Every finding on record at Hospice Care of the Lowcountry

A survey of the Home Health Agency's (HHA) Emergency Preparedness Plan(EPP) was conducted from 08/02/2021 to 08/042021. Based on observations, record reviews, interviews, and review of the HHA's EPP and policies and procedures, it was determined the HHA is in compliance with the Emergency Preparedness Condition at 42 CFR 484.102 (Establishment of the EP).

A Recertification Survey was conducted in conjunction with the COVID-19 focused Infection Control requirements from 08/02/2021 to 08/04/2021. Based on observations, record reviews, interviews, and review of the HHA's policies and procedures, it was determined the HHA is in compliance with the COVID - 19 focused infection control requirements, and standard level deficiencies resulted from the HHA's Recertification Survey.

Only as ordered by a physician CFR(s): 484.60(b)(1) Drugs, services, and treatments are administered only as ordered by a physician or allowed practitioner. This ELEMENT is not met as evidenced by: Based on review of patient charts and interview, the Home Health Agency failed to ensure home health services, and treatments were administered only as ordered by a physician or allowed practitioner for one (1) of six (6) charts reviewed. (Patient #5) The findings are: On 08/03/21 at 9:25 AM, the review of patient 5's chart revealed the patient was referred by the physician on 8/21/2020 with diagnoses of Dementia and Diabetes. The services requested were skilled nursing; social services; physical therapy and home health aide. There were twelve (12) Registered Nurse (RN) visits; 12 Home Health Aide (HHA) visits; three (3) Physical Therapy (PT) visits; and two (2) Master of Social Work (MSW) made from 08/22/2020 until 10/01/20. There was no signature noted on the order set. In an interview on 08/03/21 at 1:00 PM, the Clinical Director stated "The physician refused to follow the patient and sign the orders. This patient was treated as a charity case. We called 2 different physicians about signing the orders. One physician said he/she would sign the orders but then refused and said the patient needed to be seen by him/her. This went back and forth between us and the physicians. The patient couldn't get to the physician office."