Every finding on record at Bayada Home Health Care, Inc.

Based upon an unannounced, on-site home health Medicare recertification survey conducted between August 29, 2022 and August 31, 2022, Bayada Home Health Care, was found to be in compliance with the requirements of 42 CFR, Part 484.22, Subpart B, Conditions of Participation: Home Health Agencies-Emergency Preparedness.

Based upon an unannounced, on-site home health Medicare recertification survey conducted between August 29, 2022 and August 31, 2022, Bayada Home Health Care, was found not to be in compliance with the requirements of 42 CFR, Part 484, Subparts B & C, Conditions of Participation: Home Health Agencies.

Conformance with physician orders CFR(s): 484.60(b) Standard: Conformance with physician or allowed practitioner orders. This STANDARD is not met as evidenced by: Based on reviews of agency policy, clinical records (CR), and interview with the Director (EMP#1), it was determined the agency failed to ensure clinical staff documented repositioning patient every 2 hours as ordered on the plan of care for four (4) of seven (7) CRs reviews. (CR# 1, CR# 2, CR# 3 and CR# 4); and failed to ensure shift hours provided according to the Plan of Care for two (2) of seven (7) CRs reviewed. (CR# 1 and CR# 3) Findings included: Review of agency policy on August 30, 2022 at approximately 1:30 p.m. titled, '0-945 Client Care Plan' states, "1.0 DEVELOPMENT OF THE CARE PLAN...1.1 Actions and interventions are consistent with the care plan and are documented..." Review of CRs on August 30, 2022 between approximately 1:30 p.m. to 3:00 p.m. and on Agusut 31, 2022 between approximately 11:45 a.m. to 12:30 p.m. revealed the following: CR# 1, Start of Care (SOC), 2/21/2020: Plan of Care certification period reviewed: 8/9/2022-10/7/2022 with diagnosis: Other seizures (sudden, uncontrolled body movements and changes in behavior that occur because of abnormal electrical activity in the brain). Plan of Care Skilled Nursing (SN) shift frequency: SN to provide care 4-8 hours /day (per day), 5-7 days/week x 60 days. Two (2) hours of care provided on 8/18/2022. No documentation provided of completed 'Missed Visit Coordination Note.' Plan of Care Skilled Nursing (SN) Orders include: SN to reposition client in good body alignment q (every) 1 hour while in wheelchair, Q2 (every 2) hours while in bed. No documentation of SN repositioning patient every hour while in wheelchair or every two hours while in bed on the following shift dates: 8/10/2022, 8/12/2022 and 8/17/2022. CR# 2, SOC, 6/13/2019: Plan of Care certification period reviewed: 7/24/2022-9/21/2022 with diagnosis: Quadriplegia (paralysis from the neck down, including the trunk, legs and arms), unspecified. Plan of Care Skilled Nursing (SN) Orders include: SN to turn client q 2 hours. No documentation of SN turning patient every two hours on the following shift dates: 7/28/2022, 8/15/2022, 8/17/2022. CR# 3, SOC, 4/10/2019: Plan of Care certification period reviewed: 7/23/22-9/20/2022 with diagnosis: unspecified, convulsions (sudden, violent, irregular movement of a limb or of the body, caused by involuntary contraction of muscles). Plan of Care Skilled Nursing (SN) shift frequency: SN to provide care 8-15 hours/day, 5-6 days/week x 60 day durations. Six (6) hours of care provided on 8/4/2022, 8/5/2022 and 8/23/2022. Only provided shift care for 4 days on Week 6 (8/22/2022-8/28/2022). No documentation provided of completed 'Missed Visit Coordination Note.' Plan of Care Skilled Nursing (SN) Orders include: SN turn and reposition overnight q2hrs (every 2 hours) on the following overnight shift dates: 08/18/2022 (10:00 p.m. to 7:00 a.m.) CR# 4, SOC, 7/20/2020: Plan of Care certification period reviewed: 7/10/2022-9/7/2022 with diagnosis: Cerebral Palsy (muscle coordination spasms), unspecified. Plan of Care Skilled Nursing (SN) Orders include: SN to reposition client q 2 hrs and prn (as needed) client request/comfort. No documentation of SN repositioning patient every two hours on the following shift dates: 7/14/2022, 7/27/2022, 8/4/2022, 8/10/2022 and 8/19/2022. Interview with EMP# 1 on August 31, 2022 at approximately 12:45 p.m. confirmed above findings.

Discharge and transfer summaries CFR(s): 484.110(a)(6)(i-iii) (i) A completed discharge summary that is sent to the primary care practitioner or other health care professional who will be responsible for providing care and services to the patient after discharge from the HHA (if any) within 5 business days of the patient's discharge; or (ii) A completed transfer summary that is sent within 2 business days of a planned transfer, if the patient's care will be immediately continued in a health care facility; or (iii) A completed transfer summary that is sent within 2 business days of becoming aware of an unplanned transfer, if the patient is still receiving care in a health care facility at the time when the HHA becomes aware of the transfer. This ELEMENT is not met as evidenced by: Based on reviews of agency policy, clinical records (CR), and interview with the Director (EMP#1), it was determined the agency failed to ensure a discharge summary was sent to the primary care physician within five (5) business days for one (1) of seven (7) CRs reviewed.(CR# 7) Findings included: Review of agency policy on August 30, 2022 at approximately 2:00 p.m. titled, '0-9307 Client discharge and Transfer-Medicare-Certified Home Health and Home Care Offices' states, "...3.0 Communication and Documentation Requirements for Discharge and Transfer ...3.1 Discharge...3.1.2 The client's primary care practitioner or other health care professional who will be responsbile for providing care and services to the client must receive a DISCHARGE SUMMARY, #781 or LAST VISIT & DISCHARGE SUMMARY, #0-689 or comparable entry fields in the electronic record within five (5) business days of the client's discharge and a copy filed in the client chart or electronic record..." Review of CRs on August 30, 2022 between approximately 1:30 p.m. to 3:00 p.m. and on Agusut 31, 2022 between approximately 11:45 a.m. to 12:30 p.m. revealed the following: CR# 7, Start of Care (SOC), 10/20/2021: Plan of Care certification period reviewed: 10/20/2021-12/18/2021 with diagnosis: Heart Failure, unspecified. Patient expired on 12/7/2021. Discharge summary was sent to primary care physician (PCP) on 12/16/2021, 8 days after discharge. Interview with EMP# 1 on August 31, 2022 at approximately 12:45 p.m. confirmed above findings.