Nursing Home Moratorium Exception Frequently Asked Questions

Commence construction within 18 months.

The owner has 18 months to commence construction, see 144A.071, subdivision 1a, paragraph (d).

Applicants are required to provide an estimated value for the entire facility after completion of the project. There is not an appraisal requirement for the application. The estimated appraisal value is an important limiting factor in the final reimbursement for an approved project. Supporting documentation is requested to ensure the applicant has made reasonable assumptions about value but not as a requirement that an actual appraisal be completed.

There is no requirement that a marketing study be conducted. The applicant must respond thoroughly to all of the criteria for review in Minnesota Statutes, section 144A.073, Subdivision 4a The applicant is making its case for investment in a project that is needed and sustainable. It is important for the review committee to know that the applicant has done its due diligence in planning the project – is there a need, how much of a need, how long will the need be and how might that need change based on demographics, etc.

There is an opportunity to articulate the extent to which the applicant has researched its proposal and is willing to invest in state-of-the-art equipment and design that might exceed baseline code requirements to further enhance the quality of life for residents and working conditions for staff Minnesota Statutes, section 144A.073, Subd. 4a(4)(6). While all criteria are to be given equal weight in the decision-making process, highlighting innovation in technology or design features that are not reflected in current code requirements might distinguish the project from other proposals.

Questions can be submitted to health.nhm@state.mn.us.

No. Projects that have not been approved in a previous round must re-apply.

No. MDH has that information.

No. Survey follow the state and federal regulations.

No. The Minnesota Department of Health asks for a letter of intent to plan accordingly.

No. The moratorium prohibits additional licensure of beds to the overall system capacity. The only way that additional licensed beds could be added to the system capacity would be through specific legislation permitting this. A nursing home may acquire additional beds to add to an existing facility as part of a moratorium exception project, but it would need to acquire those from some other facility. Bed relocation always requires pre-approval from MDH and is done either via a threshold construction project or moratorium exception project. See: MS 144A.073, Subdivision 3 (c) (https://www.revisor.mn.gov/statutes/?id=144A.073)

The preliminary drawings should be as complete as needed to give you and the reviewers adequate information to make a decision about the proposal. This will depend to some extent on the type and scale of the project. However, the rule requires that the drawings be prepared by a registered architect, and it is recommended that these drawings be done to scale. It is generally in your interest to make your drawings as clear and complete as possible to describe your proposal accurately. Typically, drawings are submitted in the design development phase.

Minnesota Rules Part 4658.3005, subpart 2, states that “compliance with the standards for new construction for existing facilities must be for the areas involved and to the extent that the existing structure will permit.” Proposals will be reviewed on an individual basis to determine to what extent this will be required, but you should aim at new construction standards if possible.

Generally, yes. The new wings or new buildings will be required to comply with the standards for new construction.

If the project upgrades a physical plant to nursing home standards, or builds a new wing on a nursing home, replaces a facility, or extensively remodels a nursing home, it is necessary to have a nursing station on each floor. Please see https://www.revisor.mn.gov/rules/4658.5000/

Generally, no. New elements constructed as part of a project must meet new construction standards, i.e., cannot require waivers. If some elements of the room(s) are now waivered, and are not changed due to the project, it will generally be possible to maintain the waiver if it would have been maintained in any case.

Generally, no. As long as the rooms in the old facility are only remodeled as part of a project, it is not required that the facility provide the five percent single rooms. This assumes that no new beds are added and that the facility’s renovations do not involve adding new structures.

If those conflicts are identified early in the application process, the MDH Engineering Section and the MN Department of Labor and Industry building code staff can review the conflicts and generally reach a compromise. Contact the MN Dept. of Labor and Industry.

At least five percent of the rooms in a new wing or building must be single rooms with private toilet rooms (see Minnesota Rules, Part 4658.4100). If extensive remodeling is part of the project, it is recommended that the five percent applies to remodeled areas as well. Put Accordion Text here. This will show when the accordion is open.