Every finding on record at Axxess Home Care, Inc.

The Oklahoma State Department of Health conducted an unannounced Medicare Emergency Preparedness Program survey at the agency on 05/17/22 and 05/18/22. No deficiencies were cited as a result of the Emergency Preparedness Program survey.

The Oklahoma State Department of Health conducted an unannounced Medicare re-certification survey at the agency on 05/17/22 and 05/18/22. An entrance conference was conducted with Admin1. The survey process was explained. Questions were answered. Admim1 was identified as the contact person for administrative issues and clinical issues. Findings were discussed during an informal exit conference with Admin1, RN1 and Administrative representatives. A deficiency was cited as a result of the re-certification survey. GLOSSARY: RN Registered Nurse HHA Home Health Aide POC Plan of Care ADL Activities of Daily Living

Home health aide assignments and duties CFR(s): 484.80(g)(1) Standard: Home health aide assignments and duties. Home health aides are assigned to a specific patient by a registered nurse or other appropriate skilled professional, with written patient care instructions for a home health aide prepared by that registered nurse or other appropriate skilled professional (that is, physical therapist, speech-language pathologist, or occupational therapist). This STANDARD is not met as evidenced by: Based on clinical record review and interview, the RN failed to ensure development of HHA POC instructions determined by specific patient care needs for two (#3 and #4) of three (#3, #4 and #5) records reviewed with orders for home health aide services. Patient #3 A review of the clinical record for Patient #3 re-certification periods 03/04/22 - 07/01/22, revealed a principal diagnosis of Generalized Osteoarthritis and orders for HHA visits one time a week for nine weeks to assist with personal care, hygiene and activities of daily living. A form titled, "Aide Care Plan Report" contained instructions for the HHA to provide "Bathing- Shower" every visit. Further review of weekly HHA Visit notes for 03/11/22 to 05/13/22 indicated the HHA provided a shower every visit as instructed by the Aide Care Plan. During an interview on 05/18/22 at 11:20 am, when asked if she felt safe during her shower with the HHA, Patient #3 stated she does not take a shower and the HHA bathes her in a chair in her bedroom. Patient #3 explained that her arthritis is so bad that she does not get in the shower. Patient #4 A review of the clinical record for Patient #4 re-certification periods 03/15/22 - 07/12/22, revealed a principal diagnosis of Malignant Neoplasm of Lung and orders for HHA visits one time a week for 8 weeks to assist with personal care, hygiene and activities of daily living. A form titled, "Aide Care Plan Report" contained instructions for the HHA to provide "Bathing - Bed Bath" every visit and "Bathing - Shower" every visit. Further review of weekly HHA Visit notes for 03/31/22 to 05/12/22 indicated the HHA provided both a bed bath and shower every visit as instructed by the Aide Care Plan. On 05/18/22 at 12:10 pm, RN1 stated the Aide Care Plan is developed by the RN and instructions for Patients #3 and #4 failed to provide patient specific bathing instructions for the HHA based on patient care needs.