Every finding on record at Jhs Operations LLC

A Recertifcation Survey entrance conference was conducted on 01/26/2021 with the Alternate Administrator/Alternate Director of Nurses, Identifier B, (in person) at 11:45 AM. A pre-survey COVID-19 screening was conducted with the Alternate Administrator/Alternate Director of Nurses, per the Texas Health and Human Services protocol. Census: Parent: Licensed and Certified: 217 Licensed Home Health: 0 Greenville Branch: Licensed and Certified: 245 Licensed Home Health: An exit conference was conducted on 02/01/2021 with the Administrator/Director of Nurses, Identifier A, (in person) and the Alternate Administrator/Alternate Director of Nurses, Identifier B, (in person) at 4:15 PM. The preliminary findings were discussed. The agency was found in compliance with the Medicare Conditions of Participation and no deficiencies were cited.

A Recertifcation Survey and Complaint Investigation (Intake #216525, 133266) entrance conference was conducted on 01/26/2021 with the Alternate Administrator/Alternate Director of Nurses, Identifier B, (in person) at 11:45 AM. A pre-survey COVID-19 screening was conducted with the Alternate Administrator/Alternate Director of Nurses, per the Texas Health and Human Services protocol. Census: Parent: Licensed and Certified: 217 Licensed Home Health: 0 Greenville Branch: Licensed and Certified: 245 Licensed Home Health: An exit conference was conducted on 02/01/2021 with the Administrator/Director of Nurses, Identifier A, (in person) and the Alternate Administrator/Alternate Director of Nurses, Identifier B, (in person) at 4:15 PM. The preliminary findings were discussed. The agency was afforded the opportunity to provide additional information. Written instructions were provided for submitting a plan of correction within 10 days of the receipt of the Statement of Deficiencies. The agency was found in compliance with the Medicare Conditions of Participation. Deficiency cited at standard level. ABBREVIATIONS: ADON - Alternate Director of Nurses CMS - Centers for Medicare and Medicaid Services COVID-19 -Novel Coronavirus Disease of 2019 DON - Director of Nurses EMR: electronic medical record HHA/hha - home health aide NOMNC - Notice of Medicare Non-Coverage POC - plan of care RN - registered nurse SOC - start of care

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 record review and interview, the agency failed to provide the NOMNC written notice at least two days in advance of terminating on-going care in three of three (Patient 8, 9 and 10) discharged records reviewed whose reason for discharge was goals met. The failure of the agency to protect the rights of the patients by informing in advance of their right to appeal the discontinuation of home health services prevented the three identified patients from exercising their right to appeal the discharge decision, if they chose to appeal. Findings include: DISCHARGED PATIENT 8: Record review of the EMR contained a POC dated 07/25/2020-09/22/2020 with a SOC date of 07/25/2020. The EMR contained the CMS form titled, "Notice of Medicare Non-Coverage." The form read in part, " ...The effective date coverage of your ...services will end: 9/21/20 ..." The form was signed and dated by Patient 8 on the discharge date of 09/21/2020. During an interview with the Administrator/DON, Employee A, and the Alternate Administrator/ADON, Employee B, on 02/01/2021 at approximately 3:45 PM, the surveyor asked why the NOMNC for Patient 8 was dated the same day as discharge. Employee B stated the agency thought Patient 8 was recertifying to stay on services longer, but therapy services informed the agency they were not recertifying Patient 8 for another episode. Employee B stated the agency decided to discharge Patient 8 the same day the NOMNC was signed by Patient 8. DISCHARGED PATIENT 9: Record review of the EMR contained a POC dated 10/27/2020-12/25/2020 with a SOC date of 10/27/2020. The EMR contained a discharge date of 12/18/2020. The EMR contained a discharge nursing visit dated 12/18/2020. There was no evidence in the EMR which indicated Patient 9 had been provided the NOMNC written notice. During an interview with Employee A and Employee B on 02/01/1021 at approximately 3:50 PM, the surveyor asked why Patient 9 was not given a NOMNC at least two days prior to discharge. Employee A stated Patient 9 only received therapy services from the agency and therapy admitted and discharged Patient 9. Employee A stated therapy admissions and discharges were new for the agency and that a nurse normally admitted and discharged the patients and provided the NOMNC. DISCHARGED PATIENT 10: Record review of the EMR contained a POC dated 02/07/2020-04/06/2020 with a SOC date of 02/07/2020. The EMR contained a discharge date of 04/02/2020. The EMR contained two NOMNC notices. The first notice was titled, "Notice of Medicare Non-Coverage." The form read in part, " ...The effective date coverage of your ...services will end: 03/27/20 ..." The form was signed and dated by Patient 10 and by RN, Employee D, on 03/17/2020. The second notice was titled, "Notice of Medicare Non-Coverage." The form read in part, " ...The effective date coverage of your ...services will end: 04/02/20 ..." The form was signed and dated by Patient 10 and Employee D on 04/02/2020. During an interview with Employee A and Employee B on 02/01/2021 at approximately 3:55 PM, the surveyor asked why Patient 10 received two NOMNC notices. Employee A stated Patient 10 was a Medicare managed care patient and the managed care company gave the agency an allotted number of patient visits. Employee A stated the NOMNC dated 03/27/2020 was given to Patient 10 because the managed care company did not inform the agency of the exact date of the last visit and the agency thought the discharge date was 03/27/2020. Employee A stated the managed care company authorized more visits past 03/27/2020. Employee A stated the agency found out the last authorized visit would be 04/02/2020 and that was the day the agency discharged Patient 10.