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Mock surveys are invaluable tools for hospices and offer several benefits. These services are designed to help hospice agencies prepare for official inspections and surveys conducted by accrediting bodies, regulatory agencies, and third-party organizations. The primary goal is to identify any deficiencies or areas for improvement in the hospice agency’s operations, policies, and practices, with the ultimate aim of enhancing overall quality outcomes.

Here are some of the benefits of having a mock survey:

> Preparation: Mock surveys simulate real regulatory inspections, providing an opportunity for hospice staff tounderstand what to expect during an actual survey. This preparation helps them become familiar with theprocess, paperwork, and standards they need to meet.

> Identifying Weaknesses: Mock surveys reveal areas of non-compliance or potential deficiencies in policies, procedures, documentation, or staff training. This allows hospices to address these issues proactively before an actual survey  occurs.

> Training Opportunity: Conducting mock surveys serves as a training exercise for staff, enhancing their understanding of regulatory requirements and reinforcing best practices in patient care, documentation, and safety protocols.

> Improving Performance: By addressing identified weaknesses and implementing corrective actions based on mock survey findings, hospices can improve their overall performance and compliance with regulatory standards.

> Boosting Confidence: Successfully navigating a mock survey can boost staff confidence and morale, reassuring them that they are well-prepared for regulatory inspections. This confidence can positively impact the quality of care provided to patients.

> Risk Mitigation: By proactively addressing compliance issues through mock surveys, hospices reduce the risk of regulatory citations, fines, or other penalties during actual surveys. This helps safeguard the organization’s reputation and financial stability.

> Quality Improvement: Mock surveys not only focus on regulatory compliance but also highlight opportunities for quality improvement in patient care processes, communication, and interdisciplinary teamwork.

The most common survey deficiencies are Plan of Care, Content of and Timeframe for Completion of Comprehensive Assessment, Content and Review of Plan of Care, Coordination of Services, Clinical Records and Hospice Aide Assignments and Duties.

Overall, mock surveys play a crucial role in enhancing the readiness, compliance, and quality of care provided by hospices, ultimately benefiting both patients and staff.

Contact Senior Care Solutions for options for a mock survey with your agency.

Lisa Diez, MA, BSc
Director of Home Care and Hospice Consulting
Senior Care Solutions


The 2023 Legislative Session passed a law effective January 1st , 2024 stating healthcare entities must have an ergonomics program (healthcare entity includes Nursing Homes).

In addition to healthcare entities needing a safety committee, safe patient handling, an AWAIR program, water management committee (Legionella prevention), both Assisted Living and Skilled Nursing facilities must now comply with MN OSHA’s latest regulation on an Ergonomics program in the work place. The goal of an Ergonomics program is to reduce the work related risk of developing musculoskeletal disorders or MSDs.

MSD Definition: musculoskeletal disorder (MSD)
A disorder of the muscles, nerves, tendons, ligaments, joints, cartilage, blood vessels or spinal discs.

Here are some suggestions for putting an ergonomics program in place:

Review Injury Records
Looking at your injury and illness data will help identify ergonomic problems. Review and note the following with your safety committee:
• OSHA 300 Injury and Illness logs
• OSHA 301 reports
• Workers’ compensation records
• First aid logs/incident reports
• Accident and near-miss investigation reports
• Insurance company reports and worker reports of problems

Observe Workplace Conditions and Identify Risk Factors
By looking critically at your workplace operations, you can identify risk factors and eliminate or control them as early as possible. The risk of MSD injury depends on work positions and postures, how often the task is performed, the level of required effort and how long the task lasts. Risk factors that may lead to the development of MSDs include:

• Reaching above the shoulder to load objects or obtain supplies.
   – Can your staff safely access supplies kept in cupboards or is a step stool available?

