Onoria Health Care Provider Inc Home Health and Ho

The agency failed to ensure to updated patient records were readily available to support continuity of care during an emergency, when the agency’s emergency preparedness policy and procedure did not contain the most current patient roster.

The home health agency failed to conduct and document, at a minimum, one performance improvement projects (PIP - a concentrated effort on a particular problem in one area of the agency or agency wide; it involves gathering information systematically to clarify issues or problems, and intervening…

The facility failed to ensure patient medical supplies were properly maintained to reduce the spread of microorganisms (small organisms that can cause illness, such as bacteria and viruses), when eight foley catheter insertion trays (a tubular device that drains urine from the bladder into a…

The agency failed to ensure the patients' initial assessment was completed by a Registered Nurse (RN) within 48 hours of the physician's referral date for one of 13 sampled patients (Patient 8).

The agency failed to ensure OASIS (Outcome and Assessment Information Set-patient-specific information used in Medicare to determine reimbursement and measure quality) data (facts collected together for analysis) from patient assessments was transmitted to CMS (Centers for Medicare and Medicaid…

The agency failed to ensure OASIS (Outcome and Assessment Information Set-patient-specific information used in Medicare to determine reimbursement and measure quality) data (facts collected together for analysis) from patient assessments was accurate and complete before submission to CMS (Centers…

The agency failed to ensure all clinical documentation contained within patient charts was authenticated (a signature verifying something as true and accurate) for 10 of 11 sampled patients (Patients 1, 2, 3, 4, 5, 7, 8, 9, 10, and 11).

The agency failed to ensure all required items were included in the patients' clinical record for four of 11 sampled patients (Patients 1, 5, 6, and 9) when: 1. For Patient 1, there was no OASIS (Outcome and Assessment Information Set-patient-specific information used in Medicare to determine…

The agency failed to ensure discharge summaries were completed for three of 11 sampled patients (Patients 4, 5, and 9).

The agency failed to ensure the Condition of Participation: G 510 484.55 Comprehensive Assessment of Patients was in compliance when: 1. Based on interview and record review, the agency failed to ensure the patients' initial assessment was completed by a Registered Nurse (RN) within 48 hours of the…

The agency failed to ensure that the Condition of Participation: G 570 484.60: Care planning, coordination, quality of care was in compliance as follows: 1. Based on interview and record review, the agency failed to ensure the plan of care was reviewed and signed by a physician within 30 working…

The agency failed to ensure that the Condition of Participation: G 640 484.65 Quality assessment and performance improvement (QAPI) was in compliance as follows: Based on interview and record review, the agency failed to ensure its performance improvement activities lead to an immediate correction…

The agency failed to ensure that the Condition of Participation: G 680 484.70: Infection prevention and control was in compliance when: Based on interview and record review, the agency failed to maintain an infection control program that was integrated into the agency's Quality Assessment…

The agency failed to ensure that the Condition of Participation: G 940 484.105 Organization and administration of services was in compliance as follows: 1. Based on interview and record review, the agency failed to ensure patients' needs were continuously assessed for two of 11 sampled patients…

The agency failed to develop procedures to inform emergency preparedness officials about patients in need of evacuation and the needs the patients would require during the evacuation process, for 21 of 21 months reviewed, in a universe of 137 patients.

The agency failed to develop a policy and procedure for a back-up communication plan with Federal, State, tribal, regional and local emergency management agencies in the event of communications (phone service, including cellular phone and Internet) failure during a disaster or emergency, for 21 of…

The agency failed to develop a policy and procedure to provide information about the agency's occupancy, needs and staff available to help during an emergency or disaster, to the authority having jurisdiction, for 21 of 21 months reviewed, in a universe of 137 patients.

The agency failed to provide training to all staff, as well as contracted staff, on the emergency preparedness policy and procedure titled, "Emergency Preparedness Program [EPP] for [name of home health agency]," undated, for 12 of 12 months reviewed, in a universe of 137 patients.

The agency failed to ensure the comprehensive assessment accurately reflected the patient's status for one of 11 sampled patients (Patient 1) when the admitting Registered Nurse Supervisor (RNS) conducted an incomplete assessment of Patient 1's right heel pressure ulcer (a wound that develops from…

The agency failed to ensure the comprehensive assessment was updated for one of 11 sampled patients (Patient 4) when a Skilled Nurse (SN) failed to give report and receive new orders after the removal of a surgically placed wound dressing and a change in how the wound dressing was applied.

The agency failed to ensure the plan of care was reviewed and signed by a physician within 30 working days of the patient's start of care for one of 11 sampled patients (Patient 1).

The agency failed to provide Skilled Nursing (SN- a Registered Nurse-RN or a Licensed Vocational Nurse-LVN) services as ordered by a physician for one of 11 sampled patients (Patient 1) when four Skilled Nursing (SN) visits were not conducted as ordered.

The agency failed to maintain an infection control program that was integrated into the agency's Quality Assessment Performance Improvement (QAPI) program in order to identify infection trends (analysis of a pattern), develop action plans and improve disease prevention, for nine of nine months…

The agency failed to ensure the patients' initial assessment was completed by a Registered Nurse (RN) within 48 hours of the physician's referral date or on the physician-ordered start of care date for two of 11 sampled patients (Patients 8 and 11).

The agency failed to ensure a review of all medications the patients were taking was conducted for two of 11 sampled patients (Patients 5 and 6) when: 1. For Patient 5, two medications on the Medication Profile (MP - a current list of all medications prescribed for a specific patient) had been…

The agency failed to obtain signed physician orders before providing home health services for one of 11 sampled patients (Patient 1).

The agency failed to ensure verbal orders were signed, within 30 working days, for one of 11 sampled patients (Patient 1).

The agency failed to alert the physician of a change of condition for one of 11 sampled patients (Patient 1) when a surgical wound opened up on Patient 1's right ankle exposing metal pins and plates affixed to and holding together, Patient 1's right ankle.

The agency failed to coordinate wound care with an outside wound care service for one of 11 sampled patients (Patient 1) when Patient 1's right heel pressure ulcer (injury to skin and underlying tissue resulting from prolonged pressure on a person's heel) did not receive treatment for 41 days while…

The agency failed to ensure its performance improvement activities lead to an immediate correction, of a loss of limb, due to an infection that took hold during home health agency services for one of 11 sampled patients (Patient 1).

The agency failed to ensure patients' needs were continuously assessed for two of 11 sampled patients (Patient 1 and 3) when: 1. For Patient 1, a Licensed Vocational Nurse (LVN 1) and a Registered Nurse (RN 1) failed to assess Patient 1's right heel pressure ulcer (a wound caused by prolonged…

The agency failed to provide Certified Home Health Aide (CHHA) services for one of 11 sampled patients (Patient 1).

The agency failed to ensure a Registered Nurse (RN 1) followed accepted professional standards of practice for one of 11 sampled patients (Patient 1) when RN 1 gave clinical report for a change of condition to non-licensed office staff.

The home health agency failed to ensure the infection control and prevention program was followed when: 1. The Licensed Vocational Nurse (LVN 1) placed down the chuck (barrier ) on the floor area for use and placed the treatment supplies on the chuck while doing treatment to Patient 1.

The home health agency failed to ensure the discharged patient records were locked and stored in a storage room with a lock.

The agency failed to ensure that one of 10 sampled patients (Patient 4) medication regimen profile were accurate.