Assisted Living FAQs: Contracts

Refer to 144G.50 for the items required in an assisted living contract.

No. Each provider will be responsible for drafting their own contract with all the required elements.

Yes. It doesn't matter if someone is receiving services or not, they are all considered residents. Please refer to the definition of resident in statute 144G.09, subdivision 59. A resident will have a contract for housing at the very least. A service agreement may be added later as needed.

Adding this information to the assisted living contract is not required per 144G. There is a statute under the Minnesota Board on Aging (256.975) that requires prospective residents to call the Senior Linkage Line (SLL) prior to making a "long term care" choice. MDH has added this language to the Uniform Disclosure of Assisted Living Services & Amenities (UDALSA) so prospective residents call the SLL before signing an assisted living contract for objective counseling and support in making an informed decision.

Yes. Assisted living contracts may include contract language to limit the licensee’s liability regarding the actions of third parties, such as third-party health care providers and resident guests.

Yes; if it is simply a recommendation only and does not indicate the licensee has no responsibility related to the personal property of the resident.

Yes; but it is not necessary. Nothing in statute indicates the licensee is liable when the resident chooses to leave the premises of their own volition.

No. The statute prohibits the contract from including a waiver of the licensee’s liability for the health, safety, and personal property of the resident, or from implying a lesser standard of care or responsibility than required by law. A section heading does not violate those provisions if the content within that section is otherwise permissible.

Yes, that is acceptable. The statute requires the contract to adhere to Minnesota law, and to applicable federal and local law, so including that requirement does not violate the prohibition on choice of law provisions within the arbitration agreement.

This is typically written as a 21-day correction period. MDH recognizes changing an assisted living contract can take longer than 21 days due to the need for legal consultation. If upon revisit to the facility the assisted living contract itself is not corrected, the surveyor will ask what steps the licensee is taking to come into compliance. Changes to the contract language are not required until resolution of the appeal supporting MDH’s determination.

MDH compliance expectations are based on Minnesota Statutes 144G so if the licensee is compliant with the statutory requirements, then MDH should find the citation is corrected.

No. This is not a statutory requirement; however, this does not preclude a licensee from having a policy.

No. Minnesota Statutes 144G does not explicitly prohibit indemnification clauses; however, assisted living contract language may not waive or shift the responsibility from the licensee for certain incidents onto the resident. Indemnification clauses that apply universally to all behavior by the resident are likely prohibited because, depending on the resident’s needs and services, the licensee may be responsible for preventing that specific behavior or outcome from occurring, or at least from negatively impacting others. An indemnification clause is only acceptable if it contains language that specifies that indemnity obligations only relate to those events for which the resident is legally responsible.

The following is an example of assisted living contract language MDH has cited and upheld in the reconsideration process as violating Minnesota Statutes 144G: “As an occupant of the Facility, Resident assumes the risk for the Resident’s own safety and for the safety of the Resident’s personal property….Resident will indemnify and hold harmless Facility, its employees and agents from and against any and all claims, actions, damages, and liability and expense in connection with the loss of life, personal injury or damage to the property, arising from or out of the use by the Resident…”

This indemnification language requires the resident to assume the risk of their own health, safety, and personal property and protects the licensee from “any and all” responsibility for the resident and the resident’s property, which would be interpreted as a waiver of liability under 144G.

As another example: “Resident will indemnify and hold harmless Facility, its employees and agents from and against any and all claims, actions, damages, and liability and expense in connection with loss of life, personal injury or damage to property, arising from or out of the use by Resident or Resident’s guests of the Apartment or any other part of Facility, or caused wholly or in part by an action or omission of Resident or Resident’s guests or agents.” “Hold harmless” means to excuse from liability.

The statute requires no waiver of liability or provisions that imply a lesser standard of care of responsibility than is required by law. An assisted living contract may include language indicating that intentional, negligent or careless acts of residents or their guests may not result in licensee’s liability.

Yes; however, if an assisted living contract refers to a resident handbook, the handbook language must also be in compliance and not waive the licensee’s liability.

