Minnesota Session Laws - 1989, Regular Session

  

                         Laws of Minnesota 1989 

                        CHAPTER 194-S.F.No. 723 
           An act relating to occupations and professions; 
          regulating nursing; proposing the Minnesota nurse 
          practice act; providing penalties; amending Minnesota 
          Statutes 1988, sections 144A.43, subdivision 3; 
          145A.02, subdivision 18; 148.171; 148.181; 148.191; 
          148.211; 148.231; 148.241; 148.251; 148.261; 148.271; 
          148.281; 148.283; and 319A.02, subdivision 2; 
          proposing coding for new law in Minnesota Statutes, 
          chapter 148; repealing Minnesota Statutes 1988, 
          sections 145A.06, subdivision 3; 148.191, subdivision 
          3; 148.221; 148.251, subdivision 2; 148.261, 
          subdivision 3; 148.272; 148.281, subdivision 1a; 
          148.286; 148.29; 148.291; 148.292; 148.293; 148.294; 
          148.295; 148.296; 148.297; 148.298; and 148.299. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1988, section 144A.43, 
subdivision 3, is amended to read: 
    Subd. 3.  [HOME CARE SERVICE.] "Home care service" means 
any of the following services when delivered in a place of 
residence to a person whose illness, disability, or physical 
condition creates a need for the service:  
    (1) nursing services, including the services of a home 
health aide; 
    (2) personal care services not included under sections 
148.171 to 148.299 148.285; 
    (3) physical therapy; 
    (4) speech therapy; 
    (5) respiratory therapy; 
    (6) occupational therapy; 
    (7) nutritional services; 
    (8) home management services when provided to a person who 
is unable to perform these activities due to illness, 
disability, or physical condition.  Home management services 
include at least two of the following services:  housekeeping, 
meal preparation, laundry, shopping, and other similar services; 
    (9) medical social services; 
    (10) the provision of medical supplies and equipment when 
accompanied by the provision of a home care service; 
    (11) the provision of a hospice program as specified in 
section 144A.48; and 
    (12) other similar medical services and health-related 
support services identified by the commissioner in rule.  
    Sec. 2.  Minnesota Statutes 1988, section 145A.02, 
subdivision 18, is amended to read: 
    Subd. 18.  [PUBLIC HEALTH NURSE.] "Public health nurse" 
means a person who is licensed as a registered nurse by the 
Minnesota board of nursing under section sections 148.171 to 
148.285 and who meets the voluntary certification 
standards registration requirements established by 
the commissioner in relation to section 145A.06, subdivision 
3 board of nursing. 
    Sec. 3.  Minnesota Statutes 1988, section 148.171, is 
amended to read: 
    148.171 [DEFINITIONS.] 
    Sections 148.171 to 148.285 shall be referred to as the 
Minnesota nurse practice act. 
    As used in sections 148.171 to 148.285: 
    (1) The term "Board" shall mean means the Minnesota board 
of nursing. 
    (2) The term "Registered Nurse," abbreviated R.N., shall 
mean a natural person means an individual licensed by the 
Minnesota board of nursing to practice professional nursing.  
    (3) The practice of professional nursing means the 
performance for compensation or personal profit of the 
professional interpersonal service of:  (a) providing a nursing 
assessment of the actual or potential health needs of 
individuals, families, or communities; (b) providing nursing 
care supportive to or restorative of life by functions such as 
skilled ministration of nursing care, supervising and teaching 
nursing personnel, health teaching and counseling, case finding 
and referral to other health resources; and (c) evaluating these 
actions.  
    The practice of professional nursing includes both 
independent nursing functions and delegated medical functions 
which may be performed in collaboration with other health team 
members, or may be delegated by the professional nurse to other 
nursing personnel.  Independent nursing function may also be 
performed autonomously.  The practice of professional nursing 
requires that level of special education, knowledge, and skill 
ordinarily expected of an individual who has completed an 
approved professional nursing education program as described in 
section 148.211, subdivision 1.  A registered nurse who has 
graduated from a program of study designed to prepare registered 
nurses for advanced practice as nurse-midwives and who is 
certified through the national professional nursing organization 
for nurse-midwives may prescribe and administer drugs and 
therapeutic devices within practice as a nurse-midwife. 
    (4) "Licensed practical nurse," abbreviated L.P.N., means 
an individual licensed by the board to practice practical 
nursing. 
     (5) The practice of practical nursing means the performance 
for compensation or personal profit of any of those services in 
observing and caring for the ill, injured, or infirm, in 
applying counsel and procedure to safeguard life and health, in 
administering medication and treatment prescribed by a licensed 
health professional, which are commonly performed by licensed 
practical nurses and which require specialized knowledge and 
skill such as are taught or acquired in an approved school of 
practical nursing, but which do not require the specialized 
education, knowledge, and skill of a registered nurse. 
    (6) "Nurse" means registered nurse and licensed practical 
nurse unless the context clearly refers to only one category. 
    (7) "Nursing assistant" means an individual providing 
nursing or nursing-related services that do not require the 
specialized knowledge and skill of a nurse, at the direction of 
a nurse, but does not include a licensed health professional or 
an individual who volunteers to provide such services without 
monetary compensation. 
    (8) "Public health nurse" means a registered nurse who 
meets the voluntary registration requirements established by the 
board by rule.  
    Sec. 4.  Minnesota Statutes 1988, section 148.181, is 
amended to read: 
    148.181 [BOARD OF NURSING; MEMBERSHIP, APPOINTMENTS, 
VACANCIES, REMOVALS DISCLOSURE.] 
