Nursing Home Workforce Standards Board outlines staged wages, holiday pay and waiver process; implementation paused pending funding and approvals

ST. PAUL, Minn. — The Nursing Home Workforce Standards Board told the House Workforce, Labor and Economic Development Finance and Policy Committee on March 5 that it has spent 18 months collecting data, holding public forums and drafting rules that set minimum wages and worker protections for nursing homes. The board adopted two sets of rules in May 2024: one set requires legislative appropriation and federal approval before going into effect (earliest effective date 1/1/2026); another set, including holiday pay and posting requirements, was adopted to take effect 1/1/2025.

Leah Solow, executive director of the Nursing Home Workforce Standards Board, told the committee the board—s work included five public forums (three in person, two virtual) attended by 224 speakers and about 200 online questionnaire responses, plus multiple data reviews with state agencies. "Our purpose is to conduct investigations into working conditions in the nursing home industry and adopt rules establishing minimum employment standards reasonably necessary and appropriate to protect the health and welfare of nursing home workers," Solow said, quoting the board's enabling statute and noting the board adopted a "majority benchmark" requirement: rules must "meet or exceed existing industry conditions for a majority of nursing home workers."

The board reported the following elements: - Minimum wages: The board adopted minimum-wage standards that apply generally (dietary, laundry, housekeeping, activity aides) and separate floor wages for certified nursing assistants, trained medical assistants and licensed practical nurses. Those minimum-wage rules were adopted May 9, 2024, but require a legislative appropriation and federal approvals and therefore earliest effective date is Jan. 1, 2026. - Holiday pay: Rules adopted to take effect Jan. 1, 2025, require time-and-a-half pay for workers who work on 11 state holidays (the board relied on the list of state holidays in statute but allowed a swap provision so employers and employees may agree to substitute up to four holidays). - Certified worker organization and posting requirements: The board set a certification process for worker organizations to provide trainings and created employer posting requirements to notify workers of their rights. - Waiver and variance process: Statute required the board to design a process to allow temporary waivers or variances for facilities that demonstrate they are at risk of closure or receivership because of the standards; the board launched that application process Dec. 1, 2024, and as of the committee meeting Solow said no waiver applications had been received.

Committee members asked about the board's cost analysis and notice to facilities. Solow said the board worked with the Department of Human Services on the cost methodology for standards and that minimum-wage rules will return to the legislature for appropriation. Representative Schultz asked whether a minority report had been submitted; Solow confirmed a minority report had been provided to the board but said statute does not require the executive director to include minority reports in the annual legislative progress report.

Several members, including Representative Zalesnikar and Representative Mueller, expressed concern about the rules' fiscal impact. Zalesnikar asked how the board selected the 11 holidays and emphasized that the rules were adopted without a dedicated appropriation. Solow replied that the holidays are the 11 state holidays in statute and that the board included a swap mechanism for employer-employee agreements. She reiterated that minimum-wage rules require appropriation and noted the board's use of DHS data to align the new floors with the "majority benchmark." Solow said the board followed required data and cost procedures but offered to provide further details to the committee on value-based reimbursement and forecasting methodologies.

Solow also described the board membership (nine members: three commissioner designees from DLI, DHS and MDH and six governor appointees representing employers and workers) and said the board held 25 full meetings and 48 work-group meetings prior to adopting rules.

The committee requested the minority report that was submitted to the board and asked for further detail on the cost analyses and the waiver/variance outreach. Solow agreed to provide additional documentation to the committee staff.

The board—s rules will affect nursing home employers, staff and the state—s Medicaid-related financing of long-term care; the minimum-wage rules cannot take effect until the legislature provides funding and any necessary federal approvals are obtained.