The Center for Hospice and Palliative Care Inc

The home health agency failed to ensure an occupational therapy (OT) evaluation was conducted within 5 days of SOC for 1 of 1 records reviewed of a patient referred to the agency for OT (Patient #2).

The home health agency failed to ensure the initial comprehensive assessment included a complete assessment of the patient’s health needs for 1 of 1 record reviewed of a patient with a left ventricular assist device and wounds (Patient #1).

The home health agency failed to ensure the POC included all nursing interventions for 1 of 2 records reviewed of patients who received more than one SN visit per week.

The home health agency failed to ensure the physician was notified for a change in wound bed tissue and/or measurements for 2 of 2 records reviewed with worsening of wound bed tissue or measurements (Patient #1, 3).

The skilled nurse failed to conduct a complete and thorough assessment of the patient for 3 of 7 records reviewed (Patient #1, 3, 7).

The agency failed to ensure discharge or transfer summary contained sufficient information about current course of illness and treatment, post-discharge goals of care, and treatment preferences to ensure continuity of care in 4 of 4 patients who were transferred or discharged, from a total sample…

The agency failed to ensure coordination of care between therapy services and home health agency staff to ensure treatment effectiveness in 1 of 5 clinical records reviewed.

The agency failed to ensure completed transfer summary was sent within 2 business days of becoming aware of unplanned transfer in 1 of 4 clinical records reviewed.

The home health agency (HHA) failed to develop and implement an effective discharge planning process for the agency; failed to develop/maintain discharge/transfer summary policies, which included discharge/transfer summary content and procedure(s) to ensure the receiving facility received necessary…

The agency failed to ensure its Emergency Preparedness Plan included agency specific strategies for addressing emergency events.

The home health agency (HHA) failed to ensure its Emergency Preparedness Plan addressed its patient population and the type of services the HHA provided during an emergency.

The home health agency (HHA) failed to develop Emergency Preparedness policies and procedures specific to the HHA.

The home health agency (HHA) failed to ensure the registered nurse developed an individualized emergency preparedness plan for all agency patients during the completion of the comprehensive assessment, and failed to ensure all patients received a copy of their individualized emergency plan for 3 of…

The home health agency (HHA) failed to ensure its Emergency Preparedness Plan policies included the agency’s specific procedures to follow up with on-duty staff and patients.

The home health agency (HHA) failed to ensure its Emergency Preparedness Plan policies included a process for the use of volunteers during an emergency, or other agency specific emergency staffing strategies.

The home health agency (HHA) failed to ensure its Emergency Preparedness Communication Plan required contact information for the HHA employees, and failed to include names and contact information for entities who provided services under arrangement, all patients’ physicians, or volunteers.

The home health agency (HHA) failed to ensure its Emergency Preparedness Communication Plan contained contact information for Federal, State, tribal, regional, local emergency preparedness staff, or other sources of assistance.

The home health agency (HHA) failed to ensure its Emergency Preparedness Communication Plan contained the detailed method for sharing information and medical documentation for patients under the HHA’s care, or how the HHA would provide information about the general condition and location of…

The home health agency (HHA) failed to ensure its Emergency Preparedness Communication Plan contained the means of providing information about the HHA’s occupancy, needs, or ability to provide assistance, to the authority having jurisdiction, the Incident Command Center, or designee.

The home health agency (HHA) failed to ensure its Emergency Preparedness Program (EPP) designated itself as part of an integrated healthcare system, Findings include: A document updated October 2021, titled “Center for Hospice Care ... Emergency Preparedness Program” included all of the agency’s…

The agency failed to accurately document the patient’s referral date and/or the physician’s ordered start of care date on the initial OASIS (outcome and assessment information set) Assessment form for 3 of 7 records reviewed (#1, 6, 7).

The agency failed to ensure all patients received the home health services ordered on the plan of care (POC) for 4 of 7 records reviewed, (#1, 3, 6, 7); failed to ensure all patients’ plans of care were individualized, and included patient-specific measurable outcomes and goals for 7 of 7 records…

The agency failed to ensure all clinical record documents were legible, complete, appropriately authenticated, and/or timed for 3 of 7 records reviewed (#1, 6, 7).

The agency failed to ensure the patient and/or caregiver participated in and consented to the development of the plan of care which included (but not limited to) the disciplines that would furnish the care, the frequency of visits, and/or the care that was furnished for 3 of 3 home visits observed…

The registered nurse (RN) failed to ensure the patient’s medication profile included all the medications the patient currently took, included indications for use, and/or correct dose for 5 of 7 records reviewed (#1, 2, 4, 6, 7).

The agency failed to ensure the patient’s plan of care included all required elements such as (but not limited to) all pertinent diagnoses, the patient’s mental, psychosocial, and/or cognitive status, all equipment and/or supplies, all medications and/or treatments, or all necessary interventions…

The agency failed to ensure the physician was notified for 1 of 1 patient (#4) who experienced a significant change in condition resulting in an emergency department (ED) visit and subsequent hospitalization, from a total sample of 7. Findings include: A document revised date 07/2019 titled…

The home health agency (HHA) failed to provide all patients and/or caregivers a written home visit schedule that included frequency of visits by HHA personnel and personnel acting on behalf of the HHA for 3 of 3 home visits observed (#5, 6, 7).

The home health agency (HHA) failed to provide all patients and/or caregivers a written medication schedule for 3 of 3 home visits observed (#5, 6, 7).

The agency failed to provide all patients and/or caregivers written documentation of any treatments or care that was administered/provided by agency personnel and/or personnel acting on behalf of the agency, which included therapy services, for 3 of 3 home visits observed (#5, 6, 7).

The agency failed to provide all patients and/or caregivers written documentation of the name and contact information of the agency’s clinical manager for 3 of 3 home visits observed (#5, 6, 7).

The agency failed to ensure skilled professionals provided services that were ordered by the physician for 4 of 7 records reviewed (#1, 2, 6, 7).

The agency failed to ensure the skilled professional (registered nurse, therapist) communicated with the physician related to the current plan of care for 4 of 7 records reviewed (#1, 4, 6, 7).