D1-00005 Glendale, CA

This referral candidate is a group of 33 providers near Glendale, California, made up of 6 hospices and 27 home health agencies. Records show that as many as 10 of them list the same address down to the same suite, and 3 list the same telephone number. Seven of the companies were incorporated within a single 90 day window between November 9, 2020 and January 30, 2021, and 16 were formed in 2021 or later. One of them, Aligned Home Health Care Inc, sits in the same building as St. Angel Hospice, which appears on the Medicare revocation list with an action dated October 31, 2022, and 16 providers in the group share an address with a revoked or excluded entity. Almost all of the group reported no Medicaid billing in 2024, yet the group as a whole received $14,014,380 in Medicare hospice and home health payments in 2023.

1. 01The network consists of 33 providers around Glendale, California, made up of 6 hospices and 27 home health agencies, with a network score of 78 out of 100 and a national rank of 5. records 1
2. 02Seven separate companies in the network were incorporated within one 90 day window, between November 9, 2020 and January 30, 2021. records 2
3. 03Up to 10 providers in the network share one address, down to the same suite, and this count of providers at a single building places the network in the top 1 percent of networks in the risky direction. records 3, 10
4. 04Three providers in the network list the same phone number. records 4
5. 05Aligned Home Health Care Inc is in the same building as St. Angel Hospice, which appears on the Medicare revocation list with an action dated October 31, 2022, and in all 16 providers in the network share an address with a revoked or excluded entity. records 5
6. 06Eight providers sit at the address of a revoked or excluded company, which places the network in the top 3 percent of networks in the risky direction. records 12
7. 07Thirty three percent of the providers are at an address hosting eight or more enrollments, which places the network in the top 2 percent of networks in the risky direction. records 11
8. 08Sixteen of the providers were formed in 2021 or later, and the median company age in the network is 5.8 years, which places the network in the top 4 percent of networks in the risky direction. records 6, 13
9. 09The county has 21.2 providers of this kind per 10,000 Medicare fee for service beneficiaries, above the national norm, which places the network in the top 5 percent of networks in the risky direction. records 7, 8, 14
10. 10The providers billed Medicaid $47,633 in 2024 and received $14,014,380 in Medicare hospice and home health payments in 2023. records 9
11. 11Comfortcare Hospice Inc, a hospice in Glendale, California with National Provider Identifier 1881284883, was incorporated on December 9, 2020 and billed Medicaid $47,589 in 2024, which is nearly all of the network's reported 2024 Medicaid billing. records 16, 9
12. 12Med Care Plus Home Health Inc, a home health agency in Pasadena, California with National Provider Identifier 1871963140, was incorporated on June 19, 2015 and billed Medicaid $44 in 2024. records 17
13. 13Aligned Home Health Care Inc, a home health agency in Glendale, California with National Provider Identifier 1124618913, was incorporated on August 11, 2020 and reported no Medicaid billing in 2024. records 18
14. 14Sh Home Health Inc and Sh Hospice Inc., both located in Simi Valley, California, were each incorporated on November 9, 2020 and each reported no Medicaid billing in 2024. records 41, 47
15. 15Well Center Home Health in Glendale, California was incorporated on December 7, 2020, Trusted Home Health Care Services in Glendale was incorporated on September 13, 2021, and Lenus Health Care Inc in Glendale was incorporated on October 9, 2021, and all three reported no Medicaid billing in 2024. records 20, 44, 24
16. 16G&E Home Health and E & S Home Health Care Inc, both in Glendale, California, were incorporated on January 27, 2022 and January 13, 2022 respectively, and both reported no Medicaid billing in 2024. records 27, 33
17. 17Momentum across the rate of change factors is rising fast, with a robust z score of 1.15, described in the source as an indicative reading and not a validated forecast. records 15

Request the full Medicaid and Medicare enrollment applications, ownership and managing employee disclosures, and lease or sublease documents for the providers at the shared address and suite, starting with Aligned Home Health Care Inc and the other providers in the building occupied by St. Angel Hospice. Conduct unannounced pre enrollment and post enrollment site visits under 42 CFR 455.432 to verify that the addresses, suites and operations submitted on the applications are accurate. Confirm that the newly enrolling home health agencies and hospices in the group have received high level screening, including fingerprint based criminal background checks and site visits, as required by 42 CFR 455.450 and 42 CFR 424.518. Cross check every owner, managing employee and address against the Medicare revocation and termination databases and apply 42 CFR 455.416(c) to deny or terminate any provider terminated under Medicare, Medicaid or CHIP on or after January 1, 2011. Where an application address, suite or telephone number cannot be verified or the identity of the applicant cannot be confirmed, consider action under 42 CFR 455.416(g). Refer the Medicare payment exposure of $14,014,380 for 2023 hospice and home health services to the Unified Program Integrity Contractor and coordinate with the state survey agency and licensing board on the shared address and shared phone findings.

• Shared addresses and suites can reflect legitimate medical office buildings, shared landlords, executive suite arrangements or billing service locations rather than common control, and lease records should be pulled before any conclusion is drawn.
• A shared telephone number among three providers can reflect a common answering service, management services organization or billing vendor.
• Clusters of incorporations within a short window can reflect ordinary corporate restructuring, changes of ownership, or a law firm or consultant that formed several unrelated entities in the same period.
• Being located in the same building as St. Angel Hospice, which appears on the Medicare revocation list with an action dated October 31, 2022, does not by itself establish any relationship between the entities, and revocations can be reversed on appeal or the provider reinstated.
• The county rate of 21.2 providers per 10,000 Medicare fee for service beneficiaries may reflect genuine local demand, a large referral catchment area or population mix rather than saturation driven by improper enrollment.
• Absence of 2024 Medicaid billing for most members may reflect a Medicare only business model, data lag in the T-MSIS submission, or providers that have not yet begun serving Medicaid beneficiaries.
• Recent incorporation dates and a median company age of 5.8 years are common in home health and hospice markets and are not by themselves indicators of improper conduct.
• The momentum reading with a robust z score of 1.15 is described in the source as indicative and not a validated forecast, so it should not be weighted as evidence of a trend.