Every finding on record at Health1st LLC

Based on the findings of an onsite unannounced home health agency Medicare recertification survey conducted July 25, 2023, through July 26, 2023, Health 1st Home Health Services, 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 Medicare recertification survey conducted July 25, 2023, through July 26, 2023, Health1st Home Health Services, 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.

At discharge CFR(s): 484.55(d)(3) At discharge. This ELEMENT is not met as evidenced by: Based on a review of agency policy, clinical record (CR), and an interview with administrator, it was determined that the agency failed to update of the comprehensive assessment which include a summary of the patient's progress in meeting the care plan goals at discharge for two (2) of five (5) clinical record reviewed. (CR# 1 and 5) A review of policy “Discharge Criteria” conducted on July 28, 2023, at approximately 3:00 PM reads in part, “PROCEDURE: 5. Staff will be knowledgeable about discharge procedures, including instructions and follow up responsibilities.” A review of clinical records (CR) was conducted on July 26, 2023, starting at approximately 10:00 AM. The Start of Care (SOC) and Home Health Certification Period (CP) are shown below. CR#1 SOC 4/4/22 and CP 4/4/22 to 6/2/22 contained “PT plan of care” which read in part, “Patient will demonstrate ability to perform home exercise program within 4 weeks. Improve bed mobility to independent within 4 weeks. Independent with safe transfer skills within 4 weeks. Patient to be independent with safety issues in 4 weeks. Patient will be able to ambulate using R.WALKER device at least 150 feet with INDEP. assist with safe and effective gait pattern on even/uneven surface within 4 weeks. Increase muscle strength of B UE'S/LE'S (bilateral upper extremities/lower extremities) to >4/5 grade to improve gait pattern/stability and decrease fall risk within 4 weeks. Increase trunk muscle strength to >4/5 to improve postural control and balance within 4 weeks. Patient will have increase in Tinetti Performance Oriented Mobility Assessment score to 24 over 28 to reduce fall risk within 4 weeks. Patient will have increase in Timed Up and Go score to 18 seconds to reduce fall risk and improve mobility within 4 weeks.” A review of “Home Health Discharge Summary” dated 8/18/22 does not include the patient's progress in meeting the care plan goals set by physical therapy. CR#5 SOC 1/24/23 and CP 1/24/23 to 3/24/23 contained “PT plan of care” which reads in part, “Patient will demonstrate ability to perform home exercise program within 4 weeks. Independent with safe transfer skills within 9 weeks. Patient to be independent with safety issues in 4 weeks. Independent with ambulation without device indoor/outdoor at least 200 feet to allow community access within 9 weeks. Increase muscle strength of B LE'S/LE'S to 5/5 grade to improve gait pattern/stability and decrease fall risk within 9 weeks. Increase trunk muscle strength to 5/5 to improve postural control and balance within 9 weeks. Patient will have increase in Tinetti Performance Oriented Mobility Assessment score to 24 over 28 to reduce fall risk within 9 weeks. Patient will have increase in Timed Up and Go score to 14 seconds to reduce fall risk and improve mobility within 9 weeks.” A review of PT Re-evaluation dated 2/28/23 reads in part, “PT goals: Patient will demonstrate ability to perform home exercise program within 4 weeks. Independent with safe transfer skills within 9 weeks. Patient to be independent with safety issues in 4 weeks. Independent with ambulation without device indoor/outdoor at least 200 feet to allow community access within 9 weeks. Increase muscle strength of B UE'S/LE'S to 5/5 grade to improve gait pattern/stability and decrease fall risk within 9 weeks. Increase trunk muscle strength to 5/5 to improve postural control and balance within 9 weeks. Patient will have increase in Tinetti Performance Oriented Mobility Assessment score to 24 over 28 to reduce fall risk within 9 weeks. Patient will have increase in Timed Up and Go score to 14 seconds to reduce fall risk and improve mobility within 9 weeks.” A review of Home Health Discharge Summary does not include the patient's progress in meeting the care plan goals set by physical therapy. An interview with the administrator on July 26, 2023, at approximately 12:00 PM confirmed above findings.

Ensure clinical manager is available CFR(s): 484.105(b)(1)(iii) (iii) Ensure that a clinical manager as described in paragraph (c) of this section is available during all operating hours; This ELEMENT is not met as evidenced by: Based on a review of agency policy, surveyor observations, and an interview with the administrator, administrator failed to ensure that the clinical manager and/or administrator is available during all operating hours. (OBS #1) Findings include: Agency Policy: A review of agency policy titled "Administrator" was conducted on July 28, 2023, at approximately 12:00 pm. Policy states, "5. The Administrator of the Agency has the following responsibilities: Available during operating hours and responsible for day-to-day operations of the Agency..." Observation #1: On July 24, 2023, at approximately 9:15 am, this surveyor arrived at agency's business location at 1230 Burmont Road, Drexel Hill, PA 19026. Agency's door was locked, and no one was onsite. This surveyor referenced the agency's website to view operating hours as none were posted. Website stated operating hours were Monday through Friday, 8:30 am to 4:30 pm. This surveyor called agency's listed phone number, 610-449-1175, and call went to a message stating "mailbox is full". Surveyor waited at location and at 9:35 am, called agency's listed phone number again. Call was answered by a male who answered, "Health 1st Home Health" and did not identify himself. This surveyor asked to speak to the administrator/clinical manager and was told that she was not in the office today. This surveyor identified myself, reason for calling, and stated I was at the agency's location, and no one was there. Left message with agency staff to have administrator call surveyor back. Surveyor waited at location until 10:00 am and did not receive a call back and no one arrived at agency's business location. During an interview with the administrator on July 25, 2023, at approximately 10 am, administrator stated that staff is working remotely, and office hours are 9:30 am to 4:30 pm. Administrator also stated that she had a dentist appointment on July 24, 2023, during the time of my visit/call.

Available during all operating hours CFR(s): 484.105(b)(3) The administrator or a pre-designated person is available during all operating hours. This ELEMENT is not met as evidenced by: Based on a review of agency policy, surveyor observations, and an interview with the administrator, administrator failed to ensure that the clinical manager and/or administrator is available during all operating hours. (OBS #1) Findings include: Agency Policy: A review of agency policy titled "Administrator" was conducted on July 28, 2023, at approximately 12:00 pm. Policy states, "5. The Administrator of the Agency has the following responsibilities: Available during operating hours and responsible for day-to-day operations of the Agency..." Observation #1: On July 24, 2023, at approximately 9:15 am, this surveyor arrived at agency's business location at 1230 Burmont Road, Drexel Hill, PA 19026. Agency's door was locked, and no one was onsite. This surveyor referenced the agency's website to view operating hours as none were posted. Website stated operating hours were Monday through Friday, 8:30 am to 4:30 pm. This surveyor called agency's listed phone number, 610-449-1175, and call went to a message stating "mailbox is full". Surveyor waited at location and at 9:35 am, called agency's listed phone number again. Call was answered by a male who answered, "Health 1st Home Health" and did not identify himself. This surveyor asked to speak to the administrator/clinical manager and was told that she was not in the office today. This surveyor identified myself, reason for calling, and stated I was at the agency's location, and no one was there. Left message with agency staff to have administrator call surveyor back. Surveyor waited at location until 10:00 am and did not receive a call back and no one arrived at agency's business location. During an interview with the administrator on July 25, 2023, at approximately 10 am, administrator stated that staff is working remotely, and office hours are 9:30 am to 4:30 pm. Administrator also stated that she had a dentist appointment on July 24, 2023, during the time of my visit/call.