Healthwise Home Care Solutions Inc

The Home Health Agency (HHA) failed to provide care in conformance with physician's orders for one of three sampled patients (Patient 1).

The Home Health Agency (HHA) failed to follow the accepted standards of practice and the standard precautions (a set of infection control practices used to prevent transmission of diseases) when providing care to two of two observed patients (Patients 2 and 3) during the home visits.

The agency failed to ensure the agency's Registered Nurse (RN) provided supervision to the Certified Home Health Aide (CHHA) to ensure quality of care and services provided for one of ten sampled patients (Patient 5).

The Home Health Agency (HHA) failed to ensure three of three Comprehensive Assessments for two of ten sampled patients (Patients 1 and 5) contained all the necessary goals and interventions related to Patient 1 and 5's heath status.

The Home Health Agency (HHA) failed to review medications and update medication profiles (current list of all medications) for seven of ten sampled patients (Patients 2, 3, 4, 5, 8, 9 and 10) in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy…

The Home Health Agency (HHA) failed to complete the Discharge OASIS (Outcome and Assessment Information Set - a comprehensive discharge assessment) for one of ten patients (Patient 1) within the required 48 hours.

The Home Health Agency (HHA) failed to ensure the Plan of Care (POC) for five of ten sampled patients (Patients 1, 5, 6, 7, and 8) included all the necessary components.

The facility failed to follow physician orders for two of ten patients (Patients 4 and 5) when an extra Skilled Nursing Visit (SNV) was made for Patient 4 and an extra Physical Therapy (PT) visit was made for Patient 5. This failure had the potential for Patient 4 to receive care that did not meet…

The Home Health Agency (HHA) failed to notify the physician when five of ten sampled patients (Patients 1, 2, 3, 8, and 9) had a change in condition.

The Home Health Agency (HHA) failed to provide the necessary services as prescribed by a physician and indicated in the individualized plan of care (POC) for eight of ten sampled patients (Patients 1, 2, 3, 5, 6, 7, 8 and 9).

The Home Health Agency (HHA) failed to provide the necessary patient/caregiver education to four of ten sampled patients (Patients 1, 2, 3 and 6) as ordered by the physicians.

The Home Health Agency (HHA) failed to communicate with the physicians for five of ten sampled patients (Patients 1, 2, 5, 6 and 10) related to: Patient 2: 1. The HHA did not notify the physician when Patient 2 was identified to consume regular foods by mouth, even though Patient 2 was admitted to…

This Condition is not met as evidenced by: Based on interview and record review, the Home Health Agency failed to: G123: Establish lines of authority that were clearly identified for the overall administrative direction of the organization.

This Condition is not met as evidenced by: Based on interview and record review, the Home Health Agency failed to: G158: Ensure the plan of care for each patient was followed as ordered by the physician G159: Ensure each plan of care is specific to the patient's needs.

This Condition is not met as evidenced by: Based on interview and record review, the Home Health Agency failed to: G331: Provide a registered nurse to conduct the initial comprehensive assessment.

The Home Health Agency (HHA) was not in compliance with California State laws which require the HHA to submit all changes for the position of Director of Patient Care Services.

The Home Health Agency (HHA) failed to ensure that the lines of authority were clearly identified for the overall administrative direction of the organization as evidenced by: 1. Clinical staff were unable to identify the director of patient care services (DPCS), even though they reported to that…

The Home Health Agency (HHA) failed to designate a trained, effective employee to manage the agency in the administrator's (ADM) absence.

The Home Health Agency (HHA) failed to provide an effective Director of Patient Care Services (DPCS).

The Home Health Agency (HHA) failed to identify a director of patient care services (DPCS) designee to be available in the absence of the DPCS.

The Home Health Agency (HHA) failed to ensure the clinical records showed effective coordination for three of five sampled patients (Patients 1, 2, and 3).

The Home Health Agency (HHA) failed to ensure the plan of care (POC) was followed as ordered by the physician for three of five sampled patients (Patients 1, 2, and 4).

The Home Health Agency (HHA) failed to ensure the plan of care (POC) was specific to the patient's needs for one of five sampled patients (Patient 2).

The Home Health Agency (HHA) failed to ensure wound care performed followed the physician orders for two of five sampled patients (Patients 2 and 4).

The Home Health Agency (HHA) failed to ensure orders were written completely and signed timely by the physician per agency policy for three of five sampled patients (Patients 1, 2, and 4).

The Home Health Agency (HHA) failed to maintain current clinical records for four of five sampled patients (Patients 1, 2, 4, and 5).

The Home Health Agency (HHA) failed to provide a registered nurse to conduct the initial assessment visit for one of five patients (Patient 4).

The Home Health Agency (HHA) failed to provide an initial skilled nursing (SN) evaluation and plan of care within 48 hours of coming home from the hospital for two of five patients (Patients 1 and 4).

The agency failed to perform a review of all medications for two of five sampled patients (Patients 1 and 2) in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy…