Kismet Lgn, LLC

The agency failed to ensure training in the agency's emergency preparedness policies and procedures to 4 of 4 contracted therapy staff consistent with their expected roles in the event of an emergency/disaster.

The agency failed to follow a Plan of Care established and periodically reviewed by a physician or notify the physician of the need to vary frequency of visits or inability to perform treatments/services as originally ordered on the Plan for Care for 5 of 7 sampled patients (Patients #1, #2, #3, #4…

The agency failed to ensure 1 of 2 sampled home health aides (Staff B), demonstrated competency in extra skills prior to being independently assigned to a patient requiring the extra skill completion for 3 patients (Patients #1, #2 and #7).

The agency failed to provide individualized and specific written patient care instructions from a registered nurse (RN) to agency home health aides for 2 of 6 sampled patients receiving home health aide services (Patients #2 and #7).

The agency failed to complete a drug regimen review as part of the update to the comprehensive assessment for 2 of 7 sampled patients (Patients #1 and #6).

The agency failed to ensure accurate completion of all required components of the recertification comprehensive assessments with accompanying drug regimen review between day 56 and 60 of each 60 day certification period for 5 of 7 sampled patients requiring an update to the comprehensive assessment…

The agency failed to ensure completion of the update to the comprehensive assessment with accompanying drug regimen review 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 (Patients #1 and #6).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment used by the patient and accurate medication orders for 4 of 7 sampled patients (Patients #1, #2, #3 and #4).

The agency skilled professionals failed to follow the physician ordered Plan of Care for 1 of 6 sampled patients receiving a skilled service (Patient #1).

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 5 of 6 sampled patients receiving home health aide services…

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 for 1 of 3 sampled patients with requiring a transfer summary (Patient #1).

The agency failed to notify the physician of patient condition changes and changes in visit frequency ordered on the Plan of Care (missed visits) for 5 of 8 sampled patients (Patients #2, #3, #4, #6 and #8).

The agency failed to maintain documentation that 2 of 2 sampled home health aides, employed for more than 1 year, completed a minimum of 12 hours of inservice educational training annually (Staff C and Staff D).

The agency failed to ensure all documentation included a signature and/or date and time of signature for 4 of 4 sampled patients who received home health aide services (Patients #2, #3, #4 and #5).

The agency failed to complete a drug regimen review, including all required components, with each comprehensive assessment within the allowed time frames and/or failed to identify medication discrepancies at the time of the comprehensive assessment for 8 of 9 sampled patients (Patients #1, #2, #3…

The agency failed to ensure accurate completion of all pertinent components of the resumption of care comprehensive assessments within 48 hours of the agency's knowledge of return home from an inpatient facility for 2 of 2 sampled patients requiring a Resumption of Care Assessment (Patients #2 and…

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all services, supplies, equipment, medications and treatments for 6 of 8 sampled patients (Patients #1, #2, #3, #4, #6 and #8).

The agency failed to update the Plan of Care with new physician orders for 2 of 8 sampled patients.

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician and/or as directed by the skilled professional assigning the home health aide to the patient for 4 of 4 sampled patients receiving home health aide services (Patients #2, #3, #4 and #5).

The agency failed to ensure a registered nurse (RN) 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 paid for either by the patient or by a third party payer other…

The agency failed to ensure a registered nurse (RN) completed home health aide supervision at least every 60 days while observing the home health aide present and providing direct patient care for 1 of 1 sampled patients who received hands on personal care services with no skilled service provision.

The agency failed to complete and send a discharge summary to the physician or other health care professionals responsible for providing care to the patient after the patient's discharge for 3 of 3 discharged patients sampled (Patients #5, #6 and #7).