Interim Healthcare Services 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 upon review of agency policy/procedure, clinical records and the Centers for Medicare/Medicaid Services (CMS) system database, and based on interview with the registered nurses/Clinical Managers (RN/CM-Employees #8 and #9) and the Administrator (Admin-Employee #10), the agency failed to ensure Outcome and Assessment Information Set data (OASIS-Medicare mandated data collection for adult patients receiving skilled home health services) was transmitted to the CMS iQIES system for two (2) of three (3) active patients for whom OASIS data was collected. (Patients #1 and #4) Findings include: On February 27, 2026 at approximately 2:45 PM, review of the agency policy titled “Care Planning Process & Comprehensive Assessment” revealed the following under “Procedure”: XI. Within 30 days of M0090 (OASIS Data Set Element-Date Assessment Completed), OASIS data elements must be encoded and transmitted through the CMS iQIES system. Patient #1: Between February 25, 2026 at approximately 10:35 AM and February 26, 2026 at approximately 12:07 PM, review of the clinical record revealed the start of care date was 06/19/2024 and that SN services were ordered as documented on the “Home Health Certification and Plan of Care” for 3 of 3 certification periods between 08/13/2025 through 02/08/2026. Review of SN documentation revealed comprehensive SN reassessments, including OASIS data collection, were completed on 10/22/2025 and 12/12/2025. There was no documentation in the clinical record which provided evidence the OASIS data collected during the aforementioned comprehensive SN assessments had been transmitted to the CMS iQIES system. Patient #4: On February 25, 2026 at approximately 2:46 PM, review of the clinical record revealed the start of care date was 07/08/2013 and that SN services were ordered as documented on the “Home Health Certification and Plan of Care” for the recertification period of 11/02/20254 through 12/31/2025. Review of SN documentation revealed a comprehensive SN reassessment, including OASIS data collection, was completed on 12/01/2025. There was no documentation in the clinical record which provided evidence the OASIS data collected during the aforementioned comprehensive SN assessment had been transmitted to the CMS iQIES system. On February 25, 2026 at approximately 11:16 AM, review of the CMS system database failed to reveal that OASIS data collected during the above referenced comprehensive SN reassessments had been transmitted to iQIES for the above identified patients. During interview conducted on February 27, 2026 at approximately 2:56 PM, the Admin and RN/CM’s (Employees #8 and #9) confirmed there was no documentation in the clinical record which provided evidence the OASIS data collected during comprehensive SN reassessments had been transmitted to the CMS iQIES system for the above identified patients.”

“Update of the comprehensive assessment CFR(s): 484.55(d) Standard: Update of the comprehensive assessment. The comprehensive assessment must be updated and revised (including the administration of the OASIS) as frequently as the patient’s condition warrants due to a major decline or improvement in the patient’s health status, but not less frequently than- This Standard is not met as evidenced by: Based upon review of agency policy/procedure and clinical records and based on interview with the registered nurses/Clinical Managers (RN/CM-Employees #8 and #9) and the Administrator (Admin-Employee #10), the agency failed to ensure Outcome and Assessment Information Set data (OASIS-Medicare mandated data collection for adult patients receiving skilled home health services) was collected during the comprehensive skilled nursing (SN) reassessment for three (3) of four (4) active patients for whom orders for SN services were included on the “Home Health Certification and Plan of Care”. (Patient #1, #3 and #4) Findings include: On February 27, 2026 at approximately 2:45 PM, review of the agency policy titled “Care Planning Process & Comprehensive Assessment” revealed the following under “Procedure”: IV. Update of the comprehensive assessment: The comprehensive assessment must be updated and revised (including OASIS) as frequently as the patient’s condition warrants...but no less frequently than...A. The last five 5 days of every 60-day episode beginning with the SOE (start of episode) date... Patient #1: Between February 25, 2026 at approximately 10:35 AM and February 26, 2026 at approximately 12:07 PM, review of the clinical record revealed the start of care date was 06/19/2024 and that SN services were ordered as documented on the “Home Health Certification and Plan of Care” for 6 of 6 certification periods between 06/19/2024 and 06/13/2025. Review of clinical record documentation revealed the patient’s payor source is Medicaid as evidenced by details included on a plan summary dated 05/04/2024. Review of SN documentation revealed comprehensive SN reassessments were completed on 08/14/2024, 10/16/2024, 12/18/2024, 03/07/2025 and 05/22/2025, There was no documentation in the clinical record which provided evidence the aforementioned comprehensive SN assessments included OASIS data collection. Patient #3: Between February 25, 2026 at approximately 1:55 PM and February 27, 2026 at approximately 2:40 PM, review of the clinical record revealed the start of care date was 07/26/2024 and that SN services were ordered as documented on the “Home Health Certification and Plan of Care” for the 3 of 3 certification periods between 07/21/2025 and 01/16/2026. Review of SN documentation revealed comprehensive SN assessments were completed on 09/13/2025, 11/18/2025 and 01/13/2026. There was no documentation in the clinical record which provided evidence the aforementioned comprehensive SN assessments included OASIS data collection. Patient #4: On February 25, 2026 at approximately 2:46 PM, review of the clinical record revealed the start of care date was 07/08/2013 and that SN services were ordered as documented on the “Home Health Certification and Plan of Care” for the 3 of 3 certification periods between 07/05/2025 and 12/31/2025. Review of SN documentation revealed a comprehensive SN reassessment was completed on 09/04/2025. There was no documentation in the clinical record which provided evidence the aforementioned comprehensive SN assessment included OASIS data collection. During interview conducted on February 27, 2026 at approximately 2:56 PM, the Admin and RN/CM’s (Employees #8 and #9) confirmed there was no documentation in the clinical record which provided evidence the comprehensive SN reassessment included OASIS data collection for the above identified patients.”

