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September 21, 2026 Samatar Dualeh, Authorized Agent Silver Mountain Home Health Care LLC 2722 Park Avenue, Suite 213 Minneapolis, Minnesota 55407-1009 License Number: 1081219 (245D – HCBS) CORRECTION ORDER Dear Samatar Dualeh: On August 25, 2026, a licensing review of Silver Mountain Home Health Care LLC, located at 2722 Park Avenue, Minneapolis, 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 245A.65, subdivision 2, paragraph (b). Violation: For one of five persons whose records were reviewed (P4), the license holder did not develop an individual abuse prevention plan (IAPP) as required. The license holder provided multiple services to P4. The license holder did not include in the IAPP for P4: · an individualized assessment of P4’s susceptibility to abuse by other individuals, including other vulnerable adults and P4’s risk of abusing other vulnerable adults within the scope of each service provided to P4; and · the specific actions the program would take to minimize the risk of abuse within the scope of each licensed service provided to P4. Corrective Action Ordered: Within 30 days of receiving this order, you must: · review and revise the IAPP for P4 to include an individualized assessment of P4’s susceptibility to abuse by other individuals, including other vulnerable adults and P4’s risk of abusing other vulnerable adults within the scope of each licensed service provided to P4; · provide the updated IAPP to P4, P4’s legal representative, and P4’s case manager for review; and · provide training to all staff that work with P4 on the updated IAPP and maintain documentation of this training in the personnel record, including the date the training is provided, the number of hours per subject area, and the name of the trainer or instructor. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.05, subdivision 1. Violation: For two persons whose records were reviewed (P4 and P5), the license holder did not maintain documentation of how health needs would be met as required. a. The license holder did not maintain documentation of how P4’s health needs would be met including a description of the procedures the license holder would follow in order to use medical equipment, including a feeding tube, safely and correctly according to written instructions from a licensed health professional. b. The license holder did not maintain documentation of how P5’s health needs would be met including a description of the procedures the license holder would follow in order to provide medication assistance. The license holder maintained documentation that P5 required reminders for glucose monitoring. Repeat Violation: In a correction order that DHS issued on May 19, 2026, you were previously found in violation of this same statute. Corrective Action Ordered: Within 30 days of receiving this order, you must: · document a description of the procedures to be followed in order to use P4’s medical equipment safely and correctly according to written instructions from a licensed health professional; · document a description of the procedures to be followed in order to provide medication assistance to P5; · provide training to all staff that work with P4 and P5 on the updated procedures and maintain documentation of this training in the personnel record including the date the training is provided, the number of hours per subject area, and the name of the trainer or instructor; · conduct an audit of all persons served records to ensure health needs are documented according to the requirements in 245D.05, subdivision 1; · update the addendums for any individuals identified in the audit to not have health needs documented according to the requirements in 245D.05, subdivision 1; · provide training to all staff who work with the individuals identified in the audit on the updated health needs information and maintain documentation of this training in the personnel record including the date the training is provided, the number of hours per subject area, and the name of the trainer or instructor; and · maintain the results of the audit and corrective action taken in your program records for DHS licensors to review. On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, section 245D.071, subdivision 3. Violation: For one person whose record was reviewed (P4), the license holder did not complete assessments as required. The license holder did not complete an accurate assessment of P4’s ability to self-manage symptoms or behavior that may otherwise result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7) or other symptoms or behaviors that may jeopardize the health and welfare of P4 or others. Additionally, the license holder did not ensure the assessments produced information about P4 that described P4’s overall strengths, functional skills and abilities, and behaviors or symptoms. Corrective Action Ordered: Within 30 days of receiving this order, you must: · conduct an assessment of P4’s ability to self-manage symptoms or behavior that may otherwise result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), or other symptoms or behaviors that may jeopardize the health and welfare of P4 or others; · update the assessments of P4 to ensure that the assessments produce information about P4 that describes P4’s overall strengths, functional