Every finding on record at Citadel Home Care LLC

Based on the findings of an onsite unannounced home health agency Medicare recertification survey conducted February 8, 2021, through February 10, 2021, Citadel Home Care, LLC 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 conducted February 8, 2021, through February 10, 2021, Citadel Home Care, LLC 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.

Verbal orders CFR(s): 484.60(b)(3)(4) (3) Verbal orders must be accepted only by personnel authorized to do so by applicable state laws and regulations and by the HHA's internal policies. (4) When services are provided on the basis of a physician's verbal orders, a nurse acting in accordance with state licensure requirements, or other qualified practitioner responsible for furnishing or supervising the ordered services, in accordance with state law and the HHA's policies, must document the orders in the patient's clinical record, and sign, date, and time the orders. Verbal orders must be authenticated and dated by the physician in accordance with applicable state laws and regulations, as well as the HHA's internal policies. This ELEMENT is not met as evidenced by: Based on review of review of agency policy, clinical records (CR), and interview with the agency staff, the agency failed to follow its policy regarding signing the plan of care/ physician orders for three (3) of eight (8) CR reviewed. (CR # 3, 5, and 8). Findings included: Review of agency policy titled "Verbal/Telephone Orders" on February 8, 2021, at approximately 3:00 P.M., stated, "Policy: Signed physician's orders, which are signed and dated by the physician, are required for all services rendered by the agency... All Plans of Care/Treatment and verbal or telephone orders will be countersigned by the physician within seven (7) days." A review of the CR's conducted on February 9, 2021, from approximately 8:30 A.M. to 4:30 P.M. and February 10, 2021 from approximately 11:30 A.M. to 12:30 P.M. revealed the following: CR #3, start of care October 19, 2020, contained a Home Health Certification and Plan of Care (POC) for certification period December 18, 2020, through February 15, 2021, which was not signed by the physician. The CR contained a verbal order for wound care dated January 6, 2021, which was not signed by the physician. CR #5, start of care January 6, 2021, contained a POC for certification period January 6, 2021, through March 6, 2021, which was not signed by the physician. CR #8, start of care November 30, 2020, contained a POC for certification period November 30, 2020, through January 28, 2021, which was not signed by the physician. An interview with the administrator and director of nursing on February 10, 2021, at approximately 10:30 A.M. confirmed the above findings.