Every finding on record at Palm Beach Home Health Agency

An unannounced Complaint survey, #2020005415 was conducted on 06/14/2022 at Palm Beach Home Health Agency, Home Health Agency provider. The provider is not in compliance with 42 CFR Part 484, Subpart A-C, Conditions of Participation 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 record review and interview, the Home Health Agency failed to follow their Plan of Care for 1 of 3 sampled patients as evidenced by the failure to administer the Insulin dosage that the physician ordered (Patient #2). The Findings included: Review of Patient #2's record reveals a physician's signed Home Health Certification and Plan of Care with a Start of Care date of 9/4/21 and certification period of 5/2/22 to 6/30/22. Further review reveals physician's orders for a Registered Nurse 12 hours a day for 7 days a week. Continued review documents Novolog (Type of Insulin) Flexpen give 8-10 units at breakfast; 9-10 units at lunch and 8-10 units at dinner. Review of Patient #2's "Skilled Nursing Visit Note," dated 5/30/22 documents Novolog 14 units was administered with dinner. Review of the "Skilled Nursing Visit Note," dated 6/2/22 documents 6:00 PM Novolog 14 units administered. Further review of Patient #2's record lacked evidence of any modification to the physician's order. During an interview on 6/14/22 at 3:00PM, in the presence of the Administrator, the Registered Nurse acknowledged the findings and stated that she went to the doctor visit, with the family member and patient, the physician changed the Insulin order and the family member would not give her a copy to send to the Home Health Agency.