Every finding on record at Andventure, LLC

Based on the findings of an unannounced onsite Medicare and state complaint survey conducted on August 12-15, 2024, Aveanna Healthcare was found not to be in compliance with the requirements of 42 CFR, Part 484, Subparts B and C, Conditions of Participation: Home Health Agencies.

Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician or allowed practitioner refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician or allowed practitioner is consulted to approve additions or modifications to the original plan. This STANDARD is not met as evidenced by: Based on review of medical records (MRs), agency policies/procedures, personnel files and interview with agency administrator, the agency failed to update the patient's plan of care in one (1) of three (3) medical records reviewed (MR#3). Review conducted on August 12, 2024, at approximately 2:00 PM to 3:50 PM, of medical records (MRs) revealed: MR#3 start of care (SOC): 11/16/20; certification period: 6/19/23 to 8/17/23; physician orders, “Enteral Feeding Supplies (tubing formula) Enteral Feeding tube/ button supplies. Flush G-tube with 10 mls of h2o after medication and formula administration. SN to administer 4oz Pedialyte PRN for illness or sign/symptoms of dehydration for a total of 32-64oz per day during illness. Total fluid goal for the day 34-39 oz as tolerated (via G-tube and /or PO) Start effective date: 1/23/23.” Certification Period: 8/18/23 to 10/16/23, “Enteral Feeding Supplies (tubing formula) Enteral Feeding tube/ button supplies. Flush G-tube with 10 mls of h2o after medication and formula administration. SN to administer 4oz Pedialyte PRN for illness or sign/symptoms of dehydration for a total of 32-64oz per day during illness. Total fluid goal for the day 34-39 oz as tolerated (via G-tube and /or PO) Start effective date: 1/23/23.” Certification Period: 10/17/23 to 12/15/23, “Enteral Feeding Supplies (tubing formula) Enteral Feeding tube/ button supplies. Flush G-tube with 10 mls of h2o after medication and formula administration. SN to administer 4oz Pedialyte PRN for illness or sign/symptoms of dehydration for a total of 32-64oz per day during illness. Total fluid goal for the day 34-39 oz as tolerated (via G-tube and /or PO) Start effective date: 1/23/23.” Certification period: 12/16/2/13/24, “Enteral Feeding Supplies (tubing formula) Enteral Feeding tube/ button supplies. Flush G-tube with 10 mls of h2o after medication and formula administration. SN to administer 4oz Pedialyte PRN for illness or sign/symptoms of dehydration for a total of 32-64oz per day during illness. Total fluid goal for the day 34-39 oz as tolerated (via G-tube and /or PO) Start effective date: 1/23/23.” Certification Period: 2/14/24 to 4/13/24, “Enteral Feeding Supplies (tubing formula) Enteral Feeding tube/ button supplies. Flush G-tube with 10 mls of h2o after medication and formula administration. SN to administer 4oz Pedialyte PRN for illness or sign/symptoms of dehydration for a total of 32-64oz per day during illness. Total fluid goal for the day 34-39 oz as tolerated (via G-tube and /or PO) Start effective date: 1/23/23”. Certification period: 6/13/24-8/11/24, “Enteral Feeding Supplies (tubing formula) Enteral Feeding tube/ button supplies. Flush G-tube with 10 mls of h2o after medication and formula administration. SN to administer 4oz Pedialyte PRN for illness or sign/symptoms of dehydration for a total of 32-64oz per day during illness. Total fluid goal for the day 34-39 oz as tolerated (via G-tube and /or PO) Start effective date: 1/23/23”. Certification Period: 6/13/24 to 8/11/24, “Enteral Feeding Supplies (tubing formula) Enteral Feeding tube/ button supplies. Flush G-tube with 10 mls of h2o after medication and formula administration. SN to administer 4oz Pedialyte PRN for illness or sign/symptoms of dehydration for a total of 32-64oz per day during illness. Total fluid goal for the day 34-39 oz as tolerated (via G-tube and /or PO) Start effective date: 1/23/23”. Review conducted on July 12, 2024, at approximately 1:00 PM, of personnel files (PFs) revealed: PF #1, date of hire (doh) 11/12/14, completed skilled nurse orientation on 11/14/24. PF#3, doh 9/19/23, completed skilled nurse orientation on 9/21/23. PF#5, doh 5/1/16, completed skilled nurse orientation on 5/13/16. PF#6. Doh 8/20/19, completed skilled nurse orientation on 8/26/19. Review conducted on July 12, 2024, at approximately 3:30 PM, of agency policy #4.27.04 Physician Orders revealed: Page 4 of 13, “The Plan of Care/treatment must be reviewed and revised as frequently as the patient’s condition or needs require, …; and page 5 of 13 … Revised POC’s must reflect current information from the patient’s updated comprehensive assessment and information concerning the patient’s progress toward the measurable outcomes and goals identified in the POC.; and page 6 of 13 … It [POC] more frequently based upon: Changes in the patient’s physical and psychosocial condition … Changes regarding diagnosis, treatment including procedures, medications, and equipment.” Review conducted on July 12, 2024, at approximately 3:35 PM of agency policy #4.02.05 Reassessment and Ongoing revealed: Page 1 of 4, “Process/Procedures Patients are reassessed: … When a significant change occurs in the patient’s condition … During the course of clinical care provided … Prior to the preparation of the recertification plan of care…; page 2 of 4 Reassessment of patients receiving nursing services must be performed by a Registered Nurse to determine ongoing care needs … as appropriate assessments include: Pertinent physical findings … functional changes … Equipment (type, needs, modifications, etc.).”; and Skilled Nurse Orientation – Employee Booklet, page 9 of 17, “General Documentation Guidelines Quality nursing documentation accurately reflects patient assessment and the plan of care, provides a comprehensive description of the patient’s current condition, interventions provided, responses to care and an accurate account of events, including when they occurred.” Interview conducted on July 12, 2024, at approximately 5:00 PM, with agency administrator confirmed that MR#3’s re-certification documents did not accurately reflect current physician orders for patient care.