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June 2, 2025 Jeffrey Schultz, Authorized Agent Schultz Family Home 6228 Campfire Bend Road Northwest Walker, Minnesota 56484-2187 License Number: 1101707 (245D – HCBS) CORRECTION ORDER Dear Jeffrey Schultz: On May 21, 2025, a licensing review of Schultz Family Home, located at 6228 Campfire Bend Road Northwest, Walker 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 1a. Violation: For one of two persons whose record was reviewed (P2), the license holder did not implement medication setup procedures as required. The license holder was assigned responsibility for medication setup according to P2’s support plan addendum. The license holder failed to document the following in the P2's medication administration record: · dates of setup; · name of medication; · quantity of dose; · times to be administered; · route of administration at time of setup; and · when the person will be away from home, to whom the medications were given. Corrective Action Ordered: Immediately, you must ensure the above information is maintained in P2’s medication administration record. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.09, subdivision 4. Violation: For one of two staff persons whose record was reviewed (SP1), the license holder did not provide orientation training as required. The license holder failed to provide and ensure completion of orientation sufficient to create staff competency for SP1 in the following areas: · data privacy requirements according to sections 13.01 to 13.10 and 13.46, the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff responsibilities related to complying with data privacy practices; · the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights according to the requirements in section 245D.04; · 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. Corrective Action Ordered: Immediately, you must provide SP1 with the above-mentioned required training. On an ongoing basis, you must maintain compliance as required in these subdivisions. 3. Citation: Minnesota Statutes, section 245D.09, subdivision 4a. Violation: For two staff persons whose records were reviewed (SP1-SP2), the license holder did not provide orientation to individual needs as required. The license holder was assigned responsibility for medication set up. The license holder failed to provide SP1 and SP2 instruction on medication setup from a training curriculum developed by a registered nurse or appropriate licensed health professional. Corrective Action Ordered: Immediately, you must provide SP1 and SP2 with the above-mentioned required training. The training curriculum must incorporate an observed skill assessment conducted by the trainer to ensure unlicensed staff demonstrate the ability to safely and correctly follow medication procedures. On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.09, subdivision 5. Violation: For two staff persons whose records were reviewed (SP1-SP2), 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. The license holder failed to provide SP1 and SP2 annual training on basic first aid. The license holder maintained documentation that SP1’s first aid certification expired March 1, 2024. The license holder failed to maintain documentation that SP2 was provided first aid training. Corrective Action Ordered: Within 30 days of receiving this order, you must provide SP1 and SP2 basic first aid training. 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 ATTN: Legal Unit Licensing Division PO Box 64242 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. Nichol Ginther, Human Services Licensor Licensing Division Office of Inspector General 651-431-4822
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