Wel-Home Health of Sergeant Bluff

The agency failed to ensure training in emergency preparedness to all existing staff consistent with their expected roles at the time of orientation and every other year thereafter for 2 of 4 sampled employees (Staff C and D).

The agency failed to ensure accurate completion of all components comprising the Plan of Care, including all supplies/equipment, and medications used by the patient for 2 out or 3 home observation visits.

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 1 of 1 sampled patients who received hands on personal care services in conjunction with a skilled service provision (Patient #5).

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…

The agency failed to ensure the accurate completion of all components comprising the Plan of Care for 8 of 8 sampled patients (Patients #1, #2, #3, #4, #5, #6, #7, and #8.) The agency reported a current census of 32 patients at the time of the survey.

The agency failed to ensure skilled professionals provided care as ordered by the physician in the Plan of Care for 3 of 8 sampled patients (Patients #3, #4 and #7) with a skilled nursing service.

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician in the Plan of Care and/or as directed in writing by the skilled professional assigning the home health aide to the patient for 2 of 5 sampled patients receiving home health aide services…

The agency failed to complete and send a discharge summary to the physician and other health care professionals who would be providing care to the patient after discharge within 5 calendar days for 1 of 4 sampled patients with discharges (Patient #6).

The agency failed to ensure training in the agency's emergency preparedness policies and procedures to 6 of 6 contracted therapy staff consistent with their expected roles in the event of an emergency/disaster.

The agency failed to provide individualized and specific written patient care instructions from a registered nurse (RN) to agency home health aides for 3 of 4 sampled patients receiving home health aide services (Patients #2, #4 and #5).

The agency failed to complete a review of all required components of the drug regimen review and accurately identify actual or potential issues related to the drug regimen review as part of the update to the comprehensive assessment for 5 of 7 sampled patients (Patients #1, #2, #3, #6 and #7).

The agency failed to ensure accurate completion of all required components of the recertification comprehensive assessments with accompanying drug regimen review between day 56 and 60 of each 60 day certification period for 2 of 3 sampled patients requiring a recertification assessment (Patients #4…

The agency failed to ensure completion of the update to the comprehensive assessment with accompanying drug regimen review within 48 hours of the agency's knowledge of return home from an inpatient facility for 1 of 1 sampled patients requiring a resumption of care assessment (Patient #2).

The agency failed to provide medications, treatments or services only as ordered by the physician for 2 of 2 sampled patients with home visits for medication set up observation (Patients #1 and #2).

The agency failed to notify the physician of changes in visit frequency ordered on the Plan of Care (missed visits) for 3 of 8 sampled patients (Patients #1, #5 and #6).

The agency failed to ensure all documentation included a signature and date and time of signature for 5 of 5 sampled patients who received home health aide services (Patients #2, #3, #4, #5 and #8).

The agency failed to complete a drug regimen review, including all required components, with each comprehensive assessment within the allowed time frames for 7 of 9 sampled patients (Patients #2, #4, #5, #6, #7, #8 and #9).

The agency failed to ensure accurate completion of all required components of the recertification comprehensive assessments between day 56 and 60 of each 60 day certification period for 3 of 5 sampled patients requiring a recertification assessment (Patients #2, #3 and #8).

The agency failed to provide agency patients with written contact information for the agency's clinical manager, including the clinical manager's name and contact information (telephone number and/or email address).

The agency failed to ensure a registered nurse (RN) completed home health aide supervision at least every 60 days while observing the home health aide present and providing direct patient care for 2 of 2 sampled patients who received hands on personal care services with no skilled service provision.

The agency failed to ensure home health aides furnished care following the registered nurses' (RNs) assigned tasks and documented the tasks completed and/or identify reasons for omission of tasks for 3 of 6 sampled patients receiving home health aide services (Patients #4, #5 and #8).

The agency failed to notify the Centers for Medicare Services (CMS) and/ or the state survey agency of any change in management (the director and clinical manager positions).

The agency failed to complete and send a discharge summary to the physician or other health care professionals responsible for providing care to the patient after the patient's discharge for 2 of 2 patients discharged patients sampled (Patients #6 and #7).