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 757375 (X3) Date Survey Completed 07/07/2025
Name of Provider or Supplier Intense Home Health Inc Street Address, City, State 3786 La Crescenta Ave. Suite 104, Glendale, CA
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)
G0606 Integrate all services
CFR(s): 484.60(d)(3)

Integrate services, whether services are provided directly or under arrangement, to assure the identification of patient needs and factors that could affect patient safety and treatment effectiveness and the coordination of care provided by all disciplines.


This ELEMENT is not met as evidenced by:
Based on interview and record review the Home Health Agency (HHA) failed to ensure a contracted agency who provided patient care communicated concerns and a change of condition for one of seven sampled Patients (Patient 4).

 

This failure resulted in the HHA staff performing wound care without consultation of the Podiatrist (a doctor who specialized in feet).


During a record review of Patient 4’s Home Health Certification and Plan of Care, for certification period 7/11/2024 to 9/8/2024, indicated a primary diagnosis of chronic venous hypertension (high blood pressure in the leg veins). 



During an interview on 7/7/2025, at 12:19 p.m., Patient 4’s caregiver (CGV 1) stated Patient 4 received nursing services for wound care to the right ankle. 



During a concurrent interview and record review on 7/7/2025, at 12:45 p.m., the Director of Patient Care Services (DPCS) reviewed Patient 4’s medical records., to include the plan of care (POC) for certification period 7/11/2024 to 9/8/2024, and the nursing visit notes. The DPCS stated wound care was done to Patient 4’s right ankle on the nursing visit of 7/14/2024. The DPCS stated there was no doctor’s order for wound care. A doctor’s order was important because the order validates what needs to be assessed and what treatment the patient needs. 



During a concurrent interview and record review on 7/7/2025, at 1:06 p.m., the DPCS reviewed Patient 4’s record titled, Comprehensive Adult Nursing Assessment”, dated 7/11/2023. The record indicated, “MD (doctor) ordered HHC (Home Health Agency) to await orders for wound care from DPM” (Podiatrist-foot doctor). The DPCS stated the HHA was supposed to coordinate with the DPM regarding wound care orders. The DPCS stated there was no coordination notes or doctor’s order for wound care. 

 



During a record review of the HHA’s undated document titled, Plan of Care, the document indicated, “12...All other physicians...should be made aware of the services being provided to the patient. The referring physician will be informed of the involvement of additional consulting physicians, when applicable.”