Iowa County Health Department

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician, permitted under state law and/or as directed by the skilled professional assigning the home health aide to the patient for 1 of 5 sampled patients receiving home health aide services…

The agency failed to follow a Plan of Care established and periodically reviewed by a physician for 3 of 7 sampled patients with wounds.

The hospice failed to ensure all entries were complete and appropriately authenticated with a signature, title, date and time for 5 of 7 sampled patients (Patients #1, #2, #4, #6 and #7).

The agency failed to follow physician orders for medication set up and foley catheter placement for 2 of 7 sampled patients (Patient's #3 and #4).

The agency failed to provide an initial assessment visit within 48 hours of receipt of referral and/or known discharge date, or on the physician ordered start of care date for 1 of 2 sampled patients (Patient #2) with a start of care in 2023. Failure to provide an initial assessment visit within 48…

The agency failed to identify medication discrepancies when completing a drug regimen review with each comprehensive assessment within the allowed time frames for 2 of 3 sampled patients (Patients #1 and #2).

The agency failed to update the Plan of Care with all new physician orders for 1 of 2 sampled patients with interim physician orders.

The agency failed to obtain physician orders for wound care/treatment for the patient for 3 of 3 sampled patients (Patients #1, #2 and #3).

The agency failed to do the following: 1) ensure patients received written notice of the patient's right's and responsibilities under this rule and the agency's transfer and discharge policies as set forth in paragraph d of the regulations.

The agency: 1) failed to ensure home health aides were competency tested for all assigned tasks beyond the basic skills (G768); and 2) failed to ensure all home health aides provided care as ordered in the plan of care (G800).

The agency failed to do the following: disclose ownership and management information (G850), including the change of management at the time of change, (G852), and the name and address of each person who is an officer, a director, an agent, or a managing employee of the agency(G856).

The agency failed to do the following: 1) ensure the governing body assumed authority and responsibility for the agency's overall management and operation and the provision of all home health services (G942), 2) ensure the Administrator was responsible for all day to day operations of the agency…

The agency failed to ensure the emergency operations plan authorized in writing who will act in the the administrator's abscence.

The agency failed to ensure the emergency operations plan was updated biannually.

The home health agency failed to complete an individualized emergency plan developed as part of the comprehensive assessment, maintaining documentation of the plan in the patient's chart and in the patient's home setting, for 7 of 7 sampled patients (Patients #1, #2, #3, #4, #5, #6 and #7).

The agency failed to have a written policy and procedure for the use of volunteers in an emergency or other emergency staffing strategies, 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 have a communication plan, including names and contact information for staff, entities providing services under arrangement, patient's physicians and allowed practitioners, and volunteers, including primary and alternate means for communication.

The agency failed to have a means for providing information about the agency's census, needs, and ability to provide assistance, to the authority having jurisdiction.

The agency failed to ensure training in emergency preparedness to all existing staff consistent with their expected roles at the time of orientation and every other year thereafter for 9 of 9 sampled employees (Staff A, B, C, D, E, F, G, H, I) and 7 of 7 contracted staff (J, K, L, M, N, O and P).

The agency failed to ensure participation in an actual event, a full scale exercise that is community based or when a community based exercise is not accessible, conduct an individual agency based functional exercise, and conduct an additional "exercise of choice" at least every other year…

The agency failed to provide patients with written notice of the patient's rights and responsibilities and the agency's transfer and discharge policies 7 out of 7 patient's sampled.

The agency failed to ensure the home health aides successfully completed competencies in all home health aide skills that exceed basic skills, which require a registered nurse, or other appropriate skilled professional in consultation with a registered nurse, to evaluate the competency of the aide…

The agency failed to comply with the requirements of disclosure of ownership and management.

The agency failed to disclose to the state survey agency at the time of the agency's change in management.

The governing body failed to ensure authority and responsiblity for the overall management and operation of the agency and provision of all home health services resulting in the governing body not assuring all policies were updated by the Administrator.

The agency failed to provide patient's with written notice of the patient's rights and responsibilities and the agency's transfer and discharge policies and ensure the notice is understandable for patient's who have limited English proficiency and accessible to individuals with disabilities for 7…

The agency failed to provide agency patients with written contact information for the agency's Administrator, including the Administrator's name and contact information (telephone number and/or email address).

The agency failed to provide patients for whom OASIS data is collected an OASIS privacy notice for 6 out of 6 patient's sampled (Patient #1, #2, #3, #4, #6, and #7).

