Purpose Home Health LLC

The agency failed to ensure the HHA training/competency was independent of the agency, as agency staff had scored/graded written competency exams and placed home health aides on the State Aide Registry, despite being precluded from doing so, for 4 of 4 newly licensed HHA personnel files reviewed.

The agency failed to ensure home health aides were appropriately trained prior to providing aide services to patients; failed to ensure trainees had been adequately trained and competencied before placing on the Indiana State Aide Registry (see G0754), failed to ensure home health training was of…

The agency failed to ensure home health aides performed hand hygiene at appropriate intervals while providing care to patients, in 3 of 3 home visit observations.

The agency failed to ensure home health aides were assigned to patients by an RN with written patient care instructions prepared by the same RN, in 3 of 5 home health aides reviewed.

The agency failed to ensure the comprehensive assessment accurately represented patients functional status, in 1 of 5 active clinical records reviewed.

The agency failed to ensure patient plans of care included required elements, including but not limited to: Durable Medical Equipment (DME, a category of medical devices designed to assist individuals with disabilities, injuries, or chronic health conditions, prescribed by healthcare professionals…

The agency failed to ensure home health aides had been adequately trained and competencied before placing them on the Indiana State Aide Registry, for 4 of 6 home health aides reviewed, hired in the last 12 months.

The agency failed to ensure home health training was of an adequate duration, before placing trainees on the Indiana State Aide Registry, for 1 of 1 agency.

The agency failed to ensure home health aide care/services provided to patients were physician ordered and included in the Plan of Care, in 1 of 1 active clinical record reviewed.

The agency failed to ensure a supervising RN conducted a direct observation of a home health aide, after concerns were identified related to Patient #1's fall, due to improper use of a mechanical lift, in 1 of 1 active clinical record reviewed with reported fall.

The Administrator failed to ensure they were responsible for day to day operations including HHA training and competencies before being placed on the Indiana State Aide Registry, ensuring home health aides and nursing staff had up to date and complete personnel files, for 1 of 1 agency.

The agency failed to ensure the RN coordinated the delivery of care to meet the patient's needs for 2 of 2 active records reviewed with patients receiving outside services.

The Governing Body failed to assume responsibility for the agency's overall management and operation, including but not limited to appointment of the administrator and ensuring the provision of correct demographic and agency information such as the physical address, provider number, and scope of…

The governing body failed to appoint an administrator for 1 of 1 home health agencies.

The agency failed to ensure the protection and promotion of a patient's rights (Patient #1) upon having received a report of physical abuse for a patient with a cognitive deficit (diagnosis of dementia) by having failed to conduct/document an investigation that included a physical assessment and an…

The agency failed to implement their abuse and neglect policies in 1 of 8 records reviewed (Patient #1).

The agency failed to take action to prevent further potential risk of physical abuse and misappropriation of the patient’s property in 1 of 7 (Patient #1) records reviewed.

The agency failed to report allegations of abuse and misappropriation of property to all of the appropriate authorities in 1 of 8 records reviewed.

The agency failed to ensure services were furnished as ordered for 6 (Patients 1, 2, 3, 14, 15, 16, and 17) of 12 patients whose clinical records were reviewed.

The agency failed to ensure all personnel having direct patient contact implemented standard precautions, including proper hand hygiene, proper bathing, and proper personal care; and failed to ensure all clinicians used aseptic technique during subcutaneous injection of a medication and blood…

The agency failed to implement their policy which required all patients received a complete and accurate medication review/reconciliation at admission, recertification; and with skilled visits for 6 of 12 active records reviewed.

The agency failed to ensure all patients received a complete and accurate plan of care that included all pertinent diagnoses, an accurate psychosocial status, the supplies and equipment required, rehabilitation potential, functional limitations, nutritional requirements, all medications/treatments…

The agency failed to ensure integration of services with all disciplines involved in 8 of 12 active records reviewed.

The agency failed to ensure care coordination with other home care agencies and assisted living facilities, failed to coordinate care between the clinician and home health aide, failed to coordinate care with the patient's physician, and failed to include the patient's representative in care…

The agency failed to ensure the nurse updated and evaluated the plan of care to ensure all the patients' needs were being met and failed to ensure the plan of care was individualized based on the patient's needs for 12 of 12 active records reviewed.

The agency failed to ensure staff followed infection control policies and procedures for 4 of 6 home visits with the parent office (patient #1, 2, 3, 5, 7) and for 1 of 2 home visits at the Fort Wayne branch location (#7).

The HHA (home health aide) failed to ensure they followed the aide care plan and/ or document tasks completed as ordered or document patient's refusal for 7 of 15 clinical records reviewed at the parent office (Patient # 1, 2, 3, 9, 10, 15, and 16) and 1 of 2 clinical records reviewed in the Fort…

The agency failed to ensure the Home Health Aide (HHA) documented communication and/or coordination with the Registered Nurse (RN) case manager in relation to tasks not completed on each visit as directed on the HHA Care plan, for 7 of 16 clinical records reviewed (patients #1, 2, 3, 9, 10, 15, and…

The agency failed to ensure the implementation of its policies which requires documentation of agency communication with the patient and/or family members to be included into the clinical record for 1 of 5 discharged patients (Patient #15) in a total sample of 17 clinical records reviewed.

The agency failed to ensure the clinical record evidenced documentation that the discharge summary was sent to the physician within 5 days of discharge or within 2 days of transfer from the agency for 4 of 5 closed records reviewed (patient #13, 14, 15, and 16).