Iowa Home Care, L L C

The agency failed to ensure staff provided care in accordance with accepted infection control standards of practice observed during a home visit for 2 of 4 sampled patients (Patients #1 and #3) with home visits.

The agency failed to ensure 1 of 1 sampled home health aides (Staff Q) had documented evidence of competency in the performance of tracheostomy care, which exceeded the level of basic home health aide skills, in the presence of a registered nurse prior to being assigned to perform the task…

The agency failed to ensure clinicians followed agency policies and procedures when assessing wounds to agency patients for 4 of 5 sampled patients with wounds (Patient #4, #5, #6 and #9).

The agency failed to ensure accurate completion of all components comprising the plan of care (POC), including all medication and supplies and equipment used by the patient for 3 of 10 sampled patients (Patients #1, #2 and #6).

The agency failed to update the Plan of Care with all new physician orders for 1 of 3 sampled patients with Physical Therapy interim orders.

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician in the plan of care (POC) and/or as directed by the skilled professional assigning the home health aide to the patient for 3 of 7 sampled patients receiving home health aide services…

The agency failed to ensure the patient's clinical record included accurate and specific documentation of interventions and maintained pertinent current information in the patient record for 1 of 1 sampled patients with physician orders for international normalized ratio (INR).

The agency failed to provide medications, treatments or services only as ordered by the physician for 1 of 1 sampled patients with orders for wound assessments (Patient #3).

The agency failed to ensure clinicians followed agency policies and procedures when inserting an indwelling catheter for 1 of 5 sampled patients (Patient #4).

The agency failed to promptly notify the physician of changes in the patient condition or needs that suggest an alteration to the plan of care for 1 of 5 sampled patients receiving catheter cares (Patient #4).

The agency clinician's failed to communicate with other staff, the patient and the caregiver regarding missing scheduled visits as identified by agency policy for 1 of 6 sampled patients.

The agency failed to ensure a registered nurse (RN) completed licensed practical nurse (LPN) supervision for 1 of 3 sampled patients with LPN services.

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 1 of 6 sampled patients (Patient #5).

The agency failed to ensure clinicians followed agency policies and procedures when assessing wounds to agency patients for 2 of 4 sampled patients with wounds (Patient #4 and #16).

The agency failed to ensure completion of the update to the comprehensive assessment within 48 hours of the agency's knowledge of return home from an inpatient facility for 2 of 3 sampled patients requiring a resumption of care assessment (Patient #13 and #10).

The agency failed to include all medications in Plans of Care for 4 of 7 patients with home visits (Patient #2, #3, #5, and #7).

The agency failed to obtain physician orders for the addition of over-the-counter medications to the patient's medication regimen and changes in wound care for 2 of 17 sampled patients (Patient's #4 and #10).

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 3 of 14 sampled patients receiving home health aide services…

The agency failed to ensure accurate and thorough completion of all pertinent components of comprehensive assessments for 3 of 13 patients with a comprehensive assessment (Patients #4, #7 and #12).

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 to meet his/her needs for 4 of 13 sampled patients (Patients #2, #4, #5 and #7).

The agency failed to provide medications, treatments or services only as ordered by the physician for 2 of 13 sampled patients (Patients #4 and #6).

The agency failed to maintain documentation of each complaint, document the findings from the agency's investigation of the complaint and document the resolution of the complaint for 1 of 3 patient and/or family member complaints (Patient #6).

The agency failed to administer treatments and services only as ordered by the physician for 3 of 7 sampled patients (Patients #2, #4 and #5).

The agency failed to keep patients free of injury while providing direct patient care (G430).

The agency failed to ensure the patient remained free from injury while staff provided direct patient care and neglect for 1 of 6 sampled patients (Patient #2).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care and/ or failed to ensure the Plan of Care contained current, accurate information for 1 of 6 sampled patients (Patient #6).