Every finding on record at Centerwell Certified Healthcare Corp.

An Emergency Preparedness Survey was conducted at CenterWell Home Health on September 9, 2024 to September 11, 2024. Based on the findings, it was determined that CenterWell is in complaince with federal regulations.

A recertification survey was conducted at CenterWell Home Health on September 9, 2024 to September 11, 2024. The facility services the following counties; Cabell, Lincoln, Mason and Wayne. The unduplicated admissions for the last twelve (12) months is eight hundred and sixty-two (862). The current census is one hundred and seventy (170) patients. Seven (7) home visits and seventeen (17) record reviews were completed. It was determined the agency was not in compliance with the requirements of 42 CFR, Part 484 - The Medicare Conditions of Participation for Home Health Agencies.

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 document reviews, observations, and staff interviews, the facility failed to ensure that tablet sanitation, hand hygiene, and handling equipment were according to the agency’s policies/procedures. This failure has the potential to negatively impact all Patients receiving treatments from the agency. (Refer to 484.70(a)) Findings are as follow: An observation was conducted on 09/10/2024 at 9:43 a.m. with Staff #1. [He/She] took out the blood pressure cuff, thermometer, pulse oximeter, and stethoscope from [his/her] supply bag and start taking the Patient’s blood pressure. While [he/she] was wrapping the blood pressure cuff on the Patient’s upper arm, the blood pressure bulb (bulb) fell between the Patient and the chair. [He/She] pulled out the bulb and proceeded to take the Patient’s blood pressure without sanitizing the bulb. When [he/she] completed the Patient’s vitals, [he/she] laid the blood pressure cuff, thermometer, and the pulse oximeter on the patient’s furniture without a barrier. An observation was conducted on 09/10/2024 at 11:36 a.m. with Staff #2. [He/She] took out the stethoscope, blood pressure cuff, pulse oximeter, thermometer, and dynamometer from [his/her] supply bag and placed them on a clean barrier. After taking the Patient’s vitals, [he/she] placed the contaminated pulse oximeter on the clean barrier next to the dynamometer. [He/She] proceeded to take the Patient’s blood pressure and placed the contaminated blood pressure cuff on top of the pulse oximeter and the dynamometer on the clean barrier. When Patient’s vitals were completed, [he/she] sanitized the pulse oximeter, blood pressure cuff, stethoscope, and the thermometer with the contaminated gloves. The dynamometer was not sanitized. An observation was conducted on 09/10/2024 at 1:08 p.m. with Staff #3. While [he/she] was putting the blood pressure cuff to take the Patient’s blood pressure, the bulb fell between the Patient and the chair. [He/She] proceeded to take the Patient’s blood pressure without sanitizing the bulb and listen to the Patient with the stethoscope. Then, [he/she] changed gloved without performing hand sanitization and measured the Patient’s oxygen level with the pulse oximeter. [He/She] put the contaminated pulse oximeter into [his/her] supply bag without sanitizing it. An observation was conducted on 09/10/2024 at 3:00 p.m. with Staff #4. [He/She] took out the stethoscope, blood pressure cuff, thermometer, and the minimalist sling from [his/her] supply bag. [He/She] wore gloves to take the Patient’s temperature and blood pressure. Then, [he/she] reached into [his/her] supply bag, still wearing the contaminated gloves, and reached for the pulse oximeter. After taking the Patient’s vitals, [he/she] reached into [his/her] supply bag for the sanitizing wipes wearing the same pair of gloves. [He/She] start disinfecting the reusable equipment wearing the contaminated gloves. An observation was conducted on 09/10/2024 at 4:14 p.m. with Staff #5. While [he/she] wrapped the blood pressure cuff around the Patient’s upper arm, the blood pressure bulb touched the chair. [He/She] proceeded with taking the Patient’s blood pressure without disinfecting the blood pressure bulb. An interview was conducted on 09/09/2024 at 1:04 p.m. with Stagg #7. [He/She] explained the barrier requirement as, “We don’t have any policy stating about the barrier. But when Staffs pull out the equipment from their bag, they (Staffs) need a clean barrier if they (Staffs) are going to set the equipment down. The equipment cannot be placed on a surface without a barrier.” [He/She] further disclosed the disinfection of equipment and barrier as, “If the Staffs are going to lay the equipment down to sanitize them, they (Staffs) need a dirty barrier. They (Staffs) cannot use the clean barrier to put down used equipment. If the Staffs are going to disinfect the equipment immediately after use, they don’t need a barrier and they don’t need to dry the equipment before putting it back into the bag. When Staffs are sanitizing the equipment, they should not be wearing gloves.” An additional interview was conducted on 09/10/2024 at 9:02 a.m. with Staff #7l. [He/She] further explained the equipment disinfection process as, “We don’t have a specific policy stating how the equipment have to be sanitized. But I would expect while disinfecting the equipment, the equipment can touch the Staff’s scrub but not any other surface in the Patient’s home. If the equipment touches any surface in the Patient’s home, the Staff should sanitize the equipment.” An additional interview was conducted on 09/11/2024 at 8:42 a.m. with Staff #7. [He/She] explained the standard hand hygiene procedure as, “Before and after they (Staffs) touch the Patient, if their (Staffs’ hands are soiled), if they (Staffs) contacted blood, bodily fluid, etc. They (Staffs) have to sanitize their (Staffs’) hands if they are changing gloves as well.”

