Date: December 18, 2023

To: General Public

From: Sagar Chowdhury, Associate Director of Public Health
Re: Oakridge Treatment Center Appeal Report
Date, Time, Place of Hearing:

• Date: February 7, 2024

• Time: 8:30 AM -12:00 PM
• Place: Government Center Board Chambers (151 4th ST SE Rochester, MN, 55904)
Nature of Appeal Request:

Licensee Meridian Behavioral Health, LLC (“Meridian) and New Horizon Foods, Inc. provide the following
reasons for their appeal of the November 6, 2023, Public Health Nuisance Declaration and November
22, 2023, Notice of License Revocation. Meridian in its role as owner and operator of Oakridge
Treatment Center (“Oakridge”) believes it has taken the necessary steps to remediate the concerns
expressed by Olmsted County Public Health Services (“the County”) in the Notices. Meridian believes
that full remediation requires more time, and that the county should reverse its revocation of the public
lodging and food and beverage licenses to give the Licensees the necessary time to abate the issues
identified in the Notices and remove any “imminent health hazard.” The shortage of inpatient substance
abuse treatment facilities in Minnesota is well documented, and Meridian believes it provides a critical
service to the community while recognizing there are improvements to be made.

Meridian also argues DHS is tasked with licensing substance use disorder treatment centers, and that
authority has not been delegated to local governing bodies. Oakridge has a valid license from DHS to
operate as a treatment care facility, and the license prior to the actions of the County was considered in
good standing. DHS has also indicated in correspondence with Meridian that it supports maintaining
Oakridge’s DHS license currently. Given DHS’s role in licensure, reporting regulation, and oversight,
there is an indication that regulating substance use disorder treatment facilities is a state-level concern.

Characteristics of the Applicant’s Property and Environs:

Oakridge Treatment Center is located at 4800 48 ST NE Rochester, MN in the Haverhill Township of

Olmsted County. The land description is classified as Commercial/Industrial 1.00 and is 88.08 acres in
total. There is a gross building area of 40,897 Sq ft. The commercial structures consist of the main
structure, two additional villas, and a garage. The property is secluded and primarily surrounded by
wooded acreage. The remote location of the property highlights the need for facility staff to actively
manage the site and the vulnerable adults within it. Available support and emergency services are miles
away, with the nearest emergency department 7.6 miles away. Furthermore, when public safety

508C January 24, 2024 Page 1 of 10

resources must respond to the facility, it far removes them from the community as a whole and their
ability to support other Olmsted County residents.

Relationship of the request to the intent of the applicable ordinance:

The Minnesota Department of Health delegates Olmsted County authority to license and regulate a
wide variety of license types within Olmsted County including food, beverage, and lodging
establishments. County Code of Ordinances Chapter 3100- Environmental Public Health Services
Administrative Ordinance was also enacted to supplement, and carry out the purposes of Olmsted
County ordinances and State of Minnesota laws for public health protection, including but not limited to
ordinances regulating the following: public pools, youth camps, recreational camping areas,
manufactured home parks, public lodging, public food and beverage establishments, public health
nuisances, rabies and public non-community transient water systems that are in facilities licensed by
Olmsted County Public Health Services. Chapter 3100 applies to all incorporated municipalities and
unincorporated areas within the boundaries of Olmsted County. Where conditions imposed by any
provision of environmental public health ordinances are either more restrictive or less restrictive than
comparable provisions imposed by any other law, ordinance, statute, resolution, or regulation of any
kind, the regulations which are more restrictive, or impose higher standards or requirements, shall
prevail. In addition, Chapter 3100 grants authority to the Public Health Services Advisory Board to
declare a public health nuisance and abate said nuisance. Chapter 4000- Administrative Enforcement
and Appeals Procedure grants authority to the director to revoke a license or permit without a hearing
before a hearing office, where the Director finds (1) imminent hazard or danger to public health, safety,
or welfare of the environment or (2) a violation of applicable provisions of an ordinance or permit which
may result in construction or operations that threaten the public’s safety, welfare, or environment.

