Every finding on record at Alliance Visiting Nurses

Based on the findings of an onsite unannounced complaint investigation survey completed 8/13/2021, VNA Alliance was found not to be in compliance with the following requirement(s) of 42 CFR, Part 484, Subparts B and C, Conditions of Participation: Home Health Agencies.

Conformance with physician orders CFR(s): 484.60(b) Standard: Conformance with physician or allowed practitioner orders. This STANDARD is not met as evidenced by: Based on review of clinical records (CR) and staff (EMP) interview it was determined the agency failed to ensure the Skilled Nurse (SN) performed skilled nursing visits according to physician's orders for one (1) of three (3) CR reviewed. (CR1) Findings Included: Review of CR1 on 8/13/2021 from approximately 10:00 a.m. to 11:00 a.m. revealed a start of care (SOC) 3/26/2021 with a plan of care (POC) 5/25/2021 to 7/23/2021, primary diagnosis Encounter for orthopedic aftercare following surgical amp. POC orders "SN 2WK1, 3WK8, AND 2 SN PRN VISITS FOR SYMPTOM MANAGEMENT." A "PHYSICIAN ORDER... Date: 6/14/2021 7:53 AM... Order Description:... DECREASE SN VISITS TO 2X/WK X 6WKS." Visit records revealed SN visits were provided once per week for the weeks 6/13/2021 - 6/19/2021 and 6/20/2021 - 6/26/2021 rather than two (2) times per week as ordered. Agency provided SN visit documentation for 6/14/2021 and 6/25/2021. Agency was unable to provide missed visit information for the 2nd visit for the week of 6/13/2021 - 6/19/2021. Agency provided "MISSED VISIT NOTIFICATION... DATE OF MISSED VISIT 6/21/2021... SCHEDULED VISIT WAS MISSED BECAUSE OF CHANGE IN DIALYSIS DAYS" for the 1st visit for the week of 6/20/2021 - 6/26/2021, however, there was no evidence provided to show that the missed visit was rescheduled. Interview with EMP1, EMP2 & EMP3 on 8/13/2021 at approximately 2:00 p.m. confirmed the above findings.

Provide services in the plan of care CFR(s): 484.75(b)(3) Providing services that are ordered by the physician or allowed practitioner as indicated in the plan of care; This ELEMENT is not met as evidenced by: Based on review of clinical records (CR) and staff (EMP) interview it was determined the agency failed to ensure the Skilled Nurse (SN) performed skilled nursing visits according to physician's orders for one (1) of three (3) CR reviewed. (CR1) Findings Included: Review of CR1 on 8/13/2021 from approximately 10:00 a.m. to 11:00 a.m. revealed a start of care (SOC) 3/26/2021 with a plan of care (POC) 5/25/2021 to 7/23/2021, primary diagnosis Encounter for orthopedic aftercare following surgical amp. POC orders "SN 2WK1, 3WK8, AND 2 SN PRN VISITS FOR SYMPTOM MANAGEMENT." A "PHYSICIAN ORDER... Date: 6/14/2021 7:53 AM... Order Description:... DECREASE SN VISITS TO 2X/WK X 6WKS." Visit records revealed SN visits were provided once per week for the weeks 6/13/2021 - 6/19/2021 and 6/20/2021 - 6/26/2021 rather than two (2) times per week as ordered. Agency provided SN visit documentation for 6/14/2021 and 6/25/2021. Agency was unable to provide missed visit information for the 2nd visit for the week of 6/13/2021 - 6/19/2021. Agency provided "MISSED VISIT NOTIFICATION... DATE OF MISSED VISIT 6/21/2021... SCHEDULED VISIT WAS MISSED BECAUSE OF CHANGE IN DIALYSIS DAYS" for the 1st visit for the week of 6/20/2021 - 6/26/2021, however, there was no evidence provided to show that the missed visit was rescheduled. Interview with EMP1, EMP2 & EMP3 on 8/13/2021 at approximately 2:00 p.m. confirmed the above findings.