Oswego Health Home Care, LLC

For 1 of 4 patients (patient #2), the home health agency did not take action to prevent further potential violations while the complaint was being investigated.

The agency failed to record all orders, including verbal orders, for 3 of 4 patients (patients #2, 3, and 4), the failed to update the patients' plan of care to accurately include all orders received from the health care provider.

Agency staff for 2 of 4 patients (patients #2 and 3) the agency failed to ensure treatments are administered in accordance with physician orders.

The agency failed to ensure verbal orders are authenticated by the medical practitioner for 1 of 4 patients (patient #2).

In 2 out of 18 records, (patients #8 and 11) that comprehensive assessments were not of sufficient scope to ensure that all patient's needs were identified.

In 2 of 18 records (patients #2 and 6) the skilled nurse failed to perform comprehensive medication reviews.

In 3 of 18 records (patients #1, 3, and 10) the agency failed to develop complete and accurate plans of care that were individualized to address the total needs of the patients.

For 1 out of 18 patients (patient #10) the nurse failed to consult with the physician when changes in the patient's condition occurred.

1 of 18 records (patient #15) the agency failed to explain changes in the plan of care to the patient/caregiver. 1.Patient #15 was admitted to the agency on 05/22/24 with diagnoses of malignant neoplasm of the esophagus, sepsis, aspiration pneumonitis, and chronic obstructive pulmonary disease.

In 1 of the 18 records (patient #6) the agency failed to ensure the patient/caregiver receives appropriate education regarding the care and services identified in the plan of care (POC).

In 1 of 17 records (Patients #7) the agency failed to ensure comprehensive assessments were of sufficient scope to identify all patient needs.

In 2 of 17 records (Patients # 5 and 6) the agency failed to develop complete and accurate plans of care that were individualized to address the total needs of the patients.

The registered nurse (RN) failed to follow accepted standards of infection control practices.

The agency failed to ensure policies were created Evidence as follows: On 02/23/22, the Surveyor requested a list of all employees and documentation of their Covid-19 vaccination status. 100% of required employees were vaccinated.

In 2 of 17 records (patients #8 and 13), the skilled nurse (SN) failed to develop complete and accurate aide written instructions.

In 3 of 17 records (patients # 3, 7, and 12) the registered nurse (RN) failed to perform comprehensive medication reviews.

In 3 of 17 records (Patients # 6, 8, and 11 ) the agency failed to ensure: - This was evidenced by: Patient # 6 was admitted to the agency on 02/03/20 with diagnoses of unstageable pressure ulcer (left upper back), flaccid neuropathic bladder with cystostomy, chronic obstructive destructive…

This condition was not met as evidenced by: Failure to ensure nursing assessments are complete and consistently reflect the patient's status and needs.

This condition was not met as follows - Failure to develop comprehensive plans of care which address each patient's individual needs.

For 4 of 17 records (Patients #10, 13, 16, and 17) the agency failed to ensure initial comprehensive nursing assessments were of sufficient scope to ensure all patient needs were identified.

The agency failed to implement adequate action plans to lead to measurable improvements in areas identified during audits.

In 3 records (Patients #13, 16, and 17) the Agency failed to effectively analyze the causes of adverse events and implement preventive actions for 3 patients.

The 3/10/19 plan of care included: - diagnoses of epilepsy and sacral pressure ulcer - lifeline services in place / patient wears necklace The HHA care plan failed to include the following: - seizure precautions - instructions to ensure the life line was in place - the "bowel/elimination" section…

The agency failed to ensure that at least one qualifying service was provided directly through agency employees.

In 2 of 17 records (Patients #13 and 16), comprehensive re-assessments failed to identify changes in the patient's condition necessary to ensure that all patient's needs are identified.

In 5 of 17 records (Patients # 1, 3, 5, 10, and 17) the agency failed to develop individualized plans of care that were complete, accurate, and addressed the total needs of the patients.

For 3 out of 17 records (Patients #13, 14, and 17) the Skilled Nurse (SN) failed to consult with the physician when changes in the patient's condition occurred.

In 3 of 17 records (Patients #5, 13, and 17) the agency failed to ensure: - significant information is consistently being exchanged between individuals responsible for developing and implementing the plan of care - the skilled nurses (SNs) have a clear understanding of the role of the SN case…

In 2 of 6 records (Patients # 8 and 12) the skilled nurses (SN) failed to adequately supervise the HHA to ensure the HHA plan was followed and updated and all patients needs were met.