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March 1, 2023 CERTIFIED MAIL Beth Krehbiel, Authorized Agent Zumbro Valley Health Center Connections & Referral Unit 343 Woodlake Dr SE Rochester, MN 55904-6242 License Number 802787-DS (Detoxification Center) Report Number 202206392 DETERMINATION OF MALTREATMENT AND ORDER TO PAY A FINE Dear Beth Krehbiel: The Department of Human Services (DHS) determined that Zumbro Valley Health Center Connections & Referral Unit located at 343 Woodlake Dr SE, Rochester, Minnesota, is responsible for two incidents of maltreatment by neglect and providing false and misleading information. Based on this determination, DHS is ordering you to pay a fine of $2200. Details of our findings are provided below and in the enclosed Investigation Memorandum for report 202206392. Our next steps and your options are also detailed. I. Determination of Maltreatment It was reported that a vulnerable adult (VA) was found deceased at the facility. There were concerns that staff persons did not check on the VA as they were trained to do, that staff persons refused to do rescue breaths, and did not administer Narcan (treatment for suspected opioid overdose). DHS investigated the report as alleged maltreatment by neglect. Based on the maltreatment investigation, DHS determined that Zumbro Valley Health Center Connections & Referral Unit was responsible for two allegations of neglect of a vulnerable adult. See the enclosed Investigation Memorandum for more information. Legal Authority: Minnesota Statutes, section 626.557, subdivision 9c. Fine: $2,000 Citations Related to the Maltreatment Determination 1. Citation: Minnesota Rules, chapter 9530.6550, item A. Violation: The license holder failed to follow their own procedures for monitoring client health and providing observation. On multiple instances on September 10, 2021, staff persons failed to supervise a client, including fifteen minute and hourly checks. Corrective Action Ordered: Correct immediately and maintain compliance with this licensing requirement on a continuing basis throughout the program. Within 10 days of receipt of this order, submit documentation that all staff persons have been retained on Health Services policies and procedures. 2. Citation: Minnesota Statutes, section 245A.04, subdivision 14, paragraph (b). Violation: The license holder failed to monitor implementation of policies and procedures by program staff. On September 10, 2021, multiple staff persons failed to supervise a vulnerable adult as indicated by the facility policies and procedures. Additionally, staff persons said that when they missed a scheduled check, they would go back and document that the missed check had been done. Corrective Action Ordered: Correct immediately and maintain compliance with this licensing requirement on a continuing basis throughout the program. Within 10 days of receipt of this order, submit documentation how this will be monitored on an ongoing basis. II. Providing False and/or Misleading information Based on the maltreatment investigation, DHS determined that staff persons provided false and/or misleading information. Two staff persons provided consistent information that when a supervision check was missed and the tracking sheet had blanks or uncompleted documentation for the checks, the staff person who next completed a check filled in the missing supervision check/s without knowing if the check had been completed or who had completed the check. Legal Authority: Minnesota Statutes, sections 245A.07, subdivision 3, paragraph (a), clause (3) Fine: $200 Corrective Action Required: Within 30 days of receipt of this order, submit written documentation to your DHS licensor showing that all staff have been retrained on documentation requirements. Submissions required as part of a corrective action ordered must be sent to your Licensor at: Commissioner, Department of Human Services ATTN: Leah Wachter c/o Licensing Division PO Box 64242 St. Paul, MN 55164-0242 III. Order to Pay a Fine Because DHS determined that Zumbro Valley Health Center Connections & Referral Unit is responsible for maltreatment and providing false and/or misleading information, you must pay a $2200 fine. Legal Authority: Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), subparagraph (4). IV. Billing and Payment of the Fine DHS will send you an invoice for the $2200 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. V. YOUR RIGHT TO APPEAL You have right to appeal the maltreatment determination and/or fine. Please see options below. Should you exercise your rights to appeal send: 1.
Right to appeal the fine and maltreatment determination 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 V. 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 V. 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 only If you do not appeal the fine, you may still request reconsideration of the maltreatment determination. 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 V. 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 only You have the right to only appeal the fine. 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 V. 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 V. 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 under which conditions DHS may impose a fine against a license. · Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), clause (4), item (i) provides that DHS may impose a $1000 fine for each determination of maltreatment of a vulnerable adult under section 626.557 for which the license holder is determined responsible. · DHS may impose a $200 fine for each health, safety, or supervision licensing violation under Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), clause (4), item (iv). · 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 626.557, subdivision 9c, paragraph (c). · 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 626.557, subdivision 9d. · 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. · License holders must have and enforce written policies and procedures related to suspected maltreatment, under 245A.65, subdivision 1. Questions If you have any further questions regarding this matter, you may contact Melanie Daniel, Supervisor, at 651-431-6559. Sincerely,
Alyssa Dotson, Deputy Inspector General Licensing Division Office of Inspector General Enclosure
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