Cedar County Public Health Nursing Services

The agency failed to follow a Plan of Care established and periodically reviewed by a physician or notify the physician of the need to vary frequency of visits as originally ordered on the Plan for Care for 2 of 7 sampled patients.

The agency failed to ensure staff provided care in accordance with accepted infection control standards of practice observed during a home visit for 1 of 3 sampled patients with home visits.

The agency failed to provide a complete comprehensive assessment for patients with wounds for 1 of 4 sampled patients with wounds (Patient #3).

The agency failed to perform complete drug regimen reviews with corresponding comprehensive assessments for 3 of 7 sampled patients (Patients #3, #4 and #7).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies and equipment used by the patient to meet their needs, an accurate list of the patient's current medications and wound care orders for 4 of 7 sampled patients (Patients #1, #3…

The agency failed to update the Plan of Care with all new physician orders for 3 of 7 sampled patients with interim orders.

The agency failed to ensure the clinical record included a complete clinical record for 3 of 7 sampled patients (Patients #3, #4 and #6).

The agency failed to complete a drug regimen review with each comprehensive assessment and identify patient specific medication issues for 5 of 7 sampled patients (Patients #1, #2, #3, #5 and #6).

The agency failed to update the Plan of Care with all new physician orders for 4 of 5 sampled patients with interim physician orders.

The agency failed to ensure registered nurses supervising home health aides maintained documentation of a review of all required supervisory elements including following the patient plan of care, maintaining open communication with patient/caregiver, demonstrating competency of all assigned tasks…

The agency failed to complete a written policy or procedure to outline the use of emergency staffing strategies which included State and Federally designated health care professionals.

The agency failed to ensure all documentation in the clinical record included a date, time, staff signature and staff title for 2 of 7 sampled patients (Patients #4 and #6).

The agency failed to provide an initial assessment visit within 48 hours of receipt of referral and/or return home, for 3 of 7 sampled patients (Patients #2, #3 and #5).

The agency failed to ensure agency staff completed the comprehensive assessment at the start of care by the fifth day after the start of care for 2 of 7 sampled patients (Patients #1 and #7) admitted after the last survey (11/2/17).

The agency failed to accurately complete a drug regimen review, including completion of all required components within the required time frames as part of the comprehensive assessment for 4 of 7 records reviewed (Patients #1, #2, #4 and #6).

Agency clinicians failed to complete updates to the comprehensive assessment at recertification in the last 5 days of each certification period for 2 of 6 sampled patients requiring a recertification assessment (Patients #2 and #4).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all medications, medical equipment and supplies used by the patient for 1 of 3 sampled patients with home visit observation (Patient #3).

The agency failed to update the Plan of Care with all new physician orders for 5 of 7 sampled patients with interim physician orders.

The agency failed to identify current vaccination status at the comprehensive assessment completed at the start of care for 6 of 7 sampled patients.

The agency failed to ensure skilled professionals provided care as ordered by the physician in the Plan of Care for 1 of 1 sampled patients (Patient #7) with wounds.