Hamilton Home Health

The agency failed to electronically transmit monthly Outcome and Assessment Information Set (OASIS) data collected to the CMS system every 30 days.

The agency failed to ensure that patients' medication profiles were updated to reflect current medications for two of seven (P#) (#12,and #14) patients participating in home visit observations.

The agency staff failed to include orders to cover all pertinent diagnoses and ensure the patients' needs were addressed to include disease specific interventions/treatments were included on the plans of care for ten of seventeen ( #1, , #3, #4, , #6, #7, #9, #10,#12, #14 and #16) sampled patients…

The Home Health Agency failed to alert the relevant physician(s) to any changes in the patient's condition or needs that suggest that outcomes are not being achieved and/or that the plan of care should be altered.

The Home Health Agency failed to communicate with all physicians involved in the plan of care and other health care practitioners (as appropriate) related to the current plan of care.

The agency failed to include patient-specific measurable outcomes and goals in the plan of care /plan of treatment for 12 of 17 (#2, #4, #5, #6, #7, #8, #9, #10, #11, #12, #15, and #17) sampled patients.

The agency failed to ensure the patients' individualized plan of care/treatment included all of the required elements to address the patients' needs for 13 of 17 (#1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #11, #12 and #17) sampled patients.