Every finding on record at Amedisys Tennessee, L L C

An Emergency Preparedness Survey was conducted on 7/13/2026-7/15/2026 at Amedisys Home Health. No deficiencies were cited under 42 CFR 484.102.

A state licensure survey was conducted on 7/13/2026-7/15/2026 at Amedisys Home Health. No deficiencies were cited related to 0720-27 Standards for Home Care Organizations.

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 agency policy review, medical record review, and interviews, the agency failed to update the medication profile with new medications for 1 Patient (#7) of 17 patients medications reviewed. The findings include: Review of the agency policy titled, "Monitoring Medications,” revised 7/1/2024 revealed "...a drug regimen review will be performed on all patients...the skilled nurse is responsible for medication review and reconciliation throughout the episode...Compare medication list...to actual medications patient is taking...Review all medications including over the counter (OTC) medications, vitamins...creams and topical ointments..." Review of the agency policy titled, "Drug Regimen Review,” revised 1/15/2026 revealed "...Update the medication profile in the clinical records...when change was verified by reviewing a written prescription or prescription bottle... Medical record review revealed Patient #7 was admitted to the agency on 6/22/2026 with diagnoses including Atrial Fibrillation, Chronic Obstructive Pulmonary Disease, and Hypertension. Review of the Physician Medication List for Patient #7 dated 7/9/2026 revealed Vitamin B-12 1,000 mcg (microgram) oral route (vitamin supplement), metoprolol tartrate 25 mg (milligram) oral route (medication used for blood pressure), sertraline 25 mg oral route (medication used for mood), and Thermotabs 287 mg-180 mg-15 mg oral route (vitamin supplement). Review of the agency Client Medication Report for Patient #7 dated 6/22/2026 revealed Vitamin B-12 1,000 mcg, metoprolol tartrate 25 mg sertraline 25 mg and Thermotabs 287 mg-180 mg-15 mg had not been added to the list of current medications. During an observation and interview on 7/14/2026 at 2:15 PM, Speech Therapist (A) medication reconciliation in the home revealed Patient #7's Vitamin B-12 1,000 mcg, metoprolol tartrate 25 mg sertraline 25 mg and Thermotabs 287 mg-180 mg-15 mg had been added by the patient's Primary Care Physician on 7/9/2026. Speech Therapist A confirmed the medications in the home did not match Patient #7's current medications. During an interview on 5/14/2026 at 3:30 PM, the Director of Operations stated the medication reconciliation are to be completed on each skilled nurse visit and confirmed the medication reconciliation had not been updated to reflect Patient #7's current medication orders.

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 agency policy review, medical record review, and interviews, the agency failed to physician order for visit frequency and laboratory test for 1 Patient (#6) of 17 patients reviewed. The findings include: Review of the agency policy titled, "Plan of Care," revealed 2/9/2026 revealed "...A Plan of Care will be developed through a care planning process, which is designed to provide care, treatment, and services that are appropriate to the patient's individual needs...initiated by a physician...The frequency of visits...orders for home health...frequency and duration..." Review of the agency policy titled, "Physician Orders and Medical Supervision of the Plan of Care,” revised 1/15/26 revealed "...Verbal orders are put in writing, signed, dated, and timed with the date/time of receipt by the registered nurse or qualified therapist responsible for furnishing or supervising the ordered services...must be recorded/integrated in the plan of care to assure coordination of all services and interventions provided..." Medical record review revealed Patient #6 was admitted to the agency on 3/30/2026 with diagnoses including Chronic Kidney Disease, Anemia, and Anxiety Disorder. Review of the Plan of Care for Patient #6 dated 5/29/2026 to 7/27/2026 revealed a physician's order for SN (Skilled Nurse) weekly for 1 week dated 6/14/2026. Review of the HHA (Home Health Agency) Survey Investigation Worksheet: Calendar and Coordination Notes for Patient #6 showed the SN had not completed a visit as ordered for the week of 6/14/2026-6/20/2026. Review of a Physician Order for Patient #6 dated 6/19/2026 revealed "...Skilled Nurse to draw BMP [Basic Metabolic Panel] lab [laboratory] scheduled for 6/20/26 [6/20/2026]..." Continued review revealed a laboratory test had not been obtained on 6/20/2026. During an interview on 7/13/2026 at 11:44 AM, the Director of Operations confirmed a skilled nurse had not made a scheduled visit for 6/14/2026-6/20/2026 and had not obtained an ordered lab scheduled for 6/20/2026.

