Homecare Maryland, LLC

“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 record review and interview with AD, the agency failed to transmit completed OASIS assessments to the CMS system within 30 days of completing initial assessments, as required by regulation 484.45(a). This failure to adhere to the required time frame for OASIS transmission has the potential to compromise the accuracy and timeliness of data reporting and impact compliance with federal regulations. Review of the agency’s Error Summary Report for the period of 1/1/24 through 1/6/25 revealed error #3330 with one hundred twelve (112) records being transmitted beyond the 30-day requirement time frame.”

“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 observation during a home visit with agency clinical staff, the clinical supervisor and the Registered Nurse (RN) clinician, adequate infection control prevention was not implemented during the provision of wound care. The RN failed to demonstrate adequate infection control practices. Failure to adhere to infection control standards placed patients at risk for infection. Patient: 16 Employee: 2 Findings included: Infection prevention practices require the separation between dirty (contaminated: covered with disease-causing organisms) and clean (reduced level of contamination) tasks and areas during a dressing change an invasive procedure to prevent the transmission (cross-contamination) of bacteria/viruses, which can lead to infection. It means that hands must be washed or sanitized in addition to glove changes between dirty (for example, removing a soiled dressing, cleansing a wound, removing used clinical supplies, cleansing before an invasive procedure and touching a cellular telephone). Clean procedures (for example, inserting a urinary catheter applying new dressing materials or handling new clinical supplies, including medications). Additionally, every attempt should be made to avoid the contamination of sterile (free of bacteria) or clean items. The regulation for standard infection prevention states that the home health agency must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This did not occur. During the care visit, on 1/9/25, with patient #16, the RN performed wound care to the patient right heel. The Employee #2 RN gathered and laid the wound care dressing and bandage supplies on a barrier, the patient’s affected part was placed on a barrier, the wound cleanser and paper measuring tape were placed on the floor with no barrier, and a trash bag was placed within reach of the RN. The RN cleansed and treated the wound as ordered; however, when measuring the wound the RN used the contaminated paper measuring tape (that had been placed directly on the floor) to measure the open wound. During the interview on 1/9/25, the clinical supervisor acknowledged the breaches in universal precautions.”

“RN performs assessment CFR(s): 484.55(a)(1) A registered nurse must conduct an initial assessment visit to determine the immediate care and support needs of the patient; and, for Medicare patients, to determine eligibility for the Medicare home health benefit, including homebound status. The initial assessment visit must be held either within 48 hours of referral, or within 48 hours of the patient’s return home, or on the physician or allowed practitioner - ordered start of care date. This Element is not met as evidenced by: Based on review of patient records and interviews with agency staff, the agency staff did not communicate delays in care for 2 out of 17 patients placing the patients at risk for adverse or negative health care outcomes. Patients: #4 and #13 Findings included: The home health agency furnishing services must maintain communication to ensure that their efforts are coordinated effectively and support the objectives outlined in the patients plan of care. 1.All clinical staff members have the responsibility to communicate or refer patient care related issues to other professional disciplines to ensure the provision of optimal health care services and to prevent adverse outcomes. This did not occur, as evidenced by the review of patient records on 1/13/25. During record review on 1/13/25, Patient number four had an order for Occupational Therapy (OT) was dated 1/5/25; the OT evaluation had not been completed as of 1/13/25. When asked the agency staff had no further documentation or explanation for the delay in care. During record review on 1/13/25 for patient number thirteen, a referral for care was accepted by the agency on 9/24/24. Patient admission to the agency was scheduled for 9/27/24. The admission was rescheduled to 9/29/24 due to the patient’s doctor’s appointment on 9/27/24. There was no documentation noting why the admission did not occur on 9/29/24. Patient thirteen was noted as admitted to the agency on 10/3/24. There was no documentation for the care delay from 9/29/24-10/3/24. When asked the agency staff had no further documentation or explanation for the delay in care.”