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January 28, 2025 Abdi Osman Mohamud, Authorized Agent Hope Senior Center 1208 E Lake Street Minneapolis, Minnesota 55407 License Number: 1094453 (Rule 223) CORRECTION ORDER Dear Abdi Osman Mohamud: On December 9, 2024, a licensing review of Hope Senior Center located at 1208 E Lake Street, Minneapolis, Minnesota was conducted to determine compliance with Minnesota Statutes and Rules governing adult day care services under Minnesota Rules, parts 9555.9600 through 9555.9730 (Rule 223). 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 245A.65, subdivision 2. Violation: For three of four participants whose records were reviewed (P1, P2, and P4), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP). a. The license holder failed to review P1’s IAPP at least annually with the interdisciplinary team. P1’s IAPP was not reviewed annually with the interdisciplinary team in 2022, 2023, and 2024. b. The license holder failed to include a statement of measures that would be taken to minimize the risk of abuse to P2 in P2’s IAPP. The license holder failed to review P2’s IAPP at least annually with the interdisciplinary team. P2’s IAPP was not reviewed annually with the interdisciplinary team in 2022, 2023, and 2024. c. The license holder failed to develop an IAPP for P4 as part of the initial individual program plan that contained an individualized assessment of: · P4’s susceptibility to abuse by other individuals, including other vulnerable adults; · P4’s risk of abusing other vulnerable adults; and · statements of the specific measure to be taken to minimize the risk of abuse to P4 and other vulnerable adults. Corrective Action Ordered: Within 30 days of receiving this order, you must: · review P1’s IAPP with their interdisciplinary team; · update P2’s IAPP to include a statement of measure that would be taken to minimize the risk of abuse to P2 in P2’s IAPP; · review P2’s IAPP with their interdisciplinary team; and · develop an IAPP for P4. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Rules, part 9555.9660, subpart 1. Violation: For four participants whose records were reviewed (P1, P2, P3, and P4), the license holder did not maintain a written record as required. a. The license holder failed to include a report on a physical examination for P1 that was updated annually in 2023 and 2024. b. The license holder failed to include a report on a physical examination for P2 that was updated annually in 2022, 2023, and 2024. c. The license holder failed to include an application that included P3’s address in P3’s participant record. d. The license holder failed to include the following in P4’s participant record: · an application form that included: o P2’s address; o P2’s date of admission; o P2’s source of referral; and o the name and phone number of P4’s physician or medical provider; · a medical report, dated within the three months prior to or 30 days after P4’s admission to the center signed by a physician or signed by a physician assistant or registered nurse and cosigned by a physician, that included: o a report on a physical examination; o a medical history of P2; o indication of dietary restrictions and medication regimen, including the need for medication assistance, that apply to P2; o a release signed by the physician indicating whether P2 may engage in a structured exercise program; and o documentation that P2 was free of communicable disease or infestations, as specified in parts 4605.7000 to 4605.7090, that would endanger the health of other participants; · progress notes for P4 that were recorded at least monthly. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain the information detailed above in P1, P2, P3, and P4’s participant records. On an ongoing basis, you must maintain compliance as required in this subpart. 3. Citation: Minnesota Rules, part 9555.9700, subpart 2. Violation: For one participant whose record was reviewed (P4), the license holder did not complete initial service planning as required. a. The license holder failed to conduct a needs assessment for P4 within 30 days of admission that addressed: · P4’s psychosocial status; · P4’s functional status; and · P4’s physical status, to be determined by observation, from the intake screening interview, and from the medical report received from P4’s physician. b. The license holder failed to develop a preliminary service plan for P4 within 30 days of admission that included the following information: · scheduled days of P4’s attendance at the center; · transportation arrangements for getting P4 to and from the center; · P4’s nutritional needs and, where applicable, dietary restrictions; · role of P4’s caregiver in carrying out the service plan; and · services and activities in which P4 will take part immediately upon admission. Corrective Action Ordered: Within 30 days of receiving this order, you must update P4’s needs assessment and preliminary service plan with the information detailed above. On an ongoing basis, you must maintain compliance as required in this subpart. 4. Citation: Minnesota Rules, part 9555.9700, subpart 3. Violation: For two participants whose records were reviewed (P3 and P4), the license holder did not develop a written plan of care as required. The license holder failed to develop a written plan of care for P3 and P4 within 90 days of admission to the center that included: · an update of the preliminary service plan; · short and long-term objectives for P3 and P4 stated in concrete, measurable, and time specific outcomes; · the staff members responsible for implementing the individual plan of care; · the anticipated duration of the individual plan of care as written; and · provisions for quarterly review and quarterly revision of the individual plan of care. Corrective Action Ordered: Within 30 days of receiving this order, you must develop a written plan of care for P3 and P4 that includes the information detailed above. On an ongoing basis, you must maintain compliance as required in this subpart. 5. Citation: Minnesota Rules, part 9555.9650, item B. Violation: For three consultants whose records were reviewed, the license holder did not include all required information in the personnel record. The license holder failed to maintain the following in the registered nurse, physical therapist, and registered dietician’s personnel records: · a copy of a signed contract or letter of appointment specifying conditions and terms of employment; and · documentation that the consultant met any licensure, registration, or certification requirements required to perform services. Corrective Action Ordered: Within 30 days of receiving this order, you must: · maintain a copy of a signed contract or letter of appointment with your registered nurse, physical therapist, and registered dietician specifying conditions and terms of employment; and · maintain documentation that your registered nurse, physical therapist and registered dietician meet licensure, registration, and certification requirements required to perform the services specified in the contract. On an ongoing basis, you must maintain compliance as required in this item. 6. Citation: Minnesota Rules, part 9555.9710, subpart 1.
The license holder failed to offer a midafternoon snack. Corrective Action Ordered: Immediately, you must offer a midafternoon snack. On an ongoing basis, you must maintain compliance as required in this subpart. 7. Citation: Minnesota Rules, part 9555.9720, subparts 8 and 9.
a. The license holder failed to ensure the areas used by participants were free from debris and peeling paint. b. The license holder failed to rehearse the fire escape plan at least four times in 2023 and 2024. Corrective Action Ordered: Immediately, you must ensure all areas used by participants are free from debris and peeling paint. Within 30 days of receiving this order, you must rehearse your fire escape plan and record the date of the rehearsal in the file of emergency plans. On an ongoing basis, you must maintain compliance as required in these subparts. 8. Citation: Minnesota Rules, part 9555.9730, subpart 3.
The license holder failed to ensure restrooms used by participants were equipped with a mechanism that participants can use to signal staff members by light or by sound if participants need assistance. Corrective Action Ordered: Immediately, you must ensure all restrooms used by participants are equipped with a mechanism that participants can use to signal staff members. On an ongoing basis, you must maintain compliance as required in this subpart. 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 Human Services Licensor Licensing Division Office of Inspector General 651-431-6589
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