Every finding on record at Innovative Senior Care Home Health of Minneapolis, LLC

On 10/16/23-10/18/23, a survey for compliance with Appendix Z, Emergency Preparedness Requirements for home care agencies, §484.102 was conducted during a standard recertification survey. The facility was in compliance.

On 10/16/23-10/18/23 a recertification survey was conducted. This resulted in a partial extended survey at Brookdale Home Health Minnesota. The agency was found to have not met the requirements at 42 CFR. Part 484 for Home Health Agencies. The cumulative effects of these findings resulted in the Home Health Agency’s inability to ensure provision of quality of care. Unduplicated census previous 12 months: 510 Total home visits conducted: 4. Brookdale Home Health Minnesota 7505 Metro Blvd. Suite 325 Edina, MN 55439 No branch locations. Monday-Friday 8:00 a.m. to 4:30 p.m. List total number of records reviewed: 13. In addition to the recertification, the following complaint was reviewed. As a result: No deficiency was issued for complaint H8105006C (MN00046629).

A review of all current medications CFR(s): 484.55(c)(5) A review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy. This ELEMENT is not met as evidenced by: Based on interview and document review the facility failed to ensure all prescribed medications were identified, documented and reviewed for possible adverse side effects, drug interactions or ineffective therapy for 2 of 3 patients (P1, P12) reviewed for medications. P12’s POC for certification period 12/29/22-2/26/23, indicated P12 had diagnoses of diabetes and long-term use of insulin and received skilled nursing services once a week to provide instruction on diabetic disease process and signs/symptoms of complications. P12’s hospital discharge orders dated 12/27/22, indicated P12 was prescribed Metformin 1000 milligrams (mg) two times a day. However, P12’s POC for certification period 12/29/22-2/26/23, did not include Metformin as an active medication. During an interview on 10/18/23 at 9:30 a.m., the clinical manager stated when admitted after a hospital stay, a patient’s discharge orders were reviewed, and all current medications were included on the patient’s POC. During this review, nurses look for any possible medication interactions and makes sure the patient has their medications available to them. If there were any questions or concerns, the provider would be notified. The clinical manager verified P12’s POC had not included Metformin and expected the medication to be included. Including all current medications was important when determining any possible interactions. The facility's policy on monitoring medications last revised on 5/1/19, included a drug regimen review will be performed on all patients in conjunction with all comprehensive assessments. Additionally, all clinicians will participate in medication review and reconciliation throughout the episode. It further included the procedure for this review was to compare the medication list obtained from the facility from which the patient was transferred and/or physician orders to actual medications the patient was taking in order to identify issues such as: potential adverse effects and drug reactions, ineffective drug therapy, and significant side effects. Findings include: P1's plan of care (POC) for certification period 9/19/23-11/17/23, indicated P1 had diagnoses of chronic pain syndrome, chronic kidney disease, and received skilled nursing services once a week to monitor pain, instruct the patient on new and changed medications, high risk medications, and an any applicable drug interaction. P1's outpatient visit summary dated 9/11/23, included a physician's order for pregabalin (Lyrica) 100 milligrams (mg) capsule, take 1 capsule by mouth three times a day. However, P1's POC for certification period 9/19/23-11/17/23 did not include the medication. During an interview on 10/18/23 at 1:10 p.m. the clinical manger verified P1's POC did not include Pregabalin and stated it should have been included on the medication list and POC in P1's medical record.