Guthrie County Phns

The hospice failed to ensure 1 of 2 sampled home health aides (Staff D) satisfactorily demonstrated competency on the written skills examination prior to the home health aide providing services to patients.

The agency failed to ensure agency staff properly authenticated all clinical entry notes and/or completed within the agency's expected timeframe for 6 of 7 sampled patients( Patient #1, #2, #3, #5 #6, and #7).

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician, permitted under state law and/or as directed by the skilled professional assigning the home health aide to the patient for 2 of 5 sampled patients receiving home health aide services…

The agency failed to send a discharge summary to the physician and other health care professionals who would be providing care to the patient after discharge within 5 business days for 2 of 2 sampled patients discharged from the agency.

The agency failed to ensure agency staff completed a transfer summary and sent the transfer summary to the receiving facility for 1 of 1 sampled patients (Patient #5) reviewed requiring the completion of a transfer summary.

The agency failed to follow a Plan of Care established and periodically reviewed by a doctor of medicine, osteopathy or podiatry or notify the physician of the need to vary from the physician ordered Plan for Care for 2 of 8 sampled patients (Patients #2 and #8).

Agency policy review and home visit observation the agency failed to ensure staff provided care in accordance with agency expectations and accepted infection control standards of practice for staff observed during a home visit for 2 of 3 patients (Patients #1 and #2).

The agency failed to ensure authentication of entries made in each patient's clinical record included the employee's title and failed to complete timely documentation as directed by agency policy for 4 of 8 sampled patients (Patients #2, #4, #6 and #8).

The agency failed to provide an initial assessment visit within 48 hours of receipt of referral, within 48 hours of the of the agency's knowledge of the patient's return home from an inpatient facility or on the physician ordered start of care date for 2 of 6 sampled patients (Patients #5 and #7).

The facility 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 5 of 8 records reviewed (Patients #2, #3, #4, #6 and #8).

Agency clinicians failed to complete updates to the comprehensive assessment at recertification in the last 5 days of each certification period for 3 of 7 sampled patients requiring a recertification assessment (Patients #5, #6 and #8).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care for 2 of 8 sampled patients (Patients #2 and #4).

The agency staff failed to provide medications and treatments only as ordered by the physician for 1 of 2 sampled patients (Patients #2) receiving wound care.

The agency failed to report changes in patient clinical findings to the physician for 1 of 2 sampled patients (Patient #2) with wounds.

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician in the Plan of Care and/or as directed in writing by the skilled professional assigning the home health aide to the patient for 6 of 7 sampled patients receiving home health aide services…

The agency failed to ensure a registered nurse completed home health aide supervision at least every 60 days while observing each home health aide present and providing direct patient care for 1 of 3 sampled patients who received hands on personal care services with no skilled service provision.

The agency failed to ensure the clinical record included a copy of the patient's individualized emergency plan developed as part of the comprehensive assessment and failed to ensure patient's received a copy of an individualized emergency plan for 7 of 7 sampled patients with a record review which…

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 complete a written emergency preparedness plan.

The agency failed to provide documentation that the agency developed and maintained an emergency preparedness communication plan that complied with Federal, State, tribal and local laws.

The agency failed to ensure training in emergency preparedness for all individuals providing services under arrangement (contract staff), consistent with their expected roles on or prior to November 15, 2017. The agency reported utilizing a total of 6 contracted staff ( Physical Therapy…

The agency failed to provide individualized and specific written patient care instructions from a registered nurse (RN) to agency home health aides for 3 of 5 sampled patients receiving home health aide services (Patients 1, #2 and #4).

The agency failed to complete a drug regimen review which included all of the patient's current medications with each comprehensive assessment for 7 of 7 sampled patients Patient #1, #2, #3, #4, #5, #6 and #7).

The agency failed to update the Plan of Care with all new physician orders for 3 of 7 sampled patients (Patients #5, #6 and #7) . The agency reported a current census of 61 patients at the time of the survey.

The agency failed to ensure skilled nurses provided care as ordered by the physician in the Plan of Care for 3 of 7 sampled patients receiving a skilled nursing service (Patients #1, #3 and #5).