• Exerting excessive force. Examples include lifting heavy objects or people, pushing or pulling heavy loads, manually or maintaining control of equipment or tools.
   – What is your policy for resident transfers? After a fall?
   – What is your safe lifting rule? Refer to CDC/NIOSH Guidelines: Applications Manual for the Revised NIOSH Lifting Equation (

  Performing the same or similar tasks repetitively. Performing the same motion or series of motions continually or frequently for an extended period of time.
   – Review dishwashers, housekeeping (mopping, vacuuming)
   – Sitting for long periods–is chair properly fit

• Working in awkward postures or being in the same posture for long periods of time.
   – Using positions that place stress on the body, such as prolonged or repetitive reaching above shoulder height, kneeling, squatting, leaning over a counter, using a knife with wrists bent, or twisting the torso while lifting
   – Observe culinary staff, laundry, housekeeping and maintenance departments

• Cold temperatures.
In combination with any one of the above risk factors may also increase the potential for MSDs to develop. For example, many of the operations in culinary working in walk-ins or freezers.

• Combined exposure to several risk factors.
  May place workers at a higher risk for MSDs than does exposure to any one risk factor.

• Observe whether workers are:
   – Modifying their tools, equipment or work area
   – Shaking their arms and hands
   – Rolling their shoulders
   – Bringing products such as back belts or wrist braces into the workplace

These behaviors can mean that workers are experiencing ergonomic issues. Talk witht hem and review their work to see if any risk factors for MSDs are present. Workers canidentify and provide important information about hazards in their workplaces. Their opinions and suggestions for change also are valuable. Consider a work place survey for your employees.

Identify Problem Jobs and Identify Potentially Hazardous Tasks
• Conducting an in-depth ergonomic job analysis to identify solutions to prevent MSDs.

• An ergonomic job hazard analysis is a technique that focuses on job tasks as a way to identify hazards before they occur.
   It focuses on the relationship between the worker, the task, the tools, and the work environment.

Encouraging and Utilizing Early Reports of Injury
• Comprehensive injury reporting is important to the success of an ergonomic process. The goal of this effort is to properly assess, diagnose, and treat MSDs. Early reporting, diagnosis, and intervention can limit injury severity, improve the effectiveness of treatment, minimize the likelihood of disability or permanent damage, and reduce workers compensation claims.

• This will allow the employer to correctly identify work areas or specific tasks where injuries frequently occur or are most severe. This information helps direct the activities of the ergonomic team as well as to guide healthcare providers in making  return-to-work and light-duty work decisions. OSHA’s injury and illness recording and reporting regulation (29 CFR Part 1904) require employers to record and report work-related fatalities, injuries and illnesses.

• Frequently Asked Questions for OSHA’s Injury and Illness Recordkeeping Rule (Link)
Additional guidance to help employers comply with the recordkeeping requirements. Provides links to additional guidance, or, if additional guidance has not been developed, to the regulation.

Encouraging and Utilizing Reports MSD Symptoms:
• Reinforces worker training on recognizing MSD symptoms.
• Encourages early reporting of MSD symptoms.
• Allows for prompt medical evaluations for diagnosis, treatment and follow-up care.
• Reduces injury severity, the number of workers’ compensation claims and associated costs and the likelihood of permanent disability.
• Provides guidance on return-to-work and work placement restrictions during the healing process.
• Guides job modifications.
• Provides a mechanism to track and trend MSD injuries.
• Enables assessment of the effectiveness of work changes.

Some Healthcare Best Practices Include:
• Ceiling-mounted lift system reduces common staff-injuries when lifting and moving residents
• Modified door thresholds allow easy, direct access to adjoining rooms
• Resident ambulation made easier, safer for residents and staff members
• Full-assist mechanical lifts reduce injuries when lifting, moving nursing home residents
• Alternative mopping system reduces ergonomic risk factors
• Having chair analysis for desk nurses and office personnel
• Identify risks such as extensive overtime in employees
• Ensure adequate training and annual competency checks for all manual lifts

What Do I Do First?
• Call a meeting with your safety committee and create an action plan for next steps following the suggestions above.
• Refer to MN OSHA website
Source: MN OSHA (Accessed 12/22/2024)


Resources on Risk Factors
Easy Ergonomics: A Practical Approach for Improving the Workplace. California Department of Industrial Relations
(Cal/OSHA), (1999)
.Provides descriptions and examples of common factors that contribute to the development of MSDs.

