Central Home Health Care

The home health agency failed to ensure the physician orders were followed in 1 of 7 records (P-6) from a total of 7 records reviewed, resulting in the potential for unmet care needs for agency patients.

The agency failed to ensure that 2 (P's #2, 3) patients observed during home visits, were included in the overall planning of their care including informing the patient/caregiver in advance of the days in which services would be provided, from a total of 7 sampled records reviewed, resulting in a…

The agency failed to ensure the Initial Comprehensive Assessment accurately reflected the patient's condition at the time of admission and documented the events that lead to the need for home care for 4 (P#'s 4, 5, 6, 7) patients admitted to this agency, from a total of 7 sampled records reviewed…

The agency failed to ensure the comprehensive assessment included an accurate review of all medications to determine potential adverse effects or duplicate drug therapy in 1 of 7 (P- 6) records reviewed, resulting in the potential for harmful medication effects for all patients serviced by this…

The agency failed to ensure the plan of care included all safety measures to prevent injury in 1 of 7 records reviewed (P-7). resulting in the potential for a poor patient outcome.

The agency failed to ensure the skilled nurse performed ongoing assessments of the patient's surgical site for 1 (P-2) patient who underwent surgery and reported feeling a lump near the surgical site, from a total of 7 sampled records reviewed, resulting in the potential for worsening of condition…

The agency failed to ensure Occupational Therapy services were provided as ordered for 1 (P-2) patient who underwent cervical surgery, and 1 (P-6) patient with lumbar surgery, from a total of 7 sampled records reviewed, resulting in the potential for decline in physical functioning and unmet care…

The Agency failed to develop an emergency preparedness plan that was clear, accessible, and included guidance for the Covid-19 pandemic, resulting in lack of direction for Agency personnel in the event of an actual emergency or disaster and unsafe, unmet care needs for all 26 patients actively…

The agency failed to ensure the initial comprehensive assessment visit was completed by a registered nurse in 1 of 7 (MR# 1) records reviewed (See G514); failed to ensure the comprehensive assessment included baseline information that detailed the patient's current health at the time of admission…

The Agency failed to develop an emergency preparedness plan that was clear, accessible and included guidance for the Covid-19 pandemic, resulting in lack of direction for Agency personnel in the event of an actual emergency or disaster and unsafe, unmet care needs for all 26 patients actively…

The Agency failed to ensure an emergency plan existed that was based on a documented facility and community based risk assessment from an all hazards approach, including strategies for the Covid-19 global pandemic, resulting in the potential for lack of preparedness and poor patient and staff…

The facility failed to develop and maintain an emergency preparedness communication plan that included contact information for patient's physicians, volunteers and entities under arrangement, which had the potential to negatively affect the health and safety of the 26 patients currently serviced by…

The Agency failed to ensure all staff received initial and annual training in the Agency's emergency preparedness program, including training on the Covid-19 pandemic, resulting in staff being ill-prepared in the event of an actual disaster or emergency.

The Home Health Agency failed to perform training/evaluation prior to the aide providing services for 1 of 4 home health aide records reviewed (MR #7), out of a total of 7 records, resulting in the potential for having an unqualified aide providing personal care to patients.

The Agency failed to ensure Physical Therapy and Skilled Nursing prepared clear written patient care instructions for the home health aide regarding client needs, and safety precautions prior to providing care in 2 (MR#'s 1 and 7) of 4 records in which Home Health Aide services were ordered, from a…

The Agency failed to ensure the Registered Nurse performed the initial start of care comprehensive assessment for 1 (MR# 1) record in which both Nursing and Physical Therapy services were ordered, from a total sample of 7 records reviewed, resulting in the potential for unmet care needs.

The agency failed to ensure the comprehensive assessment included baseline information that detailed the patient's current health at the time of admission for 1 of 7 (MR# 5) records reviewed, resulting in incomplete clinical information to assist in determining the needs of the patient which…

The agency failed to ensure the comprehensive assessment included a review of all medications to identify any potential adverse effects and drug reactions for 1 of 7 (MR# 7) records reviewed, and failed to ensure a registered nurse performed a review of the patient's medication list in which…

The Agency failed to ensure that Speech Therapy services were provided for 1 (MR #3) of 1 record with Speech Therapy services ordered, resulting in the potential for physical decline, and unmet care needs.

The agency failed to ensure transfer summaries were sent within 2 business days to the receiving facility/physician for 1 of 1 (MR# 5) record reviewed in which the patient was transferred from a total sample of 7 records, resulting in the potential to negatively affect all patients transferred from…

The agency failed to include a process for cooperation and collaboration with local, regional, State and Federal emergency preparedness officials to maintain an integrated response during a disaster or emergency situation; and failed to document the agency's efforts of contacting these officials to…

The agency failed to include in the agency emergency plan a mechanism in the policy and procedures for follow-up with staff and patients to inform state and local authorities of any on-duty staff or patients that the agency is unable to contact.

The agency failed to comprise information in the agency policy and procedures regarding the use of volunteers and the process and role for integration of State and Federally designated health care professionals to address surge needs during an emergency.

The facility failed to provide documentation of an initial employee emergency preparedness training and testing program for all new staff, existing staff, and individuals providing services under arrangement to ensure all individuals are aware of the agency's emergency preparedness program.

The agency failed to provide documentation of participation in a community-based and tabletop drill, nor did the agency perform an additional exercise to test the emergency plan, and failed to provide documentation of the agency's analysis and response to the facility-based emergency event.

The agency failed to ensure the individualized Plan of Care included patient-specific measurable outcomes and goals in 5 of 8 records reviewed (MR#s 1, 2, 3, 7, and 8) out of total of 8 records reviewed.

The Registered Nurse (RN) failed to ensure the written plan of care for the assigned Home Health Aide provided specific guidance, specific safety precautions and care instructions on the needs of the patient, and was revised and kept current for 3 of 4 records reviewed with services provided by a…

The agency failed to ensure that the measurable outcomes and goals set forth in the plan of care had been achieved before discharge of the patient from Home Health services in 2 of 2 records reviewed in which the patient was transferred or discharged (MR#3 and 8) out of a total of 8 records…

The agency failed to ensure the individualized Plan of Care included patient-specific measurable outcomes and goals in 4 of 8 records reviewed (MR#s 1, 2, 7, and 8) out of total of 8 records reviewed.

The agency failed to ensure the Plan of Care included functional limitations, specific frequency of visits, and patient specific individualized interventions in 4 of 8 records reviewed (MR#s 1, 2, 7, and 8) out of a total of 8 records reviewed.

The agency failed to ensure services were provided as ordered by the physician and on the plan of care in 6 of 8 records reviewed (MR#s 2, 3, 4, 5, 6 and 8) . Findings included: **Agency Policy #0250: "Patient Care," revised 9/17/17. The policy states, "Patients are accepted for treatment on the…