Every finding on record at Georgetown Hospital Home Health

An unannounced on-site Emergency Preparedness (EP) Program survey was conducted at Amedisys Home Health Myrtle Beach from 6/20/2022 through 6/23/2022. The home health agency is in substantial compliance with the Medicare Conditions of Participation at 42 CFR 484.102 (Establishment of the Emergency Program).

An unannounced on-site Recertification Survey was conducted at Amedisys Home Health Myrtle Beach from 6/20/2022 through 6/23/2022. The Home health Agency is in substantial compliance with the Medicare Conditions of Participation at 42 CFR PART 484. Standard level deficiencies were identified during the Recertification Survey. A COVID-19 Staff Vaccination Survey was conducted in conjunction with the Recertification Survey. Amedisys Home Health Myrtle Beach is 100 percent compliance with the Medicare requirements for staff vaccination.

Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician is consulted to approve additions or modifications to the original plan. This STANDARD is not met as evidenced by: Based on record reviews and interviews, the Home Health Agency (HHA)failed to ensure its nursing staff identified measurable goals on the patient’s Plan Of Care (POC) for 15 of 17 patient records reviewed. (Patient #2, #4, #5, #6, #7, #8, #9, #10, #11, #12, #13, #14, #15, #16, and #17) On 6/21/2022 at 4:36 PM, review of Patient #17’s POC revealed the goals listed in the patient's POC were not measurable: meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, ability to perform wound care, and fall risk. The finding was verified by the Administrator at 3:11 PM on 6/23/2022. On 6/22/2022 at 3:01 PM, review of Patient #2’s POC revealed the goals listed in the patient's POC are not measurable: strategies to minimize fall risk, safe management of medication, co-morbid conditions, POC to meet patient’s needs, safe oxygen levels during activity, when to call 911, and telehealth visit. The finding was verified by the Administrator at 2:02 PM on 6/23/2022. On 6/22/2022 at 8:20 PM, review of Patient #4’s POC revealed the goals listed in the patient's POC were not measurable: signs and symptoms of anticoagulant toxicity, and when to call 911. The finding was verified by the Administrator at 2:35 PM on 6/23/2022. On 6/22/2022 at 8:40 PM, review of Patient #5’s POC revealed the goals listed in the patient's POC were not measurable: POC that meets the patient’s needs, co-morbid conditions identified, when to call 911, and ability to perform wound care. The finding was verified by the Administrator at 3:22 PM on 6/23/2022. On 6/22/2022 at 9:01 PM, review of Patient #6’s POC revealed the goals listed in the patient's POC were not measurable: POC to meet patient’s needs, co-morbid conditions, safe medication management, when to call 911, and minimize fall risk. The finding was verified by the Administrator at 2:14 PM on 6/23/2022. On 6/22/2022 at 8:40 PM, review of Patient #7’s POC revealed the goals listed in the patient's POC were not measurable: POC meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, changes in skin integrity, and fall risk. The findings were verified by the Administrator at 2:17 PM on 6/23/2022. On 6/22/2022 at 9:34 PM, review of Patient #8’s POC revealed the goals listed in the patient's POC were not measurable: POC meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, changes in skin integrity, and fall risk. The finding was verified by the Administrator at 2:26 PM on 6/23/2022. On 6/22/2022 at 9:51 PM, review of Patient #9’s POC revealed the goals listed in the patient's POC were not measurable: POC meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, and telehealth visits. The finding was verified by the Administrator at 3:26 PM on 6/23/2022. On 6/22/2022 at 10:01 PM, review of Patient #10’s POC revealed the goals listed in the patient's POC were not measurable: POC meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, changes in skin integrity, and fall risk. The finding was verified by the Administrator at 2:39 PM on 6/23/2022. On 6/22/2022 at 10:13 PM, review of Patient #11’s POC revealed the goals listed in the patient's POC were not measurable: POC meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, anticoagulation therapy, and ability to perform wound care. The finding was verified by the Administrator at 2:45 PM on 6/23/2022. On 6/23/2022 at 10:22 AM, review of Patient #12’s POC revealed the goals listed in the patient's POC were not measurable: POC meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, ability to perform wound care, and fall risk. The finding was verified by the Administrator at 2:49 PM on 6/23/2022. On 6/23/2022 at 10:55 AM, review of Patient #13’s POC revealed the goals listed in the patient's POC were not measurable: POC meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, and fall risk. The finding was verified by the Administrator at 2:50 PM on 6/23/2022. On 6/23/2022 at 11:26 AM, review of Patient #14’s POC revealed the goals listed in the patient's POC were not measurable: assistance with personal care and hygiene and ability to perform wound care. The finding was verified by the Administrator at 2:57 PM on 6/23/2022. On 6/23/2022 at 11:58 AM, review of Patient #15’s POC revealed the goals listed in the patient's POC were not measurable: POC meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, changes in skin integrity, telehealth visits, additional orders, and fall risk. The finding was verified by the Administrator at 3:03 PM on 6/23/2022. On 6/23/2022 at 12:19 PM, review of Patient #16’s POC revealed the goals listed in the patient's POC were not measurable: POC meets patient’s needs, co-morbid conditions, safe medication management, when to call 911, telehealth visits, and fall risk. The finding was verified by the Administrator at 3:25 PM on 6/23/2022.

Only as ordered by a physician CFR(s): 484.60(b)(1) Drugs, services, and treatments are administered only as ordered by a physician. This ELEMENT is not met as evidenced by: Based on record reviews and interview, the home health nurse failed to obtain wound care orders for a wound that had wound closure and then later reopened for one of one patient reviewed with a dehisced wound. (Patient #5) Patient #5 On 6/22/2022 at 8:40 PM, review of Patient #5’s chart revealed the patient had intestinal surgery with a colostomy and a lower abdominal wound. The skilled nurse documented the lower abdominal wound which had closed had reopened, but the patient's chart had no physician orders for wound care. The finding was verified by the Administrator at 3:22 PM on 6/23/2022.