Every finding on record at In Home Care Services, Ltd

Based upon an unannounced, on-site home health Medicare recertification survey conducted between December 4, 2024 and December 5, 2024, Advantage Home Health Services, Central, was found to be in compliance with the requirements of 42 CFR, Part 484.22, Subpart B, Conditions of Participation: Home Health Agencies-Emergency Preparedness.

Based upon an unannounced, on-site home health Medicare recertification survey conducted between December 4, 2024 and December 5, 2024, Advantage Home Health Services, Central, was found not to be in compliance with the requirements of 42 CFR, Part 484, Subparts B & C, Conditions of Participation: Home Health Agencies.

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 reviews of agency policy, clinical records (CRs), and interview with the agency Vice President of Compliance (EMP#1), it was determined the agency failed to ensure clinical staff documented assessing blood sugar monitoring and daily weight checks as ordered on the plan of care for one (1) of seven (7) CRs reviews. (CR# 1); and failed to ensure clinical staff documented administration of IV (intravenous) therapy as ordered on the plan of care for one (1) of seven (7) CRs reviewed. (CR# 5) Findings included: Review of agency policy on December 4, 2024 at approximately 1:30 p.m. titled, 'Plan of Care- CMS # 485 and Physician Orders' states, "PROCEDURE:... 3. 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..." Review of CRs on December 4, 2024 between approximately 11:30 a.m. to 1:30 p.m. revealed the following: CR# 1, Start of Care (SOC), 11/22/2024: Plan of Care certification period reviewed: 11/22/2024-1/20/2025 with diagnosis: Sepsis due to E. (Escherichia) Coli. Plan of Care PT (Physical Therapy) orders include: "PT: Assess blood sugar monitoring and results...Pt. Check weight daily..." No documentation provided of PT assessing blood sugar monitoring and results and checking daily weight on visit dates of: November 27, 2024 and November 30, 2024. CR# 5, SOC, 11/8/2024: Plan of Care certification period reviewed: 11/8/2024-1/6/2025 with diagnosis: Infection/inflammation reaction due to internal right knee. Plan of Care SN (Skilled Nursing) orders include: "SN: SN to administer IV (intravenous) therapy using SASH (Saline, flush, Administration of medication/solution, Saline flush, Heparin lock) during SN visits..." No documentation provided of SN administering IV (intravenous) therapy using SASH (Saline, flush, Administration of medication/solution, Saline flush, Heparin lock) during SN visits dates of: November 14, 2024, November 21, 2024 and November 26, 2024. Interview with EMP# 1 on December 5, 2024 at approximately 2:00 p.m. confirmed above findings.