Every finding on record at Addus Healthcare, Inc.

A partial extended recertification and complaint survey, which ended on 9/24/21, was conducted at Addus Healthcare, Inc. for the purpose of determining the agency's compliance with Medicare requirements. Survey activities included review of 1 complaint, 8 clinical records, 2 home visits, policy review, review of other agency documents and interviews with patients and staff. The agency was determined to be out of compliance with the following standards as required by 42 CFR Part 484, Requirements for Home Health Agencies.

Only as ordered by a physician CFR(s): 484.60(b)(1) Drugs, services, and treatments are administered only as ordered by a physician or allowed practitioner. This ELEMENT is not met as evidenced by: Based on clinical record review, policy review and staff interview, it was determined that for 1 of 5 patients (Patient #4) in the sample who received skilled nursing (SN) services for wound care, the agency failed to ensure that treatments were administered as ordered by the physician. Findings included: The agency policy entitled "Verification of Physician Orders" stated, "...Orders will be obtained from a licensed physician ...for care and services to be provided..." Clinical record review revealed: A. Patient #4 1. "Home Health Certification and Plan of Care" for 3/13 - 5/11/21 included orders for SN to: a. provide pressure ulcer care treatment 3 times per week and PRN (as needed) b. cleanse the sacrum with soap and water: 2. SN visit note dated 3/17 revealed the wound was cleaned with a "wound cleanser" and a DSD (dry sterile dressing) applied. 3. No evidence to support that the nurse followed the plan of care for wound care on 3/17. This finding was confirmed by Clinical Director A on 9/23/21 at 2:05 PM.

Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This STANDARD is not met as evidenced by: Based on observation, policy review and staff interview, it was determined that for 1 of 2 patients (Patient #2) observed during a home visit, the agency staff failed to adhere to accepted standards of practice regarding infection prevention and hand hygiene. Findings included: The agency policy entitled "Standard Operating Procedure - Hand Hygiene" stated, "...Hand hygiene with an alcohol-based hand rub ...After contact with inanimate objects (including medical equipment) in the vicinity of the patient ...between all glove changes and after removing gloves..." On 9/22/21 between 10:11 AM and 10:41 AM, the following was observed during a home visit as LPN A provided wound care to Patient #2: - performed hand hygiene - donned gloves - cleansed wound #1 - removed gloves - performed hand hygiene - donned gloves - cleansed wound #2 - removed gloves - performed hand hygiene - donned gloves - measured wounds - removed gloves - grabbed tablet to document - donned gloves LPN A failed to perform hand hygiene: - after removal of gloves - after contact with inanimate object On 9/22/21 at 11:23 AM LPN A confirmed that they failed to adhere to accepted standards of practice regarding hand hygiene. These findings were reviewed and confirmed with Clinical Director A on 9/22/21 at 12:09 PM.