Piggott Health System Southeast Missouri Home Health

The home health provider failed to: -Ensure individualized plan of care included patient-specific interventions and education were included in the plan of care (G0574); -Ensure a copy of the visit schedule, including frequency of visits, was provided to the patient (G0614); -Ensure a current copy…

The provider's staff failed to follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases in one of three home visit observations conducted (Record/Patient #2).

The 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 home health provider failed to ensure the timeliness of documentation in one of five full records reviewed (Record/Patient #3).

The home health provider failed to ensure staff performed a complete medication review in three of five full records reviewed (Records/Patients #1, #2, and #3).

The provider failed to ensure the plan of care (POC) included all required treatments and interventions in three of five records reviewed (Records/Patients #1, #2, and #4).

The provider failed to ensure the patient was provided with a written visit schedule, including the frequency of visits by all personnel, in two of three home visit observations conducted (Records/Patients #2 and #3).

The provider failed to ensure the patient was provided a written medication schedule/list, in three of three home visit observations conducted (Records/Patients #1, #2, and #3).

The provider failed to ensure the patient and caregiver received a copy of written instructions specific to the patient’s needs in one of three home visit observations conducted (Record/Patient #1).

The provider failed to ensure the contact information for the clinical manager was provided to the patient in two of three home visit observations conducted (Records/Patients #2 and #3).

The home health provider failed to ensure the aide reported changes in the patient’s condition to a registered nurse (RN) or other skilled professional in three of three reviewed records of patient's receiving home health aide services (Records/Patients #2, #3, and #4).

The home health provider failed to ensure an accurate home health aide (HHA) supervision included ensuring the HHA reported changes in the patient’s condition in one of three reviewed records of patient's receiving home health aide services (Record/Patient #4).

The home health provider failed to ensure Missouri Family Care Safety Registry (FCSR) results were obtained prior to patient contact in two of three employee records reviewed (Employees #1 and #2).

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

The agency failed to provide the written notice of patient rights that included the patient’s right to have a copy of the patient’s rights and responsibilities and the agency’s transfer and discharge policies provided to a patient-selected representative within four business days of the initial…

The agency failed to ensure staff provided written notice of patient rights to include that the Missouri state toll free home health telephone hotline hours of operation were 7:00 AM to 8:00 PM daily in three (Records/Patients #1 #2, and #3) of three home visit observations conducted.

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, two (Records/Patients #1 and #2) of five full records reviewed.

The agency failed to ensure prompt notification of the physician of changes in the patient’s condition or needs in, but not limited to, two (Records/Patients #1 and #4) of five full records reviewed.

The agency failed to ensure that the contract agreements between the home health agency and the agency contracted for services contained the statements that the agency, organization, or individual providing services under arrangement may not have been: (i) Denied Medicare or Medicaid enrollment…

The agency failed to provide evidence of dementia specific training about Alzheimer’s disease in one (Employee #1) of four employee records reviewed.

The agency failed to develop and provide the patient and/or representative with a written notice of patient rights that included all required information based on the new home health regulations effective 01/13/18. The agency failed to provide in writing, in advance of furnishing care the following…

The agency failed to meet the requirements for the Condition of Participation: Care Planning, Coordination of Services, and Quality of Care, when the agency failed to: - Ensure the agency can meet the patient's medical, nursing, rehabilitative, and social needs in his or her place of residence…

The agency failed to meet the requirements for the Condition of Participation: Skilled Professional Services, when the agency failed to: - Ensure the physical therapist and the physical therapist assistant assessed/documented the patient's pain status (G706); - Ensure the skilled nurse and physical…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include the agency's policies for transfer and discharge.

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that information must be provided to patients in a language and in a manner that is accessible and timely to persons with disabilities…

The agency failed to ensure that the home health aide competency evaluation was completed and that the home health aide was competent to perform services before the aide performed personal care to patients in one (Employees/Aides: E 1) of one home health aide employee files reviewed.

