Every finding on record at Advantage Health Systems

The following reflects the findings of the California Department of Public Health during the investigation of a complaint. Complaint Number: 98957 Representing the California Department of Public Health: 39448, Health Facilities Evaluator Nurse (HFEN). The inspection was limited to the specific complaint investigated and does not represent the findings of a full inspection of the facility. Deficiencies were issued for the complaint at G 514.

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 interview and record review, the agency failed to conduct an initial assessment within 48 hours of referral for one of two sampled patients (1). As a result, there was a delay in the care and services provided to Patient 1. Findings: Per the agency’s Home Health Certification and Plan of Care for certification period of 5/5/23 through 7/3/23, Patient 1 had a start of care on 5/5/23 with diagnoses to include pressure ulcer (a wound caused by prolonged pressure on the skin). Per the agency’s Inbound Notification, fax received on 5/1/23 of Consult/Referral to Home Health for Patient 1. Per the agency’s Charts/Clinical Notes, the Start of Care Summary was dated 5/5/23 (Four days after referral). On 8/18/23 at 3:30 P.M., a telephone interview was conducted with the Intake Coordinator (IC). The IC stated, Patient 1’s referral was faxed to the agency on 5/1/23, and the initial visit was conducted on 5/5/23. The IC further stated, they were supposed to admit new referrals within 48 hours. On 9/27/23 at 2:10 P.M., a telephone interview was conducted with the Director of Patient Care Services (DPCS). The DPCS stated, it took four days to admit Patient 1 after their referral, but the IC should have scheduled new admissions within 48 hours of referral. Per the agency’s policy, titled Admission Criteria and Process, revised October 2016, “…The initial visit must be performed…within 48 hours of the referral…”