Every finding on record at Perspective Home Health Inc

A Recertification survey was conducted by Healthcare Management Solutions, LLC, on behalf of the Nevada Health Authority. The survey conducted from 05/04/2026 to 05/06/2026 resulted in a finding of substantial compliance respective to the Emergency Preparedness Program Condition of Participation under 42 CRF 484.102.

A Recertification and Complaint Survey was conducted by Healthcare Management Solutions, LLC on behalf of the Nevada Health Authority. The survey conducted from 05/04/2026 to 05/06/2026 resulted in a finding of substantial compliance respective to the applicable Condition of Participation (CoP) under 42 CFR 484, Subparts A through C with the following standard-level deficiencies. Sample Size: 17 There were four complaints investigated. Complaint 2625983 was unsubstantiated. Complaint 2564262 was substantiated (See Tag G610). Complaint 106491 was unsubstantiated. Complaint 70735 was unsubstantiated.

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 document review, policy review, and interview, the agency failed to ensure Outcome and Assessment Information Set (OASIS) records were submitted to the internet Quality Evaluation and Improvement System (iQIES) within 30 days after completion of each assessment. The deficient practice resulted in non-compliance with federal regulations that require agencies to encode and transmit OASIS records within 30 days after completion. Findings include: (For Submission Only) Review of the HHA "Error Summary Report" located with the "Internet Quality Improvement and Evaluation System (iQIES)" reports dated 05/01/2026 revealed, the HHA had been non-compliant with CMS requirements as evidenced by the late transmissions of OASIS. Review of the iQIES agency report of "OASIS" assessments, revealed OASIS data was not transmitted to CMS within thirty days of completing the assessment for the following quarters: 120 of 690 OASIS assessments submitted during Quarter 1 of 2025, 88 of 636 OASIS assessments submitted during Quarter 3 of 2025, and 100 of 712 OASIS assessments submitted during Quarter 4 of 2025. Review of the agency’s policy titled, "Reporting of OASIS Information" dated 03/2019, approved by the Administrator and Registered Nurse/Director of Patients Care Services on 01/06/2026, revealed, "The agency will report electronically all OASIS data according to current federal and/or state requirements. Agency must encode and have the capability of transmitting OASIS data for each patient within thirty (30) days of completing any required OASIS data set assignment. The Agency will periodically conduct clinical and data entry audits to verify that collected OASIS data is consistent with reported OASIS data." Review of the CMS "Home Health (HH) Quality Reporting Program (QRP) Quick Reference Guide" dated 04/25/2024, located at https://www.cms.gov/files/document/pac-hh-quickreferenceguide-20240425.pdf indicated, OASIS data must be transmitted within 30 days of the assessment date. During an interview on 05/05/2026 at 3:40 PM, the Administrator confirmed the OASIS data had late entries. The Administrator revealed audits were conducted on a biweekly basis to see if there were any outstanding flags for inconsistencies and ensures accurate. However, there were no documented audits. Review of the Home Health Error Summary Report, dated 05/01/2026 (from the iQIES database), revealed the agency had multiple timeframes in which OASIS were not submitted as required. According to the report, the agency submitted late OASIS records as follows: During the third quarter of Calendar Year 2025, a total of 13.8% (88 of 636) OASIS records were transmitted more than 30 days after the completion date. During the fourth quarter of Calendar Year 2025, a total of 14.0% (100 of 712) OASIS records were transmitted more than 30 days after the completion date. During the first quarter of Calendar Year 2026, a total of 17.4% (120 of 690) OASIS records were transmitted more than 30 days after the completion date. The agency’s policy, "Reporting of OASIS Information" dated 03/2019, approved by the Administrator and Director of Patient Care Services on 01/06/2026, indicated "The agency will report electronically all OASIS data according to current federal and/or state requirements. Agency must encode and have the capability of transmitting OASIS data for each patient within thirty (30) days of completing any required OASIS data set assignment. The Agency will periodically conduct clinical and data entry audits to verify that collected OASIS data is consistent with reported OASIS data." On 05/05/2026 at 3:40 PM during an interview, the Administrator confirmed OASIS data had been entered late. The Administrator indicated audits were conducted on a bi-weekly basis to see if there were any outstanding flags for inconsistencies and to ensure accuracy. The Administrator was unable to produce documentation of any completed audits.

HHA administrator contact information CFR(s): 484.50(a)(1)(ii) (ii) Contact information for the HHA administrator, including the administrator's name, business address, and business phone number in order to receive complaints. This ELEMENT is not met as evidenced by: Based on interview and document review the agency failed to provide patients and/or representatives with the name of the HHA's Administrator, the Administrator's business address, and the Administrator's business phone number so patients and/or representatives could voice concerns or complaints for three of three home visits with patients (Patient (P)1, P2, and P17). This deficient practice had the potential to place all patients and/or their representatives at risk of having a complaint or concern and not knowing who to speak with to voice their concerns. Findings include: Review of the HHA's admission packet, (undated) failed to include the Administrator's name for patients and/or their representatives to contact if they have a complaint or concern. On 05/05/2026 at 11:00 AM during a home visit, P1 revealed they were not provided with contact information for the Administrator if they had a concern or complaint. On 05/06/2026 at 2:30 PM during a home visit, P2 revealed they were not provided with contact information for the Administrator if they had a concern or complaint. On 05/06/2026 at 12:30 PM during a home visit, P17 revealed they were not provided with contact information for the Administrator if they had a concern or complaint. On 05/06/2026 at 2:30 PM, the Administrator confirmed the HHA failed to include the Administrator's name in the admission packet for patients and/or their representatives to contact if they have a complaint or concern regarding the HHA's care.

