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February 6, 2023 CERTIFIED MAIL Abdi Mahamed, Authorized Agent 3601 Portland Avenue Minneapolis, MN 55407-2516 License Number: 1106844 (HCBS) ORDER OF CONDITIONAL LICENSE Dear Abdi Mahamed: The Department of Human Services (DHS) is placing your license to provide Home and Community-Based Services for Wellbeing Home Care LLC, located at 3601 Portland Avenue, Minneapolis, Minnesota, on conditional status for two years, beginning February 6, 2023. This means you must meet certain conditions to maintain your license, detailed below. This order is based on your noncompliance with Home and Community-Based Services licensing requirements. Details of our findings are also provided below. Our next steps and your options are also detailed. REASON FOR THE CONDITIONAL LICENSE On October 10, 2022, DHS licensors conducted a licensing review at your facility located at 312 10th Street Southwest, Willmar, Minnesota. As a result of this licensing visit, the DHS licensors determined that your program failed to comply with the laws and rules that apply to licensed Home and Community-Based Services, citing 18 violations. DHS has considered the nature, chronicity, and severity of these violations, as well as the health, safety, and rights of persons by the program. · Nature: Many of the violations cited in the Order of Conditional License are violations of law or rule affecting the health, safety, or rights of persons served by the program. The licensing violations include: o Failure to provide program coordination, evaluation, and oversight by a designated coordinator and a designated manager o Failure to meet the requirements for the completion of individual abuse prevention plans for persons served o Failure to meet the requirements for the completion of the assessments for persons served o Failure to develop and incorporate positive support strategies and person-centered planning o Failure to meet the requirements for intensive service planning and delivery o Failure to provide persons served with an orientation to and an explanation of the service recipient rights o Failure to meet health service needs requirements consistent with the person’s health needs o Failure to maintain service recipient records o Failure to maintain personnel records o Failure to provide required orientation and annual training to staff persons o Failure to enforce policies and procedures · Chronicity: February 11, 2021: HCBS license issued. February 17, 2022: Community Residential Services (CRS) license issued. October 13, 2022: Correction order issued by Kandiyohi Health and Human Services; 1 violation. February 6, 2023 Conditional license (this order); 18 violations · Severity: Many of the violations that led to the Order of Conditional License relate to the health and safety of persons served. Due to the serious and chronic nature of these violations, and the conditions in the program, which impact the health and safety of persons served in your care, your license to provide Home and Community-Based Services is placed on a conditional status. Licensing Violations DHS determined that your program failed to follow licensing rules and statutes, as described below. Program Coordination and Oversight Violations 1. Violation: The license holder did not meet the requirements for program coordination, evaluation, and oversight. a. The license holder failed to ensure that the designated coordinator (SP4) was competent to perform the required duties, including the supervision, support, and evaluation of activities that included: · oversight of the license holder’s responsibilities assigned in the person’s support plan and support plan addendum; · taking the action necessary to facilitate the accomplishment of the outcomes according to the requirements in section 245D.07; · instruction and assistance to direct support staff implementing the support plan and the service outcomes, including the failure to have an established process in which the designated coordinator determines the competency of the person that has been has delegated the responsibility to directly observe the service delivery activities to assess staff competency; · evaluation of the effectiveness of services delivery, methodologies, and progress on the person’s outcomes based on the measureable and observable criteria for identifying when the desired outcomes based on the measureable and observable criteria for identifying when the desired outcome has been achieved according to the requirements in section 245D.07. The failure to provide program coordination and oversight of the services provided is evidenced in citations 2 through 18. b. The license holder failed to ensure that the designated manager (SP4) was competent to perform the required program management and oversight of the services provided by the license holder, included: · maintaining a current understanding of the licensing requirements sufficient to ensure compliance throughout the program as identified in section 245A.04, subdivision 1, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21, paragraph (g); · ensuring the duties of the designated coordinator are fulfilled according to the requirements in subdivision 2; · ensuring staff competency requirements are met according to the requirements in section 245D.09, subdivision 3, including ensuring periodic performance evaluations of the direct support staff’s ability to perform the job functions based on direct observation are completed by the license holder; and · evaluating the information identified in clauses (1) to (6) to develop, document, and implement ongoing program improvements. The failure to provide program management and oversight of the services provided is evidenced in citations 1 through 18. Statute Violated: Minnesota Statutes, section 245D.081, subdivisions 2 and 3. Service Recipient Violations 2. Violation: For three of three persons whose records were reviewed (P1-P3), the license holder did not meet the requirements for individual abuse prevention plans (IAPP) as required. a. For P1 and P2, the license holder failed