| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 017027 | (X3) Date Survey Completed 07/14/2022 |
| Name of Provider or Supplier Hga Homecare, Llc | Street Address, City, State 2050 Beltline Rd Sw, Decatur, 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) |
| G0606 | Integrate all services CFR(s): 484.60(d)(3) Integrate services, whether services are provided directly or under arrangement, to assure the identification of patient needs and factors that could affect patient safety and treatment effectiveness and the coordination of care provided by all disciplines. This ELEMENT is not met as evidenced by: Based on review of medical records, policy and procedure, and interviews, it was determined the agency failed to meet the needs of all patients needing assistance with activities of daily living, including bathing, grooming, and dressing. This affected 2 of 12 active records reviewed, including HV # 2, and HV # 4, and had the potential to affect all patients. Findings include: Agency Policy: Patient Assessment, Initial and Reassessment Policy number: 2.1.002 Revised date: 3/1/22 Policy: All patient admitted to the agency will receive an initial assessment... Procedure: 1. Upon admission and reassessments, the qualified clinician performs the following assessment activities and collects the following data: a. Current health status, psychosocial, functional, and cognitive status. ...d. Medical, nursing, rehabilitative... needs. ...3. The initial assessment determines whether or not the patient meets home health eligibility and patient needs can be met safely in the home setting; the type of care and services to be provided; and the need, scope, and intensity of additional assessments... 4. Additional assessment needs are determined by patient acuity, as well as any of the following: a. Functional status: i. This takes into account...level of self-care, assistance needed... mobility... 2. HV # 4 was admitted to the agency on 5/17/22 with diagnoses including Infection/Inflammation Reaction Due To Internal Right Hip Prosthesis and Essential Primary Hypertension. Review of the HHC and POC dated 5/17/22 to 7/15/22 revealed an ordered SN visit frequency of one time a week for nine weeks, and a PT visit frequency of one time a week for five weeks. Review of the RN OASIS Admission Note dated 5/17/22 revealed the RN documented the patient lived alone, had occasional/short term assistance available at his/her residence, and was at risk for falling. Review of the Functional Assessment documented by the RN revealed the following: a. HV # 4 had an amputated lower left leg. b. Needed help with grooming. c. Needed help to put on upper body clothing. d. Needed help to put on undergarments, slacks, socks or nylons, and shoes. e. Required the presence of another person throughout the bath for assistance or supervision. f. Needed assistance/supervision by another person to safely transfer on and off the toilet or bedside commode. g. Needed help to maintain toileting hygiene and/or adjust clothing. Review of the OASIS Admission Skilled Nurse (SN) Narrative revealed the SN documented HV # 4 was, "Currently very week (weak) from infection." "Have friend help him/her occationally (occasionally)." Review of the HHC and POC dated 5/17/22 to 7/15/22 revealed no orders for assistance with activities of daily living. An interview was conducted on 7/14/22 at 11:22 AM with EI # 1, who confirmed staff failed to ensure the POC addressed the needs of HV # 4 for assistance with activities of daily living. An Entrance Conference interview was conducted on 7/12/22 at 8:15 AM with Employee Identifier (EI) # 1, Executive Director, who stated the agency currently had no Home Health Aides (HHA). The surveyor asked EI # 1 how patient needs were met if someone needed HHA services. EI # 1 stated an OT (Occupational Therapist) consult would be made and if needed, an order for a COTA (Certified Occupational Therapy Assistant) to assist and train the patient in safely bathing would be requested. 1. HV # 2 was admitted to the agency on 6/29/22 with diagnoses including Crohn's Disease, Unspecified, without Complications, and Essential (Primary) Hypertension. Review of the Home Health Certification (HHC) and Plan of Care (POC) dated 6/29/22 to 8/27/22 revealed an order for SN (Skilled Nurse) one time a week for nine weeks, PT (Physical Therapist) one time a week for one week, and MSW (Medical Social Worker) one time a week for one week. Review of the RN (Registered Nurse) OASIS (Outcome and Assessment Information Set) Admission note dated 6/29/22, revealed the RN documented the patient lived alone, with occasional/ short-term assistance, lack of caregiver support, ...and was at risk for falling. Further review of the OASIS Admission note revealed the following "Functional" assessment findings: "...decreased strength, gait abnormality...unsteadiness, walking difficulty ...someone must assist the patient to groom self ...someone must help the patient put on upper body clothing ...someone must help patient put on undergarments, slacks, socks or nylons, and shoes ...able to participate in bathing self in shower or tub, but requires presence of another person throughout the bath for assistance or supervision ...able to walk only with the supervision or assistance of another person at all times..." Review of the HHC and POC dated 6/29/22 to 8/27/22 revealed no orders for assistance with activities of daily living. An interview was conducted on 7/14/22 at 11:14 AM with EI # 1, who confirmed staff failed to ensure the POC addressed the needs of MR # 3 for assistance with activities of daily living. |