Every finding on record at Dsp Home Health Inc

The following reflect the findings of the Department of Public Health during RECERTIFICATION survey. Representing the Department of Public Health: Surveyor ID#09697 - Health Facilities Evaluator Nurse Surveyor ID#35893 - Health Facilities Evaluator Nurse Active Patients - 6 Unduplicated Admission - 66 Sample Size - 7 Home Visits - 3

Provide services in the plan of care CFR(s): 484.75(b)(3) Providing services that are ordered by the physician or allowed practitioner as indicated in the plan of care; This ELEMENT is not met as evidenced by: Based on observation, interview , and record review, the home health agency (HHA) failed to ensure that the patient's blood sugar levels were recorded for one of seven sampled patients (Patient 5). This failure resulted in the HHA's inability to monitor the patient's blood sugar which had the potential to delay the patient in reaching their goals. Findings: A review of Patient 5's Patient Information indicated, a start of care (SOC) date of 2/25/22, with a diagnosis that included type 2 diabetes mellitus (DM-an impairment in the way the body regulates and uses sugar as a fuel). During a review of Patient 5's plan of care (POC), for the certification period from 2/25/2022-4/25/2022, included an order for skilled nurse (SN) to visit daily for 7 days and then twice a week thereafter. The POC indicated for SN to monitor blood sugar and report to physician if blood sugar is less than 70 or over 350 milligrams/deciliter (mg/dl-unit of measurement). A home visit was conducted at Patient 5’s residence on 3/12/22, at 1 p.m., with licensed vocational nurse (LVN 1). During an interview, the patient’s family member stated he checked the blood sugar of Patient 5 at 12:05 p.m. and it was 186 mg/dl. He stated he did not keep a log of the blood sugar values which was taken three times a day. During an interview with LVN 1, at 1:30 p.m., she stated the purpose of the home visits were to monitor Patient 5’s blood sugar. She confirmed blood sugar level for Patient 5 needed to be recorded. She stated she would have to ensure the blood sugar values are documented daily by the patient’s family. The HHA’s policy and procedure dated 4/30/12, and titled “Plan of Care or Plan of Treatments”, indicated a standard for implementation of an individualized plan of care based on the assessment of patient needs.

In accordance with current clinical practice CFR(s): 484.105(f)(2) All HHA services must be provided in accordance with current clinical practice guidelines and accepted professional standards of practice. This ELEMENT is not met as evidenced by: Based on interview and record review, the home health agency (HHA) failed to calibrate the glucometer used to check the patient's blood sugar level for one of seven sampled patients (Patient 5). This failure had the potential to affect the accuracy of the blood sugar value. Findings: A review of Patient 5's Patient Information indicated, a start of care (SOC) date of 2/25/22, with a diagnosis that included type 2 diabetes mellitus (DM-an impairment in the way the body regulates and uses sugar as a fuel). During a review of Patient 5's plan of care (POC), for the certification period from 2/25/2022-4/25/2022, included an order for skilled nurse (SN) to visit daily for 7 days and then twice a week thereafter. The POC indicated for SN to monitor blood sugar and report to physician if blood sugar is less than 70 or over 350 milligrams/deciliter (mg/dl-unit of measurement). A home visit was conducted at Patient 5’s residence on 3/12/22, at 1 p.m., with licensed vocational nurse (LVN 1). During an interview with LVN 1, at 1:30 p.m., she stated the purpose of the home visits were to monitor Patient 5’s blood sugar. She confirmed blood sugar level for Patient 5 needs to be monitored. She stated she uses the True-Metrix glucometer to check the blood sugar of Patient 5. She further stated the glucometer does not need to be calibrated. During a review of the manufacturer’s instruction for glucometer use indicated the need for calibration every time a new test strip bottle is opened to ensure accuracy. During an interview on 3/13/22, at 11:20 a.m., LVN 1 she stated she did not read the manufacturer’s instruction for the glucometer. She stated she would have to calibrate the glucometer. The HHA’s policy and procedure dated 5/14/09, and titled “Diabetic Care and Management”, indicated the glucometer being used must be tested every week including the test solution to assure accuracy of blood sugar result .