Alternative Choice Home Care Nursing LLC

The agency failed to ensure clinical records contained current and accurate documentation of patient's clinical notes, plans of care, and orders for 4 of 5 patient records reviewed who received private duty nursing (PDN) (Patients #1, #2, #4, and #5).

A complaint investigation #CO initiated on 11/1/21 revealed the agency failed to ensure plans of care were complete and accurate; failed to ensure pediatric patients receiving private duty nursing (PDN) received care as ordered by the physician-approved plan of care and failed to coordinate with…

The agency failed to implement a quality assessment and performance improvement (QAPI) which evaluated all agency services and complied with the requirements and standards set forth in CFR 484.65. The failure created the potential for the agency to overlook trends which affected the quality of…

A complaint investigation #CO28023 was initiated on 11/1/21 and revealed the agency failed to ensure registered nurses (RNs) routinely assessed a patient who received peritoneal dialysis (PD) and complained of abdominal pain.

Specifically, the agency failed to provide physician ordered certified nurse aide (CNA) services by qualified staff.

The Administrator of the agency failed to organize, manage, and administer the agency's resources in order to attain and maintain the highest practicable functional capacity of the agency, including providing optimal care to achieve the goals and outcomes identified in the patient's plan of care…

The agency failed to ensure each patient's clinical record was accurate and adhered to current clinical record documentation standards of practice for 17 of 18 patients who received private duty nursing (PDN) services (Patient #1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #12, #13, #14, #15, #16, #17…

The agency failed to ensure each patient received home health services in accordance with the written plan of care established and periodically reviewed by a physician for 18 of 18 pediatric patients reviewed who received private duty nursing (PDN) services (Patients #1 through #18).

The agency failed to ensure each patient's Plan of Care (POC) covered the patient's status, all pertinent treatments and medications and the frequency and duration of visits for 18 of 18 pediatric patients reviewed receiving private duty nursing (PDN) (Patients #1 through #18).

The agency failed to ensure ongoing interdisciplinary assessment occurred by the Registered Nurse (RN) to re-evaluate the nursing needs for 1 of 1 pediatric patients receiving peritoneal dialysis (PD) (Patient #8).

The agency failed to ensure staff provided complete and accurate clinical notes for 18 of 18 PDN patient records reviewed (Pediatric Patients #1 through #18).

The agency failed to ensure nursing professional services communicated with the physician of changes in condition for 1 of 18 pediatric patients (Patient #8) and the agency failed to ensure nursing professional services communicated with the physician to obtain orders for changes to the Plan of…

The agency failed to ensure a certified nurse aide (CNA) who was qualified through formal training, testing and certification through the Colorado State Department of Regulatory Agencies (DORA) to function as a CNA provided care and services to patients (Employees #10, #21 and #22).

The agency failed to ensure certified nursing aides (CNAs) provided services as ordered by the physician, included in the plan of care and were consistent with home health aide training for 1 of 4 home health care patients (Patient #19) and 1 of 18 private duty nursing patients (Patient #18).

The agency failed to ensure certified nurse aides (CNA) supervision occurred at least every 14 days for 18 of 18 patients receiving CNA services (Patients #1 through #19).

The agency failed to develop and maintain an emergency preparedness plan which specified a communication plan that complied with Federal, State, and local laws.

The agency failed to encode and electronically transmit each completed Outcome and Assessment Information Set (OASIS) to the Centers for Medicare & Medicaid Services (CMS) system, regarding each beneficiary with respect to which information was required to be transmitted (as determined by the…

The agency failed to ensure home health aides (HHAs)/certified nurse aide (CNAs) completed the required observed competency evaluation program before furnishing home health services for 2 of 2 CNAs hired in 2018 (CNAs #4 and #6).

The agency failed to document the resolution of an existing complaint.

The agency failed to ensure a registered nurse (RN) conducted an initial assessment visit to determine the immediate care and support needs of the patients were held on the physician ordered start of care date for 2 of 7 patient records reviewed (Patients #2 and #7).

The agency failed to ensure each patient's Plan of Care included all pertinent diagnoses and types of services to be conducted for 2 of 7 patients whose records were reviewed (Patients #2 and #3).

The agency failed to ensure each patient's total Plan of Care was reviewed by the physician at least every 60 days.

The agency failed to ensure skilled professionals assumed responsibility for preparing and maintaining accurate and complete clinical notes for 3 of 7 patients whose records were reviewed (Patients #2, #5 and #7).

The agency failed to ensure certified nurse aide (CNA) supervision occurred at least every two weeks for 2 of 2 patients receiving skilled nursing care and CNA services (Patients #3 and #5).

The agency failed to ensure certified nurse aide (CNA) supervision occurred with the aide present at least every 60 days for patients receiving only CNA services.