Work Related Musculoskeletal Disorders (WMSDs). Canadian Centre for Occupational Health and Safety. (December 12,
Outlines common risk factors and their injuries.

Musculoskeletal Disorders and Workplace Factors (PDF). DHHS (NIOSH) Publication 97-141. (July 1997). Reviews the
majority of the relevant studies available at the time and documents the relationship between MSDs and various workplace factors.

National Research Council. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities.
Washington, DC: The National Academies Press, 2001. Presents the latest information on the prevalence, incidence and costs of musculoskeletal disorders and identifies factors that influence injury reporting.

National Research Council. Work-Related Musculoskeletal Disorders: A Review of the Evidence. Washington, DC: The National Academies Press, 1998. Based on evidence presented and discussed at the two-day Workshop on Work-Related Musculoskeletal Injuries: Examining the Research Base and on follow-up
deliberations of the steering committee assembled by the National Academy of Sciences/National Research Council.

National Research Council. Work-Related Musculoskeletal Disorders: Report, Workshop Summary, and Workshop Papers.
Washington, DC: The National Academies Press, 1999. Includes a steering committee report, workshop information and a review of interventions.

Resources on Job Analysis
Job Hazard Analysis. OSHA Publication 3071, (Revised 2002). Explains what a job hazard analysis is and offers guidelines to help conduct your own step-by-step analysis.

Easy Ergonomics: A Practical Approach for Improving the Workplace. California Department of Industrial Relations (Cal/OSHA), (1999).

Assessment Tools. Department of Defense (DoD) Environment, Safety and Occupational Health Network and Information Exchange (DENIX), Ergonomics Working Group. Provides links to assessment tools and prevention strategies developed by the DOD Ergonomics Working Group.

Manual Handling. Health and Safety Executive (HSE). Contains tools to help employers analyze lifting, carrying and team handling, repetitive upper limb tasks, and pushing and pulling.

Evaluation Tools. Provides links for some useful evaluation tools.
   – Washington State Department of Labor and Industries
   – Ergonomics Association
   – AIHA Ergonomic Assessment Toolkit

Applications Manual for the Revised NIOSH Lifting Equation (PDF). DHHS (NIOSH) Publication 94-110, (September 2021).
Contains a complete description of all terms in NIOSH’s lifting equation with several sample calculations.

Health Hazard Evaluations. National Institute for Occupational Safety and Health (NIOSH). NIOSH conducts investigations of possible health hazards in the workplace. This page allows a search for all NIOSH evaluations concerning ergonomics.
   Ergonomic Evaluation of Surfacing and Finishing Tasks during Eyeglass Manufacturing – Minnesota. National Institute for Occupational Safety and Health (NIOSH) HETA 2010-0114-3168. (November 2012). An evaluation of potential ergonomic risk factors in eyeglass manufacturing.
   Ergonomic Evaluation of Automatic Flat Sorting Machines – Colorado. National Institute for Occupational Safety and Health (NIOSH) HETA 2008-0293-3132. (June 2011). An Evaluation of potential ergonomic hazards among workers using the AFSM 100 machines.
   Ergonomic Evaluation at a Steel Grating Manufacturing Plant. National Institute for Occupational Safety and Health (NIOSH) HETA 2008-0074-3081. (May 2009). An investigation on the high number of MSDs in employees working in the barline, welding, and saw areas.
   Ergonomic Evaluation of Workers at a Cabinet Mill and Assembly Plant. National Institute for Occupational Safety and Health (NIOSH) HETA 2007-0038-3057, (March 2008). An evaluation of potential ergonomic hazards among cabinet makers.
   Interpreters for the Deaf. National Institute for Occupational Safety and Health (NIOSH) HETA 92-0268-2477. (December 1994). An evaluation of the problem of MSDs among interpreters for the deaf.

