Central Missouri Home Health

The home health provider failed to ensure that wound measurements and assessments were completed in one of six records reviewed (Record/Patient #3).

The home health provider failed to ensure that documentation of the patient's pressure ulcer was accurate and appropriately authenticated during assessments in one of six records reviewed (Record/Patient #3).

The home health provider failed to ensure the comprehensive assessment accurately reflected the patient’s status and included the current health, psychosocial, functional, and cognitive status in one of six records reviewed (Records/Patients #1).

The home health provider failed to ensure that all medications the patient was taking were current in one of three home visit observation records reviewed (Records/Patients #3).

The home health provider failed to ensure the plan of care (POC) contained all medications and treatments and patient-specific interventions and education in two of five full records reviewed (Records/Patients #1 and #2).

The home health provider failed to ensure orders from all physicians or allowed practitioners involved were integrated in the plan of care to assure the coordination of all services and interventions provided to the patient in one of six records reviewed (Record/Patient #1).

The home health provider failed to ensure patients received written instructions outlining treatments in one of three home visit observation records reviewed (Records/Patients #1).

The home health provider failed to ensure that a check of the Employee Disqualification List (EDL) was performed and failed to ensure the Family Care Safety Registry (FCSR) was checked prior to date of first patient contact, in one of six employee files reviewed, (Employee #4).

The home health provider failed to ensure patients were accepted for treatment only when there was a reasonable expectation that the provider could meet the patients’ medical, nursing, rehabilitative, and social needs in the home setting.

The home health provider may not train, or competency evaluate their home health aides for a period of two (2) years following the date of this survey.

The agency failed to: - The home health provider failed to ensure staff followed an individualized plan of care that specified the care and services necessary to meet the patient-specific needs (G572); - All patient care orders, including verbal orders, must be recorded in the plan of care (G574)…

The home health provider failed to ensure staff followed an individualized plan of care that specified the care and services necessary to meet the patient-specific needs for two of six full records reviewed (Records/Patients #1 and #2).

The home health provider failed to ensure all entries were clear, complete, and appropriately authenticated in one of five full records reviewed (Record/Patient #3).

The provider failed to provide written notice of the updated state toll free home health telephone hotline hours of operation (7:00 AM to 8:00 PM, seven days a week), in three of three home visit observations (Records/Patients #1, #2 and #3).

The provider failed to conduct the initial assessment of the patient within 48 hours of the referral to home care, or 48 hours after the patient's return home, or on the physician ordered start of care date in, but not limited to, one of six full records reviewed (Record/Patient #1).

The home health provider failed to ensure updates to the comprehensive assessment were completed within 48 hours of the patient’s return home from hospital admission, in two of six full records reviewed (Records/Patients #3 and #4).

The home health provider failed to ensure staff developed a complete, individualized plan of care (POC) in one of six records reviewed (Record/Patient #5).

The home health provider failed to promptly alert the physician or allowed practitioner to changes in the patient’s condition that suggest the plan of care should be altered in two of six full records reviewed (Records/Patients #4 and #5).

The agency failed to ensure coordination of care delivery to meet the patient's needs in two of six records reviewed (Records/Patients #4 and #5).

The home health provider failed to provide in writing the visit schedule in one of three home visit observations (Record/Patient #3).

The home health provider failed to provide in writing a list of the patient’s medications in one of three home visit observations (Record/Patient #3).

The home health provider failed to provide in writing a list of treatments to be administered by the home health provider personnel in one of three home visit observations (Record/Patient #3).

The home health provider failed to provide in writing the name and contact information of the clinical manager in one of three home visit observations (Record/Patient #3).

The agency failed to complete ongoing interdisciplinary assessment of the patient in one of six records reviewed (Record/Patient #5).

Based on the results of this extended level survey, resulting in noncompliance with one Condition of Participation: Care planning, coordination of services and quality of care.

The Home Health Provider failed to ensure one staff member (Employee-B) had completed Alzheimer’s Training upon job orientation after his/her hire date with the provider.