Accelerated Home Care, LLC

“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 the review of the Error Summary report and staff interview, for 74 of 391 assessments submitted in the last 12 months, the Agency failed to submit all reports within 30 days after the assessment was completed, which resulted in a warning. Findings include: 1. The Error Summary report for 06/01/26 TO 06/16/26 was reviewed on 06/22/26 at 9:30 AM. The report stated that 74 (18.93%) of 391 OASIS reports were submitted late, or more than 30 days after the assessment was completed. 2. During an interview with the Administrator, Assistant Administrator, Owner, Director of Nursing and Intake Coordinator on 06/24/26 at 11:30 AM, it was confirmed the error occurred.”

“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 record reviews and staff interview, in 5 of 7 (Pts. # 2, 4, 5, 6 and 7) clinical records reviewed, the Agency failed to ensure Pts./ Pts. representative were informed in advance the disciplines to provide care/service and frequency of visits provided by each discipline. Findings include: 1. The Agency’s Pt. admission folder was reviewed on 06/24/26. The admission folder included a “Consent and Agreement for Home Care Services” which lacked documentation of what services / disciplines are to be provided and their frequencies. 2. The following clinical records were reviewed from 06/22/26 to 06/24/26 and lacked documentation of the services/disciplines and proposed visit frequencies: Pt. #2 SOC 01/12/26 Pt. #4 SOC 05/21/26 Pt. #5 SOC 03/11/26 Pt. #6 SOC 05/14/25 Pt. #7 SOC 11/28/25 2. During interviews with the Administrator, Assistant Administrator, Owner, Director of Nursing and Intake Coordinator on 06/24/26 between 11:30 AM to 3:00 PM and on 06/26/26 at 9:30 AM, the Administrative staff confirmed that the Pts. were given the same Pt. admission documents at the Start of Care. During the same interview, the Administrative staff confirmed the above findings.”

“RN performs assessment CFR(s): 484.55(a)(1) A registered nurse must conduct an initial assessment visit to determine the immediate care and support needs of the patient; and, for Medicare patients, to determine eligibility for the Medicare home health benefit, including homebound status. The initial assessment visit must be held either within 48 hours of referral, or within 48 hours of the patient’s return home, or on the physician or allowed practitioner - ordered start of care date. This Element is not met as evidenced by: Based on clinical record review and staff interviews, in 3 of 7 (Pts. #3,4, and 7) clinical records reviewed The Agency failed to ensure a RN performed the initial assessment within 48 hours of the Physician’s referral for home health care services. Findings include: 1. Pt. #3 was admitted to home health services on 03/13/26 with diagnosis of Type 2 Diabetes mellitus with hyperglycemia. The clinical record was reviewed on 06/23/26. The Face-to-Face signed by the Physician and received by the Agency on 02/27/26 required Skilled Nursing and Physical Therapy services. The record lacked a Physician ordered SOC date or documentation the Pt. was discharged from an inpatient facility. As of 06/24/26, the record lacked documentation, the Agency initiated service within the required time frame. 2. Pt. #4 was admitted to home health services on 05/21/26 with diagnosis of Other specified arthritis, left knee. The clinical record was reviewed on 06/24/26. The Face-to-Face conducted by Advanced Practice Nurse on 05/07/26, was signed by the Physician on 05/15/26 and received by the Agency on the same day/date required: Skilled Nursing, Physical Therapy and Home Health Aide services. The record lacked a Physician ordered SOC date or documentation the Pt. was discharged from an inpatient facility. As of 06/24/26, the record lacked documentation, the Agency initiated service within the required time frame. 3. Pt. #7 was admitted to home health services on 11/28/25 with Diagnoses of but not limited to Polyosteoarthritis. The clinical record was reviewed on 06/24/26. The record included a Physician note dated 11/19/25 that required Skilled Nursing and therapy services. The record lacked a Physician ordered SOC date or documentation the Pt. was discharged from an inpatient facility. As of 06/26/26, the record lacked documentation, the Agency initiated service within the required time frame. 4. During interviews with the Administrator, Assistant Administrator, Owner, Director of Nursing and Intake Coordinator on 06/24/26 at 2:30 PM and on 06/26/26 at 9:30 AM, the Administrative staff confirmed the above findings.”

