Every finding on record at Bmt Homecare Services Inc

A complaint survey CCR# 2022004678 was conducted on-site on April 21, 2022, and off-site on April 28, 2022, at BMT Homecare Services Inc. The facility was in non-compliance with Code of Federal Regulations (CFR) 42, Part 484, Requirements for Home Health Agencies.

Make efforts to resolve the problem(s) CFR(s): 484.50(d)(5)(ii) (ii) Make efforts to resolve the problem(s) presented by the patient's behavior, the behavior of other persons in the patient's home, or situation; This ELEMENT is not met as evidenced by: Based on interview and record review, the Home Health Agency failed to make efforts to resolve the problem presented by 1 out of 4 (#1) sample patients (SP) Findings include: On 04/21/2022 at 2:2PM, the Office Manager stated that SP#1 wanted Staff B to purchase a vacuum. Staff B added her own money to the vacuum purchase price. SP#1 saw a vacuum online that was cheaper than the one that was purchased by Staff B. The Office Manager stated that SP#1 wanted Staff B to return the vacuum but it did not happen. The Office Manager stated that on 03/25/2022 she received a call from SP#1’s sibling about returning the vacuum. The Office Manager stated Staff B was present at SP#1’s house, when the Office Manager told Staff B to leave the premise. The Office Manager stated that SP#1’s sibling called stating that they did not want the services. The Office Manager stated that SP#1 wanted to go to another home health agency. When asked if they documented the incident and if they have documentation of their investigation, the Office Manager stated no. Record review conducted on 04/21/2022 revealed no documentation of the Home Health Agency’s efforts to resolve the problem presented by SP#1. A review of the provider’s policy for complaint resolution revealed, “Agency will investigate complaints made by a patient, the patient’s representative (if any) and the patient’s caregivers and family, including but not limited to, the following topics…Mistreatment, neglect or verbal, mental, sexual and physical abuse, including injuries of unknown source, and/or misappropriation of patient property by anyone furnishing services on behalf of the Agency…the Agency maintain records of grievances/complaints and their outcomes…” During a telephone interview with Staff B on 04/26/2022 at 12:18PM, Staff B acknowledged that she provided home health aide services to Sample Patient #1 daily for three weeks. When asked about the incident over the vacuum cleaner, Staff B stated that she never heard anything about it and that SP#1 did not have one (vacuum). When asked if she received money or used her own money to purchase a vacuum cleaner for SP#1, Staff B stated no. During a telephone interview with Staff A on 04/26/2022 at 12:42PM, Staff A acknowledged that she provided home health aide services to Sample Patient #1. Staff A stated she stopped working for the Home Health Agency on 03/15/2022. Staff A acknowledged purchasing the vacuum for SP#1. Staff A stated that she sent SP#1’s sibling a receipt for the vacuum and was reimbursed. Staff A stated that on Friday, 03/15/2022, she was at SP#1’s house when she received a phone call from the Office Manager of the Home Health Agency. Staff A was told by the Office Manager to leave or SP#1 and SP#1’s sibling were going to call the police. Staff A stated that she left SP#1’s house. Staff A stated that SP#1 wanted her to return the vacuum, but she refused. When asked if someone from the Home Health Agency ever spoken to her about the incident, Staff A stated no.

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 record review and interview, the Home Health Agency failed to ensure a Registered Nurse (RN) or other appropriate skilled professional provided written patient care instructions for the Home Health Aide (HHA) to follow for 4 out of 4 (#1, #2, #3, #4) Sampled Patients (SP). Findings include: Record review conducted on 04/21/2022 revealed SPs #1, #2, #3 and #4 received home health aide services. Further record review revealed no documentation showing written patient care instructions were provided for the home health aide services provided to SPs #1, #2, #3 and #4. During a telephone interview with Staff B on 04/26/2022 at 12:18PM, Staff B acknowledged that she provided home health aide services to Sample Patient #1 daily for three weeks. During a telephone interview with Staff A on 04/26/2022 at 12:42PM, Staff A acknowledged that she provided home health aide services to Sample Patient #1. Staff A stated that she stopped working for the Home Health Agency on 03/15/2022.

Non-skilled direct observation every 60 days CFR(s): 484.80(h)(2) If home health aide services are provided to a patient who is not receiving skilled nursing care, physical or occupational therapy, or speech-language pathology services, the registered nurse must make an on-site visit to the location where the patient is receiving care no less frequently than every 60 days in order to observe and assess each aide while he or she is performing care. This ELEMENT is not met as evidenced by: Based on record review and interview, the Provider failed to ensure accuracies of the home health aide supervisory visit documentation for 3 out of 4 (#1, #3, #4) sample patients (SP). Findings include: Record review conducted on 04/21/2022 of SP#1’s supervisory visit reports revealed discrepancies for the following dates: reports dated 01/05/2022, 01/19/2022 and 02/12/2022 do not include the name of the staff who were being supervised; reports dated 02/16/2022 and 03/02/2022, revealed the required elements are incomplete; report dated 03/30/2022 has the Administrator as the supervisor and documents the home health aide/certified nursing assistant was present during the supervisory visit. On 04/21/2022 at 2:37PM, the Office Manager stated that SP#1’s services ended on 03/25/2022. Record review conducted on 04/21/2022 of SP#3’s supervisory visit reports revealed reports dated 03/23/2022 and 04/13/2022 do not have the required elements. Record review conducted on 04/21/2022 of SP#4’s supervisory visit reports dated 01/15/2022 do not identify the name of the supervisor; Supervisory visit reports dated 02/14/2022, 03/14/2022 and 03/28/2022 do not have the name of SP#4 and do not identify the staff who were supervised. During a telephone interview with Staff B on 04/26/2022 at 12:18PM, Staff B acknowledged that she provided home health aide services to SP#1 daily for three weeks. When asked about the supervisory visit, Staff B stated that she never seen a supervisor. A review of the Provider’s policy for Home Health Aide Supervision revealed, “…the registered nurse will make an on-site visit to the location where the patient is receiving care no less frequently than every 60 days in order to observe and assess each aide while he or she is performing care…”