Every finding on record at Maim Healthcare Services, Inc

An Emergency Preparedness Survey was conducted on 3/23/2026-3/25/2026 at Maxim Healthcare Services, Inc. No deficiencies were cited under 42 CFR 484.102.

A recertification and complaint 108392, 112956, and 2562272 survey was conducted on 3/23/2026-3/25/2026 at Maxim Healthcare Services, Inc. Deficiencies were cited in relation to complaint 108392 and 2562272 and the recertification survey under 42 CFR Part 484, Requirements for Home Health Agencies.

Receive all services in plan of care CFR(s): 484.50(c)(5) Receive all services outlined in the plan of care. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure all services outlined in the Plan of Care (POC) for 1 Patient (#7) of 10 patients reviewed. The findings include: Medical record review revealed Patient #7 was admitted to the agency on 8/15/2024 with diagnoses including Atresia of Foramina of Magendie. Medical record review of the Plan of Care dated 12/13/2024 to 2/10/2025 revealed a physician's order to provide 30 hours per week of private CNA services, during school hours only. Continued review revealed a physician's order Behaviors: CNA...to redirect patient's aggressive/self-harming behaviors using distractions/bribes with his favorite toy (wheel). Review of undated facility investigation revealed on 1/31/2025 the agency was notified by an employee and school staff that Certified Nursing Assistant (CNA) B had taken away the patient's "wheel and puzzle" and attempted to get the patient to take a nap. During an interview on 3/25/2026 at 2:15 PM, the Clinical Director confirmed the physician's orders had not been followed when CNA B took away Patient #7's wheel and puzzle during the 1/31/2025 incident.

Provide services in the plan of care CFR(s): 484.75(b)(3) Providing services that are ordered by the physician or allowed practitioner as indicated in the plan of care; This ELEMENT is not met as evidenced by: Based on medical record review and interview, the agency failed to provide personal care for 1 patient (#5) of 10 patients reviewed. The findings include: Medical record review revealed Patient #5 was admitted to the agency on 4/23/2024 with diagnoses including Chronic Respiratory Failure and Malaise. Medical record review of the Plan of Care dated 4/23/2024 to 6/21/2024 revealed a physician's order for "...Registered Nurse (RN)/Licensed Practical Nurse (LPN) to provide services for 30 hours a week...personal care as needed to include bathing, dressing, diapering, skin and oral care..." Review of the undated investigation showed the agency received a complaint from Patient #5's husband stating LPN C had not provided personal care to Patient #5. Continued review revealed LPN C reported she had been placed on lifting restrictions by her physician but had not informed the agency. Continued review revealed no documentation the personal care had been provided to Patient #5. During an interview on 3/25/2026 at 1:45 PM, the Clinal Director Greenville Branch confirmed that LPN C had not informed the agency she had been placed on lifting restrictions by her physician and had failed to provide personal care.

An investigation of complaints #96982 and #97083 was conducted on 4/18/2023 at Maxim Healthcare Services, Inc. Deficiencies were cited under CFR Part 484, Requirements for Home Care Organizations Providing Home Health Care.

