Palmeira Home Healthcare

The agency failed to ensure a physician order was clear, complete and appropriately authenticated and dated for 1 of 18 patients (Patient #14) and failed to ensure a home health aide documented vital signs for 1 of 18 patients (Patient #15).

The agency failed to ensure its admission booklet contained the correct home health hotline phone number for all patients.

The agency failed to ensure it documented the existence and resolution of complaints for 1 of 18 patients (Patient #15).

The agency failed to ensure a start of care was conducted within 48 hours of discharge for 1 of 18 patients (Patient #1).

The agency failed to ensure a patient's allergies were addressed for 2 of 18 patients (Patient #5 and #9) and failed to ensure an accurate medication profile for 2 of 18 patients (Patient #13 and #14).

The agency failed to ensure it conducted and documented skilled visits as ordered for 8 of 18 patients (Patient #1, #3, #4, #5, #7, #14, #15 and #16).

The agency failed to ensure it notified a physician or the discharging hospital regarding the need for orders to address the presence of an intravenous line for three days after the start of care for 1 of 18 patients (Patient #1).

The agency failed to ensure a missed visit was documented clearly as to why the visit was missed and notify the physician accordingly for 1 of 18 patients (Patient #2) and failed to document a missed visit and notification of a change to the plan of care for 1 of 18 patients (Patient #15).

The agency failed to ensure it arranged for a mobile physician in a timely manner for 1 of 18 patients (Patient #18).

The agency failed to ensure it notified a patient of a missed visit in a timely manner for 1 of 18 patients (Patient #3).

The agency failed to ensure it delivered services specified in the plan of care for 1 of 18 patients (patient #7).

The agency failed to follow a skilled wound provider's wound care order for 2 of 18 patients (Patient #1 and #3), failed to follow skilled nurse frequency orders for 1 of 18 patients (Patient #11) and failed to ensure contact regarding or completion of initial evaluations within 5 days for 2 of 18…

The agency failed to ensure a physician signed the plan of care in a timely manner for 1 of 18 patients (Patient #18).

The agency failed to ensure as needed pain medication had specific time range limitations ordered for 1 of 18 patients (Patient #12).

The agency failed to ensure it conducted skilled nursing visits only as ordered by a physician for 2 of 18 patients (Patient #3 and #4).

The agency failed to ensure a physician was notified regarding a diastolic blood pressure reading below the ordered parameter for 1 of 18 patients (Patient #5).

The agency failed to identify pressure wounds and demonstrate that the agency had continued to assess and monitor the wounds on a regular basis for 1 of 18 patients (Patient #18).

The agency failed to ensure the clinical record included a current/complete order for 2 of 18 patients (Patient #1 and #3) and provider clinical notes for 2 of 18 patients (Patient #1 and #16).

The home health agency failed to maintain an effective infection control program that protected patients, families, visitors, and home health personnel in 2 of 2 survey joint home visits conducted with a home health patient (Patient (P)1, P 2), where wound care was completed.

The home health agency failed to ensure that annual infection control education had been documented for each staff member providing patient care services in four of 6 personnel files (Clinical Coordinator (CC) 1, CC2, Registered Nurse (RN) 2, and Physical Therapist (PT)1) reviewed.

The home health agency failed to ensure the skilled nurse coordinated care delivery to meet patient's needs and involve the patient and caregiver in the coordination of care activities in order to minimize patient discomfort and maximize the effectiveness of the patient plan of care for 1 of 4…

The home health agency failed to ensure the skilled nurse provided ongoing interdisciplinary assessment of the patient in 1 of 4 record (Patient (P) 6) reviews conducted where wound care and assessment was required.

The agency failed to develop and maintain an emergency preparedness communication plan that complies with Federal, State and local laws, was reviewed and updated at least annually and included a primary and alternate means for communicating with staff, Federal, State, tribal, regional, and local…

The agency failed to ensure staff were able to demonstrate knowledge of emergency procedures for 4 of 4 employees interviewed regarding emergency preparedness (Employee #3, #8, #12 and #14).

The agency failed to conduct exercises to test the emergency plan at least annually.

The agency failed to ensure a comprehensive assessment accurately reflect the size of a suprapubic catheter in 1 of 1 sampled patients with a suprapubic catheter (Patient #2).

The agency failed to ensure services were provided in a timely manner or according to agency policy for 3 of 17 sampled patients (Patients #6, #12 and #3).

The agency failed to provide Notice of Medicare Non-Coverage (NOMNC) at the time of a non-coverage event, by having new patients sign blank NOMNC forms during the start of care visit for 3 of 17 sampled patients (Patient #2, #16 and #8).

The agency failed to advised patients of the state toll free home health telephone hot line phone number, and hours of operation for 17 of 17 sampled patients (Patient #1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #11, #12, #13, #14, #15, #16 and #17).

The agency failed to ensure an individualized Plan of Care included the type of service and supplies needed for the care of a suprapubic catheter for 1 of 1 sampled patients with a suprapubic catheter (Patient #2).

The agency failed to ensure coordination with the physician occurred in order to ensure care and treatment of a suprapubic catheter was provided to 1 of 1 sampled patients with a suprapubic catheter (Patient #2) and failed to inform the physician services were not provided as ordered for 3 of 17…