Specialized Nursing Services Inc

The home health agency is unable to demonstrate a completed termination summary, including the date of the first visit, discharge date, type of services and frequency and medications the patient is on at the time of discharge, in 2 out of 5 Sampled Patients (SP), SP #4 and SP #5. Findings include…

The provider failed to demonstrate that all new and existing staff have received training on the emergency preparedness updated policies and procedures; and the provider is unable to demonstrate that it has conducted emergency preparedness training at least every 2 years with existing staff.

The provider failed to be in conformance with the physician order for 1 out of 10 Sampled Patients (SP).

The provided failed to notify the physician of a review and revision of the plan of care for 1 out of 10 Sampled Patients (SP).

The provider failed to demonstrate that 6 out of 10 active staff received annual in-service on infection control.

The provider failed to ensure the clinical record includes all entries appropriately authenticated (signature and a title), dated, and timed for 1 out 10 Sampled Patient (SP).

The home health agency failed to demonstrate it had obtained the patient's or legal representative's signature confirming that he or she has received a copy of the notice of rights and responsibilities for 1 out of 10 Sampled Patients (SP).

The provider failed to document all patient care orders in the Plan of Care for 1 out of 10 Sampled Patients (SP).

The provided failed to alert the relevant physician(s) to any changes in the patient's condition or needs that suggest that outcomes are not being achieved and/or that the plan of care should be altered for 1 out 10 Sampled Patients (SP).

The home health agency staff failed to provide service(s) that are ordered by the physician as indicated in the Plan of Care (POC) for 1 out 10 Sampled Patients (SP).

The home health agency staff failed to provide nursing service within the scope of practice related to patient and caregiver education for 1 out of 10 Sampled Patients (SP).

The provider failed to make an annual on-site visit to the location where a patient is receiving care in order to observe and assess each aide while he or she is performing care for 1 out of 2 employee record review.

The provider failed to ensure the clinical record included a completed transfer summary that is sent within 2 business days of becoming aware of an unplanned transfer, if the patient is still receiving care in a health care facility at the time when the home health agency becomes aware of the…

The Home Health Agency failed to develop strategies utilizing an all-hazards approach for addressing the emergency events that were identified by the risk assessment.

The Home Health Agency failed to develop and maintain an emergency preparedness plan that includes a process for cooperation and collaboration with local, tribal, regional, State, and Federal emergency preparedness officials' efforts to maintain an integrated response during a disaster or emergency…

The Home Health Agency failed to develop and implement emergency preparedness policies and procedures based on the emergency plan.

The Home Health Agency failed to show that an individualized emergency plan was completed in its entirety for 2 out of 7 sampled patients (SP).

The Home Health Agency failed to develop and maintain an emergency preparedness communication plan that complies with Federal, State and local laws that includes Names and Contact information for the entities providing services under arrangement.

The Home Health Agency failed to develop and maintain an emergency preparedness training and testing program that is based on its emergency preparedness plan that included strategies and procedures on identified risks and a completed communication plan.

The Home Health Agency failed to conduct : Initial training in emergency preparedness policies and procedures to all new and existing staff, individuals providing on-site services under arrangement consistent with their expected roles and demonstrate staff knowledge of emergency procedures.

The Home Health Agency failed to ensure that all new and existing staff; and individuals providing services under arrangement participated in the table top exercises and the drills conducted by the agency.

The Home Health Agency failed to ensure that Staff C/Registered Nurse (RN) followed accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases for 1 out of 7 Sampled Patients (SP).

The Home Health agency failed to ensure that a Physical Therapist Assistant (PTA) provided care in a prudent manner to 1 out of 7 Sampled Patients (SP).

The Home Health Agency failed to evaluate the Home Health Aide (HHA)'s performance while carrying out the following task with a patient or pseudo-patient.

The Home Health Agency failed to show that 2 out of 7 employees received at least 12 hours of in-service training during each 12-month period.

The Home Health Agency failed to ensure that a Registered Nurse (RN) or other appropriate skilled professional prepared written care instructions for the Home Health Aides (HHA) to follow for 1 out 7 Sampled Patients (SP) reviewed.

The Home Health Agency failed to ensure that all entries in the clinical record were legible for 1 out of 7 Sample Patients (SP).

The Home Health Agency failed to ensure that a Physical Therapist Assistant (PTA) who is actively providing patient care had an active/valid license in her personnel file.

The Home Health Agency failed to demonstrate it had provided written notice of the patient's rights and responsibilities, and the Home Health Agency's transfer and discharge policies to 1 out of 7 Sampled Patients (SP).

The Home Health Agency failed to show that the frequency of visits was provided on the written agreement in a clear manner that the patients and/or the patients' representatives could understand to 2 out of 7 Sampled Patients (SP).

The Home Health Agency failed to provide an advance notice of discharge in advance of reducing or terminating on-going care to 3 out of 7 Sampled Patients (SP).

The Home Health Agency failed to ensure a review of all medications the patients are currently taking was conducted for 3 out of 7 Sampled Patients (SP).

The Home Health Agency failed to ensure that 3 out of 7 Sampled Patients (SP)'s Plan of Care (POC) contained an accurate list of medications that the patients are currently taking.

The Home Health Agency failed to ensure the clinical notes contained all required documentation for 1 out of 7 Sampled Patients (SP).

The Home Health Agency failed to conduct supervisory visits of the Licensed Practical Nurse (LPN) for 2 out of 7 Sampled Patients (SP).

The Home Health Agency failed to demonstrate that a Home Health Aide who is actively providing patient care has successfully completed a training and competency evaluation program.

The Home Health Agency failed to maintain documentation that demonstrates completion of a 75 hours home health aide training for 1 out of 7 employees reviewed.

The Home Health Agency failed to ensure that onsite Registered Nurse (RN) supervisory visits were conducted to evaluate the care rendered by the Home Health Aide (HHA) at a minimum of every 2 weeks for 1 out of 7 Sampled Patients (SP) receiving skilled and Home Health Aide Services.

The Home Health Agency failed to ensure that a Registered Nurse (RN) or other appropriate skilled professional made an annual on-site visit to the location where a patient is receiving care in order to observe and assess a Home Health Aide (HHA).