Harmon County Home Health Care

The agency failed to ensure a patient centered QAPI Program for all patients and employees.

The agency failed to ensure: 1) The Infection Control Program included comprehensive infection control surveillance activities and interventions to reduce future infections and promote learning and preventative measures throughout the agency; and 2) The Infection Control Program was included in…

The agency failed to ensure development of a community-based risk assessment (All Hazards Risk Assessment) for 38 patients and all employees.

The agency failed to ensure the skilled nurse notified the physician of pain ratings outside of ordered parameters for one (Patient #1) of seven patients.

The agency failed to ensure a patient centered QAPI Program for all patients and employees.

The agency failed to ensure utilization of QAPI data to improve program effectiveness, quality of patient care and overall program improvement.

The agency failed to ensure the initiation and review of a PIP through their QAPI Program for 38 patients and all employees.

The agency failed to ensure governing body oversite of the conduction of patient centered QAPI Program activities for all patients and employees.

The agency failed to ensure: 1) The Infection Control Program included comprehensive infection control surveillance activities and interventions to reduce future infections and promote learning and preventative measures throughout the agency; and 2) The Infection Control Program was included in…

The agency failed to ensure infection control education was: 1) included in QAPI activities; 2) showed interventions to reduce future infections; and 3) provided and/or maintained for all employees and 38 current patients.

The agency failed to ensure skilled nurse frequencies showed the duration of visits for six (Patients #1, 3, 4, 5, 6 and 7) of seven patients.

The agency failed to ensure coordination of care with physical therapy for one (Patient #2) of seven patients.

The agency failed to ensure improvement activities were identified and focused on high risk problem-prone areas for 38 current patients.

The agency failed to ensure a patient centered QAPI Program which measured and tracked agency performance strategies to ensure improvements were sustained for all patients and employees.

The agency failed to develop an individualized Plan of Care for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to develop a patient centered QAPI Program.

The agency failed to ensure their infection control program included infection surveillance activities and interventions to reduce future infections and promote learning throughout the agency for all employees and 30 current patients.

The agency failed to ensure the governing body provided oversight of the agency's Quality Assessment and Performance Improvement Program.

The agency failed to: 1. ensure clinical notes were included in the clinical record for five (Patients #1, 2, 3, 4 and 5) of seven patients and 2. ensure the current plan of care was included in the clinical record for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to ensure development of an agency specific Emergency Preparedness Program for all employees and all 30 current patients.

The agency failed to ensure the development of a community-based risk assessment that was reviewed and updated at least every two years for all employees and 30 current patients.

The agency failed to document emergency drills at least annually.

The agency failed to develop an individualized Plan of Care for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to review and revise an individualized Plan of Care for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to ensure written instructions outlining services provided were provided to three (Patients #1, 2 and 5) of seven patients.

The agency failed to develop a patient centered QAPI Program for 30 current patients.

The agency failed to ensure the utilization of QAPI data to improve program effectiveness, quality of patient care and overall program improvement.

The agency failed to develop performance improvement activities to track adverse patient events.

The agency failed to ensure the initiation and review of PIPs through their QAPI Program for 30 current patients and five current employees.

The agency failed to ensure their infection control program included infection surveillance activities and interventions to reduce future infections and promote learning throughout the agency for all employees and 30 current patients.

The agency failed to ensure infection control education was: 1) included in QAPI activities; 2) showed interventions to reduce future infections; 3) provided to patients and caregivers of seven (Patients #1, 2, 3, 4, 5, 6, and 7) of seven patients; and 4) provided and/or maintained for current and…

The agency failed to notify the State agency of a change in Administrators.

The agency failed to ensure governing body oversight of the agency for 2018 and 2019. Findings: A review of governing body minutes for 2018 and 2019 showed no oversight to agency's functioning.

The governing body failed to ensure professional direction was provided to the agency.

The agency failed to hire a qualified Administrator.

The agency failed to develop an individualized Plan of Care outlining patient orders and services for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to develop an individualized Plan of Care which included all physician orders for delivery of care for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to develop an individualized Plan of Care outlining services to be provided only as ordered by a physician for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to ensure the physician reviewed an individualized Plan of Care every 60 days for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to ensure service discipline visit schedules were provided to patients and/or their caregivers for three (Patients # 1, 2 and 5) of three patients with home visits conducted.

The agency failed to develop a medication schedule/instructions for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to develop performance improvement activities that focused on high risk problem areas.

The governing body failed to appoint a qualified administrator responsible for day to day operations for all current patients and agency employees.

The governing body failed to ensure professional direction was provided in the agency's daily functions.

The agency failed to ensure to employ a qualified administrator.

The agency failed to: 1. ensure clinical notes were included in the clinical record for five (Patients #1, 2, 3, 4 and 5) of seven patients and 2. ensure the current plan of care was included in the clinical record for five (Patients #1, 2, 3, 4 and 5) of seven patients.

The agency failed to ensure all interventions, including medication administration, treatments, and services, and responses to those interventions were included in the clinical record for five (Patients #1, 2, 3, 4 and 5) of seven records reviewed.

The agency failed to develop goals in the patient's plans of care and the patient's progress toward achieving them for five (Patients #1, 2, 3, 4 and 5) of seven patients.