Every finding on record at Chmg of Atlanta, LLC.

A Recertification survey was conducted at Centerwell Home Health on October 21, 2024, and concluded on October 23, 2024. At the time of the survey, the agency was in compliance with 42 CFR Part 418.113, Emergency Preparedness and Covid-19 infection control.

A Recertification survey was conducted at Centerwell Home Health on October 21, 2024, and concluded on October 23, 2024. At the time of the survey, the agency was not in compliance with Chapter 42 CFR Part 418, Rules and Requirements for Home Health and Hospice Agencies. The census was 294. The following deficiencies were cited. The following Condition Level citation was cited: 484.45 Reporting OASIS information

Reporting OASIS information CFR(s): 484.45 Condition of participation: HHAs must electronically report all OASIS data collected in accordance with §484.55. This CONDITION is not met as evidenced by: Based on the Centers for Medicare & Medicaid Services (CMS) Home Health Agency (HHA) Error Summary by Agency Report, review of policy “Patient Assessments,” and staff interview, it was determined that the agency failed to electronically report all Outcome and Assessment Information Set (OASIS) data. Findings include: Review of CMS report titled “HHA Error Summary by Agency,” dated 9/10/2024, revealed the agency failed to transmit OASIS data to the CMS within 30 days for 126 patients. Review of policy titled “Patient Assessments,” number 03-05, revised 8/2024, revealed the following: OASIS Data Collection • OASIS data items will be collected and transmitted within 30 calendar days of the completion of the OASIS assessment. On 10/22/2024 at approximately 2:00 pm, an interview with the Branch Director (BD) confirmed OASIS data had not been submitted to CMS within 30 days of completion. The BD revealed OASIS transmission problems were identified in July of 2024 but have since been resolved.

Encoding and transmitting OASIS CFR(s): 484.45(a) Standard: An HHA must encode and electronically transmit each completed OASIS assessment to the CMS system, regarding each beneficiary with respect to which information is required to be transmitted (as determined by the Secretary), within 30 days of completing the assessment of the beneficiary. This STANDARD is not met as evidenced by: Based on the Centers for Medicare & Medicaid Services (CMS) Home Health Agency (HHA) Error Summary by Agency Report, review of policy “Patient Assessments,” and staff interview, it was determined that the agency failed to electronically transmit Outcome and Assessment Information Set (OASIS) data to the CMS within 30 days of completing the assessment. Findings include: Review of CMS report titled “HHA Error Summary by Agency,” dated 9/10/2024, revealed the agency failed to transmit OASIS data to the CMS within 30 days for 126 patients. Cross-reference to G0370 for findings related to reporting OASIS information.

At the time of the recertification survey conducted on 10/1/21, Kindred At Home in Cumming , GA was in compliance with 42 CFR Part 418.113, Emergency Preparedness for Hospices. A Focus Infection Control Survey was completed at the time of the survey. The agency census was 339 at the time of the onsite visit. No deficiencies were cited.

At the time of the survey, Kindred At Home in Cumming GA was in substantial compliance with 42-CFR Part 484, Requirements for Home Health Agencies, as a result of a partial extended survey conducted on 10/1/21. The census was 339 at the time of the visit . A Focus Infection Control Survey was completed at the time of the survey. The following deficiencies were cited:

