Amedisys Home Health of Missouri

The home health provider failed to ensure the plan of care was individualized to the specific needs of the patient in one of five full records reviewed (Record/Patient #1).

The home health provider failed to ensure staff maintain an accurate and updated medication profile in, but not limited to, two of three home visit observations (Records/Patients #2 and #3).

The home health provider failed to ensure an accurate and visit schedule was placed in the patient's home folder in one of three full records reviewed (Record/Patient #3).

The agency failed to:- Provide each patient an individualized written plan of care (G572); - Include all the elements of an individualized plan of care (G574); - Include all patient care orders, including verbal orders, in the plan of care (G576); - Provide conformance with the physician orders on…

The agency failed to meet the requirements for the Condition of Participation: Skilled Professional Services, when the agency failed to: -Assume responsibility for ongoing interdisciplinary assessment of a patient (G706); -Provide patient and caregiver education (G714); and -Ensure the skilled…

The agency failed to organize, manage, and administer its resources to attain and maintain the highest practicable functional capacity, including providing optimal care when the agency failed to show adequate governing body, administrative, and clinical manager oversight to patients resulting in…

The agency failed to include documentation of pertinent information in the comprehensive assessment regarding the insertion, location, and assessment of a PICC (peripherally inserted central catheter) in one (Record/Patient #5) of six full records reviewed.

The agency failed to review their initial assessments with physician/allowed practitioner for one (Record/Patient #1) and the agency failed to ensure that the patients received the home health services that were written on the individualized plan of care when the patient did not receive visits…

The agency failed to ensure staff followed physician orders in, but not limited to, two (Record/Patient #2 and #3) of six full records reviewed.

The agency failed to ensure accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections were followed in three (Record/Patient #1, #2 and #3) of three home visit observations completed.

The agency failed to ensure that the home health aide completed a competency evaluation program in, one (Employee/Aide A) of one home health aide employee files reviewed.

The agency failed to show the clinical managers provided oversight for assuring that the patient needs were continually assessed and the development, implementation, and updates of the individualized plan of care were completed.

The agency failed to ensure that their qualifying service for Medicare was provided in its entirety by the agency's own employees.

The agency failed to provide the patient and representative (if any) correct contact information for the current home health agency administrator, to receive complaints in one (Record/Patient #3) of the three home visits conducted.

The agency failed to provide a copy of the written notice regarding the patient's financial obligation in one (Record/Patient #1) of six full records reviewed . This deficient practice has the potential to affect all patients served by the agency.

The agency failed to provide proper written notice in advance of the agency reducing or terminating on-going care for two (Record/Patients #4 and #6) of six full records reviewed.

The agency failed to complete the initial assessment of the patient within 48 hours of the referral to home care, or 48 hours after the patient's return home, or on the physician ordered start of care date in one (Patient/Record #1) of six full records reviewed.

The agency failed to ensure a complete/accurate medication review and/or update of the patient's medications was completed in, but not limited to, three (Record #1, #2 and #3) of six full records reviewed.

The agency failed to ensure that each patient's written individualized plan of care (POC) included all the required elements in four (Records/Patients #2, #3, #4, and #6) of six full records reviewed.

The agency failed to ensure all patient care orders, including verbal orders were recorded in the plan of care in one, (Record/Patient #5) of six full record reviews completed.

The agency failed to ensure the physician was promptly alerted to changes in the patient's condition in three (Record/Patients #2, #3, and #6) of seven records reviewed.

The agency failed to provide the patient and representative (if any) current written treatments including wound care instructions in one (Record/Patient #3) of the three home visits conducted.

The agency failed to provide the name and contact information of the clinical manager in, but not limited to, three (Record/Patient #1, #2, and #3) of three home visit observations.

The agency failed to ensure staff provided ongoing assessments for three (Record/Patients #2, #3, and #4) of six full records reviewed.

The agency failed to ensure the skilled professional assumed responsibility for patient and caregiver education in two (Records/Patients #3 and #6) of six full records reviewed.

The agency failed to assure agency clinicians effectively communicated with all physicians/allowed practitioners related to the patient’s current plan of care (POC) for one (Record/Patient #6) of six full record reviews.

The agency may not train or competency evaluate their home health aides for a period of two (2) years following the date of this survey.

Findings included: Based on the current survey findings, (a condition level citation of 484.60- Care Planning, Coordination of Services, and Quality of Care- G570) the clinical manager failed to: -Ensure completion of individualized care plans specify the care and services necessary to meet the…

The agency failed to ensure all staff had the Employee Disqualification List (EDL) checked prior to hire for one (Employee #1) of four employee files reviewed and failed to ensure all staff had the Family Care Safety Registry (FCSR) checked prior to date of first patient contact, in two (Employee…

The agency failed to ensure a completed discharge summary was sent to the patient’s primary care practitioner within five days of the patient’s discharge in two (Record/Patient #6 and #7) of two discharge records reviewed.

The agency failed to ensure accurate information provided to the patients regarding the retrieval of clinical records, specifically that the clinical record must be made available to the patient, free of charge, and upon request at the next home visit or within four business days (whichever comes…

The agency failed to ensure the patient received a written notice of financial liability information in, but not limited to, two (Records/Patients #2 and #3) of five cases.

The agency failed to ensure an accurate review/update of all medications used by the patient in, but not limited to, two (Records/Patients #1 and #3) of five cases.

The agency failed to ensure drugs, services, and/or treatments were administered only as ordered by a physician in, but not limited to, one (Record/Patient #2) of five cases.

The agency failed to review/revise the patient's plan of care that included a change in the patient's condition or required needs in, but not limited to, two (Records/Patients #2 and #3) of five cases.

The agency failed to assure communication with all physicians involved in the plan of care in, but not limited to, one of five (Record/Patient #3) cases.

The agency failed to ensure the patient participated in, was informed about, and consented or refused in advance of and during treatment regarding the schedule/frequency of visits by disciplines providing care in, but not limited to, one (Record/Patient #1) of five cases.

The agency failed to ensure non-direct care employees received the Alzheimer's/dementia specific training as required by this regulation.