Every finding on record at Discovery at Home LLC

An unannounced complaint survey for complaint #2023003625 was conducted on 4/11/23 through 4/12/23 at Discovery at Home LLC a home health agency in Bonita Springs, Florida. Complaint #2023003625 was Substantiated at G442. Discovery at Home LLC is incompliance with the Code of Federal Regulations (CFR) 42, Part 484, Conditions of Participation for Home Health Services. The following is a description of the Standard level noncompliance.

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 medical record reviews and interviews the home health agency failed to ensure 2 (#1, #2) of 3 patients sampled who received Medicare specific services, through the home health agency, received written notification in advance of non-coverage care when the Medicare specific services were reduced or terminated. 1. Review of Patient’s #1 medical record revealed a home health start of care date of 1/13/23. The Patient’s comprehensive assessment was performed by the Physical Therapist. Review of the patient’s Plan of Care revealed Physical Therapy (PT) services, one visit for one week, two visit for two weeks, and one visit for two weeks. Medical record review revealed a Physical Therapy Discharge Summary date of 2/8/23. The patient was discharged from Physical Therapy services and will continue with the Home Health Agency, noted “discharged to OT.” The medical records failed to provide evidence of the patient receiving a non-coverage form; the patient was not notified of his rights to appeal for additional PT services. 2. Review of Patient’s #2 Medical Record revealed a home health start of care date 2/28/23. Review of the patient’s Plan of Care revealed PT services, one week one visit, 2 visits for 2 weeks, and one visit for one week. The patient treatment orders also included OT and Skill Nursing. The review revealed a PT discharge date of 3/24/23. It is documented the discharge is to OT and Skill Nursing services. The medical record failed to provide evidence of the patient receiving a non-coverage form; the patient was not notified of his rights to appeal for additional PT services. 3. On 4/11/23 at 2:45 p.m., during an interview, the Administrator said, "I can’t fix that. We do not give the patient a Notice of Non-Coverage after each service is discontinued. We do not give the patient the Non-Coverage form when services are decreased, only when they are completely discharged from Home Health Services. Therapy services are contracted, I can’t say what they leave in the patient’s home when they discharge a patient." On 4/12/23 at 10:45 a.m., during an interview, the Physical Therapist-Director said, “We provide the patient with a copy of the Notice of Non-Coverage at the end of the patient’s Home Health Services. Not at the end of the discontinuation of each of the therapy services.”