Every finding on record at Mahdi Home Health Care Inc

A recertification survey was completed on 3/6/24. One deficiency was cited.

5 calendar days after start of care CFR(s): 484.55(b)(1) The comprehensive assessment must be completed in a timely manner, consistent with the patient's immediate needs, but no later than 5 calendar days after the start of care. This ELEMENT is not met as evidenced by: Based on interview and record review, the agency failed to ensure a comprehensive assessment was completed no later than five calendar days after each patient's start of care for 1 of 1 patients who received physical therapy (PT) and occupational therapy (OT) records reviewed (Patient #4). Findings include: 1. The clinical record for Patient #4 was reviewed on 3/5/24. The plan of care for the certification period dated 2/6/24 to 4/5/24, revealed a start of care date of 2/6/24; diagnoses included atherosclerosis of coronary artery bypass grafting (CABG) without angina pectoris and acute ischemic heart disease. Plan of care orders included skilled nursing (SN) once every 60 days for recertification; PT once a week for four weeks to address deficits with impaired functional activity tolerance, impaired functional mobility and impaired functional strength; OT once a week for one week, twice a week for three weeks and once a week for two weeks to address deficits with impaired activity of daily livings (ADL's), impaired safety awareness and decreased functional activity tolerance; and certified nursing aide (CNA) three times per week for nine weeks to assists with ADL's. a) The agency failed to ensure a comprehensive assessment was completed within five calendar days of Patient #4's start of care date of 2/6/24. Review of a referral dated 2/5/24 revealed Patient #4 was to be evaluated by SN, CNA, PT, and OT services for evaluation and treatment post CABG. Review of Patient #4's clinical record on 3/5/24 revealed the PT performed a physical therapy assessment on 2/14/24 or eight days after the start of care. Further review of the clinical record revealed the OT performed an occupational therapy assessment on 2/22/24 or sixteen days after the start of care. During interview on 3/5/24 at 2:14 p.m., the director of nursing (DON) stated the agency contracted PT and OT services to another agency and did not send the referral for therapy services until 2/13/24, or seven days after the start of care. The DON stated she did not know why the referral for therapy services was sent late to the contracted agency.

A recertification in conjunction with a COVID 19 survey was completed on 3/24/21. One deficiency was cited.

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 observation, interview and record review, the Administrator failed to manage the overall operations of the agency. Specifically, the Administrator failed to comply with all applicable federal laws and ensure infection control processes were maintained to help prevent the possible development and transmission of coronavirus (COVID-19). Findings include: 1. REFERENCES According to the Centers for Disease Control (CDC), Establish procedures for monitoring, managing and training all visitors, which should include...passively screen visitors for symptoms of acute respiratory illness before entering the healthcare facility ... All visitors should be actively assessed for fever and respiratory symptoms upon entry to the facility. If fever or respiratory symptoms are present, visitor should not be allowed entry into the facility." Retrieved from CDC Coronavirus Disease (2019) https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html According to the State Public Health Order (PHO), dated 4/20/20, "For essential individuals entering the building, including personnel, contracted individuals or essential visitors, screen 100% prior to entry into the building, consistent with screening criteria. Essential individuals should be limited... Limit their movement within the facility to the resident's room." On 3/12/2020 Public Health Order 20-20 was put into place which read in part, "Facilities must follow CMS guidelines related to screening, limiting and restricting visitors (CMS Ref. QSO-20-14-NH (March 9, 2020). 1. Restrict visitation of non-essential individuals. a. Facilities shall post signage clearly summarizing the essential individual visitor policy, such as vendors providing necessary supplies or services for the facility or residents, and individuals necessary for the physical and/or mental well-being of the resident. 2. For essential individuals entering the building, including personnel, contracted individuals or essential visitors, screen 100% prior to entry into the building, consistent with screening criteria... " 2. Entry Screening At 12:55 PM, on 3/22/21, the Surveyors arrived to the agency and were greeted by the Administrator. No COVID screening was completed prior to entering the agency. However, the Administrator failed to ask the Surveyors the Covid-19 questions at the door and complete the temperature checks. At 1:29 PM, on 3/22/21, the Administrator came into the conference room and took both Surveyors temperatures. On 3/23/21 and 3/24/21 the day of the survey exit, the agency failed to complete the surveyors temperature check and the COVID screening questions the final two days of the survey. 3. Interviews During an interview on 3/24/21 at approximately 9:40 AM, the Backup Administrator stated COVID training was completed over the phone and through email, but no log was maintained of personnel staff who had completed the training. During an interview on 3/24/21 at approximately 12:58 p.m., the Backup Administrator stated the agency do not maintain a log for temperature checks or COVID screening questions for field staff or office personnel. 4. Trainings The agency was unable to provide evidence of training during the infection control interview. Review of the training documentation on 3/25/21 revealed no evidence all agency personnel staff were trained on infection control training and the COVID-19 updates.