Every finding on record at Centerwell Health Services (Certified) Inc

The Emergency Preparedness Plan was reviewed during the recertification survey conducted 11/16/21-11/18/21. Kindred At Home was in compliance with 42 CFR 484 Subpart A-C, Requirements for Home Health Agencies.

The recertification survey was conducted 11/16/21 to 11/18/21. Kindred At Home was not in compliance with 42 CFR 484 Subpart A-C, Requirements for Home Health Agencies.

Onsite supervisory visit every 14 days CFR(s): 484.80(h)(1)(i) If home health aide services are provided to a patient who is receiving skilled nursing, physical or occupational therapy, or speech-language pathology services, a registered nurse or other appropriate skilled professional who is familiar with the patient, the patient's plan of care, and the written patient care instructions described in §484.80(g), must make an onsite visit to the patient's home no less frequently than every 14 days. The home health aide does not have to be present during this visit. This ELEMENT is not met as evidenced by: Based on interview, record review, and review of facility policies, the Home Health Agency (HHA) failed to perform or document that a Home health aide supervisory visit was completed within the required 14 day time frame for 1 (#10) of 3 patients who received home health aide visits, out of a sample of 17. Findings: Patient #10 was admitted to the HHA on 6/2/21. The certification period reviewed was 9/30 to 11/28/21. The physician ordered services for the patient included Skilled Nursing at 1 time a week for 1 week, 3 times a week for 1 week, 2 times a week for 4 weeks, then 1 time a week for 3 weeks, and 2 as needed visits. Nursing services were discontinued on 11/10/21. Physical Therapy, visits were ordered at 1 week 2, then every other week and were ongoing. The Home health aide visits were ordered 1 time a week for 1 week, then 2 times a week for 8 weeks and were ongoing. The Medical social worker made 1 visit on 11/12/21. Review of patient #10's record revealed home health aide visits were completed by the nurse at every 14 days until 11/10/21 when nursing services were discharged. The home health aide continued her scheduled visits after 11/10/21 and the record showed no home health aide supervisory visits were completed after 10/18/21 and the aide continued to visit and service the patient. Home health aide supervisory visits were missing following this time period. In an interview with the HHA administrator and Clinical manager on 11/18/21 at 12:30 PM, they stated when nursing services are discontinued in the home and a therapist remains, the supervisory visits are to be made by the attending therapist, which would have been patient #10's Physical therapist. They confirmed there was no documentation of a home health aide supervisory note after 11/10/21 and the supervisory visit and note should have been completed by the physical therapist but was not. Review of the HHA policy 03-17: Patient Care Supervision, documented on page 1, number 4 bullet , "Supervisory visits will be documented in the clinical record." Under the the title of "Assignment and Supervision of Home Health Aides", the 5th bulleted item read: "When the patient is receiving only therapy and aide services, the licensed therapist may make supervisory visits in lieu of the RN (registered nurse) when allowed by the state.

Discharge and transfer summaries CFR(s): 484.110(a)(6)(i-iii) (i) A completed discharge summary that is sent to the primary care practitioner or other health care professional who will be responsible for providing care and services to the patient after discharge from the HHA (if any) within 5 business days of the patient's discharge; or (ii) A completed transfer summary that is sent within 2 business days of a planned transfer, if the patient's care will be immediately continued in a health care facility; or (iii) A completed transfer summary that is sent within 2 business days of becoming aware of an unplanned transfer, if the patient is still receiving care in a health care facility at the time when the HHA becomes aware of the transfer. This ELEMENT is not met as evidenced by: Based on interview and record review, the Home Health Agency (HHA) failed to complete and send patient discharge summaries and transfer summaries in the required time allotment (5 business days of discharge and 2 business days for transfers) for 3 (13, 16, and 17) of 5 discharged records, out of a sample of 17. Record review revealed patient #13 had a Start of Care date of 4/17/21. The patient was hospitalized after start of care, was placed hospital hold, with a resumption of care on 5/16/21. The patient had ordered services of nursing and physical therapy. The patient was discharged on 6/9/21. A discharge summary was documented on 6/9/21. Documentation was observed that the HHA faxed the discharge summary to the ordering physician on 6/10/21. A HHA fax status report documented the fax information failed and did not go through to the physician. There was no further attempts documented that showed the physician received the HHA discharge summary for his patient. There was report fails it should be faxed again/repeated and/or get another fax number. No evidence the DCP was supplied to the physician. In an interview with the HHA Clinical Manager on 11/18/21 at 2:25 PM, she confirmed their was no evidence documented that the physician received the discharge summary. She stated the office will fax the discharge summary to the physician and if the report documents the fax failed, it is attempted faxed again until it is successful., or they obtain another number to fax. Record review revealed Patient #16 with a start of care date to the HHA on 10/8/21. Physician ordered services documented skilled nursing and physical therapy and was signed by the local hospital's, hospitalist physician. The patient was discharged on 10/12/21 and documentation showed she had moved out of the area. The patient record showed no discharge summary had been completed and was not faxed to the original ordering physician. In an interview with the Clinical Manager on 11/18/21 at 2:45 PM, she verified the hospitalist physician did not receive a patient discharge summary. Record review for patient #17 revealed a start of care date of 6/23/21. Physician ordered services were documented for skilled nursing, physical therapy, and and occupational therapy. Documentation showed the patient declined in health and was transferred and admitted to the hospital on 7/29/21. The record showed a patient episode summary was sent to the facility on 8/5/21, which sis not meet the requirement of the 2 business day timeframe. In an interview with the Clinical Manager on 11/18/21 at 3:15 PM, she verified that the summary sent by the HHA office to the hospital was not sent in the required timeframe.