Current through Register Vol. 49, No. 13, September 23, 2024
Subpart
1.
Assessment of nursing facility applicants and newly
admitted residents.
Each nursing facility applicant or newly admitted resident must
be assessed for the purpose of determining the applicant's or newly admitted
resident's class. The assessment must be conducted according to the procedures
in items A to I.
A. The county
preadmission screening team or hospital screening team under contract with the
county must assess all nursing facility applicants for whom preadmission
screening is required by Minnesota Statutes, section
256B.0911,
and any applicant for whom a preadmission screening is not required but who
voluntarily requests such a screening in accordance with Minnesota Statutes,
section
256B.0911,
except as provided in subitems (1) and (2).
(1) The public health nurse as defined in
Minnesota Statutes, section
145A.02, subdivision
18, of the county preadmission screening team or the registered nurse case
manager shall assess a nursing facility applicant, if the applicant was
previously screened by the county preadmission screening team and the applicant
is receiving services under the Alternative Care Grants program defined in part
9505.2340 or under the medical
assistance program.
(2) An
applicant whose admission to the nursing facility is for the purpose of
receiving respite care services need not be reassessed more than once every six
months for the purpose of computing resident days under part
9549.0054, subpart
2, if the applicant has been
classified by the Department of Health within the prior six month period. In
this case, the resident class established by the Department of Health within
the prior six month period may be the resident class of the applicant. A
resident must not receive more than one assessment per respite care
stay.
B. Except as
provided in item A, subitem 2, the nursing facility must assess each applicant
or newly admitted resident for whom a preadmission screening is not required by
Minnesota Statutes, section
256B.0911,
or is not requested voluntarily in accordance with Minnesota Statutes, section
256B.0911.
For the purposes of this item, the term newly admitted resident includes a
resident who moves to a section of the nursing facility that is licensed
differently than the section the resident previously was placed in or a
resident who has been transferred from another nursing facility.
C. Except as provided in item D, the
assessment required by this subpart must be performed within ten working days
before or ten working days after the date the applicant is admitted to the
nursing facility.
D. Any resident
who is required to be assessed by the preadmission screening team under item A
or who has received a prior preadmission screening, and for whom the assessment
required under this subpart has not been performed by the preadmission
screening team within ten working days before or ten working days after the
date the applicant is admitted to the nursing facility must be assessed by the
nursing facility. The nursing facility must perform the assessment and submit
the forms to the Department of Health within 15 working days after
admission.
E. Each assessment that
the nursing facility is required to perform must be completed by a registered
nurse. The registered nurse performing the assessment must sign the assessment
form.
F. The assessment of each
applicant or newly admitted resident must be based on the QA&R procedures
of the Department of Health including physical observation of the applicant or
newly admitted resident and review of available medical records, and must be
recorded on the assessment form.
G.
Within five working days following the assessment, the preadmission screening
team or hospital screening team under contract with the county must send the
completed assessment form to the Department of Health, and provide a copy to
the nursing facility.
H. Except as
provided in item D, each assessment completed under items A to G and a
completed medical plan of care or interagency transfer form must be submitted
to the Department of Health by the nursing facility as a request for
classification within ten working days after admission or after the assessment,
whichever is later.
I. The resident
class for applicants or newly admitted residents must be effective on the date
of the person's admission to the nursing facility.
Subp. 2.
Semiannual assessment by
nursing facilities.
Semiannual assessments of residents by the nursing facility
must be completed in accordance with items A to D.
A. A nursing facility must assess each of its
residents no earlier than 162 days and no later than 182 days after the date of
the most recent annual assessment by the Department of Health's QA&R
team.
B. A registered nurse shall
assess each resident according to QA&R procedures established by the
Department of Health including physical observation of the resident, review of
the medical plan of care, and review of the resident's plan of care, and shall
record the assessment on the assessment form. The Physician's Statement of
General Condition (item 10), Individual Dependencies (items 21 to 24 and 28),
Medications (items 31 to 34), and Primary, Secondary, and Tertiary Diagnoses
(on the back of the form) do not require completion. The registered nurse
performing the assessment shall sign the assessment form on the day the
assessment is completed.
C. Within
five working days of the completion of the nursing facility's semiannual
resident assessments, the nursing facility must forward to the Department of
Health requests for classification for all residents assessed for the
semiannual assessment. These requests must include the assessment forms and the
nursing facility's daily census for the date on which the assessments were
completed including an explanation of any discrepancy between the daily census
and the number of assessments submitted. The nursing facility must provide
additional information to the Department of Health if the Department of Health
requests the information in order to determine a resident's
classification.
