Indiana Masonic Home, Inc

The agency failed to ensure all medications taken by the patient were recorded in the clinical record, in 1 of 3 home visit observations.

The agency failed to ensure a patient received services as frequently as ordered in the Plan of Care, (see G0572), the agency failed to ensure their clinicians obtained a physician order prior to performing wound care (see G0580), the agency failed to notify the ordering provider when a lapse in…

The agency failed to ensure field staff followed appropriate infection control practices per agency policy while providing wound care to patients, and the agency failed to take action when the agency became aware patients' wounds had been potentially contaminated (see G0682).

The agency failed to ensure a patient received services as ordered in the Plan of Care for 1 of 6 patients with a wound vac (device used to aide in the healing of a progressive wound).

The agency failed to ensure patients received a Plan of Care, a Medication list, and a schedule in 2 of 3 home visits conducted.

The agency failed to ensure their Quality Assessment Performance Improvement program included tracking adverse events, analyzing their cause, and implementing preventive actions.

The agency failed to ensure their Quality Assessment Performance Improvement (QAPI) program evidenced at least one Performance Improvement Project (PIP) being conducted.

The agency failed to ensure field staff followed appropriate infection control practices per agency policy while providing patient care in 3 of 3 home visits conducted, and the agency failed to take action when made aware wounds were potentially contaminated (Registered Nurse (RN) 1, Licensed…

The agency failed to ensure their clinicians obtained a physician order prior to performing wound care in 1 of 6 active record reviews.

The agency failed to notify the ordering provider when a lapse in ordered, regularly scheduled wound care occurred and the agency failed to notify physicians when the agency became aware of possible contamination of wounds had occurred, in 1 of 10 clinical records reviewed (Patient #1) and 2 of 3…

The agency failed to ensure clinicians followed the agency's policy on completion of the documentation of services they provided on the day the service was rendered in 4 of 6 active clinical records reviewed.

The agency failed to ensure clinicians followed the agency's policy when performing wound care with the use of negative pressure wound therapy in 1 of 3 home visits.

The home health agency failed to ensure nursing visits were completed as ordered in the plan of care for 1 (#2) of 7 records reviewed.

The agency failed to ensure skilled services were performed only by qualified professionals for 1 (#5) of 7 records reviewed.

The agency failed to ensure the plan of care addressed needs identified in the comprehensive assessment for 1 of 7 (#2) records reviewed and failed to provide an indication for as needed (prn) visits for 2 of 7 (#5, 7) records reviewed.

The skilled nurse failed to ensure visits were completed as ordered in the plan of care for 1 (#2) of 7 records reviewed.