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December 23, 2025 Victor Bangura, Authorized Agent Zachary Home Health Corp 693 Summer Lane Eagan, Minnesota 55123 License Number: 1066904 (245D – HCBS) CORRECTION ORDER Dear Victor Bangura: On December 17, 2025, a licensing review of Zachary Home Health Corp, located at 4585 West Greenleaf Drive, Eagan, 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, 245A.65, subdivision 1. Violation: For two of two persons whose records were reviewed (P1 and P2), the license holder did not provide orientation to the internal and external reporting procedures as required. The license holder did not provide orientation to the internal and external reporting procedures to P1 and P2 within 24 hours of admission. The license holder later provided this to P1 and P2. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, 245A.65, subdivision 2. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not provide orientation to the program abuse prevention plan (PAPP) as required. The license holder did not provide orientation to P1 and P2 on the PAPP within 24 hours of admission. Corrective Action Ordered: Within 30 days of receiving this order, you must provide orientation to P1 and P2 on the program abuse prevention plan, and notify P1’s and P2’s guardian of this orientation. You must document this orientation in the service recipient records for P1 and P2. On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, 245A.65, subdivision 2. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not meet requirements for individual abuse prevention plans. 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 did not review the IAPP with P1 and offer P1’s legal representative the opportunity to participate in the review annually in 2023 and 2024. b. The license holder did not develop an IAPP for P2 prior to or upon service initiation on January 1, 2025. P2’s IAPP was developed on April 8, 2025. c. The license holder did not develop IAPP’s for P1 and P2 that included individualized statements of the specific measures to be taken to minimize the risk of abuse to P1 and P2 within the scope of licensed services. Corrective Action Ordered: Within 30 days you must: · revise the IAPP’s for P1 and P2 to include the specific measures to be taken to minimize the risk of abuse to P1 and P2; · review the IAPP’s with P1 and P2, as well as their case managers and legal representatives. You must maintain documentation of this review; and · provide training on the revised IAPP’s to staff working with P1 and P2. On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, 245D.04, subdivision 1. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not provide the person a written notice that identified the service recipient rights and an explanation of those rights as required. a. The license holder did not provide P1 with a written notice that identified the service recipient rights and an explanation of those rights annually in 2022, 2023, and 2024. b. The license holder did not provide P2 with a written notice that identified the service recipient rights and an explanation of those rights within five working days of service initiation on January 1, 2025. The license holder provided the rights to P2 on April 8, 2025. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 5. Citation: Minnesota Statutes, 245D.05, subdivision 1. Violation: For one person whose record was reviewed (P1), the license holder did not document health needs as required. The license holder was assigned responsibility for P1’s health needs including medication administration and diabetic care. The license holder did not maintain documentation on how P1’s health needs would be met. Corrective Action Ordered: Within 30 days of receiving this order, you must document how P1’s health needs will be met in their support plan addendum including a description of the procedures that will be followed in order to: · provide medication administration; · monitor health conditions according to written instructions from a licensed health professional; · assist with or coordinate medical, dental, or other health service appointments; and · use medical equipment, devices, or adaptive aides or technology safely and correctly according to written instructions from a licensed health professional. On an ongoing basis, you must maintain compliance as required in this subdivision. 6. Citation: Minnesota Statutes, 245D.05, subdivision 2, 4 and 5. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not provide medication administration as required. a. The license holder did not obtain written authorization from P1’s legal representative to administer medication or treatment prior to administering medications. The license holder-initiated services for P1 on May 17, 2022, and obtained written authorization on December 11, 2025. b. The license holder did not obtain written authorization from P2’s legal representative to administer medication or treatment prior to administering medications. The license holder-initiated services for P2 on January 1, 2025, and obtained written authorization on April 8, 2025. c. The license holder did not ensure the following information was documented in P1’s and P2’s medication administration record: · the information on the current prescription label or the prescriber’s current written or electronically recorded order or prescription that includes the person’s name, description of the medication or treatment to be provided, and the frequency and other information needed to safely and correctly administer medication or treatment to ensure effectiveness; · information on any risks or other side effects that are reasonable to expect, and any contraindications to its use. This information must be readily available to all staff administering medication; · the possible consequences if the medication or treatment is not taken or administered as directed; · instruction on when and to whom to report the following; o if a dose of medication is not administered or treatment is not performed as prescribed, whether by error by the staff person or by refusal by the person; and o the occurrence of possible adverse reactions to the medication or treatment; · notation of any occurrence of a dose of medication not being administered or treatment not performed as prescribed, whether by error by the staff or the person or by refusal by the person, or of