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October 13, 2022 Brian Pattock, Authorized Agent Benedictine Adult Day Services 935 Kenwood Avenue Duluth, Minnesota 55811 License Number: 800181 (Rule 223) CORRECTION ORDER Dear Brian Pattock: On October 12, 2022, a licensing review of Benedictine Adult Day Services, located at 935 Kenwood Avenue, Duluth, Minnesota, was conducted to determine compliance with Minnesota Statutes and Rules governing adult day care services under Minnesota Rules, parts 9555.9600 through 9555.9730 (Rule 223). As a result of this licensing review, a Correction Order is being issued. A. Reason for Correction Order Pursuant to Minnesota Statutes, section 245A.06, if the Commissioner of the Department of Human Services (DHS) finds that the license holder has failed to comply with an applicable law or rule and this failure does not imminently endanger the health, safety, or rights of the persons served by the program, the Commissioner may issue a Correction Order to the license holder. The following violation(s) of state or federal laws and rules were determined as a result of the licensing review. Corrective action for each violation is required by Minnesota Statutes, section 245A.06 and is hereby ordered by the Commissioner of Human Services. 1. Citation: Minnesota Statutes, section 245A.65, subdivision 1, paragraph (c) and subdivision 2, paragraph (a). Violation: For one of three participants whose record was reviewed (P3), the license holder did not provide orientation to the license holder’s internal and external reporting procedures related to suspected or alleged maltreatment and the program abuse prevention plan (PAPP) as required. The license holder failed to provide orientation to P3 on the licensor holder’s internal and external reporting procedures and PAPP within 24 hours of admission. Corrective Action Ordered: Immediately, you must provide an orientation to P3 on your internal and external reporting procedures and PAPP and document the orientation in P3’s record. On an ongoing basis, you must maintain compliance as required in these subdivisions. 2. Citation: Minnesota Rules, part 9555.9640. Violation: For one participant whose record was reviewed (P3), the license holder did not distribute policies and program information to participants and their caregivers upon admission as required. The license holder failed to distribute policies, program information, and participants’ rights to P3 and their caregiver upon P3’s admission to the center. P3’s admission date was June 14, 2021. The license holder distributed policies, program information, and participants’ rights to P3’s caregiver on June 21, 2021. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this part. 3. Citation: Minnesota Rules, part 9555.9660, subpart 1. Violation: For three participants whose records were reviewed (P1, P2, and P3), the license holder did not include information in the participant’s written record as required. a. The license holder failed to maintain an application form in P1’s record that included P1's address, date of admission, telephone number, and source of referral. b. The license holder failed to maintain an application form in P2’s record that included: · P2's address, date of admission, living arrangement, telephone number, and source of referral; · the telephone number of the secondary person to call in case of an emergency involving P2; and · the telephone number of P2's physician or medical provider. c. The license holder failed to include the following information in P3’s record: · an application form that included P3's address, date of admission, and telephone number; and · a statement signed by the center director and P3 at the time of P3's admission specifying the basis on which P3 was determined to be capable or not capable of taking appropriate action for self-preservation under emergency conditions. P3 was admitted to the center on June 14, 2021 and the license holder maintained this statement on June 21, 2021. Repeat Violation: You were cited for a similar violation in a Correction Order issued on February 3, 2020. Corrective Action Ordered: Within 30 days of receiving this order, you must update P1, P2, and P3’s application forms to include the information detailed above. On an ongoing basis, you must maintain compliance as required in this subpart. 4. Citation: Minnesota Rules, part 9555.9690, subpart 3. Violation: For one of two staff persons whose record was reviewed (SP1), the license holder did not provide orientation to the center as required. The license holder failed to provide SP1 orientation to the center that included at least four hours of supervised orientation before SP1 worked directly with persons at the center. Repeat Violation: You were cited for a similar violation in a Correction Order issued on February 3, 2020. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subpart. If you fail to correct the violations specified in the Correction Order within the prescribed time lines the Commissioner may issue an Order of Conditional License or may impose a fine and order other licensing sanctions pursuant to Minnesota Statutes, sections 245A.06 and 245A.07. B. Right to Request Reconsideration If you believe any of the citations are in error, you have the right to request that the Commissioner of Human Services reconsider the parts of the Correction Order that you believe to be in error. The request for reconsideration must be in writing and received by the Commissioner within 20 calendar days after receipt of this report. Your request for reconsideration must be sent to: Commissioner, Department of Human Services ATTN: Legal Unit Licensing Division PO Box 64242 St. Paul, MN 55164-0242 Please note that a request for reconsideration does not stay any provisions or requirements of the Correction Order. The Commissioner’s disposition of a request for reconsideration is final and not subject to appeal under Minnesota Statutes, chapter 14. If you have any questions regarding this Correction Order, please contact me as soon as possible. Brittany Raddatz, Human Services Senior Licensor Licensing Division Office of Inspector General 651-431-6591
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