Resources on Injury Rates
Worker Health Charts: Musculoskeletal Health. Centers for Disease Control and Prevention (CDC). Provides descriptive occupational morbidity and mortality data in the United States. It includes figures and tables describing the magnitude, distribution and trends of the nation’s occupational injuries, illnesses and fatalities.

U.S. Department of Labor, Bureau of Labor Statistics (BLS): Nonfatal Occupational Injuries and Illnesses Requiring Days Away from Work.
Contains summary and MDS statistics (incidence rates by industry), including data tables of nonfatal occupational injuries and illnesses that require days away from work in private industry, state government, and local government.


Michelle Stober


For residents in assisted living, holiday meals are not just about sustenance; they are an integral part of the communal spirit that defines these communities. As residents prepare to come together for festive feasts, prioritizing food safety is paramount to guarantee a healthy and enjoyable celebration.

Food Safety Tips for a Festive Feast:
1. Safe Food Handling Practices:
• Emphasize proper handwashing and glove use for staff involved in food preparation.
• Ensure all utensils and surfaces are regularly sanitized to prevent cross-contamination.

2. Temperature Control:
• Monitor and record food temperatures regularly to prevent bacterial growth.
• Keep hot foods hot (above 140°F) and cold foods cold (below 40°F).

3. Proper Storage Procedures:
• Safely store perishable items, ensuring refrigerators are at the appropriate temperature.
• Label and date food items to facilitate organized storage and timely consumption.

4. Regular Kitchen Inspections:
• Conduct routine inspections of the kitchen to identify and address any potential food safety hazards.
• Maintain open communication between staff members regarding kitchen safety concerns.

5. Adapted Culinary Techniques:
• Consider modifying traditional recipes to align with residents’ dietary needs and safety requirements.
• Experiment with healthier alternatives without compromising the festive flavors.

Spread the Festive Joy, Not Germs
By prioritizing food safety in assisted living communities during the holiday season, staff and residents can create memorable celebrations without compromising health and well-being. The goal is to spread festive joy while fostering an environment that ensures the safety and happiness of everyone involved.

Nourishing the Body and Spirit
As the holiday season approaches, let’s embrace the joy of meals in assisted living communities. By adhering to food safety guidelines, we not only ensure a delightful culinary experience but also create cherished moments that resonate with the spirit of togetherness and care that defines the essence of assisted living. Cheers to a safe, happy, and healthy holiday season!

Need help ensuring you are adhering to Minnesota Food Code requirements. Senior Care Solutions can assist with providing a comprehensive kitchen audit.

Julie Dietz, RN, PHN 
VP of Community-Based Services



Navigating the holidays while grieving can be a challenging and emotional experience. Grief doesn’t take a holiday, and the festive season can intensify feelings of loss and sadness. Here are some suggestions to help individuals cope with grief during the holiday season:

Acknowledge Your Feelings and Communicate Your Needs:
It’s essential to recognize and accept your feelings of grief. Allow yourself to feel a range of emotions and understand that it’s okay not to be okay during this time. Being who you are, feeling what you are feeling as you participate in the holiday spirit is what is important. You may laugh or you may cry. You may practice remembrance, or you may be afraid of forgetting or bewildered by absence. Be who you are and feel what you feel. Communicate with friends and family about your needs during the holidays. Let them know if you prefer a quiet celebration or if you’d like their company and support. Have a plan and anticipate as much as possible how you would like the holidays to go or what you want to avoid.

Create New Traditions:
Consider creating new holiday traditions that honor the memory of your loved one. This can be a way to include them in the celebrations and create a sense of continuity. You can also take a new approach to things. The holidays are traditional times and traditions are good! But you can forget that they have their own time and place. Assess which to continue and which to stop and try something new.

