Citing coronavirus, Minnesota proposes delaying new protections for seniors in assisted-living

The Minnesota Department of Health has proposed delaying for one year implementation of new rules designed to protect thousands of seniors who live in lightly regulated assisted-living facilities — citing an urgent need to focus on fighting the novel coronavirus pandemic.

Since early 2018, the main state regulator of senior care has supported a plan to establish licensing and minimum standards of care for the state's 1,700 assisted-living facilities, which are home to more than 50,000 Minnesota seniors.

The push to regulate these facilities was set in motion last spring, following years of grassroots organizing by senior advocacy groups, who called attention to alarming conditions in many of these homes and numerous incidents of abuse and preventable deaths from neglect.

Now, state Health Department officials say their priority has shifted toward responding to COVID-19, the respiratory disease that has killed 233 Minnesotans in long-term care facilities since early March. As of Tuesday, 77% of the deaths from the virus have been in such facilities.

The agency has recommended pushing back licensing of assisted-living facilities until August 2022. "By extending the implementation date of the assisted living licensure, we can help ensure that care facilities stay focused on prevention and response rather than shifting resources to adopt and comply with new regulatory requirements," the agency said in a statement.

The proposed delay, which still must be approved by the Legislature, was immediately assailed by one of the senior advocacy groups that played a pivotal role last year in crafting landmark protections for seniors.

Leaders of Elder Voice Family Advocates, a volunteer organization, said the decision was dangerous and would delay regulations, such as new infection control and safety measures, that would protect vulnerable seniors during a pandemic.

Minnesota remains the only state in the nation that does not license assisted-living providers.

"The delay of assisted-living licensure couldn't come at a worse time," said Kristine Sundberg, executive director of Elder Voice Family Advocates. "The COVID-19 pandemic is painfully demonstrating the glaring lack of care guidelines and enforcement oversight of these facilities. Waiting 2½ years will result in hundreds of needless deaths and suffering."

Assisted-living facilities, which resemble apartment buildings with services, have been especially hard hit by the coronavirus. On Monday, Meridian Manor, a 50-bed assisted-living facility in Wayzata, shut its doors after COVID-19 swept through the home, infecting a majority of its residents and staff members and killing two residents.

Deadly clusters of the virus have begun popping up at assisted-living facilities across the state, including in Duluth, Edina and North Mankato, according to a Star Tribune review of death records.

For years, public health experts have raised alarms about the rapid growth of assisted-living facilities, which offered greater independence than nursing homes but operated with little government scrutiny.

The homes were intended originally for older people who needed some help to live independently, but over time they have begun catering to seniors who are often frail or have serious medical conditions. Some 40% of residents in assisted-living facilities have Alzheimer's disease or some other form of dementia; and nearly two-thirds need help with daily living activities, such as bathing and dressing, national studies have found.

But Minnesota's consumer protections have not kept pace with these changes, exposing residents to serious abuse and premature death, according to a 2017 investigation by the Star Tribune.

In spring 2019, senior-care advocates and industry representatives spent hundreds of hours at the negotiating table, crafting a landmark bill that would be the broadest expansion of the state's oversight of long-term care in generations.

The bill mandated for the first time that Minnesota's assisted-living facilities be licensed, starting in August 2021, and be subject to quality standards of care. State officials began a complicated process last summer for drawing up dozens of new rules governing care in these facilities.

Sen. Karin Housley, the Republican chairwoman of the Senate Family Care and Aging Committee, said the proposed delay was "disappointing but unavoidable," given the state's need to shift resources toward fighting the pandemic. She noted, however, that legislation would have to be introduced to push back the start of assisted-living licensure because the original timetable was codified in state law.

"The disappointing part is that so many people were working so hard on [assisted-living licensure] and now they have to do an about-face and go in another direction," Housley said. "It's unfortunate that this, like so many other things in our world right now, has been put on the back burner."

But Mary Jo George, associate state director of advocacy at Minnesota AARP, said licensing was just one piece of a broader effort to regulate assisted-living facilities, and the state can still move forward on implementing basic consumer safeguards, such as rules against arbitrary discharges and retaliation for reporting maltreatment.

"Let's not let this crisis today have us do away with vital consumer protections, which are even more necessary in a pandemic," George said.

State Health Department officials said many of the department's regulatory staff, who normally would be working on assisted-living regulations, have been deployed to its COVID-19 response. The agency has been sending teams of infection control specialists into long-term care facilities hit by the coronavirus, as well as helping facilities secure more staff and protective equipment. In some cases, the agency has also helped to coordinate the safe transfer of residents from facilities that have become too overwhelmed by COVID-19 cases to care for them.

Nearly 70% of the staff in the agency's health regulation division have been redeployed toward responding to the pandemic, officials said. "The priority has shifted to appropriate COVID response for nearly all health care organizations across the board," the agency said. "COVID-19 cases in congregate settings are ramping up at the same time the direct care workforce shortage is becoming more problematic."

Staff writer Glenn Howatt contributed to this report.