Minnesota Administrative Code

4652.0130 REVIEW OF REPORTS. Subpart 1. Record complete. No report required by this chapter is considered to be filed until the commissioner has determined that the report is complete. "Complete" means that the report contains adequate and appropriate data for the commissioner to…

4652.0140 VARIANCES. Subpart 1. Data from other sources. On a request by a group purchaser or on the commissioner's own initiative, the commissioner shall determine whether to use data from other sources instead of collecting data required by this chapter. To make this determinat…

4653.0100 DEFINITIONS. Subpart 1. Scope. The terms used in parts 4653.0200 to 4653.0600 have the meanings given them in this part. Subp. 2. Commissioner. "Commissioner" means the commissioner of health. Subp. 3. Complete submission. "Complete submission" means data submitted to t…

4653.0200 DATA COLLECTED. A. All health plan companies and third-party administrators must register with the data processor no later than June 15, 2009, and April 1 of each subsequent year. For the purposes of identifying data submitters, minimizing administrative burden, and ass…

4653.0300 DATA SUBMISSION REQUIREMENTS. Subpart 1. Duties of data submitters. To support the collection of the data described in part 4653.0200, a data submitter must: A. submit the data described in part 4653.0200 to the data processor in electronic format using the submission, …

4653.0500 INDIVIDUAL VARIANCES. A. The commissioner must grant a variance to a data submitter with respect to submission of a specific data element or submission specification if the data submitter demonstrates good cause. To request a variance, a data submitter must submit a pet…

4653.0600 INCORPORATION BY REFERENCE. "Minnesota Health Care Claims Reporting System: Appendices to Minnesota Administrative Rules, Chapter 4653," issued by the Minnesota Department of Health, May 2009, is incorporated by reference. It is available through the Minitex interlibrar…

4654.0100 APPLICABILITY. This chapter applies to all providers who are required to submit standardized information on quality measures associated with patient care under Minnesota Statutes, section 62U.02, and all health plan companies that collect data related to quality measure…

4654.0200 DEFINITIONS. Subpart 1. Scope. For purposes of this chapter, the following terms have the meanings given them in this part. Subp. 2. Administrative data. "Administrative data" means information contained on a health care claim or equivalent encounter transaction provide…

4654.0300 PROVIDER SUBMISSION REQUIREMENTS. Subpart 1. Physician clinics. A. Each physician clinic, except ambulatory surgical centers, must register annually with the commissioner or commissioner's designee beginning January 1, 2010, as specified in Appendix E. B. Each physician…

4654.0400 DATA VALIDATION PROCEDURES. Subpart 1. Complete submissions. A. The commissioner or commissioner's designee must notify a data submitter of a data transmission receipt within two business days of a data submission. Within 30 days after receipt of the data transmission, …

4654.0500 MEASUREMENT DEVELOPMENT AND REVIEW PROCESS. Subpart 1. Review process. The commissioner must review the standardized quality measures contained in "Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, chapter 4654,"…

4654.0600 USE OF QUALITY MEASURES BY HEALTH PLAN COMPANIES. Subpart 1. Required quality measures. A health plan company may not require providers to use or report quality measures that are not standardized quality measures. Health plan companies and providers may voluntarily use …

4654.0700 VARIANCES. The commissioner may grant a variance to a data submitter for a reported quality measure collection or submission specification if the data submitter demonstrates good cause. To request a variance, a data submitter must submit a petition, according to the req…

4654.0800 INCORPORATION BY REFERENCE. "Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654," issued by the Minnesota Department of Health, December 2017, is incorporated by reference. It is available through the…

4655.0090 SCOPE. This chapter applies to boarding care homes unless the content clearly indicates otherwise. Statutory Authority: MS s 144.56; 144A.02 to 144A.08; 256B.431 History: 19 SR 1803; 20 SR 303; 21 SR 196 Published Electronically: January 19, 2005

4655.0100 DEFINITIONS. Subpart 1. Ambulatory. "Ambulatory" shall mean a patient or resident who is physically and mentally capable of getting in or out of bed and walking a normal path to safety, including the ascent and descent of stairs in a reasonable period of time without th…

