Sea Island Comprehensive Health Care Corporation

The home health agency failed to provide the contact information for emergency officials in its facility based and community based risk assessment in its Emergency Preparedness Program.

The home health agency failed to provide a complete list of names and contact information for physicians, other home health agencies, and entities providing services under arrangements.

The home health agency failed to provide contact information for emergency officials in all of the counties served by the home health agency.

The home health agency failed to provide the contact information for emergency officials in all of the counties served by the home health agency.

The home health agency's staff failed to produce documentation that the patient/caregiver received and acknowledged the receipt of patient rights information or the consent for treatment for 4 of 7 patient charts reviewed for care and services.

The home health agency failed to perform the patient's initial nursing assessment with in 46 hours of the physician referral for two of seven patient records reviewed for care and services.

The home health agency failed to ensure the patient's plan of care developed by the Registered Nurse (RN) and approved by the physician was followed for missed visits for two of seven patient records reviewed for care and services.

The home health agency failed to include infection control indices in its QAPI Program.

The home health agency failed to show that its quality program tracked adverse patient events, analyzed their causes, or implemented preventative actions based on the causes through it quality program.

The home health agency failed to ensure its Quality Assessment and Performance Improvement (QAPI) Program included the identification and implementation of performance improvement project(s).

The home health agency's governance failed to ensure oversight of its Quality Assessment and Performance Improvement (QAPI) Program in the omission of its infection control data was not included in the home health agency's Quality program.

The Home Health Agency failed to develop a system to capture its data for complaints and grievances.

The home health agency failed to produce a nursing after hours on-call schedule and a call log of patient after hours calls received.

The home health agency failed to provide coordination of care for three of seven patient records reviewed.

The home health agency failed to include its infection control program data as a high-risk, high volume, and problem-prone area in its quality program.

The Administrator failed to provide documentation to verify a Clinical Manager was available during all operating hours of the home health agency.