Every finding on record at Care Unlimited Inc

Based on the findings of an onsite unannounced home health agency Medicare recertification survey completed January 7, 2021, Aveanna Healthcare was found to be in compliance with the requirements of 42 CFR, Part 484.22, Subpart B, Conditions of Participation: Home Health Agencies - Emergency Preparedness.

Based on the findings of an onsite unannounced home health agency Medicare recertification survey completed January 7, 2021, Aveanna Healthcare was found not to be in compliance with the requirements of 42 CFR, Part 484, Subparts B and C, Conditions of Participation: Home Health Agencies. .

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 reviews of policy/procedures, clinical records and an interview with the agency, agency staff-Home Health Aide failed to follow written instructions for patient care for two (2) of eight (8) records reviewed. (CR1, CR5). Findings include: Review of Leadership and Management: Unskilled Services policy completed on 1/7/2021 at approximately 11:00 a.m. showed section: Home Health Aide Assignments and Duties: Home Health Aides (HHA) (worker who provides care for elderly, sick or disabled people in their home) are assigned to a specific patient by a Registered Nurse (RN) or other appropriate skilled professional, with written patient care instructions for a home health aide prepared by that RN or skilled professional... A home health aide provides services that are...(b) included in the plan of care... Review of clinical records completed on 1/4/2021 between approximately 9:00 a.m. and 1:30 p.m. revealed the following: CR1, start of care (SOC): 11/9/2020, certification period: 11/9/2020 -1/7/2021. Primary Diagnosis: Angelman Syndrome (complex genetic disorder causing developmental disabilities and nerve-related disorders). Physicians orders: HHA 5-7 hours per day for 60 days-7 hours/day, 3 days per week to accompany to daycare, not to exceed 24 hours per week. Record contained "HHA Homemaker Care Plan" dated 11/6/2020 that included under "other tasks or comments" -door to basement closed. Review of four (4) daily visit forms dated: 12/22/2020, 12/28/2020, 1/4/2021 and 1/5/2021 completed by HHA revealed that task was not completed for one (1) of four (4) daily visit forms reviewed (form dated 12/28/2020). CR5, SOC: 2/14/19, certification period: 10/6/2020-12/4/2020. Primary Diagnosis: Autistic Disorder (a developmental disorder characterized by difficulties with social interaction and communication). Physicians Orders: HHA 2 to 6 hours per day for 60 days-2 to 5 days per week, M-F school days and 9 hours non-school days. Record contained "HHA Homemaker Care Plan" dated 12/23/2020 that included under "Hygiene and Grooming"- shampoo hair, under "Housekeeping"- laundry and under "Safety"- Seizure (abnormal electrical activity in the brain) precautions. Review of seven (7) daily visit forms dated: 12/23-12/24/2020, 12/28-12/31/2020 and 1/4/2021 revealed that laundry and seizure precautions were not completed for seven (7) of seven (7) daily visit forms reviewed . Shampoo hair was not completed for five (5) of seven(7) daily visit forms reviewed (12/24/2020, 12/29/2020, 12/30/2020, 12/31/2020 and 1/4/2021. Interview with Agency administrator conducted on 1/7/2021 at approximately 2:30 p.m. confirmed the above findings.

Ensure that HHA employs qualified personnel CFR(s): 484.105(b)(1)(iv) (iv) Ensure that the HHA employs qualified personnel, including assuring the development of personnel qualifications and policies. This ELEMENT is not met as evidenced by: Based on reviews of policy/procedures, clinical records and an interview with the agency administrator the agency failed to ensure adequately qualified staff to meet patients needs for two (2) of eight (8) records reviewed. (CR6, CR7). Findings include: Review of Discharge, Transfer, Referral and Corresponding Summary policy completed on 1/7/2021 at approximately 10:00 a.m. showed section: Process/procedures, 9. "The company is unable to meet the immediate or continued needs of the patient/family. Examples might include: lack of appropriately trained personnel, staffing ,..." "Before discharge for cause the following will occur: Provide the patient... with contact information for other agencies or providers who may be able to provide care and document the problem(s) and effort(s) made to resolve the problem(s) and enter this documentation into the clinical record". Review of clinical records completed on 1/4/2021 between approximately 9:00 a.m. and 1:30 p.m. revealed the following: CR6, start of care (SOC): 9/23/2020, certification period: 9/21/2020-11/19/2020. Primary Diagnosis: Cerebral Palsy (a group of disorders that affect a person's ability to move and maintain balance and posture). Physicians orders: Registered Nurse (RN)/Licensed Practical Nurser (LPN) 8-11 hours per day, 1-3 days per week. Record contained "transfer/discharge notification" dated 11/18/20 notifying patient of discharge effective 11/18/2020 due to agency inability to provide staff. Physcian not notified of same until 1/4/2021. No other documentation showing patient provided with information for other agencies or providers able to meet needs. CR7, SOC: 6/16/2020, certification period: 8/15/2020-10/13/2020. Primary Diagnosis: Cerebral Palsy. Physicians Orders: Home Health Aide (HHA) 11 hours per day, 5 days per week Mon- Fri. Record contained "transfer/discharge notification" dated 10/1/2020 notifying patient of discharge effective 10/1/2020 due to agency inability to provide staff. Physcian not notified of same until 10/14/2020. No other documentation showing patient provided with information for other agencies or providers able to meet needs. Interview with Agency administrator conducted on 1/7/2021 at approximately 2:30 p.m. confirmed the above findings.