An emergency preparedness survey was conducted as part of a recertification survey at Kindred at Home from 04/18/22 through 04/20/22. The agency is in compliance with the Emergency Preparedness Conditions of Participation for Home Health Agencies.

A recertification survey was conducted at Kindred at Home from 04/18/22 through 04/20/22. The agency provides Skilled Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Social Worker and Home Health Aide services to residents of Cabell, Lincoln, Mason, and Wayne counties. The active census at the time of survey was two hundred forty-six (246) and the unduplicated census for the past twelve (12) months was seven hundred sixty-five (765). A total of seventeen (17) medical records were reviewed, and seven (7) home visits were conducted. Two (2) standard level deficiencies were cited at G 440 and G 682.

Payment from federally funded programs CFR(s): 484.50(c)(7)(i, ii, iii, iv) Be advised, orally and in writing, of- (i) The extent to which payment for HHA services may be expected from Medicare, Medicaid, or any other federally-funded or federal aid program known to the HHA, (ii) The charges for services that may not be covered by Medicare, Medicaid, or any other federally-funded or federal aid program known to the HHA, (iii) The charges the individual may have to pay before care is initiated; and (iv) Any changes in the information provided in accordance with paragraph (c)(7) of this section when they occur. The HHA must advise the patient and representative (if any), of these changes as soon as possible, in advance of the next home health visit. The HHA must comply with the patient notice requirements at 42 CFR 411.408(d)(2) and 42 CFR 411.408(f). This ELEMENT is not met as evidenced by: Based on observation and staff interview it was determined the agency failed to provide, in writing, the extent to which payments would be expected from insurance and/or the charges the individual may have to pay before care is initiated, for three (3) of seventeen (17) records reviewed (patients #6, 12 and 13). This failure has the potential to negatively impact all patients receiving care. Findings include: An observation on 4/19/22 at approximately 11:30 a.m. at patient #13’s residence revealed no written financial statement. An observation on 4/19/22 at approximately 10:00 a.m. at patient #6’s residence revealed no written financial statement. An observation on 4/19/22 at approximately 3:30 p.m. at patient #12’s residence revealed no written financial statement. An interview was conducted with the Branch Director on 04/20/22 at 9:00 a.m. The Branch Director explained, when the financial statement was changed to the electronic signature, no process was created to give any of the patients a paper copy.

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 observation, document review and staff interview it was determined the facility failed to follow accepted standards of practice to prevent the transmission of infections and communicable diseases. This failure was identified in three (3) of three (3) visits completed (patients #10, 13 and 16). This failure has the potential to adversely affect all patients. Findings include: A home visit was completed with patient #10 on 4/19/22 at 9:30 a.m. Patient #10 lives in the garage of the home. Registered Nurse (RN) #1 placed her supply bag on a vinyl chair in the garage. RN #1 completed the blood pressure and oxygen saturation. RN #1 proceeded to spray the sphygmomanometer/blood pressure (B/P) cuff with an alcohol-based sanitizing spray and sprayed the pulse oximeter (ox) with the sanitizing spray. RN #1 failed to wipe the sanitizing spray on the entire B/P cuff and failed to wipe the pulse ox after spraying with the sanitizing spray. RN #1 failed to wipe the vinyl chair before placing her supply bag on the vinyl chair. A home visit was completed with patient #13 on 4/19/22 at 11:30 a.m. Licensed Practical Nurse (LPN) #1 completed vital signs and placed her equipment back in her supply bag. LPN #1 took the equipment for the MyNICaS reading out of a second supply bag. LPN #1 placed the cardboard box containing the MyNICaS device on the carpet in the sitting room and placed the laptop on the carpet in the sitting room. LPN #1 proceeded to hook up patient #13 to the MyNICaS device. The MyNICaS device was placed on the carpet during the procedure. After completion of the MyNICaS readings, LPN #1 proceeded to place all the equipment back into the second supply bag. LPN #1 failed to clean all the equipment after vital signs and the MyNICaS readings before putting the supplies back into the supply bags. A home visit was completed with patient #16 on 4/19/22 at 1:35 p.m. RN #2 laid down a barrier and placed her supply bag on the barrier. RN #2 completed the vital signs for patient #16. RN #2 cleaned the B/P cuff and tubing but failed to clean the rubber bulb of the B/P cuff. RN #2 laid the iPad on the table of patient #16 but did not use a barrier to lay the iPad on. A review of the policy titled “Disinfecting Tablet Computers,” revised 06/27/2018, stated in part; “After each patient visit professional staff should disinfect all exterior surfaces of their tablet computer (and, if applicable, the protective case) using 70% isopropyl alcohol (examples: alcohol wipes, prep pads, swabs)...” An interview was conducted with the Administrator on 4/19/22 at 4:30 p.m. The Administrator concurred staff did not follow acceptable standards of practice for the prevention of infection.