Every finding on record at Samaritin Home Care Provider, Inc

An unannounced Complaint survey, #2024012405 was conducted on 09/12/24 at Samaritin Home Care Provider, Inc, Home Health Agency provider. The provider is not in compliance with Title 42 Code Of Federal Regulations (CFR) Part 484, Subpart A-C, Conditions of Participation for Home Health Agencies. There were two Conditions Of Participation identified in Non-Compliance: CFR 484.100, Compliance With Federal State, And Local Laws (G848) and CFR 484.105, Organization And administration Of Services (G940). The cumulative effect of these systemic practices resulted the Home Health Agency's inability to ensure that their patients' nursing needs would be met.

Compliance with Federal, State, Local Law CFR(s): 484.100 Condition of participation: Compliance with Federal, State, and local laws and regulations related to the health and safety of patients. The HHA and its staff must operate and furnish services in compliance with all applicable federal, state, and local laws and regulations related to the health and safety of patients. If state or local law provides licensing of HHAs, the HHA must be licensed. This CONDITION is not met as evidenced by: Based on record review and observation, the Home Health Agency (HHA): Failed to comply with Federal and State Law related to the health and safety of patients resulting a finding of Medicaid Fraud and actions contributing to the death of Patient #1 in December 2023 (G0848) and (G0860). The findings include: Review of documentation reveals that on September 12, 2024, Law Enforcement charged the Alternate Administrator and Skilled Nurse #1 with actions contributing to the death of Patient #1 and Medicaid Fraud. Further review reveals that Patient #1 a non-verbal, medically fragile child, immobilized from the waist down, was to receive consistent Skilled Nursing services for tracheostomy (a tube placed in the trachea) care and tube feedings via a gastrostomy (tube placed through the abdominal wall directly into the stomach). Continued review reveals that SN #1 was to provide Skilled Nursing Services 24 hours a day/ Seven days a week including nutrition, food, medicine, medical services, home delivery of equipment and supplies. Continued review reveals that the HHA billed Medicaid for services that the HHA did not provide from September 2023 to January 2024. Further review reveals documentation that on 12/25/2023 at 2037 (8:37 PM), Patient #1 was brought to a hospital Emergency Room (ER) by Emergency Medical Services personnel who were unable to start an Intravenous (IV) line, obtain a pulse or cardiac activity after receiving a call stating Patient #1was “showing weakness, weak throughout the day.” Upon arrival to the ER, Patient #1 was in Cardio-Pulmonary arrest, “emaciated, extremely cool to the touch, with stiff extremities…has been dead for quite some time… as such resuscitation was ended. Time of death 2041 (8:41 PM).” Review of documentation reveals that Patient #1 weighed 46 pounds in May 2022 and 7 pounds at the time of death. Review of documentation reveals that on September 12, 2024, Law Enforcement charged the HHA's Alternate Administrator with Aggravated Manslaughter Of A Child, Felony Murder In The Third Degree, Neglect Of A Child and Medicaid Provider Fraud; Skilled Nurse #1 with Murder In The First Degree, Aggravated Child Abuse, Aggravated Manslaughter Of A Child, Felony Murder In The Third Degree, Neglect OF A Child and Medicaid Provider Fraud contributing to the death of Patient #1. The HHA's Alternate Administrator and Skilled Nurse #1 were arrested and jailed without bond on September 12, 2024.

Licensing CFR(s): 484.100(b) (b) Standard: Licensing. The HHA, its branches, and all persons furnishing services to patients must be licensed, certified, or registered, as applicable, in accordance with the state licensing authority as meeting those requirements. This STANDARD is not met as evidenced by: Based on record review and observation, the Home Health Agency (HHA) failed to comply with Federal and State Law related to the health and safety of patients resulting a finding of Medicaid Fraud The findings include: Review of documentation reveals that on September 12, 2024, Law Enforcement charged the Alternate Administrator and Skilled Nurse #1 with actions contributing to the death of Patient #1 and Medicaid Fraud. Further review reveals that Patient #1 a non-verbal, medically fragile child, immobilized from the waist down, was to receive consistent Skilled Nursing services for tracheostomy (a tube placed in the trachea) care and tube feedings via a gastrostomy (tube placed through the abdominal wall directly into the stomach). Continued review reveals that SN #1 was to provide Skilled Nursing Services 24 hours a day/ Seven days a week including nutrition, food, medicine, medical services, home delivery of equipment and supplies. Continued review reveals that the HHA billed Medicaid for services that the HHA did not provide from September 2023 to January 2024. Further review reveals documentation that on 12/25/2023 at 2037 (8:37 PM), Patient #1 was brought to a hospital Emergency Room (ER) by Emergency Medical Services personnel who were unable to start an Intravenous (IV) line, obtain a pulse or cardiac activity after receiving a call stating Patient #1was “showing weakness, weak throughout the day.” Upon arrival to the ER, Patient #1 was in Cardio-Pulmonary arrest, “emaciated, extremely cool to the touch, with stiff extremities…has been dead for quite some time… as such resuscitation was ended. Time of death 2041 (8:41 PM).” Review of documentation reveals that Patient #1 weighed 46 pounds in May 2022 and 7 pounds at the time of death. Review of documentation reveals that on September 12, 2024, Law Enforcement charged the HHA's Alternate Administrator with Aggravated Manslaughter Of A Child, Felony Murder In The Third Degree, Neglect Of A Child and Medicaid Provider Fraud; Skilled Nurse #1 with Murder In The First Degree, Aggravated Child Abuse, Aggravated Manslaughter Of A Child, Felony Murder In The Third Degree, Neglect OF A Child and Medicaid Provider Fraud contributing to the death of Patient #1.The HHA's Alternate Administrator and Skilled Nurse #1 were arrested and jailed without bond on September 12, 2024.

