Community Nursing Services

The home health agency (HHA) failed to provide care planning, coordination of services, and quality of care as required.

The home health agency (HHA) failed to ensure that skilled services were provided as necessary to meet the patients needs.

The home health agency (HHA) did not ensure there was care coordination between HHA staff members and the clinics monitoring patient's blood thinning medications for 5 of 9 sample patients.

The home health agency (HHA) did not ensure skilled professionals assumed responsibility for patient needs for 2 of 9 sampled patients.

The home health agency (HHA) did not ensure all patient care orders, including verbal orders, were recorded in the plan of care (POC).

The home health agency (HHA) did not ensure the integration of services, whether provided directly or under arrangement, to assure the identification of patient needs and factors that could affect patient safety and treatment effectiveness and the coordination of care provided by all disciplines.

The home health agency (HHA) did not ensure pertinent instruction related to patient care and treatments provided by the HHA, specific to patient care needs, was documented in the plan of care (POC).

The agency did not communicate with physician's involved in the plan of care or other healtyh care practitioners (as appropriate) for 3 of 9 sample patients.

For 1 of 9 sample patients, that the clinical record did not contain physician orders.