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December 1, 2022 Arnold Kubei, Authorized Agent Metro Care Human Services 6043 Hudson Road, Suite 340 Saint Paul, Minnesota 55125 License Number: 1087086 (245D – HCBS) CORRECTION ORDER Dear Arnold Kubei: Between October 24, 2022 – October 25, 2022, a licensing review of Metro Care Human Services, located at 6043 Hudson Road, Suite 340, Saint Paul, Minnesota, was conducted to determine compliance with state and federal laws and rules governing the provision of home and community-based services to persons with disabilities and age 65 and older under Minnesota Statutes, Chapter 245D. 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). Violation: For one of two persons whose records were reviewed (P2), the license holder did not provide orientation to internal and external reporting procedures related to suspected or alleged maltreatment as required. P2’s services were initiated on June 1, 2021. The license holder failed to provide orientation to P2 and P2’s legal representative on the license holder’s internal and external reporting procedures to suspected or alleged maltreatment within 24 hours of admission. The license holder informed P2 and provided copies of the required policies and procedures on July 26, 2021. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (b). Violation: For one person whose record was reviewed (P2), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP). The license holder failed to develop an IAPP for P2 as part of the initial individual program plan or service plan. P2’s services were initiated on June 1, 2021. The license holder developed an IAPP for P2 on July 26, 2021. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, section 245D.04, subdivision 1. Violation: For one person whose record was reviewed (P2), the license holder did not provide the person or their legal representative with a written notice that identified the service recipient rights as required. P2’s services were initiated on June 1, 2021. The license holder failed to provide P2 with a written notice that identified the service recipient rights and an explanation of those rights within five days of service initiation. The license holder provided P2 with a written notice that identified the service recipient rights on July 26, 2021. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.10, subdivision 4, paragraph (b). Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not provide copies of policies and procedures as required. P1’s services were initiated on July 13, 2021 and P2’s services were initiated on June 1, 2021. The license holder failed to inform P1’s case manager, P2 and P2’s case manager of the following policies and procedures and provide copies of those policies and procedures, within five working days of service initiation: · grievance policy; · service suspension policy; · service termination policy; and · emergency use of manual restraints policy. The license holder informed P2 and provided copies of the required policies and procedures on July 26, 2021.
Corrective Action Ordered: Within 30 days of receiving this order, you must provide P1’s and P2’s case manager with copies of the above mentioned policies and procedures. On an ongoing basis, you must maintain compliance as required in this subdivision. 5. Citation: Minnesota Statutes, section 245D.05, subdivision 2. Violation: For one person whose record was reviewed (P2), the license holder did not implement medication procedures in order to ensure that the person received medication as prescribed. P2 received medication orders on August 31, 2022 to increase Abilify to 40mg and start Olanzapine. At the time of the review, these medication changes were not made and medications were not being administered as prescribed. P2 received medication orders on August 8, 2022 to administer two doses of Invermectin, two weeks apart as a result of a diagnosed skin condition. There is no documentation that this medication was ever administered as prescribed. The license holder speculated that it may have been an insurance issue but there was no documentation of this. Corrective Action Ordered: Immediately upon receiving this order, you must ensure that all individuals in your program are receiving medications as prescribed. On an ongoing basis, you must maintain compliance throughout your program, as required in this subdivision. 6. Citation: Minnesota Statutes, section 245D.05, subdivision 4. Violation: For two persons whose record were reviewed (P1 and P2), the license holder did not review medication administration records as required. The license holder was assigned responsibility for medication administration for P1 and P2. The license holder failed to review the person’s medication administration records at minimum of every three months to ensure the medication administration records were current and was regularly reviewed to identify medications administration errors. Corrective Action Ordered: Within 30 days of receiving this order, you must: · review P1’s and P2’s medication administration records to ensure that the information maintained in the record is current and to identify medication administration errors; · document the reviews according to Minnesota Statutes, section 245D.095, subdivision 3; and · based on the review, develop and implement a plan to correct patterns of medication administration errors when identified. On an ongoing basis, you must maintain compliance as required in this subdivision. 7. Citation: Minnesota Statutes, section 245D.09, subdivision 4. Violation: For one of two staff persons whose record was reviewed (SP2), the license holder did not provide orientation training as required. SP2 was hired July 5, 2021. The license holder failed to provide orientation to individual needs prior to having unsupervised direct contact. The license holder provided this orientation in April 17, 2022. Additionally, the license holder failed to provide orientation training on the license holder’s policies and procedures until November 30, 2021. Corrective Action Ordered: On an ongoing basis, you must maintain compliance throughout your program, as required in this subdivision. 8. Citation: Minnesota Statutes, section 245D.095, subdivision 5. Violation: For one staff person whose record was reviewed (SP2) the license holder did not maintain a personnel record as required. a. The license holder failed to maintain documentation in SP2’s personnel record or elsewhere sufficient to determine SP2’s first date of supervised direct contact and first date of unsupervised direct contact. b. The license holder failed to document in SP2’s personnel record the amount of training hours per subject area. Corrective Action Ordered: On an ongoing basis, you must maintain compliance throughout your program, as required in this subdivision. 9. Citation: Minnesota Statutes, section 245D.10, subdivision 1. Violation: The license holder did not enforce policies and procedures as required. During the licensing review, licensors observed a printed email dated August 2, 2022 from a person who identified themselves as a designated manager addressed to a staff person, attached to an Employee Corrective Action Form. In the email, the designated manager acknowledged that the guardians of a person served by the program were “well within their right to report us to DHS for neglect and I’m surprised they didn’t” regarding a situation with a person served. Based on this email, it was evident that the license holder was aware of suspected maltreatment; however, the license holder failed to enforce their maltreatment of vulnerable adults policy by not reporting the suspected maltreatment. At the time of the licensing review, the license holder was instructed by a DHS licensor to report the suspected maltreatment. Corrective Action Ordered: Immediately upon receiving this order, you must ensure that you report all incidents of suspected or reported maltreatment within 24 hours of becoming aware and that you are following all of your policies and procedures, as required in this subdivision. 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. Submissions required as part of a corrective action ordered must be sent to your Licensor at: 1. By secure email at Desiree.B.Tiller@state.mn.us; or 2. If you are unable to submit corrective action ordered securely through email, you can mail or fax using the information below: Commissioner, Department of Human Services ATTN: Desiree Tiller Licensing Division PO Box 64242 St. Paul, MN 55164-0242 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 64953 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 your licensor, Desiree Tiller, at 651-431-4622. Tiffany Solano, Senior Human Services Licensor Licensing Division Office of Inspector General
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