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September 4, 2024 Kayf Ahmed, Authorized Agent Optimal care LLC 2021 East Hennepin Avenue Suite 435 Minneapolis, MN 55413 License Number: 1088866 (245D – HCBS) CORRECTION ORDER Dear Kayf Ahmed: On July 5, 2024, a licensing review of Optimal Care LLC, located at 2021 East Hennepin Avenue Suite 435, Minneapolis, 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 245D.07, subdivision 2, paragraph (c). Violation: For one of four persons whose record were reviewed (P1), the license holder did not meet the service planning requirements for basic support services as required. P1 received night supervision and respite services from the license holder. The license holder failed to review and revise as needed the preliminary support plan addendum to document when and by whom night supervision will be provided and how, when and by whom respite services will be provided. Corrective Action Ordered: Within 30 days of receiving this order, you must: · review and revise P1’s support plan to document the above; · audit all person served records to ensure the above is documented; and · maintain documentation of the audit results. This compliance will monitored at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.071, subdivision 3, paragraph (b). Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not meet the requirements for assessments as required. a. The license holder failed to complete assessments for P1 in the following areas: · the person’s ability to self-manage health and medical needs to maintain or improve physical, mental, and emotional well-being, including, when applicable, special dietary needs, chronic medical conditions, self-administration of medication or treatment orders, preventative screening and medical and dental appointments; and · the person’s ability to self-manage person safety to avoid injury or accident in the service setting, including when applicable, community survival skills. b. The license holder failed to complete assessments for P2 in the following areas: · the person’s ability to self-manage health and medical needs to maintain or improve physical, mental, and emotional well-being, including, when applicable, chronic medical conditions, preventative screening and medical and dental appointments; and · the person’s ability to self-manage person safety to avoid injury or accident in the service setting, including when applicable, risk of falling, mobility, and community survival skills. Corrective Action Ordered: Within 30 days of receiving this order, you must: · complete the above assessments for P1 and P2; · audit all persons served records to ensure the above is completed; and · maintain documentation of the audit results. This compliance will be monitored onsite at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, section 245D.071, subdivision 3, paragraph (c). Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not meet the requirements for service planning for intensive services as required. a. The license holder held a meeting with P1 and P1’s case manager within 45-days of service initiation, however the license holder failed to determine the following: · the person’s preferences for how services and supports are provided, including how the provider will support the person to have control of the person’ s schedule; · opportunities to develop and strengthen personal relationships with other persons of the person’s choice in the community; · opportunities to seek competitive employment and work at competitively paying jobs in the community; · a discussion on how technology might be used to meet the person’s desired outcomes. The support plan or support plan addendum must include a summary of this discussion. The summary must include: o a statement regarding any decision that is made regarding the use of technology; and o a description of any further research that needs to be completed before a decision regarding the use of technology can be made. b. The license holder held a meeting with P2 and P2’s case manager within 45-days of service initiation, however the license holder failed to determine the following: · the person’s preferences for how services and supports are provided, including how the provider will support the person to have control of the person’ s schedule; · opportunities to develop and maintain essential and life-enriching skills, abilities, strengths, interests and preferences; · opportunities to develop and strengthen personal relationships with other persons of the person’s choice in the community; · a discussion on how technology might be used to meet the person’s desired outcomes. The support plan or support plan addendum must include a summary of this discussion. The summary must include: o a statement regarding any decision that is made regarding the use of technology; and o 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: · meet with P1, P1’s case manager, other members of the support team or expanded support team, and other people as identities by the person or the person’s legal representative to determine the above; · meet with P2, P2’s case manager, other members of the support team or expanded support team, and other people as identities by the person or the person’s legal representative to determine the above; · maintain documentation of the summary of this meeting; · audit all person served records to ensure the above is documented; and · maintain documentation of the audit results. This compliance will be monitored at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.071, subdivision 4, paragraph (a), Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not meet the requirements for service outcomes and supports as required. The license holder failed to develop a service plan that documents the service outcomes and supports for P1 and P2. Corrective Action Ordered: Within 30 days of receiving this order, you must: · develop service outcomes and supports for P1 and P2; · audit all person served records to ensure the above has been developed; and · maintain documentation of the audit results. This compliance will be monitored at an upcoming compliance monitoring visit. 