| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 757287 | (X3) Date Survey Completed 11/03/2025 |
| Name of Provider or Supplier Summa Home Health Care, Inc. | Street Address, City, State 2500 E Foothill Blvd Unit 417, Pasadena, CA | |
| 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 observation, interview, and record review, the agency failed to ensure there was an effective coordination among staffs providing care and services for one of 5 sampled patients (Patient 5). This deficient practice had the potential to result in the care and services identified in the plan of care will not be implemented among staff that could affect the patient's health and safety. During a concurrent home visit on 10/30/2025, at 11:30 a.m., with the DPCS, an interview with Patient 5 (Spanish-speaking only) and Family Member 1(FM1) in the den of Patient 5’s residence. FM 1 stated that Patient 5 had a rash on his back that had been there and itching really bad for over a month. FM 1 stated that the LVN comes twice a week and that the CNA visits twice weekly. During the home visit it was observed Patient 5’s back had a large multiple bumpy red rashes on his entire back with redness around Patients 5’s coccyx (tailbone) and buttocks area. DPCS stated that she was not aware of the rashes and would have to review the records and would talk to the Skilled Nurse who was providing care. During a concurrent record review of Patient 5’s EMR and interview with the DPCS in the HHA’s office on 11/3/2025, at 12pm., The DPCS stated the CNA providing care to Patient 5 was employed through a registry due to the agency not having an in-house CNA. The DPCS confirmed there were no CNA visit notes in the Patient 5’s electronic medical record. The DPCS stated CNA documentations were stored “in a portal” and that she needed to download and put them in the chart. The DPCS further stated she had not reviewed the CNA notes or the complete chart. Review of Patient 5’s Home Health Certification and Plan of Care form, indicated Patient 5 was admitted to the HHA, with a start of care date of 2/1/2025, with diagnosis of Hypertensive heart disease with heart failure, acute kidney failure, cachexia, Alzheimer’s for the certification period of 9/29/2025 to 11/27/2025. The ADM/DPCS was unable to provide the HHA's policy and procedure as requested. |