Emerald Crest of Minnetonka.
Emerald Crest of Minnetonka is Grade D, ranked in the bottom 37% of Minnesota memory care with 2 MDH citations on record; last inspected May 2025.
A medium home, reviewed on public record.
Ranked against 187 Minnesota facilities.
ALF memory care · 36-month window. Higher percentile = better. Source: Minnesota Dept. of Health · Health Regulation Division.
FACILITY WATCH · BETA
Emerald Crest of Minnetonka has 2 citations on record. Know the moment anything changes.
New findings, complaint investigations, or status changes — emailed to you free.
Citation history, plotted month by month.
2 deficiencies on record. Each bar is a month with a citation.
Finding distribution
2 total · 36 monthsScope × Severity (CMS A–L)
Questions to ask before you visit.
A short pre-tour checklist tailored to Emerald Crest of Minnetonka's record and state requirements.
Minnesota Department of Health records show 5 inspection reports on file with 0 deficiencies cited — can you walk us through the dementia care policies and training documentation that MDH reviewed during the most recent May 15, 2025 inspection?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
The facility holds an Assisted Living Facility with Dementia Care license under Minnesota Statutes chapter 144G with 42 licensed beds — what specific dementia care programming and environmental adaptations distinguish the memory care services here from standard assisted living?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
Three complaints were filed with MDH during the inspection period on file — were any of those complaints substantiated, and can you share the facility's written response or corrective action plans for any substantiated findings?
Ask the operator on tour. Take notes and compare answers across facilities you visit.
Every MDH visit, verbatim.
4 inspections in the public record, most recent first. Click any row to expand — cited rows open automatically.
2025-05-15Annual Compliance VisitNo findings
Plain-language summary
A routine inspection of Emerald Crest of Minnetonka on May 15, 2025 found violations related to fire protection and physical environment, resulting in two state correction orders and a total fine of $1,000. The facility must document the actions it takes to correct these violations within the timeframe specified on the state form. The facility has the right to request reconsideration or a hearing within 15 business days of receiving this notice.
Full inspector notes
correction orders and document the actions taken to comply in the facility's records. The Department reserves the right to return to the facility at any time should the Department receive a complaint or deem it necessary to ensure the health, safety, and welfare of residents in your care. STATE CORRECTION ORDERS The enclosed State Form documents the state 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 Statement of Deficiencies" column. This column also includes the findings that are in violation of the state statute after the statement, "This MN Requirement is not met as evidenced by . . ." IMPOSITION OF FINES In accordance with Minn. Stat. § 144G.31, 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: Level 1: no fines or enforcement. Level 2: a fine of $500 per violation, in addition to any enforcement mechanism authorized in § 144G.20 for widespread violations; Level 3: a fine of $3,000 per violation per incident, in addition to any enforcement mechanism authorized in § 144G.20. Level 4: a fine of $5,000 per incident, in addition to any enforcement mechanism authorized in An equal opportunity employer. Letter ID: IS7N REVISED 09/13/2021 Emerald Crest Of Minnetonka July 9, 2025 Page 2 § 144G.20. Therefore, in accordance with Minn. Stat. §§ 144G.01 to 144G.9999, the following fines are assessed pursuant to this survey: 0775 - 144g.45 Subd. 2. (a) - Fire Protection And Physical Environment - $500.00 0780 - 144g.45 Subd. 2 (a) (1) - Fire Protection And Physical Environment - $500.00 Therefore, in accordance with Minn. Stat. §§ 144G.01 to 144G.9999, t he total amount you are assessed is $1,000.00. You will be invoiced approximately 30 days after receipt of this notice, subject to appeal. DOCUMENTATION OF ACTION TO COMPLY In accordance with Minn. Stat. § 144G.30, Subd. 5(c), the licensee must document 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: Identify how the area(s) of noncompliance was corrected related to the resident(s)/employee(s) identified in the correction order. 