Harmony Home Health Agency, Inc.

“Encoding and transmitting OASIS CFR(s): 484.45(a) Standard: An HHA must encode and electronically transmit each completed OASIS assessment to the CMS system, regarding each beneficiary with respect to which information is required to be transmitted (as determined by the Secretary), within 30 days of completing the assessment of the beneficiary. This Standard is not met as evidenced by: Based on review of the OASIS Error Summary report and Staff interview, it was determined in 10 of 48 reports submitted for the last 12 months, the Agency failed to submit reports within the specified time frame, resulting in a warning. Finding include: 1. The Error Summary report for 05/01/23 -04/30/24, was reviewed on 05/16/24 at 9:30 AM. The report included error # -3330 for 10 of 48 late submissions. 20.83% of the reports submitted were more than 30 days after the M0090. 2. During an interview with the Administrator and Agency Supervisor on 05/16/24 at 9:35 AM, the Administrator and Agency Supervisor, stated that there is an outside biller that submits the reports to the State and will report any errors. During the same interview, the Agency Supervisor confimred the above findings.”

“Participate in care CFR(s): 484.50(c)(4)(i,ii,iii,iv,v,vi,vii,viii) Participate in, be informed about, and consent or refuse care in advance of and during treatment, where appropriate, with respect to-- (i) Completion of all assessments; (ii) The care to be furnished, based on the comprehensive assessment; (iii) Establishing and revising the plan of care; (iv) The disciplines that will furnish the care; (v) The frequency of visits; (vi) Expected outcomes of care, including patient-identified goals, and anticipated risks and benefits; (vii) Any factors that could impact treatment effectiveness; and (viii) Any changes in the care to be furnished. This Element is not met as evidenced by: Based on clinical records review, observation during home visits and Staff interviews, it was determined that in 3 of 7 (Pts. #1, 2 and 3) clinical records reviewed, the Agency failed to ensure that Pts. were informed in advance of the disciplines to provide care/service and frequency of visits provided by each discipline. Findings include: 1. The following clinical records were reviewed from 05/14/24 at 12:30 PM to 05/15/24 at 11:30 AM: Pt. #1 SOC 03/11/24 Pt. #2 SOC 03/25/24 Pt. #3 SOC 05/04/23 2. During home visits for Pt. #1 on 05/14/24 at 2:00 PM, for Pt. #2 at 3:00 PM and for Pt. #3 on 05/15/24 at 3:00 PM, the Patient’s admission folder was observed and contained the form titled, “Service Agreement, Consent and Authorization.” The forms lacked the discipline(s) to provide service and the proposed frequency for each discipline. 3. During interviews with the Administrator and Agency Supervisor on 05/15/24 at 1:00 PM and on 05/16/24 at 9:35 AM, it was confirmed the Agency failed to ensure Pts. were informed of the proposed frequency of visits provided by each discipline.”

“State toll free HH telephone hotline CFR(s): 484.50(c)(9) Be advised of the state toll free home health telephone hot line, its contact information, its hours of operation, and that its purpose is to receive complaints or questions about local HHAs. This Element is not met as evidenced by: Based on a review of the Pt. admission folder, observation during home visits and staff interview, it was determined that in 3 of 7 (Pts. #1, 2 and 3) the Agency failed to ensure the contact information of “toll-free hotline” telephone number was provided to the Pt. Findings include: 1. The Pt. admission folder was reviewed on 05/14/24. The folder contained the form titled: “Service Agreement, Consent and Authorization” and lacked the “toll-free hotline” telephone number for which the Pt. / Pt. representative may call to communicate a concern or complaint about home care services. 2. The following home visits were conducted on 05/15/24 from 2:00 PM to 3:00 PM and on 05/15/24 at 3:00 PM. Pt. #1 SOC 03/11/24 Pt. #2 SOC 03/25/24 Pt. #3 SOC 05/04/23 During the home visits, Pt. admission folders were observed and lacked the “toll-free hotline” telephone number to which the Pt./ Pt. representative may call to communicate a concern or complaint about home care services. 3. During an interview with the Administrator and the Agency Supervisor on 05/16/24 at 9:35 AM, both confirmed that the Pt. admission folder lacked the contact information of “toll-free hotline” telephone number to which the Pt. / Pt. representative may call to communicate a concern or complaint about home care services.”

“Only as ordered by a physician CFR(s): 484.60(b)(1) Drugs, services, and treatments are administered only as ordered by a physician or allowed practitioner. This Element is not met as evidenced by: Based on the clinical record review and Staff interview, it was determined in 2 of 7 records reviewed (Pts. # 2 and 7) the Agency failed to provide the care as ordered by the physician. Findings include: 1. Pt. #2 was admitted to the Home Health Services on 03/25/24 with the diagnoses of Bilateral Primary Osteoarthritis of Knee and Type 2 Diabetes Mellitus without Complications Surgery. The clinical record was reviewed on 05/14/24. The POC dated 03/25/24 included orders for the SN to assess the blood glucose each visit. The clinical record included a SN visit note dated 03/25/24. The SN visit note lacked the assessment of the Patient’s blood glucose for 03/25/24. 2. Pt. #7 was admitted to Home Health Services on 01/04/23 with diagnoses of Primary Generalized Osteoarthritis and Type 2 Diabetes. The clinical record was reviewed on 05/15/24. The POC effective 03/05/23 to 05/03/23, required SN to perform blood glucose checks every visit. The clinical record included SN visit notes dated 04/21/24 and 04/28/24. The SN visit lacked assessment of Pt.’s blood glucose as ordered. 3. During interviews with the Administrator and Agency Supervisor on 05/15/24 at 1:00 PM and on 05/16/24 at 9:35 AM, the Agency Supervisor confirmed the above findings.”