Tama County Public Health & Ho

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including the types of services and the frequency and duration of visits to be made in 2 of 7 sampled patients ( Patient #1 and #6).

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 4 sampled patients (Patients #2, #4 and #7) with wounds.

The agency failed to, prior to initiation of a service, ensure staff advised the patient of the planned frequency of the service; extent to which payment for agency services may be expected; charges for services that may not be covered from Medicare, Medicaid, or any other federally-funded or…

The agency failed to complete a drug regimen review within the required time frames as part of the initial and/or update to the comprehensive assessment for 3 of 8 sampled patients (Patients #3, #7 and #8).

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician, permitted under state law and/or as directed by the skilled professional assigning the home health aide to the patient for 1 of 5 sampled patients receiving home health aide services…

The agency failed to ensure the clinical record included the patient's current documentation according to the agency's expectations/therapy contract for 5 of 5 sampled patients receiving contracted therapy services (Patients #1, #4, #5, #6 and #7).

The home health agency failed to ensure each patient and/or caregiver received a copy of the individualized emergency plan to keep in the home for 2 of 8 sampled patients who currently received home health services from the agency (Patients #1 and #2).

The agency failed to ensure training in emergency preparedness to all existing staff, including staff employed under arrangement of contract, consistent with their expected roles.

The agency failed to maintain a working Plan of Care for patients and update the working Plans of Care with any new verbal/interim physician orders for 5 of 5 sampled patients who had verbal orders after completion of the original Plan of Care.

The agency failed to accurately identify patient charts to indicate advanced directives identified by agency policy for 1 of 10 sampled patients.

The agency failed to ensure a registered nurse (RN) completed home health aide supervision at least every 60 days while observing each home health aide who provided direct patient care for 1 of 2 sampled patients who received hands on personal care services with no skilled service provision.

The agency failed document all required components of home health aide supervision every 14 days when a skilled services was provided in conjunction with the aide services and every 60 days when no skilled service was provided for 3 of 4 sampled patients receiving home health aide services for…