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Jan. 27, 2022
The ALL Together newsletter provides updates, details, and information about assisted living licensure for providers, residents, family members, and the public.
The Minnesota Department of Health’s Health Regulation Division (HRD) will work to provide information, news, updates, and links to resources for assisted living providers and families to help residents and loved ones live their best lives as they age in place.
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Assisted Living's Top 5 of 2021
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Assisted Living Licensure (ALL) launched on Aug. 1 with 2,000+ applications accepted, reviewed and approved within three months. It was a large undertaking that involved many people and teams from MDH’s Health Regulation Division. The project was completed successfully on time thanks to a coordinated and intentional planning effort, in addition to stakeholder collaboration. A special thank you to care providers Doug Beardsley, Jill Schewe, and others, and LeadingAge’s Bobbie Guidry, Kari Thurlow, and others for many meetings and hours of time to ensure providers had the information and education they needed to be successful.
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ALL facility required to turn heat on thanks to new law. The new Assisted Living License provided authority for the Health Regulation Division to require The Hyatt House to fix their heat as the cold winter winds began to blow. MDH was told that for that last eight years The Hyatt House was using space heaters to keep the place warm by stringing space heaters throughout the building, sometimes using extension cords in a daisy chain. While it seems simple to require a facility caring for the elderly to turn on their heat as winter approaches, MDH lacked the authority prior to the Assisted Living Licensure law. “Previously we did not have authority over the building,” Lindsey Krueger said. “The ALL law provided the MDH’s Health Regulation Division with the authority over the building to require owners to make repairs. This goes to show how effective the new survey process and findings can be to correcting issues. It ensures proper care of vulnerable adults in these settings.”
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Stonecrest, a small ALL provider, achieved a near perfect survey with intentional preparation using several resources including provider organizations materials, MDH resources, and other resources to ensure they were meeting their statutory requirements. Well done, Stonecrest staff!
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Finalizing ALL rules prior to Aug. 1, especially during the time of COVID-19. With the expedited rulemaking timeline this was a tall task successfully accomplished, ensuring that the Rules were published prior to the new licensure taking effect.
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Increased Communications. In 2021, HRD held 17 Assisted Living Licensure Teleconference calls in addition to many presentations at conferences, to help providers, residents, and others better understand the new regulations. The ALL Together Newsletter was launched in October to ensure regular communication regarding this important licensure.
Assisted Living Facilities (ALF)
The Top 10 tags issued for ALFs through Jan. 5, 2022, are listed below; these areas represent 35 percent of the tags issued.
Since Assisted Living Licensure was implemented on August 1, HRD has completed over 85 surveys with 1,461 tags issued to Assisted Living Facilities (ALF).
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Infection Control Program – Under Minn. Statute 144G.41 Subd. 3, 67 tags were issued.
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Minnesota Food Code – Under Minnesota Staute 144G.41 Subd. 1, 63 tags were issued for not following the Minnesota Food Code, Ch. 4626.
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Fire Protection and Physical environment – Under Minnesota Statute 144G.45 Subd. 2, 62 tags were issued
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Resident grievances, reporting maltreatment – Under Minnesota Statute144G.41 Subd. 7, 52 tags were issued.
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Disaster planning and emergency preparedness plan – Under Minnesota Statute 144G.42 Subd. 10, 50 tags were issued.
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No proof of staffing logic/metrics, slow response time to call lights, staff sleeping – Under Minnesota Statutes 144G.41 Subd. 1, 46 tags were issued.
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*Fire protection and physical environment – Under Minnesota Statutes 144G.45 Subd. 2 (a)(1)(i-v), 45 tags were issued. This tag is being issued for failure to have smoke alarms, failure to have smoke alarms in the correct locations, and failure to have working smoke alarms.
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Tuberculosis prevention and control – Under Minnesota Statue 144G.42 Subd. 9, 44 tags were issued.
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Posting information for reporting suspected crime and maltreatment – Under Minnesota Statute 144G.42 Subd. 7, 43 tags were issued.
