G0418: Patient'S Or Legal Representative'S Signature
CMS level: Element Minor. On this site, a condition-level citation is labeled Serious, a standard-level citation Moderate, and an element-level citation Minor. What the labels mean · How to choose an agency
Data from CMS inspection reports (Form 2567), 2018-01-02 to 2026-10-15, downloaded 2026-10-21; CMS agency list file dated 2026-09-21. CMS source file. What the labels mean
Where it was cited
- Florida24
- Indiana12
- California10
- Illinois7
- Michigan7
- Virginia7
- Massachusetts5
- New York5
- Missouri4
- Iowa3
- Minnesota3
- New Mexico2
- Pennsylvania2
- South Carolina2
- Wisconsin2
- Colorado1
- District of Columbia1
- Georgia1
- Kansas1
- Nebraska1
- New Hampshire1
- Nevada1
- Ohio1
- Oklahoma1
- Rhode Island1
- Utah1
- West Virginia1
Most recent citations
The 20 most recent of 107 citations. Newest inspection first.
Adoray Home Health and Hospice
The agency failed to document written acknowledgement that patients received their rights in 13 of 13 patients (Patient #1 - #13) medical records reviewed.
Customcare Home Health Services Inc
The home health agency (HHA) failed to obtain signed written notice of patient rights and responsibilities for one out of eight sampled patients (Patient 6).
Majestic Home Health LLC
The home health agency failed to obtain POA paperwork for 1 of 1 patient record reviewed with POA signed admission consents (Patient #4).
Integrihome Inc
The agency failed to obtain a patient's or legal representative's signature confirming a copy of the notice of rights and responsibilities had been provided upon admission to the agency for 3 patients (#2, #4 and #5), out of a total sample of 7 patients.
Aplus Health Care LLC
The agency failed to ensure a signature was obtained confirming a copy of the notice of patient rights and responsibilities was provided to 1 of 3 patients (P3) reviewed who received skilled services.
Safekeeping Home Health LLC
No longer in CMS listThe agency failed to maintain documentation showing the patient and/or patient’s representative was provided with a copy of rights and responsibilities for 10 of 10 clinical records reviewed (Patient #1, # 2, #3, #4, #5, #6, #7, #8, #9, #10).
Four Seasons Home Health Care
The agency failed to obtain the patient's or legal representative's signature as confirmation of receipt of notice of rights for 1 (P-1) of 1 patient observed during a home visit with visual and auditory impairments.
Heart Care at Home, LLC
The agency failed to ensure documentation of patient rights and responsibilities were available for review for six (Patients #1, 2, 3, 5, 6 and #7) of seven patients.
Visiting Nurse Association of Boston
The agency failed to obtain the patient's signature to confirm he/she had received a copy of the Patient Handbook and Patient Education Workbook including patient rights and responsibilities for 2 patients (#1 and #6), out of a total sample of 17 patients.
Home Health Care Inc
The agency failed to obtain the patient’s legal representative’s signature when enrolling 1 of 17 patients (P7) in home care services, not informing them of rights and responsibilities.
Abp Best Home Care Agency, Inc
The agency failed to obtain the patient's or legal representative's signature confirming that he or she had received a copy of the notice of rights and responsibilities for one patient (#4), out of total sample of seven patients.
Uphams Home Health Care
The agency failed to obtain the patient's or legal representative's signature confirming that he or she had received a copy of the notice of rights and responsibilities, for 3 patients (#5, #4 and #1), out of total sample of 7 patients.
Four Seasons Nursing & Rehabilitation Chha
The agency failed to ensure the patient’s signature confirming that he or she has received a copy of the notice of rights and responsibilities.
Iowa Home Care, L L C
The agency failed to obtain the patient's or the patient's legal representative's signature confirming he or she had received a copy of the notice of rights and responsibilities prior to the start of services for 1 of 7 sampled patients (Patient #7).
Greater Boston Home Health Care, LLC
The Agency failed to ensure that the patient’s signature was obtained confirming that he/she had received a copy service agreement and patient rights and responsibilities prior to the start of treatment for 1 of 13 (#1) applicable patients.
Green Cross Home Care Services, Inc
The provider failed to obtain the signature of 1 of 5 sample patients (Patient #5) or, in the case of a minor child, their legal representative for notice of their rights and responsibilities.
Vna of Care New England
This element is NOT MET as evidenced by: Based on record review and staff interview, it has been determined the Agency failed to obtain signature and maintain evidence in the clinical record to support they informed the patient of the bill of rights and provided a copy of such to the patient prior…
Medical Services of America Home Health
Ithe agency failed to obtain the patient's or legal representative's signature to confirm they had received a copy of the notice of rights and responsibilities for 1 of 12 sampled patients, (9).
247 Allstaff West LLC
No longer in CMS listThe agency failed to obtain the patient's or legal representative's signature confirming that he or she has received a copy of the notice of rights and responsibilities for three of seven sampled patients (Patient 1, 2, and 3).
Senior Friend Home Care
The facility failed to obtain signatures to show the Patient Bill of Rights and Responsibilities were given to the patient for 6 of 7 (P1, P2, P3, P4, P6, P7) residents reviewed for patient bill of right signature pages.