Every finding on record at A 1 Nursing Care of Cleveland, Inc

EMERGENCY PREPAREDNESS SURVEY At the time of the emergency preparedness survey completed on 08/11/21, A1 Nursing Care of Cleveland is in compliance with the provisions of 42 CFR Part 484.22, Conditions of Participation for Home Health Agencies.

Partial Extended Re-certification Survey The following deficiency is based on the partial extended re-certification survey completed on 08/11/21. A 1 Nursing Care of Cleveland is not in compliance with the requirements found at 42 CFR Part 484 Subparts B, C, Home Health Agencies.

Non-skilled direct observation every 60 days CFR(s): 484.80(h)(2) If home health aide services are provided to a patient who is not receiving skilled nursing care, physical or occupational therapy, or speech-language pathology services, the registered nurse must make an on-site visit to the location where the patient is receiving care no less frequently than every 60 days in order to observe and assess each aide while he or she is performing care. This ELEMENT is not met as evidenced by: Based on record review, interview and policy review, the agency failed to complete a supervisory visit while the home health aide was the home health aide was on duty and performing care. This affected one (Patient #5) of five patients reviewed for timeliness of supervisory visits. The agency census was 115. Findings Include: Record review revealed Patient #5 was admitted on 09/20/2017 with diagnoses including a history of a cerebral palsy. Review of the plan of care revealed the home health aide provided aide service to Patient #5 Monday through Friday six hours per day. The Registered Nurse (RN) completed her every 60 day re-certification visit and supervisory visit on 05/25/21 from 3:42.P.M. to 4:25 P.M. The aide's time sheets documented the delivery of services from 7:29 A.M. to 10:30 A.M. The RN did the next recertification and supervisory visit on 07/25/21 from 10:58 A.M. to 11:40 A.M. Review of the home health aide time sheets revealed the home health aide was on duty on 07/25/21 from 7:28 A.M. until 10:30 A.M. During interview on 08/21/21 at 11:00 A.M., the Director of Nursing confirmed the supervisory visits occurred while the aide was not on duty. Review of the agency policy titled "Supervision of Employee", undated, directed supervision of the home health aide should be conducted by a registered nurse or other professional who is familiar with the patient. If the patient is not receiving skilled nursing or therapy services, the supervising individual must observe the home health aide providing care in the patient's home no less than every 60 days.