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. Identify what changes to your systems and practices were made to ensure compliance with the specific statute(s). CORRECTION ORDER RECONSIDERATION PROCESS In accordance with Minn. Stat. § 144G.32, Subd. 2, you may challenge the correction order(s) issued, including the level and scope, and any fine assessed through 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 REQUESTING A HEARING Alternatively, in accordance with Minn. Stat. § 144G.31, Subd. 5(d), an assisted living provider that has been assessed a fine under this subdivision has a right to a reconsideration or a hearing under this section and chapter 14. Pursuant to Minn. Stat. § 144G.20, 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. Emerald Crest Of Minnetonka July 9, 2025 Page 3 To submit a hearing request, please visit: https://forms.web.health.state.mn.us/form/HRDAppealsForm To appeal fines via reconsideration, please follow the procedure outlined above. P lease note that you may request a reconsideration o r a hearing, but not both. If you wish to contest tags without fines in 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: h ttps://forms.office.com/g/Bm5uQEpHVa. Your input is important to us and will enable MDH to improve its processes and communication with providers. If you have any questions regarding the questionnaire, please contact Susan Winkelmann at susan.winkelmann@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 organization’s Governing Body. If you have any questions, please contact me. Sincerely, Jess Schoenecker, Supervisor State Evaluation Team Email: jess.schoenecker@state.mn.us Telephone: 651-201-3789 Fax: 1 -866-890-9290 JMD PRINTED: 07/09/2025 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 _____________________________ 20705 05/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 13417 LAKE STREET EXTENSION EMERALD CREST OF MINNETONKA MINNETONKA, MN 55305 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 Licensing ASSISTED LIVING PROVIDER LICENSING Correction Orders using federal software. CORRECTION ORDER Tag numbers have been assigned to Minnesota State Statutes for Assisted In accordance with Minnesota Statutes, section Living Facilities. The assigned tag 144G.08 to 144G.95 this correction order(s) has number appears in the far left column been issued pursuant to a survey. entitled "ID Prefix Tag." The state Statute number and the corresponding text of the Determination of whether a violation has been state Statute out of compliance is listed in corrected requires compliance with all the "Summary Statement of Deficiencies" requirements provided at the Statute number column. This column also includes the indicated below. When Minnesota Statute findings which are in violation of the state contains several items, failure to comply with any requirement after the statement, "This of the items will be considered lack of Minnesota requirement is not met as compliance. evidenced by." Following the evaluators' findings is the Time Period for Correction. INITIAL COMMENTS: Project # SL20705016 PLEASE DISREGARD THE HEADING OF THE FOURTH COLUMN WHICH On May 12, 2025, through May 15, 2025, the STATES,"PROVIDER'S PLAN OF survey at the above provider, and the following FEDERAL DEFICIENCIES ONLY. THIS correction orders are issued. At the time of the WILL APPEAR ON EACH PAGE. survey there were 35 residents receiving services under the Assisted Living with Dementia Care THERE IS NO REQUIREMENT TO 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 87Q811 If continuation sheet 1 of 15 PRINTED: 07/09/2025 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 _____________________________ 20705 05/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 13417 LAKE STREET EXTENSION EMERALD CREST OF MINNETONKA MINNETONKA, MN 55305 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) 0 480 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.
2025-03-18Complaint InvestigationNo findings
Plain-language summary
Minnesota Department of Health investigated a complaint that staff abused a resident by forcing her to change clothes and using a mechanical lift contrary to her care plan, which caused bruising on her hands, thighs, and arms. The investigation found the abuse allegation inconclusive because the resident had an unwitnessed fall three days before the bruising was observed, and it could not be determined whether the bruises resulted from the fall or from staff not following the updated care plan for transfers; there was no evidence staff forced the resident to change clothes. The facility trained staff on following the resident's care plan and reporting falls.