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include the administrator's name in order to receive patient complaints.

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include verbal notice of the patient's rights and responsibilities in the individual's language, free of charge, no later than the completion of…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include the written notice to the patient about their right to have a copy of the patient's rights and responsibilities provided to a…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include the patient has the right to be free from verbal, mental, sexual and physical abuse, including injuries of unknown source, neglect and…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include the patient has the right to participate in, be informed about, and consent or refuse care, with respect to completion of all…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include the patient has the right to receive all services outlined in the plan of care The deficient practice has the potential to affect the…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include the patient has the right to be advised of: - The agency must advise the patient and representative of these (financial liability)…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include the patient has the right to be informed of the right to access auxiliary aids and how to access these services.

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that the patient and representative (if any) have a right to be informed of the agency's policies for transfer and discharge when the…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that the agency policy for discharge for cause: - Determines that the patient's or other persons in the home, behavior is disruptive…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that the agency must advise the patient or representative, physicians, and healthcare professionals who will be responsible for…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that if the patient is being considered for discharge for cause, the agency must make efforts to resolve the problem.

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that if the patient is being considered for discharge for cause, the agency must provide the patient or representative with contact…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that the agency must document the problem and efforts made to resolve the problem, if the patient is considered for discharge for cause.

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include the patient and representative (if any) have a right to be informed of the agency's policies for transfer and discharge if the agency…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that if the patient, the patient's representative (if any), or the patient's caregiver or family made a complaint regarding treatment or…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that the agency must investigate mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that the patient had a right to be informed that the agency must investigate and document both the existence and resolution of…

The agency failed to update the written notice of patient rights to meet the requirements of the new federal home health regulations effective 01/13/18 to include that any agency staff in the normal course of providing services to patients, who identifies, notices, or recognizes incidences of…

The agency failed to ensure the patient's strengths, goals, and care preferences, including information that may be used to demonstrate the patient's progress toward achievement of the goals identified by the patient were assessed/documented as part of the patient's comprehensive assessment in, but…

The agency failed to include a description of the patient's risk for emergency department visits and hospital re-admission, and information related to any advanced directives on the patient's plan of care in six (Records/Patients #1, #2, #3, #4, #5, and #6) of six cases reviewed.

The agency failed to ensure drugs and treatments were administered only as ordered by a physician in, but not limited to, one (Record/Patient #1) of six patients reviewed.

The agency failed to provide the patient and/or caregiver a copy of written instructions outlining the visit schedule, including frequency of visits by agency personnel in three (Records/Patients #1, #2, and #3) of three home visit observations conducted.

The agency failed to provide the patient and/or caregiver a copy of written instructions outlining the patient's medication schedule/instructions in plain language, to include the name, dosage, frequency and which medications would be administered by the agency personnel in three (Records/Patients…

The agency failed to provide the patient and/or caregiver a copy of written instructions outlining treatments to be administered, including therapy services/home program plan, in three (Records/Patients #1, #2, and #3) of three home visit observations conducted.

The agency failed to ensure the patient was aware of the name and contact information of the clinical manager in, but not limited to, five patients (Record/Patient #1, #2, #3, #4, and #5) of six cases reviewed.

The agency failed to ensure effective ongoing interdisciplinary assessment of the patient.

The agency failed to ensure services were provided in accordance to the patient's plan of care in, but not limited to, three (Records/Patients #1, #2, and #4) of six cases reviewed.

The agency failed to ensure physical therapy assistant (PTA) services were provided under the supervision of the physical therapist (PT) in, but not limited to, two (Records/Patients #1 and #3) of three applicable cases reviewed.

The agency failed to ensure that the agency staff evaluated the aide for all of the required elements during the aide supervisory visits in one (Record/Patient #4) of one applicable records.

The agency failed to ensure that the governing body authorized in writing a qualified, predesignated, person that would assume the same responsibilities and obligations as the administrator when the administrator was not available.

The agency failed to meet applicable Missouri state law.