Minnesota Senior Care Laws, 2025: What Families Should Know

The Minnesota legislature passed a number of provisions affecting Long Term Care in their Health & Human Services budget bills last session. The following is a high-level recap of some of the most important changes taking effect. Most changes in law, unless otherwise specified, went into effect on August 1, 2025. 

General Updates

Changes to the bill of rights for persons with guardians or conservators: Unless a guardian can demonstrate good cause for substantial risk, individuals under guardianship or conservatorship maintain the right to all forms of communication, including electronic communication like email and social media. Guardians are required to first attempt limited restrictions and evaluate their effectiveness. Also mandates that guardians provide specific notifications within 48 hours of implementing any restrictions.

Missing persons definition change: A broadened definition of an endangered person to encompass individuals with dementia, traumatic brain injury, Alzheimer's, or other cognitive impairments, in addition to those diagnosed with autism.

Licensing & Operations

Director of Record Requirement: Each facility must employ a licensed assisted living director (LALD) and affiliate that LALD as the director of record with the Board of Executives of Long-Term Services and Supports (BELTSS).

Licensure Boundaries – 2 hr. Fire Barrier: Requires at least a vertical two-hour fire barrier between licensed and unlicensed areas of the facility if there is unlicensed space in the assisted living facility building.

Provisional License Denial: If a provisional assisted living license is denied, the owners and/or managers cannot reapply for a new provisional assisted living license for one year after closing the denied assisted living license. 

Resident Protections

Arbitration Agreements: Assisted living facilities cannot require residents to sign binding arbitration agreements as a condition of admission or continued care.

Assisted Living Termination Protections (Effective July 1, 2025): Assisted living facilities are required to identify other facilities willing and able to meet the resident’s service needs to ensure residents have viable alternatives and are involved in the relocation decision. 

• Metro Area Residents: At least three facilities must be identified, including one within the seven-county metro area.

• Non-Metro Residents: At least two facilities must be identified, and if available, one within two hours or 120 miles.

• The facility must document in writing that the resident or their representative has either consented to move or refused the offered options.

Language Added to Hospice Bill of Rights

Hospice residents have the right to: Have their pain and symptoms managed according to their comfort level, with necessary medications readily available. Revoke hospice care at any time. Receive curative treatment for conditions not related to their hospice qualifying illness while still under hospice care.

Clinical Care 

Registered Nurse Definition: New language was added to clarify the meaning of a “Registered nurse” as defined under the Minnesota Nurse Practice Act in Minn. Stat. 148.171, subd. 20: "Registered nurse," abbreviated RN, means an individual licensed by the board to practice professional nursing.

Medication Management: Individual medication management services must be provided by a registered nurse (RN), advanced practice registered nurse (APRN), or qualified staff delegated to by an RN. 

Clarifies what staff role is responsible for medication management services. A written medication management plan must be included in the resident’s service plan.

Nursing Reassessments and Monitoring: Does not change the RN/LPN scope of practice and responsibilities with reassessment and monitoring but clarifies the responsibilities of the RN and LPN with reassessment and monitoring of residents. An RN must review the reassessment findings collected by an LPN. 

Facility Risk Assessment 

The statutory language is changed to no longer call the assessment a “hazard vulnerability assessment” but requires a safety risk assessment. ALFDCs must conduct and document a safety risk assessment on and around the property of the facility. Any identified safety risks identified on and around the property must be mitigated to protect residents from harm. The mitigation efforts must be documented in the facility’s records.  

Advocacy

Designated Support Person (Effective January 1, 2026): An assisted living facility must allow, at a minimum, one designated support person chosen by the resident to be physically present with the resident at times of the resident's choosing while the resident resides at the facility. “Designated support person" means any person chosen by the resident to provide comfort to the resident, including but not limited to the resident's spouse, partner, family member, or another person related by affinity. A facility may restrict or prohibit the presence of a designated support person under certain circumstances. 

Level 1-5 Changes (Effective July 1, 2025)

Changes in law will create a fifth level of violations at home care or assisted living facilities, with a Level 5 violation being a violation that results in serious injury or death. Fines start at level 2 at $500. Level 5 has a fine of $5,000 per violation and possible loss of license.

The law adjusts monetary amounts for fines related to issued correction orders. According to MDH, this reflects a fairer fine structure between Levels 2-5 and corrected the issue of some licensing fines being more than substantiated maltreatment fines.