Advisacare Solutions of Nevada, Inc

The Home Health Agency (HHA) failed to ensure the timely submission of OASIS (Outcome and Assessment Information Set) to IQIES (Internet Quality and Improvement and Evaluation System).

The Home Health Agency (HHA) failed to ensure care was initiated timely after referral to the agency for one of seven sampled patients (Patient (P) 5) reviewed during the survey.

The Home Health Agency (HHA) failed to ensure the Registered Nurse (RN) conducted a medication reconciliation during homecare visits for one of seven sampled patients (Patient (P) 6) reviewed for medication reconciliation.

The home health agency (HHA) failed to ensure home health services were provided as ordered for two of seven sampled patients (Patient (P) 3 and P6).

The Home Health Agency (HHA) failed to ensure physician’s orders/plan of care were reviewed and signed timely by the Patient’s physician for five of seven sampled patients (Patients (P) 6, P1, P2, P3, and P4) reviewed during the survey.

The Home Health Agency (HHA) failed to update the contact information for emergency officials at least every two years.

The Home Health Agency (HHA) failed to include tracking, trending, and analysis of adverse events as a component of its quality assurance and performance improvement (QAPI) program.

The Home Health Agency (HHA) failed to ensure staff: 1. followed Standard Precautions during one of one patient (P)9 wound care observation, 2. completed COVID-19 screening of patients per record review and during one of two patient observations (P10), and 3. completed self-screening for COVID-19…

The Home Health Agency (HHA) failed to maintain an infection control program that included ongoing surveillance, investigation, and analysis of data or include infection control information in its quality assurance performance improvement (QAPI) program.

The Home Health Agency (HHA) failed to monitor, manage, and maintain the equipment used to access the web-based medical record system.

The Home Health Agency (HHA) failed to complete an initial assessment visit within 48 hours of the referral for one of 14 patients (Patient (P)1).

The Home Health Agency (HHA) failed to ensure an update of the comprehensive assessment was completed upon resumption of care following an inpatient hospital stay for one of 14 patients (Patient (P)5).

The Home Health Agency (HHA) failed to ensure that a current medication schedule, written in plain language, was provided to the patient and/or caregiver for 4 of 14 patients (Patient (P)1, P3, P10, P14).

The Home Health Agency (HHA) failed to ensure that a qualified individual was pre-designated by the Governing Body and the Administrator to assume the responsibilities and obligations of the Administrator when the Administrator was not available.

The Home Health Agency (HHA) failed to have a qualified Administrator (or pre-designated person) appointed by the Governing Body available during operating hours.

The Home Health Agency failed to ensure that the required assessments, clinical notes, and plans of care were present in the medical record for two of 14 patients (Patient (P)5, P12, and P14).

The Home Health Agency (HHA) failed to ensure a discharge summary was sent to the primary care practitioner for two of 14 patients (Patient (P)3 and P14).

The home health agency (HHA) failed to 1) develop, implement and maintain an ongoing home health-wide data driven quality assessment and performance improvement (QAPI) program and failed measure, analyze and track quality indicators from all aspects of performance to enable the HHA to assess…

The home health agency (HHA) 1) failed to follow accepted standards of practice to prevent the transmission of infections and communicable diseases (see G682) 2) failed to develop an infection control program that included infection prevention and control observations and analysis of surveillance…

The home health agency (HHA) failed to develop, implement and maintain an ongoing HHA-wide data driven quality assessment and performance improvement (QAPI) program.

The home health agency (HHA) failed to analyze data collection in order to implement preventative actions and make systemic improvement in HHA operations.

The home health agency (HHA) failed to develop a quality assessment and performance improvement (QAPI) program that tracked adverse patient events, analyzed their causes, and implemented preventive actions.

The home health agency (HHA) failed to develop and maintain documentation of performance improvement projects (PIP's) being conducted, the reasons for conducting these projects, and any measurable progress achieved on these projects.

The home health agency's (HHA) governing body failed to ensure the agency-wide quality assessment and performance improvement (QAPI) was developed, implemented and monitored to ensure improved quality of care and patient safety.

The home health agency failed to ensure standards of practice including the use of standard precautions were practiced by staff in the home while providing care for 3 of 6 patients (Patients (P)12, P14, and P17).

The Home Health Agency (HHA) failed to develop an infection control program that included infection prevention and control observations and analysis of surveillance data in an effort to improve care practices and control infections and transmission of communicable diseases.

The hospice failed to provide an effective infection control orientation and education program to home health care personnel in 9 of 9 professional personnel files reviewed for employees (Skilled Nurse (SN)1, SN2, SN3, SN4, SN5, SN6, SN10, Physical Therapist (PT)7 and Speech Therapist (ST)8. This…

The agency failed to ensure the home health aide completed at least 12 hours of in-service training during each 12-month period.

The home health agency was not in compliance with rules regarding safeguarding personal health information and there was the risk of loss or unauthorized use.

The home health agency (HHA) failed to document a complaint investigation, resolution and response to the patient in 3 of 3 complaints (complaint (C)1, C2 and C3) documented as having been received in the agency, potentially affecting the administration of patient rights for each of the 142…

The agency failed to complete a comprehensive assessment within five calendar days from the start of care (SOC) date for 9 of 11 patients (Patient (P)2, P3, P4, P7, P11, P14, P15, P16, and P17 for whom this information was provided.

The Home Health Agency (HHA) failed to provide a visit schedule for 5 of 6 total patients seen during home visits on 08/28/18 and 08/30/08 (Patient (P)12, P13, P14, P15, and P16).

The Home Health Agency (HHA) failed to provide a written copy of the patient's medication schedule instructions for 3 of 6 total patients observed during home visits between 08/28/18 and 08/30/2018 for Patients (P)12, P13, and P15. Findings include: 1. Record review revealed P12 had a start of care…

The home health agency (HHA) failed to develop a quality assessment and performance improvement (QAPI) program that included high risk, high volume or problem prone areas.

The home health agency (HHA) failed to develop a quality assessment and performance improvement (QAPI) program that considered incidence, prevalence and severity of problems in high risk, high volume areas.

The agency failed to ensure that visit frequency matched the visit frequency ordered by the physician for 10 of 17 sampled patients(Patients(P) 1, P4, P5, P6, P7, P10, P11, P12, P13, and P17. Findings include: 1. P1: The plan of care dated 09/08/17 to 11/06/17, specified "PT (physical therapy) Eval…

The home health agency failed to ensure the home health aide (HHA) received training on (1) "Communication skills with regards to the aide's ability to read, write, and verbally report clinical information to patients, representatives, and caregivers, as well as to other HHA staff", and (2)…

The Home Health Agency did not ensure or document an annual on-site visit conducted by a Registered Nurse (RN) or other skilled professional for the purpose of observing and assessing the aide while providing care occurred for the one home health aide (HHA) currently employed by the agency.

The agency failed to ensure a clinical manager was available during all operating hours to provide oversight of all patient care services and personnel.

The facility failed to designate a Administrator and the governing body did not approve a qualified person in writing to assume the responsibilities and obligations of the Administrator when the Administrator was not available.

The home health agency (HHA) failed to ensure a completed discharge summary was sent to the physician, or other health care professional, responsible for continuation of care within five days after discharge from the HHA in 4 of 4 discharge to home records reviewed (Patient (P)2, P3, P8 and P9).