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July 9, 2026 Amanda Burg, Authorized Agent Mankato Chemical Health 360 Pierce Ave Ste 206 North Mankato, MN 56003 License Number: 1111408 License Number: 1122728 CORRECTION ORDER Dear Amanda: On March 2, 3, 4, and 5, 2026, Department of Human Services (DHS) licensors conducted a licensing review at your facilities located at the following: · 1826 Commerce Dr, North Mankato, 56003, license number 1111408 (North Mankato) · 505 State St S, Waseca, MN 56093, license number 1122728 (Waseca) This review was conducted to determine compliance with state and federal laws and rules governing the provision of Substance Use Disorder treatment under MN Statute, chapter 245G. As a result, DHS is issuing this order which requires you to take the correction action as described under each violation. Details of our findings are provided below. Our next steps and your options are also detailed. LICENSING VIOLATIONS DHS determined that your program did not follow licensing rules and statutes, as described below. Personnel Files Personnel files reviewed are identified in the following manner: · Personnel files numbered 1 through 3, license number 1111408 (North Mankato) · Personnel file numbered 4, license numbers 1111408 (North Mankato) and 1122728 (Waseca) 1. Violation: Three of four personnel files reviewed for requirements governing annual and every two year trainings did not meet requirements. There was no documentation of the following: a) Annual trainings for calendar year 2024: 1. Internal policies and procedures related to the prevention and reporting of maltreatment (personnel files numbered 1); and 2. Reporting of maltreatment of minors (personnel files numbered 1); and b. Annual trainings for calendar year 2025: 1. Mandatory reporting as specified in Minnesota Statutes, sections 245A.65, 626.557, and 626.5572, including specific training covering the license holder’s policies for obtaining a release of client information (personnel file numbered 4); 2. Program abuse prevention plan (personnel file numbered 4); 3. Internal policies and procedures related to the prevention and reporting of maltreatment (personnel files numbered 1, 2, and 4); 4. Reporting of maltreatment of minors (personnel files numbered 1, 2, and 4); and 5. HIV Minimum standards (personnel files numbered 4); and b. Annual trainings for calendar year 2026: 1. Internal policies and procedures related to the prevention and reporting of maltreatment (personnel files numbered 1); 2. Reporting of maltreatment of minors (personnel files numbered 1 and 2); and 3. HIV Minimum standards (personnel files numbered 1); and b) Every two year trainings for calendar years 2024: 1. Emergency procedures and client rights as specified in Minnesota Statutes, sections 144.651, 148F.165, and 253B.03 (personnel file numbered 1). Statute Violated: Minnesota Statutes, sections 245A.19, paragraph (b), 245A.65, subdivision 3, 245G.13, subdivision 2, paragraphs (b), clause (2), (c) and (d). Corrective Action: Immediately and on an ongoing basis the license holder must ensure annual and every two year trainings meet all applicable requirements. Within 30 days of receipt of this order, submit completed trainings for the above staff that meets all applicable requirements. Client Files Client files reviewed are identified in the following manner: · Client files numbered 1 through 3, license number 1111408 (North Mankato) · Client files numbered 4 and 5, license number 1122728 (Waseca) 2. Violation: Five of five client files (client files numbered 1 through 5) reviewed for requirements governing client orientation did not meet requirements. There was no documentation of orientation to the program abuse prevention plan within 24 of admission. Statute Violated: Minnesota statutes, sections 245A.65, subdivision 1, paragraph (c), and 245G.09, subdivision 3, paragraph (a), clause (1). Corrective Action Required: Immediately and on an ongoing basis, the license holder must ensure client orientation meets all applicable requirements. Within 30 days of receipt of this order, submit one client orientation documentation that meets all applicable requirements. 3. Violation: Three of five client files reviewed for requirements governing initial services plans (ISP) did not meet requirements. The ISP did not meet requirements in the following ways: a) The ISP was not person-centered and client specific (client files numbered 1 and 2); and b) The ISP did not identify treatment needs to be addressed during the time between the day of service initiation and development of the individual treatment plan (client file numbered 3). Statute Violated: Minnesota statutes, section 245G.04, subdivision 1. Corrective Action Required: Immediately and on an ongoing basis, the license holder must ensure initial services plans meet all applicable requirements. 4. Violation: Five of five client files reviewed for requirements governing comprehensive assessments (CA) did not meet requirements. The CA did not include documentation of the following: a. Client’s education employment status (client file numbered 3); b. The reason for the client’s referral (client file numbered 2); c. Substance use history including: 1. Amounts of substances (client files numbered 2 and 3); 2. Periods of abstinence (client files numbered 1, 2, and 4); and 3. Circumstances of relapse (client files numbered 3 and 4); d. The client’s evaluation of the quality of each relationship (client files numbered 2 and 3); e. Client’s strengths, including the extent and quality of the client’s social networks (client file numbered 5); f. Important developmental incidents in the client’s life (client files numbered 1 through 5); g. Client’s history of: 1. Potential brain injuries (client file numbered 3); and 2. Trauma (client files numbered 1, 2, 4, and 5); and h. A determination of whether the individual screens positive for co-occurring mental health disorders using a screening tool approved by the commissioner (client files numbered 1 through 5). Statute Violated: Minnesota Statutes, section 245G.05, subdivision 3. Corrective Action Required: Immediately and on an ongoing basis, the license holder must ensure comprehensive assessments meet all applicable requirements. Within 30 days of receipt of this order, submit a comprehensive assessment that meets all applicable requirements. 