to develop an IAPP as part of the initial program plan or service prior to or upon service initiation. · P1’s services were initiated on April 21, 2022; however, the license holder failed to develop an IAPP until May 25, 2022. · P2’S services were initiated on May 13, 2022; however, the license holder failed to develop an IAPP until June 28, 2022. b. For P1, the license holder failed to include a statement of the specific measures that would be taken to minimize the risk of abuse in the IAPP. P1 was assessed to be at risk of physical abuse and at risk of abusing other vulnerable adults. The license holder listed the same measures for both assessed areas of risk. c. For P1 and P2, the license holder failed to include an individualized assessment of their susceptibility of abuse. · For P1, the IAPP stated P1 was not susceptible to self-abuse; however, this assessment was not consistent with other information in P1’s record. The support plan completed by the case manager indicated that P1 had recent concerns regarding drug and alcohol dependence, was recently homeless, had sustained frostbite, and had not accessed medical care on a regular basis. · For P2, the IAPP stated P2 was not susceptible to self-abuse; however, this assessment was not consistent with other information in P2’s record. The support plan completed by the case manager indicated that P2 had difficulties with self-care and with taking medications when P2’s mental health was poor. Another document in P2’s support plan addendum indicated P2 had a history of “cheeking” medications. d. For P3, the license holder developed an IAPP; however, they failed to document the statement of measures that would be taken to minimize the risk of abuse within the scope of each service P3 was receiving. P3 received night supervision and individual home supports with training services from the license holder. Statute Violated: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (b), clause (2). 3. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not provide the person, or their legal representative, a written notice that identified the service recipient rights and an explanation of those rights as required. Although the license holder provided P1 and P2 with a copy of the service recipient rights and an explanation of the rights within five days of service initiation, the notice failed to include the following rights: · associate with other persons of the person’s choice, in the community; · personal privacy, including the right to use the lock on the person's bedroom or unit door; · access to the person's personal possessions at any time, including financial resources; · have the freedom to come and go from the residence at will; · have access to three nutritionally balanced meals and nutritious snacks between meals each day; · have freedom and support to access food and potable water at any time; · have the freedom to furnish and decorate the person’s bedroom or living unit; · a setting that is clean and free from accumulation of dirt, grease, garbage, peeling paint, mold, vermin, and insects; · a setting that is free from hazards that threaten the person’s health or safety; and · a setting that meets the definition of a dwelling unit within a residential occupancy as defined in the State Fire Code. The license holder later provided P2 with a written notice that included the above mentioned rights on June 28, 2022. Statute Violated: Minnesota Statutes, section 245D.04, subdivision 1. 4. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not meet the person’s health needs as required. a. The license holder was assigned the responsibility of meeting P1’s health needs, including medication administration. P1 was prescribed a psychotropic medication to be administered as needed (PRN). The license holder failed to maintain documentation of how P1’s health needs would be met, including a description of the procedures the license holder would follow when administering the PRN medication to P1. b. The license holder was assigned the responsibility of meeting P2’s health needs. P2’s support plan addendum stated that the license holder was responsible for “administration of all medications; scheduling and transporting to medical appointments. Converse with providers and document appointments in health record.” P2 had an emergency room visit in September 2022 that resulted in three new prescribed medications. The license holder stated that the license holder transported P2 to the emergency room and dropped P2 off for emergency care. P2 returned to their community residential setting facility without transportation assistance from the license holder. On September 28, 2022, P2 obtained the three new medications prescribed to them during the emergency room visit. P2 stored the medications in their bedroom. Several days later P2 brought the medications to staff. Staff put the medications in P2’s medication drawer, but did not begin to administer the medications. The license holder failed to meet P2’s health needs when the license holder did not converse with the medical provider or document the emergency room visit in P2’s health record. At the time of the licensing review on October 10, 2022, a DHS licensor discovered the three prescriptions in P2’s medication drawer. The license holder was unaware of the medications that had been dispensed to P2 twelve days prior and they had not administered the medications as required in P2’s support plan addendum. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 1. 5. