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March 8, 2023 CERTIFIED MAIL Cathy Hanson, Authorized Agent Mary T Inc 1555 118th Lane NW Coon Rapids, MN 55448-7579 License Number 1073042-HCBS (Home and Community-Based Services) License Number 1073045-H_CRS (Home and Community-Based Services-Community Residential Setting) Report Number 202208541 DETERMINATIONS OF MALTREATMENT ORDER TO PAY A FINE AND ORDER OF CONDITIONAL LICENSE Dear Cathy Hanson: The Department of Human Services (DHS) determined that Mary T, Inc. Palm Village 3 located at 850 98th Avenue Northwest, Coon Rapids, Minnesota, is responsible for serious maltreatment by neglect. Based on this determination, DHS is ordering you to pay a fine of $5000. Details of our findings are provided below and in the enclosed Investigation Memorandum for report 202208541. Our next steps and your options are also detailed. Based on the aforementioned and that Mary T Inc was previously found responsible for serious maltreatment by neglect on November 9, 2022, at the same Community Residential Setting (see Investigation Report Number 202206073), DHS is placing your Home and Community-Based Services-Community Residential Setting (CRS) Mary T Inc Palm Village 3 on conditional status for two years, beginning March 8, 2023. This means you must meet certain conditions to maintain your license, detailed below. I. Determination of Maltreatment Allegation One: It was reported that a vulnerable adult (VA), who required catheter changes monthly, did not consistently have his/her catheter changed for two years. Based on the maltreatment investigation, DHS determined that Mary T, Inc. was responsible for neglect of the VA. Allegation Two: It was reported that the VA was not consistently taken to a hospital for intravenous (IV) antibiotics after a hospitalization in July 2022, (Although it was reported that this occurred in July 2022, information from the investigation showed that it occurred in June 2022). Based on the maltreatment investigation, DHS determined that maltreatment of the VA was inconclusive. See the enclosed Investigation Memorandum for more information. Legal Authority: Minnesota Statutes, section 626.557, subdivision 9c. Fine: $5,000 Additional Citations Related to the Maltreatment Determination 1. Citation: Minnesota Statutes 245D.05, subdivision 1 Violation: For one person whose records were reviewed (P), the license holder did not meet the health service needs as required. The license holder was assigned responsibility for the health need of tracking, scheduling, and accompaniment to all medical appointments for the P in the P’s Coordinated Services and Support Addendum. The license holder failed to meet the P’s assigned health need of having his/her catheter changed monthly when the license holder missed 13 of 28 monthly catheter changes and failed to have the P’s catheter changed for a six-month period. Corrective Action Ordered: You were ordered on November 9, 2022, to review all health records for each service recipient residing at CRS license number 1073045 and take any corrective action needed to attain compliance with this subdivision. You must again review all health records for each service recipient residing at CRS license number 1073045 and take any corrective action needed to attain compliance with this subdivision. Within 30 days of this order, you must submit the findings of the review and any corrective action taken or planned. On an ongoing basis, you must maintain compliance as required with this subdivision. Repeat Violation: A similar violation was cited in Correction Orders dated November 8, 2018, and May 17, 2022, and in a Determination of Maltreatment and Order to pay a Fine dated November 9, 2022. 2. Citation: Minnesota Statutes, section 245D.081. Violation: The license holder did not ensure that staff persons in the role of the designated coordinator and the designated manager provided program management and oversight of the services provided by the license holder as required. The license holder failed to: · Provide oversight of the license holder’s responsibilities assigned in the person’s coordinated service and support plan (CSSP) and coordinated service and support plan addendum (CSSPA); · Take the action necessary to facilitate the accomplishment of the outcomes according to the requirements in section 245D.07; · Provide instruction and assistance to direct support staff implementing the CSSP and the service outcomes, including direct observation of service delivery sufficient to assess staff competency; and · Evaluate the effectiveness of service delivery, methodologies, and progress on the person’s outcomes based on the measurable and observable