4655.0110 FOREWORD. These regulations will serve as the basis for licensing nursing homes and boarding care homes in accordance with the state law for licensing hospitals and related institutions, Minnesota Statutes, sections 144.50 to 144.58. Federal programs under the Social Se…

4655.0300 LICENSING IN GENERAL. Subpart 1. Required. For the purpose of these rules, a state license is required for any facility where nursing, personal, or custodial care is provided for five or more aged or infirm persons who are not acutely ill. Subp. 2. License fees. Each ap…

4655.0310 PROCEDURE FOR LICENSING OF BOARDING CARE HOMES. Application for a license to establish or maintain a boarding care home shall be made in writing and submitted on forms provided by the department. If the applicant is a corporation, the officers shall furnish the departme…

4655.0400 TYPES OF PATIENTS OR RESIDENTS NOT TO BE RECEIVED. Subpart 1. Admittance of certain adults. Maternity patients, disturbed mental patients (see part 4655.6600), and patients or residents, who in the opinion of the attending physician have or are suspected of having a dis…

4655.0500 CAPACITY PRESCRIBED. Each license shall specify the maximum allowable number of patients or residents to be cared for at any one time. No greater number of patients or residents shall be kept than is authorized by the license. Statutory Authority: MS s 144.56; 144A.02 t…

4655.0600 HOME NOT TO BE MISREPRESENTED. A nursing home or a boarding care home shall not use in its title the words of description: "Hospital," "Sanitorium," "Rehabilitation Facility," "Rehabilitation Center," or any other words which indicate that a type of care or service is p…

4655.0700 NO DISCRIMINATION. There shall be no discrimination with respect to patients or residents, employees, or staff on the ground of race, color, or national origin. Statutory Authority: MS s 144.56; 144A.02 to 144A.08 Published Electronically: January 19, 2005

4655.0800 PRELIMINARY PLANNING. Contact shall be made with the department to discuss the proposed program, location, staffing requirements, and other pertinent aspects prior to planning a new care facility or purchasing or leasing an existing care facility. Statutory Authority: M…

4655.0900 EVALUATION. Facilities shall be subject to evaluation and approval of the physical plant and its operational aspects prior to a change in ownership, classification, capacity, or services. Statutory Authority: MS s 144.56; 144A.02 to 144A.08 Published Electronically: Jan…

4655.1000 VARIANCE AND WAIVERS. A nursing home or boarding care home may request that the department grant a variance or waiver from the provisions of these rules. All requests for a variance or waiver shall be submitted to the department in writing. Each request shall contain th…

4655.1010 CRITERIA FOR EVALUATION. The decision to grant or deny a variance or waiver shall be based on the department's evaluation of the following criteria: A. the variance or waiver will not adversely affect the health, treatment, comfort, safety, or well-being of a patient or…

4655.1020 NOTIFICATION OF VARIANCE. The applicant shall be notified in writing of the department's decision. If a variance or waiver is granted, the notification shall specify the period of time for which the variance or waiver will be effective and the alternative measures or co…

4655.1030 EFFECT OF ALTERNATIVE MEASURES OR CONDITIONS. All alternative measures or conditions attached to a variance or waiver shall have the force and effect of the licensure rule(s) and shall be subject to the issuance of correction orders and penalty assessments in accordance…

4655.1040 RENEWAL. Any request for the renewal of a variance or waiver shall be submitted in writing prior to its expiration date. Renewal requests shall contain the information specified in part 4655.1000. A variance or waiver shall be renewed by the department if the applicant …

4655.1050 DENIAL, REVOCATION, OR REFUSAL TO RENEW. The department shall deny, revoke, or refuse to renew a variance or waiver if it is determined that the criteria specified in parts 4655.1010 and 4655.1020 are not met. The applicant shall be notified in writing of the decision t…

4655.1060 APPEAL PROCEDURE. An applicant may contest the denial, revocation, or refusal to renew a variance or waiver by requesting a contested case hearing under the provisions of the Administrative Procedure Act, Minnesota Statutes, chapter 14. The applicant shall submit, withi…

