Des Moines County Health Department

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 for Care for 2 of 7 sampled patients.

The agency failed to obtain physician orders for resumption of care services for 2 of 2 sampled patients (Patients #1 and #5) with resumption of care assessments.

The agency failed to ensure registered nurses supervising home health aides maintained documentation of a review of all required supervisory elements including following the patient plan of care, maintaining open communication with patient/caregiver, demonstrating competency of all assigned tasks…

The agency failed to ensure accurate completion of all pertinent components of the update to the comprehensive assessment within 48 hours of the agency's knowledge of return home from an inpatient facility for 1 of 1 sampled patients requiring an update to the comprehensive assessment at the…

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

The agency failed to update the Plan of Care with healthcare practitioner orders obtained during a 60 day certification period for 5 of 7 sampled patients (Patients #2, #3, #4, #6 and #7).

The agency staff failed to provide medications and treatments only as ordered by the healthcare practitioner for 3 of 7 sampled patients (Patients #2, #3 and #6).

The agency failed to ensure the patients clinical record included accurate and specific documentation of interventions and maintained pertinent current information in the patient record for 1 of 1 sampled patients with wounds (Patient # 2).

The home health agency failed to ensure the clinical record included documentation agency staff reviewed and/or updated the patient's individualized emergency plan with each comprehensive assessment for 4 of 7 sampled patients (Patients #3, #4, #5 and #7).

The agency failed to notify the physician of changes in visit frequency ordered on the Plan of Care for 3 of 7 sampled patients (Patients #3, #4 and #6) . The agency reported a current census of 22 patients.

The agency failed to ensure all documentation in the clinical record included a date, time, staff signature and staff title for 5 of 7 sampled patients (Patients #1, #3, #4, #6 and #7).

The agency failed to accurately complete a drug regimen review, including completion of all required components within the required time frames as part of the comprehensive assessment for 2 of 7 records reviewed (Patients #2 and #5).

The agency failed to ensure completion of the update of the comprehensive assessment at discharge within 2 calendar days of identification of the need to discharge a patient for 1 of 2 sampled patients requiring a discharge comprehensive assessment (Patient #7).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all medications and medical equipment used by the patient for 4 of 8 sampled patients (Patients #1, #2, #3 and #8).

The agency failed to ensure skilled professionals provided care as ordered by the physician in the Plan of Care for 3 of 7 sampled patients (Patients #1, #4 and #6).

Staff failed to report changes and coordinate care with the patient's physician for 2 of 7 sampled patients (Patients #2 and #4).

The agency failed to document all required components of home health aide supervision including following the patient plan of care, maintaining open communication with patient/caregiver, demonstrating competency of all assigned tasks, complying with infection prevention and control policies…

The agency failed to complete and send a discharge summary to the physician or other health care professionals responsible for providing care to the patient after discharge from the agency within 5 business day of the patient's discharge for 1 of 2 sampled patients with a discharge (Patient #6).