Twin Tier Home Health, Inc

In 6 of 17 records (patients #1, 2, 7, 9, 10, and 17) the agency failed ensure patients received the home health services that were written in the individualized plan of care.

During 2 of 7 visits (patients #5 and 7), the clinician failed to follow accepted standards of infection control practices.

In 1 out of 17 records (patient #13), the agency failed to conduct the initial assessment visit to determine immediate care needs within 48 hours of referral or return home.

In 4 of 17 records (patients #6, 8, 12, and 13) the agency failed to ensure comprehensive assessments were of sufficient scope to identify all patient needs.

In 3 of 17 records (patients #4, 5, and 8) the skilled nurse failed to perform comprehensive medication reviews.

In 7 of 17 records (patients #1, 2, 6, 7, 8, 12, and 13) the agency failed to develop complete and accurate plans of care that were individualized to address the total needs of the patients.

In 2 of 17 patients (patients #1 and 8) the agency staff failed to provide coordinated care to meet the needs of the patients.

The agency failed to ensure for 1 of 1 patient discharged from the hospital that a comprehensive assessment of the patient was conducted within 48 hours of discharge from the hospital.

In 2 records (patients #1 and 2) the clinicians failed to effectively coordinate patient care.

In 1 patient record (Patient # 8) the agency failed to have an effective process in place to ensure that all complaints related to patient care are documented, investigated, and resolved.

In 3 of 13 records of patients admitted after 01/01/18 (Patients #8, 10 and 13) the agency failed to conduct the initial assessment visit within 48 hours of referral to determine immediate care needs.

For 3 of 7 patients (Patients # 1, 4 and 5) The agency failed to provide written instructions to the patient outlining the care plan.

The 08/20/18 home health aide care plan failed to include: - diabetic precautions - oxygen precautions - bleeding/bruising precautions On 09/18/18 the record was reviewed with the Administrator, DPS and QA Manager.

In 5 records (Patients # 2, 3, 6, 15, 17), the plans of care were not of sufficient scope to meet patient needs.

In 5 records (Patients # 9, 12, 13, 15 and 16) the clinicians failed to effectively coordinate patient care.