Blessed Hands Home Care Agency LLC

The home health agency failed to ensure the home health agency failed to meet the patients medical, social and rehabilitative needs (See G570); failed to ensure all disciplines followed the medical plan of care as ordered by the primary care physician (See G572); failed to ensure the patients…

The home health agency failed to ensure all home health aides were competencied prior to their first patient home visit, and were competencied by a prior agency that did not have restrictions (See G768); skilled nurse failed to prepare a complete aide care plan to include indications for PRN [as…

The administrator failed to be involved in the day to day activities of the agency (See G948) and failed to ensure an alternate administrator was authorized in writing to assume the position of the administrator in the absence of the administrator (See G954).

The home health agency failed to ensure all disciplines followed the medical plan of care as ordered by the primary care physician in 2 of 7 clinical records reviewed with skilled nursing and/or home health aide services, out of a total of 9 clinical records reviewed.

The home health agency failed to ensure all home health aides were competencied prior to their first patient home visit, and were competencied by a prior agency that did not have restrictions in 3 of 6 home health aide records reviewed for competencies.

The skilled nurse failed to prepare a complete aide care plan to include indications for PRN [as needed] home health aide tasks in 3 of 6 clinical records reviewed with home health aide services, out of a total of 9 clinical records reviewed.

The home health agency failed to ensure all clinicians signed an dated all patient documents in 3 of 9 clinical records reviewed.

The home health agency failed to ensure all patients protected health information was safeguarded from unauthorized use in 1 of 1 home health agency.

The home health agency failed to ensure the clinical supervisor had a current registered nurse license in the state of Indiana, in 1 of 1 clinical supervisor.

The home health agency failed to ensure all home health aides had current registration with the state of Indiana in 1 of 3 home health aide personnel records reviewed.

The home health agency failed to ensure all registered nurses had updated their professional licenses prior to continuing patient care, and failed to ensure registered nurses with probationary licenses received the proper supervision while continuing to service agency patients in 2 of 4 registered…

The home health agency failed to ensure the patients received all services on their medical plan of care in 1 of 7 clinical records reviewed with skilled services, out of a total sample of 9 clinical records reviewed.

The home health agency failed to ensure all patients/ patient caregivers were informed of the cost to them of services provided by the home health agency in 2 of 9 clinical records reviewed.

The home health agency failed to ensure that a discussion occurred and an agreement by the primary physician was obtained, prior to the patient's verbal notification of discharge and failed to ensure the information sent to the physician on reason for discharge was consistent with complaint log and…

The home health agency failed to ensure communication with the physician in regards to the patients refusal was documented, failed to ensure the risks to the patients refusal of services was discussed and documented in the clinical record, and failed to ensure they investigated the reason for the…

The home health agency failed to ensure all complaints were investigated with a resolution documented in 2 of 20 complaints reviewed without a resolution.

The skilled nurse failed to ensure all the patients vital signs and current health conditions were assessed and accurately reflected patients status in 6 of 7 clinical records reviewed with skilled nursing services, out of a total of 9 clinical records reviewed.

The skilled nurse failed to ensure all medications were documented, reviewed and included the right route, frequency and indications for PRN [as needed] medication orders in 7 of 7 patients with skilled nursing services, out of a total sample of 9 clinical records reviewed.

The home health agency failed to ensure the patients medical plan of cares were complete to include all orders, medications, safety precautions, nutritional information, skilled nursing orders, and goals in 5 of 7 skilled patients, of a total sample of 9 clinical records reviewed.

The skilled nurse failed to ensure physician orders were in place before a treatment was provided and failed to ensure all orders were given by the physician involved in the plan of care in 3 of 7 clinical records reviewed with skilled nursing services, out of a total sample of 9 clinical records…

The home health agency failed to ensure the skilled nurse notified the physician of changes and unrelieved pain reported by the patient during the skilled assessment in 2 of 7 clinical records reviewed with skilled nursing services/ assessments, out of a total of 9 clinical records reviewed.

The home health agency failed to coordinate care with outside healthcare entities that provided care to agency clients in 2 of 9 clinical records reviewed.

