CARE4ME Skilled, LLC

The facility failed to develop the Comprehensive Emergency Preparedness Program that met the requirements of 484.22. This had the potential to affect all patients.

The agency failed to ensure that each patient received home health services that were written in an individualized plan of care (G572).

The agency failed to ensure the quality assessment performance improvement (QAPI) program was at least capable of showing measurable improvement in indicators for which there was evidence that improvement in those indicators would improve health outcomes, patient safety, and quality of care and…

The agency failed to ensure that each patient received home health services that were written in an individualized plan of care for three of seven sampled patient records (Patients #2, #5, and #6).

The agency failed have a program that must at least be capable of showing measurable improvement in indicators for which there was evidence that improvement in those indicators will improve health outcomes, patient safety, and quality of care and that the agency must measure, analyze, and track…

The agency failed to utilize any quality indicator data and other relevant data, in the design of its program.

The agency failed to ensure that home health aide had successfully completed a competency evaluation program using an agency patient for one of five sampled home health aide personnel files (Staff M).

The agency failed to ensure that written patient care instructions for a home health aide was prepared by a registered nurse for one of three sampled patients who received home health aide services (Patient #5).

The agency failed to ensure that a registered nurse conducted an initial assessment visit to determine the immediate care and support needs of the patient within 48 hours of referral, or within 48 hours of the patient's return home, or on the physician-ordered start of care date for one of seven…

The agency failed to update the comprehensive assessment during the last five days of every 60 days beginning with the start-of-care date for two of seven sampled patient records (Patients #2 and #7).

The agency failed to ensure that each patient's plan of care included all required information for two of seven sampled patient records (Patient #1 and Patient #3).

The agency failed to ensure that each patients' plan of care was reviewed and revised by the physician as frequently as the patient's condition or needs required, but no less frequently than once every 60 days for two of seven sampled patient records (Patient #6 and #7).

The agency failed to ensure that nursing services were provided under the supervision of a registered nurse with regard to patient assessments for one of seven sampled patient records (Patient #5).

The agency failed to ensure the home health aide provided services ordered by the physician and were included in the plan of care for one of seven sampled patient patient medical records (Patient #5).

The agency failed to ensure supervisory visits were conducted at least every 60 days by a registered nurse while the aide was present for patients not receiving skilled care for two of seven sampled patient medical records (Patients #2 and #5).

The governing body failed to appoint an Administrator.

The agency failed to designate in writing a qualified, pre-designated person should the Administrator not be available.