Ozarks Healthcare at Home, Home Health

The home health provider failed to: - Ensure that patient specific education was included on the plan of care (G574); - Ensure that the plan of care was followed (G578); - Ensure that care was coordinated between caregivers, patient, and professionals (G608); - Ensure that the patient’s home folder…

The home health provider failed to ensure that the plan of care was followed in two of five full records reviewed (Records/Patients #3 and #5).

The home health provider failed to ensure proper hand hygiene and bag technique were followed in one of three home visits conducted (Record/Patient #2).

The home health provider failed to ensure that the medications in the home matched the provider's medication list in one of three home visits conducted (Record/Patient #2).

The home health provider failed to ensure that patient specific education was included on the plan of care for one of five full records reviewed (Record/Patient #1).

The home health provider failed to ensure that care was coordinated between caregivers, patients, and professionals in one of five full records reviewed (Record/Patient #1).

The home health provider failed to ensure that the home folder contained a visit schedule in two of three home visits (Records/Patients #1 and #3).

The home health provider failed to ensure that the home folder contained a provider medication list in one of three home visits (Record/Patient #3).

The home health provider failed to ensure that the home folder contained the name and contact information of the clinical manager in two of three home visits (Records/Patients #1 and #3).

The home health provider may not train or competency evaluate their home health aides for a period of two (2) years following the date of this survey.

The agency failed to ensure staff followed acceptable standards of practice for infection control in two (Record/Patient #1 and #2) of three home visit observations.

The agency failed to complete the initial assessment of the patient within 48 hours of the referral to home care, or 48 hours after the patient's return home, or on the physician ordered start of care date in one (Patient/Record #1) of five records reviewed.

The agency failed to ensure a complete/accurate medication review and/or update of the patient's medications was completed in, but not limited to, three (Record/Patient #1, #5 and #8) of five full records reviewed.

The agency failed to ensure the physical therapy (PT) plan of care (POC) was reviewed with the physician after the initial evaluation visit and failed to ensure physician orders were obtained for the use of cold therapy in one (Record/Patient #1) of five records reviewed.

The agency failed to ensure each patient received written information related to visit schedule/instructions in one (Record/Patient #8) of three home visits made.

The agency failed to ensure the skilled nurse (SN) documented ongoing assessments in one (Record/Patient #5) of five records reviewed.

The agency failed to ensure the skilled nurse (SN) documented that patient/caregiver education was provided with return demonstration to ensure the caregiver's understanding and capability in performing wound care in one (Record/Patient #5) of five records reviewed and failed to ensure that…

The agency failed to ensure/document the administrator was appointed and approved by the governing body.

The agency failed to ensure a qualified, pre-designated person who is authorized in writing by the administrator and the governing body assumes the same responsibilities and obligations as the administrator when the administrator is not available.

The agency failed to ensure staff obtained a copy of a Durable Power of Attorney (DPOA, enables a trusted person to handle affairs if one becomes mentally incapable of making decisions) upon admission to the home health agency in, but not limited to, three (Record/Patient #1, #2, and #8) of five…

The agency failed to ensure a transfer summary was sent to the receiving facility within two days of becoming aware of the transfer in one (Record/Patient #6) of two discharge/transfer records reviewed and failed to ensure a comprehensive transfer summary that included relevant information was sent…

The agency staff failed to follow the patient's individualized plan of care (POC) related to assessment of the patient's vital signs [temperature (T), pulse (P-heart rate), respiration (R-breathing), blood pressure (B/P-measure of pressure exerted on the walls of any blood vessel, two measurements…

The agency failed to provide written notice regarding the patient's financial obligation in one (Record/Patient #2) of three records reviewed for this standard.

The agency failed to ensure the registered nurse (RN) performed an accurate review/update of all medications the patient was currently taking in, but not limited to, one (Record/Patient #2) of three records reviewed for this standard.

The agency failed to ensure the plan of care (POC) included all of the required elements in, but not limited to, two (Records/Patients #1 and #3) of three records reviewed for this standard.

The agency failed to ensure that the plan of care (POC) included all patient care orders in, but not limited to, one (Record/Patient #1) of three records reviewed for this standard.

The agency failed to provide the patient and caregiver a copy of written instructions outlining the visit schedule, including frequency of visits by agency personnel in one (Record/Patient #2) of three records reviewed for this standard.

The agency failed to provide the patient and caregiver a copy of written instructions outlining the patient's medication schedule/instructions, to include the name, dosage, frequency and which medication would be administered by the agency personnel in, but not limited to, two (Records/Patients #1…

The agency failed to ensure that the home health aide documented/provided care as directed on the aide assignment sheet in, but not limited to, one (Record/Patient #5) of two applicable records.

The agency failed to ensure that the home health aide reported changes in the patient's condition in one (Record/Patient #4) of two applicable records.

The agency failed to ensure that the agency staff evaluated the aide for all of the required elements during the aide supervisory visits in, but not limited to, one (Record/Patient # 4) of two applicable records.

The agency failed to assess/document information regarding the patient's advance directive status in one (Record/Patient #2) of three records reviewed for this standard.

The agency failed to ensure that the clinical record contained documentation for all of the interventions/treatments ordered on the plan of care in, but not limited to, one (Record/Patient #3) of three records reviewed for this standard.

The agency failed to complete or send a discharge summary within five business days of the discharge in one (Record/Patient #5) of one applicable record.