Plan of care must include the following CFR(s): 484.60(a)(2)(i-xvi) The individualized plan of care must include the following: (i) All pertinent diagnoses; (ii) The patient's mental, psychosocial, and cognitive status; (iii) The types of services, supplies, and equipment required; (iv) The frequency and duration of visits to be made; (v) Prognosis; (vi) Rehabilitation potential; (vii) Functional limitations; (viii) Activities permitted; (ix) Nutritional requirements; (x) All medications and treatments; (xi) Safety measures to protect against injury; (xii) A description of the patient's risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors. (xiii) Patient and caregiver education and training to facilitate timely discharge; (xiv) Patient-specific interventions and education; measurable outcomes and goals identified by the HHA and the patient; (xv) Information related to any advanced directives; and (xvi) Any additional items the HHA or physician or allowed practitioner may choose to include. This ELEMENT is not met as evidenced by: Based on clinical record reviews and staff interviews, it was determined the agency failed to ensure the patients' individualized plan of care included all of the required elements to address the patients' needs for five of thirteen (P#)(P#5, P#6, P#11, P#13, and #16) sampled patients. . Findings include: 1. Review of the plan of care/treatment for patient #16 (closed record) with a certification period of 6/8/21 to 8/6/21 revealed an incomplete Foley catheter order which reads as follows: Skilled nurse for insertion of Foley catheter maintenance with catheter # 16 French with 10 milliliters Balloon. Change every month and as needed for dislodgement or stoppage. The order was not complete as it did not specify what type and the amount of fluid to instill into the balloon. The agency failed to obtain a complete and accurate order for the care and maintenance of the catheter. Furthermore, the plan of care revealed that patient has a history of long-term use of Aspirin (anticoagulant ) one tablet once daily. However, the plan of care lacked teaching on signs and symptoms (s/s) of bleeding and prevention of bleeding caused by long term use of aspirin. The agency failed to ensure that the plan of care included all pertinent interventions for the care and treatment of anticoagulation therapy and to include patient-specific interventions for the comprehensive care of the patient. During an interview on 10/1/21 at 10:00 a.m. the Executive Director confirmed the plan of care/treatment lacked an accurate and complete foley catheter order for the care and maintenance of the catheter and teaching and assessment of anticoagulation therapy. 2. Review of the plan of care/treatment for patient #5 with a recertification period of 8/22/21 to 10/20/21 revealed a diagnosis of cellulitis of the left upper limb (elbow). However, the plan of care lacks treatment plan for the assessment of the left upper limb. Furthermore, review of the skilled nurse (SN) visit note dated 9/8/21, the SN documents that patient continues with draining. The review of the SN visit note dated 9/21/21, the SN documents that patient performs wound care to the left elbow. During a home visit on 9/28/21 approximately 9:30 a.m., the patient was found to have a dressing on left elbow. During an interview , patient stated that this wound has been there for a very long time and the infectious disease (ID)specialist follows the care of this wound and stated to patient, that patient has a sinus tract infection and may require a surgery to the wound on the left elbow. The agency failed to ensure that the plan of care included all pertinent interventions for the care and treatment of the cellulitis of the left upper limb and to include patient-specific interventions for the comprehensive care of the patient. During an interview on 10/1/21 at 10:00 a.m. the Executive Director confirmed the plan of care/treatment lacked comprehensive assessment and patient specific instruction of cellulitis of the left upper limb. 3. Review of the plan of care/treatment for patient #11 with a recertification period of 9/26/21 to 11/24/21 revealed a diagnosis of abdominal wound , and long-term use of anticoagulant therapy (Xarelto 10 mg daily). The wound care to the abdominal site as follows: pack wound daily and as needed for soiled and dislodgement with ¼ Dakin solution-soaked gauze . Cover with gauze and secure with tape. However, the plan of care lacks specific supplies and specific steps to clean the wound prior to packing the wound with clean dressing. Furthermore, the verbal order dated 8/26/21, the wound care order as follows: cleanse wound with wound cleanser , crust peri wound with antifungal powder and skin prep pack tract at 10 O’clock with collagen silver then apply aquacel AG plus advantage over wound bed and secure with silicone bordered foam 6x6. However, the wound order lacks specific location of the wound. Additionally, the plan of care lacked teaching on signs and symptoms (s/s) of bleeding and prevention of bleeding caused by long term use of anticoagulation therapy. The agency failed to ensure that the plan of care included all pertinent interventions for the care and treatment of wound, anticoagulation therapy and to include patient-specific interventions for the comprehensive care of the patient. During an interview on 10/1/21 at 10:00 a.m. the Executive Director confirmed the plan of care/treatment lacked complete wound care orders and included all pertinent interventions for the comprehensive care of the patient and to ensure the accurate management of the anticoagulant therapy. 4. Review of the plan of care/treatment for patient #6 with a recertification period of 9/4/21 to 11/12/21 revealed a diagnosis of type 2 diabetes mellitus with diabetic neuropathy and long-term use of hypoglycemic drugs. The plan of care requires the skilled nurse (SN) to notify md for blood sugar greater than 250 or less than 70 for three consecutive readings . However, the plan of care lacked the frequency to monitor the blood glucose parameters for notifying the physician of potential complications. The agency failed to ensure that plan of care includes blood glucose monitoring frequency to adequately manage patient's diabetes. The agency failed to obtain complete order for patient's diabetic regimen. During an interview on 10/1/21 at 10:00 a.m., the Executive Director provided no evidence that the plan of care included the frequencies to monitor blood glucose. 5. Review of the plan of care/treatment for patient #13(closed record) with a recertification period of 5/21/21 to 7/19/21 revealed a diagnosis of long-term use of anticoagulant therapy (Eliquis 5 mg twice daily). However, the plan of care lacked teaching on signs and symptoms (s/s) of bleeding and prevention of bleeding caused by long term use of anticoagulation therapy. The agency failed to ensure that the plan of care included all pertinent interventions for the care and treatment of anticoagulation therapy and to include patient-specific interventions for the comprehensive care of the patient. During an interview on 10/1/21 at 10:00 a.m. the Executive Director confirmed the plan of care/treatment lacked all pertinent interventions for the comprehensive care of the patient and to ensure the accurate management of the anticoagulant therapy. . .