    Subdivision 1.  [MEMBERSHIP.] The board of nursing shall 
consist of 11 members appointed by the governor, each of whom 
shall be a resident of this state.  Five members shall be 
registered nurses, each of whom shall have graduated from an 
approved school of nursing, shall be licensed as a registered 
nurse in this state, and shall have had at least five years 
experience in nursing practice, nursing administration, or 
nursing education immediately preceding appointment.  Two One of 
the five shall have had at least two years executive or teaching 
experience in a professional nursing education program approved 
by the board under section 148.251 during the five years 
immediately preceding appointment, and one of the five shall 
have had at least two years executive or teaching experience 
in a practical nursing education program approved by the board 
under section 148.251 during the five years immediately 
preceding appointment.  Three members shall be licensed 
practical nurses each of whom shall have graduated from an 
approved school of nursing, shall be licensed as a licensed 
practical nurse in this state, and shall have had at least five 
years experience in nursing practice immediately preceding 
appointment.  The remaining three members shall be public 
members as defined by section 214.02.  Membership terms, 
compensation of members, removal of members, the filling of 
membership vacancies, and fiscal year and reporting requirements 
shall be as provided in sections 214.07 to 214.09.  The 
provision of staff, administrative services and office space; 
the review and processing of complaints; the setting of board 
fees; and other provisions relating to board operations shall be 
as provided in sections 148.171 to 148.285 and chapter 214 and 
Laws 1976, chapter 222, sections 2 to 7.  Each member of the 
board shall file with the secretary of state the constitutional 
oath of office before beginning the term of office. 
    Subd. 2.  [VACANCIES.] On expiration of the term of a 
member who is a registered nurse, the governor may appoint a 
registered nurse from a list of members submitted by 
professional nursing groups.  Likewise on expiration of the term 
of a member who is a licensed practical nurse, the governor may 
appoint a licensed practical nurse from a list of members 
submitted by licensed practical nursing groups.  These lists 
should contain names of persons in number at least twice the 
number of places to be filled.  Vacancies occurring on the 
board, when the member is a registered nurse or a licensed 
practical nurse, may be filled for the unexpired terms by 
appointments to be made by the governor from nominations 
submitted by nursing groups in the manner aforesaid or from 
other recommendations.  Members shall hold office until a 
successor is appointed and qualified. 
    Subd. 3.  [DISCLOSURE.] All communications or information 
received by or disclosed to the board relating to any person or 
matter subject to its regulatory jurisdiction, and all records 
of any action or proceedings, except a final decision of the 
board, are private data on individuals as defined in section 
13.02, subdivision 12, and any disciplinary hearing shall be 
closed to the public. 
    Upon application of a party in a proceeding before the 
board under section 148.261, the board shall produce and permit 
the inspection and copying, by or on behalf of the moving party, 
of any designated documents or papers relevant to the 
proceedings, in accordance with rule 34 of the Minnesota rules 
of civil procedure. 
    Sec. 5.  Minnesota Statutes 1988, section 148.191, is 
amended to read: 
    148.191 [OFFICERS; RULES; EXECUTIVE DIRECTOR STAFF; 
POWERS.] 
    Subdivision 1.  [OFFICERS; STAFF.] The board shall elect 
from its members a president, a vice-president and a 
secretary-treasurer who shall each serve for one year or until a 
successor is elected and qualifies.  The board shall appoint and 
employ an executive secretary director and may employ such 
persons as may be necessary to carry on its work.  A majority of 
the board, including one officer, shall constitute a quorum at 
any meeting. 
    Subd. 2.  [POWERS.] (a) The board is authorized to adopt 
and, from time to time, revise rules not inconsistent with the 
law, as may be necessary to enable it to carry into effect the 
provisions of sections 148.171 to 148.299 148.285.  The board 
shall prescribe by rule curricula and standards for schools and 
courses preparing persons for licensure under sections 148.171 
to 148.299 148.285.  It shall conduct or provide for surveys of 
such schools and courses at such times as it may deem 
necessary.  It shall approve such schools and courses as meet 
the requirements of sections 148.171 to 148.299 148.285 and 
board rules.  It shall examine, license and renew the license of 
duly qualified applicants.  It shall hold examinations at least 
once in each year at such time and place as it may determine.  
It shall by rule adopt, evaluate and periodically revise, as 
necessary, requirements for licensure and for registration and 
renewal of registration as defined in section 148.231.  It shall 
cause the prosecution of all persons violating sections 148.171 
to 148.299 148.285 and have power to incur such necessary 
expense therefor.  It shall register public health nurses who 
meet educational and other requirements established by the board 
by rule, including payment of a fee.  Prior to the adoption of 
rules the board shall use the same procedures used by the 
department of health to certify public health nurses.  It shall 
have power to issue subpoenas, and to compel the attendance of 
witnesses and the production of all necessary documents and 
other evidentiary material.  Any board member may administer 
oaths to witnesses, or take their affirmation.  It shall keep a 
record of all its proceedings.  
    (b) The board shall have access to hospital, nursing home, 
and other medical records of a patient cared for by a nurse 
under review.  If the board does not have a written consent from 
a patient permitting access to the patient's records, the nurse 
or facility shall delete any data in the record that identifies 
the patient before providing it to the board.  The board shall 
have access to such other records as reasonably requested by the 
board to assist the board in its investigation.  Nothing herein 
may be construed to allow access to any records protected by 
section 145.64.  The board shall maintain any records obtained 
pursuant to this paragraph as investigative data under chapter 
13. 
    Subd. 3.  The board may employ such persons as may be 
necessary to carry on its work. 
    Sec. 6.  Minnesota Statutes 1988, section 148.211, is 
amended to read: 
    148.211 [LICENSING.] 
    Subdivision 1.  [LICENSURE BY EXAMINATION.] An applicant 
for a license to practice as a registered nurse or licensed 
practical nurse shall apply to the board for a license by 
examination on forms prescribed by the board and pay a fee in an 
amount determined by rule.  An applicant applying for 
reexamination shall pay a fee in an amount determined by rule. 
In no case shall fees be refunded. 
