The Homestead at Anoka.
The Homestead at Anoka is Grade C, ranked in the top 44% of Minnesota memory care with 1 MDH citation on record; last inspected Aug 2025.
A large home, reviewed on public record.
Ranked against 142 Minnesota facilities.
ALF memory care · 36-month window. Higher percentile = better. Source: Minnesota Dept. of Health · Health Regulation Division.
FACILITY WATCH · BETA
The Homestead at Anoka has 1 citation on record. Know the moment anything changes.
New findings, complaint investigations, or status changes — emailed to you free.
Citation history, plotted month by month.
1 deficiencie on record. Each bar is a month with a citation.
Finding distribution
1 total · 36 monthsScope × Severity (CMS A–L)
Questions to ask before you visit.
A short pre-tour checklist tailored to The Homestead at Anoka's record and state requirements.
MDH records show 2 complaints on file through August 2025 — were either of those complaints substantiated, and can you share the written documentation describing how the facility responded?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
The most recent inspection on August 28, 2025 resulted in zero deficiencies across 4 total reports — can you walk us through the facility's internal quality assurance process that maintains compliance between state visits?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
Minnesota's assisted living with dementia care license requires specific dementia training and program standards under Chapter 144G — can you show us the written dementia care program and explain how staff competency in memory care is assessed and documented?
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Every MDH visit, verbatim.
3 inspections in the public record, most recent first. Click any row to expand — cited rows open automatically.
2025-08-28Annual Compliance VisitNo findings
Plain-language summary
A routine inspection of The Homestead at Anoka was conducted on August 29, 2025, and two violations were found: one related to fire protection and physical environment, and one other deficiency. The facility was assessed a total fine of $1,500.00 and must document corrective actions taken to address these violations within the timeframe specified by the state.
Full inspector notes
correction orders. MDH documents state licensing correction orders using federal software. Tag numbers are assigned to Minnesota state statutes for Assisted Living Facilities .The assigned tag number appears in the far left column entitled "ID Prefix Tag". The state statute number and the corresponding text of the state statute out of compliance are listed in the "Summary Statemen tof Deficiencies "column. This column also includes the findings that are in violation of the state statute after the statement, "This MN Requiremen tis not met as evidenced by . . ." IMPOSITION OF FINES In accordance with Minn. Stat. § 144G3. 1, Subd .4, fines and enforcement actions may be imposed based on the level and scope of the violations and may be imposed immediately with no opportunity to correct the violation first as follows: Leve l1: no fines or enforcement; Leve l2: a fine of $500 per violation, in addition to any enforcement mechanism authorized in § 144G2. 0; Leve l3: a fine of $1,000 per incident, in addition to any enforcement mechanism authorized in § 144G2. 0; Leve l4: a fine of $3,000 per incident, in addition to any enforcement mechanism authorized in § 144G2. 0; Leve l5: a fine of $5,000 per violation, in addition to any enforcement mechanism authorized in § 144G2. 0. Therefore ,in accordance with Minn. Stat. §§ 144G0. 1 to 144G9. 999, the following fines are assessed pursuant to this survey: An equal opportunity employer . Letter ID: IS7N REVISE 0D9/13/2021 The Homestead at Anoka October 20, 2025 Page 2 St - 0 - 0775 - 144g.45 Subd. 2. (a) - Fire Protection And Physica lEnvironment- $500.00 St - 0 - 1290 - 144g.60 Subdivision 1- $1,000.00 Therefore ,in accordance with Minn. Stat. §§ 144G0. 1 to 144G9. 999, the total amount you are assesse dis $1,500.00. You will be invoiced approximately 30 days after receipt of this notice, subject . to appeal DOCUMENTATIO ONF ACTION TO COMPLY In accordance with Minn. Stat. § 144G3. 0, Subd .5(c), the licensee must docum ent actions taken to comply with the correction orders within the time period outlined on the state form; however, plans of correction are not required to be submitted for approval. The correction order documentation should include the following: x Identify how the area(s) of noncompliance was corrected related to the resident(s)/ employees( ) identified in the correction order. x Identify how the area(s) of noncompliance was corrected for all of the provider’s resident(s)/ employees that may be affected by the noncompliance. x Identify what changes to your systems and practices were made to ensure compliance with the specific statute(s). CORRECTIO ONRDER RECONSIDERATI OPRNOCESS In accordance with Minn. Stat. § 144G3. 