An Emergency Preparedness survey was conducted from 5/2/2023 to 5/4/2023 at Amedisys Home Health. No deficiencies were cited under CFR Part 484.22 Condition of Participation for Home Health Agencies.

A Recertification survey was conducted on 5/2/2023 to 5/4/2023 at Amedisys Home Health. Deficiencies were cited under CFR Part 484, Requirements for Home Care Organizations Providing Home Health Care.

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 review of agency policy, observation, medical record review, and interview, the agency failed to review all medications the patient was currently prescribed for 1 patient (#7) of 17 patients reviewed. The findings included: Patient #7 was admitted to the agency with diagnoses including Pressure Ulcer of Sacral Region, Stage 4 and Type 2 Diabetes Mellitus with Diabetic Peripheral Angiopathy without Gangrene. Medical record review of the agency's policy on Drug Regimen Review (revised 1/2020) revealed "...The clinician completing the OASIS (Outcome and Assessment Information Set) must complete a comprehensive drug regimen review of all medications the patient is currently taking at time of admission, recertification, resumption of care and with any major change in condition. The medication profile is completed by documenting all the patient's medications which includes medications on written prescriptions and medication bottles..." Observation of Patient #7 on 5/3/2023 at 10:30 AM, revealed a prescription of Semaglutide (antidiabetic medication used to treat Type 2 Diabetes Mellitus) 0.5 mg (milligrams) - 0.375 ml (milliliters), inject 0.5 ml under the skin every 7 days. Inject weekly on the same day. The medication bottle was dated 3/23/2023. The medication was stored in the refrigerator. Medical record review of the Transfer OASIS dated 4/3/2023 revealed the patient was transferred to the hospital for a planned medical procedure. Medical record review of the Resumption of Care OASIS dated 4/9/2023 revealed the medication Semaglutide was not listed as a current medication. Medical record review of the Medication Profile printed on 5/3/2023 revealed the medication Semaglutide was not added to the medication profile on 3/24/2023, during the skilled nurse visit following the prescription order date, and was not added to the medication profile with the resumption of care. Interview with the Area Vice President of Clinical on 5/3/2023 at 2:30 PM, confirmed the patient's medications were not reviewed for all medications and the medication profile was not updated with the new medication.

Plan of care must include the following CFR(s): 484.60(a)(2)(i-xvi) The individualized plan of care must include the following: (i) All pertinent diagnoses; (ii) The patient's mental, psychosocial, and cognitive status; (iii) The types of services, supplies, and equipment required; (iv) The frequency and duration of visits to be made; (v) Prognosis; (vi) Rehabilitation potential; (vii) Functional limitations; (viii) Activities permitted; (ix) Nutritional requirements; (x) All medications and treatments; (xi) Safety measures to protect against injury; (xii) A description of the patient's risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors. (xiii) Patient and caregiver education and training to facilitate timely discharge; (xiv) Patient-specific interventions and education; measurable outcomes and goals identified by the HHA and the patient; (xv) Information related to any advanced directives; and (xvi) Any additional items the HHA or physician or allowed practitioner may choose to include. This ELEMENT is not met as evidenced by: Based on medical record review and interview, the agency failed to include orders for patient and caregiver education and training regarding Type 2 Diabetes Mellitus for 1 patient (#13) of 17 patients reviewed. The findings included: Medical record review revealed Patient #13 was admitted to the agency on 12/17/2022 with the primary diagnosis of Type 2 Diabetes Mellitus with Foot Ulcer. Medical record review of the Home Health Certification and Plan of Care dated 12/17/2022 revealed the physician ordered skilled nursing services at 1 time a week for 2 weeks. Further review revealed the skilled nurse was to "assess, evaluate, and develop an individualized plan of care". Further review revealed the physician ordered Humulin 70/30 (insulin) 20 units twice a day. Continued review revealed the skilled nurse did not obtain blood glucose parameters from the physician. Continued review revealed no documentation the skilled nurse obtained or requested an order from the physician to provide diabetic teaching or management. Interview with the Area Vice President of Clinical on 5/3/2023 at 2:45 PM, in the conference room, confirmed the nurse did not obtain orders pertaining to the primary diagnosis of Type 2 Diabetes Mellitus from the physician or blood glucose parameters.