    Before being scheduled for examination, the applicant shall 
provide written evidence verified by oath that the applicant (a) 
is of good moral character, (b) is in good mental health, (c) (1)
has not engaged in conduct warranting disciplinary action as set 
forth in section 148.261; (2) meets secondary education 
requirements as determined by the board and other preliminary 
qualification requirements the board may prescribe by rule,; 
and (d) (3) either has completed a course of study in 
a professional nursing program approved by the board or is 
enrolled in the final term of study in such program.  The board 
shall annually publish and distribute to secondary school 
counselors the requirements for licensure for practice in 
Minnesota.  The nursing program must be approved for the 
preparation of applicants for the type of license for which the 
application has been submitted. 
    The applicant shall be required to pass a written 
examination in the subjects the board may determine.  Each 
written examination may be supplemented by an oral or practical 
examination.  An applicant failing to pass any portion of the 
examination shall be deemed to have failed the examination and 
may apply for reexamination in the subjects or sections failed. 
    Refusal to supply information necessary to determine the 
qualifications of an applicant may result in denial of the 
application. 
    Upon submission by the applicant of an affidavit of 
graduation from an approved nursing program as well as proof 
that the applicant has passed the examination, paid the required 
fees and met all other requirements stated in this subdivision, 
the board shall issue a license to the applicant.  The board may 
issue a license with conditions and limitations if it considers 
it necessary to protect the public.  
    Subd. 2.  [LICENSURE BY ENDORSEMENT.] The board may shall 
issue a license to practice professional nursing as a registered 
nurse or practical nursing without examination to an applicant 
who has been duly licensed or registered as a registered 
professional nurse under the laws of another state, territory, 
or foreign country, if in the opinion of the board the applicant 
has the qualifications equivalent to the qualifications required 
in this state as stated in subdivision 1, all other laws not 
inconsistent with this section, and rules promulgated by the 
board. 
    Subd. 4.  [EDUCATION WAIVED.] A person who has been 
licensed as a licensed practical nurse in another state, who has 
passed a licensing examination acceptable to the board, and who 
has had 24 months of experience as a licensed practical nurse in 
the five years prior to applying for a license is not required 
to meet any additional educational requirements. 
    Subd. 5.  [DENIAL OF LICENSE.] Refusal of an applicant to 
supply information necessary to determine the applicant's 
qualifications, failure to demonstrate qualifications, or 
failure to satisfy the requirements for a license contained in 
this section or rules of the board may result in denial of a 
license.  The burden of proof is upon the applicant to 
demonstrate the qualifications and satisfaction of the 
requirements. 
    Sec. 7.  [148.212] [TEMPORARY PERMIT.] 
    Upon receipt of the applicable fee and in accordance with 
rules of the board, the board may issue a nonrenewable temporary 
permit to practice professional or practical nursing to an 
applicant for licensure who is not the subject of a pending 
investigation or disciplinary action, nor disqualified for any 
other reason, under the following circumstances: 
    (a) The applicant for licensure under section 148.211, 
subdivision 1, has graduated from an approved nursing program 
and has applied to write the first examination for licensure 
given by the board following graduation.  The permit holder must 
practice professional or practical nursing under the direct 
supervision of a registered nurse.  The permit is valid from the 
date of graduation until the date the board takes action on the 
application. 
    (b) The applicant for licensure under section 148.211, 
subdivision 2, has graduated from an approved nursing program in 
another state or territory and has written the first examination 
for licensure given by that jurisdiction's board following 
graduation.  The examination must be the same examination 
required under section 148.211.  The permit holder must practice 
professional or practical nursing under the direct supervision 
of a registered nurse.  The permit shall be valid from the date 
of graduation or completion of the examination, whichever is 
later, until the date of board action on the application. 
    (c) The applicant for licensure under section 148.211, 
subdivision 2, is currently licensed to practice professional or 
practical nursing in another state, territory, or Canadian 
province.  The permit shall be valid from submission of a proper 
request until the date of board action on the application. 
    (d) The applicant for reregistration under section 148.231, 
subdivision 5, is currently registered in a formal, structured 
refresher course for nurses that includes clinical practice. 
    Sec. 8.  Minnesota Statutes 1988, section 148.231, is 
amended to read: 
    148.231 [TASK FORCE; REGISTRATION; NONPRACTICING LIST 
FAILURE TO REGISTER; REREGISTRATION; VERIFICATION.] 
    Subdivision 1.  [REGISTRATION.] Every person licensed to 
practice professional or practical nursing must also maintain 
with the board, a current registration for practice as a 
registered nurse or licensed practical nurse which must be 
renewed at regular intervals stipulated established by the board 
by rule.  Upon adoption by the board of rules establishing 
procedures and minimum requirements for successful completion of 
specified continuing education as hereinafter provided, No 
certificate of registration shall be issued by the board to a 
nurse until the nurse has submitted satisfactory evidence of 
compliance with the procedures and minimum requirements 
established by the board. 
    The fee for periodic registration for practice as a 
registered nurse shall be determined by the board by rule.  A 
penalty fee shall be added for any application received after 
the required date as specified by the board by rule.  Upon 
receipt of the application and the required fees, the board 
shall verify the application and the evidence of completion of 
continuing education requirements in effect, and thereupon issue 
to the applicant nurse a certificate of registration for the 
next renewal period. 
    Subd. 4.  [FAILURE TO REGISTER.] Any person licensed under 
the provisions of sections 148.171 to 148.285 who fails 
to reregister register within the required period hereinbefore 
provided shall not be entitled to practice nursing in this state 
as a registered nurse or licensed practical nurse. 
    Subd. 5.  [REREGISTRATION.] When A person on whose 
registration has lapsed desiring to resume practice the person 
shall make application for reregistration, and submit 
satisfactory evidence of compliance with the procedures 
and minimum requirements established by the board for continuing 
education, and pay the registration fee for the current period 
to the board.  Thereupon, the registration certificate shall be 
issued to such applicant, and such the person who shall 
immediately be placed on the practicing list as a registered 
nurse or licensed practical nurse. 
    Subd. 6.  [FEE FOR LICENSE VERIFICATION.] A person licensed 
under the provisions of sections 148.171 to 148.285 who requests 
the board to verify a Minnesota license to another 
jurisdiction state, territory, or country or to an agency, 
facility, school or institution shall pay a fee to the board for 
each verification. 