508C January 24, 2024 Page 2 of 10

Recommended Findings and Actions:

Olmsted County Public Health Services (OCPHS) has determined that Oakridge Treatment Center, (“the
Facility”) owned by Meridian Behavioral Health (“Meridian”), has failed to take sufficient steps to
mitigate the imminent hazards present to the patients or the surrounding communities as evidenced by
the following facts.

1. Meridian owns and operates twenty substance-use disorder treatment centers in different
counties throughout the State of Minnesota.
2. Meridian opened the Facility in 2017 after obtaining Minnesota Department of Human Services
(“DHS”) license 1082638 to operate a substance use disorder treatment center. Olmsted County
Public Health issued the facility two licenses 21288 (lodging) and 11525 (food and beverage)
thereby enabling the Facility to operate as an inpatient residential treatment center pursuant to
Minnesota Statutes Chapter 245G.
3. Since 2017, the Facility has generated 740 calls for emergency services in Olmsted County. This
is more than 9 times the number of calls for emergency services generated by a comparable
substance use disorder treatment facility located within Olmsted County.
4. The Facility’s patients are vulnerable adults as defined by Minnesota law.
5. The Facility and its staff are caregivers of vulnerable adults as defined by Minnesota law.
6. During the period from June 2020 to September 2022, DHS issued four memoranda
substantiating the maltreatment of vulnerable adults by Facility staff.
7. None of the maltreatment reports that resulted in DHS substantiations originated from Facility
staff.
8. None of the twenty-five total maltreatment reports received at the common entry point under
Minnesota Statutes Section 626.557 since 2017 originated from Facility staff.
9. Olmsted County Sheriff’s Office command staff met with the Facility’s Director on November 9,
2022, to notify her of their concerns regarding the Facility’s failure to provide health care and
supervision that were reasonably necessary to protect the health and safety of the vulnerable
adults at the Facility.
10. These concerns included multiple calls regarding sexual assault, drug overdoses, and patients
wandering away from the facility to seek assistance from private residences.
11. During the period between January 2023 and November 2023, the Facility generated 157 calls
for emergency services.
12. On August 25, 2023, DHS issued a corrective order identifying multiple violations of Minnesota
Statutes Chapters 245A, 245G, and Title 42 of the Code of Federal Regulations. Neither Meridian
nor the Facility has offered any evidence to OCPHS during its investigation that these
deficiencies have been corrected.
13. Between September 25, 2023, and the morning of September 26, 2023, 8 vulnerable adults
residing at the Facility required emergency medical services and ambulance transportation to
the hospital because of drug overdose.
14. Multiple Olmsted County residents and business have contacted local government entities
including the Olmsted County Sheriff’s Office, Olmsted County Adult and Family Services, the
Olmsted County Attorney’s Office, and local township officials regarding the public health and
safety concerns resulting from the failure of Meridian and the Facility to provide the health care

