Protecting, Maintaining and Improving the Health of Minnesotans

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Protecting, Maintaining and Improving the Health of Minnesotans April 24, 2008 Nosa Ogie, Administrator Precious Home Care Services 5511 102 nd Avenue North Brooklyn Park, MN 55443 Re: Telephone Interview Dear Mr. Ogie: The information discussed during a telephone interview conducted by staff of the Minnesota Department of Health, Case Mix Review Program, on April 1, 2008, is summarized in the enclosed documents listed below: Telephone Interview and Education Assessment form A summary of the items discussed during the phone interview and a listing of the education provided during the interview Resource Sheet for Home Care Providers A listing of web-sites and documents useful to home care providers in assuring compliance with home care regulations Please note, it is your responsibility to share the information contained in this letter and the information from this interview with your direct care staff and the President of your facility s Governing Body. If you have any questions, please feel free to call our office at (651) 201-4301. Sincerely, Jean Johnston, Program Manager Case Mix Review Program Enclosure(s) CMR TELEPHONE 03/08 Division of Compliance Monitoring Case Mix Review 85 East 7th Place Suite, 220 PO Box 64938 St. Paul, MN 55164-0938 651-201-4301 General Information: 651-201-5000 or 888-345-0823 TTY: 651-201-5797 Minnesota Relay Service: 800-627-3529 http://www.health.state.mn.us An equal opportunity employer

Class A and Class F Home Care Telephone Interview and Education Assessment Registered nurses from the Minnesota Department of Health (MDH) use this form to document telephone interviews and education of newly licensed Class F and Class A (licensed only) Home Care Providers as well as other providers who have not been surveyed by Case Mix Review staff. Licensing requirements listed below were reviewed during a telephone interview. Information from this interview along with other data will be considered when making decisions regarding the timing of an on site survey. The noted topics were discussed during the telephone interview and education was provided in the checked areas. Name of Home Care Licensee: Precious Home Care Services HFID #: 24851 Type of License: Class F Home Care Date of Interview: April 1, 2008, and had not begun serving clients Interview Topic Item Discussed Education Provided Access to information Home Care Rules and Statutes Web address for Home Care Rules and Statutes was sent (MN Statute 144A and MN Rule 4668) Web address for Vulnerable Adult Act was sent (MN Statute 626.557) Web address for Maltreatment of Minors Act was sent (MN Statute 626.556) Board of Nursing web address was sent Sent via: E-mail Client Needs Care needs of clients Home Care licensee is required to have staff sufficient in qualifications and numbers to meet client needs (MN Rule 4668.0050) Home Care Telephone and Interview Assessment Page 1 of 4

Home Care Bill of Rights Advertising Unlicensed personnel (ULP) who provide direct care Unlicensed personnel (ULP) and medication administration Bill of Rights given to clients Advertising should reflect services provided Training needed for ULP to be qualified to provide direct care Ongoing education needed for unlicensed personnel Training required Insulin administration by unlicensed personnel Current and appropriate version of home care bill of rights required Minnesota Dept. of Health web-site Includes all forms of advertising MN Rule 4668.0019 Initial training needed MN Rule 4668.0835 Subp. 2 (Class F) Competency testing required MN Rule 4668.0835 Subp. 3 (Class F) Inservice training MN Rule 4668.0835 Subp. 3 (Class F) Ongoing infection control training needed MN Rule 4668.0065 Subp. 3 Difference between medication administration and assistance with medication administration. MN Rule 4668.0003 Subp. 2a and Subp. 21a Medication reminders a visual or verbal cue only. MN Rule 4668.0003 Subp. 21b ULP limitations with insulin administration MN Rule 4668.0855 Subp. 6 (Class F) Prescriber orders required MN Rule 4668.0860 Subp. 2 (Class F) Home Care Telephone and Interview Assessment Page 2 of 4

Role of registered nurse (RN) and licensed practical nurse (LPN) Supervision of unlicensed personnel (ULP) Service plan or agreement Protection of health, safety and well being of clients Need to verify licenses of nurses RN does assessments LPN does monitoring Requirements for supervision and monitoring of unlicensed personnel Contents of Service Plan or Agreement Person who prepares service plan Background studies for all staff Assessment of vulnerability for all clients Difference between RN and LPN role MN Rule 4668.0820 Subp. 2 (Class F) and Minnesota Nurse Practice Act Points at which RN assessment is needed - Class F requirements RN assessment and change in condition MN Rule 4668.0845 Subp. 2 (Class F) RN supervision and LPN monitoring of unlicensed personnel Timing of supervision and monitoring MN Rule 4668.0845 (Class F) Differentiate between licensee service plan and county service plan Required components of service plan Need to review service plan MN Rule 4668.0815 (Class F) Background studies not transferable Only DHS background study accepted MN Statute 144A.46 Subd. 5 Plan to address identified vulnerabilities required MN Statute 626.557 Subd. 14b Home Care Telephone and Interview Assessment Page 3 of 4

Infection control Assisted Living Tuberculosis screening prior to direct client contact Arranged providers for assisted living required to follow 144G System for follow up on TB status after hire MN Rule 4668.0065 Subps. 1 & 2 Yearly infection control inservice required for all staff including nurses MN Rule 4668.0065 Subp. 3 Uniform Consumer Information Guide must be given to all prospective clients MN Statute 144G.03 Subd. 2b9 The data used to complete this form was reviewed with Ogie Nosa RN during a telephone interview on April 1, 2008. A copy of this Telephone Interview and Education Assessment form will be sent to the licensee. Any questions about this Telephone Interview and Education Assessment form should be directed to the Minnesota Department of Health, (651) 201-4301. This form will be posted on the MDH web-site. Home care provider general information is available by going to the following web address and clicking on the appropriate home care provider link: http://www.health.state.mn.us/divs/fpc/profinfo/cms/casemix.html Statutes and rules can be viewed on the internet: http://www.revisor.leg.state.mn.us/stats - for Minnesota Statutes http://www.revisor.leg.state.mn.us/arule/ - for Minnesota Rules Home Care Telephone and Interview Assessment Page 4 of 4