    Sec. 9.  [148.232] [REGISTRATION OF PUBLIC HEALTH NURSES.] 
    A public health nurse certified for public health duties by 
the commissioner of health under section 145A.06, subdivision 3, 
or previous authority must be deemed to be registered as a 
public health nurse under the provisions of sections 148.171 to 
148.285. 
    Sec. 10.  Minnesota Statutes 1988, section 148.241, is 
amended to read: 
    148.241 [EXPENSES.] 
    Subdivision 1.  [APPROPRIATION.] The expenses of 
administering sections 148.171 to 148.299 148.285 shall be paid 
from the appropriation made to the Minnesota board of nursing. 
    Subd. 2.  [EXPENDITURE.] All amounts appropriated to the 
board shall be held subject to the order of the board to be used 
only for the purpose of meeting necessary expenses incurred in 
the performance of the purposes of sections 148.171 to 148.285, 
and the duties imposed thereby as well as the promotion of 
nursing education and standards of nursing care in this state. 
    Sec. 11.  Minnesota Statutes 1988, section 148.251, is 
amended to read: 
    148.251 [SCHOOL OF NURSING PROGRAM.] 
    Subdivision 1.  [INITIAL APPROVAL.] An institution desiring 
to conduct a school of nursing program shall apply to the board 
and submit evidence that: 
    (1) It is prepared to provide a program of theory and 
practice in professional or practical nursing as prescribed in 
the curriculum that meets the program approval standards adopted 
by the board.  Such Instruction and required experience may be 
secured obtained in one or more institutions or agencies 
approved by the board outside the applying institution as long 
as the nursing program retains accountability for all clinical 
and nonclinical teaching.  
    (2) It is prepared to meet other standards established by 
law and by the board.  
   Subd. 2.  A survey of the institution or institutions with 
which the school is to be affiliated shall be made by a 
qualified representative of the board.  Such representative 
shall submit a written report of the survey to the board.  If 
the board determines that the requirements for an approved 
school of nursing are met, it shall designate the school as an 
approved school of nursing.  
    Subd. 3.  [CONTINUING APPROVAL.] From time to time as 
deemed necessary by the board, it shall be the duty of the 
board, through its representatives, to survey all schools of 
nursing programs in the state.  Written reports of such surveys 
shall be submitted to the board by the representative.  If the 
results of the survey show that a nursing program meets all 
board rules, the board shall continue approval of the nursing 
program.  
    Subd. 4.  [LOSS OF APPROVAL.] If the board determines that 
any an approved school of nursing program is not maintaining the 
standards required by the statutes and by the board rules, 
notice thereof in writing specifying the defect or defects shall 
be given to the school program.  If a school which program 
fails to correct these conditions to the satisfaction of the 
board within a reasonable time, approval of the program shall be 
revoked and the program shall be removed from the list of 
approved schools of nursing programs.  
    Subd. 5.  [REINSTATEMENT OF APPROVAL.] The board shall 
reinstate approval of a nursing program upon submission of 
satisfactory evidence that its program of theory and practice 
meets the standards required by statutes and board rules. 
    Subd. 4. 6.  [ADVANCED STANDING.] Associate degree nursing 
programs approved or seeking to be approved by the board shall 
provide for advanced standing for licensed practical nurses in 
recognition of their nursing education and experience.  The 
board shall adopt rules by July 1, 1982 to implement this 
section.  
    Sec. 12.  Minnesota Statutes 1988, section 148.261, is 
amended to read: 
    148.261 [REVOCATION OF LICENSE GROUNDS FOR DISCIPLINARY 
ACTION.] 
    Subdivision 1.  [GROUNDS LISTED.] The board shall have 
power to deny, suspend, revoke, suspend, limit, or restrict 
condition the license and registration of any person to practice 
professional or practical nursing pursuant to sections 148.171 
to 148.285, or to otherwise discipline a licensee or 
applicant upon proof that the person: as described in section 
13.  The following are grounds for disciplinary action: 
    (1) Failure to demonstrate the qualifications or satisfy 
the requirements for a license contained in section 148.171 to 
148.285 or rules of the board.  In the case of a person applying 
for a license, the burden of proof is upon the applicant to 
demonstrate the qualifications or satisfaction of the 
requirements. 
    Has employed (2) Employing fraud or deceit in procuring or 
attempting to procure a permit, license, or registration 
certificate to practice nursing as a registered nurse or annual 
registration for the practice of professional or practical 
nursing; or attempting to subvert the licensing examination 
process.  Conduct that subverts or attempts to subvert the 
licensing examination process includes, but is not limited to:  
    (i) conduct that violates the security of the examination 
materials, such as removing examination materials from the 
examination room or having unauthorized possession of any 
portion of a future, current, or previously administered 
licensing examination; 
    (ii) conduct that violates the standard of test 
administration, such as communicating with another examinee 
during administration of the examination, copying another 
examinee's answers, permitting another examinee to copy one's 
answers, or possessing unauthorized materials; or 
    (iii) impersonating an examinee or permitting an 
impersonator to take the examination on one's own behalf. 
    (2) Has been convicted (3) Conviction during the previous 
five years of a felony or gross misdemeanor; reasonably related 
to the practice of professional or practical nursing.  
Conviction as used in this subdivision shall include a 
conviction of an offense that if committed in this state would 
be considered a felony or gross misdemeanor without regard to 
its designation elsewhere, or a criminal proceeding where a 
finding or verdict of guilt is made or returned but the 
adjudication of guilt is either withheld or not entered. 
    (3) Is unfit or incompetent by reason of negligence, habits 
or other causes; 
    (4) Is habitually intemperate or is addicted to the use of 
habit-forming drugs; Revocation, suspension, limitation, 
conditioning, or other disciplinary action against the person's 
professional or practical nursing license in another state, 
territory, or country; failure to report to the board that 
charges regarding the person's nursing license are pending in 
another state, territory, or country; or having been refused a 
license by another state, territory, or country. 