“Last 5 days of every 60 days unless: CFR(s): 484.55(d)(1)(i,ii,iii) The last 5 days of every 60 days beginning with the start-of-care date, unless there is a- (i) Beneficiary elected transfer; (ii) Significant change in condition; or (iii) Discharge and return to the same HHA during the 60-day episode. This Element is not met as evidenced by: Based upon review of agency policy/procedure and clinical records and based on interview with the registered nurses/Clinical Managers (RN/CM-Employees #8 and #9) and the Administrator (Admin-Employee #10), the agency failed to ensure a comprehensive skilled nursing (SN) reassessment was completed in accordance with agency policy/procedure for four (4) of five (5) active patients. (Patients #1, #3, #4 and #5) Findings include: On February 27, 2026 at approximately 2:45 PM, review of the agency policy titled “Care Planning Process & Comprehensive Assessment” revealed the following under “Procedure”: IV. Update of the comprehensive assessment: The comprehensive assessment must be updated and revised...as frequently as the patient’s condition warrants...but no less frequently than...A. The last five 5 days of every 60-day episode beginning with the SOE (start of episode) date... Patient #1: Between February 25, 2026 at approximately 10:35 AM and February 26, 2026 at approximately 12:07 PM, review of the clinical record revealed the start of care date was 06/19/2024 and that SN services were ordered as documented on the “Home Health Certification and Plan of Care” for the following certification periods: 12/16/2024 through 02/13/2025, 02/14/2025 through 04/14/2025, 04/15/2025 through 06/13/2025, 06/14/2025 through 08/12/2025, 08/13/2025 through 10/11/2025, 10/12/2025 through 12/10/2025 and 12/11/2025 through 02/08/2026. There was no documentation in the clinical record which provided evidence a comprehensive SN reassessment had been completed during the following recertification periods: 12/16/2024 through 02/13/2025, 06/14/2025 through 08/12/2025 nor 08/13/2025 through 10/11/2025. Review of SN documentation revealed the comprehensive SN reassessment was conducted prior to days 56 through 60 during the following recertification periods: 02/14/2025 through 04/14/2025, 04/15/2025 through 06/13/2025, 10/12/2025 through 12/10/2025 and 12/11/2025 through 02/08/2026. Patient #3: Between February 25, 2026 at approximately 1:55 PM and February 27, 2026 at approximately 2:40 PM, review of the clinical record revealed the start of care date was 07/26/2024 and that SN services were ordered as documented on the “Home Health Certification and Plan of Care” for the following certification periods: 07/26/2024 through 09/22/2024 and 03/23/2025 through 05/21/2025. There was no documentation in the clinical record which provided evidence a comprehensive SN reassessment had been completed during the following recertification periods: 07/26/2024 through 09/22/2024 and 03/23/2025 through 05/21/2025. Patient #4: On February 25, 2026 at approximately 2:46 PM, review of the clinical record revealed the start of care date was 07/08/2013 and that SN services were ordered as documented on the “Home Health Certification and Plan of Care” for the following certification periods: 07/05/2025 through 09/02/2025, 09/03/2025 through 11/01/2025 and 11/02/2025 through 12/31/2025. There was no documentation in the clinical record which provided evidence a comprehensive SN reassessment had been completed during the following recertification period: 07/05/2025 through 09/02/2025. Review of SN documentation revealed the comprehensive SN reassessment was conducted prior to days 56 through 60 during the following recertification periods: 09/03/2025 through 11/01/2025 and 11/02/2025 through 12/31/2025. Patient #5: Between February 26, 2026 at approximately 1:24 PM and February 27, 2026 at approximately 10:12 AM, review of the clinical record revealed the start of care date was 11/15/2003 and that SN services were ordered as documented on the “Home Health Certification and Plan of Care” for the following certification periods: 11/20/2025 through 01/18/2026. There was no documentation in the clinical record which provided evidence a comprehensive SN reassessment had been completed during the following recertification periods: 11/20/2025 through 01/18/2026. During interview conducted on February 27, 2026 at approximately 2:56 PM, the Admin and RN/CM’s (Employees #8 and #9) confirmed there was no documentation in the clinical record which provided evidence the comprehensive SN reassessment had been completed in accordance with agency policy/procedures for the above identified patients.”

