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May 26, 2023 Mohamed Mohamoud Isse, Authorized Agent Hobbs Home Health Care LLC 1821 University Avenue West, Suite 285 Saint Paul, Minnesota 55104 License Number: 1105939 (245D – HCBS) CORRECTION ORDER Dear Mohamed Mohamoud Isse: On April 25, 2023, a licensing review of Hobbs Home Health Care, LLC, located at 1821 University Avenue West, Suite 285, 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 2. Violation: For two of two persons whose records were reviewed (P1 and P2), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP) as required. a. The license holder failed to include an individualized assessment of P1’s susceptibility to abuse by others, P1’s risk of abusing other adults, and provide statements of the specific measures to be taken to minimize the risk of abuse to P1 and other vulnerable adults. P1’s IAPP documented that P1 was not susceptible to abuse or at risk of abusing other vulnerable adults, however, this assessment was not consistent with information reviewed elsewhere in P1’s record. The coordinated services and supports plan (CSSP) completed by P1’s case manager indicated that P1 was susceptible to self-abuse. b. P2’s IAPP documented that P2 was susceptible to financial exploitation, and that “P2 will receiving assistance with money management to prevent any misuse of fund”, however, the license holder failed to include statements of the specific measures to be taken to minimize the risk of financial exploitation. Additionally, P2’s IAPP documented that P2 was not susceptible to any other areas of abuse or at risk of abusing other vulnerable adults, however, this assessment was not consistent with information reviewed elsewhere in P2’s record. Corrective Action Ordered: Within 30 days of receiving this order, you must: · revise the IAPP’s for P1 and P2 to include individualized assessments of susceptibility to abuse and provide statements of the specific measures that would be taken to minimize the risk of abuse for each assessed area; · review P1 and P2’s IAPP with P1 and P2, P1 and P2’s case managers, and other members of P1 and P2’s support team. You must document this review; and · submit copies of P1-P2’s IAPP’s to your licensor. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.04, subdivision 1. Violation: For one person whose record was reviewed (P1), the license holder did not provide written notice that identified the service recipient rights as required. Minnesota statues, section 245A.02, subdivision 2b defines “annual” or “annually” to mean prior to or within the same month of the subsequent calendar year. The license holder failed to provide P1 with a written notice that identified the service recipient’s rights in subdivisions 2 and 3 and explanation of those rights annually. The service recipient rights were last reviewed with P1 on June 4, 2021. Corrective Action Ordered: Within 30 days of receiving this order, you must provide P1 with a copy of the written notice that identifies the service recipient rights and an explanation of those rights and maintain documentation of the receipt and an explanation of the rights. On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, 245D.071, subdivision 3 Violation: For one person whose record was reviewed (P1), the license holder did not meet the requirements for assessment and service planning as required for intensive support services. The license holder failed to: · complete assessments of P1’s overall strengths, functional skills and abilities, and behaviors and symptoms. P1’s services were initiated on June 2, 2021. The license holder maintained a document in P1’s support plan titled, “Intensive Support Self-Management Assessment” which was completed before the 45-day planning meeting, however, the license holder documented “NA” for each required assessment area. The license holder failed to complete assessments in the following areas: o P1's ability to self-manage health and medical needs to maintain or improve physical, mental, and emotional well-being, including, when applicable, allergies, seizures, choking, special dietary needs, chronic medical conditions, self-administration of medication or treatment orders, preventative screening, and medical and dental appointments; o P1's ability to self-manage personal safety to avoid injury or accident in the service setting, including, when applicable, risk of falling, mobility, regulating water temperature, community survival skills, water safety skills, and sensory disabilities; and o P1's ability to self-manage symptoms or behavior 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. · conduct the above-mentioned assessments annually and review the results with P1 and P1’s support team or expanded support team as part of a service plan review. · determine the following based on the above-mentioned assessments, the person’s identified needs in the support plan, and the requirements in section 245D.07, subdivision 1a: o opportunities to develop and maintain essential and life-enriching skills, abilities, strengths, interests, and preferences; o opportunities for community access, participation, and inclusion in preferred community activities; o opportunities to develop and strengthen personal relationships with other persons of the person's choice in the community; o opportunities to seek competitive employment and work at competitively paying jobs in the community; o 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; and o a discussion of how technology might be used to meet P1's desired outcomes. The coordinated service and 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. Corrective Action Ordered: Within 30 days of receiving this order, you must: · complete the required assessments for P1 that produce information about the person that describes the person’s overall strengths, functional skills, and abilities; · review the results of the above mentioned assessments with P1, P1’s case manager and members of the support team. You must document this review; · have a discussion with