Review and revision of the plan of care CFR(s): 484.60(c) Standard: Review and revision of the plan of care. This STANDARD is not met as evidenced by: Based on review agency policies, observation, medical record review, and interview, the agency failed to revise the plan of care to include updating the medication profile for 1 patient (#7) of 17 patients reviewed. The findings included: Medical record review revealed Patient #7 was admitted to the agency with Pressure Ulcer of the Sacral area, Stage 4 and Type 2 Diabetes Mellitus with Diabetic Peripheral Angiopathy without Gangrene. Review of the agency's policy on Drug Regimen Review, revised 01/2020, revealed "...When medication additions or changes are not received verbally from the physician but identified in the home by review of prescription bottle or written prescription from the physician: The clinician/therapist will document new or changed medication on the clinicians visit note. The medication is then entered in the computer system...A new medication list is generated, printed and taken to the patient's home..." Review of the agency's policy on Physician Orders and Medical Supervision of the Plan of Care revised 2/28/2023 revealed "...All patient care orders from all physician's/allowed practitioners, including verbal orders, must be recorded/integrated in the plan of care to assure coordination of all services and interventions provided..." Observation of Patient #7 on 5/3/2023 at 10:30 AM, in the patient's home, revealed the medication Semaglutide (antidiabetic treatment to treat Type 2 Diabetes Mellitus) 0.5 mg (milligrams) 0.375 ml (milliliters) inject 0.5 mg under the skin every 7 days. Inject weekly on same day each week. The date on the prescription bottle was 3/23/2023. The medication was stored in the refrigerator. Medical record review of the medication profile printed on 5/3/2023 revealed the medication Semaglutide had not been updated on the medication profile. Interview with the Director of Operations on 5/3/2023 at 2:30 PM, in the conference room, confirmed the medication Semaglutide had not been added to the medication profile.

Patient and caregiver education CFR(s): 484.75(b)(5) Patient and caregiver education; This ELEMENT is not met as evidenced by: Based on medical record review and interview, the agency failed to provide diabetic education for 1 patient (#13) and medication instructions for 1 patient (#14) of 17 patients reviewed. The findings included: Medical record review revealed Patient #13 was admitted to the agency on 12/17/2022 with diagnosis of Type 2 Diabetes Mellitus with Foot Ulcer. Medical record review of the Home Health Certification and Plan of Care (485) dated 12/17/2022 to 2/14/2023 revealed a physician's order for skilled nurse at 1 time a week for 2 weeks. Further review revealed the patient was prescribed Humulin 70/30 (insulin) 20 units two times a day subcutaneous (start date 12/17/2022). Medical record review of a skilled nurse's note dated 12/17/2022 and 12/20/2022 revealed no documentation the patient was instructed or assessed on ability to perform insulin administration. Further review revealed no documentation the patient was instructed or assessed on ability to use a glucometer (measures blood sugar levels). Medical record review of a physician's order dated 12/27/2022 revealed the patient was sent to the hospital on 12/26/2022 for hypoglycemia from the Dialysis Center. Medical record review of the resumption of care orders dated 12/30/2022 revealed the physician ordered skilled nurse visits at 1 time a week for 8 weeks to provide instructions of diabetic care to include signs/symptoms of hypo/hyperglycemia, proper administration of diabetic medication and blood glucose testing frequency. Further review revealed the skilled nurse was to assess the patient's ability to perform and record blood glucose testing and to report abnormal findings to physician. Medical record review of skilled nurse's notes dated 12/30/2022, 1/4/2023, 1/10/2023, 1/20/2023. 1/27/2023 and 2/3/2023 revealed no documentation the patient was instructed or assessed on his ability to administer insulin. Further review revealed no documentation the patient was instructed or assessed on his ability to perform blood glucose monitoring. Medical record review revealed Patient #14 was admitted to the agency on 2/28/2023 with diagnoses including Myasthenia Gravis and Hypertension. Medical record review of a physician's order dated 3/15/2023 revealed the physician ordered Amiodarone (prevents and treats arrhythmias) 200 mg, take 1 tablet daily - hold if heart rate is less than 60 bpm (beats per minute). Medical record review of skilled nurse's notes dated 3/15/2023 and 3/20/2023 revealed no documentation the patient was instructed on when to take the Amiodarone. Further review revealed no documentation the patient was instructed or assessed on his ability to monitor his pulse. Medical record review of the Transfer Outcome and Assessment Information Set (OASIS) dated 3/22/2023 revealed the patient was admitted to the hospital with Myasthenia Gravis Crisis and was discharged from the hospital to Hospice Care. Interview with the Area Vice President of Clinical on 5/3/2023 at 3:30 PM, in the conference room, confirmed no documentation Patient #13 was assessed or received instruction on insulin administration and blood glucose monitoring. Further interview confirmed no documentation Patient #14 received instruction on how to monitor his pulse or how to take the Amiodarone.