Heal at Home LLC

The agency failed to ensure Home Health Aides (HHAs) were appropriately competencied by a contracted entity or Registered Nurse, by failing to ensure the Clinical Educator's contract specified the duties of the following: aide competency, skilled training, including tube feeding training, for 53 of…

The Director of Nursing failed to maintain oversight of the agency's contracted Clinical Educator, for 1 of 1 contracted Clinical Educator reviewed.

Heal at Home failed to ensure contracted staffing was provided by a registered staffing company and failed to ensure contracts identify Heal at Home as the entity responsible for maintaining all patient records.

The agency failed to ensure patients or their representatives were notified and consented to any changes in the care and documentation of such changes in their clinical record (G434) and failed to ensure patients were discharged for cause (G452).

The agency failed to ensure patients were appropriately discharged from Home Health services and failed to ensure the discharges were for cause (an accepted reason).

The agency failed to ensure home health aide in-service hours were completed and documented (778); failed to ensure the Registered Nurse (RN) failed to identify seizure precautions on the aide care plan (798); and failed to ensure a home health aide followed a patient's plan of care to provide…

The agency failed to organize, manage, and administer its resources to achieve and maintain a high level of performance in the provision of Home Health care services to ensure personnel was current with their license/certificates, current with in-services, client intakes, and scheduling: the agency…

The agency failed to ensure 6 of 6 discharge patients were discharged for cause.

The agency failed to ensure patients were discharged and/or transferred appropriately in 6 of 6 discharged records reviewed.

The agency failed to ensure staff members followed appropriate infection control practices while providing hands-on care for patients in 2 of 3 home visits observed.

The agency failed to ensure the Registered Nurse (RN) failed to identify seizure precautions on the aide care plan in 1 of 3 active records reviewed.

The Governing Body failed to hire an Administrator for the Agency and failed to ensure the management and operation of the Agency was effective in 1 of 1 agency.

The agency failed to ensure patients or their representatives were notified and consented to any changes in the care and documentation of such changes in 6 of 6 discharged clinical records.

The agency failed to ensure safety measures to protect against injury and necessary interventions to address the underlying risk factors were on the individualized plan of care for 1 of 4 active clinical records reviewed.

The agency failed to ensure verbal orders were properly obtained for 1 of 6 discharged records reviewed.

The agency failed to ensure revisions to patients discharge plans had an appropriate cause/reason and were communicated and agreed upon with the patient, caregiver and ordering provider in, 6 of 6 discharged clinical records reviewed.

The agency failed to ensure in-service hours were completed and documented with 4 of 12 home health aide (HHA) employee records reviewed.

The agency failed to ensure a home health aide followed a patient's plan of care to provide ordered hands-on personal care and within their scope of practice, in 1 of 2 home health aide visits.

The agency failed to ensure the acting Administrator was involved in discharge for cause, oversight of human resources, and scheduling of home health aides in 1 of 1 agency.

The agency failed to ensure ketone call orders were included on the plan of care in 1 of 6 active record reviews.

The agency failed to ensure patients received written instructions for their plan of care, medications, and schedules in 3 of 4 home visits.

The agency failed to ensure staff utilized appropriate infection control, personnel protective equipment, and hand hygiene practices while providing care in 1 of 4 home visits observed.

The agency failed to ensure a review of all current medications was conducted to identify any potential adverse effects, drug reactions, including ineffective drug therapy, side effects, duplicate therapy, and/or noncompliance with medication regimen, in 1 of 8 active clinical records reviewed.

The agency failed to ensure the clinical staff notified the attending physician with a medication error in 1 of 6 active records reviewed.

The Governing Body failed to ensure the frequency of data collection for the Quality Assessment Performance Improvement (QAPI) Plan was approved by the Governing Body, for 1 of 1 agency QAPI program.

The agency failed to evidence the documentation of the initiation of the performance improvement plan (PIP) activity of obtaining physician orders at the start of care, recertification, patient strengths, and care preferences for 1 of 1 Quality Assessment and Performance Improvement (QAPI) programs.

The Governing Body failed to ensure an ongoing Quality Assessment Performance Improvement program which established clear expectations for patient safety and quality of care was implemented according to the agency's plan of correction date of 12/08/23, and was maintained and evaluated for…

The agency failed to develop, implement, document, and maintain an effective, ongoing, agency-wide, data-driven Quality Assessment Performance Improvement (QAPI) program that reflected the complexity of the organization and its services; failed to evidence a QAPI program that demonstrated tracking…

The agency failed to ensure all home health aides successfully completed a competency testing program that included written competency testing and skills competency testing of the aide performing specific tasks on a live patient or pseudo-patient, including but not limited to communication skills…

The agency failed to ensure the patient's comprehensive assessment included the patient or patient representative's strengths, goals, and care preferences for 4 of 5 active clinical records reviewed.

The agency failed to ensure verbal physician's orders were received verbally from the physician or qualified physician's representative, documented at the time they were received and then read back and verified for accuracy then sent to the physician to be signed, for 5 of 6 active clinical records…

The agency failed to ensure it employed qualified home health aides (HHAs) who successfully completed an HHA training and competency program or evidenced prior equivalent training and completed the agency's HHA competency program consisting of successful completion of a written test and…

The agency failed to ensure the home health aide (HHA) reported changes in the patient's condition to a Registered Nurse for 1 of 5 active patient records reviewed.

The agency failed to ensure they provided home health aide service as ordered per the plan of care for 3 (Patient's #2, 8, 9) of 7 records reviewed of patients who were to receive home health aide services and failed to ensure hours were not reduced due to the agency's inability to staff for care…

The home health aide failed to practice standard precautions during a patient's bed bath in 1 of 1 patients receiving a bath out of 4 home visits in a sample of 8 records reviewed.

The registered nurse failed to ensure pertinent information was shared on the Aide care plan specific to the patient to include care of an external condom catheter for 1 of 2 discharged patients reviewed (patient # 7) in a total sample of 8 records reviewed.

The agency failed to ensure patient rights were met in regards to all visits ordered were provided as indicated in the plan of care in 4 of 8 patient records reviewed.

The agency failed to notify the physician of the agency's inability to meet the patient's needs and plans to discharge prior to discharging the patient for 1 of 2 discharge patients reviewed in a sample of 8 records reviewed.

The agency failed to include on the plan of care [POC] patient-specific measurable outcomes and goals for 6 of 8 total records reviewed, specific interventions for patient care in 1 of 2 discharged patients (#7) from a sample of 8 records reviewed of patients receiving home health aides, and to…

The agency failed to ensure the physician was notified and consent obtained prior to the agency's discharge, of the agency's plans to discharge due to the agency's inability to meet the patient's needs for 1 of 2 discharge patients reviewed in a sample of 8 records reviewed.

The agency failed to ensure implementation of its policies which requires documentation of communication with other members of the health care team to be included into the clinical record for 1 of 2 discharged patients (Patient #6) in a total sample of 8 patients.

The registered nurse failed to measure or describe wounds during assessments to evidence improvement of wounds in 1 of 2 patients with wounds in a sample of 8 records reviewed.

The registered nurse failed to notify the physician and clinical supervisor of the patient's non compliance with medications 1 of 1 patient (patient # 7) of a total sample of 8 records reviewed.

The home health aides failed to ensure patients received all visits as indicated in the plan of care in 4 of 8 patient records reviewed.