Failure to Ensure Timely Payment for Essential Services
Summary
The facility failed to comply with Federal, State, and Local laws and professional standards by not ensuring timely payment for goods and services necessary for daily operations. A review of the facility's accounts payable ledger revealed numerous outstanding balances for more than 121 days beyond the terms of payment. These unpaid invoices included essential services and supplies from various vendors, such as medical equipment, pharmacy services, and utility providers, which are critical for maintaining the health and safety of the residents. During an interview, the Nursing Home Administrator confirmed that the facility owners had not provided evidence of payments or payment agreements for these outstanding invoices. This lack of timely payment for essential goods and services demonstrates non-compliance with regulations that require facilities to pay bills promptly to prevent jeopardizing the health and safety of residents.
Plan Of Correction
1. There are no goods or services that are being withheld from the residents due to the status of the A/P liabilities of River View Nursing and Rehabilitation Center. 2. The facility will systematically work to make payments on cited delinquent balances not in dispute, using discretion to ensure that current, essential vendors are paid then paying down cited delinquent balances. 3. The Regional Director of Operations Consultant will educate NHA on the monthly AP/Aging report to ensure vital services are not interrupted. 4. NHA will audit the monthly AP/Aging report monthly for 3 months to ensure vital services are not interrupted due to the status of A/P liabilities. Results of the monthly audits will be submitted to the QAPI Committee for review.
Penalty
The facility failed to pay outstanding invoices to a staffing agency, leading to the withdrawal of essential nursing staff. Interviews confirmed the facility's inability to maintain required staffing levels without agency support, jeopardizing resident care.
The facility failed to ensure timely payment for essential goods and services, with numerous outstanding balances overdue by more than 121 days. The Nursing Home Administrator confirmed the lack of evidence for payments or agreements, and the administration could not verify the status of these bills, demonstrating non-compliance with regulations.
The facility failed to pay essential service bills on time, leading to service disruptions that jeopardized resident safety. Outstanding balances were owed to various providers, including Citizens Ambulance and REA, resulting in termination notices and halted services. Interviews confirmed these issues, and the facility had to change suppliers due to nonpayment.
Failure to Pay Staffing Agency Jeopardizes Resident Care
Penalty
Summary
The facility failed to pay bills incurred for services essential to the residents' health and safety in a timely manner. A review of unpaid invoices from the National Healthcare Staffing agency revealed significant outstanding balances dating from September 2024 to January 2025. The total amount owed was $324,648.00, with individual invoices ranging from $10,817.18 to $46,143.11. The facility's inability to settle these debts led to the staffing agency withdrawing their personnel from the facility. Interviews with the Nursing Home Administrator and the owner of the staffing agency confirmed the outstanding balance and the agency's decision to pull their staff due to non-payment. The Nursing Home Administrator acknowledged that the facility could not maintain the required nursing staff levels without the agency's support. A payment was sent for the oldest invoice, but the remaining invoices remained unpaid, jeopardizing the facility's ability to provide adequate care to its residents.
Plan Of Correction
National Healthcare Staffing has agreed to a payment schedule. The facility Scheduler will receive, review and process each National Healthcare Staffing invoice and forward to the Nursing Home Administrator for approval. Then the Business Office Manager/designee will forward electronically to the Accounts Payable for payment. Facility administrator will review the Accounts Payable relative to National Healthcare Staffing to ensure timely payments as follows: weekly x2, monthly x2 for timely processing of National Healthcare Staffing with results to the facility Quality Assessment and Assurance Committee.
Failure to Ensure Timely Payment for Essential Services
Penalty
Summary
The facility failed to comply with Federal, State, and Local laws and professional standards by not ensuring timely payment for goods and services necessary for daily operations. A review of the facility's accounts payable ledger revealed numerous outstanding balances as of December 20, 2024, with amounts overdue by more than 121 days. These unpaid bills included essential services and supplies from various vendors such as Allstate Pest Management, Geisinger Medical Center, and Nutro Co, among others. The total outstanding amount was substantial, with significant debts owed to entities like Total Plan Concepts and the West Mahanoy Township Tax Collector. During an interview, the Nursing Home Administrator confirmed that the facility owners had not provided evidence of payments or payment agreements for the outstanding invoices. Furthermore, the facility administration did not have access to billing or payment records, preventing them from verifying whether the listed bills had been paid. This lack of payment for essential goods and services demonstrates non-compliance with regulations requiring facilities to pay bills in a timely manner to prevent jeopardizing the health and safety of residents.
