Every finding on record at New Vision Home Health Services Inc

Purpose: A recertification/ re-licensure survey was entered on 3/26/2026. Census: Total 52 L&C-0 LHHS-52 PAS-0 Abbreviations: L&C—Licensed and Certified LHHS—Licensed Home Health Services PAS- Personal Assistance Services The agency was in compliance and no deficiencies cited.

Purpose: A recertification/ re-licensure survey was entered on 3/26/2026. Census: Total 52 L&C-0 LHHS-52 PAS-0 Abbreviations: Alt Admin: Alternate Administrator CMS: Centers of Medicare and Medicaid Services HHA- Home Health Agency IQIES- Internet Quality Improvement Evaluation System L&C—Licensed and Certified LHHS—Licensed Home Health Services OASIS- Outcome and Assessment Information Set PAS- Personal Assistance Services

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 encode and electronically transmit each completed OASIS assessment to the CMS system, within 30 days of completing the assessment of the patient for 10 of 565 assessments processed for the time reviewed from 1/1/2025 to 12/31/2025. This failure resulted in quality data used to continuously improve the effectiveness of home healthcare, failing to be reported to CMS in the required time frame. Findings included: The HHA Error Summary Report, retrieved from the iQIES website for the time of 1/1/2025 to 12/31/2025 was reviewed. Review of the HHA Error Summary Report in IQIES for the time-period 1/1/2025 to 12/31/2025 identified Error #-3330. The description for Error #-3330 read in part, “Record Submitted Late: The submission date is more than 30 days after M0090 (Item M0090 specifies the date the actual assessment was completed) on this new record.” The documentation further identified the number of assessments with the error was 10 assessments and the percentage of assessments with this error was 1.77 of the total of 565 assessments completed by the Agency. An interview was conducted with the Administrator on 3/26/2026 at 11:30 a.m., The HHA Error Summary Report was reviewed with the Administrator. The Administrator acknowledged the responsibility of the late submission and attributed it to staff not turning in their assessments on time. During a record review of an agency policy titled, “Timelines,”, reviewed 01/01/26, read in part… “all completed and encoded OASIS data will be transmitted via electronic communication software… from the Agency… within 30 days of the M0090 date…”

Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This STANDARD is not met as evidenced by: Based on observation, record review and interview, the agency failed enforce written policies addressing infection control including the prevention of the spread of infectious and communicable disease with 2 of 4 of the agency’s Patients reviewed (Patient #1, Patient #4), in that: 1) RN B failed to place medical supplies and vital sign equipment (equipment used to measure blood pressure, heart rate, and oxygen levels) on a protective barrier or clean reusable medical equipment prior to returning to medical supply bag. 2) RN A failed to place medical supplies on a protective barrier once removed from supply bag. This failure placed the agency's patients at risk for an infection. Findings included: During a home observation for Patient #4, on 3/27/2026 at 12:00 p.m., RN B was observed providing patient care. Further observation of RN B revealed that RN B placed medical supplies such as gauze for wound care and bandages directly on the patients’ floor without placing a barrier down. Further observation revealed RN B placing medical equipment including the nurse’s medical bag and reusable vital sign equipment directly on patient furniture without placing a barrier. During record review of Patient #4 clinical record revealed a start of care of 10/31/25, with a certification period of 2/28/2026-4/28/2026, and skilled nursing visits received one to three times weekly and physical therapy visits once weekly. Further record review of Patient #4’s clinical records reveal a diagnosis of epilepsy (irregular electrical impulses to the brain) and a left leg blister for weekly dressing change. During an interview with RN B on 3/27/2026 at 1:00 p.m., RN B was asked about the above findings. RN B stated that she was trained on bag technique and verbalized responsibility. RN B further stated that she was a little nervous during the visit. During home observation for Patient #1 on 3/30/26 at 10:30 a.m., RN A was observed placing wound care supplies (gauze, ointment, cleaning solution) directly on to the patient’s side table without placing a barrier under the supplies. During an interview with RN A on 3/27/2026 at 1:00 p.m., RN A was asked about the above findings. RN A stated that she was trained on bag technique and verbalized responsibility. RN B further stated that placing the wound care supplies on Patient 1’s table without a barrier was an oversight. During record review of Patient #1 clinical record revealed a start of care date of 10/18/2024, with a certification period of 2/10/2026-4/10/2026, and a primary diagnosis of hypertensive heart disease (a heart problem caused by long-term high blood pressure) and wound caused by pressure on the back. Further record review revealed Patient #1 received skilled nursing visits once weekly for wound dressing changes, physical therapy one visit weekly, and home health aide visits twice weekly. During an interview with Alt Admin on 3/30/26 at 1:00 the process of placing a barrier prior to placing equipment down within a home was discussed. The Alt Admin stated that staff received training on proper techniques to prevent the spread of infection to include bag technique and placing a barrier down before setting down equipment or supplies. No training records were given by the Administrator. During record review of agency policy “Bag Technique” last reviewed 05/01/24 read in part… “the bag is placed on a clean surface. In the Patient’s home a barrier is to be placed under the bag. Bags should never be placed on the floor.”

