Hopehealth Ltd

“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 agency failed to ensure a patient’s emergency contact was notified of a missed visit. This affected one (Patient #153) of three patients reviewed. The agency’s active census was 152. Findings include: Record review revealed Patient #153 started care on 12/10/22. Diagnoses included chronic obstructive pulmonary disease, lumbago with sciatica, type two diabetes and depression. The patient had a fair prognosis, was alert and oriented to person, place and time but forgetful. Functional limitations included ambulation, dyspnea with moderate exertion, endurance and hearing deficit. She was up as tolerated with human assistance required and a walker. The patient had a live in aide that was not employed by the agency. The resident was to receive daily skilled nurse visits for insulin injections. The certification period reviewed was 02/03/24 to 04/02/24. Review of the daily skilled nurse visit revealed the visits were made in the evening. A communication note dated 02/24/24 documented the nurse went to see the patient, arriving at 5:24 PM. The nurse knocked on the door and there was no answer. he nurse had previously called the patient, but the phone went unanswered. The physician was notified of the missed visit by leaving a phone message. The nurse was unable to administer the insulin. On 02/25/24, Staff A went to the patients home for scheduled visit. The aide answered the door stating the patient had died the day before. The live in aide did not give any details. The agency was notified. There was no evidence the patient’s daughter, who was her back up, was notified when the nurse could not locate the patient on 02/24/24. During an interview on 10/02/24 at 4:53 P.M., Registered Nurse Staff B stated he did not call the emergency back up because the patient had a live in caregiver.”

“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 medical record review and staff interview, the agency failed to ensure patients received the home health services as written in the plan of care. This affected one of four medical records reviewed (Patient #1). The agency census was 191. Findings include: Review of the medical record for Patient #1 revealed a plan of care dated 09/27/23 to 11/25/23. The plan of care contained orders for home health aide services eight times the first week and 14 times a week for the remaining eight weeks. Review of the medical record revealed six home health aide visits for one or two hours each visit from 09/27/23 to 09/30/23 and eight home health aide visits per week for one to four hours each visit from 10/01/23 through 11/18/23. The medical record lacked documentation of any home health aide services the week of 11/19/23 through 11/25/23. The medical record lacked documentation of any additional orders or physician notification the home health aide services were not provided as ordered. This was verified by Staff A on 04/04/24 at 2:35 PM.”