2, Subd .2, you may challenge the correction order(s) issued, including the level and scope ,and any fine assesse dthrough the correction order reconsideration process .The request for reconsideration must be in writing and received by MDH within 15 calendar days of the correction order receipt date. To submit a reconsideration request, please visit: https:/ / forms.web.health.state.mn.us/form/ HRDAppealsForm REQUESTIN AG HEARING Alternatively ,in accordance with Minn. Stat. § 144G3. 1, Subd .5(d), an assisted living provider that has been assesse da fine under this subdivision has a right to a reconsideration or a hearing under this section and chapter 14. Pursuan tto Minn. Stat. § 144G2. 0, Subd .14 and Subd .18, a request for a hearing must be in writing and received by the Department of Health within 15 business days of the correction order receipt date. The request must contain a brief and plain statement describing each matter or issue contested and any new information you believe constitutes a defense or mitigating factor. To submit a hearing request, please visit: https:/ / forms.web.health.state.mn.us/form/ HRDAppealsForm To appea lfines via reconside ration, please follow the pr ocedur e outlined above. Plea se note that you may request a reconsideration or a hearing, but not both. If you wish to contest tags without fines in The Homestead at Anoka October 20, 2025 Page 3 a reconsideration and tags with the fines at a hearing, please submit two separate appeals forms at the website listed above. The MDH Health Regulation Division (HRD )values your feedback about your experience during the survey and/or investigation process .Please fill out this anonymous provider feedback questionnaire at your convenience at this link: https:/ / forms.office.com/g/ Bm5uQEpHV.a Your input is important to us and will enable MDH to improve its processe sand communication with providers . If you have any questions regarding the questionnaire ,please contact Susan Winkelmann at susanw. inkelmann@state.mn.us or call 651-201-5952. You are encouraged to retain this document for your records . It is your responsibility to share the information contained in the letter and state form with your organizations’ Governing Body. If you have any questions ,please contact me. Sincerely, Kelly Thorson ,Supervisor State Evaluation Team Email: Kelly.Thorson@state.mn.us Telephone :320-223-7336 Fax :1-866-890-9290 KKM PRINTED: 10/20/2025 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ B. WING _____________________________ 29856 08/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 3002 4TH AVENUE NORTH THE HOMESTEAD AT ANOKA ANOKA, MN 55303 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION (X4) ID ID (X5) (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE PREFIX PREFIX REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE TAG TAG DEFICIENCY) 0 000 Initial Comments 0 000 *****ATTENTION***** Minnesota Department of Health is documenting the State Correction Orders ASSISTED LIVING PROVIDER LICENSING using federal software. Tag numbers have CORRECTION ORDER(S) been assigned to Minnesota State Statutes for Assisted Living Facilities. The In accordance with Minnesota Statutes, section assigned tag number appears in the 144G.08 to 144G.95, these correction orders are far-left column entitled "ID Prefix Tag." issued pursuant to a survey. The state Statute number and the corresponding text of the state Statute out Determination of whether violations are corrected of compliance is listed in the "Summary requires compliance with all requirements Statement of Deficiencies" column. This provided at the Statute number indicated below. column also includes the findings which When Minnesota Statute contains several items, are in violation of the state requirement failure to comply with any of the items will be after the statement, "This Minnesota considered lack of compliance. requirement is not met as evidenced by." Following the evaluators ' findings is the INITIAL COMMENTS: Time Period for Correction. SL29856016-0 PLEASE DISREGARD THE HEADING OF THE FOURTH COLUMN WHICH On August 25, 2025, through August 28, 2025, STATES,"PROVIDER'S PLAN OF the Minnesota Department of Health conducted a CORRECTION." THIS APPLIES TO full survey at the above provider and the FEDERAL DEFICIENCIES ONLY. THIS following correction orders are issued. At the time WILL APPEAR ON EACH PAGE. of the survey, there were 68 residents; all of whom were receiving services under the Assisted THERE IS NO REQUIREMENT TO Living Facility with Dementia Care license. SUBMIT A PLAN OF CORRECTION FOR VIOLATIONS OF MINNESOTA STATE STATUTES. THE LETTER IN THE LEFT COLUMN IS USED FOR TRACKING PURPOSES AND REFLECTS THE SCOPE AND LEVEL ISSUED PURSUANT TO 144G.31 SUBDIVISION 1-3. 0 480 144G.41 Subdivision 1 Subd. 1a (a-b) Minimum 0 480 SS=F requirements; required food services LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE STATE FORM 6899 ZGWO11 If continuation sheet 1 of 10 PRINTED: 10/20/2025 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ B. WING _____________________________ 29856 08/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 3002 4TH AVENUE NORTH THE HOMESTEAD AT ANOKA ANOKA, MN 55303 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION (X4) ID ID (X5) (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE PREFIX PREFIX REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE TAG TAG DEFICIENCY) 0 480 Continued From page 1 0 480 (a) Except as provided in paragraph (b), food must be prepared and served according to the Minnesota Food Code, Minnesota Rules, chapter 4626. (b) For an assisted living facility with a licensed capacity of ten or fewer residents: (1) notwithstanding Minnesota Rules, part 4626.
