Better Living Home Health Care, Inc

The agency failed to ensure a discharge summary containing all essential medical information concerning the patient's current disposition, diagnosed conditions for which care was being provided, treatment choices, and after discharge goals for care was provided to their primary care provider or…

The agency failed to complete an initial assessment within 48 hours of a referral and failed to document the reason for the delayed start of care for 6 of 10 record reviews.

The agency failed to ensure patient orders were recorded in the plan of care that accurately reflected the type of treatment provided at each nursing visit for 1 of 4 home visit observations.

The nurse failed to ensure integration of all specialized doctors, therapists, specialty clinics, and/or agencies involved in care or treatment outside of the ordering physician and home health were communicated clearly through care coordination and the documentation included what actions were…

The agency failed to ensure that ongoing education and training was provided and documented based on the skilled needs assessed and goals identified in the comprehensive assessment for 4 of 7 skilled patient records reviewed.

The agency failed to ensure medication was reviewed and reconciled, or reflected the orders given by the physician or the way the patient was taking the medication with documentation of communication with the physician for 2 of 4 patient home visit observations.

The agency failed to ensure the skilled nurse performed a wound assessment and measurements for patients with open wounds and failed to visually assess patients for skin integrity issues on home visits.

The agency failed to ensure HHAs were competent to provide patient care prior to first patient contact, failed to ensure education and training for advanced directives and safety precautions were provided to family caregivers in accordance with plans of care, and failed to ensure the HHA visit…

The agency failed to ensure home health aides were aware of patient code status or what an advance directive entailed.

The agency failed to investigate an unanticipated patient death, failed to monitor the accuracy of HHA competency evaluation forms to ensure HHAs were competent to provide patient care prior to first patient contact, failed to ensure HHAs were provided education and training for advanced directives…

The agency failed to ensure the comprehensive assessment accurately reflected the patient's status at the time of the home visit for 1 of 1 home visit observations with a known wound.

The agency failed update the comprehensive assessment to accurately reflect the patient status of a wound for 1 of 1 patient wound observations.

The agency failed to ensure HHAs were competent to provide patient care prior to first patient contact, failed to ensure education and training for advanced directives and safety precautions were provided to family caregivers in accordance with plans of care for 6 of 6 active HHAs (HHA 1, 6, 8, 21…

The agency’s Administration and Governing Body failed to ensure data was collected, measured, analyzed, and tracked regarding wounds and adverse / sentinel (unexpected death) events within the Quality Assurance Performance Improvement (QAPI) program for 1 of 1 QAPI program review.

The agency failed to ensure the competency program for 6 of 6 actively employed home health aides (HHA) and 1 of 1 former HHA included the required HHA subject areas and effective evaluation of HHA skills.

The agency failed to provide effective management of the provision of home health services to ensure an investigation was initiated after a patient was found without pulse and respirations, failed to ensure the accuracy of HHA competency evaluation forms were monitored to ensure HHAs were competent…

The agency failed to provide services as ordered in the plan of care for 1 of 3 closed records reviewed.

The agency failed to initiate an investigation of an unanticipated death of a patient for 1 of 1 patient death reviewed.

The agency failed to ensure all medications, diagnosis, and all pertinent information were included on the plan of care for 3 of 11 record reviews (Patient #3, #4, #10); and failed to ensure 6 of 6 actively employed home health aides (HHA) and 1 of 1 former HHA were competent to carry out assigned…

The agency failed to effectively integrate and coordinate the care provided by an outside agency to assure patients’ needs were met for 2 of 2 skilled nursing home visits.

The agency failed to ensure home health aides were aware of patient code status or what an advance directive entailed.

The Administrator failed to be responsible for all day to day operations for 1 of 1 home health agency.

The agency failed to ensure 6 of 6 actively employed home health aides (HHA) were qualified to provide safety precautions for patients in accordance with the plan of care.

The agency failed to ensure all services outlined in the plan of care were provided for 1 of 3 active record reviews.

The agency failed to ensure complaints were recorded in the complaint log for 1 of 1 home health agency.

The agency failed to ensure the initial assessment was completed within 48 hours of referral for 1 of 2 closed record reviews.

The agency failed to ensure all medications and treatments were specified and included on the plan of care and medication profile for 1 of 2 closed record reviews.

The agency failed to ensure the plan of care specified orientation, a psychosocial assessment, and cognitive status on the plan of care 4 of 5 record reviews, with the potential to affect all active records (Patients #1, #3, #4, #5) and failed to ensure all Durable Medical Equipment (DME) were…

The agency failed to ensure staff followed physician orders for 1 of 2 closed record reviews.

The Registered Nurse failed to ensure agency policy was followed regarding documentation for 1 of 2 closed record reviews.

The agency failed to ensure staff prepared and maintained clinical notes for 1 of 2 closed record reviews.

The agency failed to include the use of volunteers within the emergency preparedness communication plan for the agency.

The agency failed to ensure standard infection control precautions were followed for 1 of 3 home visit observations.

The agency failed to provide in writing an understandable and accessible discharge/transfer policy to patients for 3 of 3 home visits (Patients 1, 4, and 5) which had the potential to affect all patients served by the home health agency.

The agency failed to perform tracheostomy care as indicated on the plan of care for 1 of 2 skilled nurse observations.

The agency failed to ensure care coordination notes between clinicians administering services were documented in the patient's clinical record for 1 of 4 active records reviewed (Patient 5) and 2 of 3 closed records reviewed (Patient 2 and 3).