criteria for identifying when the desired outcomes have been achieved according to the requirements in section 245D.07. · Maintain 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 (b); · Ensure 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 · Evaluate the information identified in clauses (1) to (6) to develop, document, and implement ongoing program improvements. Corrective Action Ordered: Within 30 days of this order, you must submit the names of the designated coordinator and designated manager associated with CRS license number 1073045. Within 30 days you must submit an attestation to DHS that these persons fully under their roles and responsibilities with all applicable laws and rules. The attestation must be signed by the Authorized Agent, designated coordinator, and designated manager. II. Order to Pay a Fine Because DHS determined that Mary T, Inc. is responsible for serious maltreatment, you must pay a $5000 fine. The act of maltreatment was determined to be serious because the VA was hospitalized three times for infections that likely were the result of the VA’s catheter not being replaced in a timely manner and that for a two-year period, 13 of 28 catheter changes were missed. Legal Authority: Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), subparagraph (4). Billing and Payment of the Fine DHS will send you an invoice for the $5000 fine. Payment must be made as directed on the invoice. If you request a contested case hearing, as described below, do not pay the fine at this time. After the contested case hearing, the Commissioner of DHS will issue a final order. Please note, you may not avoid payment of this fine by closing, selling, or otherwise transferring the license to a third party. If this occurs, each controlling individual is personally and jointly responsible for payment. If you do not pay the fine on or before the date specified on the invoice and you did not request a contested case hearing, as described below, the Commissioner may issue a second fine, may not issue or reissue a license, or may suspend the license until the license holder pays the fine. III. ORDER OF CONDITIONAL LICENSE Reason for the Conditional License Pursuant to Minnesota Statutes, section 245A.06, subdivision 1, the Commissioner of Human Services may make a license conditional if the license holder fails to comply fully with applicable laws or rules. As required, the Commissioner has considered the nature, chronicity, or severity of the violation of law or rule and the effect of the violation on the health, safety, or rights of persons served by the program. Nature, Severity, and Chronicity DHS has substantiated two findings of maltreatment for which the facility was responsible which met the definition of serious maltreatment.
Based on the nature, severity, and chronicity of the violations and noncompliance in the program which impact the health and safety of persons served in your care, your license to provide Home and Community-Based Services-Community Residential Setting (HCBS-CRS) is placed on a conditional status for two years with the full expectation that Mary T Inc, Palm Village 3 will come into immediate and ongoing compliance with HCBS-CRS licensing requirements. Mary T Inc is being placed on notice that failure to demonstrate substantial compliance with licensing requirements or compliance with the terms of the conditional license may result in additional licensing sanctions, up to and including revocation of the Home and Community-Based Services license in addition to action taken on the community residential setting license. Terms of the Conditional License In addition to the Home and Community-Based Services-Community Residential Setting licensing statutes, you are required to comply with the following terms: a. Submit all corrective action ordered related to citation 1 and citation 2. b. The capacity of the community residential setting license number 1073045 will not be increased for the duration of the conditional license. c. Variances to the community residential setting license number 1073045 will not be authorized for the duration of the conditional license. d. You may not admit a new resident to the community residential setting license 1073045 for a period of 30 days for you to gain compliance. Submissions required as part of a corrective action ordered must be sent to your Licensor at: Commissioner, Department of Human Services ATTN: Diana Arnzen c/o Licensing Division PO Box 64242 St. Paul, MN 55164-0242 IV. YOUR RIGHT TO APPEAL You have right to appeal the maltreatment determination, fine, and/or conditional license. Please see options below. Should you exercise your rights to appeal send: 1.
