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 757658 (X3) Date Survey Completed 09/26/2019
Name of Provider or Supplier Accentcare Home Health Of California, Inc. Street Address, City, State 2300 Contra Costa Blvd, Suite 240, Pleasant Hill, 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)
G0590 Promptly alert relevant physician of changes
CFR(s): 484.60(c)(1)

The HHA must promptly alert the relevant physician(s) to any changes in the patient's condition or needs that suggest that outcomes are not being achieved and/or that the plan of care should be altered.


This ELEMENT is not met as evidenced by:
Based on interview and record review, the agency failed to promptly notify the attending physician regarding the plan of care not being met due to missed skilled nursing visits for one (Patient 5) of seven sampled patients.



This failure had the potential to not achieve patient goals or desired patient outcomes.



Findings:



A record review of the Plan of Care indicated Patient 5 was admitted to the agency on 5/22/19 with multiple diagnoses that included Rett's Syndrome (a rare genetic neurological and developmental disorder that affects the way the brain develops, causing a progressive loss of motor skills and speech), epileptic spasm (sudden flexion, extension or mixed flexion-extension of muscles).



Further review of the Plan of Care indicated Patient 5's Certification Period was dated 9/19/19 to 11/17/19 reflected, "Orders for Discipline and Treatments" indicated for skilled nursing 8 hours/day, 7 days/week."



During an interview and record review with the Director of Patient Care Services (DPCS) on 9/23/19 at 12:15 p.m., DPCS stated Patient 5's skilled nursing visit was missed on 9/17/19, 9/18/19, 9/19/19 and 9/20/19, without the physician's notification.



During an interview with the Administrator (ADM) on 9/23/19 at 12:20 p.m., ADM stated they notify the physician on a monthly basis, every first Monday of the month during their meeting.



During an interview with the Regional Administrator (RA) on 9/24/19 at 10:45 a.m., RA stated staff must notify the attending physician of the missed visits.



A record review of policy and procedure, "Physician Plan of Care" dated 1/13/18 indicated: The clinician responsible for any specific treatment or visit will notify the attending physician or podiatrist, supervisor, all physicians contributing to the plan of care, and other team members of significant changes in the patient's condition or inability to provide ordered services.

Notification is required when:

Inability to carry out a prescribed treatment.

Inability to perform an ordered visit.