The requirement at 42 CFR, Subpart 484.22 is NOT MET as evidenced by: Based on record review and interview, the agency failed to ensure the emergency plan included facility -based and community-based risk assessment, utilizing an all-hazards approach patients/ client population at risk (See Tag…

The agency failed to ensure that an agency wide QAPI [quality assessment and performance improvement] program reflected the complexity of its organization (See Tag 642); failed to ensure measures derived from OASIS and other relevant data was included in the design of its program (See Tag 644); and…

The agency failed to ensure they coordinated an agency wide QAPI (Quality Assessment and Performance Improvement) program for the surveillance, identification, prevention, control, and investigation of infectious and communicable diseases (See Tag G684) and failed to ensure they followed their…

The Governing Boday failed to oversee the agency's QAPI [quality assessment and performance improvement] program that reflected the complexity of its organization and services and failed to ensure that the agency documented measurable improvement in a chosen performance improvement project (See…

The agency failed to ensure the emergency plan included facility -based and community-based risk assessment, utilizing an all-hazards approach patients/ client population at risk for 1 of 1 agency.

The agency failed to ensure the emergency plan adequately identified patients/ client population at risk during an emergency event, the type of services the agency had the ability to provide during an emergency, how the ageny planned to continue to operate during an emergency, and the delegation of…

The agency failed to ensure they developed a process for the cooperation and collaboratin with local, tribal, regional, State, and Federal emergency preparedness officials for 1 of 1 agency.

The agency failed to ensure they developed and implemented emergency preparedness policies and procedures based on facility-based and community-based risk assessment, utilizing an all-hazards approach, communication plan that complies with Federal, State, and local laws for 1 of 1 agency.

The agency failed to ensure they developed a plan on how to ensure the emergency plan will be individualized and be part of the patients comprehensive assessment for 1 of 1 agency.

The agency failed to develop a process to inform State and local emergency preparedness officials about home health patients in need of evacuation from their residences at any time due to an emergency evacuation based on the patient's medical and psychiatric condition and home environment for 1 of…

The agency failed to ensure they developed a procedure to include in its emergency preparedness plan on how to follow up with staff and patients to determine services that are needed in the event that there is an interruption in services during or due to an emergency, and failed to include policies…

The agency failed to evidence documentation of volunteers and collaboration efforts with State and Federal designated health care professionals for 1 of 1 agency.

The agency failed to ensure they developed and maintained an emergency preparedness communication plan to include a method for sharing medical information for the patients under the agency's care with other health providers, a means in the event of an evacuation to release patient information, a…

The agency failed to develop and maintain an emergency preparedness training and testing program (core element) based on the emergency plan set forth for 1 of 1 agency.

The agency failed to ensure they provided an initial training in emergency preparedness policies and procedures to all new and existing staff, individuals providing services under arrangement, and volunteers, consistent with their expected role for 1 of 1 agency.

The agency failed to ensure they conducted a table top exercise to test their emergency plan for 1 of 1 agency.

The agency failed to ensure information provided to patients used plain language and was legible in 3 out of 3 (patients #1, 2, 3) home visits conducted.

The agency failed to ensure care and services were provided per the plan of care in 1 out of 7 (patient #3) records reviewed.

The agency failed to ensure legible and accurate written information was provided to the patient in 1 out of 7 (patient #3) records reviewed.

The agency failed to ensure that an agency wide QAPI [quality assessment and performance improvement] program reflected the complexity of its organization and services for 1 of 1 agency.

The agency failed to ensure measures derived from OASIS and other relevant data was included in the design of its program for 1 of 1 agency.

The agency failed to ensure measurable improvement in a chosen performance improvement project was documented for 1 of 1 agency.

The agency failed to ensure they coordinated an agency wide QAPI (Quality Assessment and Performance Improvement) program for the surveillance, identification, prevention, control, and investigation of infectious and communicable diseases in 1 of 1 agency.

The agency failed to ensure they followed their policy that staff was educated and fit tested with respirator masks in the event of exposure to tuberculosis for 1 of 1 agency.

The agency failed to ensure they notifed the Indiana State Department of Health (ISDH) of a change/ vacancy in management and intentions of adding another service for 1 of 1 agency.

The Governing Boday failed to oversee the agency's QAPI [quality assessment and performance improvement] program that reflected the complexity of its organization and services and failed to ensure that the agency documented measurable improvement in a chosen performance improvement project for 1 of…

The agency failed to ensure accurate public information was provided for 1 of 1 agency.

The agency failed to ensure all pertinent information was included in the plan of care in 1 out of 7 (patient #3) records reviewed.

The agency failed to ensure the physician was notified of a patient's allergy to a medication that was prescribed for 1 of 1 record reviewed of a patient with intravenous antibiotics in a sample of 7. (#3) Findings include: A policy titled Client Plan of Care Policy 3011 dated March 2009, states "…

The agency failed to ensure the plan of care was updated/ revised to contain all pertinent information in 1 out of 7 (patient #3) records reviewed.

The Registered Nurse failed to ensure the initial and revised/ updated plans of care contained all pertinent information in 1 out of 7 (patient #3) records reviewed.

The home health aide failed to ensure care and services were provided per the plan of care in 1 out of 7 (patient #3) records reviewed.

The administrator failed to provide overall direction and leadership of agency services, failed to ensure the agency met all rules and regulations for recertification, and failed to ensure the agency developed and maintained an emergency preparedness program for 1 of 1 agency.

The Director of Nursing failed to ensure the Registered Nurse provided all pertinent information in the initial and revised/ updated plans of care and failed to ensure the home health aide provided care and services per the plan of care for 1 out of 7 (patient #3) records reviewed.