“Within 48 hours of the patient’s return CFR(s): 484.55(d)(2) Within 48 hours of the patient’s return to the home from a hospital admission of 24 hours or more for any reason other than diagnostic tests, or on physician or allowed practitioner - ordered resumption date; This Element is not met as evidenced by: Based upon review of agency policy/procedure and clinical records and based on interview with the registered nurses/Clinical Managers (RN/CM-Employees #8 and #9) and the Administrator (Admin-Employee #10), the agency failed to ensure the initial/start of care (SOC) comprehensive nursing assessment was completed in accordance with agency policy/procedure for two (2) of two (2) active patients admitted to services after February 10, 2023. (Patients #1 and #3) Findings include: On February 27, 2026 at approximately 2:45 PM, review of the agency policy titled “Care Planning Process & Comprehensive Assessment” revealed the following under “Procedure”: 1. Initial assessment visit initiates the care planning process...The initial assessment visit must be held either within 48 hours of referral, or within 48 hours of the patient’s return home from an inpatient unit, or on the physician/allowed practitioner ordered start of care date. Patient #1: Between February 25, 2026 at approximately 10:35 AM and February 26, 2026 at approximately 12:07 PM, review of the clinical record revealed the start of care date was 06/19/2024 and that skilled nursing (SN) services were ordered as documented on the “Home Health Certification and Plan of Care” for the initial certification period of 06/19 through 08/17/2024. Review of “Home Health Certification and Plan of Care” documentation revealed the RN/CM (Employee #8) completed a SOC nursing assessment on 06/19/2024. There was no documentation in the clinical record which provided evidence the date of referral nor inpatient discharge date had been documented in the clinical record nor was documentation present which provided evidence the agency had obtained a physician-ordered start of care date. Patient #3: Between February 25, 2026 at approximately 1:55 PM and February 27, 2026 at approximately 2:40 PM, review of the clinical record revealed the start of care date was 07/26/2024 and that home health aide services were ordered as documented on the “Home Health Certification and Plan of Care” for the initial certification period of 07/26 through 09/23/2024. Review of SN documentation revealed the initial RN comprehensive assessment was completed on by the RN/CM (Employee #9) on 07/26/2024. There was no documentation in the clinical record which provided evidence the date of referral nor inpatient discharge date had been documented in the clinical record nor was documentation present which provided evidence the agency had obtained a physician-ordered start of care date. There was no documentation in the clinical record which provided evidence the clinical record which provides evidence initial comprehensive nursing assessment had been completed by the RN/CM within 48 hours of referral, within 48 hours of the patient’s return home from an inpatient unit or on the physician/allowed practitioner ordered start of care date. During interview conducted on February 27, 2026 at approximately 2:56 PM, the Admin and RN/CM’s (Employees #8 and #9) confirmed there was no documentation in the clinical record which provided evidence the initial/SOC SN assessment had been had been completed by the RN/CM within 48 hours of referral, within 48 hours of the patient’s return home from an inpatient unit or on the physician/allowed practitioner ordered start of care date for patients #1 and #3.”

“At discharge CFR(s): 484.55(d)(3) At discharge. This Element is not met as evidenced by: Based upon review of agency policy/procedure and clinical records and based on interview with the registered nurse/Clinical Manager (RN/CM-Employee #9) and the Administrator (Admin-Employee #10), the agency failed to ensure a comprehensive skilled nursing (SN) reassessment had been completed in accordance with agency policy/procedure for one (1) of one (1) patients who was discharged from the agency due to staffing issues. (Patient #6) Findings include: On February 27, 2026 at approximately 2:45 PM, review of the agency policy titled “Care Planning Process & Comprehensive Assessment” revealed the following under “Procedure”: IV. Update of the comprehensive assessment: The comprehensive assessment must be updated and revised...C. At discharge. Patient #6: On February 27, 2026 between the approximate time of 10:30 AM and 1:48 PM, review of the clinical record revealed the start of care date was 02/26/2023 and that skilled nursing services were ordered as documented on the “Home Health Certification and Plan of Care” for the following certification period: 08/31/2025 through 10/29/2025. Review of discharge summary documentation dated 10/29/2025 revealed the RN/CM (Employee #9) documented that the patient was discharged from services due to the inability to provide qualified staff. There was no documentation in the clinical record which provided evidence a comprehensive SN reassessment had been completed prior to the patient’s discharge from the agency. During interview conducted on February 27, 2026 at approximately 2:56 PM, the Admin and RN/CM (Employee #9) confirmed there was no documentation in the clinical record which provided evidence the comprehensive SN reassessment had been completed prior to discharge for patient #6.”