Buckeye Home Health Care Services LLC

“Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician or allowed practitioner refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician or allowed practitioner is consulted to approve additions or modifications to the original plan. This Standard is not met as evidenced by: Based on record review and interview, the facility failed to ensure patients received home health services that are written in an individualized plan of care for one of three patients reviewed (Patient #1). The agency had 348 active patients. Findings include: Record review revealed Patient #1 was admitted to the agency on 10/24/23 and had a start of care dated 10/26/23. The certification period reviewed was from 10/26/23 to 12/24/23. Physician orders included Skilled Nursing visits every 60 days, and Home Health Aide visits 49 hours a week for 60 days. Further review of the medical record revealed there were no Home Health Aide time sheets indicating the aide made any home visits. The facility was asked to provide all communication notes related to Patient #1. There was no evidence the physician was notified the aide did not provide visits to the individual. Interview on 01/31/24 at 2:50 P.M. with Staff C revealed she did the start of care on 10/24/23 and told the patient to call if there were any questions or concerns. The aide was to start seven days a week seven hours a day on 10/26/23. They had no time sheets because the home health aide never gained entrance to the patient’s home and never called the agency. Patient #1 called on 11/22/23 and said he did not want services. Interview on 01/31/24 at 3:21 P.M. with Staff A revealed he found out on 11/17/23 that the aide had not seen the patient when billing let him know they had not received staff hours for billing. Interview on 01/31/24 at 3:42 P.M. with the Case Manager revealed a call was received on 11/03/23 from Patient #1 who informed him the aide was a no show. The Case Manager stated he called the agency and spoke with Staff L and informed her the aide for Patient #1 was a no call no show. Staff L said the Administrator was not in and would tell him and try to get an aide out to them as soon as possible. On 11/13/23 Patient #1 called the Case Manager and said an aide came on 11/09/23, said she would return, and did not. The patient told him he did not want services and he started to look for another agency. He called the agency on 11/13/23. They told the Case Manager they would need to call back and never did. Interview on 01/31/24 at 5:11 P.M. with Staff D revealed he checked the time sheets and if he saw a missed visit, he told the Administrator. He did not notice until 11/17/23 that no time sheets had been handed in. He said he called the home health aide and she said she had not seen the patient because he had not answered the phone. Staff D said he told the Administrator. Interview on 01/31/24 at 5:55 P.M. with Staff A and Staff C verified the case manager would have called the agency if they received a call from a patient informing them their aide was not showing up. Further interview verified they should have known services were not being provided. This deficiency represents non-compliance investigated under Substantial Allegation 103667 and 103682.”

“Coordinate care delivery CFR(s): 484.60(d)(4) Coordinate care delivery to meet the patient’s needs, and involve the patient, representative (if any), and caregiver(s), as appropriate, in the coordination of care activities. This Element is not met as evidenced by: Based on record review, and interview, the facility failed to coordinate care delivery to meet the patient’s needs for one of three patients reviewed (Patient #1). The agency had 348 active patients. Findings include: Record review revealed Patient #1 was admitted on 10/24/23 and had a start of care dated 10/26/23. The certification period reviewed was from 10/26/23 to 12/24/23. Orders were for Skilled Nursing visits every 60 days, and Home Health Aide visits 49 hours a week for 60 days. Review of the medical record revealed there were no Home Health Aide time sheets indicating the aide made any home visits. Interview 01/31/24 at 2:50 P.M. with Staff C revealed she did the start of care on 10/24/23 and told the patient to call if there were any questions or concerns. The aide was to start seven days a week seven hours a day on 10/26/23. The agency had no time sheets because the aide never gained entrance to the patient’s home and never called the agency. Patient #1 called on 11/22/23 and said he did not want services. Interview on 01/31/24 at 3:35 P.M. with Patient #1 revealed there were two separate occasions that someone called but he never saw the aide. She came to the door once and never came in. Interview 01/31/24 at 4:16 P.M. with Staff M revealed she received a call 10/30/23 and was asked if she would take Patient #1. The call was followed up with a text message of the name, address and phone number of the patient. She called the patient from the front of his house on Monday 10/30/23. He answered and wanted her to come back Wednesday. She went to the office and told the Administrator. The second time she called from out front, no one answered the phone. She went to the office and told the Administrator who said he would go by. She never heard anything. She stated Administrator called her on 11/03/23 and asked how the patient was and she told him she had not gone because he, the Administrator, never called back to tell her what to do. The Administrator said he would call again. She did not hear anything until 11/15/23. The Administrator said Patient #1 called the office and said she did not show up. He asked me what happened, and he said to go see him. She went again and no one answered. She told the Administrator she was not going to see the patient. She said she hated bad communication. She stated she told the Administrator if the agency could not be on top of things, she was not going to see the patient. She said she never physically went in the house. Staff M said she wanted the case because it was not far from her home and the office, but she never heard follow up from the office when she could not reach the patient. Interview on 01/31/24 at 5:11 P.M. with Human Resource Staff D revealed he checked the time sheets and if he saw a missed visit, he told the Administrator. He did not notice until 11/17/23 that no time sheets had been handed in. He said he called Staff M and she said she had not seen the patient because he had not answered the phone. He said he told the Administrator. Interview on 01/31/24 at 5:55 P.M. with Staff A and Staff C verified they should have known services were not being provided. Further interview verified services were to start on 10/26/23 and the aide was not contacted until 10/30/23, after the start of care date. This deficiency represents non-compliance investigated under Substantial Allegation 103682 and 103667.”