Fhp Home Health

“A review of all current medications CFR(s): 484.55(c)(5) A review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy. This Element is not met as evidenced by: Based on policy review, observation, record review, and interview, the Home Health Agency (HHA) failed to ensure the Registered Nurse (RN) conducted a medication reconciliation during homecare visits for two of ten sampled patients (Patient (P) P3 and P4) reviewed for medication reconciliation. This deficient practice had the potential to affect all patients receiving services from the HHA. Findings include: Review of the Agency’s policy titled, “Plan of Care – CMS (Centers for Medicare and Medicaid) #485 Physicians Orders Care Plan” read, “Care and services provided will be provided according to physicians orders. Orders and current and updated.” 1. Observation during a homecare visit performed by Registered Nurse (RN) 2 on 06/08/26 at 1:00 PM revealed that P4’s “Medication List,” found in P4’s Electronic Medical Record (EMR), did not accurately reflect the medications being administered to the patient in her home. Oxygen currently being administered to P4 at one to two liters per nasal cannula was not on the Agency’s EMR and fluticasone (a nasal spray) one squirt in each nostril, which was indicated on the Agency’s current medication list in the EMR had been discontinued on 05/12/26 and was no longer being administered to P4. During an interview on 06/10/26 at 1:30 PM, P4’s family member/caregiver confirmed P4 was receiving oxygen one to two liters continuously via his/her nasal cannula and confirmed P4’s Fluticasone had been discontinued on 05/12/26. 2. Review of P3’s “Medication List” found in the EMR revealed documentation P3 had Clonidine 0.1 milligram (MG) as an ordered medication. There was no documented evidence P3 was taking Eliquis (a medication used to prevent blood clots) 2.5 MG twice daily. During an observation and interview on 06/09/26 at 9:30 AM while conducting a home visit, P3’s medications were reviewed. It was noted P3 had Eliquis 2.5 MG twice daily in his/her medications with a prescribed date of March 2026 and there was no Clonidine. P3 confirmed he/she was currently taking the Eliquis and no longer taking the Clonidine. During an interview on 06/10/26 at 11:15 AM, the Nurse Manager confirmed the patients were receiving routine skilled nursing visits and indicated that medications were expected to be reconciled by the nurse at every visit. He/she stated her expectation was the medications being administered to patients in their homes should match the Agency’s medication order set.”

“Only as ordered by a physician CFR(s): 484.60(b)(1) Drugs, services, and treatments are administered only as ordered by a physician or allowed practitioner. This Element is not met as evidenced by: Based on policy review, record review, and interview, the Home Health Agency (HHA) failed to ensure Physicians Orders were reviewed and signed/validated timely for three of ten sampled patients (Patient (P) P3, P6 and P8). This deficient practice had the potential to affect all patients receiving services from the HHA. Findings include: Review of the Agency’s undated policy, “Plan of Care – CMS (Centers for Medicare and Medicaid) #485 Physicians Orders Care Plan” read, “Care and services provided will be provided according to physicians orders. Orders and current and updated;” and “Physician services will be provided by a licensed Doctor of Medicine, Osteopathy or Podiatry and include: -Submitting signed orders for Plan of Care and changes in accordance with required time frames.” 1. Record review of P3’s “Plan of Care – Initial CMS 485,” (initial certification orders patient’s following 60 days of care), dated 02/20/26 and found in P3’s Electronic Medical Record (EMR), revealed the orders were not reviewed/validated and signed by the patient’s physician until 04/29/26 (more than two months after P3 began receiving care by the Agency). 2. Record review of P6’s “Plan of Care – Initial CMS 485,” dated 04/03/26 and found in P6’s EMR, revealed the orders were still not reviewed/validated and signed by the patient’s physician as of 06/10/26 (more than two months after P6 began receiving care by the Agency). 3. Record review of P8’s “Plan of Care – Initial CMS 485,” dated 01/28/26 and found in P3’s EMR, revealed the orders were not reviewed/validated and signed by the patient’s physician until 04/08/26 (more than two months after P8 began receiving care by the Agency). During an interview on 06/10/26 at 11:15 AM, the Nurse Manager and Administrator confirmed the agency had been having a difficult time tracking physician’s down to have them review and sign patient care orders for the initiation and recertification of patient care. The Nurse Manager orders were expected to be reviewed and signed within 30 days of the initiation of the orders.”