Excelsior Springs City Hospital

The home health provider failed to ensure an individualized plan of care (POC) that included functional limitations, activities permitted, equipment required, and all relevant physicians that were providing home health orders, in four of five full records reviewed (Records/Patients #1, #2, #3, and…

The home health provider failed to ensure that all verbal orders were recorded in the plan of care (POC) in one of five full records reviewed (Record/Patient #4).

The home health provider failed to ensure each patient received accurate, updated/current written instructions related to the patient’s medication schedule, in two of three home visit observations (Records/Patients #2 and #3).

The agency failed to use standard precautions to prevent the transmission of infections and communicable diseases by failing to screen visitors/non-employees for COVID-19 (pandemic infection) who entered the home health agency office.

The agency failed to ensure the patient was advised orally and in writing of the extent to which payment for services may be expected from Medicare, Medicaid, or any other federally-funded aid program, the charges of services that may not be covered in two (Record/Patient #1 and #2) of three home…

The agency failed to ensure staff provided the written notice of the updated state toll free home health telephone hotline hours of operation (7:00 AM to 8:00 PM, seven days a week).

The agency failed to ensure the patient's medications were reconciled during the start of care comprehensive assessment and that the medication profile was updated with medication changes in, but not limited to, two (Records/Patients #2 and #3) of six full records reviewed.

The agency failed to ensure services and treatments were administered only as ordered by a physician in, but not limited to, two (Record/Patient #2 and #3) of five full records reviewed.

The agency failed to promptly alert the physician to changes in the patient's condition that may suggest a need to alter the plan of care (POC) in, but not limited to, one (Record/Patient #2) of five full records reviewed.

The agency failed to provide the patient/caregiver with a copy of written instruction outlining the visit schedule, including frequency of visits in two (Records/Patients #2 and #3) of three home visit observations.

The agency failed to provide the patient/caregiver with an updated/current copy of written instructions outlining the patient’s medication schedule, including medication name, dosage, and frequency in two (Records/Patients #2 and #3) of three home visit observations performed.

The agency failed to ensure a transfer summary was sent to the receiving facility in three (Record/Patient #4, #5, and #6) of six records reviewed.

The agency failed to follow accepted standards of practice for one (Record/Patient #1) of three patients observed during home visits.

The agency failed to ensure that the registered nurse (RN) prepared a complete home health aide (HHA) assignment in two (Records/Patients #1 and #3) of three patients reviewed with HHA services.

The agency failed to ensure an accurate review and update of all current medications in, but not limited to, one (Record/Patient #1) of five cases.

The agency staff failed to complete a comprehensive assessment to include the patient's primary caregiver(s), if any, and other available supports, including their willingness and ability to provide care, and availability and schedules in, but not limited to two (Records/Patients #1 and #3) of five…

The agency failed to complete a plan of care to include the patient's prognosis, all medications and treatments, a description of the patient's risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors, and/or patient…

The agency failed to ensure effective ongoing interdisciplinary assessment of the patient in, but not limited to, two (Records/Patients #1 and #3) of five cases reviewed.

The agency failed to provide services that were ordered by the physician as indicated in the plan of care in, but not limited to, one (Record/Patient #1) of five cases reviewed.

The agency failed to ensure that the home health aide (HHA) provided services that were ordered by the physician, and included in the plan of care for two (Records/Patients #1 and #3) of three patients reviewed with HHA services.

The agency failed to ensure that home health aide (HHA) supervisory visits were complete and included the required elements in, but not limited to, one (Record/Patient #3) of three patients reviewed with HHA services.