Care Advantage Skilled-Richmond, LLC

The agency failed to ensure care was provided according to the patient's plan of care in one (1) of ten (10) medical records reviewed in the survey sample.

The agency failed to ensure a comprehensive assessment was completed no later than five (5) calendar days after the start of care in one (1) of ten (10) medical records reviewed in the survey sample.

The agency failed to include a process for cooperation and collaboration with Federal emergency preparedness officials' efforts to maintain an integrated response during a disaster or emergency situation, including documentation of the agency's efforts to contact such officials and, when…

The agency failed to ensure the agency developed individualized emergency preparedness plan as part of the comprehensive assessment for four (4) of fifteen (15) clinical records of patients admitted on or after 11/15/2017. (Clinical records # 11, 13, 14 and 17) Findings: Seventeen (17) clinical…

The agency's emergency's preparedness policy and procedures failed to include procedures to inform State and local emergency preparedness officials about home health patients in need of evacuation from their residences.

The agency failed to document the specific policies and/or procedures to implement regarding a system of medical documentation that preserves patient information, protects confidentiality of patient information, and secures and maintains the availability of records in order to support continuity of…

The agency's emergency's preparedness policy and procedures failed to include a policy and procedure for the use of volunteers in an emergency or for emergency staffing strategies, including the process and role for integration of State and Federally designated health care professionals to address…

The agency failed to include the names and contact information for the following in the Communication Plan section of their Emergency Preparedness Plan: Entities providing services under arrangement and Volunteers.

Based policy and procedure and staff interview it was determined the agency failed to document contact information for Federal emergency preparedness officials and other sources of assistance.

The agency failed to develop and maintain a method for sharing information and medical documentation for patients under the [facility's] care, as necessary, with other health providers to maintain the continuity of care and a means of providing information about the general condition and location…

The agency failed to include a means of providing information about the agency's occupancy, needs, and its ability to provide assistance, to the authority having jurisdiction, the Incident Command Center, and/or designee.

The agency failed to ensure the patient's individualized plan of care included a description of the patient's risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors and measurable outcomes and/or goals identified by the…

The agency failed to ensure drugs, services and treatments were administered only as ordered by a physician for two (2) of seventeen (17) clinical records reviewed in the survey sample.

Agency staff failed to ensure patients were advised of the name and contact information of the Home Health Agency's clinical manager for thirteen (13) of seventeen (17) patients admitted on or after 01/13/2018. (Clinical Records # 1, 2, 3, 4, 5, 10, 11, 12, 13, 14, 15, 16 and 17) Findings…

The agency failed to ensure home health aides provided services that were ordered by the physician in the plan of care for one (1) of three (3) clinical records of patients receiving home aide services in the survey sample.

The agency failed to ensure the Registered Nurse addressed all required elements for each home health aide supervisory visit conducted on or after 01/13/2018 for two (2) of two (2) clinical records reviewed in the survey sample with home health aide supervisory visits conducted on or after…

The agency failed to ensure that all medical records contained documentation of adjudication by the courts indicating the patient lacked legal capacity to make his/her own healthcare decisions and the names of the person(s) identified by the courts to exercise the patient's rights in three (3) of…

The agency failed to ensure care was provided according to the plan of care for three (3) of ten (10) medical records reviewed in the survey sample.

The agency failed to ensure each patient was informed in advance of the care to be furnished to include the frequency of visits and/or any changes in the care to be furnished in two (2) of ten (10) medical records reviewed in the survey sample.

The agency failed to ensure coordination of care delivery to involve the patient, representative, and caregiver.

The agency's staff failed to ensure home health services were provided according to the patient's individualized plan of care for one (1) of five (5) clinical records reviewed in the survey sample (Clinical record: #2 ) Findings: Five clinical records were reviewed in the agency on 3/19/2018 and…

The agency failed to implement the agency's policy, "Patient Confidentiality" to ensure the appropriate safeguards to protect the privacy of protected health information (PHI).

The governing body failed to appoint an administrator to the home health services.

The governing body and administrator failed to appoint an alternate administrator to the home health services.