Amedisys Home Health

“Immediate reporting of abuse by all staff CFR(s): 484.50(e)(2) Any HHA staff (whether employed directly or under arrangements) in the normal course of providing services to patients, who identifies, notices, or recognizes incidences or circumstances of mistreatment, neglect, verbal, mental, sexual, and/or physical abuse, including injuries of unknown source, or misappropriation of patient property, must report these findings immediately to the HHA and other appropriate authorities in accordance with state law. This Element is not met as evidenced by: Based on interviews and document reviews, the agency failed to ensure that staff immediately reported allegations of neglect in accordance to the agency policies and regulatory requirements for mandatory immediate reporting of neglect allegations for one (1) of ten (10) patients reviewed (Patient #3). Findings: The Amedisys “Assessment for Abuse/Neglect and Exploitation” policy, last revised 6/27/2024 states in part, “Agency staff will assess, identify, and intervene on the behalf of the victims of abuse and neglect and exploitation in an appropriate and professional manner. All cases of alleged, observed, or suspected abuse, neglect or exploitation will be investigated by the agency and appropriate intervention will be initiated, including mandated reporting requirements in accordance with the state regulations. Maine: Ensure that all staff are knowledgeable of the Adult Protective Services Act and that all alleged violations involving mistreatment, neglect and abuse, including injuries of unknown source and/or misappropriation of client/patient property, are reported immediately to the administrator of the home health care services provider and to other officials in accordance with the State law (Title 22 §3470 et seq.).” On 11/06/2024 at approximately 12:00 PM, ten (10) patient records were reviewed. This review revealed the following: On 9/25/2023 at 12:40 PM, Registered Nurse (“RN”) #1 had the first visit with Patient #3 for skilled nursing services; Patient #3 was known to have “an area on [his/her] buttocks that has been bothering [him/her]”; Patient #3 was known to have intermittent incontinence; Patient #3 was known to have bilateral lower extremity wounds; RN #1 documented that the wound on the lower left leg was assessed and photos were taken; RN #1 also documented that the lower left leg wound was unable to be assessed as Patient #3 was unable to remove pants; RN #1 provided no photographs of the wound that were located in the medical record; RN #1 documented that there were no signs or symptoms of an infection for the lower left leg; RN #1 also documented evidence of garbage on floor throughout the home, numerous flies in kitchen and living room, and strong odors in the living room; On 9/27/2023 at 11:04 AM, Occupational Therapist (“OT”) #1 documented that Patient #3 reported not having changed [his/her] pants in over two (2) weeks due to the leg wounds and fear of causing more damage with attempt to remove the pants; OT #1 then documents that Licensed Practical Nurse (“LPN”) #1 has a visit scheduled for later that day for wound care and recommended cutting off pants and disposing of them once removed; OT #1 noted that the patient’s home was in disarray; trash on the floor, old food on the table, and excessive clutter; On 10/02/2023, LPN #1 documented that during the visit with Patient #3 on 9/27/2023 at 1:43 PM, the lower left leg wound was found to be entirely covered in maggots; Patient #3 was sent by ambulance to the hospital and admitted for bilateral lower extremity cellulitis; and As of 11/06/2024, the agency has failed to report an allegation of neglect to appropriate State authorities. On 11/06/2024 at 2:39 PM, an interview was conducted with the Director of Operations for the Augusta Amedisys Office. [RN #1] was working for us, but RN #1 is no longer employed with the agency. She did not relay to leadership that she didn’t pull down clothes to assess the wound. LPN #1 went for a skilled nursing visit and helped Patient #3 remove [his/her] pants and when he did, maggots fell out of [his/her] pants. An internal complaint was filed from the care center because the wound was not addressed properly at the start of care. The emergency response staff and the doctor at the hospital called Adult Protective Services (“APS”). The Director stated that she did not call APS, but thought that LPN #1 had called. On 11/06/2024 at 2:39 PM, an interview was conducted with the Director of Operations. She stated that staff are required to report self-neglect and abuse, and that clinicians will routinely make the reports. If someone is found to be in an environment that could be harmful, and the patient cannot advocate for themselves, we will call. If they are of sound mind or not, it will be on the record. On 11/07/2024 at 11:45 AM, in a follow up email, the Director of Operations confirmed that RN #1 had not provided any photographs of the wound from the first visit. She also confirmed that they were unable to locate any documented evidence that LPN #1 had called APS.”