Best Choice Home Health Inc

The agency failed to ensure a community-based risk assessment (All Hazards Risk Assessment) that identified a date the assessment was developed and implemented and/or was review for all patients and employees.

The agency failed to ensure an Emergency Preparedness Communication Plan included updated required information related to current employee contact information for the agency, for all patients and employees.

The agency failed to ensure completion of a transfer/discharge summary for five (Patients #3, 10, 11, 12 and #13) of 13 patients.

The agency failed to ensure utilization of QAPI quality indicator data from OASIS (patient assessment data) reporting to improve program effectiveness, quality of patient care and overall program improvement for all patients and employees.

The agency failed to ensure the required performance improvement project documentation for the agency included measurable goals (threshold levels) to measure performance in calendar years 2023 and 2024.for all patients and employees.

The agency failed to ensure a medication profile was updated for ordered medications for one (Patient #5) of 13 patients.

The agency failed to ensure individualized patient POC included: 1. SN intervention durations for two (Patients #2 and #3) of 13 patients.

The agency failed to ensure a physician order for SN to perform wound site care and management was a part of the patient’s plan of care for one (Patient #3) of 13 patients.

The agency failed to ensure: 1. SN conducted visits as ordered for six (Patients #1, 3, 7, 10, 11 and #12) of 13 patients.

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 clinical visit note documentation was completed for two (Patients #3 and #8) of 13 patients.

The agency failed to ensure completed transfer/discharge summaries were provided to receiving service providers for five (Patients #3, 10, 11, 12 and #13) of 13 patients.

The agency failed to ensure evidence of a comprehensive patient centered QAPI Program for 73 patients and all employees.

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

The agency failed to ensure an Emergency Preparedness Communication Plan included required staff contact information for the agency potentially affecting all staff and patients.

The agency failed to ensure required documentation included an after action evaluation of the agency’s response to an emergency preparedness disaster occurrence in 02/2022 for 73 patients and all staff members.

The agency failed to ensure emergency preparedness disaster tabletop exercises and/or drills were conducted for calendar year 2020 and 2021 for 73 patients and staff members.

The agency failed to ensure completion of a transfer/discharge summary for two (Patients #6 and #7) of seven patients.

The agency failed to ensure physician notification or document an occurrence of a patient fall with significant injury for one (Patient #7) of seven patients.

The agency failed to ensure evidence of a comprehensive patient centered QAPI Program for 73 patients and all employees.

The agency failed to ensure utilization of QAPI data to improve program effectiveness, quality of patient care and overall program improvement for 73 patients and all employees.

The agency failed to ensure conduction of patient centered QAPI Program activities for 73 patients and all employees.

The agency failed to ensure PIP documentation which showed measurable progress achieved for 73 patients and all employees.

The agency failed to ensure governing body oversite of the conduction of patient centered QAPI Program activities for 73 patients and all employees.

The agency failed to ensure: 1. The Infection Control Program included comprehensive infection control surveillance activities and interventions to reduce future infections and promote learning and preventative measures throughout the agency for 73 patients and; 2. The Infection Control Program was…

The agency failed to ensure governing body oversite for 73 patients and all employees.

The agency failed to ensure governing body oversite of an operating budget, capital expenditure plan and allocation of resources activities for calendar year's 2020, 2021 and 01/01/22 through 04/19/22 got 73 patients and all employees.

The agency failed to ensure a medication profile and subsequent POC was updated and reviewed with an ordered medication for one (Patient #4) of seven patients.

The agency failed to ensure the individualized patient POCs included: 1. Blood sugar reporting parameters and Dexcom blood sugar monitoring device change treatment due dates for one (Patient #2) of seven patients; 2. Feeding tube change due dates were documented for two (Patients #3 and #5) of…

The agency failed to ensure SN: 1. visit was conducted as ordered by the physician for one (Patient #3) of seven patients and; 2. Feeding tube change treatment was completed timely for one (Patient #5) of seven patients.