2024-11-04Complaint Investigation1 · Substantiated Finding
Plain-language summary
A complaint investigation found that facility staff neglected a resident with dementia by failing to communicate about, assess, document, or provide wound care for bilateral forearm wounds over a five-week period from late June through early August 2024, despite a medical provider's orders for wound care issued in late June. Licensed staff did not document or implement the provider's verbal orders, did not forward referral orders to the home care agency, and did not monitor the wounds, which had become macerated with drainage and measured six to eight centimeters by the time skilled wound care finally began in mid-August 2024. The facility was found responsible for the maltreatment.
“MDH substantiated maltreatment or licensing violation finding”
Full inspector notes
Finding: Substantiated, facility responsibility Nature of Investigation: The Minnesota Department of Health investigated an allegation of maltreatment, in accordance with the Minnesota Reporting of Maltreatment of Vulnerable Adults Act, Minn. Stat. 626.557, and to evaluate compliance with applicable licensing standards for the provider type. Initial Investigation Allegation(s): The facility neglected the resident when facility licensed staff failed to communicate, assess, document, and implement wound care. Investigative Findings and Conclusion: The Minnesota Department of Health determined neglect was substantiated. The facility was responsible for the maltreatment. Facility licensed staff failed to communicate with each other about the resident’s wounds, failed to process provider orders for wound care, failed to assess the resident’s wounds, and failed to provide wound care according to the provider orders. The investigator conducted interviews with facility staff members, including administrative staff, nursing staff, unlicensed staff, and an alleged perpetrator. The investigator contacted a home care agency and a family member. The investigation included review of the resident record, rounding provider records, home care records, facility internal investigation, facility incident reports, personnel files, staff schedules, and related facility policy and procedures. The investigator observed facility staff interact with the resident and noted a bandage in place on top of the resident’s right hand. The bandage was not dated or initialed. The resident resided in an assisted living facility. The resident’s diagnoses included dementia. The resident’s service plan included assistance with activities of daily living, medication reminders and monitoring for fall prevention. The resident’s assessment indicated the resident had impaired cognitive abilities, relied on staff for reminders and cueing, utilized a manual wheelchair for mobility, and had a history of falls and skin injuries. Service completion records included documentation licensed staff changed the resident’s bilateral (both sides) forearm wound bandages twice over a period of five weeks, one day a week for the first two weeks of July 2024. The resident’s unsigned July 2024 assessment did not contain identifying information of the licensed staff that completed the assessment and did not include any assessment of skin condition or wounds. Progress notes indicated the last week of June 2024, a licensed staff contacted the resident’s medical provider to request antibiotics (medication to prevent infection) for bilateral forearm skin tears. A progress note dated the first day of August 2024, indicated a licensed nurse was called to the resident’s room to observe the resident’s bilateral forearm wounds that were macerated (softening and breaking down of skin) with greenish drainage surrounding old bandages. The bandages were not dated or initialed and the last bandage change date was unknown. The licensed staff notified the resident’s medical provider of the wounds. Review of the facility’s internal investigation indicated a licensed staff reviewed the resident’s record the first week of August 2024. and found unlicensed staff had notified another licensed staff of the resident’s bilateral forearm wounds the last week of June 2024. During the investigation, the licensed staff observed bandages on the resident’s arms that were not dated or initialed and needed to be changed. The licensed staff found no wound care orders, no record of bandage changes and no progress notes monitoring the wounds for the previous five weeks. Unlicensed personnel failed to enter the resident’s forearm wounds in a staff communication log because the unlicensed staff thought licensed staff were aware of the wounds that had been present for “at least 2-3 weeks”. The internal investigation also found a note unlicensed staff had