Every finding on record at Kah Development 4, LLC

. On 7/10/23 at 12:15 PM an entrance conference was conducted with Agency Representatives. The Agency was informed the purpose of the visit was to conduct a Medicare Recertification survey for compliance with the Conditions of Participation for Home Health. On 7/13/23 at 11:45 AM an exit conference was conducted with Agency Representatives. Preliminary findings of the survey were discussed. .

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 observations during home visits, the Skilled Nurse (SN) failed to follow accepted professional standards for infection control in 2 (#1 and #2) of 4 (#1- #4) home visits conducted. This deficient practice had the potential to place all patients with wound care at risk for adverse outcomes, wound infection and/or hospitalization. During a home visit 7/23/23 at 12:15 PM to observe care for Patient #1 the surveyor observed the following: A. SN donned gloves and prceeded to use scissors to cut the soiled dressings from Patient #1 wound located on left leg. Once the soiled dressing was removed, the Surveyor observed the SN to use the same un-santized scissors to cut the clean dressings that were applied to Patient #1's wound. 2. During a home visit 7/23/23 at 1:30 PM to observe care for Patient #2 the surveyor observed the following: A. SN donned gloves and prceeded to use scissors to cut the soiled dressings from Patient #2 wound located on left heel. Once the soiled dressing was removed, the Surveyor observed the SN to use the same un-santized scissors to cut the clean dressings that were applied to Patient #2's wound. 3. According to the National Institute of Health, all equipment (including scissors) used in patient care should be cleaned well to kill bacteria, fungus and virus' to prevent infection.

Onsite supervisory visit every 14 days CFR(s): 484.80(h)(1)(i) If home health aide services are provided to a patient who is receiving skilled nursing, physical or occupational therapy, or speech-language pathology services, a registered nurse or other appropriate skilled professional who is familiar with the patient, the patient's plan of care, and the written patient care instructions described in §484.80(g), must make an onsite visit to the patient's home no less frequently than every 14 days. The home health aide does not have to be present during this visit. This ELEMENT is not met as evidenced by: . Based on Clinical Record review and Agency staff interview, it was determined the Registered Nurse (RN) failed to provide timely oversight of Home Health Aide (HHA) services through on-site Supervisory Aide Visits (SAV) in 1 (#2) of 1 (#2,) Clinical Records reviewed with orders for HHA services. This lack of supervision by the RN would delay the discovery of inappropriate care or noncompliance with the Plan of Care by the HHA and has the potential to place all patients receiving HHA services at risk for adverse outcomes. A review of Cincal Record #2 revealed the following: A. An order dated 5/29/23 added Home Health Aide visits effective 6/4/23 at 1 visit per week for 6 weeks. There was no evidence of oversight of the Home Health (HHA) services through on-site supervisory aide vists were completed by an RN every 14 days as required.. B. During an interview on 7/13/23 at 10:30 A.M., Agency staff member #1 stated, that HHA services were not supervised every 14 days by an RN as required, verifying there were no HHA supervisory visits completed for Patient #2 episode of care dated 6/18/23 to 7/15/23.