508C January 24, 2024 Page 3 of 10

 and supervision that are reasonable and necessary to maintain not only the health and safety of
the vulnerable adults residing at the Facility but also the health and safety of the public.
15. Based on these reports and the failure of Meridian and the Facility to work cooperatively with
local government entities to address these concerns. OCPHS commenced an investigation
pursuant to Sections 3103.02.018 and 4008.23 of the Olmsted County Code of Ordinances on
October 13, 2023.
16. OCPHS determined through investigation that Meridian and the Facility have engaged in
activities that jeopardize the safety and health of their patients and the community at large.
17. OCPHS determined through its investigation that the consistent and ongoing failure to act by the
Meridian and the Facility jeopardizes not only the safety and health of vulnerable adults, but
also the community at large.
18. Based on these finding OCPHS presented to the OCPHS Advisory Board on November 2, 2023.
19. OCPHS Advisory Board voted unanimously to issue a determination that the conditions
identified by OCPHS demonstrate that the Facility is a public health nuisance.
20. Meridian and the Facility each were served on November 7, 2023, with written notice that the
Facility was determined to be a public health nuisance as defined by Minnesota law and
Olmsted County ordinance and were given until November 14, 2023, to remove or abate the
public health nuisance.
21. Representatives of Meridian, representatives of an external consulting firm hired by Meridian
(“Ascension”), and representatives of Olmsted County Public Health and the Olmsted County
Attorney’s Office attended a meeting on November 10, 2023. The County extended to
November 17, 2023, the deadline by which Meridian and the Facility were required to remove
or abate the public health nuisance.
22. Representatives of Olmsted County Public Health, the Olmsted County Sheriff’s Office, the
Olmsted County Attorney’s Office, and Olmsted County Adult and Family Services (collectively,
“the County”) attended a site visit and presentation on November 17, 2023.
23. Representatives of Meridian, the Facility, and Ascension attended the site visit and presentation
on November 1, 2023, including Meridian’s Chief Compliance Officer Senior Vice President of
Clinical Operations (collectively, “Facility Representatives”).
24. Facility Representatives made multiple statements regarding their commitment to addressing
the specific concerns regarding the health and safety of the vulnerable adults residing in their
facility.
25. Facility Representatives identified and the County observed, the following actions take to abate
or remove the public health nuisance:
25.1 Removal of the former Director of the Facility and appointment of an interim Director;
25.2 Implementation of an onsite security services to “harden the perimeter” of the Facility
grounds and main building;
25.3 Enhanced recruitment efforts to fill the approximately 10 open positions for direct client
care and observation;
25.4 Commencement of community engagement; and
25.5 Development of a prospectus for short-, middle-, and long-range goals to improve the
health and safety of the vulnerable adults residing in, and the community surrounding,
the Facility.

508C January 24, 2024 Page 4 of 10

 26. The County independently observed, among other things, the following:
26.1 Facility Representatives lack a basic understanding and knowledge of Minnesota’s
mandated reporting laws related to Vulnerable adults;
26.2 Facility Representatives attribute the multiple substantiated incidents of maltreatment
to the behavior of the vulnerable adults rather than the substantiated perpetrators.
26.3 Facility Representatives do not have a plan in place to address medical emergencies
other than a client “calling out” for help or waiting for a staff member to walk by on
rounds;
26.4 Facility Representatives have not installed security cameras that are sufficient to
provide a 360-degree view of the Facility’s perimeter, and
26.5 Facility Representatives do not comply with Minnesota Statutes Section 245G.10
regarding staffing requirements to address medical emergencies and mandated
reporting.

27. On November 19, 2023, a call for emergency service originated from the Facility because one of
the clients overdosed on a controlled substance. Deputies responding to the scene subsequently
observed another client with a bloodied face who wanted to report an assault. Of the 7 Olmsted
County Sheriff’s Deputies on-duty at the time of this incident, 5 had to respond to the scene to
provide emergency services and control the crime scene.
28. On November 20, 2023, the Olmsted County Sheriff’s Office received a call from a Facility client
reporting that there had been a similar incident on November 18, 2023.
29. Facility staff did not make any reports regarding either incident to the common entry point as
required under Minnesota Statutes Section 626.557.
30. Because of these incidents, Olmsted County Sheriff’s Deputies discovered that the Facility has
clients residing in two outbuilding that are separate from the main building. Facility
Representatives did not disclose this information to the County during the November 17, 2023,
site visit.
31. Further investigation by the Olmsted County Sheriff’s Office and OCPHS determined that:
31.1 These outbuilding do not have any consistent staff oversight;
31.2 These outbuildings do not have any security personnel assigned to them; and
31.3 The incidents of assault and disorderly conduct that occurred on November 18, 2023,
and the incidents of assault, disorderly conduct, and overdose November 19, 2023,
occurred at these two outbuildings.
32. On November 21, 2023, a call for service originated from the Facility because staff discovered a
client had left the facility.
33. On December 19, 2023, the County met with the acting CEO of Meridian Behavioral Health. At
which time he stated prior to the license revocation:
32.1 “The facility’s standard was to do the bare minimum;”
32.2 He was, “beside himself, because a plan does not do any good without proper
oversight;”
32.3 “The facility was not running as a safe and effective treatment center, and issues
included reporting, leadership, and other concerns;”

508C January 24, 2024 Page 5 of 10

 32.4 He had, “suspended or terminated Meridian leadership with direct line to Oakridge;”
and
32.5 He was, “trying to create significant change at Meridian, expanding the work of
Ascension to 6 additional locations in Meridian after Oakridge’s license revocation.