Scale Back & Set Boundaries:
It’s okay to scale back on holiday activities if you’re not up for the usual festivities. Choose the activities that feel most meaningful and manageable for you. Plan how you want to spend the holidays, whether it’s with family, friends, or alone. Having a plan in place can help reduce stress and uncertainty. Set boundaries with well-meaning friends and family. Let them know if there are certain topics or activities that are too difficult for you, and give yourself permission to step away if needed. Other people can be a support but they also can be a burden. On the one hand, they may want to be there for you. On the other hand, they might have expectations of you that you may not want to meet. It is OK for you to state what you feel and need.

Honor Your Loved One:
Find ways to honor and remember your loved one during the holidays. This could include lighting a candle, creating a memorial ornament, or sharing stories about them. While navigating grief, finding moments of gratitude can be healing. Reflect on positive memories, the love shared, and the impact your loved one had on your life.

Take care of yourself physically and emotionally. Get enough rest, eat well, and engage in activities that bring you comfort and peace. Recognize that grief is a personal journey, and it may unfold differently for everyone. Be flexible with yourself and others, allowing space for various emotions and coping mechanisms. Remember that it’s okay to prioritize your well-being during this challenging time. Everyone grieves differently, so be compassionate with yourself and allow the holiday season to unfold in a way that feels most authentic and supportive for you.

If the grief becomes overwhelming, consider seeking support from a therapist or counselor who specializes in grief and loss.


Lisa Diez
Director of Hospice & Home Care Consulting


Lores Vlaminck, owner of Lores Consulting, and Michelle Stober, the owner of Senior Care Solutions (SCS), are thrilled to announce a strategic partnership encompassing Assisted Living, Home Care and Hospice Services. Lores Vlaminck, a highly respected nurse consultant and educator, brings over 47 years of invaluable experience in Assisted Living, Home Care, and Hospice Services. As she embarks on a well-deserved retirement strategy, she reflects on her passion for her work. In a recent interview,. Lores humorously states, “My wonderful husband, who retired five years ago, has been patiently waiting for the time to come. It’s quite a unique position to adore your work, be profoundly passionate about it, and grapple with the idea of transitioning into a life without work—well, somewhat less.”

While Lores will continue to oversee several ongoing projects and engage in the educational work she is passionate about, she eagerly anticipates her new chapter. As Lores makes this transition, she will no longer be taking on new clients and projects. Lores is confident in her decision to partner with SCS and their excellence in consultative work!

Michelle Stober, CEO and owner of SCS, brings over 38 years of acute care experience. Michelle is thrilled about the prospect of partnering with Lores. Michelle emphasizes, “Lores has been my mentor for many years. I crossed paths with her when I was a newcomer in the consulting field. I instantly connected with her profound knowledge and her wonderful spirit. Over the years, she has earned immense respect as a consultant in the State of Minnesota, particularly in Assisted Living, Hospice and Home Care. I am honored to collaborate and work alongside Lores.”

SCS is known for its excellence in Assisted Living consulting and is expanding its services by launching a division dedicated to Home Care and Hospice Services, including consulting, interim leadership, and supplemental nursing support. They proudly announce a new affiliation with the Minnesota Home Care Association and the Minnesota Hospice and Palliative Care Network. This is in addition to their on-going business member partnerships with LeadingAge MN and Care Providers of MN.

Lores and Michelle both share unwavering mission and values of integrity and a commitment to the highest standards of quality care. Together they commit to fulfilling the diverse needs of their customers. 


It’s easy for leaders to get stuck in the day to day to do lists and get wrapped up in meeting after meeting, but it’s so important to take time to interact with your team and try to bring “fun” to work each day. Here are a few ideas to try with your team.

1. Conduct your daily stand-up meeting or weekly team meeting outside or in a new location to change it up.

2. Have lunch as a team once per month, whether everyone brings their own lunch, you order in or have a potluck style lunch! I challenge you not to discuss work over your team lunch and to really take the time to be present with your team and build relationships with them.

