Iowa Home Care, L L C

The agency failed to ensure training in emergency preparedness to all current staff annually.

The agency failed to obtain the patient's or the patient's legal representative's signature confirming he or she had received a copy of the notice of rights and responsibilities prior to the start of services for 1 of 7 sampled patients (Patient #7).

The agency failed to obtain the patient's or the patient's legal representative's signature confirming he or she had consented to services with the knowlege of services provided and the charges the patient may have to pay before care is initiated for 1 of 7 sampled patients (Patient #7).

The agency failed to provide medications, treatments or services only as ordered by the physician for 1 of 7 sampled patients (Patient #4).

The agency failed to obtain current medication orders for 1 of 3 sampled patients with a home observation visit (Patient #1).

The agency failed to ensure 3 of 4 sampled home health aides (Staff I, Staff J and Staff K), assigned to perform tasks requiring extra skills exceeding the level of basic home health skills for 2 of 3 sampled patients (Patients #1 and #2) with home health aide services, had documented evidence of…

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 1 of 2 sampled patients (Patient #1) with a home observation visit who received hands on personal care services in conjunction with a…

Staff and patient interview the agency failed to ensure the patients clinical record is available to the patient free of charge within 10 business days (per the PHE waiver) for 1 of 6 patients reviewed.

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 of Care for 1 of 7 sampled patients (Patient #3).

The agency failed to update the Plan of Care with all new physician orders for 1of 2 sampled patients with interim resumption of care orders.

The agency failed to ensure skilled professionals provided care as ordered by the physician in the Plan of Care for 1 of 7 sampled patients (Patient #1).

The agency was not operating in compliance with the Condition of Participation for the following reasons: 1) failed to ensure initial visits occurred within 48 hours of referral or within 48 hours of knowledge of the patient's discharge from an inpatient facility when the physician did not give a…

The agency was not operating in compliance with the Condition of Participation for the following reasons: 1) failed to ensure all supplies/equipment/medications/treatments required by the patient to meet his/her needs were included on each patient's Plan of Care (G574); 2) failed to provide…

The agency was not operating in compliance with the Condition of Participation for the following reasons: 1) failed to send completed transfer summaries with a medication list to the physician treating the patient during the transfer within 2 business days of knowledge of the transfer and/or failed…

The agency failed to provide individualized and specific written patient care instructions from a registered nurse (RN) to agency home health aides for 4 of 6 sampled patients receiving home health aide services (Patients #4 #12, #14 and #16).

The agency failed to ensure that all patient clinical record documentation was maintained in a secure and confidential manner for 188 patients either currently receiving home care services from the agency and/or received home care services in the past.

The agency failed to provide an initial assessment visit within 48 hours of receipt of referral, within 48 hours of the of the agency's knowledge of the patient's return home from an inpatient facility or on the physician ordered start of care date for 2 of 7 sampled patients (Patients #9 and #14).

The agency failed to complete a drug regimen review within the required time frames as part of the initial comprehensive assessment at start of care and/or as part of the update to the comprehensive assessment at the time of recertification, resumption of care and discharge for 7 of 10 sampled…

The agency failed to ensure accurate completion of all required components of the recertification comprehensive assessments between day 56 and 60 of each 60 day certification period for 5 of 11 sampled patients requiring a recertification assessment (Patients #4, #10, #12, #14 and #16).

The agency failed to ensure completion of the update to the comprehensive assessment within 48 hours of the agency's knowledge of the patient's need to discharge for 2 of 3 sampled patients requiring a discharge comprehensive assessment (Patients #4 and #18).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including inclusion of all supplies/equipment and medications used by the patient for 4 of 7 sampled patients (Patients #4, #9, #10 and #14).

The agency failed to provide medications only as ordered by the physician for 2 of 3 sampled patients receiving administration of injectable medications by an agency nurse (Patients #1 and #8).

The agency failed to report changes in patient clinical findings or changes in patient needs to the physician to obtain direction and/or failed to notify the physician of the inability to follow the Plan of Care for 5 of 14 sampled patients (Patients #1, #4, #5, #7 and #8).

The agency failed to ensure agency staff coordinated care in a way to meet patient individualized needs for 2 of 7 sampled patients (Patients #9 and #10).

The agency failed to abide by the CMS imposed prohibition to train and competency test new home health aides as a result of having Conditions of Participation out of compliance following a previous complaint survey on 8/4/2021. The agency trained and competency tested 2 of 2 sampled newly hired…

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 2 of 6 sampled patients receiving home health aide services…

The agency failed to ensure the registered nurse (RN) completed home health aide supervision at least every 60 days while observing the home health aide present and providing direct patient care for 1 of 1 sampled patients who received hands on personal care services with no skilled service…

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: 1) failed to ensure each patient received services as ordered (G572); 2) failed to ensure all supplies/equipment/medications/treatments required by the patient to meet his/her needs were included and accurate on each patient's Plan of Care (G574); 3) failed to provide medications…

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

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

The agency failed to provide treatments or services only as ordered by the physician for 1 of 3 sampled patients with orders for wound care (Patient #5 and #6).

The agency failed to notify the physician of changes in patient condition or needs that suggest an alteration to the Plan of Care for 2 of 6 sampled patients (Patients #4, #5 and #6).

The agency failed to coordinate services provided by all disciplines in a manner to effectively meet the identified needs of the patient for 1 of 6 sampled patients receiving care (Patients #2).

The agency failed to provide agency patients with written visit schedules.

The agency failed to provide agency patients with written medication schedule/instructions.