Every finding on record at Interim Healthcare of SE Ohio, Inc

Emergency Preparedness At the time of the emergency preparedness survey completed on 09/30/21, Interim healthcare of Bridgeport is in compliance with the provisions of 42 CFR Part 484.22, Conditions of Participation for Home Health Agencies.

The following deficiencies are based on the partial extended recertification survey completed 09/30/21. Interim Healthcare of Bridgeport is not in compliance with the requirements found at 42 CFR Part 484, Subpart B, C, Home Health Agencies.

RN performs assessment CFR(s): 484.55(a)(1) A registered nurse must conduct an initial assessment visit to determine the immediate care and support needs of the patient; and, for Medicare patients, to determine eligibility for the Medicare home health benefit, including homebound status. The initial assessment visit must be held either within 48 hours of referral, or within 48 hours of the patient's return home, or on the physician or allowed practitioner - ordered start of care date. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure patients received an initial assessment visit was completed on the physician-ordered start of care date. This affected two (Patients #6 and #7) of seventeen patients reviewed. This had the potential to all patients receiving services from the agency. The agency census was 107. 1.Review of Patient #6's medical record revealed a referral was received from a physician's office on 08/04/21. There was a physician’s order dated 08/12/21 for skilled nursing for cardiopulmonary assessment, disease process management and education, medication management and education. The initial visit and start of care were completed on 08/13/21. During interview on 09/29/21 at 1:51 PM, Staff C stated when the initial referral came in for Patient #6 on 08/04/21, that they turned the referral down due to not having enough nurses. The referrer could not find any other agency so they called the agency back and the agency accepted her. Staff C verified that there is no documentation showing the referral being initially turned down. 2. Review of Patient #9's medical record revealed a referral was received from a skilled nursing facility on 08/30/21. There was a physician’s order dated 09/02/21 for skilled nursing for cardiopulmonary assessment, skilled observation, disease process management and education, medication management and education. The initial visit and start of care were completed on 09/03/21. The record contained no documentation as to why the initial visit was not completed on the effective date. During interview on 09/29/21 at 3:02 PM, Staff C verified the above findings.

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 staff interview, the agency failed to follow the physician orders for services. This affected three (Patients #5, #6, and #9) of seventeen patients reviewed. This has the potential to affect all patients referred to the agency. The agency census was 107. 4. Review of the medical record for Patient #5 revealed the patient was admitted to the agency on 03/09/21 with the admitting diagnosis of chronic obstructive pulmonary disease. Review of the physician's order dated 09/10/21 revealed an order for the social worker to complete an evaluation for the week of 09/12/21. Review of the medical record revealed no documented evidence the social worker completed an evaluation of the patient. Interview with Staff C on 09/29/21 at 1:20 PM confirmed the above findings. 1. Review of Pt #6's medical record completed on 09/29/21 revealed a referral was received from a physician's office on 08/04/21 and a physician's order was noted with an effective date of 08/12/21 for skilled nursing for cardiopulmonary assessment, disease process management and education, medication management and education. The initial visit and start of care was noted to have been completed on 08/13/21. Staff C verified these findings on 09/29/21 at 1:51 PM. 2. Interview with Staff C completed on 09/29/21 at 1:51 PM revealed when the initial referral came in for Pt #6 on 08/04/21 that they turned the referral down due to not having enough nurses. The referrer could not find any other agency so they called us back and we took her then. She verified that there is no documentation showing the referral being turned down initially. 3. Review of Pt #9's medical record completed on 09/29/21 revealed a referral was received from a skilled nursing facility on 08/30/21 and a physician's order was noted with an effective date of 09/02/21 for skilled nursing for cardiopulmonary assessment, skilled observation, disease process management and education, medication management and education. The initial visit and start of care was noted to have been completed 0903/21. No documentation was noted showing why the initial visit was not completed on the effective date. Staff C verified these findings on 09/29/21 at 3:02 PM.