Every finding on record at Community Home Health Care of Arkansas, Inc

. On 8/14/23 at 11:00 AM, an entrance conference was conducted with Agency Representatives. The Agency was informed the purpose of the visit was to conduct a Medicare Recertification survey for compliance with the Conditions of Participation for Home Health. On 8/17/23 at 8:40 AM an exit conference was conducted with Agency Representatives. Preliminary findings of the survey were discussed. .

A review of all current medications CFR(s): 484.55(c)(5) A review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy. This ELEMENT is not met as evidenced by: Based on Clinical Record review and staff interviews, it was determined the Skilled Nurse (SN) failed to include chemotherapy drugs during the review of the patients' medications in 1 (#7) of 10 (#1 - #10) Clinical Records reviewed. This failed practice by the SN posed a risk of potential harm for patients on census receiving chemotherapy treatments by inhibiting the Nurse and Physician's ability to make informed decisions regarding the patients' medication regimen related to potential adverse effects, drug reactions, significant side effects or significant drug interactions. Review of Clinical Record #7 revealed the following: A. Document titled "Certification and Plan of Care (POC)" dated 6/10/23 to 8/8/23 showed a diagnosis of "Malignant neoplasm of Left fallopian tube, (cancer of female organs). B. Document titled " OASIS-E Recertification" dated 8/6/23", showed documentation by the SN stating "Patient has started chemo". There was no evidence the chemo therapy drugs were added to Patient #7's medication profile and no evidence the chemo therapy drugs were included in the drug regimen review by the SN. 2. During an interview dated 8/17/23 at 8:30 A.M., Agency staff #1 verified the chemo therapy drugs were not added to the medication profile and were not included in the drug regimen review for Patient #7.

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 during home visits, staff interviews, review of the Agency's Policy and Procedure the Skilled Nurse (SN) failed to follow accepted professional standards for infection control in 1 (#4) of 4 (#1 - #4) home visits conducted. This deficient practice had the potential to place these patients with wound care at risk for adverse outcomes, wound infection. and/or hospitalization. During a home visit with Patient #4 on 8/14/23 at 2:10 PM, the Surveyor observed the SN providing wound care for Patient #4 for a wound on the right lateral ankle. The SN washed hands, donned gloves and removed the soiled wound dressing from the right ankle. The SN proceeded to remove soiled gloves, sanitize hands and clean the wound. The SN removed soiled gloves after cleaning the wound and applied clean gloves and failed to re-sanitizing hands and proceeded to apply the clean dressings to Patient #4's wound to right lateral ankle. During an interview on 8/14/23 at 2:30 PM, Agency Staff #1 verified the SN failed to re-sanitized hands prior to applying clean gloves and applying the clean dressing to the Patient's wound.