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Contract required - Providing cares prior to contract – Under Minnesota Statute 144G.50, 37 tags were issued.
*This newsletter features a new tag on the top ten for fire protection and physical environment.
Assisted Living Facilities with Dementia Care (ALFDC)
Since Assisted Living Licensure was implemented on August 1, HRD has completed over 85 surveys with over 1,649 tags issued to Assisted Living Facilities with Dementia Care.
The Top 10 tags issued for ALFDC through Jan. 5, 2022 are listed below. These areas represent 30 percent of the tags issued.
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Infection Control Program – Under Minn. Statute 144G.41 Subd. 3, 68 tags were issued.
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Minnesota Food Code – Under Minnesota Staute 144G.41 Subd. 1, 63 tags were issued for not following the Minnesota Food Code, Ch. 4626.
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Fire Protection and Physical environment – Under Minnesota Statute 144G.45 Subd. 1, 59 tags were issued
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Fire Protection and Physical environment – Under Minnesota Statute 144G.45 Subd. 2, 52 tags were issued
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Disaster planning and emergency preparedness plan – Under Minnesota Statute 144G.42 Subd. 10, 49 tags were issued.
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Initial reviews, assessments, and monitoring – Under Minnesota Statutes 144G.70, 43 tags were issued.
- *Individualized treatment or therapy management plan – Under Minnesota Statutes 144G.72 subd. 3, 41 tags were issued. If you have residents who receive blood glucose monitoring, remember to ensure there is a treatment record where the resident’s blood sugar is recorded. Also, make sure the resident’s treatment plan includes directions for what the normal blood sugar parameters are, and what to do when the resident is outside of those normal parameters.
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No proof of staffing logic/metrics, slow response time to call lights, staff sleeping – Under Minnesota Statutes 144G.41 Subd. 1, 38 tags were issued.
- *Employee Records – Under Minnesota Statutes 144G.42 subd. 8, 38 tags were issued. Providers need to ensure all areas are included in employee records, including proof of required trainings and competency evaluations. Best practice would be to audit employee record files to ensure all required pieces are included. If they are not, develop a plan to ensure areas are not missed.
- *Compliance with requirements for reporting maltreatment of vulnerable adults, abuse prevention – Under Minnesota Statutes 144G.42 subd. 6 (b), 13 tags were issued. Providers must develop and implement individual abuse prevention plans (IAPP) for each resident. All residents, including housing only residents, are vulnerable adults. Remember if a resident has a change in condition, review the IAPP and make any adjustments as needed.
*This newsletter features new tags on the top ten for individualized treatment or therapy management plan, employee records, and compliance with requirements for reporting maltreatment of vulnerable adults, abuse prevention.
Below is a message developed by the Rapid Relocation Planning Group that was sent out to providers on December 23, 2021:
We recognize that the increasing cases of the Omicron variant has created a situation of increased concern about possible staffing shortages in long-term care. Following are options and supports that you may consider when addressing an emergent crisis situation.
Implement Internal Modifications, such as:
- Contact related facilities or partners including sister facilities and hospital partners.
- Contact supplemental nurse staffing agencies.
- Temporarily switch from 8- to 12-hour shifts.
- Encourage the use of Essential Care Givers (family and friends) within your facility.
- Determine if any residents can be safely and appropriately cared for by family during a short-term leave and discuss option with resident and family.
- Communicate with residents, resident representatives, and family and involve them in decision-making on matters regarding the resident’s care and services.
- Suspend new admissions until appropriate staffing levels are attained.
Contact External Supports
- Contact the Long-term Care Battle Plan Crisis Staffing Line at 1-833-454-0149 (toll free) or 651-201-3970 (local)
- Contact your Regional Health Care Preparedness Coordinator (RHPC) for assistance.
- Contact your Local Public Health Agency.
- Explore emergency management options through your county.
- If your facility is a member of a trade association, contact the trade association to discuss your situation.
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