Every finding on record at Apollo Home Care, Inc

The Emergency Preparedness requirements were evaluated, in conjunction with the recertification survey, on 07/26/24. The Agency was in compliance with the Condition, 42 CFR 484.102, Establishment of the Emergency Program for this survey.

Recertification survey was conducted on 07/26/24. Standard level deficiencies cited. Abbreviations: # = number % = percent AM = morning SN = Skilled Nurse SOC = Start of care RN = Registered Nurse PM = afternoon/evening Pt./ Pts. = Patient/Patients OASIS = Outcome and Assessment Information Set QAPI = Quality Assurance and Performance Improvement

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 review of the Error Summary report and Staff interview, it was determined that in 12 of 391 reports submitted for the last 12 months, the Agency failed to submit a timely report, resulting in a warning. Findings include: 1. The Error Summary report for 04/2023 to 03/2024 (12 months), was reviewed on 07/25/24. The report included a warning for Error # -3330. The Error included 12 (3.07%) assessments that were submitted late. 2. During an interview with the Director of Nursing on 07/25/24 at 11:00 AM, the Director Nursing stated that the timeframe for OASIS submission is within 30 days after completion. During the same interview, the Director of Nursing confirmed the above findings.

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: Based on a review of clinical records, and Staff interview, it was determined in 3 of 7 (Pts. #1, 7, and 3) clinical records reviewed, the Agency failed to ensure a referral was obtained to initiate service or that the initial assessment visit was done within 48 hours of receipt of the referral. Findings include: 1. Pt. #1 was admitted for Home Health services on 07/08/24 with the Diagnosis of Essential (Primary) Hypertension. The clinical record was reviewed on 07/24/24. The clinical record contained the referral/Face to Face Encounter signed by the Physician on 06/14/24 and faxed to the Agency on 6/24/24. The record lacked documentation the Pt. was discharged from an inpatient facility or that the Physician ordered a specific SOC date. The record lacked documentation that the Agency initiated service within 48 hours after the referral was received. 2. Pt. #7 was admitted for Home Health services on 01/23/24 with the Diagnosis of Lymphedema, Not Elsewhere Classified. The clinical record was reviewed on 07/24/24. The record contained the SOC comprehensive assessment completed by the SN and dated 01/23/24. As of 07/24/24, the record lacked a referral on or before 01/23/24 to initiate service. 3. Pt. # 3 was admitted to Home Health Services on 06/27/24 with Diagnosis of Polyarthritis, unspecified. The clinical record was reviewed on 07/24/24. The clinical record contained the referral/Face-to-Face encounter signed by the Physician on 05/08/24, and faxed to the Agency on 06/20/24. The record lacked documentation that the Pt. was discharged from an inpatient facility or that the Physician ordered a specific SOC date. The record lacked documentation that the Agency initiated service within 48 hours after referral was received. 4. During interviews with the Director of Nursing on 07/24/24 at 12:50 PM and with the Administrator, Director of Nursing and QAPI Coordinator on 07/25/24 at 10:05 AM, the Director of Nursing confirmed the above findings.

Onsite supervisory visit every 14 days CFR(s): 484.80(h)(1)(i) (1)(i) If home health aide services are provided to a patient who is receiving skilled nursing, physical or occupational therapy, or speech language pathology services— (A) A registered nurse or other appropriate skilled professional who is familiar with the patient, the patient's plan of care, and the written patient care instructions described in paragraph (g) of this section, must complete a supervisory assessment of the aide services being provided no less frequently than every 14 days; and (B) The home health aide does not need to be present during the supervisory assessment described in paragraph (h)(1)(i)(A) of this section. This ELEMENT is not met as evidenced by: Based on a review of clinical records and Staff interview, it was determined in 1 of 2 (Pt. #6) clinical records reviewed, wherein the Pt. received Home Health Aide services, the Agency failed to ensure the RN conduct Home Health Aide supervision every 14 days. Findings include: 1. Pt. #6 was admitted to Home Health Services on 09/18/23 with Diagnosis of Hemiplegia following Cerebral Infarction affecting Right Dominant Side. The clinical record was reviewed on 07/24/24. The record contained Home Health Aide visit notes for the certification period of 11/17/23 to 01/15/24, dated 12/02/23, 12/09/23, 12/21/23, 12/26/23, 01/02/24 and 01/09/24. As of 07/25/24, the record lacked documentation of Home Health Aide supervision by the RN for the certification period. 2. During an interview with the Administrator, Director of Nursing and QAPI Coordinator on 07/25/24 at 10:05 AM, the Director of Nursing confirmed the above findings.