    (5) Has, in a professional capacity, exhibited behavior 
which creates an undue risk of harm to others; Failure to or 
inability to perform professional or practical nursing as 
defined in section 148.171, paragraph (3) or (5), with 
reasonable skill and safety, including failure of a registered 
nurse to supervise or a licensed practical nurse to monitor 
adequately the performance of acts by any person working at the 
nurse's direction. 
    (6) Is guilty of unethical practice of nursing; Engaging in 
unprofessional conduct including, but not limited to, a 
departure from or failure to conform to board rules of 
professional or practical nursing practice that interpret the 
statutory definition of professional or practical nursing as 
well as provide criteria for violations of the statutes, or, if 
no rule exists, to the minimal standards of acceptable and 
prevailing professional or practical nursing practice, or any 
nursing practice that may create unnecessary danger to a 
patient's life, health, or safety.  Actual injury to a patient 
need not be established under this clause.  
    (7) Has willfully or repeatedly violated any of the 
provisions of sections 148.171 to 148.285.  Delegating or 
accepting the delegation of a nursing function or a prescribed 
health care function when the delegation or acceptance could 
reasonably be expected to result in unsafe or ineffective 
patient care. 
    (8) Actual or potential inability to practice nursing with 
reasonable skill and safety to patients by reason of illness, 
use of alcohol, drugs, chemicals, or any other material, or as a 
result of any mental or physical condition.  
    (9) Adjudication as mentally incompetent, mentally ill, a 
chemically dependent person, or a person dangerous to the public 
by a court of competent jurisdiction, within or without this 
state.  
    (10) Engaging in any unethical conduct including, but not 
limited to, conduct likely to deceive, defraud, or harm the 
public, or demonstrating a willful or careless disregard for the 
health, welfare, or safety of a patient.  Actual injury need not 
be established under this clause.  
    (11) Engaging in conduct with a patient that is sexual or 
may reasonably be interpreted by the patient as sexual, or in 
any verbal behavior that is seductive or sexually demeaning to a 
patient, or engaging in sexual exploitation of a patient or 
former patient.  
     (12) Obtaining money, property, or services from a patient, 
other than reasonable fees for services provided to the patient, 
through the use of undue influence, harassment, duress, 
deception, or fraud. 
     (13) Revealing a privileged communication from or relating 
to a patient except when otherwise required or permitted by law. 
     (14) Engaging in abusive or fraudulent billing practices, 
including violations of federal Medicare and Medicaid laws or 
state medical assistance laws. 
    (15) Improper management of patient records, including 
failure to maintain adequate patient records, to comply with a 
patient's request made pursuant to section 144.335, or to 
furnish a patient record or report required by law.  
    (16) Knowingly aiding, assisting, advising, or allowing an 
unlicensed person to engage in the unlawful practice of 
professional or practical nursing.  
    (17) Violating a rule adopted by the board, an order of the 
board, or a state or federal law relating to the practice of 
professional or practical nursing, or a state or federal 
narcotics or controlled substance law. 
    Subd. 3.  Any registered nurse whose license or 
registration has been suspended, restricted or revoked, may have 
the license reinstated and a new registration issued when in the 
discretion of the board the action is warranted, provided that 
such nurse may be required by the board to pay 50 percent of the 
costs of the proceedings resulting in the suspension or 
revocation of the license or registration certificate and 
reinstatement of the license or renewal certificate, and in 
addition thereto, pay the fee for the current year's 
registration. 
    Subd. 4.  [EVIDENCE.] In disciplinary actions alleging a 
violation of subdivision 1, clause (3) or (4), a copy of the 
judgment or proceeding under the seal of the clerk of the court 
or of the administrative agency that entered the same shall be 
admissible into evidence without further authentication and 
shall constitute prima facie evidence of the violation concerned.
    Subd. 5.  [EXAMINATION; ACCESS TO MEDICAL DATA.] The board 
may take the following actions if it has probable cause to 
believe that grounds for disciplinary action exist under 
subdivision 1, clause (8) or (9): 
    (a) It may direct the applicant or nurse to submit to a 
mental or physical examination or chemical dependency 
evaluation.  For the purpose of this subdivision, when a nurse 
licensed under sections 148.171 to 148.285 is directed in 
writing by the board to submit to a mental or physical 
examination or chemical dependency evaluation, that person is 
considered to have consented and to have waived all objections 
to admissibility on the grounds of privilege.  Failure of the 
applicant or nurse to submit to an examination when directed 
constitutes an admission of the allegations against the 
applicant or nurse, unless the failure was due to circumstances 
beyond the person's control, and the board may enter a default 
and final order without taking testimony or allowing evidence to 
be presented.  A nurse affected under this paragraph shall, at 
reasonable intervals, be given an opportunity to demonstrate 
that the competent practice of professional or practical nursing 
can be resumed with reasonable skill and safety to patients.  
Neither the record of proceedings nor the orders entered by the 
board in a proceeding under this paragraph, may be used against 
a nurse in any other proceeding. 
    (b) It may, notwithstanding sections 13.42, 144.651, 
595.02, or any other law limiting access to medical or other 
health data, obtain medical data and health records relating to 
a registered nurse, licensed practical nurse, or applicant for a 
license without that person's consent.  The medical data may be 
requested from a provider, as defined in section 144.335, 
subdivision 1, paragraph (b), an insurance company, or a 
government agency, including the department of human services.  
A provider, insurance company, or government agency shall comply 
with any written request of the board under this subdivision and 
is not liable in any action for damages for releasing the data 
requested by the board if the data are released pursuant to a 
written request under this subdivision unless the information is 
false and the provider giving the information knew, or had 
reason to believe, the information was false.  Information 
obtained under this subdivision is classified as private data on 
individuals as defined in section 13.02.  
    Sec. 13.  [148.262] [FORMS OF DISCIPLINARY ACTION; 
AUTOMATIC SUSPENSION; TEMPORARY SUSPENSION; REISSUANCE.] 
