Proficient Home Health Services, LLC

The Agency failed to develop an emergency preparedness plan that had been reviewed and updated at least every 2 years, to ensure its Emergency Preparedness policies and procedures were reviewed and updated at least every 2 years, to develop and maintain an emergency preparedness communication plan…

The agency failed to provide evidence of its efforts to measure, track and analyze it's quality indicators and show measurable improvement in patient care and services (See G 642); failed to develop Performance Improvement activities, as part of the agency's Quality Assessment Performance…

The home health agency failed to develop an infection control program that focused on infection prevention and control, including communicable diseases for the last 3 years (See G682); failed to ensure the infection control program was active and provided surveillance, identification, prevention…

The agency failed to ensure the skilled nursing (SN) followed accepted standards of practice in assuming responsibility for the care of 1 (Patient/P-6) of 1 patient who required wound care management, from a total of 7 sampled patient records reviewed (See G 704); failed to ensure the registered…

The Agency failed to develop an emergency preparedness plan that had been reviewed and updated at least every 2 years, resulting in lack of updated direction for Agency personnel in the event of an actual emergency or disaster.

The agency failed to ensure its Emergency Preparedness policies and procedures were reviewed and updated at least every 2 years, resulting in the potential for poor patient outcomes during a disaster if staff are ill-prepared.

The facility failed to develop and maintain an emergency preparedness communication plan that included contact information for all current staff, patient's physicians, and volunteers, as appropriate, which had the potential to negatively affect the health and safety of all patients currently…

The Agency failed to develop and maintain an emergency preparedness training and testing program for staff based on the agency's emergency plan, resulting in agency personnel not being educated in actions to take in the event of an actual disaster.

The Agency failed to provide initial and ongoing training in emergency preparedness policies and procedures to all new and existing staff, including contract employees and volunteers, as appropriate, and failed to maintain documentation of trainings, resulting in the potential for inappropriate…

The Agency failed to provide documentation for the required community/facility based full-scale exercises and failed to provide documentation of an actual event that would qualify as a test of the emergency plan, resulting in staff being ill-prepared in the event of an actual emergency.

The agency failed to develop, implement, and maintain a Quality Assessment and Performance Improvement (QAPI) program which provided documentation of its efforts to measure, track and analyze quality indicators that represented pre-established performance improvement projects (PIP's) designed to…

The agency failed to develop performance improvement activities, as part of the agency's Quality Assessment Performance Improvement (QAPI) program, that tracked and trended adverse patient events, analyze the cause and implement preventive interventions, resulting in the potential for the rendering…

The agency failed to develop a Performance Improvement Project (PIP) within its Quality Assessment Performance Improvement (QAPI) program, resulting in the agency's inability to effectively monitor proposed improvements in patient care, health outcomes, patient safety, quality of care and overall…

The Governing Body failed to ensure the agency had an active and functioning Quality Assessment and Performance Improvement (QAPI) program that addressed priorities for improved quality of care, maintained patient safety standards, and was evaluated for its effectiveness, resulting in the potential…

The agency failed to develop an infection control program which monitored staff's performance to ensure infection control policies and accepted standard practices to prevent the transmission of infections and communicable diseases were followed in the last 3 years, resulting in a lack of oversight…

The agency failed to maintain a coordinated agency-wide program for the surveillance, identification, prevention, control, and investigation of infections and communicable diseases as a part of the agency's Quality Assessment Performance Improvement (QAPI program), resulting in the potential spread…

The agency failed to provide documented evidence of infection control education for 5 of 5 sampled staff members including those employed through an arranged contract which has the potential to negatively impact on the safety and well-being of all 15 patients serviced by the agency in the past 12…

The agency failed to ensure that skilled nursing (SN) followed accepted standards of practice in assuming responsibility for the care of 1 (Patient/P-6) of 1 patient who required wound care management with unmanaged diabetes, from a total of 7 sampled patient records reviewed, resulting in the…

The agency failed to ensure that at least one qualifying service was provided directly by agency employees, resulting in the potential for interruption in continuity of care and unmet care needs.

The agency failed to ensure that 7 (P-1, P-2, P-3, P-4, P-5, P-6, P-7) of 7 records reviewed were included in their overall planning of care including informing the patient/caregiver in advance of which services would be provided, and the duration with visit frequency of those services, resulting…

The agency failed to ensure the initial assessment visit was conducted within 48 hours of the home care referral to determine the immediate care needs of the patient for 3 (P-1, P-2, P-4) of 5 records reviewed with skilled nursing services; and 1 (P-5) of 2 therapy only cases, from a total sample…

The agency failed to ensure the patient’s clinical record documented all medications with a completed reconciliation and failed to provide documented evidence that the physician was notified of identified drug interactions in for 3 (P-1, P-2, P-3) of 7 records reviewed.

The agency failed to ensure the Plan of Care (POC) included appropriate and measurable skilled nursing goals in 4 (P-1, P-2, P-5, P-6) of 7 total sampled records and failed have an appropriate number of SN visits to meet the clinical needs of the patient in 1 (Patient/P-6) 1 record reviewed with…

The agency failed to ensure that skilled nursing (SN) and physical therapy (PT) coordinated patient care needs in 1 (Patient/P-6) of 1 patient record reviewed with diabetic wound care, out of a total sample of 7 records, resulting in the potential to negatively affect the health and well-being of…

The agency failed to ensure visit frequencies were provided only as ordered by the physician for 2 (P-2, P-6) of 7 records reviewed, resulting in the potential for the provision of inappropriate care and services.