Right to appeal the fine, maltreatment determination, and order of conditional license You have the right to appeal the fine and maltreatment determination. Your request must be in writing and clearly state that you are requesting a contested case hearing for this matter. Your request must be made before the deadlines provided below. If you do not meet this deadline, you lose your right to an administrative appeal. The timeline to appeal began when you received this order. If you are mailing your request, it must be sent by certified mail and postmarked within 15 calendar days from when you received this order. See address, section IV. If your request is being personally delivered, it must be received by DHS within 15 calendar days from when you received this order. See address, section IV. Upon DHS’ receipt of your timely appeal, your case would be scheduled for a contested case hearing in front of an Administrative Law Judge. After this hearing, the Commissioner of DHS will issue a final order. 2. Request for reconsideration of the maltreatment determination and/or the order of conditional license If you do not appeal the fine, you may still request reconsideration of the maltreatment determination and/or the order of conditional license. Your request must be made before the deadlines provided below. If you do not meet this deadline, you lose your right to request reconsideration. The timeline to request reconsideration began when you received this order. Your request must: · Be in writing · Clearly state that you are requesting reconsideration of the maltreatment determination · Identify what is inaccurate or incomplete about the information in the Investigation Memorandum · Supply information that is accurate or more complete · State why you believe the finding of maltreatment should be changed · Be made before the deadlines provided below. Your request must be postmarked within 15 calendar days from when you received this order. See address, section IV. A response to your reconsideration request will be mailed within 15 working days after DHS receives your request. You have the right to request a fair hearing if a response is not mailed within 15 working days. 3. Right to appeal the order to pay a fine and/or the order of conditional license You have the right to only appeal the fine and/or the order of conditional license. Your request must be in writing and clearly state that you are requesting a contested case hearing for this matter. Your request must be made before the deadlines provided below. If you do not meet this deadline, you lose your right to an administrative appeal. The timeline to appeal began when you received this order. 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. See address, section IV. If your request is being personally delivered, it must be received by DHS within 10 calendar days from when you received this order. See address, section IV. Upon DHS’ receipt of your timely appeal, your case would be scheduled for a contested case hearing in front of an Administrative Law Judge. After this hearing, the Commissioner of DHS will issue a final order. 4. Legal representation at the contested case hearing You do not need a lawyer to appeal. However, a lawyer can help you with your appeal. The state or county will not get you a lawyer and will not pay for a lawyer. If you cannot afford a lawyer, you may be able to get free legal advice or help with your appeal. To find out if free help is available, contact: Volunteer Lawyers Network at 612-752-6677; Central Minnesota Legal Services at 612-332-8151; Southern Minnesota Legal Services at 651-222-4731; or go to www.justice4mn.org to find a local legal services program that may be able to help you. You can also find information on contested cases from the Office of Administrative Hearings website at https://mn.gov/oah/self-help. Click on Administrative Law Overview, then click on Administrative Law Contested Case Hearing Guide for a list of frequently asked questions. Legal authority for this licensing action · This action is taken under Minnesota Statutes, section 245A.07, subdivision 1, paragraph (a), which describes in addition to making a license conditional under section 245A.06, which conditions DHS may impose a fine against a license. · Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), clause (4), item (ii) provides that DHS may impose a $5000 fine for each for each determination of maltreatment of a child under chapter 260E which meets the definition of serious maltreatment for which the license holder is determined responsible. · “Serious maltreatment” is defined in Minnesota Statutes, section 245C.02, subdivision 18. · In determining whether the facility, an individual, or both are responsible for substantiated maltreatment, DHS must consider the mitigating factors provided in Minnesota Statutes, section 260E.30, subdivision 4, paragraph (a), clauses (1) and (2). · Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), clause (5) states that license holders may not avoid payment of a fine by closing, selling, or transferring a license. · License holders have a right to appeal licensing actions and request a contested case hearing, under Minnesota Statutes, chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. · License holders have a right to request reconsideration of a maltreatment determination, under Minnesota Statutes, section 260E.33, subdivision 2, paragraph (a) and (b). · Minnesota Statutes, section 245A.04, subdivision 7, paragraph (d), clause (4), states that DHS shall not issue or reissue a license if the applicant, license holder, or controlling individual has an outstanding debt related to a license fee, licensing fine, or settlement agreement for which payment is delinquent. · Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), clause (2), states that that the license holder shall pay the fine assessed on or before the payment date specified, and if the license holder does not do so the commissioner may issue a second fine or suspend the license until the license holder complies. Questions If you have any further questions regarding the maltreatment determination, you may contact Sara Schumacher, at 651-431-6555. If you have any further questions regarding the conditional license, you may contact Christala Culhane, at 651-431-6541. Sincerely,
Alyssa Dotson, Deputy Inspector General Office of Inspector General Licensing Division Enclosure
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