Every finding on record at Allegiance Home Health of Southwest Louisiana, LLC

Recertification Survey A COVID-19 Focused Infection Control Survey was conducted on 05/27/2021. Total Patients: 145 Abbreviations: LPN: Licensed Practical Nurse RN: Registered Nurse ADM: Administrator MD: Medical Doctor SNV: Skilled Nurse Visit HHA: Home Health Agency

Supervise skilled professional assistants CFR(s): 484.75(c) Standard: Supervision of skilled professional assistants. This STANDARD is not met as evidenced by: Based on observation, interview and record review the agency failed to ensure supervision of skilled professional assistants as evidenced by failure to ensure an LPN immediately communicated findings of a new or changed wound to the patient's skin to the RN for 1 (#4) of 7 sampled patients out of total census of 145 patients. Findings: Review of the Plan of Care for patient #4 for the certification period of 04/16/2021 to 06/14/2021 revealed the patient had a primary diagnosis of Pressure Ulcer of Sacrum Stage 1 - excoriation and additional diagnosis of Diabetes Mellitus Type 2. The patient's frequency for the certification revealed the patient was to be seen one time a week for nine weeks. Review of the initial assessment dated 04/16/2021 revealed the patient had an excoriated area- Stage 1 Pressure Ulcer to her Sacral area. Review of the 04/18/2021 through 04/24/2021 week revealed the patient was seen by the LPN on 04/21/2021. Review of the 04/25/2021 through 05/1/2021 week revealed the patient was seen by the LPN on 04/28/2021. Review of the 05/02/2021 through 05/08/2021 week revealed the patient was seen by the LPN on 05/03/2021. Documentation of the SNV revealed the LPN identified a new area that had redness and blister to the sacrum. The LPN notified the MD and obtained orders for wound care. There was no documentation that the LPN notified the Case Manager/RN of her findings. Review of the 05/09/2021 through 05/15/2021 week revealed the patient was seen by the LPN on 05/12/2021. Review of the 05/16/2021 through 05/22/2021 week revealed the patient was seen by the LPN on 05/19/2021. Interview with S1 RN/ADM on 05/24/2021 revealed the RN should have been notified when the patient was identified to have a new wound that required a wound care dressing on 5/3/2021 and the RN would have made a visit the next day to assess the patient's wound. She confirmed the RN was not notified of the new wound by the LPN.

Onsite supervisory visit every 14 days CFR(s): 484.80(h)(1)(i) If home health aide services are provided to a patient who is receiving skilled nursing, physical or occupational therapy, or speech-language pathology services, a registered nurse or other appropriate skilled professional who is familiar with the patient, the patient's plan of care, and the written patient care instructions described in §484.80(g), must make an onsite visit to the patient's home no less frequently than every 14 days. The home health aide does not have to be present during this visit. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure a registered nurse (RN), who was familiar with the patient and the patient's plan of care, made an onsite visit to the patient's home no less than every 14 days for aide supervisory visits for 1 (Patient #1) of 7 sampled patients out of a total census of 145 patients. Findings: Review of the clinical record revealed Patient #1 was admitted to the agency on 04/30/2014, with a principal diagnosis of Other Hereditary and Idiopathic Neuropathies. Review of the Home Health Certification and Plan of Care/485 for Certification Period of 03/24/2021 to 05/22/2021 revealed orders that included the following: HHA effective week of 03/24/2021 1W9. Review of HHA visit notes revealed documentation that an Aide Supervisory visit was conducted by S2 DON on the following dates, however there was no documentation that reflected the time the Aide Supervisory Visit was conducted on 03/31/2021, 04/14/2021, 04/28/2021, and 05/12/2021. Interview with S2 DON on 05/24/2021 at 3:42 p.m. revealed the Aide Supervisory visit was conducted by phone and was not done onsite, but should have been.