A Better Colorado Home Health Care Agency LLC

Specifically, the agency failed to ensure each patient received a comprehensive assessment within 48 hours of receiving a referral and within the last 5 days of a 60 certification period as required by regulation.

Specifically the agency failed to ensure all patients had an individualized written plan of care including any revisions or additions; to ensure services and treatments were provided in conformance with physician orders; and to ensure physicians reviewed and revised the plans of care at least once…

The agency's administration failed to ensure the agency organized, managed and administered resources to attain and maintain the highest practicable functional capacity involved in operations of care planning, coordination and quality of care for patients.

The agency failed to ensure patients had an emergency preparedness plan which included strategies for addressing emergency events identified by the risk assessment in 5 of 5 active patient records reviewed (Patients #1, #2, #3, #4,and #5).

The agency failed to ensure the emergency preparedness training, and testing program reflected the risks identified in the agency’s risk assessment and within their emergency plan.

The agency failed to ensure each beneficiary who received Medicare, a Medicare advantage plan, and/or Medicaid's Outcome and Assessment Information Set (OASIS) was electronically encoded and transmitted to the Centers for Medicare and Medicaid Services (CMS) in 5 of 5 active patient records…

The agency failed to utilize quality indicator data in the design of its program and to monitor the effectiveness and safety of services, quality of care, and opportunities for improvement.

The agency failed to document the resolution of a patient complaint for 1 of 1 patient records reviewed who called the agency with a complaint (Patient #7).

The agency failed to ensure an initial assessment was provided within 48 hours of referral by a physician for 2 of 7 patients reviewed (Patients #2 and #7).

The agency failed to ensure comprehensive assessments were performed in the last five days of a 60 day certification period for 2 of 4 active patient records reviewed who required a recertification comprehensive assessments (Patients #1 and #5).

The agency failed to have a complete and accurate plan of care (POC) for 2 of 5 active patient records reviewed (Patients #1 and #2).

The agency failed to ensure services and treatments were administered by staff only as ordered by a physician in 6 of 7 patients reviewed (Patients #1, #2, #3, #4, #5, and #7).

The agency failed to ensure the individualized plan of care (POC) was reviewed and revised by the physician once every 60 days beginning with the start of care date for 3 of 7 patient records reviewed (Patients #1, #5 and #7).

The agency failed to ensure clinical records contained accurate documentation of pertinent past and current findings in accordance with accepted professional standards for 1 of 5 active patients records reviewed (Patient #2).

The agency failed to ensure a supervising registered nurse (RN) provided consistent and appropriate day-to-day oversight and supervision of licensed practical nurses (LPN) providing patient care for 2 of 7 patient records reviewed (Patients #4 and #7).

The agency failed to ensure each patient had a plan of care for each certification period the patient received care and services for 1 of 9 patient records reviewed (Patient #9).

The agency failed to ensure services and treatments were provided in accordance with physician's orders for 3 of 9 patient records reviewed (Patients #1, #3 and #7).

The agency failed to ensure certified nurse aides (CNA) received the required observed competency evaluation in accordance with regulation prior to assignment of CNA services for 2 of 2 CNA personnel records reviewed (CNA #2 and #3).

The agency failed to ensure each patient's plan of care was reviewed by the physician at least every 60 days for 2 of 7 patients who received services for more than 60 days (Patients #1 and #5).

The agency failed to communicate all patient missed visits to the physician for 1 of 4 patients receiving certified nursing aide (CNA) services (Patient #8).

The agency failed to ensure a registered nurse (RN) or other appropriate skilled professional familiar with the patient, the patient's plan of care and the written patient care instructions made an onsite visit to the patient's home no less frequently than every 14 days to conduct certified nursing…

The administrator failed to adequately and effectively organize and direct the agency's day-to-day operations.