Heartland Home Care

The agency failed to ensure the development of a procedure to inform State and local officials of homebound patients in need of evacuation due to an emergency situation.

The agency failed to ensure the development of a written policy and procedure to inform State and local officials of any on patients they are unable to contact in the event of an interruption of services related to an emergency.

The agency failed to ensure the development of a policy and procedure for a medical documentation system that preserves patient documentation system that preserves patient information and confidentiality of patient information.

The agency failed to have a written policy and procedure for the use of volunteers in an emergency, including the process and role for integration of State and Federally designated health care professionals to address surge needs during an emergency.

The agency failed to ensure agency staff developed and maintained an emergency communication plan that included a method of sharing information and medical documentation for the agency clients to maintain the continuity of care.

The agency failed to ensure training in emergency preparedness to all current staff annually.

The agency failed to conduct exercises to test the emergency plan by participating in a community based full scale exercise or an actual natural or man- made emergency that requires activation of the emergency plan, and an additional exercise that may include a second community based full-scale…

The agency failed to complete a drug regimen review within the required time frames as part of the update to the comprehensive assessment at discharge for 3 of 7 sampled patients requiring discharge from agency services (Patients #2, #6 and #7).

The agency failed to ensure the accurate completion of all components comprising the plan of care, including all supplies and equipment used by the patient in 6 of 7 sampled patients.

The agency failed to provide medications, treatments or services only as ordered by the physician for 1 of 1 sampled patients (Pt #1) with home observation visits.

The agency failed to report changes in patient clinical findings or changes in patient needs to the physician, for 1 of 7 sampled patients.

The agency did not ensure the emergency preparedness program included a documented, facility-based and community-based risk assessment, utilizing an all-hazards approach specific for the agency.

The agency failed to have a written policy and procedure for cooperation and collaboration with tribal, regional, state and federal emergency preparedness officials.

The agency failed to ensure the development of a procedure to inform State and local officials of homebound patients in need of evacuation due to an emergency situation.

The agency failed to ensure the development of a written policy and procedure to inform State and local officials of any on patients they are unable to contact in the event of an interruption of services related to an emergency.

Staff interview the agency failed provide documentation that the agency developed and maintained an emergency plan that included primary and alternate means of communicating with the agency staff and federal, state, tribal, regional and local emergency management agencies.

The agency failed to develop and maintain an emergency training and testing program for all agency staff as part of its emergency preparedness plan.

The agency failed to ensure training in emergency preparedness to 1 of 7 staff sampled staff consistent with their expected roles during orientation and two of two sampled staff biannually per regulation.

The agency failed to conduct exercises to test the emergency plan by participating in a community based full scale exercise or an actual natural or man-made emergency that requires activation of the emergency plan, and an additional exercise that may include a second community based full scale…

The agency failed to complete an individualized Plan of Care established and periodically reviewed by a physician and/or failed to notify the physician of the inability to perform treatments/services as originally ordered on the Plan for Care for 2 of 8 sampled patients (Patients #1 and #4).

The agency failed to provide agency patients with written contact information for the agency's administrator, including the administrator's name.

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment used by the patient, accurate medication/treatment orders, advance directive information and/or emergency room/hospitalization risk with planned interventions to…

The agency failed to maintain a working Plan of Care for patients and update the working Plans of Care with any new verbal/interim physician orders for 6 of 6 sampled patients with new verbal/interim orders (Patients #1, #2, #4, #5, #6 and #8) . The agency reported a census of 5 patients at the…

The agency did not furnish at least one service only by direct employees, instead contracting skilled nursing and therapy services.

The agency failed to identify the process for protection of patient documentation and process to keep the information from unauthorized access should an emergent situation occur.

The agency failed to identify the process and role volunteers would have in an emergent situation.

The agency failed to transmit OASIS data within 30 days of the OASIS M0090 date for 1 of 1 sampled patients requiring transmission of OASIS data (Patient #2).

The agency failed to furnish skilled nursing services and at least one other therapeutic service with at least one service provided only by direct employees (by issuance of a W2 for tax purposes).

The home health agency failed to authenticate all entries in the clinical record with a clinician's signature with date and time of the signature for 7 of 7 sampled patients (Patients #1, #2, #3, #4, #5, #6 and #7).

The agency failed to complete a drug regimen review, including all required components, with each comprehensive assessment within the allowed time frames and/or failed to identify medication discrepancies at the time of the comprehensive assessment for 3 of 7 sampled patients (Patients #1, #3 and…

The agency failed to ensure accurate completion of all pertinent components of the resumption of care comprehensive assessments within 48 hours of the agency's knowledge of return home from an inpatient facility for 1 of 2 sampled patients requiring a Resumption of Care Assessment (Patient #6).

The agency failed to complete and send a transfer summary to either the primary care physician or physician and other health care professionals responsible for providing care to the patient where the patient was transferred to for 2 of 2 sampled patients who were transferred to an inpatient…