Home Call

The skilled nurse (SN) did not follow physician orders for 1 out of 18 patients reviewed.

Failure to demonstrate compliance with regulations and requirements prevented the provision of safe and effective patient care.

The agency staff did not complete the initial assessment within 48 hours of referral or the patient's return home for 5 out of 18 patient records reviewed.

All clinical staff members have the responsibility to communicate or refer patient care related issues to other professional disciplines to ensure the provision of optimal health care services and to prevent adverse outcomes.

Failure to comply with regulations places patients at risk for inadequate health care.

When asked the agency staff stated that this patient was not receiving skilled nursing services and that the missed visit note was erroneously written in this patient’s medical record.

Findings include: 1. On 3/28/2023, a review of the patient's clinical record revealed no documentary evidence to support the ongoing complaints by the patient related to visit frequencies was being addressed administratively.

The agency failed to discharge the patient for cause from services appropriately.

Failure to do so placed the patient at risk for poor health outcomes.

Failure to make efforts to resolve issues or concerns placed the patient at risk for poor health outcomes.

Failure to make efforts to resolve issues or concerns placed the patient at risk for poor health outcomes.