provided in this 1.17subdivision, a resident must consent to electronic monitoring in the resident's room or private 1.18living unit in writing on a notification and consent form. If the resident has not affirmatively 1.19objected to electronic monitoring and the resident representative attests that the resident's 1.20medical professional determines determined that the resident currently lacks the ability to 1.21understand and appreciate the nature and consequences of electronic monitoring, the resident 1.22representative may consent on behalf of the resident. For purposes of this subdivision, a 1.23resident affirmatively objects when the resident orally, visually, or through the use of 1.24auxiliary aids or services declines electronic monitoring. The resident's response must be 1.25documented on the notification and consent form. 1Section 1. S1918-2 2nd EngrossmentSF1918 REVISOR SGS SENATE STATE OF MINNESOTA S.F. No. 1918NINETY-FOURTH SESSION (SENATE AUTHORS: DIBBLE and Hoffman) OFFICIAL STATUSD-PGDATE Introduction and first reading55902/27/2025 Referred to Health and Human Services Comm report: No recommendation, re-referred to Human Services74003/13/2025 Author added Hoffman102803/24/2025 Comm report: Amended, No recommendation, re-referred to Judiciary and Public Safety1045a03/27/2025 Comm report: To pass as amended and re-refer to State and Local Government04/01/2025 2.1 (b) Prior to a resident representative consenting on behalf of a resident, the resident must 2.2be asked if the resident wants electronic monitoring to be conducted. The resident 2.3representative must explain to the resident: 2.4 (1) the type of electronic monitoring device to be used; 2.5 (2) the standard conditions that may be placed on the electronic monitoring device's use, 2.6including those listed in subdivision 6; 2.7 (3) with whom the recording may be shared under subdivision 10 or 11; and 2.8 (4) the resident's ability to decline all recording. 2.9 (c) A resident, or resident representative when consenting on behalf of the resident, may 2.10consent to electronic monitoring with any conditions of the resident's or resident 2.11representative's choosing, including the list of standard conditions provided in subdivision 2.126. A resident, or resident representative when consenting on behalf of the resident, may 2.13request that the electronic monitoring device be turned off or the visual or audio recording 2.14component of the electronic monitoring device be blocked at any time. 2.15 (d) Prior to implementing electronic monitoring, a resident, or resident representative 2.16when acting on behalf of the resident, must obtain the written consent on the notification 2.17and consent form of any other resident residing in the shared room or shared private living 2.18unit. A roommate's or roommate's resident representative's written consent must comply 2.19with the requirements of paragraphs (a) to (c). Consent by a roommate or a roommate's 2.20resident representative under this paragraph authorizes the resident's use of any recording 2.21obtained under this section, as provided under subdivision 10 or 11. 2.22 (e) Any resident conducting electronic monitoring must immediately remove or disable 2.23an electronic monitoring device prior to a new roommate moving into a shared room or 2.24shared private living unit, unless the resident obtains the roommate's or roommate's resident 2.25representative's written consent as provided under paragraph (d) prior to the roommate 2.26moving into the shared room or shared private living unit. Upon obtaining the new 2.27roommate's signed notification and consent form and submitting the form to the facility as 2.28required under subdivision 5, the resident may resume electronic monitoring. 2.29 (f) The resident or roommate, or the resident representative or roommate's resident 2.30representative if the representative is consenting on behalf of the resident or roommate, may 2.31withdraw consent at any time and the withdrawal of consent must be documented on the 2.32original consent form as provided under subdivision 5, paragraph (d). 2Section 1. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 3.1 Sec. 2. Minnesota Statutes 2024, section 144.6512, subdivision 3, is amended to read: 3.2 Subd. 3.Retaliation against a resident.A resident has the right to be free from 3.3retaliation. For purposes of this section, to retaliate against a resident includes but is not 3.4limited to any of the following actions taken or threatened by a nursing home or an agent 3.5of the nursing home against a resident, or any person with a familial, personal, legal, or 3.6professional relationship with the resident: 3.7 (1) a discharge or transfer; 3.8 (2) any form of discrimination; 3.9 (3) restriction or prohibition of access: 3.10 (i) of the resident to the nursing home or visitors; or 3.11 (ii) of a family member or a person with a personal, legal, or professional relationship 3.12with the resident, to the resident, unless the restriction is the result of a court order; 3.13 (4) the imposition of involuntary seclusion or the withholding of food, care, or services; 3.14 (5) restriction of any of the rights granted to residents under state or federal law; 3.15 (6) restriction or reduction of access to or use of amenities, care, services, privileges, or 3.16living arrangements; or 3.17 (7) unauthorized removal, tampering with, or deprivation of technology, communication, 3.18or electronic monitoring devices. 