Troubled Minnesota provider of disability services agrees to be acquired

A large and troubled provider of services to Minnesota adults with disabilities has agreed to be acquired nearly five months after state regulators revoked its license for numerous health and safety violations.

Bridges MN, which has about 400 clients and more than 90 group homes statewide, has struck a deal to be taken over by Fort Worth, Texas-based Caregiver Inc., which provides residential and in-home support to people with intellectual and developmental disabilities in five states, according to a letter sent to clients last week. The transaction is expected to close by Jan. 20, the provider said.

The deal, if approved, would save Bridges MN from being shut down or taken over by state regulators — an outcome that could have upended care for hundreds of people who rely on the St. Paul-based provider for supportive housing, employment and other services. These clients have been in limbo since late June, when the state Department of Human Services took the unusual step of revoking Bridges MN's license because of "serious and repeated" violations and findings of maltreatment involving vulnerable adults.

In interviews, some people who rely on Bridges MN for services said they have been anxious about losing their services since the summer. Finding alternative providers is daunting at a time when care providers across the state are struggling with staff shortages and thousands of caregiving jobs are going unfilled. Some social workers and families report waits of a year or longer for spots in group homes or day activity centers that support people with disabilities.

"This [acquisition] avoids the nightmare scenario," said Barnett Rosenfield, state ombudsman for mental health and developmental disabilities. "Under that scenario, everybody would be scrambling and you'd end up with dozens, if not hundreds, of clients getting put into nursing facilities, group homes or other institutional settings that lack the capacity to serve them well."

In written statements, Bridges MN has said the state's allegations of failure to report and maltreatment violations were "wrong and exaggerated" and contained factual mistakes. In July, Bridges MN appealed the state's license revocation order, which set in motion a regulatory process for determining whether the provider would be allowed to continue operating.

Bridges MN declined requests for an interview but issued a statement from its co-founder and president of disability services, Blake Elliott, that read in part, "As we've gotten to know [Caregiver], it's clear they share our person-centered approach to those we serve. By joining our two organizations, we gain the experience and resources of a large, experienced partner committed to our growth and improvement goals."

The provider said it notified DHS of Caregiver's interest in a deal in early 2022, and teams from the two companies have been working on the transition for several months.

Gary Nettis Jr., chief development officer at Caregiver Inc., could not be reached for an interview but emailed a statement saying the company had received a license to operate in Minnesota and would "ensure continuity of services for Bridges MN service recipients, guardians, and employees." He declined to disclose how much Caregiver had agreed to pay for Bridges MN, citing confidentiality provisions in the purchase agreement.

The proposed deal follows a history of regulatory problems at Bridges MN, which has been sanctioned more than 50 times the past two years. Those include reports of unsanitary conditions, failure to provide basic care, failure to complete background checks on new hires and failure to report maltreatment, state records show.

In a case early this year, a sick client who received in-home care from Bridges MN was found "lying in feces and vomit," according to the June 27 license revocation order. The person was taken away in an ambulance and died soon after. The staff who visited the client said they "sometimes" helped clean the apartment and "sometimes did not," the licensing order said.

At a Bridges MN facility in Forest Lake, state inspectors followed up on a report that a staff person had a sexual relationship with a resident. During the investigation, regulators received information that the staff person had choked the resident and had used cocaine while driving and providing services to the client, the licensing order says.

On site visits, inspectors also found staff members appeared to be asleep on couches for hours when they were supposed to be providing care, according to the state licensing action.

Kimberly Nelson, 51, who has multiple sclerosis and lives at a Bridges MN group home in Prior Lake, said she learned about the acquisition Monday but has already resolved to move out and live on her own.

Since learning of the license revocation, Nelson has been searching for more independent living options. She has put her name on waiting lists for nearly a dozen apartment buildings that have support staff for people with disabilities. Because of her limited mobility, Nelson needs help with some daily tasks, such as bathing, dressing and preparing meals, but is otherwise able to live independently. At her four-bedroom group home, she said, her daily routine is largely determined by staff and other residents.

"This whole experience has been scary and exciting at the same time," said Nelson of the license revocation and her search for a new home. "There's no comfort in knowing this place has a new owner if everything in my life is still being dictated by someone else."

Caregiver Inc. provides services to about 4,500 people with intellectual and developmental disabilities in Texas, Indiana, Ohio, Tennessee and Georgia, and has grown rapidly in recent years through acquisitions of service providers.

Kulani Moti, inspector general of the Minnesota Department of Human Services, said in a statement that Caregiver was licensed on July 28 to provide services in the state. "We will work closely with county partners, as well as both Bridges and Caregiver, to ensure that the health, safety and rights of clients continue to be supported during this transition," Moti said.