Every finding on record at Pristine Home Health Inc

The following reflects the findings of the California Department of Public Health during the investigation of a complaint: #71818 The inspection was limited to the specific complaint investigated and does not represent the findings of a full inspection of the facility. One deficiency was issued as a result of complaint investigation #71818 Representing the California Department of Public Health: Health Facilities Evaluator Nurse: 44916

Ensure that HHA employs qualified personnel CFR(s): 484.105(b)(1)(iv) (iv) Ensure that the HHA employs qualified personnel, including assuring the development of personnel qualifications and policies. This ELEMENT is not met as evidenced by: Based on observations, interviews and record reviews, the home health agency failed to follow their standard policy for hiring data entry/QA personnel. This failure had the potential for the inaccuracy of entering information on the plan of care. Findings: An unannounced visit to the home health agency for the investigation of this complaint on 9/29/22 at 9:15 a.m. During an interview on 9/29/22 at 9:58 a.m., with the Administrator (Admin), Admin stated that the agency has 2 QA (quality assurance- QA 1 and QA 2) for the data entry of the plan of care. Admin further stated that she checks the data entered on the plan of care (485) by the 2 QA personnel before submitting to CMS (Center for Medicare/Medicaid Services) for reimbursement. During the employee files review on 9/29/22, indicated that QA 1 was employed on 03/01/2013. QA 1 had a background in nursing and was computer proficient. No other job experiences noted on application form. During the employee files review on 9/29/22, QA 2 was employed on 06/19/2017. QA 2 had a certificate of attendance from the Board of Medical Specialty Coding and Compliance (refers to the process of ensuring that the coding of diagnosis, procedures and data complies with all coding rules, laws and guidelines or (BMSC) dated 9/20/22. QA 2 also had experience in medical coding since 2010. During an interview with QA 1 on 9/29/22 at 11:52 a.m., QA 1 stated that this is her first job experience. QA 1 further stated that she was trained for 2 years after her employment with the home health agency. During a concurrent interview on 9/29/22 at 11:52 a.m., the Administrator confirmed that she was hired without any coding experience and was trained by the HHA under supervision of another QA for 2 years. A review of the HHA’s document titled “Job Description Summary: Job Title /Position: Data Entry/Computer Operator” signed and dated by QA 1 on 3/1/2013, indicated the data entry/computer operator is responsible for the timely and accurate entry of a variety of data, including patient information, human resource information, and billing and payroll information. Position qualifications at least two year experience in health care data entry, preferably in home health care information systems.