posted on the main page of the electronic system notifying licensed staff of the resident’s skin tears to both forearms. The licensed staff notified the resident’s medical provider of the facility findings and the provider stated verbal orders were given to a licensed staff the end of June 2024. No documentation of verbal orders was found, and no referral orders were forwarded to a home care agency for wound care. Five-weeks later, the medical provider issued a new order to the facility for wound care to be managed by a home care agency. Home care records indicated the home care agency received orders from the facility to manage the resident’s bilateral forearm wounds the first week of August 2024. The records indicated the resident’s medical provider had initially ordered the resident’s wound care services the last week of June 2024, however, the June 2024 orders had not been forwarded to the home care agency. The records indicated skilled wound care staff did not provide skilled wound care services until the second week of August 2024. The resident’s left forearm wound measured eight-centimeters and the right forearm wound measured six-centimeters when the resident was admitted to home care. Medical provider notes indicated at the end of June 2024; licensed staff requested an antibiotic (medication to prevent infection) for the resident’s bilateral forearm skin tears that occurred the prior week. The resident’s medical provider visited the resident that day and the antibiotic was ordered along with wound care orders. The medical provider notes indicated orders provided in June 2024, were not implemented and new orders were requested on August 1, 2024. Medical provider notes indicated five weeks had passed from the time the provider initially ordered the resident’s wound care until the resident’s wound care began. During an interview, a home care licensed staff stated the resident’s wound care services began the second week of August 2024, and included two or three visits a week. The licensed staff stated it was unknown how long the resident had the bilateral arm wounds. The forearm wounds were large with one wound infected. The home care licensed staff stated she had heard there was a period of time and a delay before the medical provider was contacted about the wounds due to licensed staff conflicts at the facility. During an interview, unlicensed personnel stated she reported the bilateral forearm skin tears to licensed staff and on one occasion observed two licensed staff provide wound care for the resident. The unlicensed personnel stated unlicensed personnel were not trained to provide wound care and when a wound was found the unlicensed staff notified licensed staff. During an interview, another unlicensed personnel stated all wound concerns were reported to licensed staff. The unlicensed personnel stated she would not know how to tell when a bandage was changed or who to contact if a date and initial were not on the bandage. Unlicensed personnel stated sometimes information about wounds was shared with staff on the front page of the electronic system and sometimes it was not, but the page was viewed by all licensed and unlicensed facility staff. During an interview, licensed staff stated many licensed staff had started employment but left the facility after a short period of employment leaving a heavy workload for the remaining licensed staff. The licensed staff stated at times she was responsible for residents on all three floors and a memory care unit. The licensed staff stated the resident’s wound information was known by all licensed staff because information was posted on the facility’s electronic systems front page that was viewed by all staff when they opened the computer and logged on to the system. The licensed staff stated she had updated another licensed staff but was unsure if the other licensed staff had looked at the wounds or changed bandages. The licensed staff stated she had changed the resident’s bandages, however, was unsure if she had signed off on the bandage changes or documented anything in the resident’s record. The licensed staff stated she updated the other licensed staff on the resident’s wounds but did not recall receiving verbal orders for wound care. During an interview, the resident stated his wound bandages are changed regularly now and staff provide the resident with his needs. During an interview, a family member stated family was made aware of the wound incident by the medical provider and an outside agency was given orders to provide wound care going forward for the resident. The family member stated communication with the facility was a challenge during that time and a licensed staff had reached out to the family and stated licensed staff had “dropped the ball”. In conclusion, the Minnesota Department of Health determined neglect was substantiated. Substantiated: Minnesota Statutes, section 626.5572, Subdivision 19. “Substantiated” means a preponderance of evidence shows that an act that meets the definition of maltreatment occurred. Neglect: Minnesota Statutes, section 626.5572, subdivision 17 “Neglect” means neglect by a caregiver or self-neglect.
