Nurses and More, Inc

The agency failed to ensure the comprehensive emergency preparedness program met all requirements to ensure the health, safety, and security needs of their staff and patient population for 1 of 1 agency (E0001); failed to ensure an emergency preparedness plan was in place and reviewed every 2 years…

The agency failed to transmit any skilled Medicare or Medicaid patients utilizing federally funded health plans, not meeting the exceptions to the transmittal requirement in 1 of 1 agency.

The agency failed to ensure patients received the frequency of services listed in the POC (G0572), ensure the POCs were individualized, included all necessary parameters, the frequency of services, and reflected the current condition of the patients (G0574), ensure the treatment ordered by the…

The agency failed to use measurable indicators to improve outcomes, patient safety, and quality of care, failed to document the agency had considered the incidence, prevalence, and high-risk/problem-prone areas to select indicators and identify performance improvement projects (G646), failed to…

The Governing Body failed to ensure the agency had governing body meeting minutes and an ongoing QAPI program (G942) and ensure the Administrator was responsible for all day-to-day responsibilities (G948).

The agency failed to submit OASIS within 30 days of assessment completion for 14 of 14 qualified active skilled records reviewed (Patients: #1, 2, 4, 5, 9, 10, 12, 13, 14, 15, 16, 17, 18, and 19), and 3 of 3 qualified inactive records reviewed (Patients: # 6, 7, and 8) where OASIS information was…

The agency failed to ensure the patients received the frequency of services listed in the POC for 1 of 4 clinical records (Patient #4) reviewed with patients receiving SN services only, 1 of 2 clinical records (Patient #11) reviewed with a patient receiving HHA services only, and 1 of 2 clinical…

The RN failed to ensure the HHA assignments of duties were consistent with patient-specific care needs and the aide's skills in 1 of 2 record reviews with HHA and RN services being provided.

The governing body failed to ensure the agency had a current and on-going QAPI program.

The agency failed to ensure all patients received the contact information for the agency administrator, including the administrator's name and business phone number, in order to receive complaints in 2 (Patients: #1 and 3) of 2 active patients who received home visits.

The agency failed to ensure the POC was individualized and included all the required elements, including the patient’s correct demographics, the discipline, frequency, duration, treatment, and patient-specific parameters when to notify the physician in 4 of 6 active records reviewed.

The agency failed to ensure wounds were measured according to the POC for 1 of 2 clinical records reviewed with a SN providing wound care.

The agency failed to ensure the physician was notified of a patient's change in condition of 1 of 1 records reviewed with patients in changes in condition.

The agency failed to ensure the patients’ medication lists were provided to them for 2 of 2 patients with home visits.

The agency failed to ensure HHAs were supervised every 2 weeks for 2 of 2 clinical records reviewed who received both SN and HHA services.

The Administrator failed to ensure was aware of the Conditions of Participation, maintained a grievance log, and was involved in QAPI.

The agency failed to develop and implement COVID-19 emergency preparedness policies and procedures which addressed staff strategies during COVID-19 emergency.

The agency failed to ensure all patients received services as ordered per the plan of care in 7 out of 12 patients.

The agency failed to disclose the correct operating hours of the Nurse's and More, Inc. office hours.Findings Include: During the entry to Nurse's and More Inc., a Home Health Agency, on 08/09/21 at 8:00 AM the survey team observed the window decal on the agency entry revealed, "Hours Monday-Friday…

The agency failed to notify physicians, health care professionals/ agencies who will be responsible for providing on going care receive all of the discharge information and the patient's pertinent care needs in 4 of 4 discharged records reviewed.

The agency failed to evidence patients/ representatives with other agencies information and assistance to other health care agencies who might be able to provide care in 4 of 4 discharged patient records.

The agency FAILED to provide a discharge summary to the primary care professional and to other health care professional who will be responsible for providing care and services to the patient after discharge from agency in 3 of 4 closed records reviewed.

The agency failed to implement its policy to ensure a registered nurse performed an initial assessment within 48 hours of referral, hospital discharge, or physician ordered start of care date, to determine the patient's immediate care and support needs for 5 of 6 patients whose clinical record was…

The agency failed to ensure patients received services as ordered by the physician on the plan of care for 3 of 6 patients whose clinical record was reviewed (Patients #1, 2, and 3).

The agency failed to ensure the clinical record documentation was clear and consistent as required by agency policy for 1 of 6 patients (Patient #2) whose clinical record was reviewed.

The agency failed to accord all patients the right to have received all services in the plan of care for 3 of 6 patients whose clinical record was reviewed (Patients #1, 2, and 3).

The agency failed to implement its policy to document the existence and resolution of a patient's complaint/grievance for 1 of 6 patients whose clinical record was reviewed (Patient #2).

The agency failed to ensure all patient medications were correctly documented for 1 of 6 patients whose clinical record was reviewed (Patient #1).

The agency failed to ensure the plan of care included all the medications the patient was taking and a complete medication order for 1 of 6 patients whose clinical record was reviewed (Patient #1) and failed to ensure accurate start of care date on the the plan of care for 3 of 6 patients (Patients…

The agency failed to ensure patients received services as ordered by the physician on the plan of care for 3 of 6 patients whose clinical record was reviewed (Patients #1, 2, and 3).

The skilled nurse failed to reconcile and accurately document the patient's allergies (Patient #1) for 1 of 6 patients and failed to document the provision of all ordered care in skilled nurse visit notes (Patient #2) as required by agency policy for 1 of 6 patients whose clinical record was…

The agency failed to ensure nurses coordinated care with the attending physician to initiate a necessary revision to the plan of care for nursing visit frequency of 2 times a day, to perform care ordered 2 times a day on the plan of care, rather than the frequency on the plan of care of 1-2 nursing…

The administrator failed to ensure registered nurse case managers reviewed and ensured correction of skilled nurse visit notes which failed to document care was provided as the physician ordered in the plan of care, an on-going function of the home health agency.

The agency failed to ensure the plan of care orders were implemented as the attending physician had ordered for 3 of 6 patients whose clinical record was reviewed (Patients #1, 2, and 3.) The findings included: 1. Review of patient #1's clinical record, evidenced a start of care date of 11-10-16…