The skilled nurse failed to accurately assess the patient per the skilled nursing clinical notes in 2 of 7 clinical records reviewed with skilled nursing services, out of a total of 9 clinical records reviewed.

The skilled nurse failed to follow the plan of care as established by the primary care physician in 5 of 7 clinical records reviewed with skilled nursing services, out of a total of 9 clinical records reviewed.

The agency failed to ensure that they did not complete their own home health aide competency after being found out of compliance with conditions of participation during their February 2019 survey (Employee T) and failed to ensure they did not accept a skills competency that was conducted from…

The home health aide failed to provide all services for the patient, as directed by the registered nurse and the registered nurse failed to ensure they did not direct the home health aide to perform tasks outside of their scope of practice, in 4 of 6 clinical records reviewed with home health aide…

The home health agency failed to ensure the skilled nurse provided a supervisory visit every 14 days for patients who received skilled care, in 1 of 5 records reviewed with skilled nursing and home health aide services, out of a total sample of 9 clinical records reviewed.

The home health agency failed to ensure the skilled nurse conducted a supervisory visit to patients without skilled nursing services a minimum of every 60 days, in 1 of 1 clinical records reviewed with home health aide only services, out of a total sample of 9 clinical records reviewed.

The skilled nurse failed to ensure the home health aide was following the medical plan of care during the supervisory visit in 1 of 6 clinical records reviewed with home health aide services, out of a total of 9 clinical records reviewed.

The administrator failed to be involved in the day to day activities of the agency, in 1 of 1 home health agency.

The home health agency failed to ensure an alternate administrator was authorized in writing to assume the position of the administrator in the absence of the administrator in 1 of 1 home health agency.

The agency failed to ensure the patients/ patient representatives received the home health agency administrator's name and contact information in order for the administrator to receive complaints (See G414); failed to ensure patient rights were adhered to by failing to accept and process complaints…

The agency failed to ensure the patient's medical and nursing needs were met in his or her place of residence for 3 of 12 clinical records reviewed with the potential to fail to provide safe and effective care to these patients (see G 570); failed to ensure skilled nursing provided bowel program…

The agency failed to develop, implement, evaluate and maintain an effective, ongoing, data-driven QAPI program for 1 of 1 agency (see G 640); failed to be able to show measurable improvement in quality indicators, measure, analyze, and track quality indicators, including adverse patient events (G…

The home health agency failed to have an active infection control program for 1 of 1 agency (see G 680); failed to maintain a coordinated agency-wide program for the surveillance, identification, prevention, control, and investigation of infections and communicable diseases and incorporated the…

The agency failed to ensure all home health aides completed a competency evaluation program and / or were currently listed in good standing on the state nurse aide registry or home health aide registry for 4 of 15 records reviewed of staff who worked as home health aides for the agency (see G 752)…

The Governing Body failed to ensure the agency was providing optimal care to achieve the goals and outcomes identified in the patients careplans, assure that administrative and supervisory functions are not delegated to an unauthorized agent of the agency, failed to ensure that the agency had an…

The agency failed to ensure they followed their agency policy and that the clinical records contained accurate information for 2 of 12 records reviewed (see G 1008); failed to ensure clinical records contained plans of care (see G 1012); and failed to ensure a physician signed and dated a plan of…

The agency failed to ensure OASIS data had been transmitted within 30 days of completing an assessment in 4 of 4 clinical records reviewed (#1, #2, #3, #4) of patients that received skilled services and required comprehensive assessments and had been on service over 60 days.

The agency failed to ensure the Registered Nurse consistently and accurately reassessed the patient's needs for 2 of 4 active skilled records reviewed (#2, #4).

The agency failed to ensure skilled nursing provided bowel program per the plan of care for 1 of 1 (#1) patient record review of a patient with a bowel program, failed to ensure care was not provided absent of a physician-ordered plan of care for 4 of 12 records reviewed, and failed to ensure home…

The agency failed to ensure home health aide visits were furnished as ordered on the aide care plan and failed to ensure the aide care plan was made available to the employee for 1 of 3 active patients who were observed at a home health aide observation (#10).

