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October 16, 2024 Curt Bossert, Authorized Agent Preferred Residential Lifestyles 6600 France Ave S STE 350 Edina, Minnesota 55435 License Number: 1071036 (245D – HCBS) CORRECTION ORDER Dear Curt Bossert: On August 22, 2024, a licensing review of Preferred Residential Lifestyles, located at 108 9th Street, Windom, 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.05, subdivision 2, paragraph (c). Violation: For one of three persons whose records were reviewed (P3), the license holder did not maintain medication administration records as required. The license holder failed to document in P3’s medication administration record the possible consequences if the medication or treatment was not taken or administered as directed. Corrective Action Ordered: Within 30 days of receipt of this order, you must update P3’s medication administration record with the above information. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.05, subdivision 4. Violation: For one person whose record was reviewed (P2), the license holder did not review and report medication and treatment issues as required. a. The license holder failed to review P2’s medication administration record every three months in 2024. b. The license holder failed to report that P2 missed a dose of medication on July 1, 2024, to P2’s legal representative and case manager. Corrective Action Ordered: Within 30 days of receipt of this order, you must: · ensure P2’s medication administration record reviews are completed for 2024; and · report P2’s missed medication on July 1, 2024, to P2’s legal representative and case manager. On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, section 245D.051, subdivision 1, paragraph (b). Violation: For two persons whose records were reviewed (P2 and P3), the license holder did not meet the requirements for psychotropic medications as required. Target symptoms refers to any perceptible diagnostic criteria for a person’s diagnosed mental disorder, as defined by the Diagnostic and Statistical Manual of Mental disorders Fourth Edition Text Revision (DSM-IV-TR) or successive editions, that has been identified for alleviation. The license holder was responsible for administering P2 and P3’s medications, and P2 and P3 were prescribed psychotropic medications. The license holder failed to document a description of the target symptoms that P2 and P3’s psychotropic medications were prescribed to alleviate. Corrective Action Ordered: Within 30 days of receipt of this order, you must maintain documentation of the above-mentioned information. On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.07, subdivision 1a. Violation: For one person whose record was reviewed (P2), the license holder did not provide services in response to the person’s identified needs, interests, preferences, and desired outcomes as specified in the support plan addendum as required. The license holder failed to collect data for P2’s outcome as required in P2’s support plan. P2’s outcomes stated data would be collected daily; however, the license holder did not collect data daily for P2’s outcomes in February through June of 2024. Corrective Action Ordered: Immediately upon receipt of this order, you must collect data as required in P2’s support plan. On an ongoing basis, you must maintain compliance as required in this subdivision. 5. Citation: Minnesota Statutes, section 245D.071, subdivision 4. Violation: For one person whose record was reviewed (P2), the license holder did not document supports and outcomes as required. The license holder failed to identify any changes or modifications to the physical and social environments necessary when P2’s service supports were provided. Corrective Action Ordered: Within 30 days of receipt of this order, you must maintain the above-mentioned information for P2’s outcomes. On an ongoing basis, you maintain compliance as required in this subdivision. 6. Citation: Minnesota Statutes, section 245D.071, subdivision 5. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not review and evaluate the service plan as required. a. The license holder failed to at least once per year in coordination with P1’s support team, discuss options for transitioning out of a community setting controlled by a provider and into a setting not controlled by a provider. Furthermore, the license holder failed to include a summary of the discussion above in P1’s support plan addendum.
b. The license holder failed to identify the rationale for changing, continuing, or discontinuing implementation of P2’s supports and methods. Corrective Action Ordered: Within 30 days of receipt of this order, you must: · include a summary statement in P1’s support plan addendum about any decision made regarding transitioning out of a provider-controlled setting; and · a description of any further research or education that must be completed before a decision regarding transitioning out of a provider-controlled setting can be made. On an ongoing basis, you must maintain compliance as required in this subdivision. 7. Citation: Minnesota Statutes, section 245D.09, subdivision 4a. Violation: For one of three staff persons whose records were reviewed (SP1), the license holder did not provide orientation to individual service recipient needs as required. The license holder failed to provide SP1 with an 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 maintain compliance as required in this subdivision. 8. Citation: Minnesota Statutes, section 245D.09, subdivision 5. Violation: For one staff person whose record was reviewed (SP3), the license holder did not provide annual training as required. 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 SP3 with the following required annual training: · 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; · 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: On an ongoing basis, you must maintain compliance as required in this subdivision. 9. Citation: Minnesota Statutes, section 245D.095, subdivision 5. Violation: For two staff persons whose records were reviewed (SP1 and SP3), the license holder did not maintain personnel records as required. a. The license holder failed to document SP1’s date of first unsupervised direct contact with persons served by the program. b. The license holder failed to document SP3’s first supervised and unsupervised direct contact with persons served by the program. Corrective Action Ordered: On an ongoing basis, you must maintain compliance 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. 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. Kristopher Oberg, HCBS Licensor Licensing Division Office of Inspector General 651-431-6589
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