Every finding on record at Advanced Home Healthcare Services LLC

Substantial Allegation Survey Substantial Allegation 100371 No deficiencies were cited related to allegations contained in substantial allegation 100371 completed on 09/12/23; however, the facility was found not to be in compliance with all requirements for Home Health Agency participation and the following deficiency is cited. Advanced Home Healthcare Services LLC 369043, is not in compliance with the requirements at 42 CFR Part 484, Subpart B, C for Home Health Agencies.

Communication with physicians CFR(s): 484.75(b)(7) Communication with all physicians involved in the plan of care and other health care practitioners (as appropriate) related to the current plan of care; This ELEMENT is not met as evidenced by: Based on policy review, record review and staff interview, the agency failed to ensure its staff was in communication with all physicians involved in the plan of care for one of five patients reviewed (Patient #43). This had the potential to affect all patients receiving services from the agency. The census was 42 patients. Findings include: Review of Patient #43's medical record revealed a start of care date of 09/07/22. Review of the physician ordered plan of care for the certification period dated 03/06/23 through 05/04/23 revealed she had up to 54 hours a week of home health aide (HHA) services for 60 days. The home health aide was to assist with personal care, incontinence care, and activities of daily living per the plan of care under supervision of a Registered Nurse. Review of the homemaker/aide care plan revealed she had fall precautions and the home health aide was to notify the agency of patient falls. Review of a communication note dated 03/28/23 revealed the Home Health Aide, Staff C, had reported that the patient was transported to a local hospital due to a fall on 03/25/23. Staff C found her laying on the floor when she entered the apartment. No other information had been reported. The record revealed no evidence of the physician being notified of the fall and hospitalization. There was no evidence of an incident report being completed. Interview on 09/11/23 at 1:49 P.M. with Staff G revealed when she came to work on 03/28/23 there was a note on her desk about the fall and hospitalization. She put the communication note in on the 28th and faxed the note to the case manager. She stated they should have had the aide fill out an incident report. Interview 09/11/23 at 1:59 P.M. with Staff C revealed she was the long-term aide five to six days a week, for Patient #43. Staff C stated the patient had already fallen outside the bathroom door when she arrived. She did not know what time she arrived because she did not get her pay slip signed by the patient with her going to the emergency room, so it just said hospital. She believed it was around 8:00 A.M. when she got there. She normally worked 7:00 A.M.-1:00 P.M. or 8:00 A.M.-2:00 P.M. She said the patient said she had not been there long. The patient told her someone was at the door. When she went to answer using a walker she fell. The aide said she had no visible injuries and said no pain. She included that although the patient was 94 years old, she was in good shape and would walk the hall of the apartment building a half hour at a time to keep in shape. She gave the patient her walker and the patient got on her knees, held on to the walker and stood up. She went into the bathroom without the walker, it did not fit through the door. The patient went to the bathroom, brushed her teeth and hair. She walked with the walker to her chair and sat down. She told the aide she was fine. Staff C called the patient's daughter who lived on the second floor of the apartment building and woke her up. She told her how she found her mom and she seemed fine. She called and spoke to the Administrator who was on call, it was a Saturday. A couple hours later the daughter came to the apartment. By this time the aide had fed the patient her breakfast. The daughter was there about a half hour to an hour when her mom had to go to the bathroom. When she got up to go to the bathroom, she said she was sore. She walked with the walker to the bathroom door and the aide helped her to the toilet. The aide pulled down her pants for her. The daughter asked if she wanted to go to the hospital to be checked and she said yes because she had her birthday party coming up and she didn't want to miss it. The ambulance came when she was on the toilet, asked if she wanted to go and she said yes. She called the Administrator back when the ambulance was there to tell him she was going to the emergency room. Staff C did not write a statement related to the fall and hospitalization until 06/21/23. Interview 09/12/23 at 5:03 P.M. with Staff G and Staff A revealed Staff A did not notify the physician of the hospitalization when he received the call from Staff C. Staff G also verified she did not notify the physician when she returned to work and wrote the communication note. She said the hospital may have notified the physician when she went to the emergency room, but she just notified the case manager. Review of the agency's policy titled, Critical Incident Reports, dated 10/02/19, revealed the agency shall take every precaution to make sure the client is free from harm. The quality management team will review incidents to see what type of preventive measures can be taken to ensure accidents incidents or injuries do not happen. Safety is a top priority. When there is an accident, incident, or injury that affects the health and safety of patients immediately notify the representative and if applicable the primary care provider, emergency response team, the patient's case manager, and the emergency contact. Document the following: date and time of accident incident or injury, description of the accident, incident or injury, names of individuals who observed the accident, incident or injury, action taken by employees, staff or volunteers, individuals notified by employees, support staff or volunteers and action taken to prevent the accident incident or injury from occurring again in the future.