The agency failed to ensure the governing body exercised full legal responsibility for the agency's overall management and operations, fiscal operations, review of the budget, and its quality assessment and performance program for 1 of 1 agency.

The agency failed to ensure a physician signed a plan of care within a timely manner for 1 of 12 records reviewed.

The agency failed to ensure the patients/ patient representatives received the home health agency administrator's name and contact information in order for the administrator to receive complaints for 7 of 7 active records reviewed (#1 - 4, #6, #9, #10).

The agency failed to ensure patient rights were adhered to by failing to accept and process complaints made by a patient for 1 of 1 active records reviewed (#10) of a record found with a complaint.

The agency failed to ensure patients were informed about changes to the care to be furnished for 2 of 4 active skilled clinical records reviewed (#1 and #4).

The agency failed to ensure patient rights were adhered to and that a patient received consistent nursing care and treatment for 1 of 4 active skilled records reviewed (#1).

The agency failed to ensure they followed their policy and documentation of a patient/ patient representative being notified in advance of an impending discharge for 1 of 1 discharged records of a skilled record reviewed (#5).

The agency failed to ensure they investigated a complaint made by the patient for 1 of 1 active records reviewed (#10) of a record found with a complaint.

The agency failed to ensure they documented the existence and resolution of a complaint made by the patient for 1 of 1 active records reviewed (#10) of a record found with a complaint.

The agency failed to ensure all patient medications were updated and correctly documented for 1 of 4 active skilled patients whose clinical records were reviewed (Patient #4).

The agency and the skilled nurse failed to ensure the physician was notified of a patient's fall with possible injury in 1 of 7 active clinical records reviewed (#9) The findings include: The agency policy titled "2.6 Service Policies Nursing Service" dated 2018 stated, "Nursing service is provided…

The agency failed to ensure the plan of care was revised/ updated to include frequency and duration of skilled nurse and home health aide visits to be made in 4 of 7 active clinical records (#1, #3, #4, #9) and 1 of 5 closed records (#5), accurate medications, fluid restrictions, all interventions…

The home health agency failed to ensure they communicated new orders with the patient's primary care physician after a patient was discharged from the hospital in 1 of 1 record reviewed (#4) of a patient discharged from the hospital.

The agency failed to ensure skilled nursing and home health aides coordinated care amongst each other in 1 of 12 records reviewed.

The home health agency failed to ensure they coordinated care and services with the patient's dialysis center in 1 of 1 record reviewed (#4) of a patient receiving dialysis in a sample of 12. The findings include: The agency policy titled "2.36 Coordination of Services" dated 2018 stated, "1. To…

The home health agency failed to ensure the clinical manager's name and contact information was provided to 7 of 7 active patients ( # 1 - #4, #6, #9, #10 ).

The agency failed to ensure that a skilled nurse went out to assess a patient who had fallen and bumped their head for 1 of 1 conversation overheard of a patient who had fallen.

The agency failed to ensure all home health aides completed a competency evaluation program and/ or were currently listed in good standing on the state nurse aide registry or home health aide registry for 4 of 15 records reviewed (#J, L, N, S) of staff who worked as home health aides for the agency.

The home health agency failed to ensure a home health aides only completed tasks allowed under state law during home visits for 2 of 3 home visits observed (patient #2) with a home health aide (Employee C, HHA) and 2 of 7 active clinical records reviewed with home health aide services (#2 and #4).

The agency failed to ensure a clinical manager was available during all operating hours for 1 of 1 agency.

The agency failed to ensure all home health aides completed a competency evaluation program and/ or were currently listed in good standing on the state nurse aide registry or home health aide registry for 4 of 15 records reviewed (#J, L, N, S ) of staff who worked as home health aides for the…

The agency's clinical supervisor failed to make patient and personnel assignments for 1 of 1 agency.

The agency's clinical manager failed to coordinate referrals for 1 of 1 agency.

The agency failed to ensure clinical records contained plans of care for 1 of 12 records reviewed.