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 as required. The license holder failed to determine the following annually in 2023 and 2024 for P1: · a discussion on how technology might be used to meet the person’s desired outcomes. The support plan or support plan addendum must include a summary of this discussion. The summary must include: o a statement regarding any decision that is made regarding the use of technology; and o a description of any further research that needs to be completed before a decision regarding the use of technology can be made; and · options for transition to an employment service described in section 245D.03, subdivision, paragraph (c), clauses (5) to (7). The support plan must include a summary. The summary must include: o a statement about any decision made concerning transition to an employment service; and o a description of any further research that needs to be completed before a decision regarding transition to an employment service can be made. Additionally, the license holder failed to summarize P1’s statues and progress toward achieving the identified outcomes and make recommendations and identify the rational for changing, continuing, or discontinuing implementation of supports and methods in 2023. Corrective Action Ordered: Within 30 days of receiving this order, you must: · meet with P1, P1’s case manager and other people as identified by the person to determine the above; · audit all persons served records to ensure the above has been determined; and · maintain documentation of the audit results. This compliance will be monitored at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision. 6. Citation: Minnesota Statutes, section 245D.10, subdivision 4, paragraph (b). Violation: For one person whose record was reviewed (P3), the license holder did not provide copies of the policies and procedures affecting a persons rights as required. P3’s services were initiated on October 18, 2023. The license holder failed to inform P3’s case manager of the policies and procedures affecting a person’s rights under section 245D.04 and provide copies within five working days of service initiation. The license holder provider this to P3’s case manager on December 14, 2023. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 7. Citation: Minnesota Statutes, section 245D.09, subdivision 4. Violation: For two of five staff persons whose record were reviewed (SP1 and SP2), the license holder did provide orientation training as required. The license holder failed to provide SP1 and SP2 training on strategies to minimize the risk of sexual violence, including concepts of health relationships, consent and bodily autonomy of people with disabilities within 60 days of hire. These trainings were provided to SP1 and SP2 on later dates. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 8. Citation: Minnesota Statutes, section 245D.09, subdivision 4a, paragraph (a). Violation: For two staff persons whose record were reviewed (SP1 and SP2), the license holder did not provide orientation to individual service recipient needs as required. The license holder failed to provide SP1 and SP2 with orientation to individual service recipient needs before having unsupervised direct contact with a person served by the program. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 9. Citation: Minnesota Statutes, section 245D.09, subdivision 5. Violation: For four staff persons whose record were reviewed (SP2- SP5), the license holder did not provide annual training as required. Minnesota Statutes, section 245A.02, subdivision 2b defines “annual” or “annually” to mean prior to or within the same month of the subsequent calendar year. a. The license holder failed to provide annual training to SP2 in 2024 and SP3 in 2023 on the following required topic areas: · the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights according to the requirements in Minnesota Statutes, section 245D.04; · sections 245A.65, 245A.66, and 626.557 and chapter 260E governing maltreatment reporting and service planning for children and vulnerable adults, and staff responsibilities related to protecting persons from maltreatment and reporting maltreatment; · 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 or successor provisions, 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, or successor provisions, 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. These trainings were provided to SP2 and SP3 on later dates. b. The license holder failed to provide SP4 and SP5 with strategies to minimize the risk of sexual violence, including concepts of health relationships, consent, and bodily autonomy of people with disabilities in 2022. This training was provided to SP4 and SP5 on a later date. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 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 me as soon as possible. Robert Romani, HCBS Licensor Licensing Division Office of Inspector General 651-431-3658
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