Provide services in the plan of care CFR(s): 484.75(b)(3) Providing services that are ordered by the physician or allowed practitioner as indicated in the plan of care; This ELEMENT is not met as evidenced by: Based on review of facility policy, medical record review, review of facility documentation, and interview, the facility failed to provide skilled nursing services according to the plan of care for 1 patient (Patient #1) of 3 patients reviewed. The findings include: Review of facility policy Safe and Appropriate Use of Medical Equipment and Supplies, effective date 9/1/2014, revealed "...Instruct/orient Direct Care Staff on safe and appropriate use of HME [home medical equipment] when needs are identified...Direct Care Staff receive initial education during orientation and then annually..." Medical record review revealed Patient #1 was admitted to the agency on 9/21/2017 with diagnoses including Encephalopathy and Epilepsy. Medical record review of Licensed Practical Nurse (LPN) #1's skilled nursing note dated 2/10/2023 at 3:01 PM, revealed, "While transferring pt [patient] from the wheelchair to the bed his head was leaning backwards unsupported and with his body weight he slipped out of the sling headfirst. Landed in sideways position on the carpet. His head did not hit the metal part of the lift or anything on the way down. Hit the carpet. He cried for a short time (less than a minute). He did not lose consciousness at anytime. No signs of bleeding. Called 911 and [agency] office to let them know. No change in level of consciousness. Smiling at times, then started turning his head side to side as usual. Paramedics came and he was taken to...Hospital by ambulance..." Medical record review of the Plan of Care dated 2/22/2023 to 4/22/2023 revealed a physician's order for private duty skilled nursing services for 112 hours per week. Continued review revealed patient medical equipment included a Hoyer lift (lift used to assist the patient to transfer). Further review revealed "...Mom requests that skilled nurse bathe patient every day. Mom requests skilled nurse to bathe patient in the shower 3 times per week once the patient's electric Hoyer lift has been repaired/replaced... " Review of undated documentation provided by the agency revealed LPN #1 reported the patient fell from the Hoyer lift during transfer from the wheelchair to the bed, landing on his head and then on his side on the carpet. LPN #1 reported the patient did not hit anything when he fell and there were no visible injuries. She assessed the patient and there were no signs or symptoms of injury, she called 911, and the patient was transported to the hospital emergency department. Patient #1 was discharged home that same night with no new orders. LPN #1 was reeducated on safe patient care and received in office retraining on safe/proper use of the Hoyer lift as well as review of Body Mechanics and Transfers. LPN #3 saw Patient #1 on 2/11/2023 and reported that when she arrived, the patient's mother informed her of the fall and Emergency Room visit but told her the patient was fine and discharged the same night. LPN #3 reported the patient had no signs or symptoms of injury, "was his normal self throughout the shift", patient was laughing and did not show any signs of distress, and vital signs were within normal limits. LPN #3 reported that at the end of her shift she did observe some bruising that developed on the patient's right shoulder going into the armpit. On 2/20/2023, the Clinical Manager did a home visit to assess Patient #1 and some discoloration under the patient's right arm around the armpit was present, but it appeared to be more like a hyperpigmentation than bruising. The Hoyer lift was in full working condition. LPN #1 received all necessary reeducation but was not returned to work with Patient #1. Review of undated documentation provided by the agency revealed on 3/21/2023, LPN #2 reported Patient #1 fell when she was in the process of securing the patient in his wheelchair. LPN #2 reported she secured the seatbelt before going behind the wheelchair to adjust the patient and to fasten the harness when the lap belt unfastened, and Patient #1 fell forward to the floor. LPN #2 reported, upon assessment, the patient had a carpet burn injury above his right eyebrow and below his right eye. LPN #2 reported Patient #1 was crying but stable after the fall and experienced no other changes in condition. The patient's mother and physician were notified. No medical attention was sought. The clinical Supervisor completed a home visit to assess the patient after the fall and the patient was calm and stable upon her arrival. The patient had a small wound above and under the right eye. LPN #2 and the patient's mother were educated about fall prevention and safety in the home. LPN #2 continued working with the patient after the fall. Review of an assessment and supervisory note by Registered Nurse (RN) #1 on 3/21/2023 revealed both LPN #2 and the patient's mother were present. Patient #1 had an Abrasion on the right upper eye. The abrasion was red with 100% granulation. The wound appeared as a small “carpet burn” like wound above and below his right eye from a fall. Medical record review revealed, the facility did not provide skilled nursing services (missed visits) as follows: 3/4/2023 - 4 hours 3/5/2023 - 4 hours 3/6/2023 - 4 hours 3/10/2023 - 4 hours 3/11/2023 - 2 hours 3/12/2023 - 16 hours 3/18/2023 - 4 hours 3/19/2023 - 4 hours Continued review revealed there were no qualified caregivers were available for the above missed visits. The backup plan identified in the plan of care revealed "...In the event no qualified caregivers are able to cover the shift, family assumes care.” Interview with the Clinical Manager on 4/18/2023 at 10:30 AM, in the conference room, revealed the patient had 1 fall from the Hoyer lift on 2/10/2023 and another fall out of his wheelchair on 3/21/2023. LPN #1 underwent reeducation on safety with transfers and the use of a Hoyer lift. LPN #2 was reeducated on safety with transfers.

A complaint (#62295) survey was conducted on 5/12/2022 at Maxim Healthcare Services, Inc. Deficiencies were cited under CFR Part 484, Requirements for Homecare Organizations Providing Home Health Care.

