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October 6, 2023 Marshall Smith 444 Lafayette Road N Saint Paul, MN 55164-0979 RE: Report No. 202302948 Minnesota Security Hospital dba Forensic Mental Health Program License No. 801558 Dear Marshall Smith: CORRECTION ORDER An investigation of Minnesota Security Hospital dba Forensic Mental Health Program was completed regarding report number 202302948 which alleged violation of Minnesota Statutes, section 626.557, and under the MSH Variance to Minnesota Rules, parts 9520.0500 through 9520.0690 (Rule 36). As a result of this investigation, a Correction Order is being issued. This maltreatment allegation concerned neglect. The disposition of the investigation report is inconclusive. One violation was noted. 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. 1. Citation: Minnesota Statutes, section 245A.04, subdivision 14, paragraph (b). Violation: The license holder failed to monitor the implementation of their policies and procedures. On April 3, 2023, two facility staff persons (P1 and P2) transported a vulnerable adult (VA) from a community hospital back to the facility. P1 and P2 believed a second set of handcuffs was supposed to be used to secure the Velcro on a D-belt; however, when a second set of handcuffs was not available, a zip-tie, provided by a community hospital staff person, was used. A supervisory person (P3) said that a second set of handcuffs was not mandatory and staff persons were not trained to use zip-ties. Corrective Action Ordered: Immediately and on an ongoing basis, the license holder must ensure the implementation of policies and procedures meets all applicable requirements. If you believe the citation is 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 letter. Your request for reconsideration must be sent to: Commissioner, Minnesota Department of Human Services ATTN: Legal Unit 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 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 the investigation, contact me immediately. If you have any questions regarding compliance with this Correction Order or applicable rules, contact your licensor, Ginny Benson, at 651-431-6957. Sincerely,
Deb Neubauer-Hoffman, Investigator Office of Inspector General Licensing Division deb.neubauer-hoffman@state.mn.us 651-431-6567 Enclosure CC: Terry Carey and Soniya Hirachan
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