Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391
Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 017025 (X3) Date Survey Completed 05/12/2022
Name of Provider or Supplier Saad Enterprises, Inc. Street Address, City, State 1515 University Blvd, South, Mobile, AL
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
(X4) ID Prefix Tag Summary Statement of Deficiencies

(Each deficiency should be preceded by full regulatory or LSC identifying information)
G0444 State toll free HH telephone hotline
CFR(s): 484.50(c)(9)

Be advised of the state toll free home health telephone hot line, its contact information, its hours of operation, and that its purpose is to receive complaints or questions about local HHAs.


This ELEMENT is not met as evidenced by:
Based on review of Medical Records (MR), review of the Home Folder Packet, observations from Home Visits (HV), and interviews, it was determined the agency failed to ensure all patients were provided information for the State Hotline Number and grievance process.




This deficient practice affected 6 of 7 HV including HV # 1, HV # 2, HV # 3, HV # 4, HV # 5, HV # 7, and had the potential to affect all patients admitted to this agency.




Findings include:




Agency Policy: Home Folder




Provided to the surveyors on 5/12/22




Date: No date or number on policy




...The patient's home folder should contain the following:




1. Copies of the forms that are signed in the Electronic Medical Record:




a. Patient Bill of Rights - with attention to the Hotline number...




Agency patient form: Saad Healthcare Services.




Patient Disclosure and Notice; Patient's Consent; Patient's Bill of Rights and Responsibilities




Provided to the surveyors on 5/12/22




... C. Patient Bill of Rights (Saad Healthcare agrees to do the following in the performance of the healthcare services): Each person receiving care from Saad Healthcare shall have the right:




...12. To be informed of the State toll free Bureau of Licensure and Certification Hot Line...




















1. A copy of a current admission pack to be provided to patients on admission was provided to the surveyors on 5/10/22 at approximately 10:00 AM.




Review of the new admission pack revealed no statement of the State Hotline Number.




2. In home visits conducted on 5/10/22 and 5/11/22 on HV # 1, HV # 2, HV # 3, HV # 4, HV # 5, and HV # 7 revealed no documentation of the State Hotline Number in either of the patient's home health folders.




In an interview conducted on 5/12/22 at 11:10 AM, Employee Identifier (EI) # 8, Registered Nurse Supervisor, confirmed not all patients had the State Hotline Number in the home. EI # 8 stated the signature sheet with the State Hotline Number had been left out of the new admission packs.