5. Violation: Three of five client files reviewed for requirements governing individual treatment plans (ITP) did not meet requirements as follows: a. The individual treatment plan was not signed by the client, and there was no documentation of the client’s involvement in the development of the treatment plan (client file numbered 1); b. A change to the plan was not signed by the client (client file numbered 1); c. The ITP did not document: 1. A treatment strategy (client files numbered 1 and 2); 2. A schedule for accomplishing a client’s treatment goals and objectives (client files numbered 1 and 2); and 3. The ASAM level of care identified in Minnesota Statutes, section 254B.19, subdivision 1, under which the client is receiving services (client file numbered 2). Statute Violated: Minnesota statutes, sections 245G.06, subdivisions 1 and 1a, clause (3) and (4). Corrective Action Required: Immediately and on an ongoing basis, the license holder must ensure individual treatment plans meet all applicable requirements. 6. Violation: Four of five client files reviewed for requirements governing client records did not meet requirements as follows: a) There was no documentation of the following: 1) Amount of treatment service provided for note dated January 15, 2026 (client files numbered 1 and 2); b) Documentation was not completed within 7 days of the treatment service on: 1) November 20 and 21, 2025 (client file numbered 4). Statute Violated: Minnesota statutes, sections 245G.06, subdivisions 2a and 2b, paragraph (c). Corrective Action Required: Immediately and on an ongoing basis, the license holder must ensure client record documentation meets all applicable requirements. 7. Violation: Four of five client files reviewed for requirements governing treatment plan reviews did not meet requirements. The treatment plan review did not meet requirements in the following ways: a) The treatment plan review did not indicate the span of time covered by the review signed on: 1) November 6, December 4, 30, 2025, and January 22, 2026 (client file numbered 2); 2) October 20, 2025 (client file numbered 3); and 3) January 14, 2025 (client file numbered 5); b) There was no documentation of the following: 1) Whether the identified methods continued to be effective for the treatment plan reviews dated: a. November 6, December 30, 2025, and February 25, 2026 (client file numbered 2); and b. September 25 and October 20, 2025 (client file numbered 3); c. February 14 and December 23, 2025 (client file numbered 5); and a) Treatment plan reviews were not completed once every 30 days as follows: 1) Treatment plan review was due February 21, 2026 however; the treatment plan review was signed February 25, 2026 (client file numbered 2); 2) Treatment plan review was due September 16, 2026 however; the treatment plan review was signed September 25, 2025 (client file numbered 3); 3) Treatment plan reviews were due October 22, November 21, and December 21, 2025; however there was no treatment plan review documentation in the chart (client file numbered 4); 4) Treatment plan review was due November 23, 2025 however; the treatment plan was signed January 11, 2026 (client file numbered 5); and Statute Violated: Minnesota Statutes, section 245G.06, subdivisions 3, and 3a, paragraph (e). Corrective Action: Immediately and on an ongoing basis, the license holder must ensure treatment plan reviews meet all applicable requirements. 8. Violation: One of four client file was reviewed for requirements governing service discharge summaries (client file numbered 3) did not meet requirements. The discharge summary did not meet requirements in the following ways: a) The discharge summary was not completed within five days of service termination; and b) There was no documentation of client’s issues, strengths, and needs while participating in treatment. Statute Violated: Minnesota statute, section 245G.06, subdivision 4, paragraphs (a) and (b), clause (1). Corrective Action Required: Immediately and on an ongoing basis, the license holder must ensure service discharge summaries meet all applicable requirements. Written Response Required If you fail to correct the violation(s) 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. Submissions required as part of the corrective action ordered must be sent to your licensor by email at david.her@state.mn.us or by mail: Commissioner, Department of Human Services ATTN: David Her Licensing Division PO Box 64242 St. Paul, MN 55164-0242 YOUR RIGHT TO REQUEST RECONSIDERATION You have the right to request reconsideration of this order and the cited violations. Your request must: · Be in writing · List each violation you are challenging and identify what is inaccurate or incomplete about the information in the order · Supply information that is accurate or more complete · Be made before the deadlines provided below If you are mailing your request, it must be received by DHS within 20 calendar days from when you received this order. If you do not meet this deadline, you lose your right to request reconsideration. The timeline to appeal began when you received this order. Please send it to: Office of Inspector General Legal Counsel’s Office Attn: Licensing Legal Unit PO Box 64953 St. Paul, MN 55164-0953 If your request is being personally delivered, it must be received by DHS within 20 calendar days from when you received this order. Please bring it to: Commissioner, Department of Human Services Office of Inspector General, Legal Counsel’s Office - Licensing 444 Lafayette Road North St. Paul, MN 55155 Legal authority This action is taken under Minnesota Statutes, section 245A.06, subdivision 1. The timeline to request reconsideration of the order is provided in Minnesota Statutes, section 245A.06, subdivision 2. Questions If you have any further questions regarding this matter, you may contact me at 651-431-7229 or at david.her@state.mn.us. Sincerely,
David Her, Licensor Licensing Division Office of Inspector General
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