Coordinate care delivery CFR(s): 484.60(d)(4) Coordinate care delivery to meet the patient's needs, and involve the patient, representative (if any), and caregiver(s), as appropriate, in the coordination of care activities. This ELEMENT is not met as evidenced by: Based on interview, record review, document review, and policy review, the Home Health Agency (HHA) failed to ensure coordination of care delivery was provided to 1 of 12 patients (Patient (P)6) related to infusion therapy provided by an outside service company to meet the patient’s needs. The failure to coordinate and provide oversight of the outside service had the potential to place patients at risk for negative outcomes. Findings include: P6’s "Outcome and Assessment Information Set (OASIS) Resumption of Care (ROC)” assessment dated 04/22/2025 for the certification period of 04/13/2025-06/11/2025 revealed diagnoses including chronic kidney disease, chronic pancreatitis, cholestasis (decreased bile flow), pulmonary embolism, and dehydration. The ROC "Assessment Summary" dated 04/22/2025 included from Registered Nurse (RN)4 revealed, "Received a call from patients inpatient nephrologist who stated he is ordering IV [intravenous] hydration with 1000ML [milliliters] of LR [lactated ringers-used to replace water and electrolyte loss in patients with low blood pressure] via IV to be done twice a week x [times] 4 weeks at home. Order will be faxed to the office for review." The ROC assessment, last section, no title, following the section of "Verbal Orders" included the frequency of nursing visits, one time a week for eight weeks and one PRN (as needed), and responsibilities of the nurse regarding care and services to the patient. Administration of IV therapy was not included as a service. Nursing Progress Notes dated 04/28/2025, 05/15/2025, 05/22/2025 and 05/26/2025 did not include administration of IV therapy. The Nursing Progress Note on 06/11/2025 included "IV Therapy Administered." A Care Coordination Plan from the (name) infusion company dated 06/09/25 provided by the Intake Coordinator revealed a delineation of responsibilities for the (name) infusion company and those to be completed by the HHA. Responsibilities of the infusion company included but not limited to "Ongoing communication/Patient Care Conferences." There was no care coordination between 04/22/25, the date when the nephrologist first ordered IV hydration up until 06/11/25 when the first day the IV therapy was administered to P6. On 05/04/2026 at 11:00 AM, the Administrator confirmed there was no coordination of care between the infusion companies and the HHA and that P6 missed several days of ordered IV therapy. The Administrator revealed this agency performs skilled care and therapies. The Administrator did not provide policies and procedures, nor an agreement or contract with the infusion companies. The agency’s policy titled, "Coordination of Patient Care" dated 03/2019, approved by the Administrator and Registered Nurse/Director of Patients Care Services on 01/06/2026, revealed, "Integrate services, whether services are provided directly or under arrangement, to assure the identification of patient needs and factors that could affect patient safety and treatment effectiveness and the coordination of care provided by all disciplines."

Patients receive education and training CFR(s): 484.60(d)(5) Ensure that each patient, and his or her caregiver(s) where applicable, receive ongoing education and training provided by the HHA, as appropriate, regarding the care and services identified in the plan of care. The HHA must provide training, as necessary, to ensure a timely discharge. This ELEMENT is not met as evidenced by: Based on record review, interview, and policy review, the agency failed to ensure 1 of 17 sampled patients (Patient (P)6) received education and training by the HHA regarding the procedures to follow if complications arose during intravenous (IV) infusion therapy. This had the potential to create a medical complication. Findings include: P6’s Home Health Certification and Plan of Care dated 06/09/2025 for the certification period of 06/12/2025 to 08/10/2025 included diagnoses of "encounter for change or removal of drains [biliary duct drain], chronic pancreatitis, and chronic kidney disease." P6’s "60 Day Summary" included on the "Home Health Certification and Plan of Care" dated 06/09/2025 revealed P6 was unable to safely and effectively provide their own biliary duct drain care and PICC [peripherally inserted central catheter] line care due to the location, poor compliance with proper infection control measures, poor living conditions, and hx [history] of infections when care is under patient. There was no documentation in the electronic medical record P6 could demonstrate procedures to implement in case of an emergency related to the IV infusion when left alone. On 05/06/2026 at 2:34 PM, Registered Nurse (RN)5 revealed performing a lot of teaching/education and P6 was not grasping the information. RN5 revealed staying with P6 to administer IV therapy for one to two hours, left, and returned later to disconnect P6's IV. On 05/06/2026 at 4:54 PM the Administrator revealed there was no policy that a Nurse could not leave a patient during an IV infusion. The best practice is if the patient is able to demonstrate knowledge of emergencies related to the IV. There was no documentation that P6 demonstrated knowledge of what to do in the event of an emergency while the IV infusion was running and they were home alone. There was no documentation was provided information if they had a need while waiting for a return visit from the Nurse to unhook the IV. Coordination of patient care was not provided during the four-hour time frame when the nurse departed the home of P6 while the IV infusion was running. There was no responsible person to assist in case of an emergency. Review of the agency’s policy titled, “Coordination of Patient Care” dated 01/2026, revealed Integrate services, whether services are provided directly or under arrangement, to assure the identification of patient needs and factors that could affect patient safety and treatment effectiveness and the coordination of care provided by all disciplines.