Every finding on record at Homeaid Inc

An unannounced Home Health Agency recertification survey was conducted on September 11-13, 2023 by one (1) Medical Facilities Inspector from The Office of Licensure and Certification, Virginia Department of Health. In conjunction with this survey, the agency's emergency preparedness plan was reviewed. The agency was found to be in compliance with 42 CFR 484.102 Conditions of Participation Emergency Preparedness for Home Health Agencies.

An unannounced Medicare/Medicaid Home Health Recertification survey was conducted at the above noted agency September 11-13, 2023 by one Medical Facilities Inspector from the Office of Licensure and Certification, Virginia Department of Health. The agency identified five (5) unduplicated admissions for the past twelve (12) months. In conjunction with the survey, six (6) clinical records and six (6) personnel files were reviewed. One (1) home visit and was conducted. The agency was found to be out of compliance with the Federal requirements of 42 CFR 484, the Medicare/Medicaid Conditions for Certification of Home Health Agencies. A Deficiency was identified and cited in this report.

Discharge and transfer summaries CFR(s): 484.110(a)(6)(i-iii) (i) A completed discharge summary that is sent to the primary care practitioner or other health care professional who will be responsible for providing care and services to the patient after discharge from the HHA (if any) within 5 business days of the patient's discharge; or (ii) A completed transfer summary that is sent within 2 business days of a planned transfer, if the patient's care will be immediately continued in a health care facility; or (iii) A completed transfer summary that is sent within 2 business days of becoming aware of an unplanned transfer, if the patient is still receiving care in a health care facility at the time when the HHA becomes aware of the transfer. This ELEMENT is not met as evidenced by: Based on a review of clinical records, agency's policy and staff interview, it was determined the agency failed to send the patient's discharge summary to the primary care physician or primary care practitioner within 5 business days from the date of the final visit and failed to send the patient's transfer summary within 2 business days of becoming aware of an unplanned transfer for two (2) of five (5) closed clinical records reviewed in the survey sample. (Clinical record #'s 2 and 4). The findings: Five closed, electronic clinical records were reviewed onsite in read only mode from September 11-12, 2023. 1. The clinical record for patient #2 was reviewed for the recertification period of 08/15/2022 to 10/13/2022. The clinical record revealed that the patient was transferred from the agency on 09/09/2022. The transfer summary was sent to the primary physician on 10/07/2022; 28 days later. 2. The clinical record for patient #4 was reviewed for the recertification period of 03/15/2023 to 05/13/2023. The clinical record revealed that the patient was discharged from the agency on 05/10/2023. The clinical record failed to contain a discharge summary sent to the primary physician. On 09/11/2023 at 3 PM the Alternate Administrator stated, "It was not done. It is a scheduling issue." On 09/12/2023 the agency's Home Health Patient Handbook contained the discharge and transfer policy titled "DISCHARGE, TRANSFER AND REFEERRAL POLICY". A portion of it read as follows: Following your discharge or transfer, we will send a discharge or transfer summary within the timeframes specified by federal regulations to your primary care practitioner, other health care professional and/or facility that will be providing care and services to you after discharge from our agency. The lack of providing a discharge summary within 5 business days of the patient's discharge and a transfer within 2 business days was acknowledged prior to and during the exit conference with the Administrator and Alternate Administrator on 09/13/2023.

An unannounced Medicare/Medicaid Home Health recertification survey was conducted at the above noted agency on January 11-13, 2021 by one (1) Medical Facilities Inspector from the Virginia Department of Health, Office of Licensure and Certification. In conjunction with this survey, the agency's emergency preparedness plan was reviewed. The agency was found to be in compliance with 42 CFR 484.102 Conditions of Participation Emergency Preparedness for Home Health Agencies (Revised 02/21/2020). .

An unannounced Home Health Recertification survey was conducted January 11-13, 2021 at the above noted agency by one (1) Medical Facilities Inspector from The Office of Licensure and Certification, Virginia Department of Health. The survey was conducted onsite and remotely due to the COVID-19 pandemic. The agency was found not to be in compliance with the federal requirements of 42 CFR 484, Conditions of Participation for Home Health Agencies, (Revised 02/21/2020).

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 may choose to include. This ELEMENT is not met as evidenced by: Based on a review of clinical records and staff interviews it was determined the agency staff failed to ensure the patient's individualized plan of care included goals identified by the patient for seven (7) of seven (7) clinical records reviewed in the survey sample (clinical record #s 1-7). The findings were: Seven (7) clinical records were reviewed onsite and remotely on 1/11/2021 through 1/12/2021. A review of the clinical record for patient #1 was reviewed for the certification period of 11/25/2020 through 01/23/2021. The plan of care failed to contain goals identified by the patient. A review of the clinical record for patient #2 was reviewed for the recertification period of 11/23/2020 through 01/21/2021. The plan of care failed to contain goals identified by the patient. A review of the clinical record for patient #3 was reviewed for the recertification period of 11/25/2020 through 01/23/2021. The plan of care failed to contain goals identified by the patient. A review of the clinical record for patient #4 was reviewed for the certification period of 12/18/2020 through 2/15/2021. The plan of care failed to contain goals identified by the patient. A review of the clinical record for patient #5 was reviewed for the certification period of 12/26/2020 through 02/23/2021. The plan of care failed to contain goals identified by the patient. A review of the clinical record for patient #6 was reviewed for the recertification period of 7/01/2020 through 8/29/2020. The plan of care failed to contain goals identified by the patient. A review of the clinical record for patient #7 was reviewed for the certification period of 9/17/2020 through 11/16/2020. The plan of care failed to contain goals identified by the patient. An interview with the clinical manager on 1/11/2020 at approximately 12 PM revealed the place on the care plan where the information should be located failed to contain the information. The clinical manager acknowledged the care plans provided to the surveyor failed to contain patient stated goals.

Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This STANDARD is not met as evidenced by: Based on observation, policy review, and staff interview, it was determined the agency failed to mitigate the risk for COVID-19 transmission. Specifically, the agency failed to update polices and procedures to reflect current COVID mitigation strategies for office staff, and failed to use appropriate face coverings when social distance could not be maintained. The findings were: The Medical Facilities Inspector (MFI) arrived in the agency on 1/11/2021 at 10:20 am. The agency was a two- story office located in an older home type structure. Upon entrance to the lobby area, two desks were located adjacent to each other with two staff members sitting at the desks with no face coverings. A staff member was standing beside one of the staff members sitting down and was leaning over looking at a document. The staff member leaning over the seated staff member failed to have on face covering. The administrator stepped out of an adjacent office to introduce self to this surveyor. The administrator did not have on face covering. The surveyor was escorted by the administrator to an upstairs conference room/kitchen and passed through an office occupied by two staff members with one on each side of the walkway and neither staff member had on face coverings. While performing the entrance conference with the administrator, a staff member came into the kitchen/conference room without face covering to make coffee. Documents were brought to this surveyor by two separate staff members, neither of which had face coverings on. Staff were observed walking through the agency and through the kitchen to get to the restroom without face coverings on. A review of the agencies policies on Covid-19 completed on 1/11/2021 revealed no information specific to office staff and if they were to wear face coverings while in the office. An interview with the administrator on 1/13/2021 at 9:20 am revealed all staff are doing the self-monitoring assessment that was provided at the beginning of the pandemic and staff know they are to stay home if they have any symptoms. The administrator acknowledged there was "room for improvement".