Caring Angels Home Health, LLC

The facility failed to individualize the plan of care, by using the same visit frequency range for the services provided, for ten (10) out of ten (10) patients reviewed, patient 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10. This failure has the potential to negatively impact all patients receiving care from…

The facility failed to provide patient care according to physician's orders in one (1) out of one (1) home visits observed (Patient #7).

The facility failed to ensure patient's care was completed as ordered and coordinated by all agency staff by notifying physicians promptly of changes in patients' conditions (see Tag G 590); failed to ensure discharge plan changes were communicated with the care team or patient (see Tag G 598)…

The agency failed to ensure all staff participated in periodic discussions about patients' health status and recommendations for care (see Tag G 706); failed to ensure all staff provided all of the physician ordered services on the plan of care (see Tag G 710); failed to ensure staff completed…

The governing body (GB) failed to ensure the agency's on-call policy was followed for all current patients.

The agency failed to ensure all patients participated in their plan of care (POC) in one (1) of seven (7) records reviewed with patients who had changes to the POC (patient # 6).

The agency failed to ensure all services ordered on every patient's plan of care were carried out as ordered in two (2) of seven (7) records reviewed (patients #3 and 4).

The agency failed to notify the ordering physician of a change in the patient's condition in two (2) of seven (7) records reviewed (patients #4 and 7).

The agency failed to communicate a change in discharge plan to the patient in one (1) of seven (7) records reviewed of patients who were discharged before the anticipated discharge date and before goals were met (patient #6).

The agency failed to ensure integration of contract and non-contract services to assure the identification of patient needs and factors that could affect patient safety by coordination of care in two (2) of seven (7) records reviewed with patients who had identified needs and factors that could…

The agency failed to ensure each patient or their caregiver received ongoing education and training about the items identified in the plan of care in one (1) of seven (7) patients who had requested teaching on items identified in the plan of care but did not receive it (patient #7).

The agency failed to ensure all staff participated in periodic discussions about patients' health status and recommendations for care.

The agency failed to ensure all staff provided all of the physician ordered services on the plan of care in two (2) of seven (7) records reviewed of patients who had a physician ordered plan of care (patients #3 and 4).

The agency failed to ensure staff completed ongoing education and training about the items identified in the plan of care in one (1) of seven (7) patients who had requested teaching on items identified in the plan of care but did not receive it (patient #7).

The agency failed to ensure the skilled professional staff alerted the ordering physician of a change in patients' conditions in two (2) of seven (7) records reviewed with a physician ordered plan of care (patients #4 and 7).

The agency failed to ensure an identified registered nurse (RN) monitored and evaluated licensed practical nurse's (LPN) performance in provision of services, especially communication with the RN about the parts of the plan of care delegated to the LPN, in two (2) of seven (7) records reviewed with…

The facility failed to ensure patients were accepted for treatment on the reasonable expectation the agency could meet the patients' medical needs in their own place of residence with an individualized plan of care that specified the care and services needed to meet individualized patient goals and…

The agency failed to have a specific individual patient emergency preparedness plan, with a copy left in the patient's home, for all patients as required.

The agency failed to ensure their Emergency Preparedness written communication plan included a primary and alternate means of communication with the facility staff, local, state and/or federal official emergency management agencies.

The agency failed to ensure their Emergency Preparedness Plan included a written training and testing program.

The agency failed to provide initial training for emergency preparedness to all agency staff.

The agency failed to ensure each patient received all of the physician ordered services on the plan of care in nine (9) of nine (9) records reviewed of patients who had a physician ordered plan of care (patients #1, 2, 3, 4, 5, 6, 7, 8 and 9).

The agency failed to ensure the home health aide had a competency evaluation for all skills required by regulation for one (1) of one (1) home health aide employed by the agency.

The agency failed to ensure all patients received proper written notice of reducing or terminating on-going care in one (1) of one (1) patient records reviewed of patients who had a decrease or termination of their plan of care (patient #5).

The agency failed to ensure all patients' plans of care included the required description of the patients' risk for emergency department visits, hospital re-admission and patient specific interventions for nine (9) of nine (9) records reviewed of patients who had a physician ordered plan of care…

The agency failed to ensure services and treatments were administered only as ordered by a physician in two (2) of nine (9) records reviewed of patients who received services from the agency without a documented physician order to provide home health services (patients #3 and 5).

The agency failed to ensure the physician was promptly alerted to changes in a patient's condition that suggest outcomes are not being achieved in one (1) of one (1) record reviewed of patient's who had a change in condition differing from expected outcomes of the plan of care (patient #8).

The agency failed to ensure all revisions to a patient's plan of care, due to a change in patient health status, were communicated to the patient about their plan of care in one (1) of nine (9) patients who had a documented change in health status and a change to the patient's plan of care with no…

The agency failed to assure all staff who provided services directly or under arrangement communicated to each other about the patient's plan of care in five (5) of nine (9) records reviewed of patients who did not receive some services on the plan of care as ordered because the staff failed to…

The agency failed to ensure the patient and caregiver received education and training upon admission regarding speech therapy services for swallowing and cognitive therapy identified in the plan of care in one (1) of two (2) records reviewed of patients who were ordered speech therapy (patient #8).

The agency failed to ensure the home health aide had an annual competency evaluation for all skills required by regulation for one (1) of one (1) home health aide employed by the agency.