Adverse Effects on Public Health

1. Minnesota’ public policy recognizes the particular vulnerability of patients in residential

treatment programs such as that operated by the Facility’s owner and staff.
2. OCPHS public policy and the Community Health Needs Assessment recognizes that the
reduction of drug use and safety from fear and violence are top community priorities and
necessary to protect the public health and safety of all Olmsted County residents.
2.1 The 2022 Olmsted County Community Health Needs Assessment (CHNA) details the
County’s health priorities. The CHNA shares comprehensive data and information about
the health and well-being of Olmsted County residents and identifies three priority
issues that significantly impact health. The information is gathered from numerous data
sources both quantitative (numbers) and qualitative (voices/conversation) to ensure the
broadest voice of Olmsted County residents was heard. This effort is a community
collaborative and conducted triennially involving a multitude of community
organizations.

Both in the 2018 and 2022 CHNA, one of the top three priorities identified were
substance use (2018) & drug use (2022). This can be defined as the consumption of
drugs for non-medical purposes. Drug use has a major impact on individuals, families,
and communities. The effects of drug use are cumulative, significantly contributing to
costly social, physical, mental, and public health problems. This priority has consistently
been a top priority within the community.

The Figure shows the number

of non-fatal overdose hospital
visits for Olmsted County
residents by year. In 2022
Oakridge accounted for 8 of the
90 overdoses within the county
or approximately 9% of the
overdoses in 2022. In 2023,
Oakridge has accounted for 11
overdoses, prior to license
revocation in November.

508C January 24, 2024 Page 6 of 10

 Similarly, Safety from Fear and Violence is a top 10 priority identified in the CHNA. This
is defined as an individual’s perception of safety at home, school, work, and in the
community. Feeling unsafe affects: health outcomes, psychological well-being,
functioning, physical safety, quality of life, relationships, and connectedness. Lack of
neighborhood safety can lead to economic burdens within the community such as: lost
wages, lowered productivity, increased medical costs, and increased costs associated
with law enforcement, court services, and detention facilities.

The Haverhill Township community members expressed their concerns regarding Safety
from Fear and Violence and its relation to the operation and oversight at Oakridge
Treatment Center. The following are direct testimonials from community members of
the township.

“I am nine years old. Please do not let Oakridge Treatment Center reopen. I don’t feel
safe in my house with Oakridge still open. I wasn’t looking forward to going home after
school. I can’t say how scared I feel at HOME!”

“We realize many people need a place to make recoveries, but it appears that this
facility has not taken proper precautions or care to make it secure to help those in
need.”

“Things drastically changed when Oakridge took over the property. Patients came onto
porches requesting to make call and have cell phones charged, banging on doors
frantically for medical emergencies, surprising owners in their barns and outbuildings,
even lying down in ditches off the road.”

“Obviously, the poor management of this facility was not helping their clients and
keeping them safe.”

“My family, our grandchildren are afraid to go to the barn without an adult to pick eggs,
play in the loft or spend time with the horses.

“We have lost our freedoms and sense of security.”

“Since Oakridge has ceased operations, 48th St. has been quieter and seems safer.
Myself and many other residents pray that this peacefulness can continue so we can get
back to some normalcy of our lives and enjoy the area we chose to reside in.”

“Within months of Oakridge opening, our comfort and safety came under attack.
Rampant drug infiltration, overdoses, sexual misconduct, assaults, and frequent EMS
call have plagued the facility ever since.”

