Richard Health Systems, LLC

The facility failed to review and maintain an emergency preparedness program that meets all of the standards specified within the condition/requirement of CFR 484.102. The emergency preparedness program must describe a facility's comprehensive approach to meeting the health, safety, and security…

The agency failed to consult the physician when changes were made to the plan of care.

The agency failed to consult the physician when changes were made to the plan of care.

The failed to follow infection control procedures during a dressing change.

The facility failed to ensure patients had an accurate medication profile.

The agency failed to ensure the Emergency Preparedness Plan was reviewed and updated at least every two years.

The agency failed to provide procedures to inform state and local emergency preparedness officials about homebound patients in need of evacuation from their residences during an emergency situation.

The agency failed to procedures in place in the event on-duty staff or patients could not be contacted.

The agency failed to ensure the plan contained contact information to identify state and local officials to request assistance to provide care for homebound patients in need of evacuation.

The agency failed to conduct emergency drills as required.

The agency failed to transmit disharge Outcomes and Assessment Information Set (OASIS) assessments for three (#2, #5, and #9) patients.

The facility failed to follow the orders in the plan of care (POC) for visits and failed to notify the physician when the POC could not be completed.

The agency failed to ensure nursing staff followed physician orders for medication management for one of two (Patient #2) records reviewed with skilled nursing services.

The agency failed to include all provided services on the plan of care.

The facility failed to ensure patients receiving both skilled nurse services and home health aide service received home health aide supervisory visits no less frequently than every 14 days.

Staff interview the facility failed to ensure a plan of care was completed for each patient it serves.

Staff interview the agency failed to provide home health aide services per the physician's orders.

The agency failed to ensure the agency RN prepared a home health aide care plan for two of three (Patient #'s 1 and 2) patients reviewed.

The agency failed to ensure an RN conducts the initial assessment to determine care needs for all patients served.

The agency failed to ensure qualified home health aides were working in the patients home.

The agency failed to ensure the agency RN performed a supervisory visit of the home health aide (Patient #'s 1 and 2) and failed to ensure the aide was present at the supervisory visit (Patient #2).

The agency failed to follow up on a patient's complaint regarding home health aide services.

The agency failed to ensure patients received services that were written in the plan of care and failed to ensure physician notifications were documented for missed visits for four patients of seven patients reviewed (Patient #2, #4, #5 and #6).

The agency failed to ensure home health aide services were provided according to the plan of care for two of three patients reviewed who were received home health aide services (Patient #1 and #5).

The agency failed to complete supervisory visits every 14 days while patients were receiving skilled services for three of three patients reviewed who were receiving home health aide services and skilled services (Patient #4, #5 and #6).