Every finding on record at Eh Home Health of the Mid Atlantic, LLC

Based on the findings of an onsite unannounced home health agency Medicare recertification survey conducted between 3/30/2022- 4/1/2022, Encompass Health Home Health , was found to be in compliance with the requirements of 42 CFR, Part 484.22, Subpart B, Conditions of Participation: Home Health Agencies - Emergency Preparedness.

Based on the findings of an unannounced onsite home health agency Medicare recertification survey conducted between 3/30/2022- 4/1/2022, Encompass Health Home Health, was found to be not in compliance with the requirements of 42 CFR, Part 484, Subparts B and C, Conditions of Participation: Home Health Agencies.

Treatment or care CFR(s): 484.50(e)(1)(i)(A) (i)(A) Treatment or care that is (or fails to be) furnished, is furnished inconsistently, or is furnished inappropriately; and This ELEMENT is not met as evidenced by: Based upon review of agency policy, observation (OBS), and interview with administrator (EMP # 1) and supervising nurse (EMP # 2), agency staff failed to follow infection control protocols in one observation out of two wound care observations. (OBS # 1). Findings included: Review of agency policy on 4/1/2022 at approximately 12:30 PM-1:00 PM titled " Infection surveillance Exposure Control Plan" stated " 4.3.3.13 " All linens and trash contaminated with blood and/or body fluids must be handled as isolation materials are handed. 4.3.3.13.1. All supplies will be double bagged and disposed of with the patient's home refuse collection." Observation # 1 conducted on 3/31/2022 at approximately 8:30 AM-9:00 AM observed LPN (EMP # 3), complete removal of old sanguineous and blood saturated dressings from left leg and proceed to throw saturated dressings into kitchen trash bag. Dressings were not double bagged. Interview with EMP # 1 and EMP # 2 on 4/1/2022 at approximately 12:30 PM confirmed above findings.

Verbal orders CFR(s): 484.60(b)(3)(4) (3) Verbal orders must be accepted only by personnel authorized to do so by applicable state laws and regulations and by the HHA's internal policies. (4) When services are provided on the basis of a physician or allowed practitioner's verbal orders, a nurse acting in accordance with state licensure requirements, or other qualified practitioner responsible for furnishing or supervising the ordered services, in accordance with state law and the HHA's policies, must document the orders in the patient's clinical record, and sign, date, and time the orders. Verbal orders must be authenticated and dated by the physician or allowed pracitioner in accordance with applicable state laws and regulations, as well as the HHA's internal policies. This ELEMENT is not met as evidenced by: Based upon review of agency policy, medical records (MR), and interview with administrator (EMP # 1) and supervising nurse (EMP # 2), agency failed to obtain signed verbal physician orders within thirty (30) days for three (3) of seventeen (17) files reviewed. (MR # 9, MR # 11-12). Findings included: Review of agency policy on 4/1/2022 at approximately 12:30 PM -1:00 PM titled “Service Delivery Clinical Records” stated “3.1.3.6 “The agency obtains the physician’s signature on plans of care within 60 days and verbal orders within 30 days from the effective date of the order…. In Pennsylvania, the licensed nurse shall immediately record and sign medication verbal orders and obtain the physician’s countersignature within 7 days.” Review of MR on 4/1/2022 between 8:00 AM-12:30 PM revealed: MR # 9, Start of Care (SOC) 2/7/2022; certification period: 2/7/ 2022-4/7/2022; a ninety-one (91) year old male with diagnosis of unspecified atrial fibrillation {irregular and rapid heart rate}, chronic kidney disease with heart failure {damaged kidneys that can’t filter blood}, acute on chronic congestive heart failure {heart not pumping blood as it should}. Review of plan of care revealed no countersignature by the physician. MR # 11, SOC 2/19/2022; certification period: 2/19/2022-4/19/2022; a forty-two (42) year old female with diagnosis of encounter for change or removal of surgical wound dressing, orthopedic aftercare following surgical amp {amputation}, absence of right leg above knee, type 2 diabetes {too much sugar in blood} with diabetic peripheral angiopath {disease caused by high sugar content in blood} w/o {without} gangarene {death of tissue}. Review of plan of care revealed physician countersignature 4/1/2022. Forty-one (41) days from the start of care. MR # 12, SOC 2/4/2022; certification period: 2/4/2022-4/4/2022; a seventy-nine (79) year old male with diagnosis of acute pancreatitis {inflamed pancreas} without necrosis or infection, paroxysmal atrial fibrillation {irregular and rapid heart rate} , congestive heart failure {heart not pumping blood as it should}, rheumatoid arthritis {inflamed joints}. Review of plan of care revealed no countersignature by the physician. Interview with EMP # 1 and EMP # 2 on 4/1/2022 at approximately 12:30 PM confirmed above findings.