    Subdivision 1.  [FORMS OF DISCIPLINARY ACTION.] When the 
board finds that grounds for disciplinary action exist under 
section 148.261, subdivision 1, it may take one or more of the 
following actions:  
     (1) deny the license, registration, or registration 
renewal; 
    (2) revoke the license; 
    (3) suspend the license; 
    (4) impose limitations on the nurse's practice of 
professional or practical nursing including, but not limited to, 
limitation of scope of practice or the requirement of practice 
under supervision; 
    (5) impose conditions on the retention of the license 
including, but not limited to, the imposition of retraining or 
rehabilitation requirements or the conditioning of continued 
practice on demonstration of knowledge or skills by appropriate 
examination, monitoring, or other review; 
    (6) impose a civil penalty not exceeding $10,000 for each 
separate violation, the amount of the civil penalty to be fixed 
as to deprive the nurse of any economic advantage gained by 
reason of the violation charged, to reimburse the board for the 
cost of counsel, investigation, and proceeding, and to 
discourage repeated violations; 
    (7) order the nurse to provide unremunerated service; 
    (8) censure or reprimand the nurse; or 
     (9) any other action justified by the facts in the case. 
    Subd. 2.  [AUTOMATIC SUSPENSION.] Unless the board orders 
otherwise, a license to practice professional or practical 
nursing is automatically suspended if:  
    (1) a guardian of a nurse is appointed by order of a 
probate court under sections 525.54 to 525.61; 
    (2) the nurse is committed by order of a probate court 
under chapter 253B or sections 526.09 to 526.11; or 
    (3) the nurse is determined to be mentally incompetent, 
mentally ill, chemically dependent, or a person dangerous to the 
public by a court of competent jurisdiction within or without 
this state.  
    The license remains suspended until the nurse is restored 
to capacity by a court and, upon petition by the nurse, the 
suspension is terminated by the board after a hearing or upon 
agreement between the board and the nurse. 
    Subd. 3.  [TEMPORARY SUSPENSION OF LICENSE.] In addition to 
any other remedy provided by law, the board may, through its 
designated board member under section 214.10, subdivision 2, 
temporarily suspend the license of a nurse without a hearing if 
the board finds that there is probable cause to believe the 
nurse has violated a statute or rule the board is empowered to 
enforce and continued practice by the nurse would create a 
serious risk of harm to others.  The suspension shall take 
effect upon written notice to the nurse, served by first-class 
mail, specifying the statute or rule violated.  The suspension 
shall remain in effect until the board issues a temporary stay 
of suspension or a final order in the matter after a hearing or 
upon agreement between the board and the nurse.  At the time it 
issues the suspension notice, the board shall schedule a 
disciplinary hearing to be held under the administrative 
procedure act.  The nurse shall be provided with at least 20 
days' notice of any hearing held under this subdivision.  The 
hearing shall be scheduled to begin no later than 30 days after 
the issuance of the suspension order. 
    Subd. 4.  [REISSUANCE.] The board may reinstate and reissue 
a license or registration certificate to practice professional 
or practical nursing, but as a condition may impose any 
disciplinary or corrective measure that it might originally have 
imposed.  Any person whose license or registration has been 
revoked, suspended, or limited may have the license reinstated 
and a new registration issued when, in the discretion of the 
board, the action is warranted, provided that the person shall 
be required by the board to pay the costs of the proceedings 
resulting in the revocation, suspension, or limitation of the 
license or registration certificate and reinstatement of the 
license or registration certificate, and to pay the fee for the 
current registration period.  The cost of proceedings shall 
include, but not be limited to, the cost paid by the board to 
the office of administration hearings and the office of the 
attorney general for legal and investigative services, the costs 
of a court reporter and witnesses, reproduction of records, 
board staff time, travel, and expenses, and board members' per 
diem reimbursements, travel costs, and expenses.  
    Sec. 14.  [148.263] [REPORTING OBLIGATIONS.] 
    Subdivision 1.  [PERMISSION TO REPORT.] A person who has 
knowledge of any conduct constituting grounds for discipline 
under sections 148.171 to 148.285 may report the alleged 
violation to the board. 
    Subd. 2.  [INSTITUTIONS.] The chief nursing executive or 
chief administrative officer of any hospital, clinic, prepaid 
medical plan, or other health care institution or organization 
located in this state shall report to the board any action taken 
by the institution or organization or any of its administrators 
or committees to revoke, suspend, limit, or condition a nurse's 
privilege to practice in the institution, or as part of the 
organization, any denial of privileges, any dismissal from 
employment, or any other disciplinary action.  The institution 
or organization shall also report the resignation of any nurse 
before the conclusion of any disciplinary proceeding, or before 
commencement of formal charges, but after the nurse had 
knowledge that formal charges were contemplated or in 
preparation.  The reporting described by this subdivision is 
required only if the action pertains to grounds for disciplinary 
action under section 148.261. 
    Subd. 3.  [LICENSED PROFESSIONALS.] A person licensed by a 
health-related licensing board as defined in section 214.01, 
subdivision 2, shall report to the board personal knowledge of 
any conduct the person reasonably believes constitutes grounds 
for disciplinary action under sections 148.171 to 148.285 by any 
nurse including conduct indicating that the nurse may be 
incompetent, may have engaged in unprofessional or unethical 
conduct, or may be mentally or physically unable to engage 
safely in the practice of professional or practical nursing. 
    Subd. 4.  [INSURERS.] Four times each year, by the first 
day of February, May, August, and November, each insurer 
authorized to sell insurance described in section 60A.06, 
subdivision 1, clause (13), and providing professional liability 
insurance to registered nurses or licensed practical nurses 
shall submit to the board a report concerning any nurse against 
whom a malpractice award has been made or who has been a party 
to a settlement.  The report must contain at least the following 
information: 
    (1) the total number of settlements or awards; 
    (2) the date settlement or award was made; 
    (3) the allegations contained in the claim or complaint 
leading to the settlement or award; 
    (4) the dollar amount of each malpractice settlement or 
award and whether that amount was paid as a result of a 
settlement or of an award; and 
    (5) the name and address of the practice of the nurse 
against whom an award was made or with whom a settlement was 
made. 
