Every finding on record at Caresense Home Health

Based on the findings of an onsite unannounced home health agency Medicare recertification survey completed on December 21, 2021, Caresense Home Health, was found to be in compliance with the requirements of 42 CFR, Part 484.22, Subpart B, Conditions of Participation: Home Health Agencies - Emergency Preparedness.

Based on the findings of an onsite unannounced home health agency Medicare recertification survey completed on December 21, 2021, Caresense Home Health, was found not to be in compliance with the requirements of 42 CFR, Part 484, Subparts B and C, Conditions of Participation: Home Health Agencies.

Transmittal of OASIS data CFR(s): 484.45(c) Standard: Transmittal of OASIS data. An HHA must- This STANDARD is not met as evidenced by: Based upon policy and procedure review, review of an OASIS Final Validation Report for the time frame of May 2019 through December 2021, interview with the agency administrator, and clinical record (CR) review, it was determined the agency failed to ensure the transmittal of OASIS data for agency patients receiving skilled services, over eighteen years of age, with a Medicaid payor source for six (6) out of seven (7) CR’s reviewed (CR#1-CR#4, CR#6, and CR#7). Review of policy “Reporting of OASIS Information” on 12/21/21 at approximately 2:10 PM states “ Agency must collect, encode, and transmit OASIS date for:…Medicaid (traditional and HMO/managed care) patients that are age 18 and over and receiving skilled services…” Review of an OASIS “Final Validation Report” for the time frame May 2019 through December 2021 on 12/21/21 at approximately 8:30 AM revealed no OASIS submissions from the agency. Review of Clinical Records on 12/20/21 from approximately 12:00 PM-2:00 PM revealed the following: CR#1 (Start of Care (SOC): 8/07/2021): Over eighteen years of age, Medicaid payor source, receiving skilled nursing services from the agency. CR#2 (SOC:4/18/2017): Over eighteen years of age, Medicaid payor source, receiving skilled nursing services from the agency. CR#3 (SOC:7/21/2018): Over eighteen years of age, Medicaid payor source, receiving skilled nursing services from the agency. CR#4 (SOC:3/11/2021): Over eighteen years of age, Medicaid payor source, receiving skilled nursing services from the agency. CR#6 (SOC:4/14/2021/Closed record review, Date of discharge: 9/13/2021): Over eighteen years of age, Medicaid payor source, received skilled nursing services from the agency. CR#7(SOC:7/16/2020/Closed record review, Date of discharge: 3/05/2021): Over eighteen years of age, Medicaid payor source, received skilled nursing services from the agency. An interview with the agency administrator on 12/21/2021 at approximately 2:30 PM confirmed the above findings.

Skilled services furnished CFR(s): 484.105(f) Standard: Services furnished. Skilled nursing services and at least one other therapeutic service (physical therapy, speech-language pathology, or occupational therapy; medical social services; or home health aide services) are made available on a visiting basis, in a place of residence used as a patient's home. An HHA must provide at least one of the services described in this subsection directly, but may provide the second service and additional services under arrangement with another agency or organization. This STANDARD is not met as evidenced by: Based upon policy and procedure review, review of agency’s active personnel list, and an interview with the agency administrator, it was determined the agency failed to ensure that at least one other covered therapeutic service was offered, in addition to skilled nursing services, for 2020 and 2021. Review of policy “Services Furnished and Written Agreements/Contracts Among Providers” on 12/21/21 at approximately 2:00 PM states” Agency will make available part-time or intermittent skilled nursing services and at least one other therapeutic (PT, OT, SLP, MSW, or HHA) on a vising basis to patient’s home.” Review of agency’s active personnel list on 12/20/21 at approximately 11:00 AM revealed four (4) registered nurses and ten (10) licensed practical nurses. No other therapeutic disciplines were present on the list. An interview with the agency’s administrator on 12/20/21 at approximately 2:00 PM revealed the agency has not offered a therapeutic service in addition to skilled nursing since 2019, when Physical Therapy was available.