“A review of all current medications CFR(s): 484.55(c)(5) A review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy. This Element is not met as evidenced by: Based on observation and interview during a home visit, clinical record review and staff interviews, for 1 of 7 (Pt. #1) clinical record reviews, the Agency failed to ensure that a complete review of the medications was conducted during the comprehensive assessment. Findings include: 1. Pt. #1 was admitted to home health services on 05/06/26 with the diagnosis of but not limited to Congestive Heart Failure, Parkinson’s Disease without dyskinesia and hypertension. During a home visit conducted with the E#2 (Physical Therapist) on 06/22/26, the patient’s medications were reviewed. The clinical record was reviewed on 06/23/26. The record included documentation that a comprehensive recertification assessment was conducted on 04/28/26 by E#2 and included a POC effective 05/01/26. The POC lacked documentation of the following medications that were found during the home visit: Carbidopa-Levodopa 25-100 mg 2 tablets 4 times a day, Entacapone 200 mg 1 tablet 4 times a day, Dorzolamide hydrochloride/Timolol Maleate 2%/0.5%, 1 drop into both eyes in the morning and 1 drop in the evening, Brimodine tartrate 0.2% left eye every morning, Systane eye gel both eyes, Systane eye gel both eyes, Vitamin C 500 mg once a day, Multivitamins 1 tablet, Setraline 100 mg 2 tablets daily, Metroprolol succinate XL 25 mg, Gabapentin 100 mg 1 capsule daily. During an interview with Pt. #1’s family, it was stated that there have been no changes in medications. A “Medication Profile” which the Administrator confirmed was Pt. #1’s current medication list, was reviewed on 06/23/26 did not include the medications listed above resulting in an incomplete review to check for potential drug interactions, adverse effects, significant drug interactions and duplicates was incomplete. The profile includes the documentation, “Drug Regimen Review Acknowledgement: I have reviewed all the listed medications for potential adverse effects, drug reactions, including ineffective drug therapy, significant side effects and significant drug interactions, duplicate drug therapy and non-compliance with drug therapy” lacked the signature of the clinician and the date of review. 2. On 06/24/26 at 11:30 AM, during an interview with the Administrator, Assistant Administrator, Owner, Director of Nursing and Intake Coordinator, the above finding was confirmed.”

“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 clinical records reviews and staff interviews, for 2 of 7 clinical records reviewed (Pts. #1 and 5), the Agency failed to ensure physician orders were followed. Findings include: 1. Pt. #1 was admitted to home health on 01/01/26 with the diagnosis of Congestive Heart Failure. The clinical record was reviewed on 06/23/26 and included the document titled, “Encounter, dated 12/03/25” which included the documentation: “Dysphagia remains a concern with frequent choking episodes…recommend following up SLP evaluation.” The record included a physician order 12/16/25: “Request for Home Health Comments: PT/SLP…” The record lacked documentation that SLP (Speech Language Pathology) services were provided or documentation of refusal of SLP services. 2. Pt. #5 was admitted to home health services on 03/11/26 with the Diagnoses of but not limited to Unilateral Primary Osteoarthritis, Essential (primary) Hypertension and Type 2 Diabetes Mellitus. The clinical record was reviewed on 06/23/26. The record included a PsOC effective 03/11/26 to 05/09/26 and 05/10/26 to 07/08/26, that required to “Notify Physician of vital sign parameters out of range:…Diastolic Blood Pressure: greater than (>) 90 mmHg less than ()200 mg/dL less than ()250 mg/dL less than (<) 70 mg/dL....SN to assess diabetic status….” The clinical record included SN visits dated 05/13/26, 05/20/26 and 05/27/26 with Diastolic Blood pressure readings of 58 mmHg and lacked a Physician notification for Diastolic Blood pressure falling outside parameters, as ordered. The clinical record included SN visits 1 time a week from 05/06/26 to 06/10/26 and lacked an assessment of diabetic status / blood sugar assessments, as ordered. 3. During interviews with the Administrator, Assistant Administrator, Owner, Director of Nursing and Intake Coordinator on 06/24/26 at 11:30 AM and on 06/26/26 at 9:30 AM, the Administrative staff confirmed the above findings.”

