Every finding on record at Bhc Services, Inc.

Substantial Allegation Survey Substantial Allegation 99101 Willcare Home Health, 367503, was not in compliance with the requirements at 42 CFR Part 484, Subpart B, C for Home Health Agencies in regards to allegations contained in OH0099101.

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 medical record review, staff interview and policy review, the agency failed to follow the patient care plans to provide the total number of hours of care ordered and failed to follow the policy to notify the physician when these hours were not met. This affected two (#1 and #2) patients with the potential to affect all patients cared for by this agency. 1. The medical record for Patient #1 revealed a start of care (SOC) of 05/30/23 with a primary diagnosis hypertension. The certification period reviewed was 05/30/23 through 07/28/23. Physician orders on the plan of care were to have a home health aide (HHA) two hours per day seven days per week for a total of 14 hours. Review of the HHA visits revealed they were completed two hours a day five days a week. There were no HHA visits occurring on Tuesdays and Thursdays, thereby the patient only received 10 hours per week instead of the ordered 14 hours per week. There was no evidence the physician was aware of the total number of hours being provided being less than what was ordered. Review of the facility policies titled "Coordination of Care for Missed Visits" revealed under Bullet #4 the policy instructs staff to notify the physician when a missed visit occurs. Interview with Staff A on 07/20/23 at 3:30 PM verified the physician was not notified regarding these missed visits as the policy titled Coordination of Care for missed visits instructs. 2. The medical record for Patient #2 was reviewed on 07/21/23. Patient #2 was admitted to the agency on 06/01/23 with a primary diagnosis of age-related osteoporosis. The plan of care which was signed by a physician and included orders for a HHA 36 hours per week, with 20 hours weekly and 16 hours every other weekend (equaling 28 hours per week) to assist with bathing, meal prep and personal care. The certification period reviewed was for 06/01/23 through 07/30/23. Interview with Staff A on 07/20/23 at 11:08 AM revealed the skilled nurse made a mistake when calculating the hours. Staff A stated the plan of care should have said 28 hours, not 36 hours, further stating they must have calculated both weekends. Additional review of the medical record showed 24 hours of home health aide visits were completed for the week of June 4th-10th, 16 hours were completed for the week June 11th-17th, and 16 hours were completed for the week of June 18th-24th, instead of the ordered 36 hours or 28 corrected hours. No documentation was found in the medical record the physician was notified regarding the missed visits. Interview on 07/1/23 at 1:00 PM, Staff A verified the agency did not follow the plan of care for Patient #2's visits and did not notify the physician or the missed visits per the policy.