3.19 Sec. 3. Minnesota Statutes 2024, section 144.6512, is amended by adding a subdivision 3.20to read: 3.21 Subd. 5a.Other remedies.In addition to the remedies otherwise provided by or available 3.22under the law, a resident or a resident's legal representative may bring an action in district 3.23court against a nursing home that retaliates against the resident in violation of this section. 3.24The court may award damages, injunctive relief, and any other relief the court deems just 3.25and equitable. 3.26 EFFECTIVE DATE.This section is effective August 1, 2025, and applies to causes 3.27of action accruing on or after that date. 3Sec. 3. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 4.1 Sec. 4. Minnesota Statutes 2024, section 144A.04, is amended by adding a subdivision to 4.2read: 4.3 Subd. 13.Retaliation prevention training required.All employees of a nursing home, 4.4including managerial officials and licensed administrators, must participate in annual training 4.5on the requirements of section 144.6512 and preventing retaliation against nursing home 4.6residents. 4.7 Sec. 5. Minnesota Statutes 2024, section 144A.474, subdivision 11, is amended to read: 4.8 Subd. 11.Fines.(a) Fines and enforcement actions under this subdivision may be assessed 4.9based on the level and scope of the violations described in paragraph (b) and imposed 4.10immediately with no opportunity to correct the violation first as follows: 4.11 (1) Level 1, no fines or enforcement; 4.12 (2) Level 2, a fine of $500 per violation, in addition to any of the enforcement 4.13mechanisms authorized in section 144A.475 for widespread violations; 4.14 (3) Level 3, a fine of $3,000 per incident, in addition to any of the enforcement 4.15mechanisms authorized in section 144A.475; 4.16 (4) Level 4, a fine of $5,000 per incident, in addition to any of the enforcement 4.17mechanisms authorized in section 144A.475; 4.18 (5) for maltreatment violations for which the licensee was determined to be responsible 4.19for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000. 4.20A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible 4.21for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury; 4.22and 4.23 (6) the fines in clauses (1) to (4) are increased and immediate fine imposition is authorized 4.24for both surveys and investigations conducted. 4.25 When a fine is assessed against a facility for substantiated maltreatment, the commissioner 4.26shall not also impose an immediate fine under this chapter for the same circumstance. 4.27 (b) Correction orders for violations are categorized by both level and scope and fines 4.28shall be assessed as follows: 4.29 (1) level of violation: 4.30 (i) Level 1 is a violation that has no potential to cause more than a minimal impact on 4.31the client and does not affect health or safety; 4Sec. 5. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 5.1 (ii) Level 2 is a violation that did not harm a client's health or safety but had the potential 5.2to have harmed a client's health or safety, but was not likely to cause serious injury, 5.3impairment, or death; 5.4 (iii) Level 3 is a violation that harmed a client's health or safety, not including serious 5.5injury, impairment, or death, or a violation that has the potential to lead to serious injury, 5.6impairment, or death; and 5.7 (iv) Level 4 is a violation that results in serious injury, impairment, or death; 5.8 (2) scope of violation: 5.9 (i) isolated, when one or a limited number of clients are affected or one or a limited 5.10number of staff are involved or the situation has occurred only occasionally; 5.11 (ii) pattern, when more than a limited number of clients are affected, more than a limited 5.12number of staff are involved, or the situation has occurred repeatedly but is not found to be 5.13pervasive; and 5.14 (iii) widespread, when problems are pervasive or represent a systemic failure that has 5.15affected or has the potential to affect a large portion or all of the clients. 5.16 (c) If the commissioner finds that the applicant or a home care provider has not corrected 5.17violations by the date specified in the correction order or conditional license resulting from 5.18a survey or complaint investigation, the commissioner shall provide a notice of 5.19noncompliance with a correction order by email to the applicant's or provider's last known 5.20email address. The noncompliance notice must list the violations not corrected. 