Every finding on record at Country Style Health Care, Inc. IX

The Oklahoma State Department of Health conducted an unannounced Medicare Emergency Preparedness Program survey at the hospice on 04/28/25 to 04/29/25. No deficiencies were cited as a result of the Emergency Preparedness Program survey.

The Oklahoma State Department of Health conducted an unannounced Medicare re-certification survey in conjunction with a complaint (62277 and 106834) survey at the agency on 04/28/25 to 04/29/25. An entrance conference was conducted with Staff A. Staff A was identified as the contact person for administrative issues and Staff B was identified as the contact person for clinical issues. Findings were discussed during an informal exit conference with Staff A and B. Deficiencies were cited as a result of the re-certification survey. No deficiencies were cited as a result of the complaint survey.

Visit schedule CFR(s): 484.60(e)(1) Visit schedule, including frequency of visits by HHA personnel and personnel acting on behalf of the HHA. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to: 1. ensure aide services were provided as ordered for two (Patients #1 and 5) of seven patients; and 2. ensure skilled nurse services were provided as ordered for two (Patients #1 and 5) of seven patients. Patient #1 A review of the plan of care dated 02/24/25 to 04/24/25 showed a home health aide frequency of one visit for nine weeks and a skilled nurse frequency of two visits per week for two weeks and one visit per week for seven weeks. A review of the clinical record showed the following: A home health aide missed visit (due to the family being in town) dated 03/06/25 for the week of 03/02/25 to 03/08/25 (no completed visits) with no patient refusal, no attempts to reschedule the missed visit and no new orders to change the ordered frequency. A home health aide missed visit (due to the family being in town) dated 03/13/25 for the week of 03/09/25 to 03/15/25 (no completed visits) with no patient refusal, no attempts to reschedule the missed visit and no new orders to change the ordered frequency. A home health aide missed visit (due to no answer to the locked door and being in care of the family) dated 03/27/25 for the week of 03/23/25 to 03/29/25 (no completed visits) with no patient refusal, no attempts to reschedule the missed visit and no new orders to change the ordered frequency. A skilled nurse missed visit note (due to the patient being in care of the family) dated 04/14/25 for the week of 04/13/25 to 04/19/25 (no completed visits) with no patient refusal, no attempts to reschedule the missed visit and no new orders to change the ordered frequency. Patient #5 A review of the plan of care dated 01/23/25 to 03/23/25 showed a home health aide frequency of one visit per week for one week and two visits per week for eight weeks and a skilled nurse frequency of one visit per week for eight weeks. A review of the clinical record showed the following: A home health aide missed visit (due to no answer to the locked door) dated 03/27/25 and a home health aide visit note dated 02/21/25 for the week of 02/16/25 to 02/22/25 (one of two completed visits) with no patient refusal, no attempts to reschedule the missed visit and no new orders to change the ordered frequency. A skilled nurse missed visit (due to inclimate weather) dated 02/18/25 for the week of 02/16/25 to 02/22/25 (no completed visits) with no patient refusal of services, no attempts to reschedule the missed visit and no new orders to change the ordered frequency. On 04/29/25 at 1:30 p.m., Staff B stated the ordered frequency was not met for Patients #1 and 5.

Onsite supervisory visit every 14 days CFR(s): 484.80(h)(1)(i) (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) 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 paragraph (g) of this section, must complete a supervisory assessment of the aide services being provided no less frequently than every 14 days; and (B) The home health aide does not need to be present during the supervisory assessment described in paragraph (h)(1)(i)(A) of this section. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to provide supervisory aide visits every 14 days for two (Patients #1 and 5) of seven patients. Patient #1 A review of the plan of care dated 02/24/25 to 04/24/25 showed a home health aide frequency of one visit for nine weeks. A review of the clinical record showed the following: A home health aide visit was completed on 04/03/25. A supervisory aide visit was completed on 04/07/25. A home health aide visit was completed on 04/10/25. A home health aide visit was completed on 04/24/25. A supervisory aide visit was completed on 04/24/25 (17 days after the last completed supervisory aide visit.) Patient #5 A review of the plan of care dated 01/23/25 to 03/23/25 showed a home health aide frequency of one visit per week for one week and two visits per week for eight weeks. A review of the clinical record showed the following: A home health aide visit was completed on 03/04/25. A supervisory aide visit was completed on 03/04/25. A home health aide visit was completed on 03/07/25. A home health aide visit was completed on 03/11/25. A home health aide visit was completed on 03/14/25. A supervisory aide visit was completed on 03/20/25 (16 days after the last completed supervisory aide visit.) On 04/29/25 at 2:00 pm., Staff B stated the supervisory aide visits for Patients #1 and 5 were not completed within 14 days.