“Onsite supervisory visit every 14 days CFR(s): 484.80(h)(1)(i) (1)(i) If home health aide services are provided to a patient who is receiving skilled nursing, physical or occupational therapy, or speech language pathology services— (A) A registered nurse or other appropriate skilled professional who is familiar with the patient, the patient’s plan of care, and the written patient care instructions described in paragraph (g) of this section, must complete a supervisory assessment of the aide services being provided no less frequently than every 14 days; and (B) The home health aide does not need to be present during the supervisory assessment described in paragraph (h)(1)(i)(A) of this section. This Element is not met as evidenced by: Based on a review of clinical records and staff interviews, in 1 of 2 (Pt. # 2) clinical records reviewed, wherein the Pt. received Home Health Aide services, the Agency failed to ensure the Registered Nurse conduct Home Health Aide supervision every 14 days. Findings include: 1. Pt. # 2 was admitted to home health services on 01/12/26 with the diagnosis of Heart Failure, Unspecified. The clinical record was reviewed on 06/23/26. The clinical record included documentation that the Home Health Aide (HHA) provided service, 1 time a week from 05/16/26 to 06/23/26. As of 06/24/26, the record lacked documentation of Home Health Aide supervision by the Registered Nurse. 2. During an interview with the Administrator, Assistant Administrator, Owner, Director of Nursing and Intake Coordinator on 06/26/26 at 9:30 AM, the Administrative staff confirmed the above findings.”

“Discharge and transfer summaries CFR(s): 484.110(a)(6)(i-iii) (i) A completed discharge summary that is sent to the primary care practitioner or other health care professional who will be responsible for providing care and services to the patient after discharge from the HHA (if any) within 5 business days of the patient’s discharge; or (ii) A completed transfer summary that is sent within 2 business days of a planned transfer, if the patient’s care will be immediately continued in a health care facility; or (iii) A completed transfer summary that is sent within 2 business days of becoming aware of an unplanned transfer, if the patient is still receiving care in a health care facility at the time when the HHA becomes aware of the transfer. This Element is not met as evidenced by: Based on review of clinical records and staff interview, for 2 of 2 discharged clinical records reviewed (Pts. #6 and 7) the Agency failed to ensure a copy of the discharge summary was sent to the physician. Findings include: 1. Pt. #6 was admitted to home health services on 05/14/25 with the diagnosis of Type 2 Diabetes Mellitus. The record included a discharge assessment, indicating that Pt. #6 was discharged from the Agency on 07/10/25. As of the clinical record review on 06/24/26, the record lacked documentation that a copy of Pt. #6’s discharge summary was sent to the Physician. 2. Pt. #7 was admitted to home health services on 11/28/25 with diagnoses of but not limited to Polyosteoarthritis. The clinical record was reviewed on 06/24/26. The record included a Discharge assessment dated 05/20/26, indicating that Pt. was discharged from the Agency. The record included a discharge summary dated 06/22/26. As of 06/26/26, the record lacked documentation that the discharge summary was sent to the Physician. 3. During interviews with the Administrator, Assistant Administrator, Owner, Director of Nursing and Intake Coordinator on 06/24/26 at 11:30 AM and on 06/26/26 at 9:30 AM, the Administrative staff confirmed the above findings.”