Every finding on record at Muscogee Home Health Agency

As a result of an onsite survey visit conducted on 8/4/22 , Muscogee Home Health, Columbus was in compliance with 42 CFR Part 418.113, Emergency Preparedness for HHA.

An unannounced Recertification survey was conducted at Muscogee Home Health Columbus, Georgia, on 8/4/22 by Surveyors. It revealed that the agency was not in compliance with Chapter 42 CFR Part 418, Rules and Requirements for Home Health and Hospice Agencies. The census was zero.

Patient's needs CFR(s): 484.55(c)(4) The patient's medical, nursing, rehabilitative, social, and discharge planning needs; This ELEMENT is not met as evidenced by: Based on records review, staff and families’ interviews, agency failed to ensure patient (P), P#1 and P#3 was placed within a safe environment with the required continuation of medical care upon discharge. The Findings include: Patient (P#1) was diagnosed with pressure ulcer of the sacral region, bilateral amputees and cerebral infraction affecting the right side. Patient (P#3) was diagnosed with kidney failure with dialysis three times a week and scheduled for kidney transplant. On 8/2/22 at 12:30 p.m., an interview was conducted with a Registered Nurse (RN) it was determined that the agency failed to meet patients' needs by noncompliance with proper discharge on 7/20/22. On 8/3/22 at 3:30 p.m., During a telephone interview with the patients’ Power Of Attorney (POA) for P#1, POA stated the Agency discharged P#1 due to selling of the agency to another agency. The other agency informed Home Health Agency (HHA) they must discharge all patients before they could buy HHA. HHA spoke with the patient (POA), on 7/20/22 at 11:30 a.m., and promised to follow up with referral to another agency. HHA failed to follow up with the physician and the patient to make sure patient was placed in another Home Health Agency for continued care.

Conformance with physician orders CFR(s): 484.60(b) Standard: Conformance with physician or allowed practitioner orders. This STANDARD is not met as evidenced by: Based on review of records and interview, agency failed to follow the physician orders to meet the patients' needs as evidenced by not providing proper discharge and lack of action to follow up to meet patients’ medical needs. The Findings Include: Patient (P#1) was diagnosed with pressure ulcer of the sacral region, bilateral amputees and cerebral infraction affecting the right side. P#1 needed physical therapy and occupational therapy three times a week. Patient (P#3) was diagnosed with kidney failure with dialysis three times a week and scheduled for kidney transplant. On 8/3/22 at 4:00 p.m., an interview on the phone with (P#3) family, according to patients’ family, patient was receiving physical therapy (PT) and occupational therapy (OT) three times a week, however patient was discharged due to HHA selling the agency to another HHA agency. On 8/3/22 at 4:30 p.m., an interview was conducted with (RN). According to RN she did not follow up with physician and did not refer patients after discharge for (P#1) and (P#3) for continuation of 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 clinical record reviews and staff interviews, it was determined the Home Health Agency failed to provide services as ordered by the physician in the plan of care for patient #1 and P#3 as evidence by HHA not providing services as required for medical needs. The Finding Include: Patient (P#1) was diagnosed with pressure ulcer of the sacral region, bilateral amputees and cerebral infraction affecting the right side. P#1 needed physical therapy and occupational therapy three times a week. Patient#3 was diagnosed with kidney failure with dialysis three times a week and scheduled for kidney transplant. On 8/3/22 at 4:30 p.m., an interview was conducted with (RN). According to RN she did not follow physicians’ orders in the plan of care to place (P#1) and (P#3) in another agency for medical care.

Governing body CFR(s): 484.105(a) Standard: Governing body. A governing body (or designated persons so functioning) must assume full legal authority and responsibility for the agency's overall management and operation, the provision of all home health services, fiscal operations, review of the agency's budget and its operational plans, and its quality assessment and performance improvement program. This STANDARD is not met as evidenced by: Based on clinical record reviews and staff interviews, it was determined the Home Health Agency failed to provide services as ordered by the physician in the plan of care for patient #1 and P#3 as evidence by HHA not providing services as required for medical needs. The Findings Include: On 8/02/22 at 2:00 p.m. an interview with Chief Executive Officer (CEO) revealed the agency is being sold to another agency. CEO of HHA confirmed that all patients was discharged on July 29, 2022, and the business was closed as of July 29, 2022. CEO stated all employees had resigned except one RN. The CEO stated, RN was retained to pack equipment and after new agency obtains HHA she would be hired by new agency to admit patients. CEO confirmed administrator resigned in May 2022. Since May 2022, HHA does not have an administrator. CEO stated HHA last admission date was 4/14/22 because they would be closing, and new agency would be buying HHA. CEO stated HHA would announce the closure in the newspaper to the public October 1, 2022. During the interview the CEO stated I can admit patients right now and hire my RN as an administrator and I have contract therapist to see patients right now.

Administrator must: CFR(s): 484.105(b)(1) Standard: Administrator. The administrator must: This STANDARD is not met as evidenced by: Based on record review and staff interviews Home Health Agency failed to assign a designated person (Administrator) to assume full legal authority and responsibility for the agency's overall management and operations and provision of all home health services. The Findings Include: On 8/2/22 at 2:30 p.m., during an interview with CEO, CEO confirmed administrator resigned in May 2022. Since May 2022 HHA does not have an administrator. CEO stated HHA last admission date was 4/14/22 because they would be closing, and new agency would be buying HHA. CEO stated HHA would announce it in the newspaper to the public the closing of HHA as of October 1, 2022. It was revealed that the last quality assessment and performance improvement (QAPI)meeting was held 2015. Due to lack of administrator daily operation was not performed according to regulations agency was noncompliance with QAPI program.

Coordinate patient care CFR(s): 484.105(c)(2) Coordinating patient care, This ELEMENT is not met as evidenced by: Based on record review and staff interviews Home Health Agency failed to follow up with continuity of care for physical therapy and occupational therapy for Patient (P) #1 and P#3. The Findings Include: Patient (P#1) was diagnosed with pressure ulcer of the sacral region, bilateral amputees and cerebral infraction affecting the right side. P#1 needed physical therapy and occupational therapy three times a week. Patient (P#3) was diagnosed with kidney failure with dialysis three times a week and scheduled for kidney transplant. On 8/3/22 at 4:00 p.m., a telephone interview was conducted with OT who stated P#3 was discharged on 7/4/22. Upon discharge OT noted P#3 developed a new open wound stage 2 on right lateral side of ankle. OT confirmed (RN), was notified of new wound however, OT had to discharge patient because agency was going to be sold to another agency. The OT informed surveyors that P#1 and P#3 was discharged due to HHA agency closing. On 8/3/22 at 4:15 p.m., an interview with the agency RN informing surveyors that she was not informed by OT about a wound on patient right lateral ankle and she doesn’t know anything about it. On 8/3/22 at 4:21 p.m., a telephone interview with P#1 family revealed patient was receiving physical therapy (PT) and occupational therapy (OT) three times a week, however patient was discharged due to HHA selling the agency to another agency.