Every finding on record at Caring Hands Skilled Home Health LLC

A complaint survey, prompted by #CO116186 was completed on 7/16/25. One deficiency was cited.

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 record review, observation and interview the agency failed to follow the plan of care, specifically by not providing all services outlined in the plan of care for 1 of 3 patient records reviewed. (Patient #1). Findings include: 1. The clinical record for Patient #1 was reviewed on 7/15/25. Record review revealed a start of care date of 5/30/25. Further record review revealed a current certification period of 5/30/25 to 7/28/25. A plan of care revealed Patient #1 was diagnosed with encounter for change or removal of surgical wound dressing, nontraumatic compartment syndrome of abdomen, acute pancreatitis with infected necrosis, ileus, acute respiratory failure and delirium due to known physiological condition. a. The agency failed to provide the required skilled nursing services outlined in the plan of care for Patient #1. Review of the plan of care orders included skilled nurse visits once a week for one week, three times a week for eight weeks, and three as needed (PRN) visits for wound management. Plan of care orders also included; wound care management, assessment of vital signs and body system, education of pain medications, observations and assessment of integumentary status, and observation and assessment of skin integrity status including reporting to the physician if the blood sugar reading was less than 60 or higher than 400. Review of the skilled nursing (SN) visits notes from 6/2/25 to 7/14/25, revealed registered nurse (RN #1) noted that Patient #1 was missing the glucometer and therefore was not able to obtain a blood sugar reading to determine if the physician needed to be notified due to Patient #1 blood sugar being outside of the range. RN #1 continued to note that Patient #1 did not have a glucometer on 6/4/25, 6/6/25 and 6/8/25. During the SN visit on 6/10/25, Patient #1 stated he had contacted his physician and ordered a glucometer. Further review of the SN visits notes revealed no blood sugar being taken on 6/13/25, 6/16/25 and 6/18/25. Between the dates of 6/2/25 and 6/18/25, the agency failed to document a blood sugar reading to be able to report the physician if outside of the range for eight SN visits. During an interview on 7/16/25 at 12:10 p.m., the administrator who was also RN #1, stated she noticed Patient #1 did not have a glucometer and spoke to the patient regarding this on 6/2/25. The administrator went on to state the agency failed to contact the physician in regards to the missing glucometer and was not able to follow the physician orders on the plan of care.