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July 10, 2024 Simon Nyamari, Authorized Agent Amani Health Care Services LLC 1705 Southcross Drive West #105 Burnsville, Minnesota 55306 License Number: 1091055 (245D – Home and Community-Based Services) CORRECTION ORDER Dear Simon: On June 12, 2024, a licensing review of Amani Health Care Services LLC, located at 1705 Southcross Drive West #105, Burnsville, 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 245.05, subdivision 1 paragraph (b). Violation: For two of three persons whose records were reviewed (P1 and P2), the license holder did not maintain documentation of how health needs would be met as required. a. The license holder stated they were not responsible for any health services needs for P1, however, P1’s support plan addendum stated the license holder would provide P1 with medication assistance. The license holder failed to document how medication assistance would be provided. b. The license holder stated they were not responsible for any health services needs for P2, however, P2’s support plan addendum stated the license holder would provide P2 with medication assistance. The license holder failed to document how medication assistance would be provided. Corrective Action Ordered: Within 30 days of receipt of this order, you must document how you will meet P1 and P2’s health service needs in P1 and P2’s support plan addendums. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.07, subdivision 3. Violation: For two persons whose records were reviewed (P2 and P3), the license holder did not provide progress reports as required. 245A.02, subdivision 2b defines “annual” or “annually” to mean prior to or within the same month of the subsequent calendar year. a. P2’s support plan addendum dated April 12, 2023, documented that P2’s support team requested annual progress reports. The license holder failed to provide progress reports to P2’s support team in 2024. b. P3’s support plan addendum dated April 27, 2023, documented that P3’s support team requested annual progress reports. The license holder failed to provide progress reports to P3’s support team in 2024. Corrective Action Ordered: Within 30 days of receipt of this order, you must provide P2 and P3’s support team with progress reports as stated in P2 and P3’s support plan. On an ongoing basis, you must maintain compliance as required in this subdivision. Repeat Violation: In an Order for Conditional License that DHS issued on February 23, 2022, you were previously found in violation of this same statute. 3. Citation: Minnesota Statutes, section 245D.071, subdivision 3. Violation: For one person whose record was reviewed (P1), the license holder failed to meet service planning and delivery requirements for an intensive service as required. P1’s service initiation date was May 16, 2023. The license holder failed to meet with the person and their support team before providing 45 days of service or within 60 days of service initiation (whichever was shorter). In addition, the license holder failed to complete P1’s assessments within 45 days of providing services or 60 calendar days. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. Repeat Violation: In a Correction Orders that DHS issued on February 28, 2023, and October 18, 2023, you were previously found in violation of this same statute. 4. Citation: Minnesota Statutes, section 245D.071, subdivision 4. Violation: For one person whose record was reviewed (P1), the license holder did not develop supports and outcomes as required. The license holder failed to develop P1’s supports and outcomes within 10 days of the 45-day planning meeting. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. Repeat Violation: In Orders for Conditional License that DHS issued on February 23, 2022, and January 5, 2024, and a correction order dated October 18, 2022, you were previously found in violation of this same statute. 5. Citation: Minnesota Statutes, section 245D.071, subdivision 5. Violation: For one person whose record was reviewed (P1), the license holder did not review and evaluate the service plan as required. The license holder failed to complete progress reports for P1’s outcomes annually in 2024. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required with this subdivision. Repeat Violation: In an Order for Conditional license that DHS issued on January 5, 2024, you were previously found in violation of this same statute. 6. Citation: Minnesota Statutes, section 245D.095, subdivision 3. Violation: For three persons whose records were reviewed (P1, P2, and P3), the license holder did not maintain service recipient records as required. The license holder failed to maintain progress or daily log notes for P1, P2, and P3. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required with 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. 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 ATTN: Legal Unit Licensing Division PO Box 64953 St. Paul, MN 55164-0242 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 me as soon as possible. Diana Arnzen, Senior Human Services Licensor Licensing Division Office of Inspector General 651-431-6638
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