Every finding on record at Granite City Home Care Services, LLC

The Emergency Preparedness requirements were evaluated, in conjunction with the recertification survey, on 04/27/2022. The Facility was in compliance with the Condition, 42 CFR 484.102, Establishment of the EP Program, for this survey.

A Recertification survey was conducted on 04/27/2022. The Agency was in not compliance with standards for Home Health Agencies, 42 CFR 484, as evidenced by:

Coordination of Care CFR(s): 484.60(d) Standard: Coordination of care. The HHA must: This STANDARD is not met as evidenced by: Based on observation, document review and staff interview, it was determined for 1 of 8 patients receiving therapy services, (Pt #9), the therapy staff failed to ensure care was coordinated to assess and ensure safe use of durable medical equipment. This failure has the potential to affect all patients receiving home health services, currently a census of 165. Findings include: 1. On 4/26/22 at approximately 9:15 AM a home visit was made with registered nurse ( E#1) to Pt #9's home. Pt #9 lives alone and has minimal family support as Pt #9 reported her daughter who lives closest is ill. Pt #9 is limited in mobility and requires use of oxygen with only short periods without it. Pt #9 reported she has been receiving therapy services since coming home from the hospital in February and most recently nursing was added. Pt #9 reported she is dealing with a problem with mobility, needing to carry her oxygen and pointed to a rollator walker with seat which was given to her. Pt #9 explained the portable oxygen is heavy and she cannot carry it even in the bag. Pt #9 reported she used the rollator 2 weeks ago and can put the portable oxygen in the pouch on the front of rollator. Pt #9 reported she was told by therapy the front wheels were missing locks and needed some repair. Pt #9 reported she doesn't know what else she can do, and although the wheels don't work properly she is using it. Pt #9 also reported she had a fall in her home recently, requiring a call to EMS (emergency medical services) because she could not get herself up from the floor. A quad cane was also observed next to Pt #9's recliner and she reports she uses this around her home. 2. A review of the Agency policies was completed during the survey. The policy title "Coordination of Care, From Admit Through Discharge (dated 8/1/19)" indicates under "5. Coordination of care among disciplines: c. Appropriate, timely communication with the patient, caregivers and staff involved in the patient's care regarding patient needs, goals, and care as well as changes in these." 3. The medical record of Pt #9 was reviewed on 4/26/22 at approximately 10:30 AM. Pt #9 was admitted for home health services on 1/20/22 with diagnoses of non stemi myocardial infarction, chronic kidney disease with heart failure and lymphedema. Documentation indicates Pt #9 was recertified on 3/21/22 for skilled nursing and occupational therapy services with the same diagnoses. The plan of care indicates orders were for skilled nursing 1 time a week for 9 weeks and occupational therapy 1 time a week for 8 weeks. Both an occupational therapist (OT) and occupational therapy assistant (OTA)made visits per the physician orders. There was no documentation to indicate the OT and/or the OTA made assessments regarding the use of the rollator, safety of the device or the need to obtain another rollator or device which would allow transport of the needed oxygen while providing safety of Pt #9. 4. An interview with the executive director (E#2) was conducted on 4/27/22 at approximately 9:30 AM. E#2 reported the staff were aware of the rollator/walker but because it had been given to Pt #9 by someone else they had not addressed it being used, it's safety or evaluating it's safety for Pt #9. E#2 reported the therapy staff are working on orders for a wheelchair at this time. E#2 agreed there was no documentation addressing the rollator walker in any part of planning for Pt #9's needs.