Every finding on record at Amedisys Georgia, LLC

A Recertification Survey was conducted at Amedisys Home Health on November 18, 2024, and concluded on November 20, 2024. At the time of the survey, the agency was in compliance with 42 CFR Part 418.113, Emergency Preparedness and Covid-19 infection control.

A Recertification Survey was conducted at Amedisys Home Health on November 18, 2024, and concluded on November 20, 2024. At the time of the survey, the agency was not in compliance with compliance with Chapter 42 CFR Part 418, Rules and Requirements for Home Health and Hospice Agencies. The census was 276. The following deficiency was cited:

Encoding and transmitting OASIS CFR(s): 484.45(a) Standard: An HHA must encode and electronically transmit each completed OASIS assessment to the CMS system, regarding each beneficiary with respect to which information is required to be transmitted (as determined by the Secretary), within 30 days of completing the assessment of the beneficiary. This STANDARD is not met as evidenced by: Based on the Centers for Medicare & Medicaid Services (CMS) Home Health Agency (HHA) Error Summary by agency report, review of policy “Oasis Outcome and Information Set,” and staff interview, it was determined that the agency failed to electronically transmit monthly Outcome and Assessment Information Set (OASIS) data collected to the CMS system every 30 days. Findings include: Review of the policy titled “Oasis Outcome and Information Set,” revised 6/26/23, revealed that the agency must encode and electronically transmit each completed OASIS assessment to the CMS system within 30 days of completing the assessment of the beneficiary. Review of CMS report ran on 10/31/24 titled “HHA Error Summary by Agency,” revealed the agency failed to transmit OASIS data to the CMS system within 30 days. An interview was conducted with the Director of Operations at 11/19/2024 at 1:00 p.m. The Director of Operations confirmed OASIS reports had not been submitted to CMS within 30 days of completing the assessments.

A routine survey was conducted at Amedisys Home Health in Vidalia, GA from 11/15/21 to 11/17/21. The routine survey revealed that the agency was in substantial compliance with 42 CFR Part 484.22, Emergency Preparedness for Home Health Agencies. A focused COVID 19 Infection Control Survey was completed at the time of the on site survey. Census was 403 at the time of the on site survey. No deficiencies were cited.

A routine survey was conducted at Amedisys Home Health in Vidalia, GA from 11/15/21 to 11/17/21. The routine survey revealed that the agency was in substantial compliance with 42 CFR Part 484, Requirements for Home Health Agencies. Census was 403 at the time of the on site visit. The following deficiencies were cited:

Contact info Federal/State-funded entities CFR(s): 484.50(c)(10)(i,ii,iii,iv,v) Be advised of the names, addresses, and telephone numbers of the following Federally-funded and state-funded entities that serve the area where the patient resides: (i) Agency on Aging (ii) Center for Independent Living (iii) Protection and Advocacy Agency, (iv) Aging and Disability Resource Center; and (v) Quality Improvement Organization. This ELEMENT is not met as evidenced by: Based on home visit observations, it was determined that the home health agency failed to ensure that the agency provided contact information to the five required community agencies for seven of seven sampled patients (P (P#1, P#2, P#3, P#4, P#5, P#6, and P#7) observed during home visits. The finding include: 1.A home visit was conducted at the home of P#1 on 11/15/21, at 1:00 p.m. P#1 was admitted to the agency on 8/24/21, with the admitting diagnosis of critical illness myopathy. Upon review of the agency’s folder in the home, it was revealed that the folder did not contain contact information for the following local agencies: Area Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and Disability Resource Center and Quality Improvement Organization. 2. A home visit was conducted at the home of P#2 on 11/15/21, at 2:15 p.m. Pt#2 was admitted to the agency on 6/29/21, with the admitting diagnosis of encounter for surgical after care following surgery on the digestive system. Upon review of the agency’s folder in the home, it was revealed that the folder did not contain contact information for the following local agencies: Area Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and Disability Resource Center and Quality Improvement Organization. 3.A home visit was conducted at the home of P#3 on 11/15/21, at 3:30 p.m. Pt#3 was admitted to the agency on 7/9/21, with the admitting diagnosis of displaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for closed fracture with routine healing. Upon review of the agency’s folder in the home, it was revealed that the folder did not contain contact information for the following local agencies: Area Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and Disability Resource Center and Quality Improvement Organization. 4.A home visit was conducted at the home of P#4 on 11/16/21, at 8:00 a.m. Pt#4 was admitted to the agency on 7/6/21, with the admitting diagnosis of infection following a procedure, deep incisional surgical site (subsequent encounter). Upon review of the agency’s folder in the home, it was revealed that the folder did not contain contact information for the following local agencies: Area Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and Disability Resource Center and Quality Improvement Organization. 5.A home visit was conducted at the home of P#5 on 11/16/21, at 9:30 a.m. Pt#5 was admitted to the agency on 10/16/21, with the admitting diagnosis of unspecified dementia without behavioral disturbance. Upon review of the agency’s folder in the home, it was revealed that the folder did not contain contact information for the following local agencies: Area Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and Disability Resource Center and Quality Improvement Organization. 6. A home visit was conducted at the home of P#6 on 11/16/21, at 11:15 a.m. Pt#6 was admitted to the agency on 10/2/21, with the admitting diagnosis of hemiplegia following cerebral infarction affecting right dominate side. Upon review of the agency’s folder in the home, it was revealed that the folder did not contain contact information for the following local agencies: Area Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and Disability Resource Center and Quality Improvement Organization 7. A home visit was conducted at the home of P#7 on 11/16/21, at 12:15 a.m. Pt#7 was admitted to the agency on 10/13/21, with the admitting diagnosis of non-ST elevation myocardial infarction (NSTEMI). Upon review of the agency’s folder in the home, it was revealed that the folder did not contain contact information for the following local agencies: Area Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and Disability Resource Center and Quality Improvement Organization. The agency Administrator was informed of the findings in an interview on 11/17/21, at 11:00 a.m.

