Prevail Home Health 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 record review and interview, the agency failed to transmit completed Outcome Assessment Information Set (OASIS), group of standard data HHAs integrate into their comprehensive assessment, to collect and report quality data to the CMS assessments to the Centers for Medicare and Medicaid Services (CMS) system within 30 days of completing the OASIS assessment from April of 2025 to April of 2026. This failure prevented the patients’ data from being made available to CMS for analysis to identify agency performance levels in the provision of patient care. Findings include: During pre-survey, the Surveyor reviewed report ran on 04/27/26, titled “HHA Error Summary by Agency,” for the following reporting periods: 04/27/25 to 4/27/26 revealed 55 assessments of 182 (30%) were processed with the error warning -3330 with error description that read, “Record Submitted late: The submission date was more than 30 days after M0090 (assessment) on this new record.” Period 07/01/25 to 04/27/26 revealed 37 of 135 assessments (27.4%) were processed with error warning -3330. Period 01/01/26 to 04/27/26 revealed 17 of 38 assessments (44.7%) were processed with error warning -3330. On 04/28/26, the Surveyor requested OASIS Validation Reports from CMS for 12-month period from 04/01/25 to 04/28/26. Record review of OASIS validation reports for date range 04/21/25 to 04/20/26 revealed 194 assessments were processed with 56 assessments (28.8%) with error warning -3330. Reports for the OASIS Agency Final Validation report revealed submission date of 04/20/26 with 1 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 03/31/26 with 4 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 03/19/26 with 1 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 03/19/26 with 1 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 03/10/26 with 6 assessments submitted and showed 4 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 02/02/26 with 8 assessments submitted and showed 5 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 01/08/26 with 3 assessments submitted and showed 3 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 01/08/26 with 1 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 12/16/25 with 3 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 12/08/25 with 5 assessments submitted and showed 3 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 11/15/25 with 4 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 10/01/25 with 19 assessments submitted and showed 7 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 09/15/25 with 7 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 08/27/25 with 12 assessments submitted and showed 6 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 07/15/25 with 2 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 07/03/25 with 7 assessments submitted and showed 0 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 06/27/25 with 7 assessments submitted and showed 4 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 06/27/25 with 1 assessments submitted and showed 1 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 06/5/25 with 13 assessments submitted and showed 5 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 05/19/25 with 9 assessments submitted and showed 3 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 05/06/25 with 4 assessments submitted and showed 3 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 05/02/25 with 6 assessments submitted and showed 2 of the assessments had -3330 warning code. Reports for the OASIS Agency Final Validation report revealed submission date of 04/21/25 with 13 assessments submitted and showed 1 of the assessments had -3330 warning code. During an interview with the Admin on 04/28/26 at 11:47 A.M, the Surveyor asked the Admin if she was aware of late OASIS submissions. The Admin stated that she was not aware of late submissions because all the Medicare clients were submitted to CMS each month. The Admin was informed that all payor sources needed to be submitted to CMS, and she stated that she was not aware of that. The Admin was asked who was responsible for submitting OASIS to CMS and she stated Contract Worker A. The Admin was asked if anyone else was responsible for OASIS submissions and she said there wasn’t anyone else. The Admin was asked what was the process for OASIS submissions, and she stated that she hired Contract Worker A to handle billing and OASIS Submissions. The Admin stated that Contract Worker A did let her know about late submissions, so she would accept full responsibility for the late submissions. Admin was asked what harm could be done for submitting late OASIS and she said her agency provided quality care to the clients. She just did not know all payor sources needed to be submitted to CMS and told Contract Worker A not to worry about it. The Admin was asked what was the purpose for submitting OASIS assessments and she said it was used to show comparison to the other agencies on how the HHA was doing. An interview was held with the DON on 4/30/26 at 12:01 P.M. The DON was asked if she monitored the OASIS Validation Reports and she replied, “I can. I do.” The Surveyor asked the DON if she was aware of late submissions and she said “No.” The DON said, “if something was missed, we could make up for it by learning from it.” The DON was asked how often she checked the OASIS Validation reports and she said within 24 hours once the nurse turned in the assessment. The DON was asked when does the OASIS need to be submitted to CMS by and she said, “30 days, but 5 days is the goal.” An interview was held with Contractor Worker A on 4/30/26 at 1:42 P.M. The Surveyor asked Contractor Worker A who was responsible for submitting the OASIS and she said she was. Contractor Worker A was asked how often she submitted the OASIS, and she stated that she did it every other week. She stated that she did make the Admin aware of the late submission warnings; however, the Admin told her not to worry about it because only the Medicare clients needed to be submitted. Contractor Worker A stated that she was aware of the changes to submit all payor sources to CMS and made the Admin aware. Contractor worker A was asked when does the submission needed to be submitted to CMS by and she said she knew it was by 30 days. Contractor Worker A was asked what was the process for submitting OASIS and she to make the Admin aware of any error warnings or rejected assessment. Contractor Worker A was asked what harm to clients could be caused for late submissions and there wasn’t a reply. Review of the agency’s policy titled, “OASIS Compliance”, dated 04/2021, read in part… Within 30 days of completion (M0090), OASIS data elements will be encoded and electronically transmitted to the national OASIS system.””