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not implement medication procedures as required. a. The license holder was responsible for medication administration for P2’s medications. During the course of the licensing review conducted on October 10, 2022, a DHS licensor discovered that P2 had three recently prescribed medications that the license holder failed to list on P2’s medication administration record (MAR) and failed to administer the medications from September 28 – October 10, 2022. b. P2’s MAR for August 2022 had four blank spaces where it could not be determined if P2 received the medications. c. The license holder was responsible for administering medications for P1. P1 had one prescribed medication. P1’s MAR listed the medication as Olanzapine 10mg, take 1 tab by mouth at bedtime. Upon viewing P1’s medication, a DHS licensor observed that the prescription label on P1’s medication stated that the medication was Olanzapine 25mg, take 1 tab by mouth at bedtime as needed (PRN). The license holder had been administering the Olanzapine 25 mg tabs since at least August 2022. The license holder failed to check P1’s MAR to ensure the prescription label matched what was documented in the MAR. d. For P1 and P2, the license holder failed to ensure the following information was documented in their medication administration records: · information on any risks or other side effects that were reasonable to expect, and any contraindications to the use of each medication which must be readily available to all staff administering the medication; and · the possible consequences if the medication or treatment was not taken or administered as directed. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 2, paragraphs (a) and (b). 6. Violation: For two persons whose records were reviewed (P1 and P2), the license holder was assigned responsibility for administration of medication in their support plan addendums. The license holder did not ensure that the medication administration records were reviewed as required. Although the license holder stated that the nurse who worked for the program completed medication administration record (MAR) reviews, the license holder was unable to provide documentation showing that the reviews had been completed. A DHS licensor was unable to determine that the MAR reviews had been completed. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 4, paragraph (a). 7. Violation: For two persons whose records were reviewed (P1 and P2), the license holder was assigned responsibility for administration of medication in the support plan addendum. The license holder did not develop, implement, and maintain documentation regarding psychotropic medications as required. P1 and P2 were both prescribed psychotropic medications. For P1 and P2, the license holder failed to maintain documentation that included a description of the target symptoms that each individual psychotropic medication was to alleviate. Statute Violated: Minnesota Statutes, section 245D.051, subdivision 1, paragraph (b). 8. Violation: For three persons whose records were reviewed (P1-P3), the license holder did not provide services in response to the person’s identified needs, interests and preferences as required for each service. a. The license holder failed to provide person-centered service planning when the license holder completed assessments for P1 and P2 titled “Intensive Services Assessments (Self-Management Assessment)” that were not specific to each person’s ability to self-manage in the areas assessed. The wording in the both P1 and P2’s assessments were was almost identical throughout the document. Additionally, the assessment document for P1 listed another person’s name in the area titled “choking.” b. The license holder provided both night supervision services and individualized home supports with training services to P3. The license holder failed to ensure that P3’s support plan addendum identified how services are provided for each service, including how, when and by whom. Statute Violated: Minnesota Statutes, section 245D.07, subdivision 1a. 9. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not provide services in response the person’s identified needs, interests, preferences and desired outcomes as specified in the support plan and support plan addendum as required. a. According to P2’s support plan addendum dated June 28, 2022, P2’s service outcomes and supports were “[P2] will clean their room three times per week and will do their own laundry once every two weeks with staff supervision.” The license holder failed to collect data on P2’s outcomes from June 28, 2022 through the date of the licensing review, October 10, 2022. a. According to P3’s support plan addendum dated March 5, 2022, P3’s service outcomes and supports were: · P3 will see physicians regularly to manage physical and mental health needs; · P3 will participate in activities that they enjoy; · P3 will gain skills to become independent; and · P3 will access services through the waiver to assist with managing daily household tasks. The license holder failed to collect date on P3’s outcomes from March 5, 2022 through the date of the licensing review, October 10, 2022. Statute Violated: Minnesota Statutes, section 245D.07, subdivision 1a. 10. Violation: For three persons whose records were reviewed (P1- P3), the license holder did not complete assessments as required. a. The assessments completed for P1 and P2 both stated that they were not allergic to any medications. However, the assessment for both P1 and P2 also stated in the allergies section “if [P1/P2] were to be prescribed Mercaptopurine, staff will notify the house nurse and seek medical attention as needed.” Other documents in P1 and P2’s record indicated that P1 and P2 have no known allergies. There is no indication in the records that either P1 or P2 are allergic to or have any potential side effects if they were to take this medication. b. The support plan completed by P3’s case manager, dated November 24, 2021, stated that P3 has taken his/her clothes off and goes out into public and this has resulted in both police involvement and hospitalization. The individual abuse prevention plan completed by the license holder also documented that P3 was at risk of self-abuse due to this history. However, the license holder failed to use the information in the support plan and the IAPP when completing P3’s assessments. In the assessments dated April 12, 2022 in the community survival skills section the license holder stated “N/A” regarding P3’s ability to self-manage symptoms or behaviors that may otherwise result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension or termination of services by the license holder, or other symptoms or behaviors that may jeopardize the health and welfare of the person or others. Statute Violated: Minnesota Statues, section 245.071, subdivision 3, paragraph (b). 