Every finding on record at Liberty Home Health Care of Ohio, LLC

Substantial Allegation Survey Substantial Allegation 102452 The following deficiency is based upon substantial allegation 102452 completed on 12/11/23. Liberty Home Healthcare of Ohio, LLC 368397, is not in compliance with the requirements at 42 CFR Part 484, Subpart B, C for Home Health Agencies.

Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician or allowed practitioner refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician or allowed practitioner is consulted to approve additions or modifications to the original plan. This STANDARD is not met as evidenced by: Based on interview, record review and policy review, the facility failed to ensure each patient received home health services that are written in the plan of care for one of three patients reviewed (Patient #13). This could affect all patients receiving services from the agency. The census was 13. Findings include: Review of Patient #13's medical record revealed an 08/10/22 start of care date. Review the certification period dated 10/04/23 to 12/02/23 revealed the patient was to receive 20 hours of home health aide services weekly. The home health aide was to assist with personal care, activities of daily living, light housekeeping as needed, shower, grooming, dressing and skin care. Review the home health aide (HHA) timesheet revealed the patient was to receive services Monday through Friday from 4:00 P.M. till 8:00 P.M. The timesheet did not have any time entered for 10/24/23. The last time sheet for the patient was through 10/27/23. The patient was not to receive services on the weekend 10/28/23 or 10/29/23. The patient did not receive services on 10/30/23, 10/31/23, 11/01/23, 11/02/23 or 11/03/23. There was no evidence of missed visit forms. There was no evidence the agency notified the physician of the missed visits until 11/03/23. There was a Communication Note dated 11/03/23 stating the physician put the services on hold because the current aide had an emergency and taken some days off. The agency was trying to provide alternate aide care to cover the shift until aide returned to work. On 12/02/23 the patient was discharged from the agency due to the agency having difficulty meeting the needs of the patient. Interview on 12/11/23 at 4:05 P.M. with Staff AA verified the patient did not receive the service hours as per plan of care. Staff AA further verified the physician was not notified until 11/03/23 of the missed days on 10/24/23, 10/30/23, 10/31/23, 11/01/23 and 11/02/23. He indicated the facility did not know of the missed visits until 10/31/23 when they looked at the patient's weekly time sheet brought in by the HHA. Review of the employee handbook revealed the Attendance and Tardiness protocol was to ensure timely and consistent care and services is provided to the patient population served by Liberty Home Healthcare of Ohio agency. Any absenteeism or tardiness is to be communicated to the staff member supervisor in a timely manner. Excessive absenteeism and or tardiness may result in disciplinary action up to the including termination and may have an adverse effect on the staff members future salary increase transfer request promotion or continued employment. Each staff member including contracted personnel is responsible for reporting any absence or tardiness to his or her immediate supervisor in a timely manner according to departmental guidelines to allow the supervisor to plan for alternate staff coverage. Review of the policy titled, Provider Notification Process, effective 09/22/15, revealed to be in compliance with agency guidelines to monitor service delivery and notifying the physician and case manager of any service delivery problems, Liberty Home Healthcare of Ohio shall maintain a provider missed visit form and document reasons for the missed visits. This deficiency represents non-compliance investigated under Substantial Allegation 102452.