Every finding on record at Guardian Home Care, LLC

An abbreviated/partial extended survey was conducted at AccentCare Home Health on March 27, 2023, and concluded on March 29, 2023. At the time of the survey, the agency was in compliance with 42 CFR Part 418.113, Emergency Preparedness and Covid-19 infection control.

An abbreviated/partial extended survey was conducted at Accent Care Home Health, on March 27, 2023, and concluded on March 29.2023. At the time of the survey, the agency was not in compliance with Chapter 42 CFR Part 418, Rules and Requirements for Home Health and Hospice Agencies. Complaint #95723 was substantiated with deficiency. The census was 362. The following deficiency was cited:

Written notice of patient's rights CFR(s): 484.50(a)(1)(i) (i) Written notice of the patient's rights and responsibilities under this rule, and the HHA's transfer and discharge policies as set forth in paragraph (d) of this section. Written notice must be understandable to persons who have limited English proficiency and accessible to individuals with disabilities; This ELEMENT is not met as evidenced by: Based on clinical record review, staff and family interviews, and review of policy titled “PATIENT TRANSFER AND DISCHARGE/NOMNC NOTICE”, it was determined that the agency failed to notify patient of discharge from agency for one patient (P) (P#1) of six sampled patients (P#2, P#3, P#4, P#5, and P#6). The findings include: Review of the policy titled: PATIENT TRANSFER AND DISCHAREGE/NOMNC NOTICE: Policy Number HH 2/1/7, Revised: 07/25/22, page 5 of 20 revealed the following: Purpose: To outline the discharge/transfer process and coordination process to ensure patient participation, physician, podiatrist/NPP notification, and facilitate a patient’s a discharge/transfer from home health. 15. To discharge a patient for cause: a. A patient may be discharged for reasons including safety concerns, or the patient’s (or other persons in the patient’s home) behavior is disruptive, abusive, or uncooperative to the extent that deliver of care to the patient or the ability of the Agency to operate effectively is seriously impaired. c. The patient/patient representative and physician/podiatrist/NPP are advised of the plan to discharge/transfer. P#1 was admitted to the home health agency on 1/11/2023 with diagnosis of hypertensive heart disease with heart failure (heart problems that occur because of high blood pressure that is present over a long time). Additionally, the patient was admitted to the hospital on 1/16/2023 and discharged on 1/21/2023. The Home Health Agency scheduled resumption of care (patient is returning to a home health agency after a period of time away) on 1/21/2023. Record review of client coordination note report dated 1/21/2023 reveals that while RN (Registered Nurse) AA went to home of P#1 for resumption of care, there was a misunderstanding between RN AA and P#1 family member. The family member requested incontinent care supplies and RN AA explained that the agency does not supply incontinent supplies. Family member yelled at RN AA stating “…. you can leave!” RN AA “gather bag and proceeded to walk to door when patient’s (other family member) stood in front of door……After about 6 mins of asking (other family member) to move (other family member) moved and RN AA was able to safely leave.” An interview conducted with RN AA on 3/27/2023 at 1:00 p.m., revealed that she went to perform resumption of care assessment on 1/21/2023 and daughter of P#1 yelled at her and told her to leave the house and the granddaughter closed the door and blocked her way. RN AA asked the granddaughter to step aside so she could leave because she felt threatened, and it took a couple of minutes before she stepped aside. RN AA then left and called the office to report the incident to her supervisor RN BB. An interview conducted with RN BB on 3/27/2023 at 1:20 p.m., revealed that on 1/30/2023 the granddaughter of P#1 called her and left her a voicemail message about the incident between her and RN AA. Additionally, RN BB revealed she returned daughter’s call and apologized that no one notified her that P#1 has been discharged from the agency because of the staff safety issue which occurred on 1/21/2023 and she thought RN DD had called and notified P#1 and P#1 family of the discharge. In an interview with RN DD, float Administrator, on 3/27/2023 at 3:03 p.m., revealed that he called the physician office and told the nurse that the agency would not continue the resumption of care for P#1 due to the staff safety incident that occurred between patient’s daughter and RN AA on 1/21/2023. RN DD confirmed that he did not notify P#1 or family of P#1 of the discharge from the agency. An interview conducted with family member of P#1 on 3/28/2023 at 2:40 p.m., revealed the incident that occurred was P#1’s fault because P#1 ordered RN AA to leave the house. Family member further revealed that if RN AA had abused P#1, family member would have taken up the matter and reported it immediately and the only thing that went wrong was the agency did not inform them of P#1’s discharge.