Cerro Gordo County Department of Public Health

The agency failed to ensure training in emergency preparedness for 1 of 1 sampled individual providing services under arrangement (contract staff), consistent with their expected role for the calendar years of 2022 and 2023 (Staff C).

The agency failed to provide individualized and specific written patient care instructions from a registered nurse to agency home health aides for 4 of 4 sampled patients receiving home health aide services (Patients #2, #3, #5 and #6).

The agency failed to complete wound assessments for 1 of 3 sampled patients with wounds (Patient #5).

The home health agency failed to ensure the drug regimen review identified at a minimum the effectiveness of drug therapy, drug side effects, actual or potential drug interactions, duplicate drug therapy, and/or patient compliance with medications for 5 of 7 sampled patients (Patients #1, #3, #4…

The agency failed to provide agency patients with a written medication list, including medication name, dosage and frequency for 1 of 3 sampled patients with home visits (Patient #3).

The agency failed to ensure 1 of 1 sampled home health aide (Staff E), assigned to perform tasks requiring extra skills exceeding the level of basic home health skills for 1 of 4 sampled patients (Patient #3) with home health aide services, had documented evidence of competency by a registered…

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician, permitted under state law and/or as directed by the skilled professional assigning the home health aide to the patient for 4 of 4 sampled patients receiving home health aide services…

The agency failed to ensure the patients clinical record included Physical Therapy and Occupational Therapy documentation for 2 of 2 sampled patients with therapy services (Patients #3 and #6).

The agency failed to ensure staff provided care in accordance with accepted infection control standards of practice observed during a home visit for 1 of 3 sampled patients (Patient #4) with home visits.

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment used by the patient to meet individualized needs for 6 of 7 sampled patients (Patients #1, #2, #3, #4, #5 and #6).

The agency failed to report changes in patient clinical findings or changes in patient needs to the physician for 2 of 2 sampled patients experiencing a change in condition requiring physician notification (Patients #5 and #7).

The agency failed to ensure skilled professionals provided care as ordered by the physician in the Plan of Care for 4 of 7 sampled patients (Patients #2, #3, #4 and #6).

The agency failed to ensure the patient's clinical record included accurate and specific documentation of interventions and maintained pertinent current information in the patient record for 1 of 3 sampled patients with wounds (Patient #7).

The agency: 1) failed to follow the physician ordered Plans of Care and notifying the physician of the need to vary from the Plan (G572); a 2) failed to ensure the agency skilled staff completed an individualized Plan of Care that contained accurate information (G574); and 3) failed to ensure the…

Failure to complete the required backgrounds checks according to the State of Iowa requirements placed agency patients at risk for potential harm.

The Recertification Comprehensive Assessment, dated 1/21/19, lacked documentation of an emergency preparedness assessment and/or review of the emergency preparedness plan.

The agency failed to include an individualized assessment relating to the patient's current health status when completing comprehensive assessments for 1 of 8 sampled patients (Patients #5).

The agency failed to follow a Plan of Care established and periodically reviewed by a doctor of medicine, osteopathy or podiatry or notify the physician of the need to vary from the physician ordered Plan for 4 of 8 sampled patients (Patients #2, #3, #5 and #7).

The agency failed to ensure authentication of electronic signatures stored in the electronic medical record in each patient's clinical record included the employee discipline title with the employee signature for 8 of 8 sampled patients (Patients #1, #2, #3, #4, #5, #6, #7 and #8).

The agency failed to complete a drug regimen review, including all required components, with each comprehensive assessment within the allowed time frames for 3 of 8 sampled patients (Patients #3, #5 and #6 ).

The agency failed to ensure accurate completion of all pertinent components of the resumption of care comprehensive assessment within 48 hours of the agency's knowledge of return home from an inpatient facility for 1 of 3 sampled patients requiring a Resumption of Care Assessment (Patient #5).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care and/or failed to ensure the Plan of Care contained current information for 8 of 8 sampled patients (Patients #1, #2, #3, #4, #5, #6, #7 and #8).

The agency failed to update the Plan of Care with all new orders for 8 of 8 sampled patients (Patients #1, #2, #3, #4, #5, #6, #7 and #8).

The agency failed to administer medications and treatments only as ordered by the physician for 1 of 2 sampled patients with home visit observations (Patient #2).

The agency failed to report changes in patient clinical findings to the physician as directed on the Plan of Care or on the agency parameters for reporting for 3 of 8 sampled patients (Patients #1, #2 and #3).

The agency clinicians failed to including measurements of wounds, including length, width and depth, weekly as required for 1 of 2 sampled patients with wounds (Patient #5).

The agency failed to ensure the rehabilitative therapy services are provided only by a skilled therapist to perform the discharge planning for 1 of 2 sampled patients (Patients #6) with therapy services.

The agency failed to ensure home health aides provided services according to the home health aide written assignment for 2 of 7 sampled patients (Patients #6 and #9) receiving aide services.

The agency failed to ensure a registered nurse or other appropriate health care professional completed home health aide supervision at least every 14 days for 3 of 5 sampled patients who received hands on personal care services in conjunction with skilled service provision (Patients #4, #6 and #7).

The agency failed to ensure a registered nurse completed home health aide supervision at least every 60 days while observing each home health aide present and providing direct patient care for 2 of 2 sampled patients who received hands on personal care services with no skilled service provision.

The agency failed to complete home health aide supervision with all required components for 7 of 7 sampled patients who received home health aide services (Patients #3, #4, #5, #6, #7, #8 and #9).