Every finding on record at Good Sam Society Home Care of SW Mn

On 3/27/23 through 3/30/23, a survey for compliance with Appendix Z, Emergency Preparedness Requirements for Long Term facilities was conducted during a recertification survey with complaint investigation. The facility was found to be IN compliance. The facility is enrolled in the electronic Plan of Correction (ePoC) and therefore a signature is not required at the bottom of the first page of the State form. Although no plan of correction is required, it is required that you acknowledge receipt of the electronic documents.

On 3/27/23 through 3/30/23, a recertification survey was conducted in conjunction with a complaint investigation. This resulted in a partial extended survey at Good Samaritan Society-Home Care. The agency was found to have not met the requirements at 42 CFR. Part 484 for Home Health Agencies. The cumulative effects of these findings resulted in the Home Health Agency’s inability to ensure provision of quality of care. Unduplicated census previous 12 months: 524. Total home visits conducted: 5. The home health survey was completed at Good Samaritan Society-Home Care at 866 1st Avenue North, Windom, MN 56101. There are no branch offices for this agency. Hours of Operation: 8:00 a.m. to 4:30 p.m. List total number of records reviewed: 13. #H80611109C was investigated and was found to be substantiated, however, no deficiencies were cited.

A review of all current medications CFR(s): 484.55(c)(5) A review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy. This ELEMENT is not met as evidenced by: Based on observation, interview and document review, the agency failed to ensure medication regimen reviews were completed to ensure medications identified on the plan of care (POC) were available and set up as ordered by physician for 2 of 2 patients (P5 and P6) seen with in home visits with medication set up. P4's Team Care Plan, dated 3/27/23, identified P4 had the diagnoses of chronic obstructive pulmonary disease (a disease which causes difficulty breathing), diabetes mellitus with diabetic chronic kidney disease. venous insufficiency (poor circulation), history of diabetic foot ulcers (open sores related to diabetes), and morbid obesity. P4's plan of care (POC) for certification period of 3/19/23-5/17/23, identified a start of care of 1/18/23. POC indicated P4 was to receive skilled nursing visits on a weekly basis, and identified the services were to include medication set up, assess for knowledge of medications, use, actions, side effects and response to medications. The POC identified the medication schedule was to be updated with every medication change. During home visit on 3/27/23, at 2:30 p.m. the POC medication profile was reviewed with P4, with a comparison to the medications on hand. P4 identified there were medications listed on the POC which were no longer being used. In addition to this, there were also discrepancies in dosages, and medications currently used which were not listed on the POC. The discrepancies identified included the following: amlodipine besylate was identified as being ordered 5 mg every morning on the medication profile, however, the current dosage used was 10 mg daily as identified on the label of the prescription bottle. Ozempic (0.25 or 0.5 mg/dose) sub cutaneous (shallow injection) 2 mg/1.5 ml, 0.25 mg weekly on Wednesdays, was identified on the POC, however, patient stated he had not used since September of 2022. famotidine 20 mg twice a day as needed for gastroesophageal reflux disease was present in home and was used as stated by patient, however, was not listed on the medication profile on the plan of care. Spiriva inhaler 125 mcg (a unit of measurement) puff inhaler was present in home and was used daily as stated by patient, however, was not listed on the medication profile. Following the comparison of medications present to the profile listing, registered nurse (RN)-A stated the Spiriva orders should have been listed on the medication profile. RN-A went on to state all the medications P4 currently used should be listed on the Medication Profile. P6's Team Care Plan, dated 3/27/23, identified P6 had the diagnoses of type 2 diabetes mellitus with diabetic neuropathic arthropathy (a condition which is the result of undetected injuries to the bones of the foot, which can lead to deformity (abnormal shape) and disability, primary osteoarthritis (deterioration of the cartilage at the end of the bones) of the left ankle and foot, spondylosis (age related wear and tear of the spinal discs) and spinal stenosis (a narrowing of the spinal cord) to the lumbar spine (lower back), and long term use of non-steroidal anti-inflammatory drugs and opiate analgesics (a strong, narcotic medication used for pain). P6's plan of care (POC) for certification period of 2/1/23-4/1/23, identified a start of care of 6/6/22. POC indicated P6 was to receive skilled nursing visits every two weeks to fill P6's med caddies. In addition to this, the POC directed nursing staff to assess client knowledge of medications, use, actions, and side effects of medications. During home visit of 3/28/23, at 9:00 a.m. observation was completed of the recertification process and medication set up. Following the completion of the medication setup and review of medications by RN-B, a comparison was made of the medications listed on the POC medication profile and the medications currently in the home. The following discrepancies were noted: Calcitonin (Salmon) Nose Solution (200 Unit/Act[uation] every other day was listed on the medication profile, however, C6 stated they had never taken anything like this. Lotrimin AF External Cream 1% twice a day to affected areas was listed on the medication profile, however, C6 was unaware of any orders for this and did not recall using this. RN-B stated she had not seen P6 previously, however, when discrepancies were identified, the MD was contacted in follow up to clarify their orders. RN-B stated the medication profile and current medications in the homes were to correspond with each other. A review of P6's narrative notes for medication set ups identified on 3/28/23, a call had been made to the provider in follow up after the home visit. The note identified client did not have calcitonin in his home and did not recall taking it recently. A call was received in follow which indicated the [MD]was contacted and nurse sent a prescription to pharmacy. On 3/29/23, the administrator stated all medications which were currently used by the client should be listed on the medication profile. The administrator went on to state medication reconciliation should be completed with every medication set up to assure the medications taken by the client corresponded with the medications identified within the plan of care. The agency policy, Medication Management, Minnesota, Home Health-Enterprise, dated 10/19/22, indicated medication management was done to ensure medication records accurately reflect the patient's current medication regimen. This policy identified medication management was part of the comprehensive assessment of the patient and was to include review all medications, which included: Prescription medications. Over the counter medications. Culturally based home remedies (teas, ginseng). Over the counter herbal products. Dietary supplements. Additionally, the policy directed staff to compare the medication orders with the medication containers, which would include the drug, dose, and frequency.