Hope Land Home Health Care Inc

The Agency failed to encode and electronically transmit each completed OASIS (a tool used by CMS to collect certain patient information) assessment to the CMS system, within 30 days of completing the assessment of the patient for 12 of 58 (20.69%) assessments processed for the time reviewed of…

The agency failed to document all interventions including treatments and responses to those interventions in the patients’ medical record in 1 (Pt 3) of 7 patient records reviewed.

The agency failed to ensure that encoded OASIS data (a data set tool designed to measure outcomes for patients receiving home health services) accurately reflected the patient's status at the time of assessment for six of ten patients (Patient 1, 2, 3, 4, 5 and 6) whose records were reviewed in…

The agency failed to ensure a patient received home health services as ordered in the individualized POC in six of ten patient records reviewed (Patient 2, 3, 4, 5, 7 and 8) where nursing visits were not made as ordered.

The agency failed to ensure the POC included all pertinent diagnoses; patient-specific interventions and information related to any advanced directives (legal documents that allow you to spell out your decisions about end-of-life care ahead of time) in ten of ten records reviewed.