Mistreatment, neglect or abuse CFR(s): 484.50(e)(1)(i)(B) (i)(B) Mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and/or misappropriation of patient property by anyone furnishing services on behalf of the HHA. This ELEMENT is not met as evidenced by: Based on medical record review, review of video, and interview, the agency failed to prevent abuse for 1 patient (#1) of 3 patients reviewed. The findings include: Medical record review revealed Patient #1 was admitted to the agency on 9/27/2013 with diagnoses including Chronic Respiratory Failure and Symptomatic Epilepsy. Medical record review of the Plan of Care (485) dated 12/14/2021 to 2/11/2022 revealed the physician ordered skilled nursing services for 155 hours per week. Continued review revealed the patient was on a ventilator at night and was totally dependent on care. Review of a video supplied by the agency dated 1/25/2022 at 3:16 AM revealed the patient was lying in his bed RN #1 was in a recliner chair across the room with the feet up. RN #1 went to the bedside of the patient and taped a latex surgical glove to the patient's right hand. The patient at that time became agitated. He was swinging his right arm across his body in a constant motion. RN #1 went back to her recliner with her feet elevated and was on a cell phone or a Ipad. It appeared she did not have direct eyesight of the gloved hand. At one point, the patient laid on his left side and his right hand was between his body and side rails - at this time RN #1 could not have seen what he was doing with his right hand. Review of a video supplied by the agency dated 1/25/2022 at 3:23 AM revealed RN #1 heard something and she left the room. She immediately returned to the patient's room and removed the glove which was on the right hand of the patient. She then placed the glove into her pocket. RN #1 went back to her recliner and the patient's mother came in and they had a brief conversation. No other video was available. Review of clinical note entry dated 1/25/2022 revealed the patient's mother reported concerns she had about RN #1 to the agency. She stated concerns had been going on for months. Review of mother's statement provided by the agency dated 1/25/2022 revealed RN #1 had taped a vinyl/plastic glove to her son's hand at 3 AM on 1/25/2022. She stated the patient sucks on that hand and could have aspirated a piece of that glove. She stated that she has told her previously not to tape socks on his hands. The mother requested RN #1 be removed from the home immediately. Review of RN #1's statement provided by the agency dated 1/27/2022 revealed she placed a glove on the patient's hand and secured it with tape and monitored the patient closely (in her opinion) so that he was not in any danger. She stated it was common practice to place a sock or mitten on the patient's hand if he was slobbery or gassy to prevent him from chewing on his fingers. Review of documentation provided by the agency dated 4/13/2022 revealed on 1/25/2022 the mother of Patient #1 contacted the agency and reported RN #1 taped a latex surgical glove to the patient's right hand. She stated the patient "sucks" on this hand and the mother was concerned after she saw this that the patient could aspirate on a piece of the glove. Continued review revealed RN #1 was interviewed by the agency she stated she had placed a glove on the patient's hand, secured it with tape and monitored closely so that he was not in any danger. She said it was common practice in the home for a sock or mitten to be placed on the patient's hand if he was slobbery or gassy, to prevent him from chewing on his fingers. Interview with Patient #1's mother on 5/12/2022 at 3:44 PM via telephone revealed RN #1 placed a glove on the patient's hand. She stated that RN #1 had told another nurse she did this because she didn't like the sound of him "sucking" on his hand and he would retain "gas". She stated she (the mother) would place a sock or mitten on his hand if his hand became red and raw. However she never told RN #1 that she could not place a sock or mitten on the patient. She stated during the video after she placed the surgical glove on his right hand she could tell he became very agitated by the way he was swinging his right arm from left to right to left. She felt like her son was in danger of aspirating the glove. Interview with LPN #2 on 5/13/2022 at 11:20 AM via telephone revealed she watched the video regarding placement and removal of the surgical glove. She stated the mother found the glove in the garbage and when she looked at it you could tell he had it in his mouth at some time. She stated if a nurse was in the recliner with the feet up there was no way you could monitor the patient to see if he put anything in his mouth. Interview with the administrator on 5/12/2022 at 10:30 AM confirmed a vinyl/surgical glove should not have been placed on the patient's hand which limited his movement, caused the patient to become agitated and increased his chances of aspiration.

