Premier Homecare of Indiana

The agency failed to ensure a transfer summary was completed for a patient transferred to another provider, or a discharge summary contained all the necessary elements for 4 of 4 active clinical records reviewed with patients hospitalized (Patient #1, 2, 3, and 5) and 2 of 2 inactive clinical…

The agency failed to ensure that infection control practices were upheld according to the agency’s policy in 1 of 4 home visits for hand hygiene.

The agency failed to provide the Administrator's name and contact information to 7 of 7 active clinical records reviewed.

The agency failed to ensure that the patients were informed of the frequency of visits and ongoing care and treatment they may receive, as evidenced in 6 of 7 active records reviewed.

The agency failed to ensure the comprehensive assessment was individualized to the patient for 1 of 4 patients observed during a home visit.

The agency failed to implement its policy requiring the plan of care to be individualized to include all pertinent diagnoses, all supplies, and equipment necessary to ensure the patient’s needs were met in their home, failed to ensure documentation of patient-specific needs, all safety measures…

The agency failed to notify the physician of missed visits and changes to the plan of care for 3 of 7 active clinical records reviewed.

The agency failed to provide the patients with a visit schedule to 6 of 7 active records reviewed.

The agency failed to ensure the patients had a current medication profile in their Admission booklet in 3 of 4 home visits.

The agency failed to ensure all nurses appropriately and accurately assessed patients according to professional standards for 1 of 4 home visits completed.

The agency failed to ensure the outcome and assessment information set (OASIS) questions were answered accurately at the time of the assessment for 1 of 5 active records reviewed, out of a total of 7 clinical records reviewed.

The agency failed to inform the patient and representative (if any) in advance of their intent to discharge the patient from home health services in 1 of 2 closed records reviewed, out of a total of 7 clinical records reviewed.

The agency failed to ensure comprehensive assessments accurately reflect the patient's status at the time of admission for 1 of 4 (Patient 3) active records reviewed and 1 of 1 record reviewed of a patient who was recertified in a total sample of 7 clinical records reviewed.

The agency failed to ensure visits were made per the plan of care, vital sign parameters were individualized/ patient specific with measurable outcomes and goals, for 1 of 5 active clinical records reviewed (Patients #3) and failed to ensure daily weights were obtained as ordered per the plan of…

The agency failed to implement, evaluate, and maintain an effective, ongoing, and agency-wide, data-driven quality assurance program; failed to ensure they measured, analyzed, and tracked quality indicators, including adverse events that would improve health outcomes, patient safety, and quality of…

The agency failed to ensure they appropriately tracked adverse events and analyzed their cause for the month of September 2020. Findings include: "Adverse Events" was listed as an "Ongoing Quality Assurance Project," in the undated agency document "Indiana HomeCare QAPI [quality assurance…

The agency failed to maintain a coordinated, agency-wide infection control program that includes surveillance, identification, prevention, control, and investigation of infections and communicable diseases.

The agency failed to ensure patients were informed about the frequency of visits and the care to be furnished prior to the start of care for 1 of 5 active records reviewed, out of a total of 7 clinical records reviewed.

The agency failed to ensure patients were advised orally and in writing of the extent to which payment for services may be expected from Medicare, Medicaid, or any other federally-funded or federal aid program known to the home health agency and the potential charge for services that may not be…

The agency failed to ensure the Registered Nurse conducted an initial visit within 48 hours of the patient's return home for 1 of 5 active records reviewed in a sample of 7. (Patient #3) Finding include: Review of an undated agency policy titled "Client Admission Process" indicated, " ...

The agency failed to ensure the start of care comprhensive assessment included the patient's strengths, goals, and care preferences for 1 out of 5 active records reviewed in a sample of 7. (Patient #3) Findings include: Review of the clinical record for patient #3, evidenced a start of care…

The agency failed to ensure the plan of care included interventions to ensure patient goals are achieved for 1 of 5 active records reviewed, out of a total of 7 clinical records reviewed.

The agency failed to ensure orders were complete and included interventions to be provide and goals to achieve for 1 of 5 active records reviewed in a sample of 7 clinical records.

The agency failed to ensure the physician was notified of a patient's delay for an admission and failed to notify the physican of an abnormal blood pressure for 1 of 5 active records reviewed in a sample of 7 clinical records reviewed.

The agency failed to update the plan of care to reflect the most current information for 1 of 2 records reviewed of patients with recertifications, in a sample of 7 clinical records reviewed.

The agency failed to ensure agency staff/ clinicians collaborated amongst themselves to ensure the patient needs are being met for 1 of 5 active patient records reviewed in a sample of 7 clinical records reviewed.

The home health agency failed to ensure all skilled nursing assessments were completed and documented per the plan of care for 2 of 5 active records reviewed, out of a total of 7 clinical records reviewed.

Skilled nursing failed to ensure they educated patients per the plan of care for 1 out of 5 active clinical records reviewed, out of a total of 7 clinical records reviewed.

The agency failed to ensure home health aide duties included hands on personal care for 1 of 1 home health aide clinical records reviewed, out of a total of 7 clinical records reviewed.

The agency failed to ensure home health aide supervisory visits were conducted every 14 days during skilled nursing visits for 1 of 1 records reviewed of skilled patients receiving home health aide services, out of a total of 7 clinical records reviewed.

The agency failed to document all interventions, including medication administrations, treatments, services, and responses to those interventions for 2 of 5 active clinical records reviewed, out of a total of 7 clinical records reviewed.

The agency failed to document the patient's progress towards goals in the patient's in 3 of 5 active records reviewed.