Every finding on record at Advance Care Home Health Agency Inc

An unannounced complaint survey for #2021002587 was conducted on 3/8/21 at Advance Care Home Health Agency Inc, a home health agency in Cape Coral, Florida. Complaint #2021002587 was substantiated at F0514. Advance Care Home Health Agency Inc is in compliance with the Code of Federal Regulations (CFR) 42, Part 483, Subparts B-F, Requirements for Long-Term Care Facilities. The following is a description of the noncompliance.

RN performs assessment CFR(s): 484.55(a)(1) A registered nurse must conduct an initial assessment visit to determine the immediate care and support needs of the patient; and, for Medicare patients, to determine eligibility for the Medicare home health benefit, including homebound status. The initial assessment visit must be held either within 48 hours of referral, or within 48 hours of the patient's return home, or on the physician or allowed practitioner - ordered start of care date. This ELEMENT is not met as evidenced by: Based on record review, staff and patient's representative interviews, the home health agency failed to demonstrate effective coordination to ensure 1 (Patient #1) of 3 patients referred for services received a timely evaluation to determine the immediate care, support and maintain the patient's health, safety, and the development of a plan of care. The findings included: Review of Resident #1 medical record revealed a referral date of 2/5/21. Patient #1 was discharged from the hospital on 2/6/21. The home health agency provided a communication note with the patient's spouse dated 2/9/21. This is the first communication with the patient for the initial assessment visit, however it was not within 48 hours of the patient's discharge to home. The start of care date was noted as 2/9/21. The medical record has a start of care assessment which is not complete. The hospital discharge order for home health included Skilled Nursing, Ohysical and Occupatiional Therapies due ro Chronic Obstructive Pulmonary Disease, Pneumonia, and Small Cell Lung Cancer. Record review revealed the following Telehealth contacts, 2/11/21, 2/12/21, 2/15/21, 2/17/21, and one Telehealth form was not completed for 2/19/21. The Telehealth notes were not signed. A communication note dated 2/17/21 documented the patient's daughter questioning the service and if he needed oxygen. The 2/26/21 note was a communication with the patient's daughter who informed the home health agency she was taking her father up North. A Discharge Assessment with the patient's name, date of birth and an identification number was begun, but had no date and no signature. The medical record failed to provide coordination with the patient's doctor in the development of a plan of care. On 3/8/21, at 12:10 p.m., during an interview, the patient's daughter said the home health agency was terrible. They had an accent which made it difficult to understand. They were told them to communicate with her. They would call her mother and tell her she needed to order supplies, then her mother would call her. She did purchased a blood pressure cuff that went around the wrist and a pulse oximeter as instructed, before she realized the home health agency was supposted to communicate with the doctor and get the items them self. The Home health agency never came out to the home, they did not consult with the doctor, on the needed equipment nor on his COVID status. He was not positive after his hospitalization. On 3/8/21 at 3:15 p.m., during the interview, the administrator said Patient #1 was discharge from the hospital on 2/6/21. It is questionable if the patient was discharged COVID-19 positive. There was no order for Telehealth nor home visit. Our Registered Nurse admitted the patient.