Wel-Home Health of Red Oak

The agency failed to ensure 3 of 3 sampled home health aides (Staff E, F and G), demonstrated completion of all of the assigned extra skills while observed by a registered nurse to determine competency in each task prior to being allowed to care for agency patients independently for 2 patients…

The agency failed to provide individualized and specific written patient care instructions from a registered nurse (RN) to agency home health aides for 2 of 2 sampled patients receiving home health aide services (Patients #1 and #4).

The agency failed to complete an accurate drug regimen review with each comprehensive assessment for 3 of 3 sampled patients with home observation visits (Patients #1, #2 and #3).

The agency failed to ensure registered nurses supervising home health aides maintained documentation of a review of all required supervisory elements including following the patient plan of care, maintaining open communication with patient/caregiver, demonstrating competency of all assigned tasks…

The agency failed to complete provide wound assessments on a weekly basis per agency policy for 1 of 1 sampled patients with wounds (Patient #5).

The agency failed to ensure training in emergency preparedness for 3 of 3 sampled contracted therapists consistent with their expected roles (Staff D, F and G).

The agency failed to follow a Plan of Care established and periodically reviewed by a physician or notify the physician of the need to vary frequency of visits or inability to perform treatments/services as originally ordered on the Plan for Care for 3 of 7 sampled patients (Patients #1, #2 and #6).

The agency failed to ensure the home health aides successfully completed competencies in all home health aide skills that exceed basic skills, which require a registered nurse or other appropriate skilled professional in consultation with a registered nurse, to evaluate the competency of the aide…

The agency failed to assess each patients medications for duplication, side effects, ineffectiveness, actual or potential interactions and non-compliance within the required time frames, identifying medication discrepancies, as part of the initial comprehensive assessment at admission and as part…

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies and equipment used to meet the needs of the patient for 4 of 7 sampled patients (Patients #1, #2, #3 and #7).

The agency failed to perform ongoing interdisciplinary assessments of the patient for 2 of 2 sampled patients with alteration of skin integrity (Patient #4 and #6).

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician, permitted under state law and/or as directed by the skilled professional assigning the home health aide to the patient for 4 of 4 sampled patients receiving home health aide services…

The agency failed to ensure registered nurses supervising home health aides maintained documentation of a review of all required supervisory elements including following the patient plan of care, maintaining open communication with patient/caregiver, demonstrating competency of all assigned tasks…

The agency failed to ensure agency staff completed and sent a transfer summary to the health care professionals responsible for providing care to the patient while in a health care facility within 2 business days of the planned transfer for 3 of 3 sampled patients requiring transmission of a…

The agency: 1) Failed to ensure start of care comprehensive assessments were completed by the fifth day following each patient's start of care.

The home health agency failed to assess emergency preparedness needs of the patient with each comprehensive assessment and/or failed to ensure each patient received a copy of the individualized emergency plan the agency developed after assessing patient needs to keep in the home for 9 of 9 sampled…

The agency failed to ensure the development of a procedure to inform State and local officials of homebound patients in need of evacuation due to an emergency situation.

The agency failed to have a policy and procedure to notify State and local officials of any on-duty staff or patients the agency was unable to contact.

The agency failed to ensure training in emergency preparedness to all existing staff, including staff employed under arrangement of contract, consistent with their expected roles.

The agency failed to ensure participation in two emergency preparedness exercises in 2018. The agency reported a current census of 110 patients.

The agency failed to ensure authentication of hand written entries made in each patient's clinical record included the employee's signature, title, date and time of the signature and failed to complete timely documentation as directed by agency policy for 5 of 7 sampled patients (Patients #1, #2…

The agency failed to ensure agency staff advised the patient of the extent to which payment for agency services may be expected and the charges for services that may not be covered from Medicare, Medicaid, or any other federally-funded or federal aide program known to the agency and the charges the…

The agency failed to ensure the completion of all pertinent components of the comprehensive assessment by the fifth day following the start of care for 7 of 9 sampled patients (Patients #1, #2, #3, #4, #5, #8 and #9).

The agency failed to complete a drug regimen review with each comprehensive assessment for 9 of 9 sampled patients (Patients #1, #2, #3, #4, #5, #6, #7, #8 and #9 ).

The agency failed to ensure the completion of all pertinent components of the update to the comprehensive assessment at recertification in the last 5 days of each certification period for 8 of 8 sampled patients requiring a recertification (Patients #1, #2, #4, #5, #6, #7, #8 and #9).

The agency failed to ensure accurate completion of all pertinent components of the update to the comprehensive assessment within 48 hours of the agency's knowledge of return home from an inpatient facility for 5 of 5 sampled patients requiring a resumption of care assessment (Patients #2, #6, #7…

The agency failed to ensure completion of the update of the comprehensive assessment at discharge within 2 calendar days of identification of the need to discharge a patient for 2 of 2 sampled patients requiring a discharge comprehensive assessment (Patients #6 and #7).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment and medications used by the patient for 6 of 7 sampled patients (Patients #1, #2, #3, #4, #5 and #7,).

The agency failed to provide medications, treatments or services only as ordered by the physician for 1 of 1 sampled patients receiving a home visit for medication administration during the survey (Patient #1).

The agency failed to ensure a registered nurse or other appropriate health care professional completed home health aide supervision at least every 14 days for 3 of 3 sampled patients who received hands on personal care services in conjunction with skilled service provision (Patients #4, #5 and #7).

The agency failed to ensure a registered nurse completed home health aide supervision at least every 60 days while observing each home health aide present and providing direct patient care for 1 of 1 sampled patients who received hands on personal care services with no skilled service provision.

The agency failed to complete and send a transfer summary to the physician caring for the patient at the inpatient facility after transfer within 2 business days of the patient's transfer and/or failed to complete and send a discharge summary to the physician and other health care professionals who…