11. Violation: For three persons whose records were reviewed (P1- P3), the license holder did not meet initial service planning requirements as required. a. The license holder failed to complete a preliminary support plan addendum within 15 days of service initiation for P1 and P2. b. DHS determined the license holder held a 45-day service planning meeting with P1 and members of P1’s support team on May 25, 2022; however, it could not be determined what was discussed or decided at the meeting. For P1, the license holder failed to determine the following: a. the scope of the services to be provided to support the person's daily needs and activities; b. the person's desired outcomes and the supports necessary to accomplish the person's desired outcomes; c. the person's preferences for how services and supports are provided, including how the provider will support the person to have control of the person's schedule; d. whether the current service setting is the most integrated setting available and appropriate for the person; e. opportunities to develop and maintain essential and life-enriching skills, abilities, strengths, interests, and preferences; f. opportunities for community access, participation, and inclusion in preferred community activities; g. opportunities to develop and strengthen personal relationships with other persons of the person's choice in the community; h. opportunities to seek competitive employment and work at competitively paying jobs in the community i. how services must be coordinated across other providers licensed under this chapter serving the person and members of the support team or expanded support team to ensure continuity of care and coordination of services for the person; j. have a discussion of how technology might be used to meet the person's desired outcomes. The support plan or support plan addendum must include a summary of this discussion. The summary must include: · a statement regarding any decision that is made regarding the use of technology; and · a description of any further research that needs to be completed before a decision regarding the use of technology can be made. c. Although the license holder held a meeting within 45 days of service initiation on June 28, 2022 for P2, the license holder failed to determine the following: a. opportunities to develop and maintain essential and life-enriching skills, abilities, strengths, interests, and preferences; b. opportunities for community access, participation, and inclusion in preferred community activities; c. opportunities to develop and strengthen personal relationships with other persons of the person's choice in the community; d. opportunities to seek competitive employment and work at competitively paying jobs in the community; and e. a discussion of how technology might be used to meet the person’s desired outcomes; · the support plan or support plan addendum must include a summary of this discussion; and · the summary must include a statement regarding any decision that is made regarding the use of technology and a description of any further research that needs to be completed before a decision regarding the use of technology can be made. d. Although the license holder held a service planning meeting with P3 and members of P3’s support team within 45 days of service initiation on April 12, 2022, the license holder failed to determine the following: a. the scope of the services to be provided to support the person's daily needs and activities; b. opportunities to develop and strengthen personal relationships with other persons of the person's choice in the community; c. opportunities for community access, participation, and inclusion in preferred community activities; d. opportunities to seek competitive employment and work at competitively paying jobs in the community; e. have a discussion of how technology might be used to meet the person's desired outcomes. The support plan or support plan addendum must include a summary of this discussion. The summary must include: · a statement regarding any decision that is made regarding the use of technology; and · a description of any further research that needs to be completed before a decision regarding the use of technology can be made. Statute Violated: Minnesota Statutes, section 245D.071, subdivision 3, paragraphs (c) and (d). 12. Violation: For three persons whose record were reviewed (P1-P3), the license holder did not develop a service plan that documented the service outcomes and supports based on the assessments completed under subdivision 3 and the requirements in section 245D.07, subdivision 1a, as required. a. Although the license holder had an outcome documented for P1, the license holder failed to implement an outcome for P1. The license holder documented an outcome for P1 that was implemented and monitored by another program. b. Although the license holder had an outcome documented for P2, the license holder failed to document the following supports and methods to accomplish the outcomes: · the measurable and observable criteria for identifying when the desired outcome had been achieved; · the projected starting date for implementing the supports and methods; and · how data would be collected. c. Although the license holder had outcomes documented for P3, the license holder failed to document the following supports and methods to accomplish outcomes: · the methods or actions that will be used to support the person and to accomplish the service outcomes, including information about: o any changes or modifications to the physical and social environments necessary when the service supports are provided; o any equipment and materials required; and o techniques that are consistent with the person’s communication mode and learning style; · the measurable and observable criteria for identifying when the desired outcome has been achieved and how data will be collected; · the projected starting date for implementing the supports and methods and the date by which progress towards accomplishing the outcomes will be reviewed and evaluated; and · the names of the staff or position responsible for implementing the supports and methods. Statute Violated: Minnesota Statutes, section 245D.071, subdivision 4, paragraph (b). 13. Violation: For three persons whose records were reviewed (P1-P3), the license holder did not incorporate and evaluate positive support strategies as required. The license holder maintained a document titled “Positive Support Statement” dated August 23, 2022 in P3’s record; however, the document did not include positive support strategies for P3 and positive support strategies were not documented elsewhere in P3’s record. P1 and P2’s records did not include any positive support strategies.