Full inspector notes
Finding: Inconclusive 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 abused a resident when several staff failed to follow the resident’s plan of care. Staff forced the resident to change clothes and used a mechanical lift with one staff to transfer, which left bruising on the resident’s hands, thighs, and arms. Investigative Findings and Conclusion: The Minnesota Department of Health determined abuse was inconclusive. The facility trained the unlicensed staff to follow the resident’s care plan and to report all falls. The resident had an unwitnessed fall three days before the report of bruising. Although the staff used a higher level of assistance for transfers, it could not be determined if the resident’s bruises were from the fall or from staff using the mechanical lift contrary to the service plan. There was no evidence staff forced the resident to change clothes. The investigator conducted interviews with facility staff members, including administrative staff, nursing staff, and unlicensed staff. The investigator contacted family, spoke with other residents and another resident’s family member. The investigation included review of the resident records, facility internal investigation, facility incident reports, personnel files, staff schedules, related facility policy and procedures. Also, the investigator observed the facility, resident’s apartment, and staff/resident interactions. The resident lived in an assisted living memory care unit due to diagnoses that included dementia and atrial fibrillation. The resident’s service plan included assistance with toileting every two hours and dressing/undressing. The resident’s assessment indicated she required assist of two staff for transferring, one with a gait belt, and the other for stand-by assist. An internal investigation report indicated a nurse followed up on an unwitnessed fall report from three days earlier and observed bruising on the resident’s thigh and tops of both hands. The report indicated the resident told the nurse that staff forced her to change clothes and grabbed her hands to use the sit to stand mechanical lift. The report indicated upon admission (six days earlier) the resident required a sit to stand mechanical lift for transfers. A physical therapy/occupational therapy assessment conducted several days after admission, changed the care plan to a lower level of assistance to include transfers with a gait belt and two staff. The investigation report indicated staff did not implement the change in transfer and continued to use the higher level of assistance sit to stand mechanical lift for transfers. The investigation report concluded that bruises could have occurred either due to the unwitnessed fall or staff not following the plan of care for transfers. During an interview, a nurse stated the resident had no additional injuries or pain related to the fall or cares. The nurse stated the resident did not recall falling and had a history of refusing to allow staff to place the gait belt for transfers. The nurse stated she directed staff to reapproach the resident when she refused to allow the gait belt. During investigative interviews, multiple staff members stated the resident was new to the facility and initially required a sit to stand mechanical lift for transfers. The staff stated they were not aware the residents care plan had changed to two staff assist with a gait belt for transfers until questioned about the resident’s fall. During an interview, the resident stated she did not recall any incident that would have resulted in bruising. The resident indicated some staff were nice to her and good about providing cares. The resident expressed some concern about staffing, as it took a while to get staff to help her use the bathroom. During an interview, a family member stated the resident bruised easily due to her medications. The family member stated he could understand if the bruises came from the resident’s fall at the beginning of the weekend. In conclusion, the Minnesota Department of Health determined abuse was inconclusive. Inconclusive: Minnesota Statutes, section 626.5572, Subdivision 11. "Inconclusive" means there is less than a preponderance of evidence to show that maltreatment did or did not occur. Abuse: Minnesota Statutes section 626.5572, subdivision 2. "Abuse" means: (a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate, or aiding and abetting a violation of: (1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224; (2) the use of drugs to injure or facilitate crime as defined in section 609.235; (3) the solicitation, inducement, and promotion of prostitution as defined in section 609.322; and (4) criminal sexual conduct in the first through fifth degrees as defined in sections 609.342 to 609.3451. A violation includes any action that meets the elements of the crime, regardless of whether there is a criminal proceeding or conviction. (b) Conduct which is not an