Every finding on record at Always Care Home Health LLC

An Emergency Preparedness Survey was conducted by the Indiana Department of Health in accordance with 42 CFR 484.102 Survey Dates: 11/21, 11/22, and 11/25/2024. Active Census: 10 At this Emergency Preparedness survey, Always Home Care, Inc was found in compliance with Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers, 42 CFR 484.102 QR completed 11-27-2024

This visit was for an initial Federal Medicaid and State Licensure home health survey. Survey dates: 11/21/2024, 11/22/2024, and 11/25/2024. 12-month Unduplicated Skilled Admissions: 10 QR completed by Area 3 on 11-27-2024.

Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This STANDARD is not met as evidenced by: Based on observation, record review and interview the agency failed to ensure infection control measures hand hygiene were appropriately performed in 2 of 3 home visits observed. Home Health Aide (HHA)1 and Registered Nurse (RN) 1 Findings include: 1. A review of a policy titled, 'Hand Hygiene Policy Number: C:30' indicated but was not limited to "… 2. Employees providing care/service in the home will wash their hands at least … e. Before gloves are put on and after gloves are taken off … 4. Wash Techniques: a. Handwashing with water … vii. Use paper towel to turn faucet off …". 2. During a home visit on 11/22/2024 at 4 PM with HHA 1 to observe personal care provided to Patient #10, HHA 1 was observed washing their hands at the kitchen sink and turned the faucet off with their left hand, took Patient #10's vistal signs, assisted Patient #10 upstairs to bathroom, where they donned gloves, placed towels on the floor, turn the water on, placed a towel on the floor of the tub and a shower chair over the towel, assisted Patient #10 with undressing, and assisted them in the tub, onto the shower chair. HHA 1 doffed their gloves without performing hand hygiene, went downstairs to retrieve a trash bag from their nursing bag, returned to the bathroom, washed their hands appropriately and donned a clean pair of gloves, and finished assisting Patient #10 with their shower, and assisted with drying them off. HHA 1 doffed their gloves, dropped their cardboard box of paper towel on the bathroom floor, picked them up and placed under their arm, then proceeded to wash their hands at the sink, then donned a clean pair of gloves, and assisted Patient #10 with dressing. HHA 1 wrung out the towel in bathtub, placed all towels into 1 pile, doffed their gloves and washed their hands at the sink, and turned the faucet off with their bare hand. HHA 1 assisted Patient #10 downstairs, proceeded to clean their equipment and placed on clean barrier while drying. HHA 1 wiped the cardboard box of paper towels and placed in nursing bag. HHA 1 failed to ensure proper hand hygiene techniques were used when removing gloves and turning the faucets off. When queried if they should have reused and placed the cardboard box of paper towels in their nursing bag, they stated, "probably shouldn't have". When queried if paper towels were to be used when turning faucets off, they indicated they were to be used. When queried if they had training for hand hygiene, HHA 1 indicated the Clinical Supervisor had completed training with them this past month. 3. During a home visit on 11/25/2024 at 1PM to observe RN 1 perform a medication pill box set-up for Patient #3, RN 1 began visit by created by placing 3 barriers on the coffee table for their equipment,1 for their nursing bag, a clean barrier for their equipment, then a dirty barrier for the used equipment. RN 1 placed 2 paper towels on top of each other on the kitchen counter next to the sink, washed their hands at the kitchen sink appropriately, used the paper towel on top of the other to dry their hands, donned a clean pair of gloves, took Patient #3's vital signs, performed a head to toe assessment, doffed their gloves, and without performing hand hygiene, donned a clean pair of gloves, and began cleaning their equipment. After completed, RN 1 doffed gloves, performed hand hygiene with hand sanitizer, donned a clean pair of gloves to begin the medication pill box set-up. When the medication set-up was completed, RN 1 placed 2 paper towels on top of each other, on the kitchen counter next to the sink, began hand washing, the water temperature became too hot for RN 1, they took the paper towel that was on top to adjust the water temperature, and after completing their hand wash, used the paper towel that was laying directly on the counter to dry their hands. RN failed ensure proper hand hygiene techniques were used between doffing and donning gloves, and not using a impervious barrier when placing paper towels on a counter. When RN 1 was queried what they should have done differently, they indicated they should always use hand hygiene between glove changes, and should have had extra paper towels with them. 4. When queried what HHA 1 should have done differently, the Administrator and Clinical Supervisor indicated HHA 1 knows to use paper towels to turn faucets off, and to wash their hands when removing their gloves. The administrator indicated they shouldn't have reused the cardboard box of paper towels. When queried what RN 1 should have done differently, the Administrator indicated they shouldn't be placing anything directly on any counters. The Clinical Supervisor indicated they need to use an impervious barrier for their paper towels/soap. The Clinical Supervisor indicated RN 1 should always perform hand hygiene between glove changes. 410 IAC 17-12-1(m)