Vanguard Home Health Care Inc

The facility failed to maintain the comprehensive emergency preparedness program per the requirements of: 42 CFR 484.102 The agency failed to provide any documentation on their emergency preparedness program including procedures and policies, training and testing.

The agency failed to securely store personnel files for three of five personnel files reviewed (Staff E, O, and T).

The agency failed to ensure two of two discharged patients reviewed had physician orders for discharge from agency (Patient #6 and #7).

The HHA failed to ensure the home health aides completed the required 12 hours of inservice's at least every 12 months (G774); failed to initiate an aide plan of care and/or ensured the home health aide followed the aide plan of care (G798); and failed to conduct an on-site aide supervisory visit…

The agency failed to establish a written physician's plan of care for two of three medical records reviewed.

The agency failed to ensure all aides have at least 12 hours of in-service training during each 12 month period.

The agency failed to ensure the registered nurse generated and/or updated the aide plan of care to provide the aide with current and relevant instructions for their assigned duties and/or the registered nurse failed to ensure the aide was following the aides written plan of care.

The agency failed to update the comprehensive assessments the last five days of every 60 day period.

The agency failed to ensure the registered nurse made an on-site visit to the location where the patient is receiving care no less frequently than every 60 days in order to observe and assess each aide while he or she is performing care.