Thomas Nursing Services Inc

The home health agency failed to meet the requirements for the Condition of Participation: Organization and Administration of Services when the agency failed to: - Ensure the availability of a clinical manager during all operating hours (G950); - Ensure the availability of a pre-designated person…

The home health agency failed to ensure that a clinical manager was available to provide oversight of all patient care services and personnel when the registered nurse (RN) appointed as the clinical manager resigned without notice and the agency had no other employees qualified to act as the…

The home health agency failed to ensure the availability of adequate staffing in order to provide skilled nursing services to patients on a visiting basis.

The administrator failed to ensure that a clinical manager was available during all operating hours when the registered nurse (RN) appointed as the clinical manager resigned without notice and the agency had no other employees qualified to act as the clinical manager.

The home health agency failed to ensure that the pre-designated person qualified to act in the absence of the administrator was available during all operating hours, when the registered nurse (RN) clinical manager appointed as the pre-designated person, resigned without notice and the agency had no…

The agency failed to ensure: - The plan of care was followed in three (Records/Patients #1, #3, and #5) of five applicable cases; and - The plan of care included measurable outcomes and goals established by the agency and the patient in one (Record/Patient #3) of five applicable cases.

The agency failed to ensure the registered nurse (RN) observed the home health aide perform all tasks required on the Missouri competency evaluation basic skills test in two (Employees/Personnel Files A and B) of two applicable cases.

The agency failed to obtain a certificate of waiver laboratory project (CLIA) certificate required for monitoring/performing of laboratory testing.

The agency failed to provide written notice of all the patient's rights and responsibilities under this rule in one (Record/Patient #1) of one applicable case admitted to the agency under the new federal home health regulations on or after 01/13/18. This deficient practice has the potential to…

The agency failed to provide contact information for the agency's administrator in one (Record/Patient #1) of one applicable case admitted to the agency under the new federal home health regulations on or after 01/13/18. This deficient practice has the potential to affect the exercise of rights for…

The agency failed to provide the phone number and hours of operation for the state home health telephone hotline in, but not limited to, one (Record/Patient #1) of three applicable cases.

The agency failed to provide required information for Federally-funded and state-funded entities that serve the area where the patient resides (Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and Disability Resource Center, and Quality Improvement Organization)…

The agency failed to assure that patients received the initial assessment visit by the skilled nurse (SN) within the required 48 hour time frame in one case (Record/Patient #1) of five records reviewed.

The agency failed to ensure the registered nurse (RN) performed an accurate review/update of all medications the patient was currently using in three (Records/Patients #1, #2, and #3) of five cases.

The agency failed to ensure the registered nurse (RN) supervised the licensed practical nurse (LPN) in one (Record/Patient #2) of one applicable case.

The agency failed to ensure the registered nurse (RN) performed aide supervisory visits at least every 14 days in, but not limited to, one (Record/Patient #2) of three applicable cases.

The agency failed to ensure a registered nurse (RN) made an annual onsite visit to observe and assess the home health aide while performing care on a patient in two (Employee/Personnel Files A and D) of two applicable cases.

The agency failed to ensure the registered nurse (RN) prepared and/or updated the home health aide assignment in three (Records/Patients #1, #2, and #3) of three applicable cases.

The agency failed to offer the hepatitis B vaccine and vaccination series in four (Employees/Personnel Files A, B, C, and D) of four applicable cases.