Will I know the results of the investigation?
Yes, that is why it is important that you provide us with your name, address and phone number (including area code). You will receive confirmation that the complaint was received, and you will also receive notification afterward telling you the results of the investigation.
What are the possible outcomes of an investigation and what do they mean?
If the surveyor was able to find sufficient evidence, the complaint will be considered substantiated. If a complaint is substantiated, there are two (2) further determinations that can be made regarding the problems at the home health agency. The first determination that can be made is "substantiated with deficiencies cited." The Department will issue a statement of deficiencies or a list of problems to the agency. The agency must submit a written plan of correction to the Department. The plan tells us how the home health agency intends to prevent a recurrence of the problems in the future. A second determination that can be made is "substantiated with no deficiencies cited." This means that the allegation was true but did not violate any of the state or federal regulations. We are only permitted to issue deficiencies according to the state and federal regulations that we monitor and enforce.
It is not always possible to substantiate allegations due to the passage of time or lack of documentation or observation to support a finding of substantiation. This does not mean that the complaint was not true, it simply means we could not find enough evidence to substantiate it at the time of the investigation. Please be assured that we will continue to review all complaint issues when we visit the home health agency in the future.
What happens if deficiencies are found at a home health agency?
For every deficiency identified, the surveyor must decide how serious the problem is for the patients. The surveyor writes a description of the problem(s), which is then called a "statement of deficiencies," and submits it to the home health agency. The home health agency must respond in writing with their proposed solution to the problem(s). This is called a "plan of correction (POC)." You can ask to see a copy of this report from any home health agency. You can also review these reports on the Department of Health's website by clicking here and choosing the county where the agency is located.
Depending on the seriousness of the deficiencies, different consequences may be given to the home health agency. If the problem(s) is/are very severe, the department may revoke the home health agency's license to prevent them from providing care to patients. If the problem(s) is/are less severe, the department may issue a statement of deficiencies and request a plan of correction which allows the home health agency to continue to operate while the department monitors areas in which improvements must be made to ensure the health and safety of the patients.
Another action that can be taken is to have the home health agency lose its ability to participate in the federal Medicare or state Medicaid programs. The home health agency would lose funding from these programs if the agency's services do not meet the minimum state and federal regulations.