Every finding on record at Lhcg Xl, LLC

A Recertification Survey was conducted at SunCrest Home Health on October 30, 2023, and concluded on November 1, 2023. At the time of the survey, the agency was in compliance with 42 CFR Part 418.113, Emergency Preparedness and Covid 19 infection control.

A Recertification survey was conducted at SunCrest Home Health on October 30, 2023, and concluded on November 1, 2023. At the time of the survey, the agency was not in compliance with compliance with Chapter 42 CFR Part 418, Rules and Requirements for Home Health and Hospice Agencies. The census was 106. The following deficiency was cited:

Interventions and patient response CFR(s): 484.110(a)(2) All interventions, including medication administration, treatments, and services, and responses to those interventions; This ELEMENT is not met as evidenced by: Based on record reviews and staff interviews, the agency failed to address the interventions and education teaching during the skilled nursing visits for three patients (P) (P#2, P#8, P#10) of 18 sampled patients. Findings include: 1. Record review of the document titled, Home Health Certification and Plan of Care, (certification period 5/19/2023 to 7/17/2023) revealed P#2 was admitted with diagnoses including long-term (current) use of anticoagulants (blood thinners). The nurses’ notes lacked interventions to educate or manage the increased risk of bleeding. Initial nursing assessment dated 8/4/2023 identified anticoagulant as a high-risk drug class. Review of Visit Note Report dated 05/30/2023, and 06/13/2023, failed to include interventions related to the use of anticoagulants. 2. Record review revealed P#8 was admitted with hypertensive heart disease with hypertension (long-term condition that develops over many years in people who have high blood pressure), chronic systolic (congestive) heart failure (a serious condition that occurs when the heart does not pump blood effectively), and long-term (current) use of anticoagulants. The nurses’ notes failed to include interventions to manage heart failure and increased risk of bleeding. Initial nursing assessment dated 9/25/2023 revealed symptoms of hypertension poorly controlled and identified the anticoagulant as a high-risk medication. Clinical visit notes failed to include interventions related to heart failure or the use of anticoagulants. 3. Record review revealed that P#10 was admitted with poorly controlled hypertension and long-term use of anticoagulants. The nurses’ notes failed to include interventions to manage risk of bleeding. An initial nursing assessment dated 10/10/2023 identified the anticoagulant as a high-risk medication. The record failed to include specific interventions or teaching related to hypertension or the use of anticoagulants. An interview with the Administrator on 10/31/2023 at 2:30 p.m. revealed the Clinical Manager normally reviews admission paperwork. An interview with Registered Nurse (RN) AA on 10/31/2023 at 2:46 p.m. revealed she admitted P#10 and discussed medications with the patient but did not address them on the plan of care or document it in the nurses’ notes after visits. The agency was unable to provide a policy for the management of congestive health failure (CHF) or anticoagulant use.

Suncrest Home Health is in compliance with 42 CFR Part 418.113, Emergency Preparedness for HHA, as a result of an onsite survey visits conducted on 3/31/2021 by Qualified Nurse Surveyors.

An unannounced Recertification visit survey was conducted at Suncrest Home Health, Georgia, on 3/31/2021 by Qualified Nurse Surveyors. As a result of the recertification visit survey the agency was compliance with deficiencies. A reviewed of Covid-19 infection control revealed that the agency is in compliance with Chapter 42 CFR Part 418, Rules and Requirements for Home Health and Hospice Agencies.

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 clinical record reviews, home visit observations, and staff interviews, it was determined that the agency failed to ensure that patient's medication profile was updated to reflect current medications at the time of the comprehensive assessment for 1 of 13 patients (P#11) observed during home visits. Findings were: During a home visit observation on 3/29/21 at 1:30 p.m. for P #11 with Occupation Therapist (OT) and Executive Director, P#11 certification period of 1/30/21 to 3/30/21, this surveyor compared the current medication list in her private home to the home health agency's medication profile. According to the medication profile in P#11 private home, it was written Alprazolam 0.5 milligrams (MG) give one tablet oral as needed for anxiety. The medication profile was not accurately reflected in P#11 current medication. Alprazolam 0.5mg tablet container labeled revealed that the medication was refilled by pharmacy on 3/11/20, to be discarded on 3/11/21. The skilled nurse Registered Nurse (RN) visited P#11 on 3/10/21 and 3/24/21. Occupational Therapist (OT) visited P#11 on 3/10, 3/12, 3/17, 3/19, 3/24, 3/26 and 3/29/21. Physical Therapist (PT) visited P#11 on 3/18, 3/25 and 3/30/21. The PT/OT or RN was aware that Alprazolam 0.5 milligrams (MG) give one tablet oral as needed for anxiety has expired. The expired medication was included with P#11 current medications. During an interview on 3/29/21 at 1:30 p.m. with OT, she stated that she was not aware that P#11 Alprazolam 0.5 milligrams (MG) give one tablet oral as needed for anxiety, has expired on 3/11/21. OT provided no evidence the medication profile had been updated to reflect the patient's current medication regimen. On 3/29/21 at 2:45 p.m., an interview was conducted with RN assigned to P#11, stated that she visited patient once in two weeks according to the frequency. RN said she visited P#11 twice this month on 3/10/21 and 3/24/21, but did not notice that Alprazolam 0.5 milligrams (MG) give one tablet oral as needed for anxiety, has expired on 3/11/21. On 4/1/21 at 1:37 p.m., an interview was conducted with PT, stated that she visited P#11 on 3/18/21 and 3/25/21. She said that she reviewed P#11 Alprazolam 0.5 milligrams (MG) give one tablet oral as needed for anxiety, but she was not aware that Alprazolam 0.5 mg has expired on 3/11/21.