No. An assisted living contract must not contain any waiver of facility liability with the health, safety and personal property of resident. While there are many situations such as natural disasters and acts of third parties which would not be the responsibility of the licensee, an assisted living licensee could be liable depending on the licensee’s role in the resident’s loss, and those narrow instances may not be waived.

No. Typical landlord-tenant contract clauses and commonly accepted landlord-tenant laws often hold the landlord is not responsible for the actions of their tenants. This ignores that assisted living facilities have heightened responsibilities with respect to their resident-tenants, who are vulnerable adults. While there are many situations, such as natural disasters and acts of third parties which would not be the responsibility of the facility, an assisted living licensee could be liable depending on the licensee’s role in the resident’s loss, and those narrow instances may not be waived.

An assisted living facility must give a complete copy of the signed assisted living contract to the resident promptly after it is signed. This signed copy must include any addendums, all supporting documents, and attachments. The resident must agree in writing to any additions or amendments to the contract.

If a resident is receiving services, their assisted living contract must include their assisted living service plan. This plan must include parts listed in Minnesota Statutes 144G.50, subdivision 4.

Yes. An assisted living facility must provide a Uniform Disclosure of Assisted Living Services and Amenities (UDALSA) to all prospective residents under Minnesota Statutes 144G.40 before an assisted living contract is signed. The UDALSA must be provided separately from all other documents and forms. Whenever a facility changes the services it offers under the assisted living contract, the facility must submit an updated UDALSA to the Minnesota Department of Health within 30 calendar days of the change in services.

No. Assisted living contracts executed prior to August 1, 2022, will not require contract amendment. Instead, MDH surveyors will review contracts executed on August 1, 2022, and after to apply the new statutory language.

A pre-termination meeting is still required. See Rule 4659.0120, Subpart 11.A. "A facility seeking an expedited termination under Minnesota Statute section 144G.52, must comply with all of the requirements of this part." This includes pre-termination meeting requirements discussed in subpart 1.

1. The resident receives written notice of the pre-termination meeting.
2. There is a 5-business-day waiting period.
3. The predetermination meeting occurs.
4. The resident receives a written summary of the meeting within 24 hours.
5. The termination notice given to the resident must be 7 days after the pre-termination meeting.

It is only considered a resident-initiated termination if the resident has made a formal notice that they are moving and have taken the steps to relocate themselves. If the resident merely discusses wanting to move, but the facility takes the initiative of terminating the contract based on that discussion, that is considered a facility-initiated termination and the requirements of statute section 144G.52 and rule part 4659.0120 must be met.

The table below shows the acceptable reasons for a facility to initiate termination and the required timing of notices of termination.

1. The resident receives the termination notice.
2. The resident has 15 days (expedited) or 30 days to appeal.
3. The resident has a right to a hearing. The hearing is held within 14 calendar days of the Office of Administrative Hearings receiving the request to appeal.
4. The Administrative Law Judge gives its decision to the Commissioner of Health no later than 10 days following the hearing.

No. Per Minnesota Statute § 144G.52 subdivision 10 If a resident is absent from a facility for any reason, including an emergency relocation, the facility shall not refuse to allow a resident to return if a termination of housing has not been carried out.

The facility must continue providing all housing and services under the contract while the appeal is pending. However, the facility is not obligated to provide any additional services that the resident may require. The resident is responsible to contract for those additional services, either with the facility or another provider.

Whenever a facility changes the services that they offer under the assisted living facility contract, the facility must submit an updated UDALSA to the commissioner within 30 calendar days of the change in services. A current UDALSA must be provided to each prospective resident and each prospective resident's representative who requests information about the facility.

144G.40, subdivision 2, states that an assisted living facility must provide the UDALSA to prospective residents before a contract is executed. As long as that condition is met, yes. The key is to make sure the language or date of signature indicates the UDALSA was received before the contract is signed. Another option could be to photocopy the signature page and place that in the resident record.

You will want to indicate in the comments section if there are any limits such as you will only do mechanical soft vs. a pureed diet.

No. Only submit one UDALSA per HFID. If you are licensed as a campus or hold an assisted living with dementia care license, and the indicated services are provided at more than one building/unit/address, list all additional buildings/units/addresses this applies to. Utilize the “Comments” section to list any differences in offerings between buildings/units/addresses.