3. Go for team walks! Fresh air, sunshine and exercise have so many positive benefits. It could be as simple as a walk around the block or building just to get team members out of their office and reset for the rest of their day. Put this on your team calendar a few times a week with a meeting location and see who can join you.

4. Make your daily stand-up meetings fun! Start the meeting with an interactive question and have each team member provide a response: What’s your favorite restaurant? Favorite vacation location? Favorite season? What is something you’re looking forward to? Or bring a Bluetooth speaker and play some music to start out the meeting.

5. Monthly team building activity – team scavenger hunt, bring in baby picture and guess who is who, team baking/cooking competition – example: who makes the best chocolate chip cookies? Ask your team for ideas and plan them out for the year.

It’s so crucial as a leader to set an example for your team. Show them that you encourage and support having fun at work! Show them you’re taking the time to invest in them beyond the work tasks. I encourage you to set aside 10 minutes this week to brainstorm and plan out 3 new ideas to try with your team. Keep it simple!!


How is your organization dealing with the shortage of healthcare talent?
In addition to permanent staff, many healthcare organizations need to rely on supplemental staff to maintain adequate staff levels. Supplemental staffing can offer various options, including emergency coverage, single shifts, block booking, or extended contracts. Assignment dates and lengths can vary, depending on your needs. Your organization may also use a combination of these options at different times and in different situations. If you are using supplemental staffing in your facility, keep the following valuable tips in mind.

1. Accreditation
Since not all staffing agencies are created equally, you will want to ensure they meet certain criteria before partnering with them. First, verify the agency in consideration is properly registered with the MDH Supplemental Nurse Services Agency. Next, read the reviews and testimonials to better understand the agency’s capabilities and what to expect when making the organization a trusted partner.

2. Personnel Record
When a facility contracts with a supplemental staffing agency, those individuals must meet the same requirements required for personnel employed by the facility. Therefore, the supplemental staff should be treated as employees of the facility. As such, facility management should request a copy of the employee’s background study, TB testing, licensure verification, and completed required educationand training records. Finally, records should be maintained for each supplemental staff member employed at your facility. Minnesota
Department of Health has been targeting supplemental staff employee records during surveys. Make sure you are prepared.

3. Agency Orientation
Like your facility employees, agency individuals need to be appropriately orientated to your site to help ensure quality care to residents and teamwork among staff. Create a supplemental staff orientation checklist to review with a new agency employee. Include topics such as:

>  orientation to residents and care plans

>  equipment use

>  medication system

>  communication system

>  infection control practices

>  emergency procedures

>  policies and procedures, including vulnerable adult

It is helpful to have all this content in a central binder. Have a designated facility staff member responsible for the supplemental staff to report directly to should they have questions or need further support.

The Bottom Line
As the staffing shortage looms, the need for proper staffing is critical to help prevent staff burnout and maintain quality resident care. With more healthcare facilities beginning to understand the importance of having a multi-faceted approach to staffing and MDH focusing on contracted staff, leaders need to become more knowledgeable about the different types of staffing agencies and factors to consider to best fit their needs.

For more information on Supplemental Staffing Suport contact us at


There are no requirements in facilities for coffee temperature. The preferred temperature for brewing is 195 degrees or greater -— but it only takes 1 second for a serious burn to occur from liquids starting at 155 degrees. 

The issue with turning the temperature down is that the coffee doesn’t brew as well and people complain about the
flavor -— we can’t turn the coffee machines down low enough to be safe without sacrificing quality. So, the answer is to eliminate the risk of burns by taking preventative steps: locking machines, moving the machines, making public coffee only available in air pots, using travel mugs with spill-resistant lids, etc.  

If burns are happening from coffee pots -— leave pots open in the kitchen after filling, before covering and putting in resident reach or add ice cubes to the pot to achieve a safer, yet still palatable temperature. 