D. Any change in
resident class due to a semiannual assessment must be effective on the first
day of the month following the date of the completion of the semiannual
assessments.
Subp. 3.
Change in classification due to annual assessment by Department of
Health.
Any change in resident class due to an annual assessment by the
Department of Health's QA&R team will be effective as of the first day of
the month following the date of completion of the Department of Health's
assessments. QA&R shall not establish classifications for residents who
experience an admission, transfer, hospital return, or discharge occurring
during the QA&R team visit.
Subp.
4.
Assessment upon return to the nursing facility from a
hospital.
Residents returning to a nursing facility after hospitalization
must be assessed according to items A to D.
A. A nursing facility must assess any
resident who has returned to the same nursing facility after a hospital
admission. The assessment must occur no more than five working days after the
resident returns to the same nursing facility.
B. In addition to the assessment required in
item A, residents who have returned to the same nursing facility after hospital
admission must be reassessed by the nursing facility no less than 30 days and
no more than 35 days after return from the hospital unless the nursing
facility's annual or semiannual reassessment occurs during the specified time
period.
C. A registered nurse shall
perform the assessment on each resident according to QA&R procedures
established by the Department of Health, including physical observation of the
resident, review of the medical plan of care, and review of the resident's plan
of care, and shall record the assessment on the assessment form. The registered
nurse who performs the assessment shall sign the assessment form. Within five
working days of the completion of the assessment, the nursing facility must
forward to the Department of Health a request for a classification for any
resident assessed upon return to the nursing facility after a hospital
admission. This request must include the assessment form and the resident's
medical plan of care or interagency transfer form. Upon request, the nursing
facility must furnish the Department of Health with additional information
needed to determine a resident's classification.
D. Any change in resident class due to an
assessment provided under item A must be effective on the date the resident
returns to the nursing facility from the hospital. Any change in resident class
due to a reassessment provided under item B must be effective as of the first
of the month following the assessment.
Subp. 5.
Change in resident class due
to audits of assessments of nursing facility residents.
Any change in resident class due to a reclassification required
by part
4656.0050 must be retroactive to
the effective date of the assessment audited.
Subp. 6.
False information.
If the nursing facility knowingly supplies inaccurate or false
information in an assessment or a request for reconsideration, the commissioner
shall apply the penalties in part
9549.0041, subpart 15.
Subp. 7.
Reconsideration of
resident classification.
Any request for reconsideration of a resident classification
must be made under part
4656.0070.
Subp. 8.
Change in resident class due
to request for reconsideration of resident classification.
Any change in a resident class due to a request for
reconsideration of the classification must be made in accordance with items A
and B.
A. The resident classification
established by the Department of Health must be the classification that applies
to the resident while any request for reconsideration under part
4656.0070 is pending.
B. Any change in a resident class due to a
reclassification under part
4656.0070 must be effective as of
the effective date of the classification established by the original assessment
for which a reconsideration was requested.
Subp. 9.
Resident access to assessments
and documentation.
The nursing facility must provide access to information
regarding rates, assessments, and other documentation provided to the
Department of Health in support of the resident's assessments to each nursing
facility resident or the resident's authorized representative according to
items A to D.
A. The nursing facility
must post a notice of its current rates for each resident class in a
conspicuous place. The rates must be posted no later than five days after
receipt by the nursing facility. The nursing facility must include a notice
that the nursing facility has chosen to appeal the rates under part
9549.0080.
B. The nursing facility must provide written
notice to each private paying resident or the person responsible for payment of
any increase in the total payment rate established by the commissioner 30 days
before the increase takes effect as required by Minnesota Statutes, section
256B.47, subdivision 2.
The notice must specify the current classification of the resident. This item
does not apply to adjustments in rates due to a necessary change in the
resident's classification as a result of an assessment required in this
part.
C. The nursing facility must
provide each nursing facility resident or the person responsible for payment
with each classification letter received from the Department of Health within
five days of the receipt of the classification letter. When the private paying
resident is not the person responsible for payment, the classification letter
must be sent to the person responsible for payment. If the resident's
classification has changed, the nursing facility must include the current rate
for the new classification with the classification letter.
D. The nursing facility must provide each
nursing facility resident or the resident's authorized representative with a
copy of the assessment form and any other documentation provided to the
Department of Health in support of the assessment within three working days of
receipt of a written request from the resident or the resident's authorized
representative.
Statutory Authority: MS s
256B.41;
256B.431
