Angels Care Home Health of Mccook

“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 record review, policy and procedure review, observation of the provision of care, and staff interview, the agency failed to ensure 2 of 3 staff, (Staff D and E) observed during the provision of care for 2 of 3 patients (Patients 1 and 2) performed proper hand hygiene, cleaning of equipment, and bag technique according to the agency’s policies and procedures. The total sample size was 7. The census was 22. A. Review of the agency’s policy and procedure titled Infection Control, no date indicated, revealed staff were to perform proper hand hygiene before applying and after removing gloves. B. Review of the agency’s policy and procedure titled Hand Hygiene Policy and Compliance Program, no date indicated, revealed staff were to perform proper hand hygiene before and after a lab draw. C. Review of the agency’s policy and procedure titled Nursing Bag Precautions, no date indicated, revealed: 1. Staff were to perform proper hand hygiene before and after entering the nursing bag. 2. Staff were to clean equipment prior to returning it to the nursing bag. D. Review of the clinical records revealed: 1. Patient 1’s Home Health Care Certification and Plan of Care (POC) for certification period 6/6/25 through 8/4/25 included orders for Skilled Nursing (SN), 3 times weekly for Peripherally Inserted Central Catheter (PICC, a thin, flexible tube that is inserted into a vein in the upper arm and guided into a large vein near the heart) dressing change, injection cap change and lab draw. 2. Patient 2’s Home Health Care Certification and Plan of Care for certification period 6/4/25 through 8/2/25 included orders for Physical Therapy (PT) for muscle strengthening and gait training, and Home Health Aide (HHA) 2 times weekly for hygiene assistance. E. Observation of the provision of care, for Patient 2 on 6/24/25 at 1:00 PM, revealed Staff D failed to clean the tablet prior to returning it to the nursing bag after use by the SN and patient. F. Observation of the provision of care, for Patient 1 on 6/25/25 at 10:30 AM, revealed Staff E failed to: 1. Remove gloves and perform proper hand hygiene after providing PICC dressing change and lab draw prior to entering the nursing bag to obtain equipment. 2. Remove gloves and perform proper hand hygiene after providing patient care and prior to returning clean equipment to the nursing bag. 3. Clean the tablet prior to returning it to the nursing bag after use by the SN and patient. G. During an interview on 6/25/25 at 3:45 PM, the agency Director confirmed that Staff D and E failed to follow the agency’s policies and procedures for proper hand hygiene, cleaning of equipment, and bag technique during the provision of care to Patient 1 and 2.”

“Onsite supervisory visit every 14 days CFR(s): 484.80(h)(1)(i) (1)(i) If home health aide services are provided to a patient who is receiving skilled nursing, physical or occupational therapy, or speech language pathology services— (A) A registered nurse or other appropriate skilled professional who is familiar with the patient, the patient’s plan of care, and the written patient care instructions described in paragraph (g) of this section, must complete a supervisory assessment of the aide services being provided no less frequently than every 14 days; and (B) The home health aide does not need to be present during the supervisory assessment described in paragraph (h)(1)(i)(A) of this section. This Element is not met as evidenced by: Based on record review, policy and procedure review, and staff interview, the agency failed to conduct an on-site home health aide (HHA) supervisory visit by a Registered Nurse (RN), or other appropriate skilled professional, at least every 14 days, to 2 of 4 patients (Patients 2 and 7) receiving HHA services. The total sample size was 7. The census was 22. A. Review of the agency policy and procedure titled Home Health Aide Supervision, revised February 2024, revealed HHA supervisory visits were to be made by an RN, or other appropriate skilled professional, every 14 days. B. Review of Patient 2’s clinical record revealed: 1.The Home Health Care Certification and Plan of Care (POC) for the certification period of 6/4/25 through 8/2/25 included orders for Skilled Nurse (SN) to visit 1 time to perform start of care (SOC), HHA services 2 times weekly to assist with personal care, and Physical Therapy (PT) 2 times weekly to teach gait training exercises and perform pre-gait training activities. 2. The agency failed to conduct an on-site HHA supervisory visit by an RN, or other appropriate skilled professional, every 14 days from 6/8/25 to 6/26/25. C. Review of Patient 7’s clinical record revealed: 1.The POC for the certification period of 2/24/25 through 4/24/25 included orders for SN 1 time to perform SOC, HHA services 1 time weekly to assist with personal care, PT 2 times weekly to establish/upgrade home exercise program for strengthening, gait training, muscle strengthening exercises and perform standing balance, and Occupational Therapy (OT) 1 time per week x2 for transfer training. 2. The agency failed to conduct an onsite HHA supervisory visit by an RN, or other appropriate skilled professional, every 14 days from 2/24/25 to 4/11/25, discharge date. D. During an interview on 6/25/25 at 4:30 PM, the agency Director confirmed the agency failed to conduct an on-site HHA supervisory visit by an RN, or other appropriate skilled professional, every 14 days to Patients 2 and 7.”