Trinity Home Health Services

The agency: 1) Failed to ensure the agency skilled staff completed an individualized Plan of Care that contained accurate information.

The agency reported hiring 19 employees either directly or by contract since 6/29/16. Failure to complete the required backgrounds checks according to the State of Iowa requirements placed agency patients at risk for potential harm.

The agency failed to have a written policy and procedure for cooperation and collaboration with tribal, regional, State, and Federal emergency preparedness officials.

The agency failed to have a written policy and procedure that individual emergency preparedness plans for each patient must be included as part of the comprehensive patient assessment and a copy of the individualized emergency preparedness plan to be kept in the patient's file as well as a copy…

The agency failed to have a written policy and procedure for the use of volunteers in an emergency or other emergency staffing strategies, including the process and role for integration of State and Federally designated health care professionals to address surge needs during an emergency.

The agency failed to ensure training in emergency preparedness to all existing staff consistent with their expected roles for directly hired and contracted staff in 2017 and 2018. The agency provided services to 158 patients at the time of the survey.

The agency failed to provide an initial assessment visit within 48 hours of receipt of referral and/or return home, for 6 of 17 sampled patients (Patients #2, #5, #6, #10, #13 and #14).

The agency failed to ensure timely completion of the update of the comprehensive assessment between day 56 and 60 of each 60 day certification period for 2 of 4 sampled patients requiring a recertification assessment (Patients #9 and #15).

The agency failed to ensure accurate completion of all pertinent components of the update to the comprehensive assessment within 48 hours of the agency's knowledge of return home from an inpatient facility for 1 of 4 sampled patients requiring a resumption of care assessment (Patient #11).

The agency failed to ensure completion of the update of the comprehensive assessment at discharge within 2 calendar days of identification of the need to discharge a patient for 2 of 5 sampled patients requiring a discharge comprehensive assessment (Patients #13 and #15).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care and/ or failed to ensure the Plan of Care contained current, accurate information for 5 of 18 sampled patients (Patients #2, #4, #6, #9, and #12,).

The agency failed to update the Plan of Care with all new orders for 14 of 18 sampled patients (Patients #1, #3, #4, #5, #6, #7, #8, #9, #10, #11 #12, #14, #17 and #18) with interim physician non-therapy treatment orders.

The agency failed to administer medications and treatments only as ordered by the physician for 1 of 6 sampled patients (Patient #1).

The agency failed to report changes in patient clinical findings or changes in patient needs to the physician for 3 of 18 sampled patients (Patients #3, #15 and #16).

The agency failed to ensure patient care delivery was coordinated in a way to meet patient individualized needs for 2 of 18 sampled patients (Patients #3 and #8).

The agency failed to ensure a registered nurse or other appropriate health care professional completed home health aide supervision at least every 14 days for 2 of 8 sampled patients who received hands on personal care services in conjunction with skilled service provision (Patients #15 and #17).

The agency failed to complete and send a transfer summary to the physician caring for the patient at the inpatient facility after transfer within 2 business days of the patient's transfer and/or failed to complete and send a discharge summary to the physician and other health care professionals who…