Every finding on record at G T S Home Health Inc

The following reflects the findings of the California Department of Public Health during a Recertification Survey. Representing the California Department of Public Health: Surveyor # 40992, Health Facilities Evaluator Nurse Surveyor # 19096, Health Facilities Evaluator Nurse Unduplicated Admissions - 52 Active Patients - 20 Sample Size - 7 Home Visits- 3

Infection control education CFR(s): 484.70(c) Standard: Education. The HHA must provide infection control education to staff, patients, and caregiver(s). This STANDARD is not met as evidenced by: Based on observation, interview and record review the Home Health Agency (HHA) failed to ensure patient care supplies were not expired. The deficient practice had the potential to result in patients receiving supplies that are already expired. During a concurrent observation and interview on 5/17/2023 at 1:15 p.m., with the agency's Intake Coordinator, in the agency's office supply room, a Bardia Foley catheter (a flexible tube inserted into the bladder through the urethra, used to empty the bladder and collect urine into a drainage bag) 22 French (size) with an expiration date 6/28/2022 was observed in the supplies, the Intake Coordinator stated, “I missed it. I should have thrown this out.” During an interview on 5/17/2023 at 1:20 p.m., Director of patient care services (DPCS), DPCS stated, “we were slow during Coronavirus disease (COVID 19 (a highly contagious infectious respiratory illness that can spread from one person to another) and missed it. It should have been thrown away. All expired supplies should be disposed.” During a review of the job description summary for Office Manager dated (revised July, 2008), the job description policy indicated, “Essential Job Functions/ Responsibilities 9. Order and maintains accurate records of medical equipment and supplies.”

Patient and caregiver education CFR(s): 484.75(b)(5) Patient and caregiver education; This ELEMENT is not met as evidenced by: Based on interview and record review, the home health agency (HHA) failed to provide patient and caregiver education as indicated in the plan of care (POC) for 1 of 7 sampled patients, (Patients 4). This deficient practice had the potential to result in the HHA's inability to ensure needed services and high quality healthcare were provided to the patients under their care. A review of Patient 4’s Face sheet indicated that a Start of Care (SOC) date of 2/04/23 with the recertification period reviewed on 4/05/23 to 6/03/23 with a diagnosis diabetes mellitus type 2 with hyperglycemia (a condition which causes the pancreas to not produce enough insulin resulting in high levels of blood sugar), and hypertensive heart disease (refers to heart problems that occur because of high blood pressure that is present over a long time). Skilled nursing (SN) visit frequency of once a week for nine weeks. SN to educate patient/patient caregiver on medication compliance/regimen/ signs/symptoms of adverse reactions to report to MD; SN to educate patient/patient caregiver on proper management of medication as prescribed by MD… During a review of patient 4’s medication profile, there was an order for Acetaminophen with codeine (pain medication) #3 Oral 300-30 mg to take 1 tablet every 6 hours as need for severe pain. A home visit was conducted on 5/18/23 at 11:15 a.m., at Patient 4’s residence with director of patient care services (DPCS). During the home visit on 5/18/23 at 11:15 a.m., with Patient 4, the patient stated she was not experiencing any pain and was not taking pain medication. A review of Patient 4’s medications the acetaminophen with codeine #3 (pain medication) was missing. During an interview on 5/18/23 at 11:30am with Patient 4, when asked where the acetaminophen with codeine was, Patient 4 stated she ran out of the acetaminophen with codeine a few days ago and it hasn’t been delivered by pharmacy yet since her date of delivery from the pharmacy isn’t for another few days. When asked how often patient 4 takes this medication. Patient 4 stated almost every day. During an interview with the Director of Nursing (DON) on 5/18/23 at 11:45 a.m., DON stated she was not aware the patient ran out of the medication. When asked if there was education provided on reordering medications before it runs out, DPCS stated LVN 1 is the primary nurse and she is out of town. A review of the HHA's policy titled " Patient Education Process" revised 7/2008, indicated “Unless otherwise ordered by physician (or other authorized licensed independent practitioner), the patient and family/caregiver will receive verbal and, as appropriate, written instructions: medication management and administration.”