Adara Home Health Inc

The facility failed to notify the physician on missed medications for 1 of 3 clients (C1) reviewed who did not receive prescribed Venlafexine (used to treat depression, general anxiety disorder, social anxiety disorder, and panic disorder) resulting in in-patient hospitalization.

The agency failed to timely encode and submit Outcome and Assessment Information Set (OASIS) in accordance with Center for Medicare (CMS) requirement.

The agency failed to ensure all medications were not expired during medication set up for 1 of 2 patients (R4) who was observed during a home visit.

The agency also failed to assure the medication profile was reconciled with routine visits for 1 of 2 patients (P6) reviewed for wound care observation.

The home health agency (HHA) failed to meet the Condition of Participation: Care planning, Coordination of Services and Quality of Care Services at 42 CFR 484.60. The agency failed to provide safe skilled nursing services to monitor the patients skin who had worsening of pressure ulcers, identify…

The home health agency (HHA) failed to effectively provide safe skilled nursing services within the patient’s home for 1 of 3 patients (P1) when the HHA was did not adequately monitor changes of wounds and did not notify P1’s physician when the plan of care was not followed.

The home health agency (HHA) failed to include durable medical equipment (DME) on the plan of care (POC) for 12 of 17 patients (P1, P2, P3, P4, P8, P9, P12, P13, P14, P15, P16, P17) reviewed for the individual plan of care.

The agency failed to follow infection control practices for 2 of 3 patients (P6 and P7) observed home health visits to prevent the transmission of infections and communicable diseases.

The agency failed to maintain a current plan of care for 1 of 3 (P8) residents reviewed for quality of care.

The agency failed to follow orders for medication set up for 1 of 1 (P8) patients reviewed for medication management.

The agency failed to ensure accurate medication set-up for 2 of 2 patients (P1 and P2) reviewed when an antipsychotic medication, Abilify, for P1 was not ordered and set up as prescribed.

The facility failed to thoroughly investigate a medication error for 1 of 1 client (P3) who reported her iron medication was set up daily instead of every other day as ordered.

The agency failed to ensure accurate medication set-up for 2 of 2 patients (P1 and P2) reviewed when an antipsychotic medication, Abilify, for P1 was not ordered and set up as prescribed.

Based on the number and/or severity of the deficiency cited the Condition of Participation 42 CFR 484.50 Patient Rights at G430 was not met.

The agency failed to identify the potential adverse effects with the drug therapy Clozaril, an antipsychotic medication, and Cymbalta, an antidepressant for 1 of 1 patient (P1) reviewed for medication.

The agency failed to provide medications as ordered by the patient's physician for 1 of 3 patients (P1) reviewed, when nursing staff failed to set-up the patient's anti-psychotic medication and anti-depressant medications as ordered and did not notify the provider.

The agency failed to respect the preference of patients when assigning visit schedules for 3 of 3 patients (P1, P2, and P3) reviewed.

Clozaril is indicated for treatment of patients who fail to respond adequately to standard antipsychotic treatment.

The facility failed to thoroughly investigate a complaint made to the home health care agency for 2 of 3 patients (P1, and P2) reviewed.

The agency failed to identify the potential adverse effects with the drug therapy Clozaril, an antipsychotic medication, and Cymbalta, an antidepressant for 1 of 1 patient (P1) reviewed for medication.

The agency failed to ensure the plan of care (POC) included a description of the risk for emergency department visits and hospital re-admission, advanced directives, and/or education, including all necessary interventions to address the underlying risk factors, and identify parameters for goals and…

The facility failed to provide 1 of 3 patients (P1) and/or representatives a with a medication regimen, including medication name, dose and frequency and which medications will be set-up by the home health agency (HHA) in the patient’s home.

The home health agency (HHA) failed to provide 1 of 3 patients (P1) pertinent instruction related to the patient’s specific care needs.

The home health agency (HHA) failed to involve an interdisciplinary approach from all health providers for involvement in the patient’s initial assessment, follow-up assessments, and plan of care for 1 of 3 patients (P1) reviewed.

The facility failed to ensure clinical notes were prepared to reflect care given during patient visits for 1 of 3 patients (P1) whose records were reviewed.

The parent home health agency (HHA) failed to provide support and administrative control of its branches.

The agency failed to ensure the physician orders were followed for 1 of 18 patients (P7), who had home health aide ordered, but the service had not been provided, and the physician had not been notified the service was not provided.

The home health agency (HHA) failed to ensure screening for COVID-19 signs and symptoms was completed prior to the start of a visit for 1 of 7 patients (P4) observed during home visits.

The agency failed to complete a comprehensive drug regimen review to ensure the accuracy of all medications/dosage for 2 of 7 patients, (P7) and P(8) whose medications were reviewed during home visit and record review.

The agency failed to obtain physician orders to provide skilled nursing (SN), for 1 of 18 patients (P7), reviewed for home care services.

The home health agency (HHA) failed to to obtain branch status approval at the Mendota Heights branch which was determined to be fully operational from this location at the time of survey.

The parent home health agency (HHA) failed to ensure support and administrative control was being provided by parent location.

The agency failed to ensure direct supervisory visits were completed every 60 days, as required for 2 of 3 non-skilled patients (P5 and P10) reviewed.

The agency failed to update the comprehensive assessment at least every 60 days for 1 o f patient's, (P1), reviewed when the patient was receiving home health aide services but a 60 day assessment of the patient's condition, including a physical assessment of the patient was not completed.