Organization and administration of services CFR(s): 484.105 Condition of participation: Organization and administration of services. The HHA must organize, manage, and administer its resources to attain and maintain the highest practicable functional capacity, including providing optimal care to achieve the goals and outcomes identified in the patient's plan of care, for each patient's medical, nursing, and rehabilitative needs. The HHA must assure that administrative and supervisory functions are not delegated to another agency or organization, and all services not furnished directly are monitored and controlled. The HHA must set forth, in writing, its organizational structure, including lines of authority, and services furnished. This CONDITION is not met as evidenced by: Based on observation and document review, the Home Health Agency failed to: Ensure the organization, management, and administration of its resources to attain and maintain the highest practicable functional capacity, including providing optimal care to achieve the goals and outcomes identified in the patient's plan of care, for each patient's medical, nursing, and rehabilitative needs (G0940) and Ensure that the Governing Body's Appointed Administrator and Alternate Administrator managed the day-to-day operations of the Home Health Agency (G0948). The actions of the Administrator, the Alternate Administrator and the Home Health Agency's Nurse resulted in a finding by Law Enforcement of Medicaid Fraud and contributed to the death of Patient #1 in December 2023, who was under the care of the Home Health Agency. The cumulative effect of these systemic practices resulted the Home Health Agency's inability to ensure that their patients' nursing needs would be met.

Responsible for all day-to-day operations CFR(s): 484.105(b)(1)(ii) (ii) Be responsible for all day-to-day operations of the HHA; This ELEMENT is not met as evidenced by: Based on observation and record review, the Home Health Agency (HHA)'s Administrator failed to be responsible for the day-to-day operations of the HHA. The findings include: Review of documentation reveals that on September 12, 2024, Law Enforcement charged the Alternate Administrator and Skilled Nurse #1 with actions contributing to the death of Patient #1 and Medicaid Fraud. Further review reveals that Patient #1 a non-verbal, medically fragile child, immobilized from the waist down, was to receive consistent Skilled Nursing services for tracheostomy (a tube placed in the trachea) care and tube feedings via a gastrostomy (tube placed through the abdominal wall directly into the stomach). Continued review reveals that SN #1 was to provide Skilled Nursing Services 24 hours a day/ Seven days a week including nutrition, food, medicine, medical services, home delivery of equipment and supplies. Continued review reveals that the HHA billed Medicaid for services that the HHA did not provide from September 2023 to January 2024. Further review reveals documentation that on 12/25/2023 at 2037 (8:37 PM), Patient #1 was brought to a hospital Emergency Room (ER) by Emergency Medical Services personnel who were unable to start an Intravenous (IV) line, obtain a pulse or cardiac activity after receiving a call stating Patient #1was “showing weakness, weak throughout the day.” Upon arrival to the ER, Patient #1 was in Cardio-Pulmonary arrest, “emaciated, extremely cool to the touch, with stiff extremities…has been dead for quite some time… as such resuscitation was ended. Time of death 2041 (8:41 PM).” Review of documentation reveals that Patient #1 weighed 46 pounds in May 2022 and 7 pounds at the time of death. Review of documentation reveals that on September 12, 2024, Law Enforcement charged the HHA's Alternate Administrator with Aggravated Manslaughter Of A Child, Felony Murder In The Third Degree, Neglect Of A Child and Medicaid Provider Fraud; Skilled Nurse #1 with Murder In The First Degree, Aggravated Child Abuse, Aggravated Manslaughter Of A Child, Felony Murder In The Third Degree, Neglect OF A Child and Medicaid Provider Fraud contributing to the death of Patient #1. The HHA's Alternate Administrator and Skilled Nurse #1 were arrested and jailed without bond on September 12, 2024. On 09/12/24 at 11:09 AM, observation reveals the HHA’s office location door had a sign with their business hours listed as 9:00 AM to 5:00 PM Monday through Friday and on-call 24 hours; the door had a metal box hung from the door labeled, “Nurses notes drop box” (Photographic evidence). On 09/12/24 at 11:09 AM, the surveyor knocked at the HHA’s locked office location door and received no answer. On 09/12/24 at 11:10 AM, at 11:12 AM, at 11:22 AM, at 11:36 and at 11:39 AM, a telephone call was made to the HHA’s telephone number listed on file and observed on the HHA’s office door (954-894-4244); the telephone did not ring and a voice recorded message was activated that states, “Please leave your message for”, no name was mentioned, people talking in the background was heard, then another recorded message came on and states, “Sorry the mailbox is full." On 09/12/24, observation from 11:09 AM through 11:39 AM, reveals no HHA staff members came to the HHA’s door, and no one opened the HHA’s door to allow entrance. On 09/12/24 at 1:33 PM and 1:34 PM, a telephone call was made to the Administrator’s telephone number on the Agency for Health Care Administration (AHCA)’s Home Care Licensing Application dated as "received Mar (March) 21, 2023;" the telephone did not ring, a voice recorded message was activated and states, “Please leave your message for (Administrator’s Name)” then another recorded message came on and states, “Sorry the mailbox is full."

