Angels Care Progressive Home Health

Failed to follow the agency’s policy and procedure for proper hand hygiene and bag technique.

The agency failed to ensure that medication orders were included, accurate, and updated on the patient’s medication profile (a real-time document used by the agency that lists the patient’s medications, including new and updated orders) and on the physician’s approved plan of care, on admission and…

Deficiencies cited at E006 and E039. E006 Based on review of the agency's Emergency Management Plan and policy and staff interview, the agency Administrator failed to maintain documentation the agency conducted a facility-based and community-based risk assessment in 2018 and 2019 to identify the…

Deficiencies cited at G514, G522, and G544. G514 Based on review of agency records, policies, and procedures and staff interview, the agency failed to conduct an initial assessment by a Registered Nurse (RN) within 48 hours of referral to the agency for 1 of 7 patients sampled (Patient 3) to…

Deficiencies cited at G572, G574, G590, G592 and G606. G572 Based on record review, policy and procedure review, and staff interview, the agency failed to document missed visits, attempt to reschedule missed visits, and consult the physician to modify the plan of care (POC) when all services were…

Deficiencies cited at G642 and G658. G642 Based on review of the agency's Quality Assurance Performance Improvement (QAPI) Program, policies and procedures, and staff interview, the agency failed to follow its policy to improve organizational performance and failed to measure, analyze, and track…

Deficiencies cited at G702 and G726 G702 Based on record review, policy and procedure review, and staff interview, the agency failed to ensure nursing services provided for agency patients with wounds included a weekly assessment by the Registered Nurse (RN) for 4 of 4 patients sampled who had…

Deficiencies cited at G768, G808, and G818. G768 Based on review of agency forms, policies, procedures, and personnel files and staff interview, the agency failed to conduct a written examination and skills observation by a Registered Nurse (RN) to verify the competency for 1 of 1 home health aide…

The agency failed to conduct a pre-employment registry check of the Adult Protective Services Central Registry (APS) and the Central Registry of Child Protection Cases (CPS) for 1 of 1 Home Health Aide (HHA) personnel files reviewed (HHA-F) prior to the HHA providing care for the agency patients as…

Deficiencies cited at G950, G954, G958, and G966. G950 Based on review of agency forms, personnel files, policies and procedures, and staff interview, the agency Administrator failed to ensure a Clinical Manager was available to staff during all operating hours of 9:00 AM to 5:00 PM Monday through…

The agency Administrator failed to maintain documentation the agency conducted a facility-based and community-based risk assessment in 2018 and 2019 to identify the agency's risk in the event of a natural or man-made disaster.

The agency Administrators failed to conduct a second exercise, either a full-scale, individual facility-based, or table-top exercise in 2018 and 2019. This had the potential to affect all 12 of agency patients on census.

The agency failed to have a Registered Nurse (RN) update the comprehensive assessment for 2 of 2 patients who had documentation of improvement or decline in health status (Patient 2 and 3).

The agency failed to document missed visits, attempt to reschedule missed visits, and consult the physician to modify the plan of care (POC) when all services were not provided as ordered for 3 of 5 patients who had missed visits for Home Health Aide (HHA), Physical Therapy (PT), Occupational…

The agency failed to follow its policy to improve organizational performance and failed to measure, analyze, and track quality indicators to assess the agency's processes and identify areas of needed improvement, which had the potential to affect all 12 agency patients on census.

The agency failed to conduct performance improvement projects (PIP) and failed to document the PIP projects, the reasons for the PIP projects, and the measureable progress achieved on these PIP projects for 2018 and 2019, which had the potential to affect all 12 of the agency patients on census.

The agency failed to ensure nursing services provided for agency patients with wounds included a weekly assessment by the Registered Nurse (RN) for 4 of 4 patients sampled who had wounds (Patient 1, 2, 6, and 7).

The agency failed to conduct a written examination and skills observation by a Registered Nurse (RN) to verify the competency for 1 of 1 home health aide (HHA-F) personnel files reviewed, prior to the HHA providing HHA services for agency patients.

The agency clinical manager failed to ensure the initial assessment of 2 of 7 agency patients (Patient 3 and 5) were conducted within 48 hours of the agency receiving the referral for home health services.

