The Pines Home Health

The agency failed to: (E-0004) maintain, review and update the emergency preparedness plan annually; (E-0006) develop a community-based risk assessment prior to developing the agency's emergency plan; (E-0009) include a process for cooperation and collaboration with local, tribal, regional, State…

The facility failed to ensure the following: (0642) implement a Quality Management program/plan, which poses a potential risk to the health and safety of patients if the HHA does not measure, analyze, and track quality indicators, including adverse patient events, and other aspects of performance…

The facility failed to ensure the following: (0682) an Infection Control program was maintained, documented, available and implemented to ensure the health and safety of its patients that the facility cares for.

The agency failed to maintain, review and update the emergency preparedness plan annually.

The facility failed to develop a community-based risk assessment prior to developing the facility's emergency plan.

The agency failed to update the plan with a process for cooperation and collaboration with local, tribal, regional, State, and Federal emergency preparedness officials.

The agency failed to update and annually review the EP plan and policies, to inform State and Local emergency preparedness officials about patients in need to be evacuated from their residence.

The agency failed to develop and implement a policy and procedure for the use of volunteers in an emergency.

The facility failed to develop and implement an emergency preparedness Communication Plan that complies with Federal, State, and local laws and must be reviewed and updated at least annually.

The agency failed to have a primary and alternate means of communication during an emergency.

The facility failed to develop and implement a method for sharing information and medical documentation for patients under the HHA'S care, as necessary, with other health care providers to maintain the continuity of care.

The agency failed to develop a means to sharing information on occupancy, needs, and it's ability to provide assistance to the authority having jurisdiction.

The facility failed to develop a facility based emergency planning, training and testing program.

The agency failed to have the existing staff review the emergency preparedness policies and procedures training, at least annually.

The facility failed to conduct exercises to test the emergency plan at least annually.

The facility failed to ensure that completed Oasis assessments related to beneficiary were encoded and electronically transmitted to the CMS system as required within 30 days of completing the assessment of beneficiary.

The facility failed to implement a Quality Management program/plan, which poses a potential risk to the health and safety of patients if the HHA does not measure, analyze, and track quality indicators, including adverse patient events, and other aspects of performance to be to assess processes of…

This facility failed to ensure an Infection Control program was documented, available and implemented to ensure the health and safety of its patients that the facility cared for.

The facility failed to ensure that 6 of 7 patient medical records reviewed ( patients #1, #2, #3, #4, #5 and # 7), contained a Medication Administration Record completed at the start of care.

The facility failed to ensure that coordination between therapy services and the registered nurse (RN) for other home health services for the patient was documented for 5 of 7 patient records reviewed (#1-#5); which poses the potential risk that all the needs of the patient will not be provided and…

The facility failed to ensure there was a written and signed contract for their contracted services, to include Physical Therapy, and Occupational Therapy.