Apex Home Health

The agency failed to ensure development, implementation and maintenance of processes and contact information for an integrated emergency preparedness response with Federal, State, Tribal, Regional and Local emergency management officials for all patients and employees.

The agency failed to ensure a ROC (updated comprehensive [OASIS]) assessment after an in-patient stay was completed for one (Patient #15) of 17 patients.

The agency failed to ensure an advance beneficiary notice was provided prior to discharge from agency services for one (Patient #16) of 17 patients.

The agency failed to ensure: 1. A SOC assessment was conducted within 48 hours of referral for six (Patients #2, 3, 4, 5, 7 and #9) of 17 patients; and 2. A SOC assessment was conducted on one (Patient #6) of 17 patients.

The agency failed to ensure a medication profile was collected or reviewed for ordered medications for one (Patient #6) of 17 patients.

The agency failed to ensure individualized patient POC's included ankle measurement reporting parameter's (alternate to weight monitoring) for one (Patient #8) of 17 patients.

The agency failed to ensure: 1. Physician ordered SN visit for administration of an injectable medication for one (Patient #6) of 17 patients; and 2. Physician ordered SN visit for one (Patient #15) of 17 patients.

The agency failed to ensure care was coordinated between the agency and physician for five (Patients #1, 3, 4, 8 and #11) of 17 patients.

The agency failed to ensure: SN performed ordered administration of medication for one (Patients #4) of 17 patients; MSW visits were conducted as ordered for one (Patient #7) of 17 patients; PT visits were conducted as ordered for two (Patients #11 and #14) of 17 patients; CHHA visits were…

The agency failed to ensure multi-disciplined skilled professional staff were available to participate and provide input into the agency’s QAPI program for all patients and employees.

The agency failed to ensure certified home health aide supervisory visits were completed every 14 days for two (Patients #7 and #11) of 17 patients.

The hospice failed to ensure development of a community-based risk assessment (All Hazards Risk Assessment) for patients and all employees.

The agency failed to ensure: 1. the physician was notified of finger stick blood sugar levels outside the ordered parameters for one (Patient #2) of 17 patients; 2. weights were obtained as ordered for one (Patient #3) of 17 patients; 3. the physician was notified of weights outside of ordered…

The agency failed to ensure review and evaluation of a patient centered QAPI Program for all patients and employees.

The agency failed to ensure skilled professionals (Registered Nurse and Physical Therapist) accurately documented clinical diagnosis and/or the reason for visits by the clinician for two (Patients #1 and 3) of seventeen patients.

The agency failed to ensure physician orders were obtained for skilled nurse visits for one (Patient #2) of seventeen patients.

The agency failed to ensure physician notification of missed visits for three (Patients #1, 5 and 8) of 17 patients.

The agency failed to document emergency drills at least annually for 179 current patients and all employees.

The agency failed to ensure physical therapy was provided as ordered for one (Pt #12) of 12 patients.

The agency failed to ensure the governing body provided oversight of agency operations and programs for 179 current patients and all employees.

The agency failed to ensure the initial assessment was completed within 48 hours of the referral for three (Pt #1, 6 and 8) of 12 patients reviewed.

The agency failed to ensure the medication profile was updated for one (Pt #1) of twelve patients.

The agency failed to ensure ST visits were performed in accordance with the POC for one (Pt #2) of twelve patients.

The agency failed to ensure physician notification of: 1) missed visits 2) vital signs outside of ordered parameters Findings: Pt #3 A POC dated 10/12/18 - 12/10/18 showed a SN frequency of once a week for seven weeks.