Aplus Health Care LLC

The home health agency failed to meet the Condition of Participation for basis and scope, 42 CFR § 484.1 at G0325. The agency failed to ensure primary engagement in providing skilled nursing and other therapeutic services and meet Condition of Participation requirements.

The home health agency failed to meet the Condition of Participation for Comprehensive Assessments of Patients, 42 CFR § 484.55 at G0510. The agency failed to ensure comprehensive assessments were individualized to the patient and/or completed.

The home health agency failed to meet the Condition of Participation for care planning, coordination and quality of care at 42 CFR § 484.60 at G0570. The agency failed to ensure patients' care plans were individualized and included the care and services necessary to meet patients’ needs.

The home health agency failed to meet the Condition of Participation for Quality assessment/performance improvement, 42 CFR § 484.65 at G0640. The agency failed to implement, evaluate and maintain a Quality Assessment Process Improvement (QAPI) program.

The home health agency failed to meet the Condition of Participation for Organization and administration of services, 42 CFR § 484.100 at G0848. The agency failed to ensure their comprehensive home care licensure was active.

The home health agency failed to meet the Condition of Participation for Organization and administration of services, 42 CFR § 484.105 at G0940. The agency had skilled nursing services available and lacked at least one additional therapeutic service available for current and future patients the…

The home health agency failed to meet the Condition of Participation for clinical records, 42 CFR § 484.110 at G1008. The agency failed to ensure accurate and complete medical records were available to ensure safe care was delivered.

The facility failed to ensure 5 of 8 employees (PCA-A, PCA-B, ADON, DON, and administrator) received ongoing emergency preparedness training at least every 2 years.

The agency failed to ensure they conducted emergency preparedness exercises annually which involved different scenarios to test their emergency plan.

The agency failed to report all OASIS data collected in accordance with federal regulations for 2 of 3 patients (P3, P1) reviewed for skilled care.

The agency failed to ensure a discharge summary was completed for 1 of 1 patients (P3) reviewed who received skilled services and was discharged.

The agency failed to ensure 2 of 3 (P1, P3) patients reviewed received care consistent with the providers orders listed in the plan of care (POC).

The agency failed to establish a process to measure, analyze and track quality indicators.

The agency failed to utilize quality data to identify opportunities for improvement.

The agency failed to identify performance improvement activities.

The agency failed to ensure an ongoing quality assurance performance improvement program was implemented and maintained.

The agency failed to ensure infection control education was provided yearly for 5 of 5 staff members (patient care assistant (PCA)-A, PCA-B, PCA-C, Assistant Director of Nursing (ADON) and Director of Nursing (DON), reviewed for education.

The agency failed to ensure they were licensed in accordance with the state licensing authority.

The agency failed to ensure one other skilled service was provided along with skilled nursing services.

The agency failed to ensure complete clinical records were retained for 5 years after patient discharged for 1 of 2 patients (R3) reviewed for skilled services who discharged.

The agency failed to ensure the OASIS privacy notice was provided to 1 of 3 patients (P3) reviewed who recieved skilled services.

The agency failed to ensure a signature was obtained confirming a copy of the notice of patient rights and responsibilities was provided to 1 of 3 patients (P3) reviewed who received skilled services.

The agency failed to ensure the right to lodge a complaint against the agency was provided to 1 of 3 patients (P3) reviewed who received skilled services.

The agency failed to ensure 2 of 3 patients (P1, P3) reviewed who received skilled services were informed of and agreed upon care services provided by the agency.

The agency failed to conduct a comprehensive assessment that accurately reflected the health status for 1 of 3 patients (P3) reviewed who received skilled services.

The agency failed to ensure the patient's goals were accurately reflected in the comprehensive assessment for 1 of 3 patients (P3) who received skilled services.

The agency failed to ensure caregiver information was included in the comprehensive assessment for 1 of 3 patients (P3) who received skilled services.

The agency failed to ensure the patient representative was included in the comprehensive assessment for 1 of 3 patients who received skilled services.

The agency failed to ensure a comprehensive discharge assessment was completed for 1 of 2 patients (P3) who received skilled services and discharged from the facility.

The agency failed to ensure patient's plan of care included all required components in the patient's individualized care plans for 3 of 3 patients (P2, P3, P1) reviewed for skilled services.

The agency failed to ensure all patient care orders, were part of the plan of care (POC) for of 2 of 3 patients (P3, P1) reviewed for skilled nursing services.

The agency failed to ensure the Plan of Care was reviewed and signed by the provider for 1 of 3 patients (P3) reviewed who received skilled services.

The agency failed to implement, measure and track performance improvement activities.

The agency failed to ensure clinical notes were prepared for 2 of 3 patients (P3, P1) reviewed who received skilled services.

The agency failed to ensure medical records included the most recent comprehensive assessments for 1 of 3 patients and clinical notes for 3 of 3 patients (P3, P1, and P2) reviewed who received skilled services.

The facility failed to ensure patient's goals were included in the plan of care (POC) and had documented progress towards achieving them for 1 of 1 patient (P3) who reviewed who received skilled services.

The agency failed to ensure a completed discharge summary was completed for 1 of 2 residents (R3) reviewed for skilled services and was discharged.

The facility failed to offer two (2) or more Medicare qualified services to their patients as required by the Center for Medicare and Medicaid services (CMS).