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March 28, 2025 Kia Vang Yang, Authorized Agent Harmony Adult Day Center LLC 7756 Hemingway Avenue South Cottage Grove, Minnesota 55016 License Number: 1104184 (Rule 223) CORRECTION ORDER Dear Kia Vang Yang: On March 27, 2025, a licensing review of Harmony Adult Day Center LLC located at 475 Etna Street, Saint Paul, 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, paragraph (b). Violation: For four of four participants whose record were reviewed (P1-P4), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP).
The license holder failed to review P1-P4’s IAPP with P1-P4’s interdisciplinary team, at least annually in 2024, using the individual assessment and any reports of abuse relating to the person. Repeat Violation: In a Conditional Order that DHS issued on December 12, 2024, you were previously found in violation of this same rule. Corrective Action Ordered: Within 30 days of receiving this order, you must review P1-P4’s IAPP with P1-P4 and their interdisciplinary team and document the review. 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-P4), the license holder did not include information in the participant’s written record as required.
The license holder failed to include the following information in P1-P4’s record: · a medical report, dated within the three months prior to or 30 days after P1-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 release signed by the physician indicating whether P4 may engage in a structured exercise program; and o documentation that P4 was free from communicable disease or infestations, as specified in parts 4605.7000 to 4605.7090, that would endanger the health of other participants. Repeat Violation: In a Conditional Order that DHS issued on December 12, 2024, you were previously found in violation of this same rule. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain all information detailed above in P1-P4’s participant record. On an ongoing basis, you must maintain compliance as required in this subpart. 3. Citation: Minnesota Rules, part 9555.9700, subpart 2. Violation: For four participants whose records were reviewed (P1-P4), the license holder did not complete initial service planning as required. The license holder failed to conduct needs assessments for P1-P4 that included the participant’s physical status, determined by observation, from the intake screening interview, and from the medical report received from the participant’s physician. Repeat Violation: In a Conditional Order that DHS issued on December 12, 2024, you were previously found in violation of this same rule. Corrective Action Ordered: Within 30 days of receiving this order, you must update P1-P4’s needs assessments to include information from the medical report received from the participant’s physician. On an ongoing basis, you must maintain compliance as required in this subpart. 4. Citation: Minnesota Rules, part 9555.9700, subpart 3. Violation: For four participants whose records were reviewed (P1-P4), the license holder did not develop a written plan of care as required. The license holder failed to develop written plans of care for P1-P4 that included: · an update of the preliminary service plan and additional services required by the participant; and · short and long term objectives for the participant stated in concrete, measurable, and time specific outcomes. Repeat Violation: In a Conditional Order that DHS issued on December 12, 2024, you were previously found in violation of this same rule. Corrective Action Ordered: Within 30 days of receiving this order, you must develop written plans of care for P1-P4 that include the information detailed above. 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. Desiree Tiller, HCBS Licensor Licensing Division Office of Inspector General 651-431-4622
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