Every finding on record at Community Nurses Home Health and Hospice Inc

Based on the findings of an off-site unannounced, complaint investigation survey conducted May 24, 2022 through May 27, 2022, Penn Highlands Community Nurses, 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.

Conformance with physician orders CFR(s): 484.60(b) Standard: Conformance with physician or allowed practitioner orders. This STANDARD is not met as evidenced by: Based on review of agency policy and procedure, clinical records (CR), and interview with staff (EMP1), the agency failed to follow the physician's ordered plan of care for one (1) of three (3) clinical records reviewed (CR1). Findings included: Entrance interview with EMP1-agency administrator-Kristen Genevro on 9/30/22 related to complaint revealed the following : EMP1 reported to state surveyor that " On 9/2/22 patient daughter called in stating physical therapy assistant (PTA) Kelly turned patient oxygen from 3L(liters) NC(nasal canula) to 2 L NC patient became hypoxic (medical definition– deficient amount of oxygen reaching tissue) spo2(oxygen saturation) in the 80's% and patient passed out. family turned oxygen back up to 3L to recover. I was made aware of the complaint... Penn Highlands has an investigation procedure that was immediately initiated and followed… staff has been re-educated…. Patient has received a letter and follow up phone call” 10/4/22 at approximately 11:00 a.m. review of CR1 plan of care (POC) with a Start of Care (SOC) date: 8/26/22… revealed documentation of a physician order dated 8/26/22 to “administer O2 (oxygen) at prescribed flow rate…3(three) LPM (liters per minute) via NC (nasal canula) cont. (continuous)” Review of documentation/visit notes dated 9/1/22 and signed by agency physical therapy assistant (PTA) revealed that PTA “….reduced patient’s oxygen from 3(three) LPM via NC down to 2(two) LPM via NC…” There was no supporting documentation that updated/new physician orders were received. Physical Therapy Assistant job description/policy reviewed approximately 1:00 pm on 10/4/22 revealed “Essential Core Job Duties…provides physical therapy services to home health patients according to directions of physical therapist and in accordance with the physician’s plan of care.” An exit conference was conducted at approximately 2:20 PM on 10/4/22 with agency administrator (EMP1). Above findings were reviewed.