A review of all current medications CFR(s): 484.55(c)(5) A review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy. This ELEMENT is not met as evidenced by: Based on home visit observations, clinical record review and staff interview it was determined that the home health agency failed to ensure that the medication profile was updated in to reflect current medications at the time of the comprehensive assessment for five of seven sampled patients (P) (P#1, P#2, P#4, P#5 and P#6 observed during home visits. The finding include: 1.A home visit was conducted at the home of P#1 on 11/15/21, at 1:00 p.m. P#1 was admitted to the agency on 8/24/21 with the admitting diagnosis of critical illness myopathy. The clinical record was reviewed for certification period 10/23/21 to 12/21/21. Upon review of the medications in the home with Licensed Practical Nurse (LPN) #BB during the visit, it was revealed that the patient was taking the hypertension medication Losartan 50 mg (milligrams) twice daily. However, the medication was not listed on the agency’s electronic medical record (EMR). When LPN #BB asked P#1 if he was taking the pain medication Tramadol 50 mg every six hours as directed in the EMR, P#1 responded: “I stopped taking that several weeks ago.” In an interview at the home, LPN #BB acknowledged that the medications in the home did not match the medications listed in the agency’s EMR. 2.A home visit was conducted at the home of P#2 on 11/15/21, at 2:15 p.m. P #2 was admitted to the agency on 6/29/21, with the admitting diagnosis of encounter for surgical care following surgery on the digestive system. The clinical record was reviewed for certification period 10/27/21 to 12/25/21. Upon review of the medication in the home with physical therapist assistant (PTA) #AA during the visit, it was revealed that the patient was taking the diuretic medication furosemide 20 mg daily for hypertension. However, the medication was not listed in the agency’s EMR. The patient also had the medication pantoprazole 40 mg delayed release tablets in the home with the instructions to take twice daily for gastroesophageal reflux. However, the agency’s EMR had the medication pantoprazole 40 mg delayed release tablets listed with instructions for P#2 to take once daily. In an interview in the home, PTA#AA acknowledged that the medications in the home did not match the medications listed in the agency’s EMR. 3.A home visit was conducted at the home of P#4 on 11/16/21, at 8:00 a.m. P#4 was admitted to the agency on 7/6/21, with the admitting diagnosis of infection following a procedure, deep incisional surgical site (subsequent encounter). The clinical record was reviewed for certification period 11/2/21 to 1/1/21. Upon review of the medication in the home with Registered Nurse (RN) #CC during the visit it was revealed that the patient had the following medications in the home but not listed in the agency EMR: Magic Mouthwash, with is prescribed for mouth pain. The instructions were: swish and gargle one to two teaspoons four times a day as prior to each meal and at bedtime. P#4 also had the medication gabapentin, which is used for neuropathic pain. The instructions were: take one 300 mg capsule by mouth at bedtime for five days, then take one 300 mg capsule by mouth twice daily for five days, then take one 300 mg capsule by mouth three times per day. In an interview in the home, RN #CC acknowledged that the medications in the home did not match the medications listed in the agency’s EMR. 4.A home visit was conducted in the home of P#5 on 11/16/21, at 11:15 a.m. P#5 was admitted to the agency on 10/16/21, with the admitting diagnosis of unspecified dementia without behavioral disturbance. The clinical record was reviewed for certification period 10/16/21 to 12/14/21. Upon review of the medication in the home with physical therapist (PT) #DD during the visit, it was revealed that the patient had the following medications in the home but not listed in the agency’s EMR: ProAir HFA inhaler, which is used for shortness of breath, with the instructions to inhale one puff every six hours as needed; guaifenesin oral liquid100mg/5ml (milliliters), which is used for cough, with the instructions to take 10 ml every 6 hours as needed for cough; omega 3 1000mg over the counter gel caps, which P#5’s caregiver stated the patient takes twice daily for a dietary supplement. In an interview in the home, PT #DD acknowledged that the medications in the home did not match the medications listed in the agency’s EMR. 5.A home visit was conducted in the home of P#6 on 11/16/21, at 11:15 a.m. Pt#6 was admitted to the agency on 10/2/21, with the admitting diagnosis of hemiplegia following cerebral infarction affecting right dominate side. The clinical record was reviewed for certification period 10/2/21 to 11/30/21. Upon review of the medication in the home with occupational therapist assistant (OTA) #EE during the visit it was revealed that the patient had the following medication in the home but not listed in the agency EMR: allopurinol 100 mg per day for gout pain. In an interview in the home OTA #EE acknowledged that the medications in the home did not match the medications listed in the agency’s EMR. The agency Administrator was informed of these findings in an interview at the agency on 11/17/21, at 11:00 a.m.