5.21 (d) For every violation identified by the commissioner, the commissioner shall issue an 5.22immediate fine pursuant to paragraph (a), clause (6). The license holder must still correct 5.23the violation in the time specified. The issuance of an immediate fine can occur in addition 5.24to any enforcement mechanism authorized under section 144A.475. The immediate fine 5.25may be appealed as allowed under this subdivision. 5.26 (e) The license holder must pay the fines assessed on or before the payment date specified. 5.27If the license holder fails to fully comply with the order, the commissioner may issue a 5.28second fine or suspend the license until the license holder complies by paying the fine. A 5.29timely appeal shall stay payment of the fine until the commissioner issues a final order. 5.30 (f) A license holder shall promptly notify the commissioner in writing when a violation 5.31specified in the order is corrected. If upon reinspection the commissioner determines that 5.32a violation has not been corrected as indicated by the order, the commissioner may issue a 5.33second fine. The commissioner shall notify the license holder by mail to the last known 5Sec. 5. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 6.1address in the licensing record that a second fine has been assessed. The license holder may 6.2appeal the second fine as provided under this subdivision. 6.3 (g) A home care provider that has been assessed a fine under this subdivision has a right 6.4to a reconsideration or a hearing under this section and chapter 14. 6.5 (h) When a fine has been assessed, the license holder may not avoid payment by closing, 6.6selling, or otherwise transferring the licensed program to a third party. In such an event, the 6.7license holder shall be liable for payment of the fine. 6.8 (i) In addition to any fine imposed under this section, the commissioner may assess a 6.9penalty amount based on costs related to an investigation that results in a final order assessing 6.10a fine or other enforcement action authorized by this chapter. 6.11 (j) Fines collected under paragraph (a), clauses (1) to (4), shall be deposited in a dedicated 6.12special revenue account. On an annual basis, the balance in the special revenue account 6.13shall be appropriated to the commissioner to implement the recommendations of the advisory 6.14council established in section 144A.4799. The commissioner must publish on the department's 6.15website an annual report on the fines assessed and collected, and how the appropriated 6.16money was allocated. 6.17 (k) Fines collected under paragraph (a), clause (5), shall be deposited in a dedicated 6.18special revenue account and appropriated to the commissioner to provide compensation 6.19according to subdivision 14 to clients subject to maltreatment. A client may choose to receive 6.20compensation from this fund, not to exceed $5,000 for each substantiated finding of 6.21maltreatment, or take civil action. This paragraph expires July 31, 2021. 6.22 Sec. 6. Minnesota Statutes 2024, section 144A.4799, is amended to read: 6.23 144A.4799 DEPARTMENT OF HEALTH LICENSED HOME CARE PROVIDER 6.24AND ASSISTED LIVING ADVISORY COUNCIL. 6.25 Subdivision 1.Membership.The commissioner of health shall appoint 13 14 persons 6.26to a home care and assisted living program advisory council consisting of the following: 6.27 (1) two four public members as defined in section 214.02 who shall be persons who are 6.28currently receiving home care services, persons who have received home care services 6.29within five years of the application date, persons who have family members receiving home 6.30care services, or persons who have family members who have received home care services 6.31within five years of the application date, one of whom must be a person who either is 6.32receiving or has received home care services within the five years prior to initial appointment, 6.33one of whom must be a person who has or had a family member receiving home care services 6Sec. 6. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 7.1within the five years prior to initial appointment, one of whom must be a person who either 7.2is or has been a resident in an assisted living facility within the five years prior to initial 7.3appointment, and one of whom must be a person who has or had a family member residing 7.4in an assisted living facility within the five years prior to initial appointment; 7.5 (2) two Minnesota home care licensees representing basic and comprehensive levels of 7.6licensure who may be a managerial official, an administrator, a supervising registered nurse, 7.7or an unlicensed personnel performing home care tasks; 7.8 (3) one member representing the Minnesota Board of Nursing; 7.9 (4) one member representing the Office of Ombudsman for Long-Term Care; 7.10 (5) one member representing the Office of Ombudsman for Mental Health and 7.11Developmental Disabilities; 7.12 (6) beginning July 1, 2021, one