County of Decatur

The agency failed to: 1) determine satisfactory competency with extra skills provided as an extension of nursing prior to assigning an aide to a patient who required the task to be performed (G768); 2) assure all aides are assigned to a patient by a registered nurse working for the agency (G798)…

The home health agency failed to ensure the clinical record included a copy of an individualized emergency plan developed as part of the comprehensive assessment for 7 of 7 sampled patients (Patients #1, #2, #3, #4, #5, #6 and #7).

The agency failed to ensure the development of a procedure to inform State and local officials of homebound patients in need of evacuation due to an emergency situation.

The agency failed to have a policy and procedure to notify State and local officials of any on-duty staff or patients the agency was unable to contact.

The agency failed to have a written policy and procedure for transfer of patients.

The agency failed to ensure a registered nurse or other appropriate skilled professionals in consultation with a registered nurse as appropriate performed direct observation of home health aide performance of all extra home health aide skills on a home health patient and failed to evaluate written…

The agency failed to ensure the registered nurse updated the written patient care instructions for home health aides for 1 of 4 sampled patients receiving home health aide services (Patient #5).

The agency failed to conduct and document the investigation of a complaint made by a patient related to missing items for 1 patient (Patient #8).

The agency failed to ensure the documentation of the resolution of a complaint made by a patient related to missing personal items for 1 patient (Patient #8).

The agency failed to have a written policy and procedure in place to investigate complaints, including intake, investigation timeframe, investigation documentation, outcomes and actions that agency may take to resolve complaints.

The agency failed to ensure accurate completion of all pertinent components of the start of care comprehensive assessment within the required time frame for 2 of 7 sampled patients (Patients #1 and #3) with a start of care date after the last survey (12/30/15).

The agency failed to include an individualized assessment relating to the patient's current health status when completing comprehensive assessments for 3 of 5 sampled patients (Patients #3, #4 and #6).

The agency failed to accurately identify all medications taken by the patient with each comprehensive assessment/drug regimen review and/or failed to maintain an accurate list of medications, including times of administration for 7 of 7 sampled patients (Patients #1, #2, #3, #4, #5, #6 and #7).

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

The agency failed to update the Plan of Care with all new physician orders for 1 of 6 sampled patients admitted after 1/12/18 with interim orders.

The agency failed to administer medications and treatments only as ordered by the physician for 2 of 7 sampled patients (Patients #3 and #6).

The agency failed to ensure home health aides provided services according to the home health aide written assignment for 4 of 4 sampled patients (Patients #1, #2, #3 and #5) receiving aide services.

The agency failed to complete home health aide supervision at least once every 14 days for 1 of 3 sampled patients receiving home health aide services in conjunction with a skilled service (Patient #1).

The agency failed to ensure home health aides furnished care following the registered nurses' (RNs) assigned tasks and documented the tasks completed for 4 of 4 sampled patients receiving home health aide services for longer than 14 days (Patients #1, #2 and #3).

The agency failed to have authorization, in writing, which identified a qualified designee appointed by the governing body to assume the administrator's role if the agency administrator is not available.

The agency failed to ensure the clinical record contained complete, accurate and up to date information for 1 of 3 sampled patients with wounds (Patient #4) and 2 of 4 patients with home health aide services (Patients #3 and #5).