United Integrity Home Health Inc

The agency failed to ensure the emergency preparedness plan included an updated facility-based and community-based risk assessment utilizing an all-hazards approach, creating the potential risk of not providing the necessary care and services to the patients during the emergency events.

The agency failed to ensure the emergency preparedness plan analyze the response to the HHA's emergency drills.

The agency's Administrator failed to be responsible for the day-to-day operations as the agency's P&P related to the CHHA 12 hours in service training was completed for CHHA 3. This failure had the potential for not providing quality of care and services to the patients receiving services from the…

The agency failed to ensure the written patient care instructions for the CHHA was developed by the RN who was responsible for the supervision of the CHHA for three of eight sampled patients (Patients 1, 5, and 8).

The agency failed to ensure the initial assessment visits were conducted within 48 hours after referral for one of eight sampled patients (Patient 6).

The agency failed to ensure the initial comprehensive assessments were completed in a timely manner, consistent with the patient's immediate needs, but no later than 5 calendar days after the SOC date for four of eight sampled patients (Patients 2, 3, 6, and 8).

The agency failed to ensure the review of the medications included all of the patient's current medications to identify any potential adverse effects and drug reactions for three of eight sampled patients (Patients 1, 2 and 3 ).

The agency failed to ensure the comprehensive assessments were updated within the last five days of every 60 days for four of eight sampled patients (Patients 3, 4, 6, and 8 ).

The agency failed to ensure the update comprehensive assessment was completed within 48 hours of the patient's return to home from the acute care hospital for one of eight sampled patients (Patient 1).

The agency failed to ensure the POCs included specific information related to medications and assessment of blood sugar for two of eight sampled patients (Patients 3 and 6).

The agency failed to ensure wound treatment was provided only with a physician's order for two of the eight sampled patients (Patients 1 and 3).

The agency failed to revise and update the POC for two of eight sampled patients (Patients 5 and 8).

The agency failed to ensure PT services were timely for one of eight sampled patients (Patient 7).

The agency failed to provide a written instruction outlining the visit schedule for three of eight sampled patients (Patients 1, 2, and 3).

The agency failed to ensure the patients received care and services as per the written plan of care for five of eight sampled patients (Patients 3, 4, 5, 6, and 8).

The agency failed to ensure the patient and or caregiver was provided education related to anticoagulant medication and oxygen therapy as per the plan of care for one of eight sampled patients (Patient 5).

The agency failed to ensure the agency's skilled professionals prepared accurate clinical notes for seven of eight sampled patients (Patients 1, 2, 3, 5, 6, 7, and 8).

The agency failed to ensure the HHA’s RN provided supervision to the LVN to ensure quality of care and services were provided for one of eight sampled patients (Patient 8).

The agency's Administrator failed to be responsible for the day-to-day operations related to CHHA in-service training documentation.

The agency failed to ensure care and services were provided in accordance with the care plan for two of eight sampled patients (Patient 5 and 6).

The agency failed to ensure the agency's RN provided the onsite supervision for the CHHA no less frequently than every 14 days to ensure quality of care and services provided for one of eight sampled patients (Patient 6).

The agency's Administrator failed to be responsible for the day-to-day operations related to the written agreements with the contracted RD, PT, and OT.

The agency failed to ensure the agency's P&Ps were implemented related to the following: No discharge summary sent to the physician within five business days for one of eight sampled patients (Patient 6).

The agency failed to ensure the agency's CHHA prepared accurate visit notes for one of eight sampled patients (Patient 1).

The agency failed to ensure the completed discharge summaries were sent to the primary care practitioner within five business days of the discharge date for two of two sampled discharged patients (Patients 6 and 7), and the completed transfer summary for one of eight sampled patients (Patient 1).

The agency failed to ensure the emergency preparedness plan was reviewed and updated at least every two years.

The agency failed to ensure their comprehensive emergency preparedness program was based on community based risk assessment, utilizing an all hazards approach.

The agency failed to ensure their emergency P&P and plan included a process for cooperation and collaboration with local, tribal, regional, state, and federal emergency preparedness officials.

The agency failed to establish a comprehensive emergency preparedness program based on the risk assessment and ensure to review every two years.

The agency failed to establish and maintain a comprehensive emergency preparedness program including plans for the patients during a natural and man made disaster.

The agency failed to ensure the emergency preparedness plan and P&P included procedures to inform the state and local emergency officials about the patients in need of evacuation from their residences due to an emergency situation.

The agency failed to ensure the emergency preparedness plan included procedures to follow up with on-duty staff and patients, to determine services needed and procedures to inform state and local officials of any on-duty staff or patients they are unable to contact.

The agency failed to ensure the emergency preparedness P&P addressed a system of medical documentation that protected confidentiality of the patient information, and secured and maintained availability of records.

