Health Now Home Healthcare, Inc.

The home health agency did not have a clinical manager designated to oversee clinical care for 47 of 47 sampled patients.

The home health agency (HHA) failed to provide skilled nursing services for one (Patient 9) as ordered.

The home health agency did not provide discharge service notification for one (Patient 2) of 47 sampled patients.

The agency's licensed nursing staff did not consistently provide ongoing nursing care assessments for one (Patient 2) of 47 sampled patients.. Patient 2 had wounds that were not assessed.

The agency failed to meet the Condition of Participation for Comprehensive Assessment of Patients when the agency did not ensure the initial assessment was completed by a registered nurse, perform complete and accurate initial assessments, and perform medication review during the initial…

The agency failed to meet the Condition of Participation for Care Planning, Coordination, and Quality of Care when the agency did not develop a plan of care that included goals and intervention, ensure the physician was notified of changes of condition, revise the plan of care to include patients…

The agency failed to submit the Outcome and Assessment Information Set (OASIS, an assessment tool) in a timely manner for one (Patient 15) of 16 sampled patients when OASIS assessment was not conducted for Patient 15 after discharge from the agency.

The agency staff failed to coordinate care for two of 16 sampled patients (Patients 1 and 11) when Patient 1 complained to staff that her bed was uncomfortable and was causing back pain, and Patient 11 told staff their healthcare goal was to reduce pain when sitting and standing.

The agency failed to ensure qualified licensed personnel provided care to one of 16 sampled patients (Patient 16) when Licensed Vocational Nurse 3 (LVN 3) provided care as a Registered Nurse (RN) without prior verification of RN credentials and qualification.

The agency failed to ensure the clinical record contained accurate and complete documentation for one of 16 sampled patients (Patient 7) when Home Health Aide 1 (HHA 1) documented his visits and signed his name without a job title on the assessment form used by registered nurses (RN).

ADM/OW stated the agency did not verify LVN 3's credentials and qualifications before assigning LVN 3 to perform as a registered nurse.

The agency failed to perform a complete and accurate initial assessment upon admission to the agency for three of 16 sampled patients, (Patients 4, 13, and 15) when: 1. For Patient 15, the urostomy (a surgical procedure that creates a stoma [artificial opening] through the abdomen to collect urine)…

The agency failed to perform an accurate medication review for one of 16 sampled patients (Patient 13) when the assessment did not include Patient 13's use of a high risk medication, Eliquis (blood thinner used to prevent clot formation) on the initial assessment.

The agency failed to ensure the plan of care was developed to include included goals and interventions for three of 16 sampled patients (Patients 15, 13 and 3) when: 1. For Patient 15, there was no goals and interventions for the urostomy (a surgical procedure that creates a stoma (artificial…

The agency's failed to notify the physician of changes in medical condition for five of 16 sampled patients (Patients 6, 8, 9, 12, and 14).

The agency failed to revise the plan of care to include patients current medical condition for four of 16 sampled patients (Patients 6, 8, 9, and 14).

In an interview, at 10:50 a.m. on 9/27/18, Registered Nurse 4 (RN 4) stated he did not train HHA 1 to perform urinary catheterizations because is a HHA and not a nurse.