Home Health Care Inc

The home health agency failed to meet the Condition of Participation: G570 at 42 CFR 484.60. The agency failed to provide services in the care plan for 5 of 17 patients (P1, P2, P3, P5, P17), to ensure all requirement were included in the plan of care (POC) for 4 of 17 patients (P1, P2, P7, P14)…

The home health agency failed to meet the Condition of Participation: G750 at 42 CFR 484.80. The agency failed to involve the patients’ aides as member of the interdisciplinary team in the coordination of care for 2 of 17 patients (P1, P7), conduct 14-day supervisory visits for patients receiving…

The agency failed to develop a comprehensive emergency preparedness program (EPP) which addressed the patient population, including persons at risk, with identified needs for required services.

The agency failed to ensure an individualized emergency plan was developed for 14 of 17 patients (P1, P2, P3, P4, P5, P6, P7, P9, P10, P11, P12, P13, P16, P17) reviewed who received home care services.

The agency failed to maintain updated policies and procedures to maintain a system of for medical documentation that secured and maintained the availability of patient information.

The agency failed to maintain a communication plan within the agency which demonstrated how agency staff would be alerted if there was need for emergent response and provided with instructions as to response.

The facility failed to fully develop and maintain an emergency communication plan to allow for ongoing communication between the agency, staff, patients and other partners at the local, county, regional, State, Tribal and Federal levels in the event of an emergency.

The agency emergency preparedness plan lacked a training and testing program to reflect the risks and effectiveness of their emergency plan.

The facility failed to report all Outcome and Assessment Information Sets (OASIS) data collected in accordance with federal regulations.

The agency failed to provide services indicated in the plan of care for 5 of 17 patients (P1, P2, P3, P5, P17) reviewed for individualized plan of care.

The agency failed to provide written education regarding wound care and pertinent instructions related to care and treatment for 1 of 17 patients (P1) reviewed for patient/caregiver education.

The agency failed to develop performance improvement projects (PIPs).

The agency health care professional failed to practice according to the agency’s policies and procedures related to assessing patients, completing documentation of clinical findings, and coordination of care for 3 of 17 patients (P1, P2, P7).

The agency failed to obtain the patient’s legal representative’s signature when enrolling 1 of 17 patients (P7) in home care services, not informing them of rights and responsibilities.

The agency failed to conduct a comprehensive assessment with accurate reflection of patient status for 1 of 17 patients (P1) reviewed for comprehensive assessment.

The agency failed to ensure all requirements were included in the plan of care (POC) for 4 of 17 patients (P1, P2, P7, P14) who received home care services.

The agency failed to provide treatments only as ordered by a physician for 1 of 17 patients (P6) reviewed for physician orders.

The agency failed to ensure 3 of 17 patients (P1, P2,P14) plans of care (POC) were reviewed and signed in their entirety by their provider every 60 days.

The agency failed to promptly inform the physician of changes in condition for 2 of 17 patients (P1, P2) reviewed for change of condition, when P1 was admitted to the hospital with four pressure injuries and cachexia (significant weight and muscle loss) without his physician aware of the wounds and…

The agency failed to revise the plan of care (POC) for 2 of 17 patients (P1, P2) reviewed when there were changes in nutrition and wounds.

The agency failed to integrate services provided by the agency and services provided by other entities were coordinated to evaluate treatment effectiveness and promote patient well-being for 2 of 2 (P1, P13) patients who received services from other medical specialties or care agencies.

The agency failed to involve the patients’ representative in the coordination of care for 2 of 17 patients (P1, P7) when the registered nurse (RN) failed to communicate with P1's family member, who also served as P1's personal care assistant (FM/PCA)-C, regarding P1's declining condition including…

The agency failed to complete clinical notes for 3 of 17 patients (P1, P2, P5) reviewed for completion of clinical notes.

The agency failed to involve the patients’ aides as member of the interdisciplinary team in the coordination of care for 2 of 17 patients (P1, P7) when the registered nurse (RN) failed to communicate with P1's aide who is also P1’s family member, (FM/PCA)-C, regarding P1's declining condition.

The agency failed to conduct 14-day supervisory visits for patients receiving aide services for 2 of 17 patients (P1, P17) reviewed.

The agency failed to ensure an onsite supervisory visit was conducted every 60 days for 1 of 1 patient (P15) who received Community First Services and Support (CFSS) without skilled services.

The agency failed to ensure staff were following accepted standards of infection control practices during home care observation visits for 3 of 7 residents (P8, P9, P12).

The agency failed to identify and update all prescription and non-prescription medications for 2 o7 patients (P6, P10) reviewed during home visits.

The agency failed to include all durable medical equipment (DME) on 1 of 7 patient’s (P7) plan of care (POC) reviewed during home visits.

The agency failed to ensure catheter insertion was provided within standards of practice for 1 of 3 (P1) patients reviewed for catheter insertion.

The home health agency (HHA) failed to meet the Condition of Participation at 484.50, Patient Rights.

The agency failed to ensure skilled nursing services were provided effectively in accordance with physicians' orders and standard of practice for 1of 2 patients (P2) reviewed for wound care.

The home health agency (HHA) failed to arrange a safe and appropriate transfer for 1 of 1 patient (P1) who had multiple stage 2 and 3 pressure ulcers who was hospitalized and when discharged from the hospital went home with no skilled nursing services.

The agency failed to ensure skilled nursing visits (SNV) were provided per order frequency and failed to assess wounds as directed in the plan of care (POC), to show progress towards goals, for 1 of 2 patients (P2) reviewed for wound care P2's plan of care (POC) with the certification period dated…

The agency failed to ensure the physician orders were followed for 1 of 3 patients (P1) who received skilled nursing visits but the service had not been provided promptly when ordered, and the physician had not been notified the service was not provided.

The agency failed to ensure skilled nursing services were provided effectively and safely in accordance with physicians' orders for 3 of 4 patients (P1, P3, P5) reviewed for wound care.

The agency failed to encode the Home Health Outcome and Assessment Information Set (OASIS) data accurately for 2 of 4 patients (P1, P5) who received wound care from the agency.

The agency failed to ensure the patient's care delivery was coordinated with the caregivers, regarding the care and services identified in the plan of care for 1 of 5 patients (P1) reviewed.

The agency failed to ensure skilled nursing visits (SNV) were provided per order frequency and failed to assess wounds as directed in the plan of care (POC), to show progress towards goals, for 3 of 4 patients (P1, P3, P5), reviewed.