Available during all operating hours CFR(s): 484.105(b)(3) The administrator or a pre-designated person is available during all operating hours. This ELEMENT is not met as evidenced by: Based on observation, and record review, the Home Health Agency (HHA) failed to ensure that the Home Health Agency's Administrator and Director Of Nursing, or their Alternates, were available during the HHA's operating hours Monday through Friday, 9:00 AM to 5:00 PM or that the HHA's staff person was available to answer the telephone and the HHA's office door. The findings included: Review of documentation reveals that on September 12, 2024, Law Enforcement charged the Alternate Administrator and Skilled Nurse #1 with actions contributing to the death of Patient #1 and Medicaid Fraud. Further review reveals that Patient #1 a non-verbal, medically fragile child, immobilized from the waist down, was to receive consistent Skilled Nursing services for tracheostomy (a tube placed in the trachea) care and tube feedings via a gastrostomy (tube placed through the abdominal wall directly into the stomach). Continued review reveals that SN #1 was to provide Skilled Nursing Services 24 hours a day/ Seven days a week including nutrition, food, medicine, medical services, home delivery of equipment and supplies. Continued review reveals that the HHA billed Medicaid for services that the HHA did not provide from September 2023 to January 2024. Further review reveals documentation that on 12/25/2023 at 2037 (8:37 PM), Patient #1 was brought to a hospital Emergency Room (ER) by Emergency Medical Services personnel who were unable to start an Intravenous (IV) line, obtain a pulse or cardiac activity after receiving a call stating Patient #1was “showing weakness, weak throughout the day.” Upon arrival to the ER, Patient #1 was in Cardio-Pulmonary arrest, “emaciated, extremely cool to the touch, with stiff extremities…has been dead for quite some time… as such resuscitation was ended. Time of death 2041 (8:41 PM).” Review of documentation reveals that Patient #1 weighed 46 pounds in May 2022 and 7 pounds at the time of death. Review of documentation reveals that on September 12, 2024, Law Enforcement charged the HHA's Alternate Administrator with Aggravated Manslaughter Of A Child, Felony Murder In The Third Degree, Neglect Of A Child and Medicaid Provider Fraud; Skilled Nurse #1 with Murder In The First Degree, Aggravated Child Abuse, Aggravated Manslaughter Of A Child, Felony Murder In The Third Degree, Neglect OF A Child and Medicaid Provider Fraud contributing to the death of Patient #1. The HHA's Alternate Administrator and Skilled Nurse #1 were arrested and jailed without bond on September 12, 2024. On 09/12/24 at 11:09 AM, observation reveals the HHA’s office location door had a sign with their business hours listed as 9:00 AM to 5:00 PM Monday through Friday and on-call 24 hours; the door had a metal box hung from the door labeled, “Nurses notes drop box” (Photographic evidence). On 09/12/24 at 11:09 AM, the surveyor knocked at the HHA’s locked office location door and received no answer. On 09/12/24 at 11:10 AM, at 11:12 AM, at 11:22 AM, at 11:36 and at 11:39 AM, a telephone call was made to the HHA’s telephone number listed on file and observed on the HHA’s office door (954-894-4244); the telephone did not ring and a voice recorded message was activated that states, “Please leave your message for”, no name was mentioned, people talking in the background was heard, then another recorded message came on and states, “Sorry the mailbox is full." On 09/12/24, observation from 11:09 AM through 11:39 AM, reveals no HHA staff members came to the HHA’s door, and no one opened the HHA’s door to allow entrance. On 09/12/24 at 1:33 PM and 1:34 PM, a telephone call was made to the Administrator’s telephone number on the Agency for Health Care Administration (AHCA)’s Home Care Licensing Application dated as "received Mar (March) 21, 2023;" the telephone did not ring, a voice recorded message was activated and states, “Please leave your message for (Administrator’s Name)” then another recorded message came on and states, “Sorry the mailbox is full."