Adaptive Nursing and Healthcare Services, LLC

The agency failed to ensure that the comprehensive assessment was updated after a change in condition for 1 of 1 patient reviewed for a complaint of injury due to suspected abuse and injury of unknown source.

The agency failed to adhere to the discipline specific visit frequency as ordered in the plan of care (POC) for 5 of 9 records reviewed.

The governing body failed to assume responsibility for the agency's overall management and operation, including review and update of all policies, and review, development, and execution of the agency's complaint process, including investigation, documentation, resolution, and communication.

The agency failed to ensure an assessment was conducted by a registered nurse when allegations of abuse were reported for 1 of 1 record reviewed of reported abuse.

The agency failed to ensure all complaints were resolved and resolutions were documented for 1 of 3 active patient complaints reviewed (patient #4), and 2 of 3 discharged patient complaints reviewed.

The agency failed to ensure the physician was notified of a significant change in condition for 1 of 1 active patients reviewed for a complaint of suspected abuse.

The Administrator failed to ensure they were involved and provided oversight/management of a complaint allegation for abuse, including adequate investigation (including on-sight assessment, documentation, and communication with patient/family), and failed to ensure all patient information was…

The agency failed to have in place a current written contract for the agent, acting on behalf of the agency, to ensure the confidentiality of all patient identifiable information included in the clinical record for 1 of 1 agency.

The agency failed to ensure patient and/ or patient representatives were provided an accurate notice of the Patient Bill of Rights, Authorization, Agreement, and Acknowledgement Forms, and Notice of Privacy Rights before the initiation of treatment and failed to ensure all patients admitted after…

The agency failed to evidence a skilled service was provided to establish the start of care [SOC], ensured the comprehensive assessment accurately reflected the patient's current health, psychosocial, functional status, including a correct home safety evaluation, and a correct nutritional risk…

The agency failed to ensure the patient's medical and nursing needs were met in their place of residence, visits were provided per the plan of care, ensured a physician order was in place prior to providing care, ensured a patient's received services in accordance with the written plan of care…

The agency failed to: ensure there was a quality assurance program that was capable of showing measurable improvement and must measure, analyze and track quality indicators, including adverse patient events, and other aspects of performance that enable the agency to assess processes of care, HHA…

The agency failed to ensure infection control practices were followed in the use of gloves and handwashing during personal care and failed implement an agency-wide infection control program for the surveillance, identification, prevention, control and investigation of infectious and communicable…

The agency failed to ensure a Home Health Aide was competent in performing a bed bath, failed to ensure that all prospective home health aide (HHA) staff performed all tasks, in their entirety with a patient and not simulated, as required, to demonstrate competence for placement on the home health…

The agency failed to ensure the organizational chart for this agency was accurate, complete, and in writing, the clinical manager failed to ensure communication among staff and with physicians were conducted, failed to ensure a system was in place for tracking referrals, to ensure patients were…

The agency failed to ensure the clinical record included documentation with primary caregivers and the agency regarding staff scheduling, communication and documentation with the attending physician, documentation of medications and feedings by gastronomy tube, and the most recent clinical notes…

The agency failed to submit OASIS (outcome and assessment information set) within 30 days of assessment completion for 1 of 1 skilled record where OASIS information was collected and transmitted.

The agency failed to ensure care and services were not provided prior to the physician approving the plan of care (Patient #2), failed to ensure nutritional supplement was provided per the plan of care (Patient #2) and OSHA kit was in place per agency policy and plan of care failed to ensure home…

The agency failed to ensure infection control practices were followed in the use of gloves and handwashing during personal care of a client during 1 of 3 home visits.

The agency failed implement an agency-wide infection control program for the surveillance, identification, prevention, control and investigation of infectious and communicable diseases for 1 of 1 agency.

The agency failed to ensure that all prospective home health aide (HHA) staff performed all tasks, in their entirety with a patient and not simulated, as required, to demonstrate competence for placement on the home health aide registry and failed to ensure that the aide applications submitted to…

The agency failed to ensure the continuing education for the Home Health Aides (HHA) annual inservices met the requirements for 8 of the 12 required inservices for 3 of 3 HHAs reviewed for these inservices.

The agency failed to ensure the home health aide care plan was updated and accurately reflected patient preference for bathing in 1 of 4 closed records reviewed.

The agency failed to offer skilled services to new patients, following their certification survey dated 6/15/2018, for 1 of 1 home health agency.

The agency failed to ensure all documentation was appropriately authenticated with signature, title, date, and times for 2 of 8 clinical records reviewed. [2 and 7] Findings include: A policy entitled "Supplemental Physician Orders", dated 07/25/18, stated "The order must include: (a)(iii)…

The agency failed to ensure patient and/ or patient representatives were provided an accurate notice of the Patient Bill of Rights, Authorization, Agreement, and Acknowledgement Forms, and Notice of Privacy Rights before the initiation of treatment in 4 of 8 active clinical records reviewed (#1, 2…

The agency failed to ensure patients / patient representatives admitted after 6/07/2019, received the accurate home health agency administrator's name, business address, and business phone number in order to receive complaints for 3 of 3 active clinical records reviewed with start of care after…

The agency failed to ensure the patient's right to have a confidential clinical record for 1 of 1 skilled clinical records reviewed.