Plan Of Correction
1. January 1, 2025 the company obtained a new accounts payable company. The facility administrator will work with the new company designee to research accuracy of the listed vendors. There are no goods or services that are being withheld from the residents due to the status of the AP liabilities of Ridgeview Healthcare and Rehabilitation Center. 2. The Administrator will receive an AP/Aging report monthly and review the report that bills are paid in a timely manner and continued vital services are rendered for resident care. 3. The Regional Administrator will educate the Administrator on reviewing the monthly vendor AP/Aging report to ensure vital resident services are not interrupted. 4. Administrator/designee will maintain documentation of the monthly review of the AP/Aging reports and implement a monthly accounts payable call to ensure current services for vital goods and vendors are not interrupted and being provided. Results of the monthly accounts payable call will be submitted to the QA Committee for three months for any changes or recommendations.
Failure to Pay Essential Service Bills Jeopardizes Resident Safety
Penalty
Summary
The facility failed to pay bills in a timely manner for services essential to the residents' health and safety, as evidenced by a review of the facility's accounts payable ledger and interviews with administrative staff. The outstanding balances included significant amounts owed to various service providers such as Citizens Ambulance, REA for electric service, Suburban Propane, US Foods, Liberty Healthcare, Medvan Transport, RCP O2, Twin Med, Supply Line, Penn Highlands Dubois, Hugill Sanitation, and ICMSA. These unpaid bills resulted in termination notices and service disruptions, which could jeopardize the residents' well-being. An email communication revealed that the facility had fallen behind in payments to Citizen's Ambulance Service, leading to a halt in non-emergent transportation services until the payment was settled. Additionally, a billing statement from REA indicated a significant arrears balance, and a termination notice from the Indiana County Municipal Authority highlighted an overdue water bill. Interviews with the Nursing Home Administrator and Business Office Manager confirmed the existence of these outstanding balances and the receipt of termination notices due to nonpayment. The facility had to change medical suppliers and transportation services when services were terminated for nonpayment.
Plan Of Correction
The facility cannot retroactively correct. The residents' health and safety were / are not jeopardized due to this practice. The disposition of the listed invoices are: - Citizens Ambulance - invoice to be paid December 30. - REA Energy - $3872.83 was due within the past week and was paid in full. - Suburban Propane - Was paid on 12/4 and delivery received on 12/6. - US Foods - This vendor has always been on autopay and has never been late. - Liberty Healthcare - This is a consulting firm that ended service in August of 2022. They were assigned to review the buyout and not clinically related. - MedVan - Up to date, invoice payment made. - RCP 02 - paid up and regular deliveries every Friday prior to survey and since. - Twin Med - Invoice paid December 2. - Supply Line - invoice paid under payment agreement. - Penn Highlands Dubois - We don't know what this is for as they are not a vendor. - Hugill Sanitation - no service break, invoices up to date. - ICMSA - Invoice paid 12/3/24 with no break in service at any time. The accounts payable ledger was reviewed for any other outstanding invoices with shut-off notices and none were found. REA Energy, the provider that initiated this survey, was put on the auto-pay list so their invoices will be automatically paid upon receipt. The Nursing Home Administrator (NHA) or designee will educate the Operator (person responsible for approving payment to vendors) on timely bill payment for invoices incurred in the operation of the facility that for services without which the residents' health and safety would be jeopardized. The NHA or designee will audit the monthly payment arrangement to ensure payments are made to the vendor per the arrangement plan. These audits will be performed monthly for three months, and the results of these audits will be reviewed by the Quality Assurance Performance Improvement committee for adherence or further action. The plan of correction date of compliance will be January 7, 2025.
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