Home Health of the Ozarks

The staff failed to follow accepted infection control standards of practice while providing care to patient's in two of three home visit observations (Records/Patients #1 and #2).

The home health provider failed to ensure professional staff followed the provider's policies and procedures regarding discharges/transfers in one of two discharge records reviewed (Record/Patient #6).

The home health provider failed to ensure the aide assignment sheet included all instructions needed for the aide to provide safe care to the patient in, but not limited to, two of four aide assignment sheets reviewed (Records/Patients #2 and #3).

The provider failed to ensure the patient's plan of care (POC) was individualized with appropriate parameters and treatments in, but not limited to, two of six records reviewed (Records/Patients #1 and #2).

The home health provider failed to ensure that a written visit schedule for all personnel providing visits was given to the patient in three of three home visits conducted (Records/Patients #1, #2, and #3).

The provider failed to ensure that home health aide (HHA) services were provided as ordered by the physician or allowed practitioner in two of four records that received aide services (Records/Patients #1 and #2) This deficient practice has the potential to affect all the patients that receive aide…

The agency failed to develop and provide the patient and/or representative with a written notice of patient rights that included all required information.

The agency failed to provide an individualized, written plan of care specifying the care and services that met the requirements for the Condition of Participation: Care Planning, coordination of services and quality of care.

The agency failed to comply with all federal, state, and local emergency preparedness (EP) requirements when the agency failed to review and update their EP policies and procedures at least every two years.

The agency failed to develop an emergency preparedness system of documentation that preserved patient information, protected confidentiality, and secured and maintained the availability of records.

The agency failed to update the written notice of patient rights to include that the agency must inform the patient and representative (if any) of the agency's policies for transfer and discharge.

The agency failed to ensure the written patient rights information included; information must be provided to patients in a language and in a manner that is accessible and timely to persons with disabilities, including accessible web sites and the provision of auxiliary aids services, that are at no…

The agency failed to provide evidence that collection of quality data was on going during 2021 to: -Identify opportunities for improvement; and -Included OASIS (Outcome and Assessment Information Set) outcome measures and other relevant agency data.

The agency failed to provide evidence that the governing body was responsible for ensuring the agency had an ongoing program for quality improvement and patient safety.

The agency failed to maintain a coordinated agency-wide program for the surveillance of infectious and communicable diseases as an integral part of the agency’s quality assurance and performance improvement (QAPI) program.

The agency failed to update the written notice of patient rights to include: - Rights and responsibilities that are understandable to persons who have limited English proficiency; and - Rights and responsibilities accessible to individuals with disabilities.

The agency failed to update the written notice of patient rights to be advised, orally and writing, of financial liability changes as soon as possible, in advance of the next home health visit of charges for services that may not be covered by Medicare, Medicaid, or any other Federally-funded or…

The agency failed to ensure staff provided the written notice of patient rights to include that the Missouri state toll free home health telephone hotline hours of operation was 7:00 AM to 8:00 PM daily.

The agency failed to update the written notice of patient rights to include that the patient and representative (if any) be advised of the name, addresses, and telephone number of the following Federally and state funded entities that serve the area where the patient resides: * Quality improvement…

The agency failed to update the written notice of patient rights to include that the patient and representative (if any) have a right to be informed of the agency's policies for transfer and discharge when the agency can no longer meet the patient's needs.

The agency failed to update the written notice of patient rights to include the patient and representative (if any) have a right to be informed of the agency's policies for transfer and discharge if the physician and agency agree that the outcomes and goals have been achieved and the patient no…

The agency failed to update the written notice of patient rights to include that the patient and representative (if any) have a right to be informed of the agency's policies for transfer and discharge when the patient refuses services or elects to be transferred or discharged.

