Home Sweet Home Care

The agency failed to complete a written emergency preparedness plan that included a process for cooperation and collaboration with local, state, and federal emergency preparedness officials' efforts to maintain an integrated response during a disaster or emergency situation, including documentation…

The agency failed to complete a written emergency preparedness plan that included procedures to inform State and local officials of any on duty staff they are unable to contact in the event of an interruption of services related to an emergency.

The agency failed to provide documentation the agency developed and maintained an emergency plan that included primary and alternate means of communicating with the agency staff and federal, state, tribal, regional and local emergency management agencies.

The agency failed to ensure agency staff participated in at least one full scale community emergency preparedness exercise, or if a full scale community exercise was unavailable, then a facility based functional exercise in 2023 or 2024. Failure to conduct or participate in emergency preparedness…

The agency failed to ensure staff provided care in accordance with accepted infection control standards of practice observed during a home visit for 1 of 3 sampled patients (Patient #2) with home visits.

The agency failed to provide a complete comprehensive assessment for patients with wounds during start of care, recertifications, resumption of care and discharge assessments for 1 of 2 sampled patients with wounds (Patient #7).

The agency failed to ensure the drug regimen review identified ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy and noncompliance with drug therapy for 6 of 7 sampled patients (Patients #1, #2, #3, #4, #6 and #7).

The agency failed to ensure accurate completion of all components comprising the Plan of Care, including all supplies/equipment and all medications and treatments used by the patient for 5 of 7 sampled patients (Patients #1, #2, #4, #5 and #6).

The agency failed to follow physician orders for treatments for 4 of 7 sampled patients (Patients #2, #3, #4 and #5).

The agency failed to assure nurses taking verbal orders from a physician documented the orders in the clinical record (signed, dated and timed) sending the orders to the physician for authentication, including signature and date of signature for 1 of 7 sampled patients (Patients #6).

The agency failed to complete and send a transfer summary to the physician caring for the patient at the inpatient facility after transfer within 2 business days of the patient's transfer and/or failed to complete and send a discharge summary to the physician and other health care professionals who…

The agency did not ensure the emergency preparedness program included a documented, facility-based and community-based risk assessment, utilizing an all-hazards approach specific for the home health agency.

The agency failed to ensure the emergency preparedness program addressed the continuity of operations including delegation of authority and succession plans.

The agency failed to complete a written emergency preparedness plan that included a process for cooperation and collaboration with local, state, and federal emergency preparedness officials' efforts to maintain an integrated response during a disaster or emergency situation, including documentation…

The agency failed to complete a written emergency preparedness plan that included procedures to inform State and local officials of any on duty staff they are unable to contact in the event of an interruption of services related to an emergency.

The hospice failed to ensure the development of a policy and procedure for a medical documentation system that preserves patient information and confidentiality of patient information.

The home health agency failed to develop an Emergency Preparedness communication plan that includes name and contact information of staff and patient healthcare practitioners.

The agency's emergency preparedness communication plan failed to include contact information for state and federal official emergency staff.

Staff interview the agency failed provide documentation that the agency developed and maintained an emergency plan that included primary and alternate means of communicating with the agency staff and federal, state, tribal, regional and local emergency management agencies.

The agency failed to ensure agency staff developed and maintained an emergency communication plan that included a method of sharing information and medical documentation for the agency clients to maintain the continuity of care.

Staff interview the agency failed provide documentation that the agency developed and maintained an emergency communication plan that included a means of providing information about the agency's occupancy, needs and its ability to provide assistance, to the authority having jurisdiction, the…

The agency failed to ensure agency staff participated in at least one full scale community emergency preparedness exercise, or if a full scale community exercise was unavailable, then a facility based functional exercise in 2020 or 2021. Failure to conduct or participate in emergency preparedness…

The agency failed to follow a Plan of Care established and periodically reviewed by a physician or notify the physician of the need to vary frequency of visits or inability to perform treatments/services as originally ordered on the Plan for Care for 6 of 7 sampled patients (Patients #1, #2, #3…

The agency failed to ensure staff provided care in accordance with agency expectations and accepted infection control standards of practice observed during a home visit for 1 of 3 sampled patients with a home visit observation (Patient #3).