P1, P1’s case manager and other members of the support team and include a summary in P1’s support plan about the following: o how technology might be used to meet P1’s desired outcomes, 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. o opportunities to develop and maintain essential and life-enriching skills, abilities, strengths, interests, and preferences; o opportunities for community access, participation, and inclusion in preferred community activities; o opportunities to develop and strengthen personal relationships with other persons of the person's choice in the community; o opportunities to seek competitive employment and work at competitively paying jobs in the community; and o 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; · submit copies of the required above mentioned assessments for P1 to your licensor. On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.071, subdivision 4. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not develop a service plan that documents the service outcomes and supports as required. The license holder failed to develop a service plan that documented the service outcomes and supports for P1 and P2 that included the following within 10 working days of the 45-day planning meeting: · the methods or actions that will be used to support the person and to accomplish the service outcomes, including information about any changes or modifications to the physical and social environments necessary when the service supports are provided, any equipment and materials required, and 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. Corrective Action Ordered: Within 30 days of receiving this order, you must: · develop a service plan for P1 and P2 that documents the service outcomes and supports that includes the following: o the methods or actions that will be used to support P1 and P2 to accomplish the service outcomes, including information about: § any changes or modifications to the physical and social environments necessary when the service supports are provided; § any equipment and materials required; and § techniques that are consistent with the person’s communication mode and learning style; o the measurable and observable criteria for identifying when the desired outcome has been achieved and how data will be collected; o 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 o the names of the staff or position responsible for implementing the supports and methods. · submit a copy of the service outcomes for P1 and P2 to your licensor. On an ongoing basis, you must maintain compliance as required in this subdivision. 5. Citation: Minnesota Statutes, section 245D.071, subdivision 5. Violation: For one person whose record was reviewed (P1), the license holder did not meet the requirements for service plan review and evaluation. The license holder failed to meet with P1, P1’s case manager and other members of the support team to participate in the ongoing review and development of the service plan and methods used to support the person and accomplish outcomes. The annual review must include the following: · a summary of the person's status and progress toward achieving the identified outcomes and make recommendations and identify the rationale for changing, continuing, or discontinuing implementation of supports and methods identified in subdivision 4 in a report available at the time of the progress review meeting; and · a discussion about how technology might be used to meet the person's desired outcomes. The support plan must include a summary of this discussion. The summary must include: o a statement regarding any decision made related to the use of technology; and o a description of any further research that must be completed before a decision regarding the use of technology can be made. Corrective Action Ordered: Within 30 days of receiving this order, you must meet with P1, P1’s case manager and other members of the support team to participate in the ongoing review and development of P1’s support plan. On an ongoing basis, you must maintain compliance as required in this subdivision. 6. Citation: Minnesota Rule, 9544.0030, subpart 1. Violation: For one person whose record were reviewed (P1), the license holder did not incorporate and evaluate positive support strategies as required. The license holder failed to incorporate positive support strategies in writing into P1’s existing support plan. Additionally, the license holder failed to evaluate the identified positive support strategies with P1 every 6 months. Corrective Action Ordered: Within 30 days of receiving this order, you must incorporate positive support strategies in writing into P1’s existing support plan. Additionally, you must evaluate the identified positive support strategies with P1 every 6 months. On an ongoing basis, you must maintain compliance as required in this subdivision. 7. Citation: Minnesota Statutes, Section 245D.09, subdivision 5. Violation: For one of two staff persons whose were reviewed (SP2), the license holder did not provide annual training as required. The license holder failed to provide SP2 with annual training as required in the following areas: · 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. Corrective Action Ordered: Within 30 days of receiving this order, you must: · provide SP2 with the above-mentioned trainings; and · submit copies of the above-mentioned trainings to your licensor. On an ongoing basis, you must provide orientation training 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 amber.n.nielsen@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: Amber Nielsen 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 Office of Inspector General Legal Counsel’s Office Attention: Licensing Legal Unit PO Box 64953 St. Paul, MN 55164-0953 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 Amber Nielsen at 651-431-3661 or amber.n.nielsen@state.mn.us as soon as possible. Christala Culhane, HCBS Licensing Supervisor Licensing Division Office of Inspector General
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