Medicare plans to stop paying a Boise-based home health and hospice agency to care for people on Medicare and Medicaid after the agency failed two inspections.
Saint Alphonsus Home Health and Hospice fell out of compliance with a federal law that requires agencies to “provide services which are sufficient to meet the needs of its patients,” according to a March 17 legal notice by the Centers for Medicare and Medicaid Services.
Inspectors reported an unlicensed nurse and incidents where employees failed to administer drugs and treatments prescribed by patients’ physicians, among other problems.
The agency is a joint venture between Saint Alphonsus and Frontier Home Health and Hospice, a network of agencies in the Mountain West and Alaska. It has been approved to take Medicare patients since 1978 and provided hundreds of visits to Treasure Valley patients in its most recent fiscal year.
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The violations “do not impact patient health and safety,” said Brad Hoaglun, director of communications and public relations for Saint Alphonsus Health System. “The home health agency strongly disagrees with the citations and is in the process of appealing the findings.”
The October inspection report said that “systemic failures seriously impeded the agency’s organizational functioning and negatively impacted the quality, coordination and safety of patient care.” For example, one of the agency’s nurses provided care to 18 home-health patients without a current license.
The agency responded by saying it would check licenses at least monthly, taking workers off the patient schedule until they provide proof that they are licensed.
The December inspection found that, among other problems, Saint Alphonsus Home Health and Hospice did not make sure its staff followed patients’ care plans, which were incomplete. Employees failed to notify doctors of changes in patients’ conditions and did not give drugs and treatments as ordered by doctors, the inspection report said.
“This resulted in unmet patient needs and care provided without physician authorization,” the report said.
The state did another inspection more recently, but that inspection report is not yet public.
The agency filed its appeal Feb. 7, Hoaglun said. If the appeal is denied, the agency would have 30 days from April 3 to transfer patients to new health care providers.
The agency’s quality rating — 3 1/2 out of five stars — is slightly above the national average on the federal Home Health Compare website. More than 300 surveys from patients who received care from the agency between July 1, 2015, and June 30, 2016, gave it a rating slightly below average for Idaho and for the U.S., according to the website.