A Recertification Survey was initiated on 11/03/2022. Census: Licensed and Certified- 12 Licensed Home Health- 0 The agency was found in substantial compliance with the Medicare Conditions of Participation for Emergency Preparedness, no deficiencies were cited.

A Recertification Survey was initiated on 11/03/2022. Census: Licensed and Certified- 12 Licensed Home Health- 0 Acronyms used: POC- Plan of Care SOC- Start of Care COPD- Chronic Obstructive Pulmonary Disease PVD- Peripheral Vascular Disease MD- Medical Director RN- Registered Nurse

Written notice within 4 business days CFR(s): 484.50(a)(4) Provide written notice of the patient's rights and responsibilities under this rule and the HHA's transfer and discharge policies as set forth in paragraph (d) of this section to a patient-selected representative within 4 business days of the initial evaluation visit. This ELEMENT is not met as evidenced by: Based on record review and interviews, the agency failed to provide patients with written notice of the Agency’s transfer and discharge policies in 3 (Patient’s #2, 3 and 5) of 3 patients home folders reviewed during a home visit, the agency failed to provide the transfer/discharge policy to the patients. This failure placed the agency's patients at risk of not being involved in the safe and effective transition of care to a facility or physician following discharge or transfer from the agency. FINDINGS INCLUDE: Definition: Atrial fibrillation (A-fib) is an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots in the heart. A-fib increases the risk of stroke, heart failure and other heart-related complications. Resource: www.mayoclinic.org Patient #2: Record review of the clinical record included a POC with a SOC date 01/01/2022 and a certification period 08/29/2022 to 10/24/2022. The POC included the following diagnoses: Alzheimer’s disease; Atrial Fibrillation and Essential Hypertension. A recertification assessment competed by the DON on 08/24/2022 included on page 24, “… DISHCARGE [SIC] PLANS: Discharge to self/caregiver/family under MD supervision when … skilled services are longer needed…” During a home visit with Patient #2 on 11/09/2022 at approximately 9:05 AM, the patient's home folder was reviewed. The patient was unable to participate in the visit due to “a rough night with the dementia and was sleeping” reported by her family/caregiver. The surveyor asked Patient #2's family/caregiver if any paperwork from the home folder had been removed or placed elsewhere? The caregiver stated nothing was missing. The surveyor found no evidence of a transfer/discharge policy in the home folder for Patient #2. Patient #3: Record review of the clinical record included a POC with a SOC date 03/23/2022 and a certification period 07/21/2022 to 09/18/2022. The POC included the following diagnoses: Heart disease without failure; Type 2 Diabetes and COPD. A recertification assessment competed by the DON on 09/14/2022 included on page 24, “… DISHCARGE [SIC] PLANS: Discharge to self/caregiver/family under MD supervision when, goals met, skilled services are longer needed…” During a home visit with Patient #3 on 11/10/2022 at approximately 11:15 AM, the patient's home folder was reviewed. The surveyor asked Patient #3 if any paperwork from the home folder had been removed or placed elsewhere? Patient #3 stated there was nothing missing. The surveyor found no evidence of a transfer/discharge policy in the home folder for Patient #3. Patient #5: Record review of the clinical record included a POC with a SOC date 04/27/2022 and a certification period 08/25/2022 to 10/23/2022. The POC included the following diagnoses: Heart disease with failure; Type 2 Diabetes; PVD and Hemiplegia affecting left dominant side. A recertification assessment competed by the RN, G on 08/23/2022 included on page 24, “… DISHCARGE [SIC] PLANS: Discharge to self/caregiver/family under MD supervision when, goals met, skilled services are longer needed…” During a home visit with Patient #5 on 11/09/2022 at approximately 9:30 AM, the patient's home folder was reviewed. The surveyor asked Patient #5 if any paperwork from the home folder had been removed or placed elsewhere? Patient #5 stated there was nothing missing. The surveyor found no evidence of a transfer/discharge policy in the home folder for Patient #5. In an interview with the Administrator and DON on 11/10/2022 at approximately 12:30 PM, the surveyor presented the above findings of no transfer/discharge policies provided to patients. The Administrator reviewed the sample home folder and stated the discharge policy was not found and was not given to the patients in advance. Agency policy dated "3Q/2020" and quoted in part, “DISCHARGE PLANNING, POLICY: Discharge planning for all patients will be initiated upon admission. PURPOSE: To involve patient/family in setting goals for care, establish desired outcomes, and assist the patient/caregiver in the safe and effective transition of care to the receiving facility or health care practitioner. PROCEDURE: 1. Discharge planning will be initiated by the RN or therapist upon patient’s admission to service by setting goals. The Patient Education Book, provided to each patient at admission, provides a synopsis of this policy….”