accident or therapeutic conduct as defined in this section, which produces or could reasonably be expected to produce physical pain or injury or emotional distress including, but not limited to, the following: (1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable adult; (2) use of repeated or malicious oral, written, or gestured language toward a vulnerable adult or the treatment of a vulnerable adult which would be considered by a reasonable person to be disparaging, derogatory, humiliating, harassing, or threatening; or (3) use of any aversive or deprivation procedure, unreasonable confinement, or involuntary seclusion, including the forced separation of the vulnerable adult from other persons against the will of the vulnerable adult or the legal representative of the vulnerable adult unless authorized under applicable licensing requirements or Minnesota Rules, chapter 9544. (c) Any sexual contact or penetration as defined in section 609.341, between a facility staff person or a person providing services in the facility and a resident, patient, or client of that facility. Vulnerable Adult interviewed: Yes Family/Responsible Party interviewed: Yes Alleged Perpetrator interviewed: Not Applicable Action taken by facility: Facility provided education to all staff to read and implement the residents’ care plans prior to providing care. Four staff who provided cares, but did not follow the updated care plan received written warnings in their personnel file. Action taken by the Minnesota Department of Health: No further action taken at this time. cc: The Office of Ombudsman for Long Term Care The Office of Ombudsman for Mental Health and Developmental Disabilities PRINTED: 03/20/2025 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ C B. WING _____________________________ 20705 03/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 13417 LAKE STREET EXTENSION EMERALD CREST OF MINNETONKA MINNETONKA, MN 55305 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 On March 13, 2025, the Minnesota Department of Health initiated an investigation of complaint #HL207058501C/#HL207059402M. No correction orders are issued. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE STATE FORM 6899 KKM511 If continuation sheet 1 of 1
2024-11-08Complaint Investigation1 · Substantiated Finding
Plain-language summary
A complaint investigation found that a resident with dementia sustained a large, deep laceration to her right elbow that required emergency room treatment and sutures; MDH determined an unlicensed caregiver neglected the resident by failing to perform required reassurance checks throughout the night shift, and facility camera footage showed the caregiver was not checking on the resident as the care plan required. The caregiver is no longer employed at the facility, and MDH issued a correction order regarding the resident's right to be free from maltreatment. The resident was deceased at the time of the investigation.
“MDH substantiated maltreatment or licensing violation finding”
Full inspector notes
Finding: Substantiated, individual 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 the resident obtained an injury of unknown cause. The resident obtained a large, deep laceration to her right elbow area which required medical attention. Investigative Findings and Conclusion: The Minnesota Department of Health determined neglect was substantiated. An individual alleged perpetrator, who was an unlicensed caregiver, was responsible for the maltreatment. The alleged perpetrator failed to follow the resident’s service plan and complete reassurance checks on the resident through the night shift. The resident was not checked on until early the following morning, at which time the injury of unknown cause was found. The investigator conducted interviews with facility staff members, including administrative staff, and unlicensed staff. The investigator contacted the resident’s family member. The investigation included review of the resident record, hospital records, facility internal investigation, personnel files, and related facility policy and procedures. The resident resided in an assisted living facility. The resident’s diagnoses included dementia. The resident’s service plan included assistance with bed mobility, transfers, toileting, and completing reassurance checks. The resident’s assessment indicated the resident was alert and oriented, able to make needs known, and had short-term memory loss. Early one morning, the progress notes indicated an unlicensed caregiver called a nurse to report the resident had a “really large” deep skin tear on the right elbow, which was not bleeding at the time. The note indicated the caregiver was unsure when or how the resident sustained the skin tear. The nurse who received the call notified a hospice nurse who would send someone to the facility to assess the wound. Later the same day, progress notes indicated the resident was sent to the emergency