Alpine Home Health Care, LLC

This condition was not met as evidenced by: Failure of the Registered Nurse (RN) to conduct an initial assessment within 48 hours of referral, within 48 hours of the patient's return home, or on the physician-ordered start of care date.

This condition was not met as evidenced by: Failure to develop comprehensive plans of care which address each patient's individual needs.

9) the agency failed to ensure the comprehensive assessment is consistent and accurately reflects the patient's status and needs.

The ROC comprehensive assessment was not of sufficient scope to identify the current patient needs.

The agency failed to provide services in accordance with the Plan of Care (POC).

The agency failed to measure, analyze, and track quality indicators, including patient events, and to implement adequate action plans to lead to measurable improvements in areas identified.

For 2 of 3 closed records (Patient # 8 and 9) the Agency failed to effectively analyze the causes of adverse events and implement preventive actions.

The agency failed to disclose changes in the role of Director of Patient Services (DPS) to the New York State Department of Health's Western Regional Office (WRO).

The agency failed to ensure it obtained a Clinical Laboratory Improvement Amendment (CLIA) Certificate of Waiver in order to perform venipuncture, blood glucose testing and collect other laboratory tests.

The agency failed to ensure that patients are informed, before care is initiated, of their potential financial liability for services provided.

For two (2) of six (6) patients (Patient # 2 and 6) the agency failed to ensure the Registered Nurse (RN) conducted an initial assessment of the patient within 48 (forty-eight) hours of referral, the patient's return home, or on the physician-ordered start of care date.

The agency failed to ensure the Physical Therapist (PT) conducted an initial assessment of the patient within 48 (forty-eight) hours of referral, the patient's return home, or on the physician-ordered start of care date.

6 and 8) the agency failed to ensure that a comprehensive assessment consistent with the patient's needs was performed within five (5) calendar days after the start of care (SOC).

The clinical record lacked documented evidence of a complete review of all medications the patient was currently using to identify any potential adverse effects, drug reactions, or concerns.

The agency failed to ensure comprehensive assessments are updated and revised within forty-eight (48) hours of the patient's return to the home from a hospital admission of twenty-four (24) hours or more.

The agency failed to develop an individualized plan of care that is complete, and accurate and addresses the total needs of the patients.

Failed to include evidence that orders were obtained for changes in the plan of care.

The agency failed to ensure that treatments are administered in accordance with physician orders.

The agency staff failed to promptly alert the physician to any changes in the patient's condition that suggests the need to alter the plan of care (POC).

The agency failed to ensure that discharge planning was communicated with the patient/caregiver and the responsible physician prior to discharge from the agency.

The agency failed to ensure performance improvement (PI) activities lead to immediate correction of identified problems that resulted in negative outcomes for two (2) of two (2) patients (Patient #8 and 9) that received emergent care for hypo/hyperglycemia, and has the potential to threaten the…

The agency failed to ensure ongoing interdisciplinary assessments and communication of the patient.

The agency failed to ensure clinicians prepare and document complete and accurate clinical and progress notes.

The agency failed to ensure agency staff communicated with the patient's physician regarding the patient's need for a pressure mattress.

The agency staff failed to follow the accepted professional standards and agency policies when providing services.

The agency failed to complete a discharge summary and send it to the primary care practitioner within 5 business days of the date of the order for discharge.