2024-08-01Complaint InvestigationNo findings
Plain-language summary
MDH investigated a complaint that staff missed notifying this facility about a resident's admission, causing her to miss meals and medications. The investigation found the allegation was not substantiated—staff were properly notified of the admission, the resident did not miss any meals, and she received all medications except for one blood pressure medication that the pharmacy could not fill until Monday, which the family and resident were informed about. The facility was found in noncompliance and implemented a shift communication book; the resident was hospitalized for weakness and fever unrelated to the allegations and later recovered.
Full inspector notes
Finding: Not Substantiated Nature of Investigation: The Minnesota Department of Health investigated an allegation of maltreatment, in accordance with the Minnesota Reporting of Maltreatment of Vulnerable Adults Act, Minn. Stat. 626.557, and to evaluate compliance with applicable licensing standards for the provider type. Initial Investigation Allegation(s): The facility neglected the resident when staff were unaware the resident admitted, therefore the resident missed meals and medications. The staff sent the resident to the hospital after her physical health declined. Investigative Findings and Conclusion: The Minnesota Department of Health determined neglect was not substantiated. The facility alerted staff of the resident’s admission via verbal and written notification. The resident never missed any meals, and staff administered all medications other than a medication that family was aware was unavailable when admitted. The investigator conducted interviews with facility staff members, including administrative staff. The investigator also interviewed the resident and the resident’s family member. The investigation included review of the resident records, facility internal investigation, facility incident reports, staff schedules, facility policies and procedures. Also, the investigator toured the facility and observed medication administration and a meal service. The resident had recently transferred from transitional care to assisted living. The resident’s diagnoses included weakness and aftercare following nervous system surgery. The resident’s service plan included assistance with medication administration, meals, dressing, bathing, and housekeeping. The resident was able to walk with a walker and made breakfast independently in her apartment from personal food supply. During an interview, a family member said the resident reported she never received her medications Friday evening or Saturday morning. Also, the resident missed two doses of her evening blood pressure medication because the facility was unable to obtain the medication from the pharmacy until Monday. The family member denied the resident missed a meal while at the facility but said the resident reported the food was cold and unappetizing. During an interview, the resident said she transferred from transitional care to assisted living on a Friday. She said transitional care was out of her blood pressure medication and the assisted living was unable to obtain the medication until Monday. She said she received all other medications over the weekend. The blood pressure medication missing was a morning medication and she did not receive it Saturday morning. The resident said she was able to walk with a walker, had food in her apartment, and made her own breakfast. She ate lunch and dinner provided by the facility and her family member brought in lunch on Saturday. She never missed a meal, but her dinner came late Friday and Saturday. She said a family member visited Friday, Saturday, and Sunday. On Sunday, she felt weak and had a temperature. She went to the hospital. The resident had a personal cell phone and was able to contact people. According to the resident’s medication administration record, the resident received her medications as ordered. During an interview, a member of management said the resident arrived at the facility without one of her medications. The facility was unable to obtain the medication from pharmacy due to the timing of arrival. The facility informed both the family and resident of the missing medication. The nurse informed staff of the resident’s admission and entered an alert on the computer home page to alert staff. She said the resident never missed any meals and staff administered medications during her stay. The member of management was onsite Friday, Saturday, and Sunday and met with the resident all three days. Staff sent the resident to the hospital on Sunday for weakness and fever. She recovered and discharged back to the