Interim Healthcare

The agency failed to send a patient's transfer OASIS (Outcome and Assessment Information Set) to the receiving hospital and/or to another home health agency for a safe and effective transition of care for one (1) of two (2) closed clinical records reviewed in the survey sample.

The agency staff failed to follow the individualized plans of care.

The agency failed to ensure patients were informed about and consented to the frequency of proposed visits in advance of starting care for two (2) of seven (7) patients in the survey sample (Clinical records #'s: 3 and 4).

The agency failed to ensure it completed a review of all medications the patient is currently using in order to identify any potential adverse effects and or drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and…

The agency staff failed to ensure the plan of cares included evidence the patient participated in goal setting and/or agreed with goals identified by the Home Health Agency; a description of the patient's risk for emergency department visits and hospital re-admissions.

The agency failed to send the patient's transfer summary within 2 business days of becoming aware of an unplanned transfer in one (1) of two (2) closed clinical records reviewed in the survey sample.

The agency failed to ensure each patient was advised in advance of providing care the extent to which payment for HHA (home health agency) services may be expected from Medicare, Medicaid, or any other federally-funded or federal aid program known to the HHA, the charges for services that may not…

The agency failed to ensure the patient's individualized plan of care included all required elements for seven (7) of seven (7) clinical records reviewed in the survey sample.

The agency failed to ensure patients and/or caregivers were provided with a copy of written instructions outlining the following: the patient's visit schedule, including frequency of visits by home health agency (HHA) personnel and personnel acting on behalf of the HHA for seven (7) of seven (7)…

The agency failed to ensure patients and/or caregivers were provided with a copy of written instructions outlining any treatments to be administered by HHA (Home Health Agency) personnel and/or personnel acting on behalf of the HHA, including therapy services. for seven (7) of seven (7) clinical…

The Administrator failed to ensure the agency employed qualified staff.

The agency failed to send the patient's discharge summary to the primary care physician within five (5) business days from discharge for one (1) of two (2) discharge records reviewed in the survey sample.