Every finding on record at Kittson Memorial Hospital Association

On 5/28/24 through 5/30/24, a survey for compliance with Appendix Z, Emergency Preparedness requirements, , §483.73(b)(6) was conducted during a standard recertification survey. The facility was IN compliance.

On 5/28/24 through 5/30/24, a recertification survey was conducted. This resulted in a partial extended survey at Kittson Memorial Home Health Care. The agency was found to have not met the requirements at 42 CFR. Part 484 for Home Health Agencies. Unduplicated census previous 12 months: 29 Total home visits conducted: 3 Parent location visited, address verified on site: Kittson Memorial Home Healthcare 1010 South Birch Ave #430 Hallock, MN 56728 Hours of Operation: 8:30 a.m. to 4:30 p.m. Total number of records reviewed: 7

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 observation, interview, and document review, the agency failed to complete a comprehensive drug regimen review to ensure the accuracy of all medications/dosages for 1 of 7 clients (P5) whose medications were reviewed during home visits and record review. P5's plan of care (POC) 4/3/24 through 6/1/24, identified a start of care (SOC) 4/3/24, with diagnoses which included intervertebral disc disorder, diabetes and hypertension. Services included skilled nurse visits (SNV) one time per week and as needed (PRN) to assess cardiac and respiratory systems, assist with medication setup, reordering medications and monitoring medication compliance, assess pain and pain control and assess safety in home. P5 was prescribed a number of medications which included Novolog flexpen insulin 30 units three times per day with meals. A notation identified P5 administered this medication subcutaneously independently. The POC medication list did not identify any pain relieving medications scheduled or PRN. During a home visit on 5/29/24, at 9:50 a.m. for SNV and recertification for home care, P5 stated she was only taking 24 units Novolog with meals and had been doing so for a couple of months because she had been experiencing low blood sugars. She lowered the dose a few months ago after her last medical appointment. In addition, P5 stated she was taking two ibuprofen 200 milligram capsules at night and occasionally during the day for her back pain. She used the ibuprofen off and on since she had back surgery two years ago. She felt it helped take the edge of her pain and did help her sleep at night. When interviewed on 5/29/24, at 10:50 a.m. registered nurse (RN)-A stated she always asked P5 if she had any changes with her medications and P5 always told her she did not. She had wondered if P5 was taking an over the counter pain reliever when she reviewed her medication list that morning. P5 frequently adjusted her insulin slightly, but she had really thought she was taking the 30 units with her meals. It would be important to keep client's medication lists current and up to date so the physician would know what clients were taking. The ibuprofen should be listed on P5's medication list in case she developed any problems with her kidney function. During interview on 5/28/24, at 1:00 p.m. the home care administrator stated nurses were expected to ask to see all a client's medications and compare them with current orders at SOC. Nurses were also expected to ask clients about and review medications on-going and at recertification visits. The agency's policy Initial and On-going Nursing Assessment of Clients dated 3/14/24, identified the nurse would do a review of all medications a client was currently using at SOC. The nurse would reassess each client on an on-going basis and revise the client's service plan based on client needs.