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August 11, 2023 Shannon Kay Bock, Authorized Agent CCRI, Inc. 2903 15th Street South Moorhead, MN 56560 RE: Report No. 202303627 CCRI, Inc. License No. 1069088/1069059 Dear Shannon Kay Bock: CORRECTION ORDER An investigation of CCRI, Inc. was completed regarding report number 202203627, which alleged violation of Minnesota Statutes, section 626.557, and Minnesota Statutes, Chapter 245D. This maltreatment allegation concerned neglect. The disposition of the investigation report is inconclusive. One violation was noted. VIOLATIONS AND CORRECTION ORDERS The following violation of state and (or) federal laws and rules was observed. Corrective action for the violation is required by Minnesota Statutes, section 245A.06, and is hereby ordered by the Commissioner of Human Services. Failure to correct the violations within the prescribed amount of time may result in fines and/or action against your license, as provided for in Minnesota Statutes, sections 245A.06 and 245A.07. Citation: Minnesota Statutes 245D.05, subdivision 2, paragraph (a), clause (4). Violation: The license holder did not document the administration of a medication or treatment or the reason for not administering the medication or treatment. The facility was responsible for meeting a client’s (C’s) health needs as assigned in the support plan and support plan addendum. The facility had tracking documentation regarding the C’s range of motion exercises to be done twice daily and use of a stander to be done once daily. However, the documentation was missing data for more than half of the days. Corrective Action Ordered: Correct immediately and maintain compliance with this licensing requirement on a continuing basis throughout the program. If you believe any of the citations are in error, you may ask the Commissioner of Human Services to reconsider the parts of the correction order that you believe to be in error. If you choose to exercise this right, your request for reconsideration must be in writing and received by the Commissioner within 20 calendar days after receipt of this letter. Your request for reconsideration must be sent to: Commissioner Minnesota Department of Human Services c/o Licensing Division PO Box 64242 St. Paul, MN 55164-0242 You must include any and all information, documentation, or other evidence you have to support your request for reconsideration. Please note that a request for reconsideration does not stay any provisions of the correction order. If you have any questions regarding the investigation, contact me immediately. If you have any questions regarding compliance with this Correction Order or applicable rules, contact your licensor, Krista Hastings at 651-431-4825. Sincerely,
Beth Virden, Senior Investigator Office of Inspector General Licensing Division 651-431-6572 Enclosure
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