Accord

The agency failed to meet the Conditions of Participation (CoP) for Organization and administration of services, 42 CFR § 484.105 at G0940. The agency failed to ensure skilled nursing services and at least one other therapeutic service was made available for patients.

The facility failed to ensure skilled nursing services and at least one other therapeutic service was made available for patients.

The agency failed to arrange a safe and appropriate discharge when the provider was not aware of the discharge, therefor measurable goals and outcomes were not set forth for 1 of 3 patients (P3) reviewed for inappropriate discharge.

The agency failed to ensure it developed policies and procedure on staffing strategies and surge planning surrounding natural disasters and failed to develop a policy on the use of volunteers in an emergency and other emergency staffing strategies to address surge needs.

The home health agency (HHA) failed to ensure discharges were appropriate and allowed by the practitioner/physician who was responsible for the home health plan of care for 3 of 3 patients (P1, P5, P8).

The home health agency (HHA) failed to notify identified other health care professionals who may be involved in the patient's care when discharge becomes imminent for 3 of 3 patients (P1, P5, P8).

The home health agency (HHA) governing body failed to ensure patient discharges were coordinated with other health care professionals who may be involved in the patient's care when multiple patients discharges become imminent.

The agency failed to transmit Outcome and Assessment Information Set (OASIS) data for 2 of 7 patients (P7, and P2) who received skilled services, within 30 days of completing the assessments.

The agency failed to ensure each patient had an initial assessment visit within 48 hours of their referral date for 1 of 7 patients (P7) who received nursing services.

The home health agency (HHA) failed to ensure the registered nurse (RN) completed a follow-up comprehensive assessment within the last 5 days of the current 60 day certification period (between and including days 56-60) for 1 of 1 patient (P2) who had received services for greater than 60 days.

The agency failed to ensure the plan of care (POC) included durable medical equipment (DME) used by 1 of 2 patients (P7).