Medisource Home Health Services

“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, interview, policy review, and training aide review, the facility failed to ensure that one of two staff (Physical Therapist (PT) 1) observed during home visits performed hand hygiene in a manner to prevent cross contamination. This had the potential to affect nine of nine patients Physical Therapist (PT 1) regularly visited. Findings include: Review of the undated agency policy titled, “Safety/Infection Control Hand washing,” revealed, “All personnel will wash their hands: Upon arrival to work, before and after each contact with a client . . . When leaving work. Procedure A. Hand washing with water 1. Turn on the water. 2. Adjust temperature to warm. Avoid hot water as it increases the risk for dermatitis. 3. Wet hands. 4. Apply the soap and work into a heavy lather using vigorous friction, covering the entire hands, top and bottom, front and back, between the fingers and back of the hands. 5. Pay special attention to the nails and between the fingers and back of hands. 6. Wash hands for at least 20 seconds. 7. Rinse hands thoroughly with running water while holding them downwards and allowing the water to run off. 8. Dry hands with a paper towel or clean unused cloth towel. 9. Use a towel to turn off faucet.” During observation of Patient (P) 2’s home visit on 04/22/24 at 5:00 PM, PT1 went into P2’s kitchen, turned on the faucet with his/her hands, washed both hands with soap and water, and then with his/her clean hands, turned off the same faucet, potentially contaminating his/her hands. After the visit was completed, PT1 went back into P2’s kitchen, turned on the faucet with his/her hands, washed his/her hands with soap and water, and then using clean his/her hands, turned off the faucet, potentially contaminating PT1’s hands. During an interview immediately following the observation, PT1 confirmed he/she did not use a barrier to turn the faucet off and therefore possibly contaminated his/her hands. During an interview on 04/23/2025 at 8:25 AM, the Administrator informed the surveyor that PT1 had telephoned the Administrator the evening of 04/22/2025 to report that he/she forgot to get his/her paper towels out of his/her vehicle and verified turning off the potentially contaminated faucet with clean hands. The Administrator reported that he/she did hand hygiene teaching with PT1 via an email on the evening of 04/23/2025. Review of the copy of the handwashing training document the Administrator sent to PT 1 via email on 04/23/2025, showed pictures of turning off faucets with a paper towel after cleansing hands.”

“In accordance with current clinical practice CFR(s): 484.105(f)(2) All HHA services must be provided in accordance with current clinical practice guidelines and accepted professional standards of practice. This Element is not met as evidenced by: Based on observation, interview, and policy review, the Home Health Agency (HHA) failed to ensure that supplies kept in the supply storage room in the agency’s office for patient use were not expired. This had the potential to negatively affect 23 of 23 patients receiving services. Expired products may not perform as intended, leading to ineffective treatment, and/or increase the risk of infection. Findings include: Review of the undated facility document titled, “Medical Supplies and Equipment” revealed, “No supplies will be issued that are damaged or expired. They will be disposed of per manufacture recommendations.” During an observation on 04/24/25 at 2:15 PM, the surveyor and Administrator toured the agency’s supply room. The following expired supplies were noted: Three containers labeled “Adapt Stoma Powder” with an expiration date of 10/2022. Four “COVID” test kits with the expiration date of 09/08/22. Three bags labeled “Biohazard Specimen” that expired on 07/26/23. Four “COVID” test kits with the expiration date of 09/08/22. Three bags labeled “Biohazard Specimen” that expired on 07/26/23. Three bottles labeled “Iodoform Packing Strips” that expired on 10/15/24. The Administrator confirmed the supplies were past their expiration date and removed the items.”