member of a county health and human services or county 7.13adult protection office; 7.14 (7) two Minnesota assisted living facility licensees representing assisted living facilities 7.15and assisted living facilities with dementia care levels of licensure who may be the facility's 7.16assisted living director, managerial official, or clinical nurse supervisor; 7.17 (8) one organization representing long-term care providers, home care providers, and 7.18assisted living providers in Minnesota; and 7.19 (9) two public members as defined in section 214.02. One public member shall be a 7.20person who either is or has been a resident in an assisted living facility and one public 7.21member shall be a person who has or had a family member living in an assisted living 7.22facility setting one representative of a consumer advocacy organization representing 7.23individuals receiving long-term care from licensed home care or assisted living providers. 7.24 Subd. 2.Organizations and meetings.The advisory council shall be organized and 7.25administered under section 15.059 with per diems and costs paid within the limits of available 7.26appropriations. Meetings will be held quarterly and hosted by the department. Subcommittees 7.27may be developed as necessary by the commissioner. Advisory council meetings are subject 7.28to the Open Meeting Law under chapter 13D. 7.29 Subd. 3.Duties.(a) At the commissioner's request, the advisory council shall provide 7.30advice regarding regulations of Department of Health licensed assisted living and home 7.31care providers in this chapter and chapter 144G, including advice on the following: 7.32 (1) community standards for home care practices; 7Sec. 6. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 8.1 (2) enforcement of licensing standards and whether certain disciplinary actions are 8.2appropriate; 8.3 (3) ways of distributing information to licensees and consumers of .home care and 8.4assisted living services defined under chapter 144G; 8.5 (4) training standards; 8.6 (5) identifying emerging issues and opportunities in home care and assisted living services 8.7defined under chapter 144G; 8.8 (6) identifying the use of technology in home and telehealth capabilities; 8.9 (7) allowable home care licensing modifications and exemptions, including a method 8.10for an integrated license with an existing license for rural licensed nursing homes to provide 8.11limited home care services in an adjacent independent living apartment building owned by 8.12the licensed nursing home; and 8.13 (8) recommendations for studies using the data in section 62U.04, subdivision 4, including 8.14but not limited to studies concerning costs related to dementia and chronic disease among 8.15an elderly population over 60 and additional long-term care costs, as described in section 8.1662U.10, subdivision 6. 8.17 (b) The advisory council shall perform other duties as directed by the commissioner. 8.18 (c) The advisory council shall annually make recommendations annually to the 8.19commissioner for the purposes of allocating the appropriation in section sections 144A.474, 8.20subdivision 11, paragraph (i) (j), and 144G.31, subdivision 8. The recommendations shall 8.21address ways the commissioner may improve protection of the public under existing statutes 8.22and laws and improve quality of care. The council's recommendations may include but are 8.23not limited to special projects or initiatives that: 8.24 (1) create and administer training of licensees and ongoing training for their employees 8.25to improve clients' and residents' lives, supporting ways that support licensees, can improve 8.26and enhance quality care, and ways to provide technical assistance to licensees to improve 8.27compliance; 8.28 (2) develop and implement information technology and data projects that analyze and 8.29communicate information about trends of in violations or lead to ways of improving resident 8.30and client care; 8.31 (3) improve communications strategies to licensees and the public; 8.32 (4) recruit and retain direct care staff; 8Sec. 6. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 9.1 (5) ensure sufficient education related to the care of vulnerable adults in professional 9.2nursing programs, nurse aide programs, and home health aide programs; and 9.3 (6) other projects or pilots that benefit residents, clients, families, and the public in other 9.4ways. 9.5 EFFECTIVE DATE.This section is effective July 1, 2025, and the amendments to 9.6subdivision 1, clause (1), apply to members whose initial appointment occurs on or after 9.7that date. 9.8 Sec. 7. Minnesota Statutes 2024, section 144A.751, subdivision 1, is amended to read: 9.9 Subdivision 1.Statement of rights.An individual who receives hospice care has the 9.10right to: 9.11 (1) receive written information about rights in advance of receiving hospice care or 9.12during the initial evaluation visit before the initiation of hospice care, including