Capuano Home Health Care Inc

The agency failed to ensure Outcome and Assessment Information Set (OASIS) assessments were transmitted to Centers for Medicare and Medicaid Services (CMS) within 30 days of completing the assessment of the beneficiary, as required.

The Agency failed to ensure home health services that are written in an individualized plan of care (POC) that identifies patient-specific measurable outcomes and goals, were provided for 3 Patients (#1, #7 and #8), out of a total sample of 8 patients.

The Agency failed to ensure that 1 of 3 clinicians (Registered Nurse #1) observed during home visits, adhered to infection control practices to limit the risk of spread of infection.

The Agency failed to ensure the Registered Nurse conducted an initial assessment within 48 hours of the referral date for 2 patients (#8 and #2), from a total sample of 8 patients.

The agency failed to ensure that 1.) the clinician prepared clinical notes for 1 Patient (#4), and 2.) failed to ensure clinical notes were completed timely for 3 Patients (#6, #7 and #8), out of a total sample of 8 patients.

The Agency failed to ensure the staff communicated to the physician when there was a change in the plan of care (POC) for 2 patients (#8 and #7), out of a total sample of 8 patients.

The Home Health Agency failed to ensure that a Registered Nurse (RN) completed a supervisory assessment of the Home Health Aide (HHA) services, at least every 14 days for 1 patient (#2), in a total sample of 8 patients.

The agency failed to ensure their Emergency Preparedness Plan had been reviewed and updated at least every two years.

The agency failed to ensure an individual Emergency Preparedness (EP) plan was included as part of the comprehensive patient assessment for five Patients ( #1, #3, #4, #6 and #7), out of a total sample of seven patients.

The agency failed to ensure the Emergency Preparedness (EP) plan included policies and procedures for the use of volunteers in an emergency or other emergency staffing strategies, including the process and role for integration of State and Federally designated health care professionals to address…

The agency did not ensure a method for sharing information and medical documentation for patients under the agency's care, as necessary, with other healthcare providers to maintain the continuity of care during an emergency.

The agency failed to revise the plan of care to accurately reflect the current physician orders for three Patients (#1, 5 and 7) out of a total sample of seven patients reviewed.

The agency failed to develop the plan of care in partnership with the patient, representative and/or caregiver for all seven sampled Patients (#1, #2, #3, #4, #5, #6 and #7).

The agency failed to have a skilled professional make supervisory visits for two Patients (#1 and #3) who received Home Health Aide (HHA) services.