Rule Violated: Minnesota Rules, part 9544.0030, subpart 1. Staff Violations 14. Citation: Minnesota Statutes, section 245D.09, subdivision 4. Violation: For three of four staff persons whose records were reviewed (SP1-SP3), the license holder did not provide orientation training as required. a. At the time of the licensing review, a DHS licensor requested training curriculums for the training the license holder provided. The license was unable to provide any documentation of material covered or how competency was evaluated for SP1 and SP2 for any of the training topics. A DHS licensor was unable to determine if the license holder provided the trainings. The license holder failed to provide orientation training on the following topics to SP1 and SP2: · data privacy requirements according to sections 13.01 to 13.10 and 13.46, the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff responsibilities related to complying with data privacy practices. · the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights according to the requirements in section 245D.04; · the principles of person-centered service planning and delivery as identified in section 245D.07, subdivision 1a, and how they apply to direct support service provided by the staff person; · the safe and correct use of manual restraint on an emergency basis according to the requirements in section 245D.061 and what constitutes the use of restraints, time out, and seclusion, including chemical restraint; · staff responsibilities related to prohibited procedures under section 245D.06, subdivision 5, why such procedures are not effective for reducing or eliminating symptoms or undesired behavior, and why such procedures are not safe; · basic first aid; and · strategies to minimize the risk of sexual violence, including concepts of healthy relationships, consent, and bodily autonomy of people with disabilities. b. The license holder failed to provide orientation training on the following topics to SP3: · the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights according to the requirements in section 245D.04; · the principles of person-centered service planning and delivery as identified in section 245D.07, subdivision 1a, and how they apply to direct support service provided by the staff person; and · basic first aid. Statute Violated: Minnesota Statutes, section 245D.09, subdivision 4. 15. Violation: For two staff persons whose records were reviewed (SP1 and SP2), the license holder did not provide orientation to individual service recipient needs as required. a. SP1’s orientation did not include all required training regarding P1. SP1’s orientation training record listed that SP1 was trained on April 22, 2022 on P1’s services and supports; however, the license holder had not yet developed the following documents listed in the training record: · P1’s support plan or support plan addendum as it related to the responsibilities assigned to the license holder; · P1’s medication setup, assistance, or administration procedures established for the person when assigned to the license holder according to section 245D.05, subdivision 1, paragraph (b); · P1’s individual abuse prevention plan, to achieve and demonstrate an understanding of the person as a unique individual, and how to implement those plans. b. The license holder failed to provide SP1 and SP2 medication administration orientation and training from a training curriculum developed by a registered nurse or appropriate licensed health professional that incorporated an observed skill assessment conducted by the trainer to ensure unlicensed staff demonstrated the ability to safely and correctly follow medication procedures. A DHS licensor requested the license holder’s medication training curriculum during the licensing review on October 10, 2022. The license holder was unable to produce a medication training curriculum at the time of the licensing review. c. The license holder failed to ensure SP1, and SP2 administered medications only after successful completion of a medication administration training. Statute Violated: Minnesota statutes, section 245D.09, subdivision 4a, paragraph (d). Record Requirement Violations 16. Violation: For one person whose record was reviewed (P3), the license holder did not maintain documentation in the service recipient record as required. a. The license holder failed to maintain progress or daily log notes in P3’s record. b. The license holder stated P3 was provided orientation to the license holder’s maltreatment reporting policies and procedures at service initiation; however, the license holder failed to maintain documentation of this orientation in P3’s record. Statute Violated: Minnesota Statutes, section 245D.095, subdivision 3, paragraph (b). 