Every finding on record at Medical Centers Homecare, LLC

Based on the recertification survey conducted on 9/22/22, Medical Centers Homecare was found to be in substantial compliance with the Conditions of Participation for Emergency Preparedness and related standards.

A recertification survey was conducted at Medical Centers Homecare on 9/20/2022 through 9/22/2022, standard level deficiencies were cited and will require a plan of correction.

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, agency policy and procedure, review of medical records (MR), and interviews it was determined the agency failed to ensure the Client Medication Report (CMR), for each patient was current and accurate. This affected 2 of 7 Home Visits (HV) conducted, including HV # 2, and HV # 5, and had the potential to affect all patients served by the agency. Findings include: Agency Policy Number: 10.008 Title: Monitoring Medications Revised Date: 5/01/19 Purpose: To provide a process to ensure continuous monitoring of medications in the patients home. Policy: A drug regimen will be performed on all patients... throughout the episode... Procedure: 1...a. Compare medication list...to actual medications patient is taking. b. Review all medications including over the counter (OTC) medications...to identify issues such as: ...x. Drug omissions 2. All clinicians... are responsible to assist with the maintenance of accurate patient medication throughout the episode of care... 2. HV # 5 was admitted to the agency on 7/30/22 with diagnoses including Pressure Ulcer of Sacral Region, Stage 4, and Pressure Ulcer of Right Buttock, Stage 3. Review of the HHC and POC dated 7/30/22 revealed a SN visit frequency of one time a week for one week, two times a week for eight weeks, and one time a week for one week. A HV was conducted on 9/20/22 at 2:00 PM to observe care provided by EI # 9, Licensed Practical Nurse (LPN). EI # 4, Registered Nurse (RN) PCM was also present. During the HV, a comparison was made between medications observed in the home, and the CMR provided to the surveyor, printed 9/20/22. The following discrepancy was observed: Bactrim DS (Trimethoprim 160 mg and Sulfamethoxazole 800 mg) with fill date 9/14/22, take one tablet twice daily for ten days was in the home, and not on the CMR. The patient confirmed he/she was taking the Bactrim as prescribed. In an interview conducted on 9/22/22 at 3:00 PM with EI # 10, PCM, EI # 10 confirmed medication reconciliation was to be performed on every visit, and the Bactrim should have been added to the CMR on the 9/17/22 SN visit, and was not. 1. HV # 2 was admitted to the agency on 6/08/22 with diagnoses including Encounter for Adjustment and Management of VAD (Vascular Access Device) and Encounter for Attention to Ileostomy. Review of the 8/07/22 to 10/05/22 Home Health Certification (HHC) and Plan of Care (POC) revealed skilled nurse (SN) visits one time a week for nine weeks. A HV was conducted on 9/20/22 at 12:30 PM to observe care provided by Employee Identifier (EI) # 2, SN. Also present was EI # 11, Patient Care Manager (PCM). Medication reconciliation was performed with the patient and SN using the agency CMR and medication found in the home. The following medications were found in the home, verified by the patient, and not documented on the agency CMR: (a) Hemp CBD Extract 25 milligrams (MG) capsules, take once a day for joint pain. Patient stated he/she has been taking the medication for six months. (b) Melatonin ten mg tablets, take one at night as needed for sleep. Patient stated he/she has been taking this for three months. An interview was conducted 9/22/22 at 2:53 PM with EI # 11 PCM who confirmed staff failed to ensure HV # 2's CMR was accurately reconciled throughout the episode of care.