Dhulmar Health Care Services, LLC

Based record review and interview, the agency failed to develop and maintain a comprehensive emergency preparedness program that was reviewed and updated annually.

The agency failed to establish and maintain a comprehensive emergency preparedness program that included a documented agency and community based risk assessment utilizing the all-hazards approach.

The agency failed to develop policies and procedures based on the emergency preparedness plan.

The agency failed to establish an alternative means of communication with staff and federal, state, tribal, regional and local emergency preparedness staff.

The agency failed to ensure the physician was notified in accordance with the phsycian plan of care.

The agency failed to provide a plan of care to one (Patient #2) of one patient receiving HHA services reviewed during a home visit.

The agency failed to ensure an initial assessment was completed within 48 hours of referral.

The agency failed to ensure medication reviews were current.

The agency failed to include the frequency and duration of visits to be made in the plan of care.

The agency failed to ensure the parent agency maintained work product, documents and administrative control over the branch.