Vns Ithaca Tompkins Co Chha

In 1 out of 4 records (patient #17) the skilled nurse failed to develop complete and accurate aide written instructions.

In 8 of 17 patients (patients #1, 2, 6, 8, 9, 10, 13, and 17) the agency failed to ensure comprehensive assessments were of sufficient scope to identify all patient needs.

In 2 out of 17 records (patients #1 and 8) the nurse failed to perform complete and accurate medication assessments.

In 4 of 17 records (patients #10, 13, 16 and 17) the agency failed to develop complete and accurate plans of care that were individualized to address the total needs of the patients.

In 2 out of 4 records (patients #9 and 17) the skilled nurse failed to ensure that all home health aides providing services to patients receiving skilled services are supervised no less frequently than every two weeks.

The skilled nurse (SN) failed to follow accepted standards of infection control practices.

In 5 of 7 records (patients # 3, 8, 10, 11 and 12) the skilled nurse (SN) failed to developed complete and accurate aide written instructions.

In 8 out of 17 records (patients #1, 2, 4, 7, 8, 10, 13 and 16) the skilled nurse (SN) failed to complete a comprehensive assessment of sufficient scope to ensure all patient's needs were identified.

In 6 out of 17 records (patients # 2, 3, 5, 6, 9, and 11) the skilled nurse (SN) failed to perform complete and accurate medication assessments.

In 10 out of 17 records (patients # 2, 3, 4, 6, 8, 10, 11, 13, 14 and 15) the agency failed to develop individualized plans of care that were complete, accurate, and addressed the total needs of the patient.

For 7 out of 17 records (patients # 3, 4, 5, 9, 10, 16 and 17), the skilled nurse (SN) failed to promptly alert the physician to patient's needs, or changes in the patient's condition, to determine whether the plan of care should be altered.

In 7 of 12 records reviewed (Patients # 2, 4, 5, 7, 8, 11 and 12), the agency failed to conduct the initial assessment visit within 48 hours of referral or return home to determine immediate care needs.

In 5 of 17 records (Patients # 7, 8, 9, 11 and 15) the agency failed to conduct the initial assessment visit within 48 hours of referral to determine immediate care needs.

The skilled nurse (SN) failed to specify when the aide was to provide the patient with a shower as opposed to a sponge bath, instead leaving it up to the aide to make the determination. - On 12/28/17, 01/11/18, 01/25/18 and 02/01/18 the HHA time sheets revealed the patient refused a shower and…

In 8 out of 16 records, (Patients # 3, 5, 6, 8, 11, 14, 15 and 16) that the initial comprehensive assessments were not of sufficient scope to ensure that all patient's needs are identified.

In 12 out of 17 records (Patients # 1-3, 7, 8-10, 12, and 14-17), the agency failed to develop individualized plans of care that were complete and accurate, and addressed the total needs of the patients.

For 4 out of 17 records (Patients #2, 6, 8 and 14) the Skilled Nurse (SN) failed to consult with the physician when changes in the patient's condition occurred.

In 2 of 17 records (Patients # 12, and 15) the agency failed to ensure the patient's plan of care was effectively coordinated: This was evidenced by: 1. Patient # 12 was admitted to the agency on 05/03/17 with diagnoses of cerebrovascular accident (stroke), congestive heart failure (CHF) and type 2…

In 3 of 17 records (Patients # 6, 11 and 15) patient care provided was not in accordance with the written plan of care, and the physician's orders.