adverse reactions, and when and to whom the report was made; and · notation of when a medication or treatment is started, administered, changed, or discontinued. d. The license holder did not complete medication administration reviews a minimum of every three months for P1 and P2. e. The license holder did not obtain authorization to administer injectable medications for P1. P1 was prescribed two injectable medications. The license holder had authorization to administer one of those medications. Corrective Action Ordered: Within 30 days of receiving this order, you must: · ensure the information listed above is documented in P1’s and P2’s medication administration records; · complete medication administration reviews for all persons served at least every three months to ensure the information is current and to identify any medication administration errors; · based on those reviews, you must develop and implement a plan to correct patterns of medication administration errors when identified; and · obtain authorization to administer P1’s injectable medication. On an ongoing basis, you must maintain compliance as required in this subdivision. 7. Citation: Minnesota Statutes, 245D.051, subdivision 1. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not meet conditions for psychotropic medication administration as required. The license holder did not track target symptoms for P1 and P2 and did not complete quarterly reports. The license holder was responsible for administering psychotropic medications to P1 and P2. The support plan addendum assigned the license holder with tracking target symptoms and providing quarterly reports for P1 and P2 to their prescribers and support teams. Corrective Action Ordered: Within 30 days of receiving this order you must: · update the support plan addendums for P1 and P2 to include documentation methods the license holder will use to monitor and measure changes in the target symptoms that are to be alleviated by the psychotropic medications; and · collect and report on medication and symptom-related data as assigned by the prescriber or the support plan addendum. On an ongoing basis, you must maintain compliance as required in this subdivision. 8. Citation: Minnesota Statutes, 245D.071, subdivision 3. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not complete service planning as required. a. The license holder did not complete a preliminary support plan addendum for P1 within 15 days of service initiation. b. The license holder did not conduct an initial planning meeting with P1, P1’s legal representative, and P1’s case manager, before providing 45 days of service to P1. c. The license holder did not complete assessments for P1 before providing 45 days of service, or annually thereafter. The license holder-initiated services for P1 on May 17, 2022. Assessments were conducted on December 11, 2025. d. The license holder did not complete a preliminary support plan addendum for P2 within 15 days of service initiation and did not conduct an initial planning meeting with P2, P2’s legal representative, and P2’s case manager, before providing 45 days of service to P2. The license holder-initiated services for P1 on January 1, 2025. A progress review meeting was completed on April 8, 2025. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 9. Citation: Minnesota Statutes, 245D.071, subdivision 4. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not develop outcomes and supports as required. The license holder did not develop a service plan that included supports and methods to accomplish service outcomes for P1 and P2. Corrective Action Ordered: Within 30 days of receiving this order, you must develop supports and methods to accomplish service outcomes for P1 and P2 including: · the methods or actions that will be used to support the person and to accomplish service outcomes, including information about: o any changes or modifications to the physical and social environments necessary when the service supports are provided; o any equipment and materials required; and o techniques that are consistent with the person’s communication mode and learning style; · the measurable and observable criteria for identifying when the desired outcome has been achieved and how data will be collected; · the projected starting date for implementing the supports and methods and the date by which progress towards accomplishing the outcomes will be reviewed and evaluated; and · the names of the staff or position responsible for implementing the supports and methods. On an ongoing basis, you must maintain compliance as required in this subdivision. 10. Citation: Minnesota Statutes, 245D.071, subdivision 5. Violation: For one person whose record was reviewed (P1), the license holder did not complete service plan review as required. a. The license holder did not complete annual progress review meetings in 2023 and 2024 as assigned in P1’s support plan addendum. b. The license holder did not discuss with P1, P1’s case manager, and P1’s legal representative, how technology might be used to meet P1’s desired outcomes, and options for transitioning out of a community setting controlled by a provider and into a setting not controlled by a provider. c. The license holder did not summarize P1’s status and progress toward achieving the identified outcomes annually as assigned in the support plan addendum. Corrective Action Ordered: Within 30 days of receiving this order, you must: · have the discussions listed above with P1, P1’s legal representative, and P1’s case manager; · summarize the discussions in P1’s support plan addendum; · summarize P1’s progress toward achieving identified outcomes; · make recommendations; and · identify the rationale for changing, continuing, or discontinuing implementation of supports and methods. On an ongoing basis, you must maintain compliance as required in this subdivision. 11. Citation: Minnesota Statutes, 245D.10, subdivision 4. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not provide policies and procedures as required. a. The license holder did not inform P1 and P1’s case manager of the policies and procedures affecting a person’s rights under section 245D.04, and provide copies of those policies and procedures, within five working days of service initiation on May 17, 2022. The license holder provided the policies and procedures to P1 and P1’s case manager on December 11, 2025. b. The license holder did not inform P2 and P2’s case manager of the policies and procedures affecting a persons rights under section 245D.04, and provide copies of those policies and procedures, within five working days of service initiation on January 1, 2025. The license holder provided the policies and procedures to P2 and P2’s case manager on April 8, 2025. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 12. Citation: Minnesota Rule, 9544.0030, subpart 1. Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not document and review positive supports as required. The license holder did not incorporate positive support strategies in writing to P1’s and P2’s service plan. Corrective Action Ordered: Within 30 days of receiving this order, you must incorporate positive support strategies into the service plans for P1 and P2. You must evaluate these positive support strategies with P1 and P2, at least every six months. On an ongoing basis, you must maintain compliance as required in this subdivision. 13. Citation: Minnesota Statutes, section 245A.65, subdivision 3. Violation: For two of three staff persons whose records were reviewed (SP2 and SP3) the license holder did not provide annual training to the orientation of mandated reporters as required. 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 did not provide SP2 with annual training as required on the program abuse prevention plan in 2025. This training was provided in January 2024 and September 2025. b. The license holder did not provide SP2 with annual training as required in sections 245A.65 and 626.557 governing maltreatment reporting and service planning for vulnerable adults, and staff responsibilities related to protecting persons from maltreatment and reporting maltreatment in 2025. This training was provided in January 2024 and September 2025. c. The license holder did not provide SP3 with annual training on the program abuse prevention plan in 2023. d. The license holder did not provide SP3 with annual training in sections 245A.65 and 626.557 governing maltreatment reporting and service planning for vulnerable adults, and staff responsibilities related to protecting persons from maltreatment and reporting maltreatment in 2023. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 14. Citation: Minnesota Statutes, section 245D.09, subdivision 4. Violation: For two staff persons whose records were reviewed (SP2 and SP3), the license holder did not provide orientation training as required. a. The license holder did not provide SP2 with an orientation to the following within 60 calendar days of hire on August 10, 2023: · 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; and · 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. These trainings were completed in September 2024. b. The license holder did not provide SP2 with an orientation to the emergency use of manual restraint policy and procedure required under Minnesota Statutes, chapter 245D, including their location, access, and staff responsibilities related to the implementation of those policies and procedures, within 60 days of hire. c. The license holder did not provide SP3 with an orientation to the following policies and procedures required under Minnesota Statutes, chapter 245D, including their location, access, and staff responsibilities related to the implementation of those policies and procedures, within 60 days of hire: · emergency use of manual restraint; · service admission; and · health service coordination and care. Corrective Action Ordered: Within 30 days of receiving this order, you must provide SP2 and SP3 with an orientation to the training requirements identified above. On an ongoing basis, you must maintain compliance as required in this subdivision. 15. Citation: Minnesota Statutes, section 245D.09, subdivision 4a. Violation: For one staff person whose record was reviewed (SP2), the license holder did not provide orientation to individual service recipient needs training as required. The license holder did not provide SP2 with the following training on P1’s injectable medication administration procedures as established in P1’s support plan addendum before having unsupervised direct contact with P1: · completion of injectable medication administration training, from a training curriculum developed by a registered nurse or appropriate licensed health professional; and · completion of an observed injectable medication administration skill assessment by the trainer. Corrective Action Ordered: Within 30 days of receiving this order, you must provide SP2 with instruction on medication administration for P1. On an ongoing basis, you must maintain compliance as required in this subdivision. 16. Citation: Minnesota Statutes, section 245D.09, subdivision 5. Violation: For two staff persons whose records were reviewed (SP1 and SP3), the license holder did not provide annual training as required. a. The license holder did not provide SP1 with annual training on the following topics prior to or within the same month of the subsequent calendar year as required: · 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 in 2024; · 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 in 2024. b. The license holder did not provide SP3 with annual training on the following topics prior to or within the same month of the subsequent calendar year as required: · data privacy requirements according to sections 13.01 to 13.10 and 13.46, the federal Health Insurance Portability and Accountability Act of 1996 (HIPPA), and staff responsibilities related to complying with data privacy practices in 2023; · 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 in 2023; · 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 in 2023; · 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 in 2023; · 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 in 2023; · basic first aid in 2024; · strategies to minimize the risk of sexual violence, including concepts of healthy relationships, consent, and bodily autonomy of people with disabilities in 2023; and · cardiopulmonary resuscitation (CPR) training as CPR was identified as necessary training for all staff persons by the license holder in 2024. 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. Kelly Bosch, HCBS Licensor Licensing Division Office of Inspector General 651-431-6621
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