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<br />11 <br />relief or refer to appropriate public or private agencies upon receipt of information which may indicate failure of a <br />housing with services establishment to meet legal requirements. Furthermore, housing with services establishments <br />holding out to be assisted living establishments are required to meet additional requirements for the minimum level <br />of services provided, including but not limited to 24-hour access to an on-call registered nurse, and the home care bill <br />of rights for assisted living clients must contain additional protection regarding changes in services or charges. MDH <br />also retains similar authority with respect to assisted living establishments as it does with respect to housing with <br />services establishments. <br />Effective August 1, 2021, facilities in Minnesota that provide elderly assisted living and memory care <br />services are subject to licensing and other regulatory requirements in accordance with Chapter 144G of the Minnesota <br />Statutes (the “Assisted Living Laws”). Assisted living services in the Assisted Living Laws adopt the same definition <br />as the currently effective supportive services in Chapter 144D of the Minnesota Statutes set to be repealed August 1, <br />2021. Therefore, the Project will become subject to the Assisted Living Laws’ licensing and regulation requirements <br />on August 1, 2021. MDH is currently working on finalizing the operational regulations pursuant to the Assisted Living <br />Laws, so there can be no assurance that compliance with applicable requirements will not in the future impose financial <br />or other regulatory burdens on the Project. <br />The Assisted Living Laws require assisted living facilities to become annually licensed by the MDH. New <br />assisted living facility applicants will be granted a provisional license beginning August 1, 2021, which will be <br />followed by a survey conducted by MDH to determine compliance. If the provisional licensee is in substantial <br />compliance, MDH will issue a facility license. All licensees will be subject to background studies of individuals <br />providing services that have direct contact with residents and be subject to continuing compliance history review and <br />surveys conducted at least every two years. Compliance issues could result in correction orders, fines, or license <br />revocation. Each license requires annual renewal and compliance with additional regulatory requirements. For <br />example, assisted living facilities are required to enter into contracts with each of their residents that provide certain <br />statutorily prescribed information, maintain staffing requirements, and provide residents with a Uniform Checklist <br />Disclosure of Services. Additional statutory minimum requirements include, as examples: distributing the assisted <br />living bill of rights; providing 24-hour access to health and safety assistance; maintaining adequate resident records; <br />and ensuring site, environment, and fire safety. Regulatory requirements specific to medication management and <br />therapy services may also be applicable. Assisted living facilities providing dementia care services are subject to <br />further licensing and regulatory requirements including demonstrating service ability and training and implementing <br />additional security and safety features. <br />The Corporation also advertises the provision of hospice care services. Facilities providing such services <br />require licensure, regulation, and inspection by the MDH as hospice providers in accordance with the Nursing and <br />Home Care Laws. The Nursing and Home Care Laws establish a number of minimum requirements applicable to the <br />business operations and services provided by hospice providers. Among other things, with respect to hospice <br />providers, the Nursing and Home Care Laws establish minimum standards with respect to health; sanitation; safety <br />and comfort; staff qualifications and training requirements; and availability of staff. In addition, all hospice providers <br />must implement and comply with a hospice bill of rights and provide notice of the hospice bill of rights to their <br />patients. <br />The Corporation’s inability to maintain any of its licenses or registrations, enforcement actions by MDH as <br />a result of failure to comply with applicable legal requirements, or client lawsuits alleging a breach of statutorily <br />prescribed rights at the Project may have a material negative financial impact on the Corporation. <br />Special Care Units for Alzheimer’s Patients. Minnesota housing with services establishments (or assisted <br />living facilities as of August 1, 2021) that secure, segregate, or provide a special program or special unit for residents <br />with a diagnosis of probable Alzheimer’s disease or any other related disorder (or that advertise themselves as <br />providing such specialized care) are considered “special care units” under Chapter 325F.72 of the Minnesota Statutes. <br />Accordingly, housing with services establishments (or assisted living facilities as of August 1, 2021) that have these <br />“special care units” must provide a written disclosure to (i) the Commissioner of MDH, if requested, (ii) the Office of <br />Ombudsman for Long-Term Care, and (iii) each person seeking placement within a residence, or the person’s <br />authorized representative, before an agreement to provide care is entered into and finalized. The written disclosure <br />must outline the special care unit’s criteria for who may reside in the special care unit, the process for assessment and <br />establishment of service plans, staffing credentials, physical environment and design and security features that address