St. Francis Medical Center

The facility failed to ensure a clean surface barrier was placed for clean equipment brought into the home during a home visit.

The facility failed to ensure the administrator was appointed by the governing body.

The facility failed to ensure a pre-designated person who assumes the same responsibilities and obligations as the administrator when the administrator is not available, was provided in writing, as authorized by the administrator and governing body.

For 1 of 2 (Pt #12) patients, with a diagnosis of heart failure, the Agency failed to ensure care was provided as indicated in the Plan of Care (POC).

For 1 of 7 (Pt #1) patients observed during home visits, the Agency failed to ensure infection control measures were observed to prevent the potential for cross-contamination, as per Agency policy.

For 1 of 7 (Pt #5) patients, in which home visits were conducted, the Agency failed to ensure medication lists were accurate and discrepancies were clarified.

In 1 of 5 (Pt #3) patients' records reviewed, the Agency failed to ensure patients, accepted for treatment, had an assigned physician for consultation to approve additions or modifications to the original plan of care.

For 1 of 2 (Pt #7) home visits observed with a skilled nurse, the nurse failed to utilize standard precautions to prevent the transmission of infections.

For 2 of 13 (Pt #6, Pt #9) patients, reviewed for initial assessments, the Agency failed to ensure the initial assessments were conducted within 48 hours of referral or Hospital discharge or on the physician ordered start of care date.

In 1 of 1 (Pt #3) patient record reviewed, the comprehensive assessments lacked an accurate assessment of the patient's current health.

In 3 of 3 (Pt #1, Pt #6, and Pt #7) patients' records reviewed, the Agency failed to ensure medications were reconciled per policy.

For 2 of 17 (Pt #1, Pt #16) patients, the Agency failed to ensure the individualized plan of care (POC) included all the required pertinent elements needed to provide care and services for the patient.

For 1 of 1 (Pt #16) telemonitoring patient, the Agency failed to ensure telemonitoring services were ordered by the physician, in accordance with its' policy.

In 2 of 17 (Pt #1, Pt #3) patients' records reviewed, the Agency failed to ensure the physician was notified of changes in the patient's condition, which indicates outcomes are not being achieved and/or that the plan of care should be altered.

In 1 of 5 (Pt #3) patients' records reviewed, the Agency failed to ensure services were integrated to prevent the potential for negative patient outcomes.

For 4 of 7 (Pt #1, Pt #5, Pt #6, Pt #7) patients, in which home visits were conducted, the Agency failed to ensure written visit schedules, including discipline and frequency of visits, were provided to the patient/caregiver.

In 4 of 7 (Pt #1, Pt #5, Pt #6, Pt #7) patients' records reviewed, the Agency failed to ensure written medication instructions were provided to the patient/patient's caregiver and left in the home per policy.

In 2 of 17 (Pt #10, Pt #11) clinical records reviewed, the Agency failed to ensure services were provided per physician's order.

In 2 of 17 (Pt #11, Pt #17) patients' records reviewed, the Agency failed to ensure patient clinical notes were prepared in accordance with Agency policy.

For 1 of 2 (Pt #1) patients, who received Home Health Aide (HHA) services, the Agency failed to ensure HHA supervision was conducted at least every 14 days.

For 1 of 1 (Pt# 17) patient transfer of care record reviewed. that the Agency failed to complete the transfer of care within 2 days after inpatient admission to the Hospital.