Abby Health Care Inc

The facility failed to develop and maintain an emergency preparedness plan based on a community-based risk assessment, utilizing an all-hazards approach.

The facility failed to develop and maintain an emergency preparedness communication plan that included names and contact information for the Staff and Entities providing services under arrangement.

The facility failed to develop and maintain an emergency preparedness training and testing program based on the risk assessment, policies and procedures, and communication plan that is reviewed and updated at least every 2 years.

The facility failed to maintain documentation that staff demonstrated knowledge of emergency procedures initially for three (3) of four (4) PF reviewed (PF1-3) and at least every 2 years for two (2) of two (2) PF that had 2 years of more of employment (PF 1 & 4).

The facility failed to test the emergency plan at least annually for two (2) of three (3) years reviewed.

The agency failed to provide evidence that a discharge/transfer summaries was sent to the physician/receiving facility for two (2) of two (2) CR's reviewed (CR 1 & 2).

The agency governing body failed to ensure that an ongoing program for quality improvement and patient safety is defined, implemented, and maintained for one (1) of one (1)observation.

The agency failed to follow its policy pertaining to infection control for two (2) of two (2) clinical home visits conducted, (HV 1 & 3).

The agency failed to coordinate an agency-wide program for the surveillance, identification, prevention, control, and investigation of infectious and communicable diseases for one (1) of one (1) observation.

The agency failed to ensure the nurse clarified indications for as needed medications for four (4) of seven (7) clinical records (CR) reviewed (CR3, 4, 6, & 7).

The agency failed to ensure the patient's plan of care included All medications and treatments for two (2) of seven (7) clinical records (CR) reviewed (CR3 &5).

The agency failed to demonstrate the presence of baseline screening for mycobacterium tuberculosis (TB) for three (3) of four (4) PF reviewed (PF1, 3 & 4), annual TB education for four (4) of four (4) PF reviewed (PF1-4), and Clinical Practice License for three (3) of four (4) PF reviewed (PF2-4).

The agency failed to ensure physicians orders were carried out for two (2) of seven (7) CRs reviewed (CR #2 & #6).

The agency failed to all ensure all entries are legible and clear for six (6) of seven (7) clinical records reviewed (CR#1, & CR#3-CR#7).

The agency failed to ensure the initial assessment visit be held either within 48 hours of referral, or within 48 hours of the patient's return home, or on the physician ordered start of care date for three (3) of seven (7) clinical records reviewed (CR#4, CR#5, & CR#6).

The agency failed to conduct a review of all medications the patient is currently using for three (3) of seven (7) CRs reviewed (CR #2, #3 & #4).

The agency failed to ensure the Plan of Care (POC) contained supplies and equipment required for three (3) of seven (7) CRs reviewed (CR#2 #3, & #6), safety measures to protect against injury for four (4) of seven (7) CRs reviewed (CR#2 #3, #4, & #6), patient specific interventions and measurable…

The agency failed to document care coordination in accordance with agency policy for one (1) of one (1) CR reviewed with more than a single discipline providing care (CR#3).

The registered nurse failed to implement standard precautions to include disinfection of equipment prior to returning to equipment bag for two (2) of two (2) home visits observed (HV1 with CR5 and HV2 with CR6).

The registered nurse failed to implement standard precautions to include disinfection of equipment prior to returning to equipment bag for two (2) of two (2) home visits observed (HV1 with CR5 and HV2 with CR6).; failed to inform physician of assessment findings for elevated blood glucose…

The agency failed to accurately develop an individualized plan of care that included all the pertinent elements for seven (7) of seven (7) CR reviewed (CR1-CR7).

The registered nurse failed inform physician of assessment findings for elevated blood glucose assessments and/or clarify physician orders for blood glucose monitoring for two (2) of seven (7) CR reviewed (CR2, CR7).