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 757737 (X3) Date Survey Completed 03/19/2026
Name of Provider or Supplier Alaunus Home Health, Inc Street Address, City, State 110 S Rosemead Blvd. Suite R4, Pasadena, 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)
G0570 Care planning, coordination, quality of care
CFR(s): 484.60

Condition of participation: Care planning, coordination of services, and quality of care. Patients are accepted for treatment on the reasonable expectation that an HHA can meet the patient's medical, nursing, rehabilitative, and social needs in his or her place of residence. Each patient must receive an individualized written plan of care, including any revisions or additions. The individualized plan of care must specify the care and services necessary to meet the patient-specific needs as identified in the comprehensive assessment, including identification of the responsible discipline(s), and the measurable outcomes that the HHA anticipates will occur as a result of implementing and coordinating the plan of care. The individualized plan of care must also specify the patient and caregiver education and training. Services must be furnished in accordance with accepted standards of practice.


This CONDITION is not met as evidenced by:
Based on observation, interview and record review, the Home Health Agency (HHA, an organization that delivers skilled nursing and other therapeutics service to a patient at home) failed to meet the Condition of Participation (conditions that healthcare organizations must meet in order to participate in federally funded healthcare programs) for Care Planning, Coordination of Services and Quality of Care as follows:


 

The HHA failed to ensure the plan of care (POC, a detailed, written document outlining the services and support an individual needs to meet their healthcare goals) was individualized that addressed the treatment needs for three of seven sampled patients (Patient 1, Patient 5, and Patient 6).

 

This failure resulted in Patient 1, Patient 5, and Patient 6 receiving home health services without a detailed, patient specific plan of care that included management of their medical conditions and/or diagnosis that could lead to declination of health condition and hospitalization of the patients. (Refer to G574)

 

The cumulative effect of these systemic practices resulted in the failure of the HHA to deliver statutorily (written law) mandated compliance with Federal regulation for Care Planning, Coordination, and Quality of Care to ensure the highest quality of care were being provided to patients certified to receive home health care and services.