Palo Alto Community Health

The agency failed to ensure 2 of 2 sampled home health aides (Staff E and Staff F) had documented evidence of competency in the application of a pain patch, which exceeded the level of basic home health aide skills, in the presence of a registered nurse prior to being assigned to perform the task…

The agency failed to provide individualized and specific written patient care instructions from a registered nurse (RN) to agency home health aides for 2 of 3 sampled patients receiving home health aide services (Patients #1 and #6).

The home health agency failed to ensure the drug regimen review identified at a minimum the effectiveness of drug therapy, drug side effects, actual or potential drug interactions, duplicate drug therapy, and/or patient compliance with medications for 3 of 3 sampled patients with observation home…

The agency failed to ensure accurate completion of all components comprising the Plan of Care, including all medical equipment/supplies, all medications and all treatments for 4 of 7 sampled patients (Patients #2, #3, #6 and #7).

The agency failed to provide a complete wound assessment on a weekly basis per agency policy for 1 of 3 sampled patients with a wound (Patient #6).

The agency failed to ensure staff provided care in accordance with accepted infection control standards of practice observed during a home visit for 2 of 3 sampled patients (Patient #1 and #3) with home visits.

The agency failed to wound assessments for 2 of 3 sampled patients with wounds (Patients #4 and #7).

The agency failed to complete a drug regimen review with all of the required components and patient specific for each patient for 7 of 7 sampled patients requiring drug regime reviews (Patients #1, #2, #3, #4, #5, #6 and #7 ).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment and medications used by the patient for 3 of 3 sampled patients with surveyor home visit observation(Patients #2, #3 and #6).

The agency failed to provide medications, treatments or services only as ordered by the physician for 1 of 1 sampled patients with coumadin ordered and 1 of 4 sampled patients with physical therapy (PT) Patient #1. The agency reported a current patient census of 32 patients.

The agency failed to provide copies of paperwork signed by the patient identifying the treatments to be administered by the agency for 2 of 3 patients with home visits ( Patients #1 and #3).

The clinical record review identified the record lacked a copy of the patient's individualized emergency preparedness plan.

The agency failed to assure all clinician's followed basic infection control practices when providing care to agency patients for 1 of 3 sampled patients with home visits (Patient #2).

The agency failed to ensure agency staff advised the patient of the extent to which payment for agency services may be expected and the charges for services that may not be covered from Medicare, Medicaid, or any other federally-funded or federal aide program known to the agency and the charges the…

The agency failed to accurately complete a drug regimen review (DRR), including completion of all required components and identification of any findings within the required time frames as part of the comprehensive assessment for 7 of 7 sampled patients (Patients #1, #2, #3, #4, #5, #6 and #7).

The agency failed to ensure accurate completion of all pertinent components of the resumption of care comprehensive assessments within 48 hours of the agency's knowledge of return home from an inpatient facility for 1 of 3 sampled patients requiring a resumption of care assessment (Patient #1).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including frequency and duration and duration of visits to be made, patient specific interventions, medications, and/or equipment/supplies used to meet the patient's individualized needs for 7 of 7…

The agency failed to update the Plan of Care with all new physician orders in a timely manner for 5 of 5 sampled patients with interim/verbal orders.

The agency failed to complete and send a transfer summary and discharge to the physician or other health care professionals responsible for providing care to the patient while in a health care facility within 2 business days of knowledge of the occurrence of the transfer for 3 of 3 sampled patients…