Cardenas Friendship Homes, Knob Hill

MDH’s finding, as written: “No further action required.”

Rule cited: “(a) The facility must meet the following requirements: (1) have a written emergency disaster plan that contains a plan for evacuation, addresses elements of sheltering in place, identifies temporary relocation sites, and details staff assignments in the event [...]”

MDH’s finding, as written: “No further action required.”

Rule cited: “Contents of a resident record include the following for each resident: (1) identifying information, including the resident's name, date of birth, address, and telephone number; (2) the name, address, and telephone number of the resident's emergency contact, [...]”

Rule cited: “(a) Each assisted living facility must comply with the State Fire Code in Minnesota Rules, chapter 7511, and: (1) for dwellings or sleeping units, as defined in the State Fire Code: (i) provide smoke alarms in each room used for sleeping purposes; (ii) [...]”

MDH’s finding, as written: “No further action required.”

Rule cited: “(a) Staff who only provide assisted living services specified in section 144G.08, subdivision 9, clauses (1) to (5), must be supervised periodically where the services are being provided to verify that the work is being performed competently and to identify [...]”

MDH’s finding, as written: “No further action required.”

Rule cited: “(c) Resident reassessment and monitoring must be conducted no more than 14 calendar days after initiation of services. [...]”

MDH’s finding, as written: “No futher action required.”

Rule cited: “(a) No later than 14 calendar days after the date that services are first provided, an assisted living facility shall finalize a current written service plan. [...]”

MDH’s finding, as written: “No further action required.”

Rule cited: “(a) For each resident who requests medication management services, the facility shall, prior to providing medication management services, have a registered nurse, licensed health professional, or authorized prescriber under section 151.37 conduct an [...]”

MDH’s finding, as written: “No further action required.”

Rule cited: “(a) For each resident receiving medication management services, the assisted living facility must prepare and include in the service plan a written statement of the medication management services that will be provided to the resident. [...]”

MDH’s finding, as written: “No further action required.”

Rule cited: “(a) Any current medications being managed by the assisted living facility must be provided to the resident when the resident's service plan ends or medication management services are no longer part of the service plan. [...]”

Summary: MDH found the licensee failed to implement an Emergency Preparedness Plan (EPP) that contained all the required components listed in Appendix Z. The licensee failed to prominently post the EPP.

MDH’s finding, as written: “Based on observation, interview and record review, the licensee failed to implement an Emergency Preparedness Plan (EPP) that contained all the required components listed in Appendix Z. The licensee failed to prominently post the EPP. This had the potential to affect all residents, staff, and visitors. [...]”

Rule cited: “(a) The facility must meet the following requirements: (1) have a written emergency disaster plan that contains a plan for evacuation, addresses elements of sheltering in place, identifies temporary relocation sites, and details staff assignments in the event [...]”

MDH’s finding, as written: “Based on interview and record review the licensee failed to ensure resident records included current and previous assessments and service plans for two (R1 and R2) of three residents reviewed. [...]”

Rule cited: “Contents of a resident record include the following for each resident: (1) identifying information, including the resident's name, date of birth, address, and telephone number; (2) the name, address, and telephone number of the resident's emergency contact, [...]”

MDH’s finding, as written: “0780 Based on observation and interview, the licensee failed ensure smoke alarms are interconnected so that actuation of one alarm causes all alarms in the dwelling to actuate as required. This had the potential to directly affect all residents, staff, and visitors. [...]”

Rule cited: “(a) Each assisted living facility must comply with the State Fire Code in Minnesota Rules, chapter 7511, and: (1) for dwellings or sleeping units, as defined in the State Fire Code: (i) provide smoke alarms in each room used for sleeping purposes; (ii) [...]”

Summary: MDH found the licensee failed to ensure documentation of direct supervision of unlicensed personnel (ULP-D and ULP-E) for two or two staff records reviewed.

MDH’s finding, as written: “Based on interview and record review, the licensee failed to ensure documentation of direct supervision of unlicensed personnel (ULP-D and ULP-E) for two or two staff records reviewed. This had the potential to affect all three residents. [...]”

Rule cited: “(a) Staff who only provide assisted living services specified in section 144G.08, subdivision 9, clauses (1) to (5), must be supervised periodically where the services are being provided to verify that the work is being performed competently and to identify [...]”

Summary: MDH found the licensee failed to complete smoking assessments for two of two residents (R1 and R2) reviewed.

MDH’s finding, as written: “Based on observation, interview, and record review, the licensee failed to complete smoking assessments for two of two residents (R1 and R2) reviewed. This practice resulted in a level two violation (a violation that did not harm a resident's health or safety but had the potential to have harmed a resident's health or safety) and was issued at a widespread scope (when problems are pervasive or represent a systemic failure that has affected or has the potential to affect a large portion or all [...]”

Rule cited: “(c) Resident reassessment and monitoring must be conducted no more than 14 calendar days after initiation of services. [...]”

Summary: MDH found the licensee failed to ensure two of two residents (R1, R2) service plans and revisions included the required signature of authentication by the facility and by the resident agreeing to the plan.

MDH’s finding, as written: “Based on observation, interview, and record review, the licensee failed to ensure two of two residents (R1, R2) service plans and revisions included the required signature of authentication by the facility and by the resident agreeing to the plan. [...]”

Rule cited: “(a) No later than 14 calendar days after the date that services are first provided, an assisted living facility shall finalize a current written service plan. [...]”

Summary: MDH found the licensee failed to ensure a registered nurse (RN) conducted an individualized assessment to determine what medication management services would be provided, and how the services would be provided for two of two residents (R1, R2) records reviewed.

MDH’s finding, as written: “Based on interview, observation, and record review, the licensee failed to ensure a registered nurse (RN) conducted an individualized assessment to determine what medication management services would be provided, and how the services would be provided for two of two residents (R1, R2) records reviewed. [...]”

Rule cited: “(a) For each resident who requests medication management services, the facility shall, prior to providing medication management services, have a registered nurse, licensed health professional, or authorized prescriber under section 151.37 conduct an [...]”

Summary: MDH found the licensee failed to develop an individualized medication management record with the required content for two of two residents (R1,R2) with records reviewed.

MDH’s finding, as written: “Based on interview and record review, the licensee failed to develop an individualized medication management record with the required content for two of two residents (R1,R2) with records reviewed. [...]”

Rule cited: “(a) For each resident receiving medication management services, the assisted living facility must prepare and include in the service plan a written statement of the medication management services that will be provided to the resident. [...]”

Summary: MDH found the licensee failed to provide documentation in the resident's record regarding the disposition of all medications to include the medication strength, prescription number, and quantity for all medications for one of one discharged resident (R-3) with records reviewed and outdated or discontinued medications for two of three resident (R1 and R2)

MDH’s finding, as written: “Based on observation and interview, the licensee failed to provide documentation in the resident's record regarding the disposition of all medications to include the medication strength, prescription number, and quantity for all medications for one of one discharged resident (R-3) with records reviewed and outdated or discontinued medications for two of three resident (R1 and R2) records reviewed. [...]”

Rule cited: “(a) Any current medications being managed by the assisted living facility must be provided to the resident when the resident's service plan ends or medication management services are no longer part of the service plan. [...]”