Mga Homecare

“Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician or allowed practitioner refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician or allowed practitioner is consulted to approve additions or modifications to the original plan. This Standard is not met as evidenced by: Based on interviews and record reviews, the agency failed to follow the plan of care, specifically by approaching the physician or allowed practitioners to reduce the frequency of services based solely on the availability of the agency staff for 1 of 7 patients. (Patient #1) Findings include: 1. The clinical record for Patient #1 was reviewed on 12/30/24. Plan of care orders for the certification period dated 11/7/24 to 1/5/25 revealed a start of care date of 11/13/23; diagnoses included infantile spinal muscular atrophy, gastronomy status, congenital deformities of the hip, scoliosis, deforming dorsopathy, lack of expected normal physiological development in childhood, dependence on other enabling machines and devices. Plan of care orders included skilled nursing services seven days a week for complete total care to include ventilator care, gastronomy tube feedings, airway maintenance, medication administration, and non weight bearing transfers. a. The agency failed to follow the plan of care, specifically by approaching the physician or allowed practitioners to reduce the frequency of services to Patient #1 based solely on the availability of the agency staff. A review of Patient #1’s record revealed the agency had sent a nurse to the Patient #1’s home on 11/7/24 to recertify the patient for home care skilled nurse services despite knowing the agency did not have the skilled nurse on staff to provide care. A review of the recertification documentation sent to the physician revealed the agency had documented the following “Patient to receive 80 hours a week upon obtaining authorization and identification of staff. The family is aware of the recruiting efforts of the agency.” An interview was conducted on 12/31/24 at 10:20 a.m., with the vice president of clinical operations, administrator and director of nursing (DON) revealing the agency was unaware they were not allowed to approach physicians to reduce patient care hours based solely on the availability of the agency staff. They acknowledged Patient #1 was dependent on the agency’s skilled nurse services for total care and they failed to follow the plan of care and physician’s orders.”

“Be free from abuse CFR(s): 484.50(c)(2) Be free from verbal, mental, sexual, and physical abuse, including injuries of unknown source, neglect and misappropriation of property; This Element is not met as evidenced by: Based on interviews and record reviews the agency failed to protect patient rights specifically; to provide goods and/or services necessary to avoid physical harm, mental anguish or mental illness for 1 of 7 patients (Patient #1). Findings include: 1. The clinical record for Patient #1 was reviewed on 12/30/24. Plan of care orders for the certification period dated 11/7/24 to 1/5/25 revealed a start of care date of 11/13/23; diagnoses included infantile spinal muscular atrophy, gastronomy status, congenital deformities of the hip, scoliosis, deforming dorsopathy, lack of expected normal physiological development in childhood, dependence on other enabling machines and devices. Plan of care orders included skilled nursing services seven days a week for complete total care to include ventilator care, gastronomy tube feedings, airway maintenance, medication administration, and non weight bearing transfers. a. The agency failed to provide goods and/or services necessary to avoid physical harm, mental anguish or mental illness. A review of Patient #1’s record revealed the agency had stopped providing skilled nurse services on 11/8/24 and through the present day of 12/31/24. An interview was conducted on 12/31/24 at 10:18 a.m., with the vice president of clinical operations, administrator and director of nursing (DON) revealed the agency had staffing issues and did not have a skilled nurse to provide patient care. During the same interview, they admitted that the agency failed to deliver the required care, treatment, and services to Patient #1, recognizing this as a neglectful practice that they aim to rectify promptly.”