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Minnesota health commissioner unveils plan for tougher state oversight of assisted-living facilities

Health commissioner says assisted-living industry is too lightly regulated in Minnesota, leaving seniors at risk. 

Photo by Star Tribune

Minnesota’s top health regulator unveiled a plan Wednesday to intensify oversight of the state’s rapidly growing assisted-living industry, amid growing concerns that an absence of basic care standards is putting thousands of seniors in harm’s way.

At a legislative hearing Wednesday morning, state Health Commissioner Jan Malcolm proposed a system for licensing assisted-living homes, which now serve more than 60,000 Minnesotans but operate under less supervision than state-licensed nursing homes. Minnesota is the only state that does not license such facilities, making it difficult for the state to enforce minimum standards of care for an increasingly vulnerable population.

“We need to build on that system and create higher levels of regulation, including licensure, tied to the complexity of the services that are offered in those settings and the complexity of need,” Malcolm said in her testimony.

The case for reform gained momentum early last year following a Star Tribune investigation detailing how such facilities had failed to protect their residents from hundreds of incidents of criminal abuse, including beatings, sexual assaults and thefts. The report also found that residents of assisted-living facilities had few protections against unsafe or unfair business practices. Those who spoke openly about being mistreated sometimes faced retaliation by facility staff, and even threats of eviction, the Star Tribune found.


“Assisted-living is the fastest-growing residential care option for elders in the United States, and regulations have not kept up with the realities on the ground,” said Eilon Caspi, a gerontologist and research associate at the University of Minnesota School of Nursing.


Unlike a year ago, when a broad-based effort to reform Minnesota’s laws for protecting seniors collapsed amid partisan discord, there appears to be strong bipartisan support in the 2019 Legislature for licensing assisted-living. The leaders of long-term care committees in both houses support the measure, as does the senior care industry’s largest trade group, Care Providers of Minnesota.


“It’s easy to agree on concepts,” said Kristine Sundberg, president of Elder Voice Family Advocates, a volunteer group seeking better care for seniors. “The real challenge will be settling on the specific standards that would protect people who are not being protected now.”

By Chris Serres Star Tribune | JANUARY 23, 2019 — 10:13PM


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