    An insurer shall also report to the board any information 
it possesses that tends to substantiate a charge that a nurse 
may have engaged in conduct violating sections 148.171 to 
148.285. 
    Subd. 5.  [COURTS.] The court administrator of district 
court or another court of competent jurisdiction shall report to 
the board any judgment or other determination of the court that 
adjudges or includes a finding that a nurse is mentally ill, 
mentally incompetent, chemically dependent, a person dangerous 
to the public, guilty of a felony or gross misdemeanor, guilty 
of a violation of federal or state narcotics laws or controlled 
substances act, guilty of operating a motor vehicle while under 
the influence of alcohol or a controlled substance, or guilty of 
an abuse or fraud under Medicare or Medicaid, appoints a 
guardian of the nurse under sections 525.54 to 525.61, or 
commits a nurse under chapter 253B or section 526.09 to 526.11. 
    Subd. 6.  [DEADLINES; FORMS.] Reports required by 
subdivisions 2 to 5 must be submitted no later than 30 days 
after the occurrence of the reportable event or transaction.  
The board may provide forms for the submission of reports 
required by this section, may require that the reports be 
submitted on the forms provided, and may adopt rules necessary 
to assure prompt and accurate reporting.  The board shall review 
all reports, including those submitted after the deadline. 
     Sec. 15.  [148.264] [IMMUNITY.] 
     Subdivision 1.  [REPORTING.] Any person, health care 
facility, business, or organization is immune from civil 
liability or criminal prosecution for submitting in good faith a 
report to the board under section 14 or for otherwise reporting 
in good faith to the board violations or alleged violations of 
sections 148.171 to 148.285.  All such reports are investigative 
data as defined in chapter 13.  
    Subd. 2.  [INVESTIGATION.] Members of the board and persons 
employed by the board or engaged in the investigation of 
violations and in the preparation and management of charges of 
violations of sections 148.171 to 148.285 on behalf of the board 
or persons participating in the investigation or testifying 
regarding charges of violations are immune from civil liability 
and criminal prosecution for any actions, transactions, or 
publications in the execution of, or relating to, their duties 
under sections 148.171 to 148.285. 
     Sec. 16.  [148.265] [NURSE COOPERATION.] 
     A nurse who is the subject of an investigation by or on 
behalf of the board shall cooperate fully with the investigation.
Cooperation includes responding fully and promptly to any 
question raised by or on behalf of the board relating to the 
subject of the investigation and providing copies of patient or 
other records in the nurse's possession, as reasonably requested 
by the board, to assist the board in its investigation and to 
appear at conferences and hearings scheduled by the board.  The 
board shall pay for copies requested.  If the board does not 
have a written consent from a patient permitting access to the 
patient's records, the nurse shall delete any data in the record 
that identify the patient before providing it to the board.  The 
board shall maintain any records obtained pursuant to this 
section as investigative data under chapter 13.  The nurse shall 
not be excused from giving testimony or producing any documents, 
books, records, or correspondence on the grounds of 
self-incrimination, but the testimony or evidence may not be 
used against the nurse in any criminal case. 
    Sec. 17.  [148.266] [DISCIPLINARY RECORD ON JUDICIAL 
REVIEW.] 
     Upon judicial review of any board disciplinary action taken 
under sections 148.171 to 148.285, the reviewing court shall 
seal the administrative record, except for the board's final 
decision, and shall not make the administrative record available 
to the public. 
    Sec. 18.  Minnesota Statutes 1988, section 148.271, is 
amended to read: 
    148.271 [ALLOWABLE UNLICENSED PRACTICES EXEMPTIONS.] 
    The provisions of sections 148.171 to 148.285 shall not 
prohibit: 
    (1) The furnishing of nursing assistance in an emergency. 
    (2) The practice of professional or practical nursing by 
any legally qualified registered or licensed practical nurse of 
another state who is employed by the United States government or 
any bureau, division or agency thereof while in the discharge of 
official duties. 
    (3) Under the direct supervision of a registered nurse, the 
practice of nursing by a graduate of a school of professional 
nursing approved by the board between the date of graduation and 
the date of notification to the graduate of the board action 
upon application for licensure hereunder, provided that the 
graduate will take the first examination for licensure hereunder 
following graduation given by the board and will be issued a 
permit by the board to engage in supervised practice of 
professional nursing while awaiting notification of the results 
of such examination.  The board is authorized to issue permits 
to such graduates which shall permit the practice of 
professional nursing under direct supervision from the date of 
graduation until the date that the board shall notify the 
graduates of the results of their applications for registration 
conditioned upon the graduates making prompt application for 
registration and taking the first examination given by the board 
which they are eligible to take following graduation.  These 
permits shall not be renewable. 
    (4) The practice of any profession or occupation licensed 
by the state, other than professional or practical nursing, by 
any person duly licensed to practice the profession or 
occupation, or the performance by a person of any acts properly 
coming within the scope of the profession, occupation or license.
    (5) The performance of any act in the nursing care of the 
sick by a nurse's aide under the direction of a registered nurse.
    (4) The provision of a nursing or nursing-related service 
by a nursing assistant who has been delegated the specific 
function and is supervised by a registered nurse or monitored by 
a licensed practical nurse. 
    (6) The practice of nursing by a person licensed as a 
professional nurse in another jurisdiction and qualified for 
licensure in the state of Minnesota pursuant to a temporary 
permit issued by the board of nursing which permit shall be 
issued by the board pursuant to rules as it may promulgate, for 
the period between the submission of a proper application for 
licensure by the person and the date of action upon the 
application by the board. 
    (7) The care of the sick, injured or infirm in a private 
home by any person who does not assume or represent to be a 
registered or professional nurse. 
    (8) (5) The care of the sick with or without compensation 
when done in a nursing home covered by the provisions of section 
144A.09, subdivision 1. 
