Excelacare Home Health

“Provide contact info other services CFR(s): 484.50(d)(5)(iii) (iii) Provide the patient and representative (if any), with contact information for other agencies or providers who may be able to provide care; and This Element is not met as evidenced by: Based on record review and interview the facility failed to provide contact information for other agencies on elective transfer from agency for 1 (P[patient]14) out of 2 (P14, and P15) patients reviewed for filing complaints with the agency. This deficient practice could lead to patients not receiving home care services after requesting to end services with this agency. The findings are: A. Record review of the agency’s policy titled, “Discharges, Transfers, and Discharge Planning” dated 12/2023 stated, “X. The patient will be discharged or transferred from any discipline/service when, on consultation with the patient or his family and the physician/practitioner, it is determined that. . . D. The patient refuses services or elects to be transferred or discharged . . . iii. The agency will provide the patient and representative (if any) with contact information for other agencies or providers who may be able to provide care. . .” B. Record review of a complaint report dated 04/14/2024 for P14 revealed that the interventions in response to the patient’s complaint were, “Transfer/discharge from agency.” Patient was discharged from the agency on 04/16/2024. C. Record review of P14’s record did not reveal any evidence that patient was provided with contact information for home care agencies that could provide the services patient needed. D. During an interview on 12/5/2024 at 8:27 AM with S(staff), non-clinical, it was confirmed that there was no contact information provided to the patient.”

“Verbal orders CFR(s): 484.60(b)(3)(4) (3) Verbal orders must be accepted only by personnel authorized to do so by applicable state laws and regulations and by the HHA’s internal policies. (4) When services are provided on the basis of a physician or allowed practitioner’s verbal orders, a nurse acting in accordance with state licensure requirements, or other qualified practitioner responsible for furnishing or supervising the ordered services, in accordance with state law and the HHA’s policies, must document the orders in the patient’s clinical record, and sign, date, and time the orders. Verbal orders must be authenticated and dated by the physician or allowed pracitioner in accordance with applicable state laws and regulations, as well as the HHA’s internal policies. This Element is not met as evidenced by: Based on record review and interview the agency failed to ensure that verbal orders received for services were entered in the system for 1 (P[patient]13) out of 13 (P1-P13) patients reviewed for order accuracy. This deficient practice could lead to services being completed without an active order from a physician. The findings are: A. Record review of the agency’s policy titled, “Plan of Care” dated 12/2023 number 5 under, “Procedure” stated “Verbal orders received from the physician/allowed practitioner shall be accepted by personnel authorized to do so by applicable state and federal laws and regulations as well as agency policies. A. All verbal orders shall have the signature, date and time of the authorized personnel receiving the order. B. Verbal orders shall be authenticated and dated by the physician/allowed practitioner in accordance with agency policies and applicable state law and regulations.” B. Record review of P13’s referral received 11/26/2024 under, “Type of Service Requested” it was marked that the only service being requested was physical therapy. C. Record review of P13’s start of care note dated 11/27/2024 revealed that the visit was completed by skilled nursing and revealed that patient was to be scheduled for future skilled nursing visits. D. There was no evidence of an order for skilled nursing services in P13’s record. E. During an interview on 12/4/2024 at 2:50 PM with S(staff)1, non-clinical, it was explained that the order for skilled nursing services was a verbal that had not been entered in the system.”