Harrison County Home Health & Hospice

The home health provider failed to ensure that a complete and accurate patient specific comprehensive assessment was completed for each patient.

The provider failed to: - Ensure that each patient received services that were written in the plan of care (POC) and signed by the physician, when therapy treatment plans failed to be included on the POC, and were not signed by a physician or allowed practitioner (G572); -Ensure that each patient's…

The provider failed to ensure the contract PT (physical therapist) received the provider’s emergency management training in one of one contract employee file review (Contract PT).

The home health provider failed to ensure that each patient received services that were written in the plan of care (POC) and signed by the physician, when therapy treatment plans and orders/interventions, failed to be included on the POC, and were not signed by a physician or allowed practitioner…

The provider failed to ensure the initial assessment was completed within 48 (forty-eight) hours of the referral in two of five full records reviewed (Records/Patients #1 and #2).

The provider failed to ensure the registered nurse (RN) completed the comprehensive assessment no later than five days after the start of care in one of five full records reviewed (Patient #3).

The home health provider failed to ensure the comprehensive assessment accurately reflected the patient’s current health status including relevant past medical history in, three of five full records reviewed (Records/Patients #3, #4, and #5).

The home health provider failed to ensure that each patient's written individualized plan of care (POC) included safety measures to prevent against injury, functional limitations, patient-specific interventions, and all types of services required, in three of five full records reviewed…

The home health provider failed to ensure treatments were provided as ordered by the physician, when the staff provided treatments without physician orders in, two of five full records reviewed (Records/Patients #4 and #5).

The home health provider failed to promptly alert the physician to changes in the patient's condition or needs, to clarify orders and/or receive orders, in four of five full records reviewed (Records/Patients #2, #3, #4, and #5).

The provider failed to integrate orders from all physicians involved in the plan of care (POC), to assure that coordination of all services and interventions were provided to the patient in, one of five full records reviewed (Record/Patient #3).

The home health provider failed to coordinate care delivery to meet the patient’s needs, between all individuals involved in the patient’s care, as well as the patient and/or caregiver(s) in, three of five full records reviewed (Records/Patients #2, #4, and #5).

The home health provider failed to ensure that each patient and his or her caregiver(s), received education regarding the physician order to discontinue the use of Tylenol due to drug to drug medication interaction, and the risks for continued use, in one of five full records reviewed…

The provider failed to provide the patient/caregiver with a copy of written instructions outlining the patient’s medication schedule/instructions in, but not limited to, one of three home visit observations, (Record/Patient #1).

The provider failed to provide SN (skilled nursing) and PT (physical therapy) services at the frequency ordered in one of five full records reviewed (Record/Patient #3).

The provider failed to ensure contract staff were provided annual agency In-service training in one of one contract employee file reviewed (Contract Physical Therapist-PT).

The provider may not train or competency evaluate their home health aides for a period of two (2) years following the date of this survey.

The agency failed to ensure staff provided the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/2018 to include a completed and signed copy of the agency's Condition of Patient Rights form which included the written notice of the…

The agency failed to ensure staff followed infection control standards of practice in two (Record/Patient #1 and #2) of three home visits observations.

The agency failed to provide the skilled professional services of the registered nurse (RN) when the RN failed to provide services according to standards of practice and the agency's policy and procedures in two (Records/Patients #1 and #3) of five full records reviewed.

The agency failed to ensure staff provided the written notice of patient rights, to meet the requirements of the new federal home health regulations effective 01/13/2018, to include a completed and signed copy of the agency's Condition of Patient Rights form which included rights and…

The agency failed to ensure staff provided the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/2018 to include the rights of the patient and representative (if any) regarding contact information for the home health agency…

The agency failed to ensure staff provided the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/2018 to include; the patient and representative (if any) have the right to be advised orally and in writing of, the extent to which…

The agency failed to ensure staff provided the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/2018 to include a completed and signed copy of the agency's Condition of Patient Rights form which included the Missouri state toll…

The agency failed to complete the initial assessment of the patient within 48 hours of the referral to home care, or 48 hours after the patient returned home, or on the physician ordered start of care date to determine the immediate care and support needs of the patient and to determine eligibility…

The agency failed to ensure staff reviewed all of the medications the patients were currently using in order to identify any potential adverse effects and drug interactions in three (Record/Patient #1, #3 and #6) of three home visit observations.

The agency failed to ensure that each patient's written individualized plan of care (POC) included all the required elements in two (Record/Patient #1, and #3) of five full records reviewed.

The agency failed to ensure all patient care orders were recorded in plan of care (POC) in one (Record/Patient #6) of five full record reviews.

The agency failed to ensure communication with all physicians involved in the plan of care (POC) in two (Record/Patient #2 and #3) of five full records reviewed.

The agency failed to ensure the staff provided a written visit schedule to patients that included what discipline was visiting and the frequency of visits in three (Record/Patient #1, #2, and #4) of three home visit observations.

The agency failed to ensure staff provided the patient or caregiver (if any) with a copy of written instructions outlining the patient's medication schedule/instruction, including the medication dosage which affected one (Record/Patient #2) of three home visit observations.

The agency failed to ensure staff provided the patient or caregiver (if any) with a copy of instructions of any treatments being administered by the agency in three (Record/Patient #1, #2, and #4) of three home visit observations.

The agency failed to ensure staff provided the information of the name and contact number of the clinical manager in the admission packet during the initial assessment which affected three (Record/Patient #1, #2, and #4) of three home visit observations.

The agency failed to ensure a comprehensive transfer summary was sent within two business days of a transfer if the patient's care will be immediately continued in a health care facility in one (Record/Patient #6) of three discharge records reviewed.

The agency failed to conduct emergency preparedness training for two employees (E #1 and #4) of four employees reviewed.

The agency failed to ensure the comprehensive assessment included a complete and accurate review of the patient's medication regimen by the registered nurse (RN) in, but not limited to, two of five cases (Records/Patients: #4, and #5).

The agency failed to ensure the plan of care (POC) was individualized and/or contained complete and accurate information for services and interventions in, but not limited to three (RECORD/PATIENT #1, #4, and #5) of five records reviewed.

The agency nurses and/or home health aide (HHA) and skilled nursing (SN) failed to coordinate with other home health staff regarding the patient's condition or plan of care ordered by the physician in, but not limited to two (RECORD/PATIENT #3 and #5) of five records.

The contract failed to contain information regarding the home health agency maintaining overall responsibility for the services provided under arrangement in one of one agency contracts.

The agency failed to maintain compliance with regulations by failing to ensure the following upon hire in, but not limited to, four applicable cases (Employees #1, #2,#3, and #4) who failed to complete a criminal disclosure statement.