Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391
Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 017016 (X3) Date Survey Completed 06/18/2025
Name of Provider or Supplier Southeast Alabama Homecare, Llc Street Address, City, State 804 Glover Avenue, Enterprise, AL
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
(X4) ID Prefix Tag Summary Statement of Deficiencies

(Each deficiency should be preceded by full regulatory or LSC identifying information)
G0580 Only as ordered by a physician
CFR(s): 484.60(b)(1)

Drugs, services, and treatments are administered only as ordered by a physician or allowed practitioner.


This ELEMENT is not met as evidenced by:
Based on review of Medical Records (MR) and staff interview the agency failed to follow physician orders for wound care.  

This deficient practice did affect one of four MRs reviewed with wounds, including MR # 2, and had the potential to negatively affect all patients with wounds served by the agency. 

Findings include: 


1. MR # 2 was admitted to the agency on 6/19/24 and recertified for continued care from 8/18/24 to 10/16/24 with diagnoses including Infection of Amputation Stump, Right Lower Extremity and Pressure Ulcer of Other Site, Stage 2.  

Review of the Physician Order dated 8/21/24 revealed orders to irrigate the right 3rd toe, wound # 3, with vashe (Brand of wound cleanser), cover with vashe moistened gauze, wrap foot with rolled gauze, then wrap with electric matrix wrap daily. Patient or caregiver to perform wound care once Skilled Nurse (SN) had observed a return demonstration of the wound care.  

Review of five of five SN visits dated 8/22/24 to 9/2/24 revealed the SN failed to performed wound care to wound # 3 per the physician's order and there was no documentation the patient and/or caregiver was provided education on the wound care. 

An interview was conducted on 6/18/25 at 9:40 AM with Employee Identifier # 2, Patient Care Manager, who confirmed wound care was not provided to wound # 3 per the physician's order.