what to do 9.13if rights are violated; 9.14 (2) receive care and services according to a suitable hospice plan of care and subject to 9.15accepted hospice care standards and to take an active part in creating and changing the plan 9.16and evaluating care and services; 9.17 (3) be told in advance of receiving care about the services that will be provided, the 9.18disciplines that will furnish care, the frequency of visits proposed to be furnished, other 9.19choices that are available, and the consequence of these choices, including the consequences 9.20of refusing these services; 9.21 (4) be told in advance, whenever possible, of any change in the hospice plan of care and 9.22to take an active part in any change; 9.23 (5) refuse services or treatment; 9.24 (6) know, in advance, any limits to the services available from a provider, and the 9.25provider's grounds for a termination of services; 9.26 (7) know in advance of receiving care whether the hospice services may be covered by 9.27health insurance, medical assistance, Medicare, or other health programs in which the 9.28individual is enrolled; 9.29 (8) receive, upon request, a good faith estimate of the reimbursement the provider expects 9.30to receive from the health plan company in which the individual is enrolled. A good faith 9.31estimate must also be made available at the request of an individual who is not enrolled in 9Sec. 7. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 10.1a health plan company. This payment information does not constitute a legally binding 10.2estimate of the cost of services; 10.3 (9) know that there may be other services available in the community, including other 10.4end of life services and other hospice providers, and know where to go for information 10.5about these services; 10.6 (10) choose freely among available providers and change providers after services have 10.7begun, within the limits of health insurance, medical assistance, Medicare, or other health 10.8programs; 10.9 (11) have personal, financial, and medical information kept private and be advised of 10.10the provider's policies and procedures regarding disclosure of such information; 10.11 (12) be allowed access to records and written information from records according to 10.12sections 144.291 to 144.298; 10.13 (13) be served by people who are properly trained and competent to perform their duties; 10.14 (14) be treated with courtesy and respect and to have the patient's property treated with 10.15respect; 10.16 (15) voice grievances regarding treatment or care that is, or fails to be, furnished or 10.17regarding the lack of courtesy or respect to the patient or the patient's property; 10.18 (16) be free from physical and verbal abuse; 10.19 (17) reasonable, advance notice of changes in services or charges, including at least ten 10.20days' advance notice of the termination of a service by a provider, except in cases where: 10.21 (i) the recipient of services engages in conduct that alters the conditions of employment 10.22between the hospice provider and the individual providing hospice services, or creates an 10.23abusive or unsafe work environment for the individual providing hospice services; 10.24 (ii) an emergency for the informal caregiver or a significant change in the recipient's 10.25condition has resulted in service needs that exceed the current service provider agreement 10.26and that cannot be safely met by the hospice provider; or 10.27 (iii) the recipient is no longer certified as terminally ill; 10.28 (18) a coordinated transfer when there will be a change in the provider of services; 10.29 (19) know how to contact an individual associated with the provider who is responsible 10.30for handling problems and to have the provider investigate and attempt to resolve the 10.31grievance or complaint; 10Sec. 7. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 11.1 (20) know the name and address of the state or county agency to contact for additional 11.2information or assistance; 11.3 (21) assert these rights personally, or have them asserted by the hospice patient's family 11.4when the patient has been judged incompetent, without retaliation; and 11.5 (22) have pain and symptoms managed to the patient's desired level of comfort, including 11.6ensuring appropriate pain medications are immediately available to the patient; 11.7 (23) revoke hospice election at any time; and 11.8 (24) receive curative treatment for any condition unrelated to the condition that qualified 11.9the individual for hospice, while remaining on hospice election. 11.10Sec. 8. Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision to 11.11read: 11.12 Subd. 55a.Registered nurse."Registered nurse" has the meaning given in section 11.13148.171, subdivision 20. 