The agency failed to ensure the home health aides successfully completed competencies in all basic home health aide skills which require a registered nurse, or other appropriate skilled professional in consultation with a registered nurse, to evaluate the competency of the aide by direct…

The agency failed to ensure all clinical entry notes included a date and time and staff signature with title for 6 of 7 sampled patients (Patients #1, #3, #4, #5, #6 and #7).

The agency failed to assess each patients medications for duplication, side effects, ineffectiveness, actual or potential interactions and non-compliance within the required time frames, identifying medication discrepancies, as part of the initial comprehensive assessment at admission and as part…

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies and equipment used to meet the needs of the patient for 4 of 7 sampled patients (Patients #1, #3 and #7).

The agency failed to ensure staff provide services, medications and treatments only as ordered by the physician and per the Plan of Care for 3 of 7 sampled patients (Patients #1, #3 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 4 of 6 sampled patients receiving home health aide services…

The agency failed to ensure agency staff completed and sent a discharge summary within 5 business days of knowledge of a patient discharge for 2 of 2 patients requiring a discharge summary and a transfer summary to the health care professionals responsible for providing care to the patient while in…

3. Patient #2, a patient receiving services from the branch office in Clarinda, had a start of care date of 10/26/15 and a discharge date of 7/18/18. The initial comprehensive assessment, dated 2/9/18, lacked documentation of assessment of the patient's emergency preparedness needs and risks.

The agency failed to have a policy and procedure to notify State and local officials of any on-duty staff or patients the agency was unable to contact.

The agency failed to identify the process for protection of patient documentation and process to keep the information from unauthorized access should an emergent situation occur.

The agency failed to ensure initial and annual training in emergency preparedness to all staff consistent with their expected roles for 19 of 67 directly hired staff and 2 of 6 contracted staff.

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 1 of 7 sampled patients (Patients #7).

The agency failed to ensure 2 of 5 sampled home health aides (Staff Y and Z), assigned to perform tasks requiring extra skills exceeding the level of basic home health skills for 1 sampled patients (Patient #2) had documented evidence of competency by a registered nurse in the assigned task area…

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment and medications used by the patient, risk of emergency room and hospital readmission for 7 of 7 sampled patients (Patients #1, #2, #3, #4, #5, #6, and #7).

The agency failed to assess/measure wounds thoroughly for 2 of 7 sampled patients (Patients #2 and #7).

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 by the skilled professional assigning the home health aide to the patient for 3 of 6 sampled patients receiving home health aide services (Patients…

The agency failed to ensure a registered nurse or other appropriate health care professional completed home health aide supervision at least every 14 days for 2 of 6 sampled patients who received hands on personal care services in conjunction with skilled service provision (Patients #3 and #5).

The agency failed to complete and send a transfer summary to the physician or other health care professionals responsible for providing care to the patient after transfer within 2 business days of the patient's transfer or a discharge after the change in regulation on 1/13/18 for 1 of 3 sampled…

The agency staff failed to document patient care accurately, resulting in falsification of patient documents for 5 of 11 sampled patients.

The agency failed to ensure accurate completion of a discharge comprehensive assessment within 2 calendar days of identification of the need to discharge a patient for 1 of 1 sampled patients requiring a discharge comprehensive assessment (Patient #11).

The agency failed to coordinate care provided by all disciplines and integrate services to assure patient needs are being met for 1 of 11 sampled patients receiving skilled services (Patient #11).

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician and/or as directed by the skilled professional assigning the home health aide to the patient for 3 of 9 sampled patients receiving home health aide services (Patients #3, #5 and #11).

The agency failed to ensure home health aides reported patient concerns to a registered nurse as required by agency policy for 3 of 9 sampled patients receiving home health aide services (Patients #1, #4 and #5).

The administrator failed to organize and direct the ongoing functions of the agency to assure all staff followed the Conditions of Participation during the provision of patient care.