D1-00003 Burbank, CA

This referral candidate is a group of 35 providers clustered around Glendale, California, made up of 5 hospices and 30 home health agencies. Eight of the companies were incorporated between February 15, 2021 and May 5, 2021, and 15 of the 35 were formed in 2021 or later. Records show up to 5 providers at a single address, 3 providers listing the same phone number, and 3 owners appearing on three or more of the companies. One provider, Peaceful Home Health, Inc., sits in the same building as Slr Medco Group Inc, which appears on the Medicare revocation list with an action dated April 11, 2025, and 20 providers in the group share an address with a revoked or excluded entity. An owner name, Kristine Arutyunyan, matches the OIG exclusion list at medium confidence with an action dated January 18, 2024, and the group as a whole reported $12,795,368 in Medicare hospice and home health payments in 2023 against $10,965 in Medicaid billing in 2024.

1. 01The cluster consists of 35 providers around Glendale, California, made up of 5 hospices and 30 home health agencies, with a network score of 78 of 100 and a national rank of 3. records 1
2. 02Eight separate companies in the group were incorporated within one 90-day window, between February 15, 2021 and May 5, 2021. records 2
3. 03Fifteen of the providers were formed in 2021 or later, and the median company age in the network is 5.8 years, placing it in the top 4 percent of networks in the risky direction. records 7, 15
4. 04Three owners appear on three or more of these providers, and the most connected owner sits on 3 of them. records 3
5. 05Up to 5 providers share one address and 3 providers list the same phone number. records 4, 5
6. 06Peaceful Home Health, Inc. is in the same building as Slr Medco Group Inc, which appears on the Medicare revocation list with an action dated April 11, 2025, and 20 providers in the group share an address with a revoked or excluded entity. records 6
7. 07The factor desk records 10.5 providers at the address of a revoked or excluded company, in the top 2 percent of networks in the risky direction, and 57 percent of providers at an address hosting eight or more enrollments, in the top 1 percent. records 13, 14
8. 08An owner named Kristine Arutyunyan matches the OIG exclusion list at medium confidence, with an action dated January 18, 2024. records 8, 10
9. 09Every provider in the network had an NPI issued within six months of incorporation, a rate of 100 percent, in the top 5 percent of networks in the risky direction. records 16
10. 10The county has 21.2 providers of this kind per 10,000 Medicare fee-for-service beneficiaries, above the national norm and in the top 5 percent of networks in the risky direction. records 9, 11, 17
11. 11The providers billed Medicaid $10,965 in 2024 and received $12,795,368 in Medicare hospice and home health payments in 2023. records 12
12. 12Next Door Home Health Services, NPI 1558967786, Glendale, California, incorporated December 1, 2020, is the provider that billed Medicaid $10,965 in 2024. records 19
13. 13Providers incorporated inside the 2021 window include Hope Haven Home Health Inc, incorporated February 15, 2021, Comcare Home Health Agency Inc, incorporated February 22, 2021, Healthy Ca Home Health, incorporated March 8, 2021, Rhodos Homehealth, incorporated March 27, 2021, Holy Light Home Health Inc, incorporated April 6, 2021, Respected Healthcare Services, incorporated April 29, 2021, and Sera Healthcare, incorporated May 5, 2021. records 48, 29, 34, 21, 30, 31, 41
14. 14The network includes 5 hospices: Clear Path Hospice & Palliative Care Inc, V & G Hospice Inc, Well Care Hospice & Palliative Care Inc, Progress Palliative Care Inc and Fountain Hospice Inc. records 35, 39, 44, 46, 50
15. 15Momentum across the rate-of-change factors is rising fast with a robust z of 1.28, described in the source as an indicative reading and not a validated forecast. records 18

Request the full ownership and control disclosures for all 35 providers under 42 CFR 455.104, including every person with a 5 percent or greater ownership or control interest, managing employees, and family or business relationships among them, and compare the disclosures across the 8 companies incorporated between February 15, 2021 and May 5, 2021. Resolve the medium confidence name match on owner Kristine Arutyunyan against the OIG exclusion list using date of birth, Social Security number and license data, and if the match is confirmed apply 42 CFR 1001.1901 to any payments for items or services furnished on or after the exclusion effective date, and evaluate denial or termination under 42 CFR 455.416(b). Verify the revocation status of Slr Medco Group Inc and screen every provider sharing an address with a revoked or excluded entity against the termination database for action under 42 CFR 455.416(c). Order pre-enrollment and post-enrollment site visits under 42 CFR 455.432 for the addresses hosting multiple enrollments, including the address shared by up to 5 providers and the building shared by Peaceful Home Health, Inc., and confirm that each location has independent operations, staff and records. Confirm that each newly enrolled home health agency and hospice received high risk screening with fingerprint criminal background checks and site visits under 42 CFR 455.450 and 42 CFR 424.518. If site visits or document review show that addresses, phone numbers or applicant identities cannot be verified, evaluate denial or termination under 42 CFR 455.416(g). Refer the Medicare payment volume of $12,795,368 for 2023 to the Medicare program integrity contractor and the Unified Program Integrity Contractor for the region, and coordinate with the state Medicaid agency on the single provider with 2024 Medicaid billing.

• Shared addresses and shared phone numbers can reflect a common landlord, a medical office building, a billing service or a management company that legitimately serves multiple unrelated agencies.
• Common ownership across several agencies is lawful when it is fully disclosed at enrollment and revalidation, and the group may be a legitimate multi-site operator using a supervisory or shared administrative billing convention.
• Clustered incorporation dates may reflect a corporate restructuring, a change of ownership, or a response to a state or federal enrollment moratorium lifting rather than coordinated new entity creation.
• The owner match to the OIG exclusion list is medium confidence only and may be a common name collision; it must be confirmed with identifiers before any payment action.
• A revocation or exclusion of one entity at a building does not by itself establish any relationship to the other tenants at that address.
• The revocation action for Slr Medco Group Inc is dated April 11, 2025 and may be under appeal or subject to reinstatement, which would change its status.
• Medicaid billing of zero for most providers may reflect a Medicare only practice, managed care encounter data that does not appear in the fee-for-service extract, or data lag in the 2024 T-MSIS file.
• High provider density per 10,000 beneficiaries can reflect genuine local demand and referral patterns in a large metropolitan county.
• The momentum reading is described in the source as indicative and not a validated forecast, so it should not be treated as predictive.