Southeast Iowa Regional Home Health

The agency failed to report changes in patient clinical findings or changes in patient needs to the physician for 3 of 13 sampled patients (Patients #2, #7 and #9).

The agency failed to perform complete and accurate drug regimen reviews with corresponding comprehensive assessments for 2 of 14 sampled patients (Patients #5 and #13).

The agency failed to ensure agency staff accurately completed of all components comprising the Plan of Care, including identifying all supplies/equipment used by the patient for 4 of 14 sampled patients (Patients #3, #4, #6 and #9).

The agency failed to administer treatments only as ordered by the physician for 1 of 1 sampled patients (Patient #3) with home visit observation of a medication set up and 1 of 3 sampled patients (Patient #3) with physician orders for the nurse to complete a laboratory blood draw.

The agency failed to ensure skilled professionals provided care as ordered by the physician in the Plan of Care for 2 of 12 sampled patients (Patients #5 and #12) with a skilled nursing service.

The agency failed to ensure the patient's clinical record included accurate and specific documentation of interventions and maintained pertinent current information in the patient record for 3 of 14 sampled patients (Patients #2, #5 and #10).

The agency failed to complete and send a transfer summary to the receiving facility in 2 business days of the patient's transfer for 3 of 5 sampled patients (Patients #8, #11 and #14) with a transfer to an inpatient facility.

The agency failed to ensure 4 of 5 sampled home health aides (Staff F, G, H and I), assigned to perform tasks requiring extra skills exceeding the level of basic home health skills for 2 of 5 sampled patients (Patients #6 and #8); had documented evidence of competency by a registered nurse in the…

The agency failed to ensure the accurate completion of all components comprising the Aide Care Plan for 2 of 4 sampled patients (Patients #6 and #11).

The agency failed to complete a drug regimen review, including all required components, with each comprehensive assessment for 2 of 11 sampled patients (Patients #4 and #7).

The agency failed to ensure accurate completion of all pertinent components of the recertification comprehensive assessments between day 56 and 60 of each 60 day certification period for 1 of 6 sampled patients requiring a recertification comprehensive assessment (Patient #11).

The agency failed to ensure completion of a discharge comprehensive assessments within 2 days of the agency's knowledge of the need for discharge for 1 of 3 sampled patients discharged from agency services (Patient #7).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care and/or failed to ensure the Plan of Care contained current, accurate information for 3 of 11 sampled patients (Patients #1, #2 and #4).

The agency failed to administer medications and treatments only as ordered by the physician for 2 of 11 sampled patients (Patients #2 and #9).

The agency failed to ensure that registered nurses coordinated between other services offered by the home health agency and with physicians for 3 of 11 sampled patients (Patients #2, 9 and #11).

The agency failed to document whether extra skills competencies were evaluated in a laboratory setting using a pseudo patient or in a home setting while being performed on an actual patient for 6 of 6 sampled home health aides (Staff F, G, H, I, J and M).

The agency failed to ensure home health aides provided services according to the home health aide written assignment for 2 of 4 sampled patients (Patients #8 and #9) receiving aide services.

The agency failed to complete home health aide supervision at least once every 14 days for 1 of 4 sampled patients receiving home health aide services in conjunction with a skilled service (Patient #9).

The agency failed to ensure a registered nurse (RN) completed home health aide supervision at least every 60 days while observing the home health aide present and providing direct patient care for 1 of 1 sampled patients who received hands on personal care services with no skilled service provision.