11.14Sec. 9. Minnesota Statutes 2024, section 144G.31, subdivision 8, is amended to read: 11.15 Subd. 8.Deposit of fines.Fines collected under this section shall be deposited in a 11.16dedicated special revenue account. On an annual basis, the balance in the special revenue 11.17account shall be appropriated to the commissioner for special projects to improve resident 11.18quality of care and outcomes in assisted living facilities licensed under this chapter in 11.19Minnesota as recommended by the advisory council established in section 144A.4799. The 11.20commissioner must publish on the department's website an annual report on the fines assessed 11.21and collected, and how the appropriated money was allocated. 11.22Sec. 10. Minnesota Statutes 2024, section 144G.51, is amended to read: 11.23 144G.51 ARBITRATION. 11.24 (a) An assisted living facility must If an assisted living facility includes an arbitration 11.25provision in the assisted living contract, the provision and contract must: 11.26 (1) clearly and conspicuously disclose, in writing in an assisted living contract, any 11.27arbitration provision in the contract that precludes, or limits, or delays the ability of a resident 11.28or the resident's agent from taking a civil action.; 11Sec. 10. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 12.1 (b) An arbitration requirement must not include a choice of law or choice of venue 12.2provision. Assisted living contracts must (2) adhere to Minnesota law and any other 12.3applicable federal or local law.; 12.4 (3) not require any resident or the resident's representative to sign a contract containing 12.5a provision for binding arbitration as a condition of admission to, or as a requirement to 12.6continue to receive care at, the facility; and 12.7 (4) explicitly inform the resident or the resident's representative of the resident's right 12.8not to sign a contract containing a provision for binding arbitration as a condition of 12.9admission to, or as a requirement to continue to receive care at, the facility. 12.10Sec. 11. Minnesota Statutes 2024, section 144G.71, subdivision 3, is amended to read: 12.11 Subd. 3.Individualized medication monitoring and reassessment.The assisted living 12.12facility A registered nurse or qualified staff delegated the task by a registered nurse must 12.13monitor and reassess the resident's medication management services as needed under 12.14subdivision 2 when the resident presents with symptoms or other issues that may be 12.15medication-related and, at a minimum, annually. 12.16Sec. 12. Minnesota Statutes 2024, section 144G.71, subdivision 5, is amended to read: 12.17 Subd. 5.Individualized medication management plan.(a) For each resident receiving 12.18medication management services, the assisted living facility a registered nurse or qualified 12.19staff delegated the task by a registered nurse must prepare and include in the service plan 12.20a written statement of the medication management services that will be provided to the 12.21resident. The facility must develop and maintain a current individualized medication 12.22management record for each resident based on the resident's assessment that must contain 12.23the following: 12.24 (1) a statement describing the medication management services that will be provided; 12.25 (2) a description of storage of medications based on the resident's needs and preferences, 12.26risk of diversion, and consistent with the manufacturer's directions; 12.27 (3) documentation of specific resident instructions relating to the administration of 12.28medications; 12.29 (4) identification of persons responsible for monitoring medication supplies and ensuring 12.30that medication refills are ordered on a timely basis; 12Sec. 12. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 13.1 (5) identification of medication management tasks that may be delegated to unlicensed 13.2personnel; 13.3 (6) procedures for staff notifying a registered nurse or appropriate licensed health 13.4professional when a problem arises with medication management services; and 13.5 (7) any resident-specific requirements relating to documenting medication administration, 13.6verifications that all medications are administered as prescribed, and monitoring of 13.7medication use to prevent possible complications or adverse reactions. 13.8 (b) The medication management record must be current and updated when there are any 13.9changes. 13.10 (c) Medication reconciliation must be completed when a licensed nurse, licensed health 13.11professional, or authorized prescriber is providing medication management. 