Only as ordered by a physician CFR(s): 484.60(b)(1) Drugs, services, and treatments are administered only as ordered by a physician or allowed practitioner. This ELEMENT is not met as evidenced by: Based on clinical record review and home visit observation it was determined that the agency staff failed to ensure treatments were administered only as ordered by the physician for two of 17sampled patients (P). (#4 and #7 The findings include: 1.P#4 was admitted to the agency on 7/6/21, with the diagnosis of infection following a procedure, deep incisional surgical site (subsequent encounter). The clinical record was reviewed for certification period 11/3/21 to 1/1/21. The clinical record contained an order dated 11/1/21, stating: “Skilled nurse to perform/teach patient/ caregiver wound care to left jaw: cleanse with wound cleanser, pat dry with gauze, apply NS (normal saline) wet to dry gauze dressing, apply dry gauze dressing, secure with tape, change twice daily and prn for soiled or displaced dressing”. A home visit was conducted with Registered Nurse (RN) #CC on 11/16/21, at 8:00 a.m. During the home visit, RN #CC was observed providing wound care. RN #CC cleaned the wound with normal saline after P#4 removed the dressing. RN #CC then patted the wound dry with gauze, applied normal saline to gauze and covered the wound. RN #CC then covered the wet gauze with a dry gauze dressing and secured with tape. RN #CC did not follow the wound care order, which instructed the skilled nurse to cleanse the wound with wound cleanser. 2.P#7 was admitted to the agency on 10/13/21, with the diagnosis of non-ST elevation myocardial infarction (NSTEMI). The clinical record was reviewed for certification period 10/13/21 to 12/11/21. The clinical record contained an order dated 10/13/21, stating: “Enteral feeding/ care and teaching: skilled nurse to perform and instruct in management of gastrostomy including care of site, equipment, and preparation/ administration of feedings. Type Ensure Enlivevia bolus cans 1 frequency 5 times daily. Flush gastrostomy with 50cc (cubic centimeters) of water frequency before and after feeding, site care daily and prn, dry dressing and paper tape. A home visit was made on 11/16/21, at 12:15 p.m. to P#7’s home with Licensed Practical Nurse (LPN) #FF. During the visit LPN #FF provided gastrostomy site care to the patient. LPN #FF was noted to clean the gastrostomy site with wound cleanser, pat dry and cover with dry gauze. When reviewing the order with LPN #FF, LPN #FF acknowledged the order did not contain instructions regarding what should be used to clean the gastrostomy site. Additionally, while at the visit, P#7 was noted to be receiving oxygen at two liters per minute via nasal cannula from an oxygen concentrator. The clinical record did not contain an order for oxygen administration. P#7’s clinical record also revealed the following medications that had instructions to administer the medications by mouth: “Potassium chloride 20 meq(milliequivalents)/ 15 ml (milliliters) oral liquid. Give 15 ml oral daily by mouth”. This is an electrolyte replacement medication. However, P#7’s caregiver stated the medication was given via gastrostomy tube. “Tylenol extra strength 500 mg tablet. One tablet four times daily by mouth”. This is a mediation to reduce pain and/ or fever. However, P#7’s caregiver stated the medication was given via gastrostomy tube.“Tylenol PM (nighttime) extra strength 25mg/500mg. One tablet at bedtime”. This is a medication to reduce pain and induce sleep. However, P#7’s caregiver stated the medication was given via gastrostomy tube. The agency Administrator was informed of these findings in an interview at the agency on 11/17/21, at 11:00 a.m.