Prescribed Home Health Inc.

“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 and interview, the agency failed to ensure the registered nurse conducted an on-site visit to the patient’s home no less frequently than every 14 days to assess the quality of care and services provided by the home health aide for 1 of 10 patients whose records were reviewed. (Patient #3) There was no aide supervisory visit from 10/7/25 to 10/22/25 (15 days) for Patient #3. This failure has the potential of placing patients at risk of receiving ineffective and inappropriate care and services. Findings include: Record review of the POC for Patient #3 dated 9/26/25 to 11/24/25 indicated he was a 85-year-old female with a SOC date of 1/29/25 and diagnoses including chronic obstructive pulmonary disease (progressive lung condition characterized by persistent airflow limitation), mild persistent asthma (chronic inflammation of the lungs that causes swelling and narrowing of the airways), emphysema (long term lung condition that causes shortness of breath), and dementia (cognitive impairment caused by brain damage from impaired blood flow). The POC indicated orders for SN visits once a week and HHA visits once a week. Record review of the nursing tab visit management calendar for Patient #3 dated 9/26/25 to 11/24/25 indicated a SNV with Aide Supervision was conducted on 10/7/25, 10/22/25, and 11/4/25. The visit calendar gave no indication that any RN visits for supervision of the home health aide were conducted from 10/7/25 to 10/22/25 (15 days) for Patient #3. Record review of the clinical record for Patient #3 did not include a home health aide supervisory visit from 10/7/25 to 10/22/25 (15 days). During an interview on 12/2/25 at 10:00 am, RN A said the RNs were responsible for completing the aide supervisory visits. RN A said aide supervisory visits were completed every two weeks. During an interview on 12/3/25 at 10:00 am, the Alternate Supervising Nurse said the RNs were responsible for completing HHA supervisory visits. The Alternate Supervising Nurse said the HHA supervisory visit should be completed every 2 weeks. The Alternate Supervising Nurse said every visit including the HHA supervisory visit should be documented. The Alternate Supervising Nurse said Patient #3 should have had a HHA supervisory visit completed between 10/7/25 and 10/22/25. The Alternate Supervising Nurse said the HHA visit should have been done every 14 days. The Alternate Supervising Nurse said she did not know why the HHA supervisory visit was not done within the time frame. The Alternate Supervising Nurse said the HHA supervisory visit was done every 14 days to ensure the patient got the care they needed. The Alternate Supervising Nurse said the HHA supervisory visit needed to be done to make sure the patient was receiving the care they needed and to make sure the aide was meeting the patient’s needs. During an interview and record review on 12/3/25 at 10:34 am, the Alternate Administrator/ Supervising Nurse said the RNs were responsible for completing HHA supervisory visits. The Alternate Administrator/ Supervising Nurse said HHA supervisory visits should be completed every 14 days. The Alternate Administrator/ Supervising Nurse said the HHA supervisory visit were supposed to be documented in the EMR. The Alternate Administrator/ Supervising Nurse reviewed the EMR for Patient #3 and verified there was no HHA supervisory visit completed between 10/7/25 and 10/22/25. The Alternate Administrator/ Supervising Nurse said there should have been a HHA supervisory visit completed in between so it was less than 15 days apart. The Alternate Administrator/ Supervising Nurse said generally Patient #3’s visits were done every Tuesday by herself. The Alternate Administrator/ Supervising Nurse said on 10/21/25 Patient #3 had a doctor’s appointment for a follow up visit with her cancer doctor that the family said they would be gone all day, so that week her visit was moved. The Alternate Administrator/ Supervising Nurse said if the HHA supervisory visit was not completed every 14 days the HHA would not be being supervised in a timely manner and would not have oversite. During an interview on 12/3/25 at 11:03 am, the Administrator said the RNs were responsible for completing HHA supervisory visits. The Administrator said HHA supervisory visits should be completed every 14 days. The Administrator said the HHA supervisory visit should be documented. The Administrator said Patient #3’s HHA supervisory visit should have absolutely been completed between 10/7/25 and 10/22/25. The Administrator said if the HHA supervisory visit was not completed every 14 days the agency wouldn’t know if the patient was getting the care they should be. Record review of an undated Unlicensed Personnel policy revealed, “… Purpose Provide optimal level of care consistent with needs of client related to Home Health Aides. … They are closely supervised to ensure their competence in providing care. … The Home Health Aide will be observed every two weeks by an RN Case Manager. …” Record review of a Responsibilities/Supervision of Clinical Services policy dated 8/2012 revealed, “… Purpose To ensure that there is a process for … overseeing all clinical care and services. Supervision of clinical care and services will be available twenty-four hours a day, seven days a week. The clinical director will assure that the following supervision is maintained within the agency: Home Health Aide: Home Health Aide supervisory visits will be conducted on-site at least every two weeks by skilled personnel. …””