State of New Mexico CHILDREN, YOUTH and FAMILIES DEPARTMENT MICHELLE LUJAN GRISHAM BRIAN BLALOCK GOVERNOR CABINET SECRETARY HOWIE MORALES TERRY L. LOCKE LIEUTENANT GOVERNOR DEPUTY CABINET SECRETARY October 4, 2019 Mr. Mark M. Conteno President, VisionQuest, 600 Swan Rd. Tucson, Az. 85711 RE: Informal Resolution Conference Outcome Dear Mr. Contento, This correspondence con?rms that earlier today, VisionQuest, Ltd. (VQ) and the Children, Youth, and Families Department (CYFD) informally met pursuant to NMAC 7.8.3.19.A-D in regards to August 28, 2019 Denial of Initial License, attached hereto. Additionally, this correspondence informs VQ that CYFD af?rms and upholds its August 28, 2019 Denial of Initial License letter. If VQ does not accept this letter as an informal resolution of this matter, VQ may, within 10 business days of receiving this letter, provide Licensing and Certi?cation Authority Bureau (LCA) written noti?cation of intent to appeal. An administrative hearing will be held within 30 calendar days of receipt of that written noti?cation pursuant to NMAC 7.8.3.19.A-D. If LCA does not receive a letter requesting appeal within the aforementioned timeframe, CYFD will consider this matter resolved. Email or fax noti?cation of hearing option to: CYFD: Licensing and Certi?cation Authority Bureau Attn: Lillian Rainer, Bureau Chief Email: Lillian.Rainer@state.nm.us Fax: (505) 827-4595 Sincerely, WM Kate Girard Chief General Counsel Children, Youth, and Families Department Cc: File State of New Mexico CHILDREN, YOUTH and FAMILIES DEPARTMENT MICHELLE LUJAN GRISHAM GOVERNOR BRIAN BLALOCK CABINET SECRETARY HOWIE MORALES LIEUTENANT GOVERNOR TERRY L. LOCKE DEPUTY CABINET SECRETARY August 28, 2019 Ms. Carol Keller Director of Operations, AZ VisionQuest, 600 Swan Rd. Tucson. AZ. 8571 1 RE: VisionQuest Denial oflnitial License Dear Ms. Keller. The Licensing and Certi?cation Authority Bureau (LCA) has received VisionQuest?s initial Letter oflntent on 8-12-19 (which included target population and proposed facility address information). regulatory compliance history (information received on 8?14-19 and reports received on 8-15-19), and a final Letter of Intent (received on These documents address all inlormation requested per 8-6-19 State ofNew h-?Iexieo h-Iulti Service Home Regulatory letters. Per the letter, the information is specific to requirements for shelter licensing in New Mexico and allows LCA to determine next steps. The following information has been provided by VisionQuest: 0 Proposed facility and type of land 0 Target population I How supervision, clinical care, medical care, case management. and other sen ices will be provided 0 Governing Body and Director 0 Direct service provision 0 Staff training - Trauma-informed trauma-responsive serv ices 0 Staff with experience expertise ho will be developing policies procedures 0 Regulatory compliance implementation I Regulatory compliance history Bl ll .81 llt'l NSING Bl 192': SI. H. \l - HJFI - TAX: HUS) 53" Upon review of the above items, a signi?cant area of concem has been identified. During the course of correspondence with VisionQuest, requests for regulatory compliance history were made on 8-6-19, 8-13-19, and 8-14-19. On 8?14-19, VisionQuest provided the following (which is also included in the 8-23?19 Letter oflntent): ?VisionQuest National, Ltd. never had a program license revoked or suspended but we have had the license on one of the living units in one of our programs temporarily revoked. The state of separately licenses each living unit (ex: a donnitory or other sleeping quarters) as opposed to licensing a program as a whole. At the facility we operated in South Mountain the state licensed three separate living units. In October 2015, the state cited several licensing de?ciencies in one ofthose living units living unit and revoked the license on that living unit as a result. Neither ofthe other two living units at the South Mountain facility was effected by that license revocation although we did ultimately (and temporarily) close the South Mountain facility for other reasons. The South Mountain facility was eventually re- opened in February 2018 and a state license was reissued at that time. The Senth Mountain facility remains open and operational today. The reasons for the October 2015 living unit license revocation were as follows: medical errors documentation missing; staff not timely and properly diagnosing a youth ultimately determined to be suffering from pneumonia; staff not properly trained to dispense medication; two youth rights violation one being improper emergency safety physical intervention and two being not treating a youth with fairness. dignity and respect.? Documented regulatory compliance history was not provided until after LCA requested compliance history reports on 8?14-19 and 8-15-19. The above compliance history information provided by VisionQuest does not re?ect the reports which a ere provided to LCA on 8-15-19. The reports include the following health, safety, and welfare violations: October 22, 2015 Licensure Revocation for License #328470 Child Residential Facility 10-14-15 Revocation Report Violations: a Staff member bent the arm of a child behind the child?s hack and in an upward position because the child refused to complete chores. The incident caused pain to the child and was witnessed by several other children and another staff. 