The agency failed to provide patient's with written notice of the patient's rights and responsibilities including the patient's right to be free from verbal, mental, sexual, and physical abuse, including injuries of unknown source, neglect and misappropriation of property for 7 out of 7 sampled…

The agency failed to ensure patients were advised of the names, addresses, and telephone numbers of the following Federally-funded and state-funded entities that serve the area where the patient resides: Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and…

The agency failed to inform patients of the right to access auxiliary aids and language services and how to access the services for 7 out of 7 patient's sampled.

The agency failed to have a policy for the purpose of addressing discharge for cause for patients (or other persons in the patient's home) disruptive, abusive, or uncooperative behavior to the extent that delivery of care to the patient or the ability of the agency to operate effectively is serious…

The agency failed to provide an initial assessment visit within 48 hours of receipt of referral, within 48 hours of the of the agency's knowledge of the patient's return home from an inpatient facility or on the physician ordered start of care date for 2 of 3 sampled patients with a physician…

The agency failed to complete a drug regimen review within the required time frames as part the comprehensive assessments for 3 of 7 sampled patients (Patient #1 , #4 and #6).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment and medications used by the patient for 3 of 3 sampled patients (Patients #1, #2, and #3) with home visits.

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 2 of 3 sampled patients with new verbal/interim orders.

The agency failed to provide agency patients with written contact information for the agency's clinical manager, including the clinical manager's name and contact information (telephone number and/or email address).

The agency failed to ensure home health aides provided care to agency patients as ordered by the physician, permitted under state law and/or as directed by the skilled professional assigning the home health aide to the patient for 2 of 4 sampled patients receiving home health aide services…

The agency failed to disclose to the state survey agency the name and address of each person who is an officer, a director, an agent, or a managing employee of the agency.

The governing body failed to ensure the Administrator was responsible for all day to day operations of the agency including updating the policies.

The governing body failed to ensure the Administrator assured development of policies.

The agency failed to complete and send a transfer summary to the physician caring for the patient at the inpatient facility after transfer within 2 business days of the patient's transfer and/or failed to complete and send a discharge summary to the physician and other health care professionals who…

6. Patient #2 had a start of care date of 8/28/01. The clinical record review revealed the following: a. no documentation an emergency plan had been completed since 11/13/17 (the date the regulation went into effect); b. updates to the comprehensive assessment at recertification, dated 5/24/19…

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 duty staff and patients they are unable to contact in the event of an interruption of services related to an emergency.

The agency's emergency preparedness communication plan failed to include a policy and procedure for cooperation and collaboration with Federal emergency preparedness officials.

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 existing staff consistent with their expected roles for 10 of 10 direct hired employees and 8 of 8 contracted staff in 2017 and 12 of 12 direct hired staff and 9 of 9 contracted staff for 2018. Lack of emergency preparedness…

The agency failed to ensure training in emergency preparedness to all existing staff consistent with their expected roles for 10 of 10 direct hired employees and 8 of 8 contracted staff in 2017 and 12 of 12 direct hired staff and 9 of 9 contracted staff for 2018. Lack of emergency preparedness…

The agency failed to assure all clinician's followed basic infection control practices when providing care to agency patients for 2 of 3 sampled patients with home visits (Patients #2 and #3).

The agency failed to ensure authentication of hand written entries made in each patient's clinical record included the employee's signature, title, date and time of the signature for 5 of 5 sampled patients (Patients #3, #4, #5, #6 and #8) with hand written documentation.

The agency failed to ensure the completion of all pertinent components of the update to the comprehensive assessment at recertification in the last 5 days of each certification period for 3 of 5 sampled patients requiring a recertification (Patients #2, #5 and #10).

The agency failed to ensure accurate and timely completion of all pertinent components of the update to the comprehensive assessment 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 #9).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care for 6 of 7 sampled patients (Patients #1, #2, #3, #4, #5 and #7).

The agency failed to update the Plan of Care with new physician orders for 6 of 7 sampled patients (Patients #1, #2, #3, #5, #7 and #9) with interim physician orders.

The agency failed to ensure a registered nurse or other appropriate health care professional completed home health aide supervision at least every 14 days for 2 of 2 sampled patients who received hands on personal care services in conjunction with skilled service provision (Patients #3 and #5).

The agency failed to ensure registered nurses supervising home health aides maintained documentation of a review of all required supervisory elements including following the patient plan of care, maintaining open communication with patient/caregiver, demonstrating competency of all assigned tasks…

The agency failed to ensure the clinical record contained complete, accurate and up to date information for 1 of 1 sampled patients receiving wound care (Patient #7).