Every finding on record at Asian Network Pacific Home Care, Inc.

The following reflects the findings of the California Department of Public Health during a Recertification survey from 8/22/2022 to 8/26/2022. Representing the Department: 31403 and 38534 The unduplicated census was 956. Sample size was 17. One deficiency was cited. See tag 572

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 interview and record review, the home health agency’s licensed staff did not provide services as outlined in the plan of care for one of 17 patients (Patient 1). Patient 1 required daily weights which were not completed and tracked. This failure contributed to the development of worsening congestive heart failure (CHF) and an unnecessary hospital admission. CHF is a weakness of the heart muscle which can lead to fluid backup in the lungs causing shortness of breath. Findings: Record review on 8/23/2022 at 3:50 p.m. of the document, “Home Health Certification and Plan of Care” showed Patient 1’s start of care date was 6/20/2022 with the current certification period 6/20/2022 to 8/18/2022. The diagnoses included CHF. Review of the medication list showed, “furosemide (water pill to treat fluid retention and swelling caused by CHF) Oral 20 mg (milligram) 2 tab(s) by mouth every morning.” Review of the orders and treatments showed Patient 1 was to be weighed every day. (Note: CHF patients are weighed frequently in order to assess the amount of fluid retention and possible need to adjust the furosemide dosage) Record review on 8/23/2022 at 3:50 p.m. of the documents, “Skilled Nursing Visit(s)” showed the following: 7/6/2022 visit: weight: 182 pounds – Patient 1 had crackles bilateral bases in the lungs (crackles: fluid) 7/8/2022 visit: weight: 182 pounds – Crackles bilateral bases 7/11/2022 visit: no documented weight – Crackles bilateral bases 7/14/2022 visit: no documented weight – diminished breath sounds at the bases with sputum (fluid coughed up from the lungs and diminished breath sounds can indicate air or fluid around the lungs) In a concurrent interview, the agency’s Director of Clinical Services (DCS) confirmed the missing weights that staff failed to obtain. DCS stated the weights were important to do because Patient 1 had CHF. Record review on 8/23/2022 at 3:50 p.m. of the document, “Patient Communication” showed Patient 1 went to the hospital's Emergency Department (ED) on 7/15/2022. In an interview on 8/25/2022 at 10:53 a.m., the Licensed Vocational Nurse 1 (LVN 1) confirmed she had not monitored Patient 1’s weight on 7/11/2022. LVN 1 stated it was important to weigh the patient because of Patient 1's CHF and “Potential for fluid overload.” LVN 1 stated Patient 1 was not bedbound and was able to get up and use his walker in order to be weighed. Record review on 8/31/2022 at 11:14 a.m. of the document, “Discharge Summary” dated 7/18/2022, showed Patient 1 was admitted to the hospital's ED on 7/15/2022 with respiratory failure and hypoxia ( low oxygen in the tissues). Patient 1 passed away on 7/18/2022. The cause of death was “Acute hypoxemic respiratory failure.”