Every finding on record at Home Care of Trmc

From 12/13/2021 through 12/26/21, the State Agency conducted an Emergency Preparedness survey. The facility is in compliance with Medicare Condition of Participation at 482.102 (Establishment of the Emergency Preparedness Program).

From 12/13/2021 through 12/16/2021, the State Agency conducted a Recertification and a COVID - 19 focused Infection Control survey. The facility is in substantial compliance with the Medicare Conditions at 42 CFR PART 484 and the COVID - 19 focused Infection Control requirements. Standard level deficiencies resulted from the Recertification survey.

Plan of care must include the following CFR(s): 484.60(a)(2)(i-xvi) The individualized plan of care must include the following: (i) All pertinent diagnoses; (ii) The patient's mental, psychosocial, and cognitive status; (iii) The types of services, supplies, and equipment required; (iv) The frequency and duration of visits to be made; (v) Prognosis; (vi) Rehabilitation potential; (vii) Functional limitations; (viii) Activities permitted; (ix) Nutritional requirements; (x) All medications and treatments; (xi) Safety measures to protect against injury; (xii) A description of the patient's risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors. (xiii) Patient and caregiver education and training to facilitate timely discharge; (xiv) Patient-specific interventions and education; measurable outcomes and goals identified by the HHA and the patient; (xv) Information related to any advanced directives; and (xvi) Any additional items the HHA or physician or allowed practitioner may choose to include. This ELEMENT is not met as evidenced by: Based on record review and interview, the Skilled Nurse (SN) failed to obtain parameters of blood glucose levels to report to the physician on the Plan Of Care (POC) in one out of two patients with blood glucose monitoring (Patient #2). The findings are: On 12/15/2021 at 9:43 AM, a review of Patient #2’s chart reveals the orders to instruct in all aspects of diabetic management. The orders do not contain reporting parameters to notify the physician for abnormal levels. This finding is verified by the Administrator at 9:33 AM on 12/16/2021.

Conformance with physician orders CFR(s): 484.60(b) Standard: Conformance with physician or allowed practitioner orders. This STANDARD is not met as evidenced by: Based on record review and interview, the agency Skilled Nurse (SN) failed to comply with physician orders on the Plan Of Care (POC) in the monitoring of patient with blood glucose monitoring one out of two patients with blood glucose monitoring (Patient #8). On 12/15/2021 at 8:50 AM, a review of Patient #8’s chart reveals Patient # 8 has a Start of Care (SOC) dated 8/3/2021. The Certification Period reviewed is dated 10/2/2021 to 11/30/2021. The reporting parameters to notify the physician for blood glucose is listed as less than 70 milligrams per decilitre (mg/dL) and greater than 350 mg/dL. On 11/24/2021, the SN visit documentation did not show a blodd glucose level. and no documentation the physician was notified. This finding is verified by the Administrator at 9:48 AM on 12/16/2021.