Every finding on record at Revolutionary Home Health Inc

Based on the findings of an unannounced onsite Medicare complaint survey conducted onsite September 6, 2022 and completed offsite September 7, 2022, Revolutionary Home Health, Inc. was found not to be in compliance with the following requirements of 42 CFR, Part 484, Subparts B and C, Conditions of Participation: Home Health Agencies.

Standard: Initial assessment visit. CFR(s): 484.55(a) Standard: Initial assessment visit. This STANDARD is not met as evidenced by: Based on a review of agency policy, review of clinical records, and an interview with the agency Administrator, the agency failed to complete the initial assessment visit within 48 hours of referral, or within 48 hours of the patients return home, or on the physician-ordered start of care date, for two (2) of two (2) clinical record referrals reviewed (CR#1, CR#2). Findings: A review of agency Policy/Procedure was conducted on September 7, 2022 at approximately 3:00 p.m. Policy No. 2-004.1, 'Intake Process' 'Procedure' (5.D) "The initial visit will be perfromed either within 48 hours of the referral, or within 48 hours of a patients return home, or on the start of care date orderd by the authorized licensed independent practitioner." A review of clinical records completed on September 7, 2022 at approximately 2:00 p.m. revealed the following: CR#1 SOC 07/11/22: This patient is the subject of the complaint. Referral from (hospital) for skilled nursing services on 06/23/22. No patients return home specified nor physician ordered start of care date specified. Documentation of initial assessment visit by registered nurse on 07/11/21. CR#2 SOC 06/07/22: Referral from (skilled nursing facility) for skilled nursing services, physical therapy, and occupational therapy on 06/02/22. No patients return home specified nor physician ordered start of care date specified. Documentation of initial assessment visit by registered nurse visit on 06/07/22. A telephone interview conducted with the agency Administrator on September 7, 2022 at approximately3:30 p.m. confirmed the above findings.

Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician or allowed practitioner refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician or allowed practitioner is consulted to approve additions or modifications to the original plan. This STANDARD is not met as evidenced by: Based on a review of agency policy, review of clinical records, and an interview with the agency Administrator, the agency failed to provide skilled nursing services, in accordance with the written orders of the physician, for one (1) of two (2) clinical records (CR) reviewed (CR#1). Findings: Agency Policy/Procedure for notifying physician of missed visits was requested on September 7, 2022 at approximately 3:00 p.m. No policy provided. A review of clinical records completed on September 7, 2022 at approximately 2:00 p.m. revealed the following: CR#1 SOC 07/11/22: This patient is the subject of the complaint. Certification period 07/11/22-09/08/22 reviewed. 'Orders for Discipline and Treatments' list "SN: Start on 06/28/22" 1xwk x 1 wk, 1xday x 1 day, 3x wk x 1 wk, PRN x6 complications/med changes." Addendum frequency order dated 07/27/22 list "SN:1xwk x 1 wk (07/29/22-07/29/220, 3x wk x 6 wks (07/30/22-09/08/22)." No documentation provided of three (3) skilled nursing visits being provided, as ordered by the physician, for the week of 08/27/22- 09/02/21. Documentation provided of one (1) skilled nurse visit on 08/29/22. No documentation provided of the physician being notified of the missed skilled nurse visits. A telephone interview conducted with the agency Administrator on September 7, 2022 at approximately 3:30 p.m. confirmed the above findings.