Noble Hospice & Home Health Care, Inc

The home health agency (HHA) failed to meet the Condition of Participation for Care Planning, Coordination, Quality of Care when the agency licensed nursing staff did not report to the doctor and manage effectively Patient 9's elevated blood pressures.

The home health agency’s licensed staff did not follow the plan of care for one of nine sampled patients (Patient 9).

The agency failed to follow accepted standards of practice and standard precautions (minimum infection prevention practices that apply to all patient care which include hand hygiene, gloves mask or eyewear), for one of nine sampled, selected patients (Patient 6).

The agency failed to maintain privacy during care for one of nine sampled selected patients (Patient 6) when Registered Nurse (RN) 1 entered Patient 6's room without knocking on the door and started to perform a physical exam without providing privacy.

The agency failed to inform one of nine sampled selected patients (Patient 3) about the change in plan of care and discharged the patient from the agency sooner than the planned discharge date.

The home health agency’s licensed staff did not notify the doctor for a change in condition for one of nine sampled patients (Patient 9).

The home health agency’s licensed staff did not update the plan of care for one of nine sampled patients (Patient 9).

The agency failed to ensure a registered nurse (RN) supervised the care provided by licensed vocational nurses (LVNs) when two of nine sampled, selected patients (Patient 3 and Patient 9) did not have a supervisory visit during the time period that they received care from the agency.

The agency failed to meet the §484.60 Condition of Participation for Care Planning, Coordination, and Quality of Care.

The home health agency's licensed nursing staff did not ensure the doctor's orders for three (Patients 4, 11 and 14) of 14 sampled patients were followed.

The home health agency's licensed nursing staff failed to communicate with the physicians to ensure goals were being met for four (Patients 4, 6, 13, and 14) of 14 sampled patients.

The home health agency failed to complete the Home Health Aide (HHA) annual training hours for one of two (HHA 1) sampled patients.

The home health agency's licensed nursing staff did not notify the doctor when there were changes in condition for four (Patients 4, 6, 13 and 14) of 14 sampled patients.

The home health agency did not coordinate care to meet the patient's needs for one, (Patient 14) of 14 sampled patients.