The agency failed to ensure the physician was notified of the patient’s non-compliance with ordered medications and treatments in 1 (P-3) of 7 records reviewed, which resulted in the potential of uncontrolled blood sugars.

The agency failed to ensure the discharge summary was complete, provided the patient's current health status at the time of discharge, progress toward goals, and included all ordered disciplines that provided care in 2 (Patient/P-6, Patient/P-7) of 6 closed records, from a total of 7 sampled…

The agency failed to ensure services were provided only as ordered by a physician for 1 of 2 (MR#1) records reviewed with new starts of care, resulting in a lack of physician approval and oversight of this patient's home care services.

The agency failed to ensure the initial assessment visit was conducted within 48 hours of referral for 3 of 7 (MR# 3, 5, 7) records reviewed (refer to G514); failed to ensure the comprehensive assessment was completed within 5 calendar days of providing hands on care for 1 of 7 (MR#3) records…

The agency failed to ensure the plan of care was developed and included interventions, treatments, measurable outcomes, and goals, for 5 of 7 (MR# 1, 2, 3, 4, 5) records reviewed (refer to G574); failed to ensure the plan of care included orders for physical therapy services for 1 of 7 (MR#4)…

The agency failed to ensure the clinical record contained accurate information for 1 of 1 (MR#2) records reviewed (refer to G1010); failed to ensure the clinical record contained a completed comprehensive assessment, a plan of care, or an updated assessment at discharge for 2 of 7 (MR# 3, 7)…

The agency failed to ensure the skilled nurse notify the physician of findings that fell outside the parameters ordered in the patient’s plan of care in 2 of 7 (MR# 1, 2) records reviewed; and failed to ensure social work services were provided for 1 of 1 (MR#6) records reviewed with orders for…

The agency failed to ensure the clinical record contained accurate information for 1 of 1 (MR#2) records reviewed in which the patient was transferred to the hospital, resulting in a lack of accurate information detailing the events of this patient's care.

The agency failed to advise patients of the names, addresses and telephone numbers of Federally funded and State funded entities that serve the areas where the patients reside, resulting in a lack of information regarding available resources which has the potential to affect the quality of care for…

The agency failed to ensure the initial assessment visit was conducted within 48 hours of referral for 3 of 7 (MR# 3, 5, 7) records reviewed, resulting in a delay in determining the immediate care and support needs for these patients.

The agency failed to ensure the comprehensive assessment was completed within 5 calendar days of providing hands on care for 1 of 7 (MR#3) records reviewed, resulting in a lack of information to direct and support the care needs for this patient.

The agency failed to ensure the comprehensive assessment accurately reflected the patient's current health status for 1 of 7 (MR# 1) records reviewed, resulting in incomplete clinical information to aide in determining the needs of this patient and assist in developing the patient's plan of care.

The agency failed to ensure a registered nurse conducted a review of the patient's medications for any potential adverse effects such as: side effects, drug interactions, and duplicate drug therapy for 1 of 7 (MR# 3) records reviewed, resulting in the potential for harmful medication effects for…

The agency failed to ensure the plan of care was developed, included interventions, treatments, measurable outcomes, and goals, for 5 of 7 (MR# 1, 2, 3, 4, 5) records reviewed, resulting in the potential for poor patient outcomes due to a lack of quantifiable measures to determine patient progress…

The agency failed to ensure the plan of care included orders for physical therapy services for 1 of 7 (MR#4) records reviewed, resulting in the provision of physical therapy services without a physician order for this patient.

The agency failed to ensure that physical therapy services were provided as ordered by the physician in the plan of care for 2 of 7 (MR # 2, 7) records reviewed in which physical therapy services were ordered, resulting in the potential for poor patient outcomes for these patients.

The agency failed to ensure skilled professionals were responsible for preparing clinical notes for 1 of 4 (MR# 4) records reviewed with nursing services, resulting in a lack of information regarding the health status of these patients.

The agency failed to ensure the skilled nurse communicated with the physician regarding vital signs beyond parameter limits for 2 of 4 (MR# 1, 2) records reviewed with skilled nursing services, resulting in a lack of physician involvement in directing the appropriate care for these patients.

The agency failed to ensure the clinical record contained a completed comprehensive assessment, a plan of care, or an updated assessment at discharge for 2 of 7 (MR# 3, 7) records reviewed, resulting in a lack of information for the physician and all agency staff caring for these patients.

The agency failed to ensure a detailed transfer summary was sent to the receiving health care facility within 2 business of becoming aware of the transfer for 1 of 1 (MR# 2) records reviewed with transfers to other health care facilities, and failed to ensure a completed discharge summary was sent…

The home health agency failed to inform the patients of the administrator's name, address and business phone number, as the person to receive complaints for the agency, resulting in a potential for unaddressed patient concerns or complaints for 2 of 2 active patients (M.R. #1 and #2).

The agency failed to inform the patients of the Michigan toll free home health telephone hot line number and the right to use the number at any time for all patients receiving agency services, resulting in patients not being informed of their rights.

The Administrator failed to ensure the Clinical Manager was available at all times during operating hours, resulting in the lack of clinical supervision and oversight and the potential for unmet care needs for the agency's existing patients.

The governing body failed to assume responsibility for the agency's operational plans in not providing home health services to patients in the community in which they were located, resulting in the potential for unfulfilled care needs of patients (See tag G 0942).

The governing body failed to assume responsibility for the agency's operational plans in not providing home health services to patients in the community in which they were located, resulting in the potential for unfulfilled care needs of patients.