Time and Temperature for Water to Cause a Serious Burn in a Healthy Adult
155ºF               68ºC               1 second
140ºF               60ºC               5 seconds
127ºF               52ºC               1 minute
120ºF               48ºC               5 minutes
100ºF               38ºC               safe bathing temp

For more information on health and safety practices visit our website at


From the desk of Julie 

It’s hard to believe a year has passed since the Minnesota Department of Health (MDH) introduced new assisted living regulations. To date, there have been 346 survey results posted by MDH. The average number of deficiencies per survey is approximately 14. The top five most common survey deficiencies cited following a state survey were:

1. Tag 0810: 144G.45 Subd. 2 (b)-(f) Fire protection and physical environment – Fire Safety and Evacuation Plans, Training, and Drills (79% of surveys)
Common problems identified:

  • No evidence employees were trained on fire safety and evacuation plans upon hire and twice per year
  • No evidence of a plan or policy/procedure to make available annual fire safety and evacuation training for residents able to assist in their own evacuation
  • Fire/evacuation drills were not planned or documented
  • Failure to ensure fire safety and evacuation plans were readily available to residents, staff, and visitors
  • Failure to identify residents who may need additional assistance for evacuations

2. Tag 0480: 144G.41 Subdivision 1. (13) (i) (B) facility is not following the Minnesota Food Code, Ch. 4626; Completed by EH – (75% of surveys)
Common problems identified:

  • Inaccurate refrigerator temperature or no thermometer to check the temperature
  • TCS food not date-labeled or stored past date
  • No method to verify sanitizing solution (test strips) or no solution available
  • No certified food protection manager is employed or being shared across multiple communities
  • No proof staff had been trained in vomit or fecal matter cleanup procedures, and no PPE or cleanup kit made readily available
  • Improper food storage – dry goods on the floor, food stored on the floor of the walk-in cooler, raw foods not on the lowest level of the refrigerator
  • Unkempt kitchen area – rusty shelves, soiled mugs, slime on ice machine, light bulbs burned out, grease on the floor, floor drain missing a cover

3. Tag 0680: 144G.42 Subd. 10 – Disaster planning and emergency preparedness plan – (60% of surveys)
Common problems identified:

  • No prominent signage or postings regarding the facility’s emergency plan at the facility entrance, in the hallways, in the dining area, or the living areas
  • Emergency exit diagrams were not posted on each floor
  • Emergency preparedness staff training (on hire and twice annually) was not planned or documented
  • Emergency drills were not planned or documented
  • Hazard Vulnerability Analysis lacking analysis of potential vulnerabilities
  • Emergency Preparedness Plan failed to describe the population served by the facility, the process for cooperation with state and local officials, and policies and procedures for sheltering in place

4. Tag 0800: 144G.45 Subd. 2 (a) Physical environment – Good Repair and Condition – (48% of surveys)
Common problems identified:

  • Emergency lights or regular lights that do not work
  • Doors held open by wedges or that do not latch properly
  • Exit doors blocked
  • Inadequate unobstructed space below sprinkler heads
  • Loose or missing handrails
  • Flooring – cracked or missing tiles, worn or torn carpeting
  • Windows in secured unit missing stoppers to restrict resident elopement
  • Windows in sleeping rooms that are too small.

5. Tag 0780: 144G.45 Subd. 2. (a) (1) Fire protection and physical environment – Smoke Alarms – (42% of surveys)
Common problems identified:

  • Unplugged smoke alarms
  • Smoke alarms not installed where required
  • Disconnected or disabled smoke alarms
  • Smoke alarms with dead batteries or expired (more than10 years old)
  • Smoke alarms that were not interconnected within a unit
  • Obstructed sprinkler heads or covered in lint
  • Use of unfused and unapproved power strips and multiplug adapters

* Data obtained from Care Providers of Minnesota

What this means for you:
Be prepared for when the state arrives at your facility. As you can see, most of the top deficiencies are areas new to the assisted living license – food code and environmental. Make sure your maintenance and kitchen staff understand the new regulations. Have your maintenance team conduct environmental inspections to ensure that your facility is in good condition and that the emergency plan is up to code. Make sure to have a Certified Food Protection Manager and that there is always a person in charge. Managers should conduct  routine audits of kitchens and staff to ensure proper food safety.

