Every finding on record at Guardian Angel Health Agency LLC

EMERGENCY PREPAREDNESS SURVEY At the time of the emergency preparedness survey completed on 03/08/23, Guardian Angel Health Agency is in compliance with the provisions of 42 CFR Part 484.102, Conditions of Participation for Home Health Agencies

Partial Extended Recertification Survey An entrance conference was conducted on 03/06/23 with administrative staff. An exit conference was conducted on 03/08/23 with administrative staff. The following deficiencies are based on the standard recertification survey completed 03/09/23. Guardian Angels Health Agency, is not in compliance with the requirements found at Home Health Agency 42 CFR Part 484, Subpart B, C

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 or allowed practitioner refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician or allowed practitioner is consulted to approve additions or modifications to the original plan. This STANDARD is not met as evidenced by: Based on medical record review, observation and staff interview, the agency failed to provide all services included in a patients physician's ordered plan of care (485). This affected one (Patient #1) of three patients who had a home visit completed. The agency's census was 21. Medical record review revealed Patient #1's physician's ordered plan of care (485) for the certification period of 01/18/2023 - 03/18/2023 included a diagnosis of diabetes. The 485 further revealed the Skilled Nurse (SN) was to perform a complete physical assessment each visit with emphasis on diabetes. On 03/07/23 at 1:05 PM observation of a home visit was conducted with Staff A. During the observation Patient #1 was noted to be wearing socks. Staff A did not ask Patient #1 if she could check her feet or remove her socks. Interview on 03/07/23 at 1:42 PM Staff A confirmed she did not check Patient's #1's feet. Staff A stated Patient #1 often refused a foot check, however Staff A stated she did not document Patient #1's refusal of foot checks. Staff A agreed a foot check should be include in the SN assessment which was part of the plan of care.