department for treatment of the wound. The note indicated the resident required sutures for her arm and the resident returned to the facility. The facility conducted an internal investigation whose documents indicated the skin tear was found by the alleged perpetrator at the end of her night shift and she notified the on-call nurse. The documents indicated management staff member(s) reviewed camera footage, which showed did not check on the resident throughout the shift as the resident’s care plan indicated to do so. Internal investigation interviews with caregivers, completed by management, indicated the resident did not have a skin tear at bedtime the evening prior. The notes from the interview with the alleged perpetrator indicated camera footage showed the alleged perpetrator sleeping during her shift and that when asked if she had been sleeping, she said “yes”. During an interview, an unlicensed caregiver stated he was assigned to float from multiple locations the night of the incident. The caregiver stated he was in the resident’s location for about an hour earlier that night and did not return until the alleged perpetrator called for assistance early the next morning. The caregiver stated the alleged perpetrator called for help to assist the resident to the bathroom and with bleeding from the resident’s hand. The caregiver stated the resident had a “big skin tear” and the alleged perpetrator had not notified the nurse, so he did. During an interview, a manager stated camera footage was reviewed for the overnight shift and there was no movement seen for a period of time even though there were scheduled tasked due. The manager stated she is confident the resident was not checked on by the alleged perpetrator until right before the end of her shift. 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. (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: No. The resident was deceased. Family/Responsible Party interviewed: Yes. Alleged Perpetrator interviewed: No, attempts were unsuccessful Action taken by facility: The facility investigated the incident. The employee is no longer employed by the facility. Action taken by the Minnesota Department of Health: The facility was issued a correction order regarding the vulnerable adult’s right to be free from maltreatment. You may also call 651-201-4200 to receive a copy via mail or email https://www.health.state.mn.us/facilities/regulation/directory/provcompselect.html The responsible party will be notified of their right to appeal the maltreatment finding. If the maltreatment is substantiated against an identified employee, this report will be submitted to the nurse aide registry for possible inclusion of the finding on the abuse registry and/or to the Minnesota Department of Human Services for possible disqualification in accordance with the provisions of the background study requirements under Minnesota 245C. cc: The Office of Ombudsman for Long Term Care The Office of Ombudsman for Mental Health and Developmental Disabilities Hennepin County Attorney Minnetonka City Attorney Minnetonka Police Department PRINTED: 11/12/2024 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 _____________________________ 20705 10/07/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 13417 LAKE STREET EXTENSION EMERALD CREST OF MINNETONKA MINNETONKA, MN 55305 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 144G.08 to 144G.95, these correction orders are far-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. #HL207058437C / #HL207055941M PLEASE DISREGARD THE HEADING OF THE FOURTH COLUMN WHICH On October 7, 2024, the Minnesota Department STATES,"PROVIDER'S PLAN OF of Health conducted a complaint investigation at CORRECTION." THIS APPLIES TO the 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 33 residents receiving services under the provider ' s Assisted Living THERE IS NO REQUIREMENT TO with Dementia Care license. SUBMIT A PLAN OF CORRECTION FOR VIOLATIONS OF MINNESOTA STATE The following correction order is issued/orders STATUTES. are issued for #HL207055941M, tag identification 2360. 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. 02360 144G.91 Subd. 8 Freedom from maltreatment 02360 Residents have the right to be free from physical, LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE STATE FORM 6899 N2CA11 If continuation sheet 1 of 2 PRINTED: 11/12/2024 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.
2023-11-06Complaint Investigation1 · Substantiated Finding
Plain-language summary
A complaint investigation on November 6, 2023, found that the facility failed to make menus available to residents and did not inform residents when meals or menu items changed, such as when milk was unavailable—a violation that affected all 34 residents and had the potential to harm their health or safety. The facility was issued a correction order for this deficiency, which was classified as a level two violation with widespread scope.
