Every finding on record at Amedisys Sc, LLC

An onsite unannounced Emergency Preparedness Program (EPP) Survey was conducted at Amedisys Home Health Bluffton from 08/14/2023 to 08/17/2023. Amedisys Home Health Bluffton is in compliance with the Medicare Conditions at 42 CFR PART 484.102 (Establishment of the Emergency Program).

An onsite unannounced Recertification survey was conducted at Amedisys Home Health Bluffton from 08/14/2023 to 08/17/2023. Amedisys Home Health Bluffton is in substantial compliance with 42 CFR PART 484.

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 record reviews and interviews, the Home Health Agency staff failed to ensure 4 of 17 patient records reviewed (Patient #4, #9, #11, and #13) received Skilled Nursing (SN) and/or therapy visits as ordered. Review on 8/16/23 at 2:15 PM of physician orders for Patient #9 revealed orders dated 7/14/23 for skilled nursing to visit one time a week for 9 weeks. Review of the calendar of nursing visits scheduled and of nursing notes documented in the record revealed nothing to indicate that skilled nursing had come to do a home visit the week of 7/16/23 - 7/22/23. During an interview on 8/17/23 at 10:40 AM, Skilled Nurse #1 verified the missed visit for Patient #9. Review on 8/16/23 at 3:31 PM of physician orders for Patient #11 revealed orders dated 7/10/23 for skilled nursing to visit three times a week from week 3 through week 6, for wound care. Review of the calendar of nursing visits scheduled and of nursing notes documented in the record revealed a nurse had been scheduled and had come out on 8/7/23 and 8/11/23, twice in week 5; instead of three times as ordered. The finding was verified by Skilled Nurse #1 during an interview on 8/17/23 at 10:45 AM. Patient #4 On 08/16/2023 at 2:20 PM, record review reveals physician orders for Physical Therapy (PT) visit 3 times a week for 1 week, 2 times a week for 5 weeks and 1 time a week for 3 weeks. PT visits documented on 07/03/2023 and 07/07/2023 only for the first week. There is no documentation for third visit during that week. Interview on 08/17/2023 at 11:10 AM, Skilled Nurse (SN) #1 reports “it wasn’t put on the schedule”. Patient #13 On 08/17/2023 at 8:50 AM, record review reveals physician orders dated 07/12/2023 for Medical Social Worker (MSW) to evaluate patient. There is no documentation in the chart for MSW visit performed. Interview on 08/17/2023 at 11:15 AM, Skilled Nurse (SN) #1 reports “it wasn’t put on the schedule”.

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 observations and record review, the home health agency failed to update an accurate medication record for 2 of 6 applicable patients. (Patient #2 and #5) Observation during a home visit on 8/15/23 at 12:55 PM with Skilled Nurse #3 revealed a medication bottle for Patient #2 labeled Carbidopa 25 milligrams (mg)-Levodopa 250 mg, to take one tablet three times a day. The pharmacy label on the bottle indicated the medication had been filled on 7/20/23. Patient #2 verified this was the dose s/he was currently taking. Concurrent review of the patient's medication list provided by the Home Health agency revealed the patient was currently taking Carbidopa 25-Levodopa 100 mg tablet three times a day since 5/3/23. During an interview on 8/15/23 at 1:00 PM, Skilled Nurse #3 stated s/he had been coming for scheduled visits once a week. Skilled Nurse #3 verified the patient's medication list had not been updated to include the changed dosage. The Finding includes: Patient #5 Home visit on 08/15/2023 between 9:19 AM and 10:15 AM reveals agency medication list inaccuracy for: Caregiver reports Bacid with Lactospore 1 Billion Cell Capsule, 1 capsule by mouth daily. This medication is discontinued on the agency medication list since 07/18/2023. On 08/15/2023 at 10:05 AM, Skilled Nurse (SN) #2 verifies the finding.