Every finding on record at Franklin Home Care Services LLC

An unannounced Home Health Agency recertification survey was conducted on October 18-20, 2021 by one (1) Medical Facilities Inspector from The Office of Licensure and Certification, Virginia Department of Health. In conjunction with this survey, the agency's emergency preparedness plan was reviewed. The agency was found to be in compliance with 42 CFR 484.102 Conditions of Participation Emergency Preparedness for Home Health Agencies.

An unannounced Home Health Agency recertification survey was conducted on October 18-20, 2021 by one (1) Medical Facilities Inspector from The Office of Licensure and Certification, Virginia Department of Health. The agency reported an unduplicated census of 436 for the past twelve months with no branch locations. In conjunction with the survey, ten (10) clinical records, four (4) personnel files, an admission packet, the complaint log, emergency preparedness, COVID-19 data, CLIA (Clinical Laboratory Improvement Amendments), Quality Improvement and the organization chart were reviewed. Four (4) home visits and staff interviews were conducted. The agency was found not to be in compliance with the federal requirements of 42 CFR 484, Conditions of Participation for Home Health Agencies. Deficiencies were identified and cited in this report.

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 staff interview and review of clinical records it was determined the agency staff failed to follow physicians orders for one (1) of ten (10) clinical records in the survey samples (clinical record #4). The findings were: Clinical record #4 was reviewed for the certification period of 8/21/2021 through 10/19/2021. The patient was being treated for a pressure ulcer to the sacrum with wound care orders as, "clean with dermal wound cleanser, apply duoderm dressing". The order changed on 8/25/2021 to discontinue duoderm and start Aquacel, cover with foam dressing. The nurse made a visit on 8/27/2021 after the new order was written and still documented using the duoderm on the wound. On 8/29/2021, the wound care orders changed to discontinue Aquacel and use collagen and cover with foam dressing. On the 8/31/2021 and 9/3/2021 nursing visits, the nurse continued to document the use of Aquacel. An interview with the administrator on 10/20/2021 at 8:45 am revealed that if the order is put in outside of a visit, it does not carry over to the plan of care. The plan of care orders are then carried over to the visit notes so if the nurse marks in the chart that orders were completed as ordered and didn't read what was pulled over, they could be documenting the wrong orders. The nurse may be doing the correct wound care but the electronic record may not reflect it.