Essential Medical Services Inc

The agency failed to develop an emergency preparedness plan.

The agency failed to develop and implement policies and procedures based on the emergency plan and risk assessment.

The agency failed to ensure the comprehensive assessment was updated and revised at the time of patient discharge for 1 of 1 patient records reviewed that had been discharged (Patient #7).

The agency failed to provide services in accordance with clinical practice guidelines and accepted professional standards of practice.

The agency failed to maintain clinical documentation of patient assessment findings for 1 of 7 active patients.

The agency failed to maintain clinical documentation of all interventions, including medication administration, treatments, services, and patient responses to those interventions for 1 of 7 active patients.

The agency failed to ensure a discharge summary was sent to the primary care practitioner within five business days of discharge for 1 of 1 patients records reviewed requiring a transfer or discharge summary (Patients #7).

The agency failed to ensure the skilled nurse (SN) followed accepted standard infection control practices to prevent the transmission of infections and communicable diseases for 1 of 1 patients observed receiving wound care during a home visit (Patient #1).

The agency failed to ensure nursing staff promptly alerted the physician of changes in the patient's condition or needs that suggested outcomes were not being achieved or the plan of care (POC) needed to be altered for 1 of 3 patients observed during a home visit (Patient #1).

The agency failed to ensure the patient received care in conformance with physician's orders and as indicated in the plan of care for 1 of 5 active patient records reviewed (Patients #1).

The agency failed to ensure home health aides (HHAs)/certified nursing aides (CNAs) provided services permitted to be performed under state law for 1 of 1 active patients reviewed who received delegated wound care by HHA (Patient #2).

The agency failed to ensure home health aides (HHAs)/certified nurse aide (CNAs) assignments were adequately supervised, included in the Plan of Care, permitted to be performed under state law, and performed by CNAs who were deemed competent by a registered nurse (RN) prior to service delivery.

The agency failed to include individual plans for each patient as part of the comprehensive patient assessment for 6 of 6 patient records reviewed (Patients #1, #2, #3, #4, #5 and #6).

The agency failed to provide emergency preparedness training at least annually.

The agency failed to annually conduct, document and analyze two emergency exercises to test the agency's emergency plan.

The agency failed to ensure home health aides (HHAs)/certified nurse aide (CNAs) completed the required observed competency evaluation program before furnishing home health services for 1 of 1 CNAs hired in 2018 (CNA #9).

The agency failed to ensure the registered nurse (RN) or other appropriate skilled professionals prepared patient-specific written care instructions for the home health aide (HHA)/certified nurse aide (CNA) for 4 of 5 patient records reviewed where the patient was receiving CNA services (Patients…

The administrator/director of nursing (DON) failed to provide oversight of certified nurse aide (CNA) services and personnel.

The agency failed to ensure each patient's Plan of Care included all medications and treatments for 1 of 6 patient records reviewed (Patient #2), the frequency of visits to be made for 1 of 6 patient records reviewed (Patient #4), and all equipment required for 1 of 6 patient records reviewed…

The agency failed to ensure home health aides (HHAs)/certified nursing aides (CNAs) provided services included in the Plan of Care, permitted to be performed under state law, and consistent with CNA competency training for 3 of 5 patients reviewed receiving CNA services (Patients #1, #5 and #6).

The agency failed to supervise the CNAs competency with assigned tasks and adherence to the care plan to ensure care was furnished in a safe and effective manner for 3 of 5 patients who received CNA services (Patients #1, #5 and #6).