    (9) The practice of nursing by a graduate of an approved 
professional nursing program in another jurisdiction provided 
the graduate has applied for licensure in the state of Minnesota 
by interstate endorsement and has written the first examination 
for licensure following graduation.  Practice under this clause 
is allowable only under a temporary permit issued by the board 
which shall be issued pursuant to rules as the board may 
promulgate, and which shall be valid only for the period between 
submission of a proper application and completion of the 
examination by the person and the date of action upon the 
application by the board.  The examination must be the same 
examination required of applicants for licensure by examination 
in Minnesota.  The permit shall authorize the practice of 
nursing only under the direct supervision of a licensed 
professional nurse.  The permit shall not be renewable.  
    (6) Professional nursing practice by a registered nurse or 
practical nursing practice by a licensed practical nurse 
licensed in another state or territory who is in Minnesota as a 
student enrolled in a formal, structured course of study, such 
as a course leading to a higher degree, certification in a 
nursing specialty, or to enhance skills in a clinical field, 
while the student is practicing in the course. 
    (7) Professional or practical nursing practice by a student 
practicing under the supervision of an instructor while the 
student is enrolled in a nursing program approved by the board 
under section 148.251. 
    Sec. 19.  Minnesota Statutes 1988, section 148.281, is 
amended to read: 
    148.281 [VIOLATIONS; PENALTY.] 
    Subdivision 1.  [VIOLATIONS DESCRIBED.] It shall be 
unlawful for any person, corporation, or association, to: 
    (1) Sell or fraudulently obtain or furnish any nursing 
diploma, license or record, or aid or abet therein; 
    (2) Practice professional or practical nursing or practice 
as a public health nurse under cover of any diploma, permit, 
license, registration certificate, or record illegally or 
fraudulently obtained or signed or issued unlawfully or under 
fraudulent representation; 
    (3) Practice professional or practical nursing unless the 
person has been issued a temporary permit under the provisions 
of section 7 or is duly licensed and currently registered to do 
so under the provisions of sections 148.171 to 148.285; 
    (4) Use any abbreviation or other designation tending to 
imply licensure as a registered nurse or licensed practical 
nurse unless duly registered and licensed and currently 
registered so to practice professional or practical nursing 
under the provisions of sections 148.171 to 148.285 except as 
authorized by the board by rule; 
    (5) Use any abbreviation or other designation tending to 
imply registration as a public health nurse unless duly 
registered by the board; 
    (6) Practice professional or practical nursing in a manner 
prohibited by the board in any restriction limitation of a 
license or registration issued under the provisions of sections 
148.171 to 148.285; 
    (6) (7) Practice professional or practical nursing during 
the time a license or current registration issued under the 
provisions of sections 148.171 to 148.285 shall be suspended or 
revoked; 
    (7) (8) Conduct a school of nursing program for the 
training education of persons to become registered nurses or 
professional licensed practical nurses unless the school or 
course program has been approved by the board.; and 
    (9) Knowingly employ persons in the practice of 
professional or practical nursing who have not been issued a 
current permit, license, or registration certificate to practice 
as a nurse in this state.  
    Subd. 1a.  It shall be unlawful to operate any 
nongovernmental partnership, corporation or unincorporated 
association which is organized primarily to render professional 
nursing through its agents, unless the partnership, corporation 
or unincorporated association is registered pursuant to rules 
adopted by the board. 
    Subd. 2.  [PENALTY.] Any person, corporation, or 
association violating any provisions of subdivision 1 shall be 
guilty of a gross misdemeanor, and shall be punished according 
to law. 
    Sec. 20.  Minnesota Statutes 1988, section 148.283, is 
amended to read: 
    148.283 [UNAUTHORIZED PRACTICE OF PROFESSIONAL AND 
PRACTICAL NURSING.] 
    The practice of professional or practical nursing by any 
person who has not been licensed to practice professional or 
practical nursing under the provisions of sections 148.171 to 
148.285, or whose license has been suspended or revoked, 
or whose registration has expired, is hereby declared to be 
inimical to the public health and welfare and to constitute a 
public nuisance.  Upon complaint being made thereof by the board 
of nursing, or any prosecuting officer, and upon a proper 
showing of the facts, the district court of the county where 
such practice occurred may enjoin such acts and practice.  Such 
injunction proceeding shall be in addition to, and not in lieu 
of, all other penalties and remedies provided by law.  
     Sec. 21.  Minnesota Statutes 1988, section 319A.02, 
subdivision 2, is amended to read: 
    Subd. 2.  "Professional service" means personal service 
rendered by a professional pursuant to a license or certificate 
issued by the state of Minnesota to practice medicine and 
surgery pursuant to sections 147.01 to 147.29, chiropractic 
pursuant to sections 148.01 to 148.105, registered nursing 
pursuant to sections 148.171 to 148.285, optometry pursuant to 
sections 148.52 to 148.62, psychology pursuant to sections 
148.88 to 148.98, dentistry pursuant to sections 150A.01 to 
150A.12, pharmacy pursuant to sections 151.01 to 151.40, 
podiatric medicine pursuant to Laws 1987, chapter 108, sections 
1 to 16, veterinary medicine pursuant to sections 156.001 to 
156.14, architecture, engineering, surveying and landscape 
architecture pursuant to sections 326.02 to 326.15, accountancy 
pursuant to sections 326.17 to 326.23, or law pursuant to 
sections 481.01 to 481.17, or pursuant to a license or 
certificate issued by another state pursuant to similar laws. 
    Sec. 22.  [REPEALER.] 
    Minnesota Statutes 1988, sections 145A.06, subdivision 3; 
148.191, subdivision 3; 148.221; 148.251, subdivision 2; 
148.261, subdivision 3; 148.272; 148.281, subdivision 1a; 
148.286; 148.29; 148.291; 148.292; 148.293; 148.294; 148.295; 
148.296; 148.297; 148.298; and 148.299, are repealed. 
    Presented to the governor May 18, 1989 
    Signed by the governor May 19, 1989, 12:14 a.m.