Every finding on record at Prospect Homecare Agency

An unannounced Home Health Agency complaint investigation #VA00051240 (#35335) was conducted on October 13, 2021 at the above captioned agency by one Medical Facilities Inspector from The Office of Licensure and Certification, Virginia Department of Health. The agency reported an unduplicated census of 539 in the last twelve (12) months with a current census of 76. In conjunction with the survey, five (5) clinical records, the complaint log and the admission packet were reviewed. One interview was conducted. The complaint was unsubstantiated with unrelated deficiencies cited. The agency was found to be out of compliance with 42 CFR 484, Conditions of Participation for Home Health Agencies (HHAs).

Participate in care CFR(s): 484.50(c)(4)(i,ii,iii,iv,v,vi,vii,viii) Participate in, be informed about, and consent or refuse care in advance of and during treatment, where appropriate, with respect to-- (i) Completion of all assessments; (ii) The care to be furnished, based on the comprehensive assessment; (iii) Establishing and revising the plan of care; (iv) The disciplines that will furnish the care; (v) The frequency of visits; (vi) Expected outcomes of care, including patient-identified goals, and anticipated risks and benefits; (vii) Any factors that could impact treatment effectiveness; and (viii) Any changes in the care to be furnished. This ELEMENT is not met as evidenced by: Based on interviews and document review, it was determined the agency failed to ensure that patients were informed about and consented to the frequency of proposed visits in advance of starting care in two (2) of five (5) clinical records reviewed in the survey sample (clinical record #'s 1 and 3). The findings were: The electronic clinical records were reviewed onsite on October 13, 2021. The consent for care for clinical record #1 and #3 failed to contain documentation of the frequency of visits to be provided by any of the disciplines providing care. The admitting clinician put a check mark next to the discipline to provide services but failed to fill in the blank line provided for visit frequency. An interview with the Compliance Officer on October 13, 2021 at 11:45 PM revealed the consents in question had been reviewed and the nurse involved had been counseled and no longer worked at the agency.

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 review of clinical records and staff interviews, it was determined the agency failed to provide a Notice of Medicare Non-Coverage (NOMNC) to Medicare patients in advance of terminating care for one (1) of one (1) closed/discharge clinical records reviewed in the survey sample for which a NOMNC was applicable. (clinical record #3). The findings were: Clinical record #3 contained a plan of care to include skilled nursing visits for 3 times per week for 8 weeks. The skilled nurse made visits for 3 times a week for 4 weeks and 1 time a week to discharge the patient on the following week (week of 4/11/2021). The nurse failed to provide advance notice of terminating care early. An interview was conducted with the compliance officer on 10/13/2021 at 11:15 AM. The compliance officer reviewed the record and was unable to locate a NOMNC.