The agency failed to ensure that patients were provided current names, addresses, and telephone numbers for the Indiana Area Agency on Aging by service area for 1 of 1 agency.

The agency failed to ensure the home health agency arranged a safe and appropriate transfer to another care entity(s) when the needs of the patient exceeded the HHA's capabilities for 2 of 2 adult skilled records reviewed (#1 and 6).

The agency failed to investigate injuries of an unknown source and misappropriation of patient property by anyone furnishing services on behalf of the HHA (home health agency) for 2 of 25 grievances reviewed.

The agency failed to document the resolution of complaints made by the patient / legal representative for 4 of 25 grievances reviewed.

The agency failed to ensure the comprehensive assessment accurately reflected the patient's current health and functional status including a correct home safety evaluation (patient #2); failed to be consistent with the plan of care in regards to the nutritional risk assessment (patient #7); failed…

The agency failed to ensure the patient's care preference for Boost and a sink bath were based on the comprehensive assessment for 1 (patient #2) out of 1 pediatric skilled record reviewed and 1 (patient #7) out of 2 closed records reviewed.

The agency failed to update a client's current medication additions and changes in medications for 1 of 3 home visits conducted (Patient #4) and 1 of 2 discharged records reviewed.

Basd on reord review, the agency failed to ensure an updated comprehensive assessment was completed within the last 5 days of certification period for 1 of 1 focused discharged records reviewed.

The agency failed to complete an updated comprehensive assessment at discharge for 4 of 4 closed clinical records reviewed. [Patients 6, 7, 8, and 9] Findings include: 1. Review of clinical record for patient #7, physician order dated 05/07/19 stated "discharge client from agency effective 05/07/19…

The agency failed to ensure that the individualized care plan included patient-specific interventions with measurable outcomes for aspiration precautions (patient #2), fall precautions (patient #7), pain precautions (patient #7) for 2 of 2 clinical records reviewed.

The agency failed to ensure the skilled nurse put new orders in writing to be sent to the physician for signature in 1 of 4 closed records reviewed.

The agency failed to ensure the physician was notfied when it was decided the patient declined to have skilled nursing services as ordered per the plan of care (Patient #6), changes in feeding supplements (Patient #2), and unrelieved pain (Patient #7) for 3 of 8 records reviewed.

The agency failed to ensure the revised plan of care included patient preference for bathing and failed to be developed based on the comprehensive assessment in 1 of 4 closed records reviewed.

The agency failed to ensure care and services were not provided prior to the physician approving the plan of care (Patient #2), failed to ensure nutritional supplement was provided per the plan of care (Patient #2), failed to ensure an OSHA kit was in place per agency policy/ and plan of care…

The skilled professional failed to ensure skilled nursing clinical notes were completed for 1 of 1 skilled pediatric clinical record reviewed.

The skilled professional failed to ensure the physician was notfied when it was decided the patient declined to have skilled nursing services as ordered per the plan of care (Patient #6), changes in feeding supplements (Patient #2), and unrelieved pain (Patient #7) for 3 of 8 records reviewed.

The agency failed to ensure a Home Health Aide was competent in performing a bed bath for 1 of 3 home visits conducted.

The agency failed to ensure visits were provided as ordered on the plan of care for 2 of 5 home health aide only records reviewed.

The home health aide failed to notify the case manager of patients pain for 1 of 4 closed clinical records reviewed.

The clinical manager failed to ensure communication among staff and with physicians were conducted for 3 of 8 clinical records reviewed (#2, 6, 7).

The clinical manager failed to ensure a system was in place for tracking referrals, to ensure patients were assessed, and a timely start of care for 1 of 1 agency.

The clinical manager failed to ensure care and services were not provided prior to the physician approving the plan of care (Patient #2), failed to ensure nutritional supplement was provided per the plan of care (Patient #2) and OSHA kit was in place per agency policy and plan of care for 1 of 1…

The agency failed to ensure a current written contract was in place for the contracted Registered Nurse (RN), Contract RN 01, who was completing the Home Health Aide's competency of skills, prior to placement on the Indiana State Registry, for 1 of 1 agency.

The agency failed to ensure the clinical record included documentation with primary caregivers and the agency regarding staff scheduling, communication and documentation with the attending physician, documentation of medications and feedings by gastronomy tube, and the most recent clinical notes…

The agency failed to ensure contact information for the patient / caregiver was current and accurate for 1 of 3 home visit observations with clinical record reviews.

The agency failed to evidence a discharge summary, that included accurate information and was provided the the primary care physician within 5 business days, in 3 of 4 closed records reviewed. [Patient #6, 7, 8] The findings include: 1. A review of record #6 with a start of care 7/02/2019, failed…