Every finding on record at Best Home Health & Hospice LLC

Based on observation, medical record review, patient interview, staff interview, and review of State Agency correspondence, the agency failed to gain approval from Medicare before providing hospice care and services to Medicare patients at a multiple location for 2 of 3 active patients (#2, #3). The findings were: --- Observation during a home visit on 8/27/24 at 10:30 am with RN #2 and patient #3 showed routine hospice care was provided to the patient and his/her family. Observation on 8/27/24 at noon showed the agency had an additional location in Rawlins, Wyoming (WY) that operated as part of the Evanston, Wyoming location. Review of the medical record for patient #2 showed s/he had elected hospice care on 7/20/24, lived in Rawlins, WY, had received hospice care and services from the agency and was a Medicare beneficiary. Review of the medical record for patient #3 showed s/he had elected hospice care on 8/19/24, lived in Rawlins, WY, had received hospice care and services from the agency and was a Medicare beneficiary. Interview with patient #3 during a home visit on 8/27/24 at 10:40 am confirmed s/he had received nursing care and home health aide services under the agency's hospice program. Interview with the hospice administrator on 8/26/24 at 1:55 pm confirmed the agency provided hospice services in Rawlins, WY and there were 3 active hospice patients residing at that location. Interview with Registered Nurse #2 on 8/27/24 at 11:45 am confirmed she worked for the hospice and utilized the Rawlins, WY office to conduct hospice business. Interview with office staff #1 on 8/27/24 at 12:16 pm confirmed she worked out of the Rawlins office and conducted hospice business from that office. Interview with the Director of Nursing on 8/29/24 at 10:20 am verified the Evanston location provided the required support to the Rawlins location as required. Review of State Survey Agency correspondence showed no evidence the hospice had submitted a CMS-855 to the Centers for Medicare and Medicaid Services Medicare Area Contractor (MAC) for a multiple location in Rawlins, WY.