| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 017037 | (X3) Date Survey Completed 05/11/2023 |
| Name of Provider or Supplier Alabama Homecare Of Montgomery, Llc | Street Address, City, State 400 South Union Street Suite 285, Montgomery, 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) |
| G0578 | Conformance with physician orders CFR(s): 484.60(b) Standard: Conformance with physician or allowed practitioner orders. This STANDARD is not met as evidenced by: Based on the review of medical records (MR), agency policy and procedure and staff interviews it was determined the agency staff failed to follow physician orders for visit frequency. This deficient practice did affect two of seventeen MRs reviewed, including Home Visit (HV) # 4 and MR # 7 and had the potential to affect all patients served by the agency. Findings include: Agency Policy: Plan of Care (POC) Policy Number: 2.1.007 Revised Date: 12/1/21 Purpose: ...To ensure that physician/ (or) authorized practitioner's orders are followed. Policy: Each patient has an individualized POC developed in consultation with the...physician or authorized practitioner... to address specific services being provided. Procedure: ...2. The POC includes: ...b. Types, frequency, and duration of services required 1. HV # 4 was admitted to the agency on 4/12/23 with diagnoses including Multiple Sclerosis and Anemia, Unspecified. Review of Home Health Certification (HHC) and POC dated 4/12/23 to 6/10/23 revealed an Occupational Therapy (OT) frequency of once a week for one week, then twice weekly for three weeks, then once a week for one week, and a Medical Social Worker (MSW) frequency of once a week for one week effective 4/16/23. Review of the OT notes for the week of 4/16/23 revealed missed visits on 4/19/23 and 4/20/23. There was no documentation the OT attempted to reschedule the visits in conformance with the physician ordered frequency of twice a week. Review of the MSW notes for the week of 4/16/23 revealed a missed visit on 4/20/23. There was no documentation the MSW attempted to reschedule the visit in conformance with the physician ordered frequency of once a week. Review of the OT notes for the week of 4/30/23 revealed an OT visit was performed on 5/5/23. There was no documentation the OT attempted a second visit in conformance with the physician ordered frequency of twice a week. An interview was conducted on 5/11/23 at 10:54 AM with Employee Identifier (EI) # 1, Executive Director, who confirmed the agency staff failed to follow physician orders for visit frequency. 2. MR # 7 was admitted to the agency on 12/19/22 with diagnoses including Hypertensive Heart and Chronic Kidney Disease with Heart Failure and Stage 1 Through Stage 4 Chronic Kidney Disease, or Unspecified Chronic Kidney Disease, Unspecified Systolic (Congestive Heart Failure) and Type 2 Diabetes Mellitus with Diabetic Chronic Kidney Disease. Review of the HHC and POC dated 12/19/22 to 2/16/23 revealed an order for a Physical Therapy (PT) frequency of once a week for one week, then twice weekly for three weeks, then once weekly for one week. Review of the PT notes for the week of 12/25/22 revealed a missed visit on 12/30/22. There was no documentation the PT attempted to reschedule the visit in conformance with the physician ordered frequency of twice a week. Review of the PT notes for the week of 1/8/23 revealed a missed visit on 1/12/23. There was no documentation the PT attempted to reschedule the visit in conformance with the physician ordered frequency of twice a week. An interview was conducted on 5/11/23 at 10:57 AM with EI # 1 who confirmed the agency staff failed to follow physician orders for visit frequency. |