Immediate reporting of abuse by all staff CFR(s): 484.50(e)(2) Any HHA staff (whether employed directly or under arrangements) in the normal course of providing services to patients, who identifies, notices, or recognizes incidences or circumstances of mistreatment, neglect, verbal, mental, sexual, and/or physical abuse, including injuries of unknown source, or misappropriation of patient property, must report these findings immediately to the HHA and other appropriate authorities in accordance with state law. This ELEMENT is not met as evidenced by: Based on abuse policy review, medical record review, and interview, the agency failed to report allegations of abuse for 1 patient (#1) of 3 patients reviewed. The findings include: Review of the agency's policy on Abuse, Neglect, or Exploitation revised on 4/9/2021 revealed "...Employees who identify, notice, suspect or recognize incidences or circumstances of mistreatment, verbal, mental, sexual and/or physical abuse, including injuries of unknown source, neglect, misappropriate of personal patient property, or exploitation of patient/clients and /or family/caregivers or employees must report these observations/concerns immediately to the agency..." Medical record review revealed Patient #1 was admitted to the agency on 9/27/2013 with diagnoses including Chronic Respiratory Failure and Symptomatic Epilepsy. Medical record review of the Plan of Care (485) dated 12/14/2021 to 2/11/2022 revealed the physician ordered skilled nursing services for 155 hours per week. Continued review revealed the patient is on a ventilator at night and received tube feedings at night. The patient was totally dependent on care and non-verbal. Review of statement of LPN #1 provided by the agency dated 1/27/2022 revealed there was one time that she had to go to the back door and knock because no one answered the front door. She stated the curtains were drawn so she could not see if RN #1 was sleeping. She stated she had to knock on the door for a long time. She stated she did not remember the date of this incident. Review of statement of LPN #2 provided by the agency dated 1/27/2022 revealed she had "caught" RN #1 sleeping at shift change 3 to 4 times since last summer. She did not know the dates. She would knock on the front door and then have to go to the back door. She stated she would have to knock and yell for around 3 to 4 minutes before she would wake up. Review of statement of RN #1 provided by the agency dated 1/27/2022 revealed RN #1 stated regarding the allegations of sleeping at shift change, it may have happened a couple of times. She stated it was not always easy to hear someone knocking on the front door as the patient's room was in the back of the house. Review of LPN #1's personnel file revealed she completed in-service on Abuse on 6/25/2021. Review LPN #2 personnel file revealed she completed in-service on Abuse on 6/26/2021. Interview with Patient #1's mother on 5/12/2022 at 3:44 PM via telephone revealed she knew about RN #1 taking naps - she had told her if she (mother) was up and RN #1 needed a nap she could take a nap while the mother monitored patient #1. She stated she knew she was tired as she was in nurse practitioner's school. She stated she never gave her permission to take a nap if she (mother) was not available to monitor the patient. Interview with LPN #2 on 5/13/2022 at 9:00 AM revealed she never saw RN #1 sleeping. She had to wait 15 minutes for her to answer the door, but could not be sure she was sleeping. She did see her in the recliner with her feet up. She had her phone and it appeared that her eyes were closed. She could not see from where she was what the patient was doing at that time. She did state no alarms were going off (patient is on tube feedings and a ventilator). She confirmed that she did not report her concerns or suspensions to the agency in a timely manner and waited until after the mother reported her concerns to the agency. Interview with LPN #2 on 5/13/2022 at 11:20 AM via telephone revealed she knew RN #1 was sleeping, however she felt it was the mother's responsible to notify the agency. She confirmed she did not contact the agency with her concerns regarding care provided to the patient by RN #1. Interview with the administrator on 5/12/2022 at 10:30 AM confirmed LPN #1 and LPN #2 did not report concerns regarding care provided by RN #1 in a timely manner per policy.

During an investigation of complaint #TN52976 on 7/12/2021-7/14/2021 at Maxim Healthcare Services INC. A deficiency was cited in relation to the complaint under CFR Part 484, Requirements for Home Care Organizations Providing Home Health Care.