For assistance with updating your documents please visit our website at


Julie Dietz, RN, PHN
Senior Assisted Living Consultant



From the desk of Julie  —

Are you complying with recently passed changes to Minnesota’s long-term care consultation services statute?Many of the provisions affecting assisted living licensees, become effective August 1, 2022.


Here is a summary of the key changes —

  1. Changes to the Assisted Living Bill of Rights. Modifies the assisted living bill of rights regarding personal treatment and privacy. “Residents have the right to consideration of their privacy, individuality, and cultural identity as related to their social, religious, and psychological well-being. Staff must respect the privacy of a resident’s space by knocking on the door and seeking consent before entering, except in an emergency unless otherwise documented in the resident’s service plan.”

B. Modifies the additional language that must be provided with the assisted living bill of rights. “If you want to report suspected abuse, neglect, or financial exploitation, you may contact the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about the facility or person providing your services, you may contact the Office of Health Facility Complaints, Minnesota Department of Health. If you would like to request advocacy services, you may contact the Office of Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health and Developmental Disabilities.”


  1. Changes to the grievance policy. Removes the requirement in the posted grievance policy to post the contact information for regional ombudsman.

B. Adds a requirement in the posted grievance policy to state that if an individual has a complaint about the facility or person providing services, the individual may contact the Office of Health Facility Complaints at the Minnesota Department of Health.


  1. Changes to the assisted living contract. Modifies information that must be included in an assisted living contract, to require “a delineation of the grounds under which residents may have housing terminated or be subject to emergency relocation.”

B. Also requires the facility’s health facility identification number, rather than license number, to be included on the contract in a conspicuous place and manner.


  1. Most areas of 144G that currently reference the Office of Ombudsman for Long-Term Care will now also be required to reference the Office of Ombudsman for Mental Health & Developmental Disabilities. Documents needs to include the following language:“You may contact the Ombudsman for Long-Term Care for questions about your rights as an assisted living facility resident and to request advocacy services. As an assisted living facility resident, you may contact the Ombudsman for Mental Health and Developmental Disabilities to request advocacy regarding your rights, concerns, or questions on issues relating to services for mental health, developmental disabilities, or chemical dependency.” 


Documents impacted by the new language:• Notice to residents (144G.20 Subd.12)• Resident transfer plans regarding final revocation, refusal to renew, or suspension of license (144G.20 Subd. 15)• Notice regarding a meeting to discuss a resident’s termination (144G.52 Subd.2)• Included as part of the content of notice of termination (144G.52 Subd.8)• Included as part of the content of emergency relocation (144G.52 Subd.9)• Included as part of the content of nonrenewal of housing (144G.53(b))• Included as part of the content of a coordinate move (144G.55 Subd.1)• Included as part of the content of a transfer within the facility (144G.56 Subd.3)• Included as part of the content of a closure plan (144G.57 Subd.3)• Included as part of the resident notice regarding an approved closure plan (144G.57 subd.5)• Included as a required element of the service plan (144G.70 Subd.4)• Included in the updated assisted living bill of rights (144G.91 Subd.21)• Included as a reason to prohibit retaliation (contact with) regarding complaints (144G.92 Subd.1)• Included as information to be included with every assisted living contract (144g.93)


What this means for you:The new law will require administrators and nursing staff to once again update their notices, postings, and policies. Contracts and service plans will need to be modified, and a new bill of rights will need to be provided. For a full review of all the changes, see the attached link to the Minnesota Department of Health 06/16/2022 bulletin. HTTPS://


For assistance with updating your documents please visit our website at


Julie Dietz, RN, PHNSenior Assisted Living ConsultantSenior Care


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