Every finding on record at Bzkz Inc

EMERGENCY PREPAREDNESS SURVEY At the time of the emergency preparedness survey completed on 07/11/22, Berkshire Homecare is in compliance with the provisions of 42 CFR Part 484.102, Conditions of Participation for Home Health Agencies.

Partial Extended Recertification Survey An entrance conference was conducted on 07/05/22 at 9:50 AM with the Assistant Director of Nursing. An exit conference was conducted on 07/11/22 at 12:05 PM with administrative staff. The following deficiencies are based on the partial extended recertification survey completed 07/11/22. Berkshire Homecare 368414, is not in compliance with the requirements found at 42 CFR Part 484, Subpart B, C for Home Health Agencies.

Promptly alert relevant physician of changes CFR(s): 484.60(c)(1) The HHA must promptly alert the relevant physician(s) or allowed practitioner(s) to any changes in the patient's condition or needs that suggest that outcomes are not being achieved and/or that the plan of care should be altered. This ELEMENT is not met as evidenced by: Based on record review, observation and staff and patient interview, the agency failed to ensure staff promptly alerted the physician to any changes in the patient's condition that that the plan of care should be altered for one of two patients observed with wound care (Patient #3). The census was 95. Findings include: Review of undated agency policy titled, "Physician Communication and Receiving Orders, Policy CLN.005," revealed communication with the patient's physician is required when there is a change in the patient's condition. Review of Patient #3's record revealed the patient was admitted to the agency on 02/24/22 with diagnoses including paraplegia, multiple sclerosis and diabetes. A home visit was made for Patient #3 on 07/06/22 at 10:00 AM with Staff F, a Registered Nurse, present. Patient #3 was confined to a wheelchair and frequently bumped his feet into the wall. Staff F stated on Monday, 07/04/22, there was a new open wound found on the patient's right great toe. Staff F stated in an interview during the home visit that Patient #3 went to a podiatrist and they would see it. Interview with Patient #3 during the home visit revealed he did not know when the next Podiatry appointment was. Staff F told Patient #3, "when you go to the Podiatrist tell them about your new "booboo" because it will need wound care orders." Per interview on 07/06/22 at 2:05 PM Staff C stated Staff F should have notified the patient's doctor regarding the new wound and obtained wound care orders. Staff C confirmed this was not done.

Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This STANDARD is not met as evidenced by: Based on policy review, observations and staff interview, the agency failed to use of standard precautions, to prevent the transmission of infections and communicable diseases. This could potentially affect all patients receiving services from the agency. The census was 95. Findings include: Review of the undated agency policy titled, "Monthly Bag/Equipment Cleaning Log 2020," revealed "Always use a barrier under all bags and equipment set down in the home". Review of the undated agency policy titled, "Infection Control in the Home," revealed staff are to wash their hands before and after giving any care to the patient (even if wearing gloves). Review of the undated agency policy titled, "Hand Washing Policy: QMI.018.1," revealed Staff will follow proper hand washing procedure before and after applying gloves during patient care. 1. On 07/05/22 at 3:30 PM a home visit was made for Patient #1 with Staff J present. Staff J was observed to bring in a red purse and placed it directly on the patient's table without placing a barrier down first. Per interview on 07/05/22 at 3:58 PM Staff J confirmed the lack of a barrier used. 2. On 07/06/22 at 10:00 AM a home visit was made for Patient #3 with Staff F present. Staff F was observed to place his equipment bag directly on the patient's chair without placing a barrier down first. Staff F proceeded to place the blood pressure cuff, thermometer and pulse oximeter directly on the kitchen table, again without the use of a barrier. During the home visit Staff F was observed to don gloves without washing his hands or using hand sanitizer first. Staff F was then observed to remove the old dressing on Patient #3's left foot, go to a closet to get a wash cloth, wash the foot and reapply the dressing. Staff F then removed the patient's right foot dressing, all with the same pair of gloves. Staff F then changed gloves without washing his hands or using hand sanitizer. After applying the right foot dressing Staff F removed his gloves without washing his hands or using hand sanitizer. Staff F was observed to use the blood pressure cuff, thermometer and pulse oximeter on Patient #3. He returned each item back into the equipment bag without sanitizing them first. Per interview on 07/06/22 at 10:25 AM Staff F confirmed this finding.