Nett Hands Home Care, Inc.

“Encoding and transmitting OASIS CFR(s): 484.45(a) Standard: An HHA must encode and electronically transmit each completed OASIS assessment to the CMS system, regarding each beneficiary with respect to which information is required to be transmitted (as determined by the Secretary), within 30 days of completing the assessment of the beneficiary. This Standard is not met as evidenced by: Based on a review of the Agency’s OASIS submission report and staff interview it was determined that the Agency failed to submit OASIS assessment within the required time frame. Findings include: 1. The Agency’s past 12 months OASIS submission report was reviewed on 09/20/24. The report contained information that out of the 74 Agency’s OASIS assessment reports, 20 (27.03 %) were submitted beyond the required time frame of 30 days. 2. During an interview with the Clinical Manager on 09/20/24 at 1:00 PM. The Clinical Manager confirmed the Agency’s late OASIS submission.”

“Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This Standard is not met as evidenced by: Based on home visit observation, Agency policy and staff interview, it was determined that in 1 of 3 (Pts. #1 and 2) home visits, the Agency failed to ensure infection control measures were observed to prevent the potential for cross-contamination, as per Agency policy. Findings include: 1. Pt. #1 was admitted to Home Health Services on 10/14/22 with the Diagnosis of: Heart Failure, unspecified. During a home visit conducted with Employee # 1 (Clinical Manager) on 09/18/24 at 2:30 PM, Employee # 1 was observed to put down nursing bag on top a box of gloves in Pt. #1’s home without placing a barrier. During an interview with Employee # 1 on 09/18/24 at 3:30 PM, Employee #1 confirmed that she did not put a barrier between nursing bag and box of gloves that was already in the Pt. #1’s home. 2. Pt. #2 was admitted to Home Health Services on 06/03/24 with the Diagnosis of: Cerebral Infarction, Unspecified. During a home visit conducted with Employee #2 (LPN) on 09/19/24 at 2:15 PM, Employee #2 was observed to put down nursing bag on top of a green plastic chair in Pt. #2’s home without placing a barrier or cleaning the surface. During an interview with Employee #2 on 09/19/24 at 2:30 PM, Employee # 2 confirmed that she did not put a barrier between nursing bag and plastic chair in Pt.#2’s home. 3. The Agency policy titled: “Exposure Control Plan: OSHA Regulations” was reviewed on 09/20/24 and required: “…..Nursing Bag Technique….2. Upon entering the home, place the bag on a clean surface; paper towels or plastic bag may be used….” 4. During an interview with the Administrator and Clinical Manager on 09/20/24 11:00 AM, both confirmed the above findings.”

“Provide services in the plan of care CFR(s): 484.75(b)(3) Providing services that are ordered by the physician or allowed practitioner as indicated in the plan of care; This Element is not met as evidenced by: Based on clinical records review and staff interviews it was determined that in 4 of 7 (Pts # 6,1 ,2, and 5) clinical records reviewed, the Agency staff failed to provide services as ordered by the Physician. 2. Pt. #1 was admitted to Home Health Services on 10/14/22 with the Diagnosis of: Heart Failure, unspecified. The clinical record was reviewed on 09/18/24 and 09/19/24. The POC effective 08/04/24, required SN: “Notify Physician of vital sign parameters:…Heart Rate….Respirations…Systolic BP….Diastolic BP….” The SN visit note dated 08/22/24 lacked documentation of assessments for Heart rate, respirations, systolic and diastolic BP. The SN visit note dated 09/06/24, lacked documentation of a BP assessment. There was no modification of Physician orders or communication as to why assessment was not done as ordered. 3. Pt. #2 was admitted to Home Health Services on 06/03/24 with the Diagnosis of: Cerebral Infarction, Unspecified. The clinical record was reviewed on 09/19/24. The POC effective 08/02/24, required SN: “Notify Physician of vital sign parameters:….Heart Rate…Systolic BP….Diastolic BP….” The SN visit note dated 09/05/24, lacked documentation of a BP assessment. There was no modification of Physician orders or communication as to why assessment was not done as ordered. 4. Pt. # 5 was admitted to Home Health Services on 07/19/24 with the Diagnosis of: Systemic Lupus Erythematosus, Unspecified. The clinical record was reviewed on 09/18/24. The POC effective 09/17/24, required SN: “Notify Physician for vital sign parameters: ….Systolic BP….Diastolic BP….” The following SN visit notes dated: 09/29/24, 08/05/24, 08/13/24, 08/20/24, 08/29/24 and 09/10/24, lacked documentation of a BP assessment. There was no modification of Physician orders or communication as to why assessment was not done as ordered. 5. During interviews with the Clinical Manager on 09/19/24 at 2:00 PM and with the Administrator and Clinical Manager on 09/20/24 at 11:00 AM, both confirmed the above findings. Findings include: 1. Pt # 6. was admitted to Home Health Services on 03/19/24 with Diagnosis of Pressure Ulcer of Right Buttock stage 2. The clinical record was reviewed on 09/18/24. The clinical record contained a POC for certification period 03/19/24 to 05/17/24 that required SN visits 2 times a week for 9 weeks. The clinical record lacked SN visits for week of 05/08/24 (week 8).”

“Ensure that HHA employs qualified personnel CFR(s): 484.105(b)(1)(iv) (iv) Ensure that the HHA employs qualified personnel, including assuring the development of personnel qualifications and policies. This Element is not met as evidenced by: Based on Agency staff list, personnel file review, Home Health Agency license and Staff interview, it was determined that the Agency failed to ensure that the Administrator employed qualified staff to provide Home Health Aide services. Findings include: 1. On 09/19/24 at 10:15 AM, a review of Staff list and included Employee #3 (Home Health Aide / Date of Hire 02/14/24). The personnel file for Employee # 3 was reviewed on 09/19/24, included an undated printout from a public website, and an undated printout from IDPH Web Portal, indicated Employee #3, “….Competency: 04/23/2023….Result: Failed…. 2. The HHA original license number 1010766, indicated the Agency can provide Home Health Aide services. As of 09/19/24, the Agency lacked a qualified Home Health Aide to provide personal care for patients. 3. During an interview with the Administrator and Clinical Manager on 09/19/24 at 11:00 AM, the Clinical Manager stated that Employee #3 has not seen patients in the prior 12 months. On 09/19/24 at 11:00 AM, both confirmed the above findings.”