Every finding on record at Cambridge Home Health Care, Inc

EMERGENCY PREPAREDNESS SURVEY At the time of the emergency preparedness survey completed on 02/09/23, Cambridge Caretenders 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 02/06/23 at 8:45 AM with the Interim Administrator. An exit conference was conducted on 02/09/23 at 4:00 PM with administrative staff. The following deficiency is based on the partial extended recertification survey completed 02/09/23. Cambridge Caretenders 368168, is not in compliance with the requirements at 42 CFR Part 484, Subpart B, C for Home Health Agencies. Branches: 36Q8168002 210 East Milltown Road, Suite C Wooster, Ohio 44691 36Q168004 2990 Johnson Rd Suite 1A Steubenville, Ohio 43952

A review of all current medications CFR(s): 484.55(c)(5) A review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy. This ELEMENT is not met as evidenced by: Based on medical record review, policy review, observation and staff interview, the agency failed to conduct a review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy for two of six patients reviewed with home visits (Patient #5 and #6). The total sample was 17 patients. The census was 243. Findings include: 1. Review of the agency policy titled, Monitoring Medications, revised 05/01/19, revealed a drug regimen review will be performed on all patients with all comprehensive assessments. All staff will participate in medication review and reconciliation. The staff will compare the medication list from the facility which the patient was transferred and/or physician orders to actual medications patient is taking. A home visit was made on 02/07/23 at 8:00 AM for Patient #5 with Staff D present. Review of the medications Patient #5 took in the home revealed Protonix (used to treat acid reflux) 40 milligrams (mg), to be taken twice daily, with an original date 09/09/22, and Trulicity (used to lower blood sugar) 4.5 mg taken weekly, with original date 12/22/21. Review of the patient's current medication profile did not reveal these medications listed. Review of the medication bottle for Gabapentin (used for nerve pain) 300 mg, three times daily. Review of the current medication profile revealed Gabapentin 100 mg three times daily. Interview on 02/07/23 at 8:16 AM with Patient #5 revealed the Gabapentin was increased to 300 mg two years ago. Review of the medication profile revealed Nexium (used to treat acid reflux and ulcers) 20 mg, twice daily and Norvasc (for high blood pressure) 5 mg to be taken daily. Interview on 02/07/23 at 8:33 AM with Patient #5 revealed he never took the Nexium at home, only at the hospital. Patient #5 stated the Protonix replaced the Nexium and he had not taken the Norvasc for a couple of months. Review of the agency form titled, Medication Review, included in the patient's medical record revealed a blank form with no documentation of the last medication review. Review of the last comprehensive assessment dated 01/03/23 revealed Patient #5 was able to independently take the correct medications and proper dosages at the correct times. Interview on 02/07/23 at 8:40 AM with Staff D confirmed the medication review was not completed and the medications taken by Patient #5 did not match the medication profile. 2. A home visit was made on 02/07/23 at 9:00 AM for Patient #6 with Staff D present. Review of the medications taken by Patient #6 revealed they were sealed in a blister pack from the pharmacy. This pack listed the medications inside, including Metoprolol Succinate ER (used to treat high blood pressure) 25 mg, taken daily with the original date of 11/21/22, Midodrine HCL (used to treat orthostatic hypotension) 10 mg, taken twice daily with original date of 10/24/22, and Potassium Chloride 10 mg daily. Review of the current medication profile did not reveal any of these medications. During the home visit, Patient #6 was observed to be using oxygen at three Liters/minute. There was no order for oxygen. Review of the Medication Review form in the patient's medical record revealed the medications were last reviewed 01/31/23. Review of the last comprehensive assessment revealed it was completed on 12/14/22. Interview on 02/07/23 at 9:30 AM with Staff D confirmed these medications were not listed on the medication profile and should have been caught on the last assessment.