Hundreds of Minnesotans with disabilities and mental illnesses could see their lives thrown into turmoil if a large disability services provider fails to resolve serious health and safety violations that threaten its survival.

Bridges MN, which has 1,400 employees and serves some 500 adults statewide, received formal notice from state regulators this week that its license will be revoked because of repeat violations of state laws governing the care of vulnerable adults. The provider, which intends to appeal the enforcement action, was cited for a wide range of violations — such as failure to report sexual abuse, neglect by caregivers and leaving clients in unsanitary conditions, according to a license revocation order filed Monday by the state Department of Human Services (DHS).

The move by state regulators to revoke a large provider's license is highly unusual, and comes at a time when Minnesota's social safety net for adults with disabilities is severely strained by staff shortages and long waits for services. The closure of Bridges MN could strand people with serious mental illnesses and developmental disabilities who rely on the provider for housing, employment services and in-home care. Many of these clients have nowhere else to turn — particularly as group homes and day service providers curtail services, according to disability advocates and families.

In a reflection of the situation's magnitude, more than 260 county, tribal and state workers participated in a state webinar Wednesday about the enforcement action.

Barnett Rosenfield, state ombudsman for mental health and developmental disabilities, has been working on ways to ensure continued services for Bridges MN clients. "If and when that revocation goes into effect, you could potentially have hundreds of people who are homeless and without services."

In a statement Wednesday, Bridges MN said it plans to appeal the license revocation and will continue providing care while the appeal is pending. If the order isn't appealed, Bridges would be prohibited from providing services as of 6 p.m. July 12. The Department of Human Services said it is already moving forward with "other options" to ensure continued care for Bridges' clients, including the possibility of placing the provider under state receivership.

DHS Inspector General Kulani Moti said the agency took the enforcement action "because of serious and repeated licensing violations and maltreatment findings ..." The St. Paul-based provider has been operating under a conditional license for the past two years. "Bridges serves a large client community and our primary concern is to ensure that quality services continue to be available to clients and their health and safety is protected," Moti said. "We are evaluating options to fill this need."

Bridges MN had built a reputation as one of the state's most innovative disability service providers. The company developed a matchmaking service — known as "Rumi" — that connects people with disabilities who receive Medicaid services with a compatible caregiver and roommate. Bridge's co-founder, Blake Elliott, said in a in a 2019 Star Tribune interview that he believed the service would help people with disabilities live more independently.

Yet since receiving its license in September 2015, Bridges MN has "demonstrated a history of noncompliance with licensing rules," according to Monday's enforcement action. The provider has been sanctioned more than 50 times for infractions that include unsanitary conditions, failure to provide basic care and failure to conduct regular background checks on new employees.

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.

In another case, staff at Bridges MN called 911 for a client who lived at home and received services from the provider. Emergency responders found the individual had mottled skin and was "lying in feces and vomit," the licensing order says. 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. DHS found Bridges MN was responsible for neglect of the vulnerable adult, according to state records.

On multiple occasions, regulators found that Bridges MN had failed to report allegations of maltreatment as required under state law. In one case, two clients of Bridges MN accused a staff person of "touching them sexually," including on their buttocks. Yet the supervisor was told the allegations did not need to be documented because the supervisor did not witness the incident, and because the two clients declined when asked if they wanted to make a report, the order said.

State inspectors also found several incidents in which basic services were not provided. On site visits, inspectors found that staff members appeared to be asleep on couches for hours at a time when they were supposed to be providing care. Staff at a Bridges MN facility also failed to transport a client to and from a job, as required in the person's care plan, which resulted in the person losing wages, the licensing order states.

"It's horrifying," said Sue Abderholden, executive director of the Minnesota chapter of the National Alliance on Mental Illness (NAMI), said of the details in the enforcement action. "We need to protect people's dignity, and we shouldn't have people lying in their feces and urine."

Jody Brennan, a Shakopee City Council member, has a 32-year-old daughter with Down syndrome who lives at a group home that was acquired by Bridges MN several years ago. Overall, Brennan said she has been satisfied with her daughter's care, but was troubled that Bridges MN did not notify her of the license revocation. — or that it had been operating under a conditional license.

"I believe they have a responsibility to inform families when their license is in jeopardy," so they can begin making other plans, Brennan said. "If they're not even telling people what is going on, it leaves you wondering, what else aren't they telling us?"

Staff writer Alex Chhith contributed to this story.