Amedisys Home Health Services

“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 record review and interview, the agency failed to ensure the patient’s written Plan of Care was followed as evidenced by physician’s orders not followed for 1 (Patient #12) of 13 (Patients #1-#13) sampled patient records reviewed. Findings: Review of Patient #12’s medical record revealed an admit date of 08/13/2024 with diagnoses that included in part…Type 2 Diabetes Mellitus, Cellulitis of Right Lower Limb, and Pressure Ulcer of Left Buttock, Stage 2. Review of the certification period 08/13/2024 through 09/03/2024 revealed the patient was ordered to receive skilled nurse visits twice per week for two weeks, then once per week for 7 weeks. Review of the plan of care revealed an order as follows: 08/23/2024 order: Skilled Nurse to obtain CBC, CMP, Urinalysis, and A1C at next visit. Review of Patient #12’s medical record revealed the next visit after 08/23/2024 occurred on 08/29/2024 and the record contained no documentation that blood work and urine were collected, as ordered. In an interview on 01/15/2025 at approximately 12:00 p.m., S1 Director and S2 Area Vice President confirmed the bloodwork and urinalysis were not obtained, as ordered.”

“Services by skilled professionals CFR(s): 484.75(a) Standard: Provision of services by skilled professionals. Skilled professional services are authorized, delivered, and supervised only by health care professionals who meet the appropriate qualifications specified under §484.115 and who practice according to the HHA’s policies and procedures. This Standard is not met as evidenced by: Based on record review and interview, the agency failed to ensure a Registered Nurse performed an assessment of a patient’s wounds at least weekly, including measuring the wound, per the agency policy for 1 (#12) of 1 sampled patients with pressure ulcers. Findings: Review of the agency’s policy on 01/15/2025 titled The Provision of Wound and Skin Care dated 12/12/2024 revealed in part…In accordance with best practice and standard of care, wounds will be measured a minimum of one time a week, preferably on the first visit of the week, by the same nurse, utilizing the same tool and measurement terminology. Review of Patient #12’s medical record revealed an admit date of 08/13/2024 with diagnoses that included in part…Type 2 Diabetes Mellitus, Cellulitis of Right Lower Limb, and Pressure Ulcer of Left Buttock, Stage 2. Review of the certification period 08/13/2024 through 09/03/2024 revealed the patient was ordered to receive skilled nurse visits twice per week for two weeks then once per week for 7 weeks. Review of the plan of care revealed an order as follows: Registered Nurse/Licensed Practical Nurse to perform/teach patient/caregiver wound care to pressure injury to left buttocks pressure wound. Irrigate/cleanse with wound cleanser, apply zinc oxide and foam dressing. Change dressing daily and as needed if soiled. Review of Patient #12’s skilled nurse visit notes revealed there were no wound assessment with measurements performed or documented by the skilled nurse for the following visits: 08/17/2024 08/20/2024 08/23/2024 08/29/2024 Review of the skilled nurse visit notes for the above dates revealed the visits were made by a Licensed Practical Nurse. Review of the skilled nurse visit notes for the certification period revealed the patient was only seen by a Registered Nurse on one occasion on 08/13/2024, upon admit. In an interview on 01/15/2025 at 1:47 p.m., S2 Area Vice President confirmed Patient #12’s pressure ulcer should have been measured weekly by a Registered Nurse, but was not.”