“My wife and I have young children, and this facility and the mismanagement of this
“recovery” center has robbed us of our peace and safety.”

508C January 24, 2024 Page 7 of 10

 “The mental health impact of those of us living in this area is significant, and each time
we talk with our neighbors it is clear that many have significant anxiety due to these
events. The parents living here raising young children, myself included, are fearful.
Children are fearful to play.”

“The Oakridge leadership has made it clear they do not care to be bothered by our
concerns, declining to hear us.”

The figure shows data

collected by the Community
Health Needs Assessment.
Statistics show an increase in
community members who do
not feel safe from fear and
violence within the county.
This is a top 10 priority to the
community. Public safety
resources continue to be
diverted to Oakridge,
consistently removing their
availability to serve the
community.

3. OCPHS public policy recognizes that ensuring the availability of resources is necessary to
protect the public health and safety of all Olmsted residents.

The following figure is from

Overdose Detection Mapping
Application Program (ODMAP).
It is a tool for collecting and
mapping suspected overdose
events. This map includes
hotspots within Olmsted County
for non-fatal overdoses in
Olmsted County documented by
first responders between
1/1/2022-11/30/2023.

508C January 24, 2024 Page 8 of 10

 4. Meridian and the Facility have failed to act in a manner consistent with multiple governing
provisions including Minnesota Statutes Chapters 245A and 245G; Minnesota Statutes Sections
145F.165, 253B.03, and 626.557; DHS administrative rules and corrective orders and State and
OCPHS public policy.

5. This failure to act has caused increased substance abuse in Olmsted County and jeopardized the
health and safety of vulnerable adults and members of the community in which the Facility is
located.

Number of Service Calls to Olmsted County

Sheriff Office for Overdose by Facility
2022-2023
20
Number of Calls

15

10

0
Oakridge Teen Challenge Pathways Gables

The figure above highlights OCSO service calls for suspected overdoses at Olmsted
County treatment centers between 2022-Present.

6. This failure to act has resulted in multiple near-fatal medical emergencies at the Facility and
within the Community in which the Facility is located.
7. This failure to act has had, and will continue to have unless abated, a direct impact on the
availability of resources available to any Olmsted County resident in need of emergency medical
and other first responder services.

508C January 24, 2024 Page 9 of 10

 Number of Service Calls to Olmsted County
Sheriff Office by Facility and Call Type
2022-2023

Oakridge 19

Pathways

Gables

Teen Challenge

0 20 40 60 80 100 120 140 160 180 200

Number of Calls

Assault Assist Criminal Sexual Conduct

Disorderly Conduct Medical Person in Crisis
Overdose

The figure above highlights OSCO call volumes for various treatment centers in Olmsted
County between 2022-present.

8. This failure to act has jeopardized, and will continue to jeopardize unless abated, the health and
safety of all Olmsted County residents.

Conclusion
Olmsted County has been delegated regulatory authority over food and beverage and public lodging
licenses and the enforcement of these licenses by the Minnesota Department of Health as set forth in
the County’s Environmental Public Health Services Ordinance – Chapter 3100 and the County’s
Administrative Enforcement and Appeals Procedure – Chapter 4000 of the County’s Code of Ordinances
and the Minnesota Department of Health delegation agreement with the County. Pursuant to this
authority, Oakridge Treatment Center was issued a license to operate a public lodging facility and food
and beverage kitchen by Olmsted County Public Health Services. Unfortunately, under Section
3102.01.09, Oakridge Treatment Center posed an imminent hazard to the vulnerable adults within the
facility and a potential threat to the community of Olmsted County. This necessitated the intervention of
Olmsted County Public Health Services under Chapter 4008.32: The Director revoked a the licenses,
without a hearing before a hearing officer, because the Director found that an imminent hazard or
danger to the public health, safety, or welfare or the environment existed at Oakridge Treatment
Center. The Director and Olmsted County Public Health Services stand behind this decision and seek
confirmation of their actions from the hearing officer.

508C January 24, 2024 Page 10 of 10