Every finding on record at Great Lakes Home Health Ohio 1, LLC

Substantial Allegation Survey Substantial Allegation 108437 Elara Caring Home Healthcare LLC., 367730 was in substantial compliance with the requirements of Home Health Agency 42 CFR Part 484, Subpart B, C in regard to the allegations contained in the substantial allegation 108437 completed on 09/04/24.

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 review, policy review, and staff interview, the facility failed to provide proper written notice in advance of terminating on-going care. This affected one patient (Patient # 3) with the potential to affect all patients cared for by this agency. The agencies current census was 511. The medical record for Patient #3 revealed a start of care (SOC) date of 06/04/24. Diagnoses included chronic obstructive pulmonary disease (COPD), high blood pressure and Type I diabetes. The certification period reviewed was for 06/04/24- 08/02/24 and 08/03/24-10/01/24. Physician orders were received for skilled nursing (SN) one time per week to assess, complete dressing change to the left shin wound, and to educate. Home health aides (HHA) were to provide services one time per week to assist with bathing. . A re-certification was completed on 08/01/24. The last visit by a HHA was on 08/09/24. A discharge was completed on 08/09/24 for Patient #3 with a note stating this patient had changed insurances which was found upon re-certification. A note on 08/08/24 stated this patient does not have active coverage as of 07/31/24. A note dated 08/13/24 to the team stated due to this patient's new insurance the agency must discharge immediately. Patient #3 was informed and denied changing insurances, which was re-verified. An order to discharge was written and the physician was notified. There was no documentation of a Notice of Medicare Non-coverage was provided to Patient #3. Review of the agency policy titled "Client Discharge Process" revealed Medicare clients will be given the Notice of Medicare Non-Coverage a minimum of 48 hours prior to discharge as indicated and/or the appropriate advance Beneficiary Notice or Home Health Change of Care notice to explain agency decision to discharge from services. This notice will be served after all appropriate actions have been taken to assure the clients ongoing medical needs have been met as needed. Interview on 09/04/24 at 11:00 AM, Staff A and Staff B verified there was no documentation of a Notice of Medicare Non-coverage provided to Patient #3.