Every finding on record at Lagniappe Homecare Alexandria, LLC

The entity is in compliance with the federal emergency preparedness requirements.

Recertification Survey

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 record review, the agency failed to ensure the patient’s medication profile accurately listed the correct medications the patient was taking for 2 (Patient #9 and Patient #18) of 7 (Patient #6, Patient #7, Patient #9, Patient #10, Patient #11, Patient #12 and Patient #18) patients medication profiles reviewed during home visits. Findings: Review of the Provider’s Medication Profile/Medication Review Policy revealed in part… 4. Visiting clinicians will review medications with the patient on each subsequent visit and communicate with the physician any issues of concern identified. 5. The medication profile will be updated with new, discontinued or changed medications after confirmation with the physician or visualization of new drug labels/prescriptions. 6. The review of the medication regimen and completion of a medication profile will be repeated with each comprehensive exception with the exception of the discharge assessment. #9 Review of Patient #9’s CPOC with a start of care date of 03/22/2023 and a certification date of 07/20/2023-09/17/2023 revealed Patient #9 had diagnosis of Coronary Artery Disease, Hypertension, Hypothyroidism, Type II Diabetes Mellitus, Osteoarthritis, Asthma, GERD, Depression, and Muscle Weakness. Patient #9’s Plan of Care revealed the following Orders of Discipline and Treatments including: Skilled Nurse to review medication profile and reconcile medications as needed. Skilled Nurse may instruct new/changed medications and any with assessed knowledge deficits. Observation on 08/01/2023 at 12:45 p.m. during a home visit revealed S3 LPN performed a medication reconciliation. Further observation revealed Patient #9 had a bottle of Latanoprost 0.005% eye drops with instructions to administer 1 drop in each eye at bedtime. Interview on 08/01/2023 with Patient #9 at the time of observation revealed Patient #9 had been using the eye drops for about 9 years, after being diagnosed with Glaucoma. Interview on 08/01/2023 at 12:48 p.m. with S3 LPN revealed Patient #9’s eye drops were not on her medication list and should have been. #18 Review of Patient #18’s 06/06/2023 – 08/04/2023 Plan of Care revealed Patient #18 was admitted on 06/06/2023. Resident #18 had the following diagnoses including Essential (Primary) Hypertension, Orthostatic Hypotension, Repeated Falls, and Hyperlipidemia, Unspecified. Patient #18 had a skilled nurse visit frequency of 1 time a week for 9 weeks according to her Plan of Care and review of 06/2023 – 08/2023 visit notes revealed the patient was seen on a weekly basis by a skilled nurse. Patient #18’s Plan of Care revealed the following Orders of Discipline and Treatments including: Skilled Nurse to review medication profile and reconcile medications as needed. Skilled Nurse may instruct new/changed medications and any with assessed knowledge deficits. Review of Patient #18’s Medication List revealed the patient was on Nifedipine ER 30 mg tablet, Extended Release at HS. A Home visit was conducted on 08/01/2023 at 2:02 p.m. with S2 RN revealed Resident #18 sitting in a chair in her room. Her daughter was sitting beside her. S2 RN performed a medication reconciliation during this visit and noted that Nifedipine ER 30 mg Extended Release tablets were not included in Resident #18’s medication. S2 RN asked Resident #18’s daughter if she was on the medication and Resident #18’s daughter stated the physician had stopped this medication on 06/09/2023. S2 RN confirmed this medication should have been removed from the list during a previous visit.