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April 24, 2024
Rachael Swanson, Authorized Agent Hazelden Plymouth 15251 Pleasant Valley Rd., PO BOX 11, FO-1 Center City, MN 55012 License Number: 1038741 Report Number: 202308285
CORRECTION ORDER Dear Rachael Swanson: A licensing investigation of Hazelden Plymouth, located at 11505 36th Ave N., Plymouth, MN 55441, was conducted to determine compliance with state and federal laws and rules governing the provision of children’s residential facilities under Minnesota Rules, part 2960.0010 through 2960.0120, children's group residential facilities under Minnesota Rules, part 2960.0130 through 2960.0220, and chemical dependency services under Minnesota Rules, part 2960.0430 through 2960.0490. As a result of this licensing investigation 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 an applicant or 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 applicant or license holder. The following violations 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. Violation: The license holder’s program abuse prevention plan (PAPP) did not meet requirements. The license holder’s Children’s Residential Facility was co-located to their licensed Detoxification Services and Substance Use Disorder Treatment programs, which were licensed to serve adults, and a Facility Abuse Prevention Plan addressed all three licensed programs: a. The PAPP did not include measures to limit the possibility of harmful substances being brought into the facility at admission or accessed by residents in shared public spaces, such as bathrooms, visiting areas, and the cafeteria; and b. The PAPP did not include measures providing more frequent supervision of children who display behaviors that pose an imminent risk of harm. Corrective Action Ordered: Immediately and on an ongoing basis, the license holder must ensure the program abuse prevention plan (PAPP) meets all applicable requirements. Within 30 days receipt of this order, submit a revised program abuse prevention plan (PAPP) that meet requirements to demonstrate compliance. 2. Citation: Minnesota Rules, parts 2960.0160, subpart 2. Violation: The resident (R1) file did not contain documentation demonstrating the license holder determined whether the resident is a danger to themselves or others. Corrective Action Ordered: Immediately and on an ongoing basis, the license holder must ensure the documentation of admission criteria meets all applicable requirements. 3. Citation: Minnesota Rules, part 2960.0090, subpart 2. Violation: The no-eject discharge documentation for a resident (R1) did not meet requirements. The documentation did not demonstrate that all identified persons of the resident’s treatment team were included to develop any additional strategies to resolve the issues leading to discharge to allow the resident an opportunity to continue receiving services from the license holder. Corrective Action Ordered: Immediately and on an ongoing basis, the license holder must ensure the documentation of a no-eject discharge meets all applicable requirements. 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. Submissions required as part of a corrective action ordered must be sent to DHS Licensing at: 1. By secure email to: tina.christensen@state.mn.us; or 2. By mail to: Commissioner, Department of Human Services ATTN: Tina Christensen Licensing Division PO Box 64242 St. Paul, MN 55164-0242 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.  Sincerely, Tina Christensen, MH/SUD/CRF Senior Licensor Licensing Division Office of Inspector General 651-431-6610
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