Every finding on record at Caresouth HHA Hoidings of Washington, LLC

MEDICARE HOME HEALTH RECERTIFICATION SURVEY The Washington State Department of Health (DOH) in accordance with Medicare Conditions of Participation set forth in 42 Part 484 conducted this health and safety survey. Examination number: 2024-345 Dates Onsite: 06/11-14/24 This survey was conducted by: Surveyor #5 DOH staff found the facility in substantial compliance with all Conditions of Participation except those standard-level deficiencies listed below. . . . . . . . .

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 discharged patient data to the Centers for Medicare and Medicaid Services (CMS) database in a timely manner for 15 of 1027 records transmitted between 05/01/23 and 05/31/24. Failure to transmit discharged patient data in a timely manner could result in patients not receiving full benefits when transferring services to another agency. 1. As part of the pre-survey preparation, the Surveyor reviewed the "HHA Error Summary by Agency" report from 05/01/23 and 05/31/24 generated from the iqies.cms.gov site. The review showed that the agency had 15 of 1027 patient assessments that were not submitted in a timely manner. This resulted in a 1.46% late submission error rate. 2. On 06/14/24 at 8:30 AM, the Surveyor interviewed the Vice President of Operations (Staff #501) regarding the error rate. Staff #501 stated that after reviewing the error report information, the agency determined that the electronic medical record (EMR) system used by the agency system does not allow for two payor systems to be entered at one time. Staff #501 stated that in order for the agency to submit their data they must enter one payor source and then resubmit the information a second time with the information for the second payor source. The agency's EMR system captures the date of the first submission which is "on-time" so the agency shows zero errors when the report is generated from their EMR. This impacts patients that have private insurance as the primary payor and Medicare as a secondary payor. Staff #501 stated that they just learned that the Internet Quality Improvement and Evaluation System (iQIES) platform will delete the date of the first submission once the assessment is pulled back. It will re-populate with date of the second submission which is causing it to show as late. Staff #501 stated they will work with their third-party vendor to find a solution to this system issue.