University of Iowa Health Care Medical Center Downtown Home Health

The agency: 1) Failed to ensure start of care comprehensive assessments were completed by the fifth day following each patient's start of care.

The agency: 1) Failed to ensure the agency met the patients' assessed needs for therapy services.

The agency failed to: 1) To maintain all patient documentation in the agency's primary home health office and to maintain accurate, complete clinical records for agency patients.

The home health agency failed to ensure the clinical record included an assessment of the emergency plan as part of all comprehensive assessments 3 of 10 sampled patients (Patients #1, #6 and #9).

The agency failed to ensure training in emergency preparedness for all staff, including individuals providing services under arrangement (contract staff), consistent with their expected roles for the calendar year of 2018. The agency employed a total of 36 directly hired staff and utilized a total…

The agency failed to ensure accurately and thoroughly complete completion of the other follow up (significant change in condition) comprehensive assessment in a timely manner for 1 of 1 sampled patients requiring a significant change in condition assessment (Patient #12).

The agency failed to follow a Plan of Care established and periodically reviewed by a doctor of medicine, osteopathy or podiatry, or notify the physician of the need to vary from the physician ordered Plan for 6 of 10 sampled patients (Patients #1, #2, #4, #6, #8 and #10).

The agency failed to ensure authentication of hand written entries made in each patient's clinical record included the employee's signature, title, date and time of the signature for 4 of 4 sampled patients with hand written visit documentation completion (Patients #1, #3, #4 and #7).

The agency failed to ensure the completion of all pertinent components of the comprehensive assessment by the fifth day following the start of care for 3 of 10 sampled patients (Patients #1, #2 and #4).

The agency failed to ensure accurate and thorough completion of all pertinent components of comprehensive assessments for 3 of 12 sampled patients (Patients #6, #8 and #9).

The agency failed to ensure timely completion of the recertification comprehensive assessments between day 56 and 60 of each 60 day certification period for 4 of 7 sampled patients requiring a recertification assessment (Patients #3, #7 #10 and #12).

The agency failed to ensure accurate completion of all pertinent components of the resumption of care comprehensive assessments within 48 hours of the agency's knowledge of return home from an inpatient facility for 3 of 3 sampled patients requiring a resumption of care assessment (Patients #1, #6…

The agency failed to ensure completion of the discharge comprehensive assessments within 2 calendar days of identification of the need to discharge a patient for 2 of 2 sampled patients requiring a discharge comprehensive assessment (Patient #8 and #9).

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment used by the patient to meet patient needs, medications taken by the patient and patient risk for emergent care and hospitalization risk, including all necessary…

The agency failed to provide medications, treatments or services only as ordered by the physician for 3 of 3 sampled patients receiving home visits during the survey (Patients #1, #2 and #3).

The agency failed to coordinate care and integrate services to assure patient needs are being met for 3 of 10 sampled patients with home visit observations (Patients #2, #3 and #4).

The agency failed to ensure 3 of 3 sampled home health aides (Staff E, I and J), assigned to perform tasks requiring extra skills exceeding the level of basic home health skills for 1 of 7 sampled patients with home health aide services (Patient #5), had documented evidence of competency evaluation…

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 present and providing direct patient care for 1 of 1 sampled patients who received hands on personal care services with no skilled service…

The agency failed to ensure the clinical record contained complete, wound assessments for 1 of 3 sampled patients with wounds.

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…