Community Health Services

The agency failed to follow a Plan of Care established and periodically reviewed by a physician or notify the physician of the need to vary frequency of visits or inability to perform treatments/services as originally ordered on the Plan of Care for 3 of 5 sampled patients with missed visits…

The agency failed to provide a complete comprehensive assessment for patients with wounds during start of care for 1 of 3 sampled patients with wounds (Patient #7).

The agency failed to ensure completion of the update to the comprehensive assessment within 48 hours of the agency's knowledge of patient's return home from an inpatient facility for 1 of 2 sampled patients requiring a resumption of care assessment (Patient #6).

The agency failed to ensure accurate completion of all components comprising the Plan of Care (POC), including all medical supplies/equipment, all medications, and treatments used by the patient for 2 of 3 sampled patients with home visits (Patients #2 and #3).

The agency failed to ensure nurses taking verbal orders from a physician documented the orders in the clinical record (signed, dated and timed) sending the orders to the physician for authentication, including signature and date of signature for 1 of 1 sampled patients with a catheter (Patient #4).

The agency failed to ensure registered nurses provided individualized and specific written patient care instructions to agency home health aides for 2 of 6 sampled patients receiving home health aide services (Patients #1 and #2).

The agency failed to ensure 1 of 2 sampled home health aides (Staff E), performing tasks requiring extra skills exceeding the level of basic home health aide skills for 2 of 3 sampled patients (Patients #2 and #6), had documented evidence of a successful return competency demonstration signed off…

The agency failed to 1) ensure agency staff completed and sent a transfer summary to the receiving facility within 2 business days of the patient's transfer for 1 of 1 sampled patients (Patient #6) with a transfer; and, 2) ensure agency staff completed a discharge summary and sent that summary to…

The agency: 1) Failed to provide an initial assessment visit within 48 hours of receipt of referral.

The agency: 1) Failed to ensure the agency skilled staff completed an individualized Plan of Care that contained accurate information.

The nurse checked the agency folder kept in the home and noted the emergency plan form was blank and the folder lacked a copy of the emergency plan found in the clinical record at the agency.

The agency failed to ensure training in emergency preparedness for all employed staff and all individuals providing services under arrangement (contract staff), consistent with their expected roles on or prior to November 15, 2017. The agency reported utilizing a total of 20 employed staff and 3…

The agency failed to ensure staff provided care in accordance with agency expectations and accepted infection control standards of practice observed during a home visit for 1 of 1 sampled patients (Patient #5) with a home visit observation of contracted staff.

The agency failed to ensure the home health aides successfully completed competencies in all home health aide skills that exceed basic skills, which require a registered nurse, or other appropriate skilled professional in consultation with a registered nurse, to evaluate the competency of the aide…

The agency failed to provide an initial assessment visit within 48 hours of receipt of referral, within 48 hours of the of the agency's knowledge of the patient's return home from an inpatient facility or on the physician ordered start of care date for 2 of 6 sampled patients (Patients #5 and #7).

The agency failed to ensure accurate and thorough completion of all pertinent components of comprehensive assessments for 3 of 8 patients with a comprehensive assessment (Patient #3, #4 and #7).

The agency failed to complete a thorough drug regimen review (DRR) with each comprehensive assessment within the allowed time frames for 8 of 8 sampled patients (Patients #1, #2, #3, #4, #5, #6, #7 and #8).

The agency failed to ensure the completion of all pertinent components of the update to the comprehensive assessment at recertification in the last 5 days of each certification period for 1 of 6 sampled patients requiring a recertification (Patient #8).

The agency failed to ensure accurate completion of all pertinent components of the resumption of care comprehensive assessments within 48 hours of the agency's knowledge of return home from an inpatient facility for 2 of 3 sampled patients requiring a resumption of care assessment (Patients #1 and…

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies and equipment used by the patient to meet his/her needs, an accurate list of the patient's current medications, and information related to any advanced directives for 5 of 8…

The agency failed to update the Plan of Care with all new physician orders for 2 of 8 sampled patients.

The agency failed to administer treatments and services only as ordered by the physician for 5 of 8 sampled patients (Patients #1, #3, #4, #5, and #7).

The agency failed to assure nurses taking verbal orders from a physician documented the orders in the clinical record (signed, dated and timed) sending the orders to the physician for authentication, including signature and date of signature for 2 of 8 sampled patients (Patients #2 and #7).

The agency failed to report changes in patient clinical findings to the physician for 1 of 3 sampled patients (Patient #7) with wounds.

The agency failed to ensure that registered nurses communicated and coordinated care and services with a patient's physician providing care for 3 of 8 sampled patients (Patients #2, #3 and #7).

Surveyor: McNelly, Lisa Based on clinical record review and patient/caregiver interview, the agency failed to ensure home health aides provided care to agency patients only as ordered by the physician in the Plan of Care and/or as directed by the skilled professional assigning the home health aide…

The agency failed to ensure the clinical record included the patient's current physician orders for 5 of 8 sampled patients (Patients #1, #2, #3, #6 and #7).

The agency failed to administer treatments and services only as ordered by the physician for 2 of 4 sampled patients with alteration of skin integrity (Patients #1 and #7).

The agency failed to complete and send a transfer summary to the physician or other health care professionals responsible for providing care to the patient while in a health care facility within 2 business days of knowledge of the occurrence of the transfer for 2 of 3 sampled patients (Patients #1…