Every finding on record at Advant Home Health Services Inc

Purpose of visit: Recertification/Relicensure Survey Entrance: 01/24/2022 The agency's census was: L&C-0, LHHS-0, PAS-46 Exit: 01/26/2022 An entrance conference was conducted on 01/24/2022 at 9:36 AM with the Alternate Administrator. The agency was informed that the purpose of the survey was to conduct a Recertification/Relicensure Survey. The "Home and Community Support Services Agencies (HCSSAs), What To Expect During Your Agency's Survey" was provided and explained. The information card giving instructions on how to complete the on-line comment survey was provided. An exit conference was conducted on 01/26/2022 at 2:36 PM with the Administrator. The preliminary findings of the survey were discussed, and a written copy provided. The agency was informed which records were duplicated. The agency was afforded the opportunity to ask questions regarding the survey and given the opportunity to provide additional information. Additional information was not received. Written instructions were provided and explained for submitting a plan of correction within 10 days of receipt of the Statement of Violation. Abbreviations: Director of Nursing (DON) Outcome and Assessment Information Set (OASIS)

Purpose of visit: Recertification/Relicensure Survey Entrance: 01/24/2022 The agency's census was: L&C-0, LHHS-0, PAS-46 Exit: 01/26/2022 An entrance conference was conducted on 01/24/2022 at 9:36 AM with the Alternate Administrator. The agency was informed that the purpose of the survey was to conduct a Recertification/Relicensure Survey. The "Home and Community Support Services Agencies (HCSSAs), What To Expect During Your Agency's Survey" was provided and explained. The information card giving instructions on how to complete the on-line comment survey was provided. An exit conference was conducted on 01/26/2022 at 2:36 PM with the Administrator. The preliminary findings of the survey were discussed, and a written copy provided. The agency was informed which records were duplicated. The agency was afforded the opportunity to ask questions regarding the survey and given the opportunity to provide additional information. Additional information was not received. Written instructions were provided and explained for submitting a plan of correction within 10 days of receipt of the Statement of Violation. Abbreviations: Director of Nursing (DON) Outcome and Assessment Information Set (OASIS)

Written notice for non-covered care CFR(s): 484.50(c)(8) Receive proper written notice, in advance of a specific service being furnished, if the HHA believes that the service may be non-covered care; or in advance of the HHA reducing or terminating on-going care. The HHA must also comply with the requirements of 42 CFR 405.1200 through 405.1204. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure proper written notice was provided, in advance of terminating on-going care in five of five (patients # 8, 9 and 10) inactive patient records reviewed. The agency failed to provide the Centers for Medicare and Medicaid form titled Notice of Medicare Non-Coverage. The failure could place the patients at risk of harm due to inadequate or inappropriate continuity of care in the patients' post-discharge needs and could prevent the patients from exercising the right to appeal the discharge decision, if desired. FINDINGS INCLUDED: Clinical Record # 8: Record review 01/25/2022. Record review of the electronic clinical record for Patient # 8 revealed a discharge OASIS dated 11/17/2020 and showed a discharge date of 11/17/2020. The record included a written Notice of Medicare Non-Coverage signed and dated by the patient on 11/11/2021. The written Notice of Medicare Non-Coverage included an incorrect phone number Identifier C instead of Identifier E as the correct phone number for an immediate appeal. Patient # 6's clinical record did not show that the patient or patient representative received a proper written notice of intent to discharge no later than two days in advance of terminating on-going care on, 11/17/2020. Clinical Record # 9: Record review 01/25/2022. Record review of the electronic clinical record for Patient # 9 revealed a discharge OASIS dated 11/27/2020 and showed a discharge date of 11/27/2020. The record included a written Notice of Medicare Non-Coverage signed and dated by the patient on 11/27/2020. The written Notice of Medicare Non-Coverage included an incorrect phone number Identifier C instead of Identifier E as the correct phone number for an immediate appeal. Patient # 9's clinical record did not show that the patient or patient representative received a proper written notice of intent to discharge no later than two days in advance of terminating on-going care on, 11/27/2020. Clinical Record # 10: Record review 01/25/2022. Record review of the electronic clinical record for Patient # 10 revealed a discharge OASIS dated 05/06/2021 and showed a discharge date of 05/06/2021. The record included a written Notice of Medicare Non-Coverage signed and dated by the patient on 04/29/2021. The written Notice of Medicare Non-Coverage included an incorrect phone number Identifier D instead of Identifier E as the correct phone number for an immediate appeal. Patient # 10's clinical record did not show that the patient or patient representative received a proper written notice of intent to discharge no later than two days in advance of terminating on-going care on, 05/06/2021. In an interview on 01/26/2022 at approximately 9:45 a.m. with the Administrator/DON/License Holder (Identifier A), the surveyor discussed the above findings of the written notices of the intent to discharge with the Notice of Medicare Non-Coverage form in advance of terminating on-going care for Patients # 8, 9 and 10. The surveyor discussed the phone number for an immediate appeal provided to the patient was incorrect and showed the administrator/DON how to access the correct phone number. The surveyor asked how could this oversight affect patient care if the patient is not provided the right phone number in a timely manner to appeal? The Administrator replied, “The patients may not get the continuing care they need.” Review of agency policy titled "PE.6 Patient Discharge" dated 080114 read in part: "Policy...Agency will deliver the Notice of Medicare Non-Coverage... to the patient (or authorized representative), at least 2 calendar days before Medicare covered services end or the second to last day of service if care is not provided daily...." According to §405.1200 - Notifying beneficiaries of provider service terminations: (a) (2) (b)(1) Timing of notice. A provider must notify the beneficiary of the decision to terminate covered services no later than 2 days before the proposed end of the services. If the beneficiary's services are expected to be fewer than 2 days in duration, the provider must notify the beneficiary at the time of admission to the provider. If, in a non-residential setting, the span of time between services exceeds 2 days, the notice must be given no later than the next to last time services are furnished.