Horn Memorial Hospital

The agency failed to ensure accurate and thorough completion of pertinent components of the initial comprehensive assessment for 1 of 2 sampled patients with wound care.

The hospice failed to ensure the development of a procedure to inform State and local officials of homebound patients in need of evacuation due to an emergency situation.

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 8 sampled patients (Patients #1, #2, #3…

The agency failed to ensure authentication of staff documentation in each patient's clinical record included the date and time of the employee signature for 8 of 8 sampled patients (Patients #1, #2, #3, #4, #5, #6, #7, and #8).

The agency failed to complete a drug regimen review, including all required components, with each comprehensive assessment within the allowed time frames for 2 of 8 sampled patients (Patients #3 and #7).

The agency failed to ensure completion of the update to the comprehensive assessment within 48 hours of the agency's knowledge of return home from an inpatient facility for 1 of 2 sampled patients requiring a resumption of care assessment (Patient #3).

The agency failed to ensure completion of all required components of the discharge comprehensive assessments within 2 calendar days of identification of the need to discharge a patient for 1 of 2 sampled patients requiring a discharge comprehensive assessment (Patient #7).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment used by the patient, accurate medication orders and physician approved staff interventions for 6 of 8 sampled patients (Patients #1, #2, #3, #5, #6 and #7).

The agency failed to document the home health aide successfully completed a training and competency evaluation program as specified per regulatory requirements 1 of 1 sampled home health aides hired since the last survey(Staff E).

The agency failed to document whether extra skills competencies were evaluated in a laboratory setting using a pseudo patient or in a home setting while being performed on an actual patient for 2 of 3 sampled home health aides (Staff F and G).

The agency failed to ensure the patient's clinical record included accurate and complete documentation of interventions in the patient record for 1 of 2 sampled patients with wounds/surgical incisions (Patient #5).

The agency failed to send a discharge summary to the physician and other health care professionals who would be providing care to the patient after discharge within 5 business days for 1 of 1 sampled patients with a discharge where a summary should have been sent (Patient #7).

The agency: 1) failed to ensure skilled professionals provided care as ordered by the physician in the Plan of Care (G572); 2) failed to ensure the agency skilled staff completed an individualized Plan of Care that contained accurate information (G574); 3) failed to ensure the agency skilled staff…

The agency failed to ensure training in emergency preparedness to all individuals providing services under arrangement, consistent with their expected roles.

The agency failed to notify the physician of changes in visit frequency ordered on the Plan of Care (missed visits) or perform interventions as ordered in the Plan of Care for 4 of 8 sampled patients (Patients #3, #5, #6 and #7).

The agency failed to include an individualized assessment relating to the patient's current health status when completing comprehensive assessments for 4 of 7 sampled patients (Patients #1, #3, #5 and #6).

The agency failed to ensure completion of a discharge comprehensive assessment within 2 days of the agency's knowledge of the need for discharge for 1 of 2 sampled patients discharged from agency services (Patient #7).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies and equipment used by the patient to meet his/her needs for 2 of 3 sampled patients with home visits (Patients #1 and #4).

The agency failed to update the Plan of Care with all new physician orders for 3 of 7 sampled patients.

The agency failed to report changes in patient clinical findings to the physician as directed on the Plan of Care for 3 of 4 sampled patients with a diagnosis of diabetes (Patients #1, #3 and #6).

The agency failed to coordinate care provided by all disciplines and integrate services to assure patient needs are being met for 5 of 6 sampled patients with Physical Therapy or Occupational Therapy (Patients #1, #2, #5, #6 and #7).