The agency failed to update the written notice of patient rights to include that the agency's policy for discharge for cause: - Determines that the patient's or other persons in the home, behavior is disruptive, abusive or uncooperative to extent that the delivery of care to the patient or the…

The agency failed to update the written notice of patient rights to include that the agency must advise the patient or representative, physicians, and healthcare professionals who will be responsible for providing care after discharge, that a discharge for cause is being considered.

The agency failed to update the written notice of patient rights to include that if the patient is being considered for discharge for cause, the agency must make efforts to resolve the problem.

The agency failed to update the written notice of patient rights to include that if the patient is being considered for discharge for cause, the agency must provide the patient or representative with contact information for other agencies or providers who may be able to provide care after discharge.

The agency failed to update the written notice of patient rights to include that the agency must document the problem and efforts made to resolve the problem, if the patient is considered for discharge for cause.

The agency failed to ensure the patient's current health status was assessed and documented in two (Patients/Records #2 and #5) of five records reviewed.

The agency failed to ensure an accurate medication reconciliation was performed in, but not limited to, two (Records/Patients #1 and #3) of five full records reviewed.

The agency failed to include all the elements of an individualized plan of care in five (Records/Patients #1, #2, #3, #4 and #5) of five full records reviewed.

The agency failed to ensure staff obtained a physician order for treatment and services which affected two (Records/Patients #2 and #5) of five full records reviewed.

The agency failed to ensure prompt notification of the physician(s) of any changes in the patient’s condition or needs that suggest that outcomes are not being achieved and/or that the plan of care should be altered in, but not limited to, three (Records/Patients #2, #4, and #5) of five full…

The agency failed to ensure that services ordered by the physician are provided as indicated in the plan of care, in two (Records/Patients #3 and #4) of five full records reviewed.

The agency 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 a qualified, pre-designated person who is authorized in writing by the administrator and the governing body, assumes the same responsibilities and obligations as the administrator when the administrator is not available.

The agency failed to request and obtain results of findings of the Family Care Safety Registry (FCSR) prior to patient contact for three employees (Employees #1, #2, and #3) of four personnel files reviewed.

The agency failed to ensure the registered nurse (RN) or other appropriate skilled professional developed a complete aide care plan/assignment in one (Record/Patient #4) of one record that received aide services.

The agency failed to ensure patient needs were met in two (Records/Patients #2 and #4) of five records reviewed.

The agency failed to ensure an accurate medication review and/or update of the patient medications was completed in, but not limited to, two (Records/Patients #1 and #2 ) of five records reviewed.

The agency failed to develop a complete/accurate plan of care (POC) in, but not limited to, three (Records/Patients #2, #4 and #5) of five records reviewed.

The agency failed to ensure that communication to the physician regarding the patient's assessment/plan of care occurred in, but not limited to, one (Record/Patient #2) of five records reviewed.

The agency failed to provide the patient with a copy of written instructions outlining the patient's medication schedule/instructions, to include the names, dosages, frequency and which medications would be administered by agency personnel in, but not limited to, two (Records/Patients #2 and #3) of…

The agency failed to provide the patient and/or caregiver a copy of written instructions outlining the patient's wound care in one (Record/Patient #3) of three home visit observations.

The agency failed to follow physician orders as directed in the plan of care in, but not limited to, one (Record/Patient #5) of five records reviewed.

The agency failed to ensure that patient and caregiver education was provided in, but not limited to, two (Records/Patients #3 and #4) of five records reviewed.

The agency failed to ensure that the agency staff evaluated the aide for all of the required elements during the aide supervisory visits in one (Record/Patient # 4) of one record reviewed that received aide services.

The agency failed to assure all staff had the Employee Disqualification List (EDL) checked prior to hire and had the Family Care Safety Registry (FCSR) checked prior to patient contact when one staff member (Employee A) out of two applicable files reviewed did not have this information available.

The agency failed to ensure a completed transfer summary was sent to the receiving healthcare facility within two business days of becoming aware of an unplanned transfer in one (Record/Patient #1) of one record reviewed that had an unplanned transfer after 1/13/18 when the new federal regulations…