05-13-2020 Council Packet - Laserfiche WebLink

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28 Amendments to Documents Certain amendments to the Loan Agreement, the Mortgage, and the Indenture may be made without notice to or the consent of the registered owners of the Series 2020 Bonds, and other amendments may be made with the consent of the registered owners of not less than a majority in aggregate principal amount of all Bonds outstanding under the Indenture. Such amendments may affect the security for the Series 2020 Bonds and are binding on all Bondholders, whether or not they have consented to the amendment. See “APPENDIX D - DEFINITIONS AND SUMMARY OF CERTAIN PRINCIPAL DOCUMENTS” in this Official Statement. Elder Care & Vulnerable Adult Protection Act of 2019 In May 2019, the Minnesota Legislature adopted, and Governor Walz signed, the Elder Care & Vulnerable Adult Protection Act of 2019 which was intended to provide a new framework for and establish clarity and expectations for the operation of assisted living facilities and skilled nursing care facilities in Minnesota. The provisions of the Elder Care & Vulnerable Adult Protection Act relating to licensure are not effective until August 1, 2021 and the rulemaking process required under the law will start in July 2019. There will be two levels of licensure commencing in 2021: (i) assisted living and (ii) assisted living with dementia care. The long-term effects of the provisions of the Elder Care & Vulnerable Adult Protection Act are not known at this time since the law was just enacted and the corresponding rulemaking framework is not yet in place. [COVID-19 REVISIONS OF THIS ACT TO BE ADDED PRIOR TO PRINTING OF THE POS] State Licensing Issues [TO BE UPDATED UPON REVIEW OF THE MIX OF REVENUES AS SET FORTH IN THE FORECAST] Legislation may be introduced from time to time in the Minnesota Legislature relating to the operations of senior living and skilled nursing facilities, including the Project. No precise determination can be made at this time whether the bills that may be introduced or the regulations which may be proposed for the purpose of containing costs, providing access to care, or otherwise affecting senior living and memory care provider revenues, or increasing competition among senior living and memory care providers, will be enacted, or, if enacted, whether and to what degree such legislation will impact the financial conditions and results of operations of the Project. State Laws Impacting the Project. The Project are subject to various laws and regulations administered by MDH and other state government agencies, including landlord-tenant laws, laws requiring registration of sex offenders or violent crime offenders seeking placement at the Project, laws requiring criminal arrest checks on certain persons offered employment, laws relating to the employment of nurse’s aides, and laws related to compensation of caregivers. State Regulatory Issues Minnesota Prohibition on Self-Referral. Under Section 144.6521 of Minnesota Statutes, health care providers with financial or economic interests in, or employment or contractual arrangements that limit referral options with, certain types of health care facilities are prohibited from making referrals to such facilities without disclosing their relevant interests and posting a notice of such interest in a public area of the provider’s facility. In addition, Section 62J.23, Subdivision 5 of the Minnesota Statutes directs the Commissioner of MDH to access provider records for the purpose of auditing the referral patterns of providers that qualify for exceptions under the federal Stark Law. The Commissioner is required to report to MDH any audit results that reveal a pattern of referrals by a provider for the furnishing of health services to an entity with which the provider has a direct or indirect financial