skills and abilities, and behaviors or symptoms; · provide the updated assessments to P4, P4’s legal representative, and P4’s case manager for review; and · provide training to all staff that work with P4 on the updated assessments and maintain documentation of this training in the personnel record including the date the training is completed, the number of hours per subject area, and the name of the trainer or instructor. On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.071, subdivision 4. Violation: For one person whose record was reviewed (P4), the license holder did not document the supports and methods as required. The license holder did not document the supports and methods to be implemented to support P4 and accomplish outcomes including: · the measurable and observable criteria for identifying when the desired outcome had been achieved; and · the projected starting date for implementing the supports and methods. Corrective Action Ordered: Within 30 days of receiving this order, you must update P4’s supports and methods to include the information outlined above. On an ongoing basis, you must maintain compliance as required in this subdivision. 5. Citation: Minnesota Statutes, section 245D.095, subdivision 3. Violation: For one person whose record was reviewed (P5), the license holder did not maintain the person’s current support plan as required. The license holder did not maintain P5’s current support plan or that portion of the plan assigned to the license holder in P5’s record. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain P5’s current support plan or that portion of the plan assigned in P5’s record. Concerns regarding the provider not maintaining current support plans was referred to the Department of Human Services, Office of Inspector General, Program Integrity and Oversight Division. On an ongoing basis, you must maintain compliance as required in this subdivision. 6. Citation: Minnesota Rules, part 9544.0030, subpart 1. Violation: For one person whose record was reviewed (P4), the license holder did not evaluate positive support strategies as required. The license holder did not evaluate with P4 whether the identified positive support strategies met the standards in subpart 2 at least every six months. The license holder reviewed the positive support strategies in December 2025 and June 2026. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 7. Citation: Minnesota Rules, part 9544.0100, subpart 1. Violation: For two persons whose records were reviewed (P3 and P4), the license holder did not maintain documentation of services provided as required. The license holder did not maintain appropriate data that revealed the progress or lack of progress towards each outcome or goal for P3 and P4. Repeat Violation: In a correction order that DHS issued on May 19, 2026, you were previously found in violation of this same statute. Corrective Action Ordered: Concerns regarding the provider’s absence of data collection was referred to the Department of Human Services, Office of Inspector General, Program Integrity and Oversight Division. On an ongoing basis, you must maintain compliance as required in this subdivision. 8. Citation: Minnesota Statutes, section 245D.09, subdivision 4a, paragraph (c) and (e). Violation: For three of five staff persons whose records were reviewed (SP3, SP4, and SP5), the license holder did not provide orientation to individual service recipient needs as required. a. SP3 and SP4 provide services to P4. The license holder did not ensure SP3 and SP4 reviewed and received instruction on the safe and correct operation of medical equipment used by P4 to sustain life. b. The license holder did not ensure SP5 reviewed and received instruction on the person served support plan or support plan addendum as it relates to the responsibilities assigned to the license holder, and when applicable, the person’s individual abuse prevention plan, to achieve and demonstrate an understanding of the person as a unique individual, and how to implement those plans. Repeat Violation: In a correction order that DHS issued on May 19, 2026, you were previously found in violation of this same statute. Corrective Action Ordered: Within 30 days of receiving this order, you must: · ensure SP3 and SP4 review and receive instruction on the safe and correct operation of medical equipment used by P4 to sustain life. The training must be provided by a licensed health care professional or manufacturer’s representative and incorporate an observed skill assessment to ensure SP3 and SP4 demonstrate the ability to safely and correctly operate the equipment according to the treatment orders and the manufacturer’s instructions; · provide SP5 with instruction on the support plan addendum as it relates to the responsibilities assigned, and when applicable the individual abuse prevention plan, for each individual SP5 works with; and · maintain documentation of the training provided to SP3, SP4, and SP5 in the personnel record, including the date the training is provided, the number of hours per subject area, and the name of the trainer or instructor. 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. Erin White, Home and Community Based Services Licensor Licensing Division Office of Inspector General 651-431-4821
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