13.12Sec. 13. Minnesota Statutes 2024, section 144G.92, subdivision 2, is amended to read: 13.13 Subd. 2.Retaliation against a resident.A resident has the right to be free from 13.14retaliation. For purposes of this section, to retaliate against a resident includes but is not 13.15limited to any of the following actions taken or threatened by a facility or an agent of the 13.16facility against a resident, or any person with a familial, personal, legal, or professional 13.17relationship with the resident: 13.18 (1) termination of a contract; 13.19 (2) any form of discrimination; 13.20 (3) restriction or prohibition of access: 13.21 (i) of the resident to the facility or visitors; or 13.22 (ii) of a family member or a person with a personal, legal, or professional relationship 13.23with the resident, to the resident, unless the restriction is the result of a court order; 13.24 (4) the imposition of involuntary seclusion or the withholding of food, care, or services; 13.25 (5) restriction of any of the rights granted to residents under state or federal law; 13.26 (6) restriction or reduction of access to or use of amenities, care, services, privileges, or 13.27living arrangements; or 13.28 (7) unauthorized removal, tampering with, or deprivation of technology, communication, 13.29or electronic monitoring devices. 13Sec. 13. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 14.1 Sec. 14. Minnesota Statutes 2024, section 144G.92, is amended by adding a subdivision 14.2to read: 14.3 Subd. 4a.Other remedies.In addition to the remedies otherwise provided by or available 14.4under the law, a resident or a resident's legal representative may bring an action in district 14.5court against a facility that retaliates against the resident in violation of this section. The 14.6court may award damages, injunctive relief, and any other relief the court deems just and 14.7equitable. 14.8 EFFECTIVE DATE.This section is effective August 1, 2025, and applies to causes 14.9of action accruing on or after that date. 14.10Sec. 15. Minnesota Statutes 2024, section 145C.07, is amended by adding a subdivision 14.11to read: 14.12 Subd. 6.Visits by others.A health care agent may not restrict the ability of the principal 14.13to communicate, visit, or interact with others, including receiving visitors, making or 14.14receiving telephone calls, sending or receiving personal mail, sending or receiving electronic 14.15communications including through social media, or participating in social activities, unless 14.16the health care agent has good cause to believe a restriction is necessary because interaction 14.17with the person poses a risk of significant physical, psychological, or financial harm to the 14.18principal, and there is no other means to avoid such significant harm. Notwithstanding 14.19section 145C.10, paragraph (c), restrictions made in violation of this subdivision carry no 14.20presumption that the health care agent is acting in good faith. 14.21Sec. 16. Minnesota Statutes 2024, section 145C.10, is amended to read: 14.22 145C.10 PRESUMPTIONS. 14.23 (a) The principal is presumed to have the capacity to execute a health care directive and 14.24to revoke a health care directive, absent clear and convincing evidence to the contrary. 14.25 (b) A health care provider or health care agent may presume that a health care directive 14.26is legally sufficient absent actual knowledge to the contrary. A health care directive is 14.27presumed to be properly executed, absent clear and convincing evidence to the contrary. 14.28 (c) Except as provided in section 145C.07, subdivision 6, a health care agent, and a 14.29health care provider acting pursuant to the direction of a health care agent, are presumed to 14.30be acting in good faith, absent clear and convincing evidence to the contrary. 14.31 (d) A health care directive is presumed to remain in effect until the principal modifies 14.32or revokes it, absent clear and convincing evidence to the contrary. 14Sec. 16. S1918-2 2nd EngrossmentSF1918 REVISOR SGS 15.1 (e) This chapter does not create a presumption concerning the intention of an individual 15.2who has not executed a health care directive and, except as otherwise provided by section 15.3145C.15, does not impair or supersede any right or responsibility of an individual to consent, 15.4refuse to consent, or withdraw consent to health care on behalf of another in the absence of 15.5a health care directive. 15.6 (f) A copy of a health care directive is presumed to be a true and accurate copy of the 15.7executed original, absent clear and convincing evidence to the contrary, and must be given 15.8the same effect as an original. 15.9 (g) When a patient lacks decision-making capacity and is pregnant, and in reasonable 15.10medical judgment there is a real possibility that if health care to sustain her life and the life 15.11of the fetus is provided the fetus could survive to the point of live birth, the health care 15.12provider shall presume that the patient would have wanted such health care to be provided, 15.13even if the withholding or withdrawal of such health care would be authorized were she not 15.14pregnant. This presumption is negated by health care directive provisions described in 15.15section 145C.05, subdivision 2, paragraph (a), clause (10), that are to the contrary, or, in 15.16the absence of such provisions, by clear and convincing evidence that the patient's wishes, 15.17while competent, were to the contrary. 15Sec. 16. S1918-2 2nd EngrossmentSF1918 REVISOR SGS