Bayada Home Health Care, 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 reviewing the IQIES Report from April 1, 2024, to April 30, 2025, the agency failed to ensure the timely submission of OASIS assessments to the CMS system. The findings include: A review of the agency’s Error Summary Report revealed that 179 OASIS assessments were submitted late, exceeding the 30-day submission requirement”

“Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician or allowed practitioner refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician or allowed practitioner is consulted to approve additions or modifications to the original plan. This Standard is not met as evidenced by: Based on medical record reviews, the agency’s staff failed to complete the patient’s visit frequencies as ordered in the plan of care (POC). The missed visits were undocumented, or the patient’s physician was not notified of the missed visit. Missed visits and the lack of notification to the patient’s physician placed patients at risk for not meeting outcome goals and risk for delays in appropriate treatments and care. Patient: #8 Findings include: 1. On 5/20/2025, a review of patient #8 clinical record revealed visit weeks #7 and #8; the patient had no home visits documented. The frequency ordered at this point was 1wk5. There is no documentary evidence that shows the patient’s physician was notified of these missed visits. 2. The agency’s administrator was given the opportunity to check to ensure missed visit documentation was not missed during the review by this surveyor. He/she confirmed no documentation was present. To ensure the patient’s needs are still met, the physician should be notified of missed visits, and the agency should attempt to reschedule them.”

“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: Home visit #3 and Patient #7 Findings include: On 5/19/2025, a review of home visit patient #3 clinical record revealed the referral date as 2/28/2025. The patient’s start of care (SOC) was 3/4/2025. The agency’s documented care coordination notes indicate the patient’s family was not contacted until 3/3/2025 to set up services by the agency. There was no documentary evidence to support that the physician ordered this SOC or that it was requested by the patient/family. On 5/19/2025, a review of patient #7 clinical record revealed the referral date as 2/7/2025. The patient’s SOC was 2/11/2025. The agency’s documented care coordination note indicates on 2/11/25, the patient/family was contacted on 02/11/2025 to set up services. There was no documentary evidence to support that the physician ordered this SOC or that it was requested by the patient/family. Based on a review of medical records, the agency’s administration failed to ensure that an assessment of the patient by nursing or rehabilitation therapy occurs within 48 hours of referral. The agency not performing assessments timely placed the patients at risk for delays in care and adverse health care outcomes.”

“Aides are members of interdisciplinary team CFR(s): 484.80(g)(4) Home health aides must be members of the interdisciplinary team, must report changes in the patient’s condition to a registered nurse or other appropriate skilled professional, and must complete appropriate records in compliance with the HHA’s policies and procedures. This Element is not met as evidenced by: Home health aides are members of the interdisciplinary team. They must report changes in the patient’s condition to a registered nurse or other appropriate skilled professional and complete appropriate records required by the HHA. Failure to comply with regulations places patients at risk for inadequate health care. During interdisciplinary team meetings, all HHA staff involved in the patient’s care must be present and, where appropriate, should contribute to any discussion regarding the patient’s care. This did not occur. Findings include: 1. On 5/14/2025, a review of the agency’s interdisciplinary team meeting (case conference invite records), records for the past 2 months of huddle included meetings on 3/3, 3/5, 3/6, 3/7, 3/10, 3/13, 3/14, 3/26, 3/28, 4/2, 4/4, 4/8, 4/10, 4/11, 4/14, 4/15, 4/18, 4/21, 4/22, 4/24, 4/25, 5/2, 5/8/2025 revealed no home health aide (HHA) is invited to participate in these meetings. 2. The agency’s administrative staff confirmed during an interview that aides do not currently participate in the interdisciplinary team meetings (huddles).”