Every finding on record at Baycare Home Care Inc

During the re-certification survey conducted from April 27-28 2022 at Baycare Home Care, a Home Health Agency, Emergency Preparedness was reviewed. Baycare Home Care is not in compliance with Emergency Preparedness per Code of Federal Regulations (CFR) 42, Part 484.22, Condition of Participation for Home Health Agencies.

An unannounced Recertification survey was conducted on April 27 - 28, 2022 at Baycare Home Care a home health agency a home health facility Baycare Home Care was found not to be in compliance with requirements 42 CFR 484 Sub part A-C for this survey.

Receive all services in plan of care CFR(s): 484.50(c)(5) Receive all services outlined in the plan of care. This ELEMENT is not met as evidenced by: Based on record reviews and interviews Baycare Home Health Agency failed to ensure that patient's received all services in plan of care for 1 of 5 discharged patients. Patient #14. A clinical record review of the form 485 patient plan of care for resident #14 read, the patient was to receive SN:2 WK 1, 1 WK 4, 2 as needed. A clinical record review read that on 12/11/2021 and 12/12/2021 nursing missed visits were documented. however, the missed visits were not reported to the physician until 12/20/2021. A review of the calendar visits showed no skilled nursing visits for the week of 12/20/21 to 12/26/21. During an interview on 4/28.22 at 10:02 AM with the General Director of East region stated, The clinician plots their own schedule with the patient. Comparison can be done for scheduled visits against what the clinician plots. But if the clinician doesn't plot the appoints then there is nothing to compare. Human error caused the missed visits for this patient for the week of 12/20/21 to 12/26/21. The patient had missed visits on 12/11 and 12. MD not notified until the 20th. The nurse did not enter the missed visits until the 20th per the automatic date stamp. No visits were scheduled by the nurse for the week of 12-20-21 to 12-26-21.

Authentication CFR(s): 484.110(b) Standard: Authentication. All entries must be legible, clear, complete, and appropriately authenticated, dated, and timed. Authentication must include a signature and a title (occupation), or a secured computer entry by a unique identifier, of a primary author who has reviewed and approved the entry. This STANDARD is not met as evidenced by: Based on record reviews and interviews the home health agency failed to ensure a Physician or an Advanced Nurse Registered Practitioner had signed 6 of 17 patients form 485 patient plan of care as required. Patient #4,7,8,12,14 and 16. Based upon clinical record review of patient number 4, form 485 for the certification period of 4/1/2022 to 5/30/22 did not not contain the required physician/APRN signature. Patient #4,7,8,12,14,16. During an interview on 4/28/22 at 10:02 AM with the General Director of the East Region he stated, the physician has not signed the plan of care as of today 4/28/2022 for patient #4,7,8,12,14 and 16. We go to the clinician to attempt to get the signatures and it's often difficult. Based upon clinical record review of patient number 7, form 485 for the certification period of 3/5/2022 to 5/3/22 did not not contain the required physician/APRN signature. Based upon clinical record review of patient number 8, form 485 for the certification period of 3/25/2022 to 5/23/22 did not not contain the required physician/APRN signature. Based upon clinical record review of patient number 12, form 485 for the certification period of 3/31/2022 to 5/29/22 did not not contain the required physician/APRN signature. Based upon clinical record review of patient number 14, form 485 for the certification period of 12/8/2021 to 2/5/22 did not not contain the required physician/APRN signature. Based upon clinical record review of patient number 16, form 485 for the certification period of 12/15/2021 to 2/12/22 did not not contain the required physician/APRN signature. A review of the policy and procedure titled Physicians orders-billing doc. last revised 3/14/2011 read, a physician signed plan of care, and face to face. a physician signed plan of care, and face to face must be dated by the physician.