“MDH substantiated maltreatment or licensing violation finding”
Full inspector notes
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. #HL207055017C PLEASE DISREGARD THE HEADING OF THE FOURTH COLUMN WHICH On November 6, 2023, the Minnesota STATES,"PROVIDER'S PLAN OF Department of Health conducted a complaint CORRECTION." THIS APPLIES TO investigation 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 complaint investigation, there were 34 residents receiving services under the provider's THERE IS NO REQUIREMENT TO Assisted Living with Dementia Care license. SUBMIT A PLAN OF CORRECTION FOR VIOLATIONS OF MINNESOTA STATE The following correction orders are issued for STATUTES. #HL207055017C, tag identification 0485 and 0510. 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. 0 485 144G.41 Subdivision 1. (13)(i)(A)and(C) Minimum 0 485 SS=F Requirements LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE STATE FORM 6899 2EZ311 If continuation sheet 1 of 9 PRINTED: 11/17/2023 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 _____________________________ 20705 11/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 13417 LAKE STREET EXTENSION EMERALD CREST OF MINNETONKA MINNETONKA, MN 55305 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) 0 485 Continued From page 1 0 485 (13) offer to provide or make available at least the following services to residents: (i) at least three nutritious meals daily with snacks available seven days per week, according to the recommended dietary allowances in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables. The following apply: (A) menus must be prepared at least one week in advance and made available to all residents. The facility must encourage residents' involvement in menu planning. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes; and (C) the facility cannot require a resident to include and pay for meals in their contract; (ii) weekly housekeeping; (iii) weekly laundry service; This MN Requirement is not met as evidenced by: Based on record review, observation and interview, the licensee failed to ensure menus were made available to all residents and failed to inform residents of menu changes. This had the ability to impact all 34 residents receiving services. 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, but was not likely to cause serious injury, impairment, or death) 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 of the residents). The findings include: STATE FORM 6899 2EZ311 If continuation sheet 2 of 9 PRINTED: 11/17/2023 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 _____________________________ 20705 11/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 13417 LAKE STREET EXTENSION EMERALD CREST OF MINNETONKA MINNETONKA, MN 55305 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) 0 485 Continued From page 2 0 485 R2's diagnoses included vascular dementia with mood disturbance and stage 4 chronic kidney disease. R2's service plan agreement dated July 1, 2023, indicated R2 received medication administration, cueing and standby assistance with walking. R2's progress note dated August 4, 2023 at 11:07 a.m., indicated she likes ice water and would like milk at lunch and dinner. R3's diagnoses included repeated falls, and mild cognitive impairment. R3's service plan agreement dated April 13, 2023, indicated R3 received medication management and transfer assistance. During an observation on November 6, 2023, at 10:35 a.m., a staff member prepared baking trays of potatoes for the midday meal. Two residents (R2 and R3) were seated at a dining table talking. During an interview on November 6, 2023, at 10:45 a.m., R2 said the residents do not have access to menus and do not know what the meals are until they get the food served. R2 said the food is not good and she does not always eat what is served which concerns her because she is petite and thin. R2 said she likes a glass of milk with meals but has sometimes been told by staff the milk has gone bad or there is no milk available. R2 said that was not communicated to the residents as a menu change. During the same interview, R3 said there are no menus posted. R3 said she she sits with R2 at the same dining table and heard staff tell R2 there is no milk when she's asked for a glass. During an interview on November 6, 2023, at STATE FORM 6899 2EZ311 If continuation sheet 3 of 9 PRINTED: 11/17/2023 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 _____________________________ 20705 11/06/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 13417 LAKE STREET EXTENSION EMERALD CREST OF MINNETONKA MINNETONKA, MN 55305 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) 0 485 Continued From page 3 0 485 11:20 a.m., unlicensed personnel (ULP)-E said she is scheduled to prepare the meals and clean kitchen, wash dishes today. ULP-E said there is a menu in the kitchen and opened an upper cabinet door. A menu was taped to the inside of the cabinet door. ULP-E said the staff do not give out menus to the residents, they can tell the residents what is on the menu. Review of the menu indicated beverage choices were: milk, coffee and water for all three meals with lemonade as an added choice for lunch. ULP-E opened the refrigerator and there were gallons of milk on one shelf. During an observation at 11:40 a.m., the surveyor saw a daily mealtime schedule posted near the kitchen (breakfast 8:30, lunch 12:00, dinner 5:00), but did not see a meal menu posted. During an interview on November 6, 2023, at 1:15 p.m., administrative assistant (AD)-F said the meals are prepared at their Burnsville site kitchen and sent over for cooking. Snacks and alternative meal choices also come from the Burnsville site and they will let staff know if there is a menu change. AD-F said residents can get a menu if they ask for one and there is a portal they or families can log into to access menus. A policy titled Dining Services, dated August 1, 2021, indicated menus were prepared at least one week in advance and made available to all residents. Residents were encouraged to be involved in menu planning and informed in advance of menu changes. TIME PERIOD TO CORRECT: Twenty-one (21) Days STATE FORM 6899 2EZ311 If continuation sheet 4 of 9 PRINTED: 11/17/2023 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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