Universal Home Health, Inc.

The agency failed to: (E-0004) maintain, review and update the emergency preparedness at least every 2 years; (E-0006) develop a community-based risk assessment prior to developing the agency's emergency plan; (E-0009) include a process for cooperation and collaboration with local, tribal…

This facility failed to ensure the following: (G-0640) that a Quality assessment and performance improvement program (QAPI) was established, developed, implemented, maintained, and evaluated, and reflected implementation of process improvement measures to improve quality of patient care requiring…

The Governing body failed to insure a method to evaluate the data collected to identify a concern about the provision of services, and a method to determine whether actions taken improved the provision of services.