17. Violation: For one staff person whose record was reviewed (SP3), the license holder did not maintain personnel records as required. The license holder failed to maintain the hours of training per subject area and the name of the trainer in SP3’s personnel record for each required training subject area. Statute Violated: Minnesota Statutes, section 245D.095, subdivision 5, paragraph (a). Corrective action required You must immediately correct the violations cited above. Compliance with this order will be reviewed onsite on an ongoing basis. If you fail to demonstrate substantial compliance with Home and Community-Based Service requirements or with the terms of your conditional license that are provided below, DHS may take an additional licensing action, including revocation, against your license. CONDITIONAL LICENSE TERMS In addition to the Home and Community-Based Services licensing rules and statutes, you are required to comply with the following terms: 1. Within 15 days of receiving this order, you must notify current persons receiving services, all parties who refer persons to the program, and all payer sources of the conditional status of your license. The notification must be approved by DHS Licensing prior to being sent to persons receiving services and all other parties. Therefore, the draft notice must be submitted to DHS for approval within 10 days of receiving this order. The notification must specify the length of time of the conditional status of your license, the reasons your license was made conditional, and it must include either a copy of the Order of Conditional License or an offer to provide a copy of the order upon request. While the license is on conditional status, you must notify new persons receiving services, referral sources, and payer sources that the license is on conditional status before they begin receiving services. The notification to new persons receiving services must specify the length of time of the conditional status of the license, the reasons the license was made conditional, and it must include either a copy of the Order of Conditional License or an offer to provide a copy of the order upon request. Within 30 days of receiving this order, you must submit to the DHS Licensing Division a list of the individuals and parties that received the notice. 2. Within 30 days of receiving this order, you must: · designate a staff person, other than SP4, who is responsible for delivery and evaluation of services provided by the license holder; · designate a managerial staff person, other than SP4, to provide program management and oversight of the services provided by the license holder; and · submit this staff person’s name and qualifications to your licensor for review and approval. The same person may perform both functions if the work and education requirements outlined in section 245D.081, subdivisions 2 and 3 are met. 3. Within 45 days of receiving this order, you must: · submit a written plan detailing how you will ensure the corrective action ordered in this order is completed; and · submit a written plan to your DHS licensor detailing how you will audit all participant and personnel records for compliance with all applicable rules and statutes. 4. Within 60 days of receiving this order, you must: · develop and maintain a training curriculum for each training topic required to be provided to staff persons; · complete the audit of all participant and personnel records according to your written plan; · submit the results of the audit to your licensor; and · submit the date to your licensor that all participant and personnel records will be brought into compliance based on the results of your audit. 5. You may not admit new participants to your program from the date of this order until you have successfully demonstrated to DHS compliance with the terms of the conditional license and have maintained substantial compliance with all licensing standards. At a minimum, you may not admit new participants to your program for a period of six months from the date of this conditional license. Admission of any new participant during the duration of the conditional license is only allowed with prior approval from DHS. YOUR RIGHT TO REQUEST RECONSIDERATION You have the right to request reconsideration of this order and the cited violations. Your request must: · Be in writing · Clearly state that you are requesting reconsideration of the conditional license · List each citation you are challenging and identify what is inaccurate or incomplete about the information in the order · Supply information that is accurate or more complete · State why you believe your license should not be on a conditional status · Be made before the deadlines provided below If you are mailing your request, it must be sent by certified mail and postmarked within 10 calendar days from when you received this order. If you do not meet this deadline, you lose your right to request reconsideration. The timeline to appeal began when you received this order. Please send it to: Commissioner, Department of Human Services Office of Inspector General Legal Counsel’s Office Attention: Licensing Legal Unit PO Box 64953 St. Paul, MN 55164-0953 If your request is being personally delivered, it must be received by DHS within 10 calendar days from when you received this order. Please bring it to: Commissioner, Department of Human Services Office of Inspector General Legal Counsel’s Office Attention: Licensing Legal Unit 444 Lafayette Road North St. Paul, MN 55155 Legal authority for this licensing action · This action is taken under Minnesota Statutes, section 245A.06, subdivision 1. · Home and Community-Based Services license holders are required to follow Minnesota Statutes, Chapters 245A, 245C, and 245D and Minnesota Rules, Chapter 9555. · The timeline to request reconsideration of the order is provided in Minnesota Statutes, section 245A.06, subdivision 4. · If a license holder files a timely reconsideration request, the terms of the conditional license are stayed pending a decision by DHS under Minnesota Statutes, section 245A.06, subdivision 4. · Minnesota Statutes, section 245A.06, subdivision 3 states that DHS may impose additional licensing actions against a license holder that does not correct the violations cited in a conditional license order. Questions If you have any further questions regarding this matter, you may contact Christala Culhane, HCBS Unit Supervisor, at 651-431-6541. Sincerely,
Jill Slaikeu, HCBS Unit Manager Licensing Division Office of Inspector General
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