0 Child requested Mueinex medication after exhibiting signs of breathing distress. Staff instructed client to drink water and told the client it as just a cold. The next morning. the client was taken to the emergency room and admitted to the hospital for pneumonia. - Sixteen medication errors were documented (involx ing five clients), including failure to administer medications as ordered medications, over the counter, and prescription medications) 0 Four staff who administered medications to clients did not complete approved medication administration training A client was allowed to have a \"entolin inhaler and self-administered 70 puffs between bedtime and rooming. A trained and qualified staff member was not present in the home at the time. 9-22-15 Inspection Summary Violations: - Staff dragged a child out of bed by the child?s arms. The child?s underwear was exposed to at least one other child during the incident. 0 assessment not completed until seven days after a child was admitted (required within 24 hours of admission) 0 Five clients? health safety assessments did not hm immunization history documented as required 0 One client did not have a health examination completed until 19 days alter admission (due within 15 days of admission) 0 Two clients did not have required sickle cell screening 0 Four staff who administered medications to clients did not complete approved medication administration training - Dated photographs were not completed for three clients Regulatory compliance history information provided by \"isionQucst on 8-14-19 does not accurately the health, safety, and elfarc violations of the licensure revocation and sun'ey reports. This, in addition to VisionQuest not providing compliance history reports until LCA made two requests, is considered to be purposeful or intentional misrepresentation of information on documents provided to LCA. This, in addition to the history of licensure revocation. are grounds a for denial of initial application for license pursuant to NMAC 7.8.3.18.D and F: 7.8.3.18 GROUNDS FOR REVOCATION, SUSPENSION OF LICENSE, DENIAL OF INITIAL OR RENEWAL APPLICATION FOR LICENSE, OR IMPOSITION OF A license may be revoked or suspended. an initial or renewal application for license may be denied, or sanctions may be imposed after notice and opportunity for a hearing, for any ofthe following: D. Purposeful or intentional 1nisrepresentation(s) or falsificationts) ofany information on application forms or other documents provided to the Licensing Authority. F. Presence of and or a history of licensure revocation, denial, other similar disciplinary actions taken by regulatory bodies within this state, or other states regardless ofwhether any of these actions resulted in a settlement. Right to Hearing: Pursuant to NMAC 7.8.3.19.A-D, an appeal of this denial can be made in writing to the Licensing Authority within 10 business days of receipt of the official notice of licensure denial. When an appeal is filed the sanction is stayed until a hearing is held and final determination issued or an infonnal resolution reached, unless it is an emergency revocation or suspension of license. A hearing will be held within 30 calendar days. The entity ?ling the appeal may also request an informal resolution conference at that time. The purpose of the informal Bl'll HEALTH SERVICES (lik?l'll?lCA'l?lON Bl. Rl \l .920 ill lil ST. - SANTA FE. NM. S"?i 5 - FAX: {505} $2?-4595 resolution conference is to allow the entity the sanction an opportunity to present information on plans to remedy de?ciencies and discuss possible pro-hearingr dispositions. This does not apply to the emergency revocation or suspension of a license or to the imposition of emergency sanctions. The Licensing Authority and the licensee may informally resolve any ?led or potential appeal arising from the imposition of sanctions. Please initial by the line beside the option you wish to choose. if you do not choose an option below, your hearing will be held as detailed below. I wish to: 1. Request a hearing (or informal resolution conference). 2. Waive my right to a hearing (or informal resolution conference) on the denial. Email or fax notification of hearing option to: Children, Youth and Families Department Licensing and Certification Authority Bureau Attn: Lillian Rainer, Bureau Chief Email: state.nm.us Fax: (505) 827-4595 I can be contacted at 505-231-3129 should you have questions regarding this correspondence or other Licensing and Certi?cation iSsues. Sincerely, Lillian Rainer, LCSW Bureau Chief Licensing and Certification .-\uthority Bureau CYFD, Behavioral Health Sen-ices Cc: File