4655.1070 DEFINITIONS. Subpart 1. Scope. For the purposes of parts 4655.1070 to 4655.1098, the following terms have the meanings given them in this part. Subp. 2. Advisory review panel. "Advisory review panel" means the group of individuals that must form recommendations accordin…

4655.1072 INCORPORATION BY REFERENCE OF ANNUAL STATISTICAL REPORT. The 1994 Annual Statistical Report to the Commissioner of Health, Nursing Homes and Boarding Care Homes, and future amendments are incorporated by reference and are available through the Minitex interlibrary loan …

4655.1074 APPOINTMENT OF ADVISORY REVIEW PANEL. Subpart 1. Procedures. The INTERCOM shall appoint an advisory review panel according to subparts 2 to 5. Subp. 2. Membership. The advisory review panel must consist of five members: A. two representatives from organizations that rep…

4655.1076 INTERCOM PUBLICATION OF REQUEST FOR PROPOSALS. Subpart 1. Date of publication of request for proposals. The INTERCOM shall publish in the State Register a request for proposals within 30 days of the first day of each state fiscal biennium, and as frequently thereafter a…

4655.1078 FORMAT AND CONTENTS OF PROPOSAL. A proposal must be on a form approved by the commissioner and must: A. include the name, telephone number, and address of the proposer or other authorized person who can be contacted by the commissioner or the INTERCOM with questions reg…

4655.1080 SUBMISSION OF PROPOSAL. Subpart 1. Who may submit proposal. A proposal must be submitted by a proposer. Subp. 2. Where to submit proposal. A proposal must be submitted to the INTERCOM. Subp. 3. Submission deadline. A proposal must be received by the INTERCOM no later th…

4655.1082 INITIAL SCREENING OF PROPOSALS BY INTERCOM. The INTERCOM shall process a proposal according to items A to K. A. The INTERCOM shall determine whether a proposal was submitted according to the submission deadline under part 4655.1080, subpart 3. B. If a proposal was not s…

4655.1084 DATA COLLECTION. Subpart 1. Staff. The INTERCOM and the commissioners of agencies represented on the INTERCOM shall assign staff to collect the data under subparts 2 to 14. The INTERCOM shall use the data collected under this part to develop recommendations to the commi…

4655.1086 FORMATION OF ADVISORY REVIEW PANEL RECOMMENDATIONS TO INTERCOM. Subpart 1. Review of proposals. A proposal that satisfies the requirements of part 4655.1082 shall be reviewed, evaluated, and ranked by the advisory review panel. Subp. 2. Method of evaluation. The advisor…

4655.1088 PUBLIC HEARING. The INTERCOM shall hold one public hearing on all proposals submitted in response to a request for proposals. The public hearing shall be held after the submission deadline under part 4655.1080, subpart 3, but before the INTERCOM submits recommendations …

4655.1090 EVALUATION, COMPARISON, AND RANKING OF PROPOSALS. The INTERCOM shall use the findings of the staff data collection process, the advisory review panel, and the public hearing to evaluate, compare, and rank the proposals according to the long-term care needs they address.…

4655.1092 REIMBURSEMENT LIMITS. Subpart 1. Cost reimbursement. The acceptance or determination of costs under parts 4655.1070 to 4655.1098 is not binding for reimbursement. Actual reimbursement of costs is determined according to parts 9549.0010 to 9549.0080. Subp. 2. Medical ass…

4655.1094 INTERCOM RECOMMENDATIONS TO COMMISSIONER. The INTERCOM shall recommend that the commissioner approve or disapprove a proposal. A recommendation under this part must be based on the evaluation, comparison, and ranking completed under part 4655.1090. A written report of t…

4655.1096 COMMISSIONER'S APPROVAL OR DISAPPROVAL OF PROPOSAL. Subpart 1. Approval or disapproval of proposal. The commissioner shall approve or disapprove a proposal within 30 days after receiving the INTERCOM recommendations. Subp. 2. Notice of approval or disapproval. No later …