Every finding on record at Amedisys Tennessee, LLC

An Emergency Preparedness Survey was conducted on 4/6/2026-4/8/2026 at Amedisys Home Health Chattanooga. No deficiencies were cited under 42 CFR 484.102.

A recertification survey was conducted on 4/6/2026-4/8/2026 at Amedisys Home Health Chattanooga. Deficiencies were cited under 42 CFR Part 484, Requirements for Home Health Agencies.

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 (#5) 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 #5 was admitted to the agency on 3/17/2026 with diagnoses including Pneumonia, Chronic Obstructive Pulmonary Disease, and Diabetes Mellitus. Review of the agency Client Medication Report for Patient #5 dated 3/17/2026 revealed Farxiga (a medication used for diabetes mellitus) 10 milligrams (MG) with a start date of 3/1/2026. During an observation and interview on 4/7/2026 at 11:30 AM, Licensed Practical Nurse (LPN) A medication reconciliation in the home active medication list revealed Patient #3's Farxiga 10mg had been replaced by Empagliflozin (a medication used to treat diabetes mellitus) 25mg on 3/12/2026. Continued review revealed Farxiga 10mg had been discontinued on 3/12/2026. LPN A confirmed Farxiga 10mg should have been discontinued on 3/12/2026 and Empagliflozin 25mg should have been added to the client medication report. During an interview on 4/8/2026 at 12:10 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 #5's current medication orders.

An Emergency Preparedness survey was conducted from 3/14/2023 to 3/16/2023 at Amedisys Home Health Chattanooga. No deficiencies were cited under CFR Part 484.22 Condition of Participation for Home Health Agencies.

A Recertification survey was conducted on 3/14/2023 to 3/16/2023 at Amedisys Home Health Chattanooga. Deficiencies were cited under CFR Part 484, Requirements for Home Care Organizations Providing Home Health Care.

Verbal orders CFR(s): 484.60(b)(3)(4) (3) Verbal orders must be accepted only by personnel authorized to do so by applicable state laws and regulations and by the HHA's internal policies. (4) When services are provided on the basis of a physician or allowed practitioner's verbal orders, a nurse acting in accordance with state licensure requirements, or other qualified practitioner responsible for furnishing or supervising the ordered services, in accordance with state law and the HHA's policies, must document the orders in the patient's clinical record, and sign, date, and time the orders. Verbal orders must be authenticated and dated by the physician or allowed pracitioner in accordance with applicable state laws and regulations, as well as the HHA's internal policies. This ELEMENT is not met as evidenced by: Based on review of the agency's policies, medical record review, and interview, the agency failed to obtain written physician orders for a changed medication for 1 patient (#6) of 17 patients reviewed. The findings included: Review of the agency's policy Drug Regimen Review revised 1/2020 revealed "...When medication changes or additions are received verbally from the Physician, a supplemental order is completed identifying the additions or changes and forwarded to the Physician for signature..." Review of the agency's policy Physician Orders and Medical Supervision of the Plan of Care revised on 2/28/2023 revealed "...Verbal orders are put in writing, signed, dated and timed with the date/time of receipt by the registered nurse...responsible for furnishing or supervising the ordered services..." Medical record review revealed Patient #6 was admitted to the agency on 4/9/2022 with diagnoses including Type 2 Diabetes Mellitus with Diabetic Chronic Kidney Disease and Morbid Obesity. Review of the skilled nurse's notes dated 2/8/2023 to 3/1/2023 revealed the patient's glucometer blood glucose levels ranged between 211 and 341 (normal 60-120). Review of the Client Coordination Note Report dated 3/1/2023 revealed the physician had increased the patient's Lantus (insulin) from 15 units twice a day to 22 units twice a day. Review of physician's orders from 3/1/2023 to 3/15/2023 revealed no documentation a physician's order was completed and sent to the physician for signature. Interview with the Executive Director of Operations on 3/15/2023 at 1:45 PM, in the conference room, confirmed the skilled nurse had not transcribed the verbal order to writing and a supplemental order was not sent to the physician for signature.

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 of the agency's policies, medical record review, and interview, the agency failed to revise the plan of care to include updating the medication profile for 2 patients (#2 and #6) of 17 patients reviewed. The findings included: Review of the agency's policy on Drug Regimen Review revised 01/2020 revealed "...Once a verbal order is transferred to the agency, the RN-Clinical Manager...will review the order; mark the order complete; the order will then update the medication list in HCHB (Home Care Home Base - computer program). A new medication profile will be generated and printed...A copy of the Medication Profile is taken to the patient's home and placed in the patient's home folder and also incorporated in the medical record...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 for 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..." Medical record review revealed Patient #2 was admitted to the agency on 2/10/2023 with diagnoses including Aftercare Following Surgery for Neoplasm and Essential Hypertension. Medical record review of the skilled nursing note dated 2/10/2023 revealed the patient complained of "burning" with urination. Further review revealed the patient's physician was notified of the patient's complaint with no further orders received. Medical record review of the skilled nursing note dated 2/14/2023 revealed the patient complained of "burning" with urination. Further review revealed the patient's physician was notified of the patient's complaint. Continued review revealed a urinalysis (checks the status of the urine for possible infection) was ordered and collected by the skilled nurse. Medical record review of the Client Coordination Note Report dated 2/21/2023 revealed the patient had received Macrobid (antibiotic) 100 mg (milligram) 1 capsule two times a day for 5 days to treat the patient's Urinary Tract Infection. Medical record review of the medication profile printed 3/15/2023 revealed the Macrobid had not been updated on the medication profile. Medical record review revealed Patient #6 was admitted to the agency on 4/9/2022 with diagnoses including Type 2 Diabetes Mellitus with Diabetic Chronic Kidney Disease and Morbid Obesity. Review of the skilled nurse's notes dated 2/8/2023 to 3/1/2023 revealed the patient's glucometer blood glucose levels ranged between 211 and 341 (normal 60-120). Review of the Client Coordination Note Report dated 3/1/2023 revealed the physician had increased the patient's Lantus (insulin) from 15 units twice a day to 22 units twice a day. Review of the medication profile dated 3/14/2023 revealed the increase of Lantus to 22 units twice a day had not been updated on the medication profile. Interview with the Executive Director of Operations on 3/15/2023 at 1:00 PM, in the conference room, confirmed the Macrobid had not been added to the medication profile and the increased Lantus had not been changed to 22 units until 3/15/2023.