The agency failed to conduct an initial assessment by a Registered Nurse (RN) within 48 hours of referral to the agency for 1 of 7 patients sampled (Patient 3) to determine the immediate care needs of the patient.

The agency failed to conduct a comprehensive assessment by a Registered Nurse (RN) for 1 of 7 patients (Patient 3).

Staff interview the agency failed to include the frequency and duration of all services to be provided, all treatments, and the patient's risk for emergency department visits and hospital readmissions on the patient's plan of care (POC) for 6 of 7 clinical records reviewed (Patient 1, 2, 3, 4, 6…

Staff interview the agency failed to promptly notify the physician for 3 of 7 patient records sampled when a change in wound status and treatment availability occurred (Patient 2), a change in elimination status occurred (Patient 4), and elevated blood glucose levels (the level of a sugar in the…

Staff interview the agency failed to include the patient's progress towards the measureable outcomes and goals identified by the patient and the home health agency on the plan of care (POC) for 5 of 7 patient records sampled (Patient 1, 2, 3, 4, and 5).

The agency failed to involve occupational therapy (OT) to evaluate the showering needs of 1 of 7 patient records sampled (Patient 1) after the Registered Nurse (RN) identified on 9/30/19 a need for assistance with showering due to the patient's poor balance, muscle weakness, unsteady gait, and…

The agency failed to follow the agency's policy to conduct an onsite visit by a Registered Nurse (RN) to the home of 7 of 7 patients sampled (Patient 1-7) for the purpose of supervising the nursing care provided by the agency's licensed practical nurse (LPN)-C.

The agency failed to conduct onsite visits every 14 days by the registered nurse (RN) in the home for 2 of 2 patients sampled who received home health aide (HHA) services (Patient 1 and 3) to ensure the HHA was meeting the patient's needs and following the HHA plan of care.

The agency failed to ensure the home health aide (HHA) followed the plan of care during the provision of bathing services for 1 of 2 patients receiving HHA services (Patient 1), resulting in the patient's fall with injury on 11/22/19. The total sample size was 7. The census was 12. Findings are: A.

The agency Administrator failed to ensure a Clinical Manager was available to staff during all operating hours of 9:00 AM to 5:00 PM Monday through Friday when nursing and home health aide serves were provided by the agency and the hours of 5:00 PM Friday through 9:00 AM Monday when the agency…

1 of 1 Administrators (Administrator-A) failed to have a qualified, pre-designated person, authorized in writing by the Administrator, to coordinate, manage, and be available to all 16 of the agency staff in the absence of the Administrator.

The clinical manager failed to ensure ongoing assessments were conducted by a Registered Nurse (RN) for 4 of 4 patients who received wound care (Patient 1, 2, 6 and 7) to ensure the patient's wound care needs were met.

The agency failed to include all clinical notes, physician orders, past and current patient information in the clinical record of 3 of 7 clinical records reviewed (Patient 1, 2, and 3).

The agency failed to send a completed transfer summary to the receiving facility for 2 of 2 patients who had a transfer to an inpatient facility (Patient 3 and 7) and failed to send a discharge summary to the physician assuming cares for 1 of 1 patients who had a discharge (Patient 6).

The agency failed to ensure all services were provided in accordance with the physician approved written Plan of Care (POC) and failed to notify the Clinical Supervisor/Director and the physician of missed/extra visits or the need to alter the POC for 1 of 5 patients (Patient 7) receiving Home…

The agency failed to ensure a Registered Nurse (RN) completed an onsite Home Health Aide (HHA) supervisory visit with or without the HHA present no less frequently than every 14 days for 2 of 5 patients (Patients 5 and 7) receiving HHA services from the agency.

The agency Administrator failed to be responsible for the day to day operation of the home health agency, as the agency staff provided services to 3 of 11 patients reviewed (Patients 17, 21 and 22) who resided outside of the agency's approved geographical area from 8/25/17 through 2/2/18 without…

The agency failed to ensure a clinical manager (Clinical Supervisor) was available during all hours of operation for the coordination of patient cares, making patient and personnel assignments, coordinating patient referrals, assuring patient needs were continually met and assessed; and for…