A-Plus Home Health Care, Inc

The agency failed to provide documented evidence of annual infection control education for 4 of 10 sampled staff members including those employed through an arranged contract, which has the potential to negatively impact the safety and well-being of all 89 patients serviced by the agency in the…

The agency failed to ensure the patient was able to be informed about, and consent or refuse care in advance of treatment with respect to the care being furnished based on the comprehensive assessment in 3 (P-1, P-3 and P-5) of 7 sample records reviewed resulting in the patient not receiving…

The agency failed to ensure the Registered Nurse (RN) conducted the initial assessment when RN services were ordered in 3 (P-2, P-5 and P-6) of 7 sample records reviewed, and failed to ensure that an initial assessment was completed within 48 hours of referral or physicians ordered start of care…

The agency failed to ensure the comprehensive assessment included a review of all medications the patient was currently taking for significant drug interactions and duplicate drug therapy in 5 (P-1, P-2, P-5, P-6, and P-7) of 7 sample records reviewed potentially resulting in unknown complications…

The agency failed to ensure the plan of care was individualized and included patient-specific measurable interventions, outcomes, and goals of care in 3 (P-3, P-4 and P-7) of 7 sample records reviewed resulting in the potential for unidentified and unmet patient goals of care, and lack of ability…

The agency failed to ensure visit frequencies were provided only as ordered by the physician for 1 (P-3) of 7 records reviewed, resulting in the potential for the provision of inappropriate care and services.

The agency failed to ensure the physician was promptly alerted to a change in the patient’s condition that suggest that outcomes are not being achieved in 1 (P-7) of 7 sample record reviews resulting in the physician being unaware of pertinent patient information and the potential for a poor…

The agency failed to ensure that skilled services were administered in accordance with the physician's orders and the Plan of Care in 1 (P-3) of 7 records reviewed, resulting in the potential for decline in physical functioning, unidentified health concerns and unmet care needs.

The agency failed to ensure physical therapy services prepared and entered clinical notes per agency expectation in 1 (P-7) of 7 sample records reviewed resulting in a delay of clinical information being available in the medical record.

The agency failed to ensure the home health aide provided services as ordered by the physician and included in the plan of care for 1 (P-6) of 1 sample records reviewed in which a joint visit with a home health aide occurred, could potentially result in poor patient outcomes.

The clinical manager failed to ensure the timely development and implementation of the plan of care per agency expectation in 1 (P-7) of 7 sample record reviews resulting in the medical record lacking pertinent medical information for clinicians to refer to when providing care and the potential for…

The agency failed to provide accurate information to patients regarding the complaint process in the start of care folder, resulting in the potential for complaints to go unresolved.

The agency failed to conduct a patient-specific, comprehensive assessment that accurately reflected the patient's current health status based on past medical history that included dates of onset, exacerbations, treatments and outcomes, and history of events leading to current home care needs; and…

The agency failed to have skilled nursing perform a comprehensive drug review in 3 of 3 (MR #2, 6 and 7) records where therapy only cases were assigned, resulting in the potential for harmful medication effects for all therapy only patients serviced by this agency.