Visiting Nurse Association

3. Patient #3 had a start of care date of 4/18/17. The clinical record included documentation of a Recertification Comprehensive Assessment, dated 12/12/17. The Assessment lacked documentation of an individualized emergency plan based on the results of a risk assessment .

The home health agency failed to ensure training in emergency preparedness policies and procedures to all individuals providing services under arrangement.

The agency failed to notify the physician of changes in the patient condition that would require modifications to the Plan of Care for 1 of 4 sampled patients (Patient #5) that required a Resumption of Care.

The agency failed to ensure the accurate completion of all components comprising the Plan of Care for 11 of 12 sampled patients (Patients #1, #2, #3, #4, #5, #6, #8, #9, #11, #12 and #13).

The agency failed to ensure all home health aides successfully completed a competency evaluation program for all basic skills competencies prior to providing care to patients for 1 or 2 sampled home health aides (Staff I) hired since the last survey date (1/28/15).

The agency failed to provide individualized and specific written patient care instructions assigned by a registered nurse (RN) to agency home health aides for 2 of 5 sampled patients receiving home health aide services (Patients #3 and #10).

The agency failed to ensure all home health aides provided services only as ordered by the physician and according to the home health aide written assignment and document the tasks completed during home health aide visits or indicate the reason for omission of a task for 2 of 5 sampled patients…

The agency failed to complete home health aide supervision at least once every 14 days for 2 of 4 sampled patients receiving home health aide services in conjunction with a skilled service (Patients #4 and #8).

The agency failed to ensure the agency staff completed and incorporated accurate documentation into patient clinical records in a timely manner and/or corrected errors in documentation according to agency policy for 11 of 12 sampled patients (Patients #1, #3, #4, #5, #6, #7, #8, #9, #10, #12 and…

The agency failed to transmit accurate Outcome Assessment and Information Set (OASIS) data items collected with each comprehensive assessment for 4 of 5 sampled patients who required the transmission of OASIS data (Patients #1, #3, #6 and #8).

The agency failed to include all prescription and over the counter medications taken by the patient when completing drug regimen reviews with each corresponding comprehensive assessment and/or failed to complete a drug regimen review, including all required components, with each comprehensive…

The agency failed to ensure completion of all pertinent components 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, #4, #8 and #9).

The agency failed to ensure accurate completion of all pertinent components of the discharge comprehensive assessments within 2 days of the agency's knowledge of the patient's return home from an inpatient facility for 4 of 4 sampled patients requiring a resumption of care comprehensive assessment.