The agency failed to ensure the emergency preparedness P&P addressed the use of volunteers in an emergency and other emergency staffing strategies to address surge needs during an emergency.

The agency failed to ensure the emergency preparedness communication plan was reviewed and updated every two years, creating the increased risk of not addressing the care needs for the patients during the emergency events.

The agency failed to ensure the emergency preparedness communication plan included the updated name and contact information of the staff, entities provided services under agreement, patients' physician, and volunteers.

The agency failed to ensure the emergency preparedness communication plan included the contact name and information for the federal, state, tribal, regional, and local emergency preparedness staff and other sources of assistance.

The agency failed to ensure the emergency preparedness communication plan included the information related to the alternate means for communicating with staff, federal, state, regional and local emergency management agencies, creating the risk of not being able to communicate to meet the patient…

The agency failed to ensure the emergency preparedness plan included the method for sharing information and medical documentation for the HHA's patients with other health providers to maintain the continuity of care, creating the increased risk of not providing appropriate, consistent, and quality…

The agency failed to ensure the emergency preparedness communication plan included a means of providing information about the agency's occupancy, needs, and its ability to provide assistance to the authority having jurisdiction, the Incident Command Center, or designee.

The agency failed to ensure the emergency preparedness training and testing program were reviewed and updated every two years, creating the increased risk of not addressing the care needs for the patients during emergency events.

The agency failed to ensure initial training in the emergency preparedness program was provided to volunteers and contracted individuals providing services under arrangement and documentation of all the emergency preparedness training was maintained.

The agency failed to ensure the HHA conducted exercises to test the emergency plan at least annually.

The agency failed to ensure the physician was informed when the care and services were not provided timely as ordered for three of seven sampled patients (Patients 1, 5, and 7), creating the risk of not providing appropriate, consistent, and quality of care to these patients.

The agency failed to ensure the CHHA were provided a written patient care instructions for one of the seven sampled patients (Patient 4), creating the risk of not providing the necessary care to the patients.

The agency failed to ensure the written agreement with the contracted social services company (Company 1) included the role of the contracted company in discharge planning.

The agency failed to ensure the clinical record was completed in a timely manner for two of seven sampled patients (Patients 1 and 7), creating the risk of not appropriately authenticating the contents of the patient's clinical record.

The agency failed to ensure the patients and PCGs were advised of the availability of the state’s contact information for two of seven sampled patients (Patients 4 and 5), creating the risk of violating the patient’s rights to be informed of the process of filing a complaint to the appropriate…

The agency failed to implement their P&P addressing the grievances of two nonsampled patients (Patients A and B), creating the risk of violating the patient's rights and not providing quality of care and services to these patients.

The agency failed to ensure the RN conducted the initial assessment visit within 48 hours of the referral for one of seven sampled patients (Patient 7), creating the risk of not identifying and addressing the care needs in a timely manner for this patient.

The agency failed to ensure the initial comprehensive assessments were completed in a timely manner, consistent with the patient's immediate needs, but no later than five calendar days after the SOC date for four of seven sampled patients (Patients 1, 3, 4, and 5), creating the risk of not…

The agency failed to ensure the medication profiles were updated for three of seven sampled patients (Patients 1, 4, and 5), creating the risk of not identifying the potential adverse effects, significant drug interactions, duplicate drug therapy, and drug reactions for these patients.

The agency failed to ensure the POCs included pertinent information for two of the seven sampled patients (Patients 4 and 7), creating the risk of not addressing the care needs of these patients.

The agency failed to ensure effective coordination of care and services for one of seven sampled patients (Patient 2), creating the risk of not providing necessary care and services to these patients.

The agency failed to provide the written instructions on the SN visit schedule for two of seven sampled patients (Patients 4 and 5), creating the risk of not providing the necessary information to these patients.

The agency failed to ensure the skilled professionals provided care and services in accordance with the POC for three of the seven sampled patients (Patients 1, 3, and 6), creating the risk of not providing appropriate, consistent, and quality care to the patient.

The agency failed to ensure the agency's skilled professionals prepared accurate clinical notes for one of seven sampled patients (Patient 1), creating the increased risk of substandard healthcare outcomes to this patient.

The CHHA failed to provide services as per the plan of care for three of seven sampled patients (Patients 1, 4, and 7), creating the risk of not providing the appropriate care and services to this patient.

The agency failed to ensure the agency's RN provided the onsite supervision for the CHHA no less frequently than every 14 days to ensure quality of care and services provided for one of seven sampled patients (Patient 3), creating the risk of substandard health outcomes to these patients.

The agency failed to ensure the discharge/transfer summary for two of seven sampled patients (Patients 1 and 2) were completed.