Horizon Healthcare Services, LLC

The agency failed to ensure each patient received home health services as written in the individualized plan of care and failed to notify the physician of delayed start of care and missed visits.

The facility failed to conduct an initial assessment visit within 48 hours of referral to determine the immediate care and support needs of the patient.

The facility failed to ensure provided services were ordered by a physician.

The agency failed to ensure patients received services as written in the plan of care for two of three medical records reviewed (Patients # 1 and # 2).

The agency failed to ensure services were administered only as ordered by a physician for one of three medical records reviewed (Patient #1).

The agency failed to ensure supervisory visits were conducted no less frequently than every fourteen days for patients who were receiving skilled care for one of three medical records reviewed (Patient #1).

The agency failed to ensure patients received services as written in the plan of care for three of five patients reviewed (Patient #2, #3, and #4).

The agency failed to ensure patients were informed of changes in the care to be furnished for three of five sampled patients (Patient #2, #3, and #4).

The agency failed to develop and maintain a comprehensive emergency preparedness program that was reviewed and updated annually.

The agency failed to establish and maintain a comprehensive emergency preparedness program that included a documented agency and community based risk assessment utilizing the all-hazards approach.

The agency failed to develop and maintain a comprehensive emergency preparedness program which would collaborate with the local, tribal, regional, state, and federal emergency preparedness officials.

The agency failed to develop and maintain a comprehensive emergency preparedness program to inform State and local emergency preparedness officials about Home Health Agency patients in need of evacuation.

The agency failed to establish a process for notification of state or local officials of any on duty staff or patients the agency was unable to contact in the event of a disaster or emergency.

The agency failed to establish and maintain a comprehensive Emergency Preparedness program that incorporated a Communication Plan.

The agency failed to establish an alternative means of communication with staff and federal, state, tribal, regional and local emergency preparedness staff.

The agency failed to establish and maintain a comprehensive Emergency Preparedness program, related to training.

The agency staff failed to ensure patients received health services written in a plan of care for five of seven patient medical records reviewed (Patient #1, #2, #3, #6 and #7).

The agency failed to document refusal of service for one of two discharged patients reviewed (Patient #6).

The agency failed to ensure medications the patients were taking was current for four of seven patients reviewed (Patient #1, #2, #3 and #4).

The agency failed to include the frequency and duration of visits to be made in the plan of care for two of seven records reviewed (Patient #1 and #3).

Staff interview, the agency provided skilled nursing services without physician orders for one of seven medical records reviewed (Patient #3).