facility. In conclusion, the Minnesota Department of Health determined neglect was not substantiated. “Not Substantiated” means: An investigatory conclusion indicating the preponderance of evidence shows that an act meeting the definition of maltreatment did not occur. Neglect: Minnesota Statutes, section 626.5572, subdivision 17 Neglect means neglect by a caregiver or self-neglect. (a) "Caregiver neglect" means the failure or omission by a caregiver to supply a vulnerable adult with care or services, including but not limited to, food, clothing, shelter, health care, or supervision which is: (1) reasonable and necessary to obtain or maintain the vulnerable adult's physical or mental health or safety, considering the physical and mental capacity or dysfunction of the vulnerable adult; and (2) which is not the result of an accident or therapeutic conduct. Vulnerable Adult interviewed: Yes. Family/Responsible Party interviewed: Yes. Alleged Perpetrator interviewed: Not Applicable Action taken by facility: The facility completed an internal investigation and implemented a communication book between shifts. The facility provided medications available and meals. Action taken by the Minnesota Department of Health: The facility was found to be in noncompliance. To view a copy of the Statement of Deficiencies and/or correction orders, please visit: https://www.health.state.mn.us/facilities/regulation/directory/provcompselect.html If you are viewing this report on the MDH website, please see the attached Statement of Deficiencies. You may also call 651-201-4200 to receive a copy via mail or email cc: The Office of Ombudsman for Long Term Care The Office of Ombudsman for Mental Health and Developmental Disabilities PRINTED: 08/ 02/ 2024 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/ SUPPLIER/ CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ C B. WING _____________________________ 29856 06/ 20/ 2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 3002 4TH AVENUE NORTH THE HOMESTEAD AT ANOKA ANOKA, MN 55303 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER' S PLAN OF CORRECTION (X4) ID ID (X5) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS- REFERENCED TO THE APPROPRIATE DATE TAG TAG DEFICIENCY) 0 000 Initial Comments 0 000 ******ATTENTION****** Minnesota Department of Health is documenting the State Correction Orders ASSISTED LIVING PROVIDER CORRECTION using federal software. Tag numbers have ORDER been assigned to Minnesota State Statutes for Assisted Living Facilities. The In accordance with Minnesota Statutes, section assigned tag number appears in the far 144G. 08 to 144G. 95, these correction orders are left column entitled "ID Prefix Tag. " The issued pursuant to a complaint investigation. state Statute number and the corresponding text of the state Statute out Determination of whether a violation is corrected of compliance is listed in the "Summary requires compliance with all requirements Statement of Deficiencies" column. This provided at the statute number indicated below. column also includes the findings which When a Minnesota Statute contains several are in violation of the state requirement items, failure to comply with any of the items will after the statement, "This Minnesota be considered lack of compliance. requirement is not met as evidenced by." Following the evaluators ' findings is the INITIAL COMMENTS: Time Period for Correction. #HL298569945C/ #HL29856210 1M PLEASE DISREGARD THE HEADING OF THE FOURTH COLUMN WHICH On June 20, 2024, the Minnesota Department of STATES, "PROVIDER' S PLAN OF Health conducted a complaint investigation at the CORRECTION. " THIS APPLIES TO above provider, and the following correction FEDERAL DEFICIENCIES ONLY. THIS orders are issued. At the time of the complaint WILL APPEAR ON EACH PAGE. investigation, there were 78 residents receiving services under the provider' s Assisted Living with THERE IS NO REQUIREMENT TO Dementia Care license. SUBMIT A PLAN OF CORRECTION FOR VIOLATIONS OF MINNESOTA STATE The following correction orders are issued for STATUTES. #HL298569945C/ #HL29856210 1M, tag identification 0460. THE LETTER IN THE LEFT COLUMN IS USED FOR TRACKING PURPOSES AND REFLECTS THE SCOPE AND LEVEL ISSUED PURSUANT TO 144G. 31 SUBDIVISION 1-3. 0 460 144G. 41 Subdivision 1 Minimum requirements 0 460 SS= D (5) provide a means for residents to request LABORATORY DIRECTOR' S OR PROVIDER/ SUPPLIER REPRESENTATIVE' S SIGNATURE TITLE (X6) DATE STATE FORM 6899 FO9U11 If continuation sheet 1 of 3 PRINTED: 08/ 02/ 2024 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/ SUPPLIER/ CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ C B.
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