Every finding on record at Cp Napa Valley N-Ca Hh, LLC

The following reflects the findings of the California Department of Public Health during an investigation of a Complaint # 94861. Representing the California Department of Public Health: Health Facilities Evaluator Nurse 36790. The inspection was limited to the specific Complaint and did not represent the findings of a full inspection of the facility. One Deficiency cited for Complaint #94861.

Provide contact info other services CFR(s): 484.50(d)(5)(iii) (iii) Provide the patient and representative (if any), with contact information for other agencies or providers who may be able to provide care; and This ELEMENT is not met as evidenced by: Based on record review and interview, the facility failed to notify Patient 1 and Representative Party of other agencies and their contact information, when they discharged Patient 1 for Cause. This was for 1 of 3 sampled discharged patients (Patient 1), who was discharged from the care of the home health agency when agency staff could not met the needs of Patient 1 based on Patient 1's abusive behavior to the staff and refusal of care. This failure made it difficult for Patient 1 to find another health care arrangement. During a review of Patient 1’s clinical records, it was revealed Patient 1 was discharged for cause. Cause can be instances when the agency staff are abused, threatened or in danger and unable to provide care in the home. Patient 1's Care Visit note dated 1/20/22 indicated the following: "Patient was discharged...because of patients disrespectful and inappropriate behavior with clinicians, supervisors and support staff." After multiple attempts to explain acceptable behavior, the patient did not change the behaviors. Home Health discharged Patient 1 and notified the Physician (MD.) During a review of Patient 1's Care Visit note dated 1/20/22 concerning the discharge, the following was documented: "Notified MD for referral to another home health agency." Under community resources for the patient instruction was documented "Referred to another home health agency." During an interview on 2/9/23 at 12:00 p.m., Case Manager stated during the discharge the patient and family would have been told verbally the information for other agencies. During record review and concurrent interview on 2/9/23 at 12:00 p.m., Case Manager acknowledged that Patient 1's Care Visit note dated 1/20/22 concerning the discharge, included the following "Referred to another home health agency." but did not specify the names nor give contact information for other agencies or providers who may be able to provide care. During an interview and concurrent record review on 2/9/22 at 12:30 p.m., the Case Manager showed an email documenting the MD's notification of the discharge. This email was dated 1/20/22 and indicated " we are recommend her to be referred to a home health agency... (Accent Care). patient and family have been instructed to follow up with you for her care." Case Manager stated they did not have other nursing notes, letters or emails sent to the patient and family documenting other agencies or providers by name and contact information who may be able to provide care to the patient. During the review of the agencies policy, "HH Transfer/Discharge Criteria and Process" dated 11/2018, indicated "discharge for cause instances, home health agency will: Provide the patient and their representative with contact information for other agencies or providers who may be able to provide care."