Beacon Home Health

“Receive all services in plan of care CFR(s): 484.50(c)(5) Receive all services outlined in the plan of care. This Element is not met as evidenced by: Based on medical record review and interview, the agency failed to provide home health aide services as ordered by the physician for 1 patient (#10) out of 1 patient who received home health aide visits. The findings included: . Medical record review revealed Patient #10 was admitted to the agency on 11/01/2022 with the diagnosis of Unspecified Dementia without Behavioral Disturbance. Review of a Home Health Certification and Plan of Care (485) dated 06/29/2023 to 08/27/2023, revealed a physician’s order for home health aide at 30 hours per week. Review of home health aide supervisory note dated 01/09/2023, revealed neither the patient or family had any concerns or complaints regarding HHA (home health aide) #1. Continued review revealed HHA #1 was present during the supervisory visit. Review of home health aide supervisory note dated 02/27/2023, revealed no complaints or concerns were voiced by the patient or family. Continued review revealed HHA #1 was present during the supervisory visit. Review of home health aide supervisory note dated 05/08/2023, revealed no complaints or concerns were voiced by the patient or family. Continued review revealed HHA #1 was present during the supervisory visit. Review of home health aide supervisory note dated 6/26/2023, revealed no complaints or concerns were voiced by the patient or family. Continued review revealed HHA #1 was not present during the supervisory visit. Review of documentation provided by the agency dated 08/16/2023, revealed the Private Duty Executive Director (PDED) was completing an audit on Patient #10. It was noted the patient’s signature was not always the same. Contact was made with the patient and family who informed the PDED that HHA #1 did not always “show up” or completed the hours ordered. The family and patient stated they did not inform the office of the non-visits because they “felt sorry for the HHA”. Review of documentation provided by the agency, not dated, revealed during the month of April 2023, a total of 72 hours was paid to HHA #1. Continued review revealed she had not worked those hours, however, was paid for the 72 hours. Further review revealed during the month of May 2023, a total of 96 hours was paid to HHA #1. Continued review revealed she had not worked those hours, however, was paid for the 96 hours. Further review revealed during the month of June 2023, a total of 84 hours was paid to HHA #1. Continued review revealed she had not worked those hours, however, was paid for the 84 hours. Further review revealed during the month of July 2023, a total of 84 hours was paid to HHA #1. Continued review revealed she had not worked those hours, however, was paid for the 84 hours. Further review revealed from 08/01/2023 to 08/11/2023, a total of 39.25 hours was paid to HHA #1. Continued review revealed she had not worked those hours, however, was paid for the 39.25 hours. Further review revealed the physician was notified of the visits not completed. Continued review revealed the payor source was reimbursed for the hours the HHA did not provide. Interview with the PDED on 05/15/2024 at 1:45 PM, in the conference room, confirmed the physician’s order for home health aide at 30 hours a week was not followed.”

“Communication with all physicians CFR(s): 484.60(d)(1) Assure communication with all physicians or allowed practitioners involved in the plan of care. This Element is not met as evidenced by: Based on medical record review and interview, the agency failed to document the physician was notified of a missed visit by physical therapy for 1 patient (#5) of 10 patients reviewed. The findings included: Medical record review revealed Patient #1 was admitted to the agency on Type 2 Diabetes Mellitus and Chronic Ulcer on Lower Extremity. Review of a Home Health Certification and Plan of Care dated 03/26/2024 to 05/24/2024 revealed a physician’s order for physical therapy visits at one time a week for 7 weeks. Review of the physical therapy visits for the week of 04/07/2024 revealed a physical therapy visit was not completed that week. Further review revealed no documentation the physician was notified of the missed visit. Interview with the Executive Director on 05/15/2024 at 1:45 PM, in the conference room, confirmed the physical therapy visit was missed and no documentation the physician was notified.”