Treatment or care CFR(s): 484.50(e)(1)(i)(A) (i)(A) Treatment or care that is (or fails to be) furnished, is furnished inconsistently, or is furnished inappropriately; and This ELEMENT is not met as evidenced by: Based on medical record review, facility documentation review, and interview the agency failed to furnish treatment and care consistently and appropriately for 1 Patient (#1) of 3 patients reviewed for nursing services. Based on medical record review, facility documentation review, and interview the agency failed to furnish treatment and care consistently and appropriately for 1 Patient (#1) of 3 patients reviewed for nursing services. The findings included: Review of the medical record showed, Patient #1 was admitted to the Home Health Agency on 6/20/2019 with diagnoses including Epilepsy, Spastic Diplegia Cerebral Palsy, Disorder of Psychological Development, Dependence on Supplemental Oxygen, and Encounter for Attention to Tracheostomy. Review of the facility's documentation undated revealed,"...On 12/27/2020 [Name of the patients mother], the mother of [Name of the Home Health Agency][Patient #1] called our offices and requested that nurse [License Practical Nurse #1], not return to her home. Patient's mother relayed concerns with how [Licensed Practical Nurse (LPN) #1] applied Patient's CPT vest [a vest used to help move mucus out of the lungs] and was positioning Patient in bed. Specifically, Patient's mother indicted [LPN #1] did not support Patient's head while repositioning Patient, Patient's face was "covered" with the CPT vest for greater than 5 seconds. Upon interview, [LPN #1] acknowledged the concerns and stated she was aware of what was requested of her but that "she [LPN #1] was tired and did it differently" Based on the reported events and [LPN #1's] response to this event, a final written warning was administered and [LPN #1] was trained on properly lifting and transferring patients and on using the hoyer lift, Assignments for [LPN #1] are also monitored to ensure she is able to effectively manage the patient's needs..." Review of the LPN #1's Corrective Action form dated 12/28/2020 revealed the LPN was placed on Administrative Leave following the incident on 12/26/2020. Review of LPN #1's Corrective Action form dated 1/7/2021 revealed a case review was completed by the agency. The agency investigative findings were the allegations of safety concerns were substantiated. LPN #1's administrative leave was lifted. During an interview with Patient #1's mother on 7/12/2021 at 2:21 PM, by telephone, Patient #1's mother revealed she had a video camara in Patient #1's room. The patient's mother stated, "I rolled the camara back on 12/27/2020 it was a Sunday. It happened the day after Christmas. She (LPN #1) put it (CPT vest) over his face. The Velcro got hung and his head fell forward and his head went to his crotch. He (Patient #1) had no control of his head. Then she (LPN #1) laid him (Patient #1) back without supporting his head. She let him fall forward on the bed. She [LPN #1] had worked Christmas night 7PM-7AM. I called the on-call service (12/27/2020). I told them I don't want her (LPN #1) here. I called and reported it Monday to her Manager (Clinical Nurse Manager #1) on Monday (12/28/2020) and sent (emailed) her a copy of the video". During an interview on 7/13/2021 at 12:12 PM, by telephone, LPN #1 revealed she had provided care to Patient #1 on 12/26/2021 from 7 PM-7 AM. LPN #1 stated, "You have to fully raise him (Patient #1) up to put vest on. He (Patient #1) didn't have neck control. When I raised him up his neck fell forward. I didn't have good hold of him and his neck fell forward. That day I tried to position him forward. I had it (CPT vest) pullup at top of his head. The AP stated "I should have slowed down and took more precautionary measures to control his head. I didn't support his head and could not position the vest appropriately. (Patient #1) was a mistake and my fault. I only had a couple hours of sleep. I should have called in. It was fully my fault what happened". LPN #1 confirmed she placed Patient #1's CPT vest on wrong. LPN #1 confirmed she attempted to put the CPT vest over the patient's head instead of placing the CPT vest on correctly by putting the vest on through each arm and velcroing the CPT vest at his waist. The LPN confirmed the agency failed to apply Patient #1's CPT vest appropriately and failed to reposition Patient #1 appropriately while applying his CPT vest. During an interview on 7/13/2021 at 2:31 PM, by telephone, Clinical Manager #2 confirmed Patient #1's mother called the previous Clinical Nurse Manager (Clinical Nurse Manager #1) in 12/2020 and notified the agency she did not want (LPN #1) in her home. Clinical Manager #2 stated, "When (LPN #1) was interviewed by the agency the LPN stated "She was tired and didn't want to do it that way. She (LPN #1) pulled the vest over his head and when she done this he fell forward with his upper torso because he is dead weight and she let him fling back. The Mom said she laid the vest over his face. She wasn't supposed to put the vest on that way. We did an investigation and she admitted she wasn't supposed to do it that way and she was tired. She did it her own way. She admitted to it". Interview confirmed LPN #1 was trained on 10/9/2015 on how to appropriately apply a CPT vest correctly on patients. Clinical Nurse Manager #2 confirmed the agency failed to provide and furnish care appropriately and consistently when applying Patient #1's CPT vest and when repositioning the patient on 12/26/2020. During an interview on 7/13/2021 at 3:05 PM, by telephone, the Operations Manager stated, "The nurse never supported the patient's head. The way the patient laid forward didn't support the patient's head. That’s not proper care". The Operations Manager confirmed the agency failed to provide and furnish care consistently and appropriately for Patient #1. During an interview on 7/13/2021 at 3:26 PM, the Administrator confirmed the allegations in the complaint were substantiated by the agency. The Administrator stated, "She admitted she did not provide care appropriately with the CPT vest and did not support the patient's head". The Administrator confirmed the agency failed to provide and furnish care consistently and appropriately for Patient #1.