Every finding on record at Patriot Homecare, Inc

Substantial Allegation Survey Substantial Allegation 109675 At the time of the substantial allegation survey completed on 10/23/24, Patriot Homecare is in compliance with the provisions of 42 CFR Part 484, Subpart B,C, Home Health Agency, in regard to allegations contained in substantial allegation number 109675.

Promptly alert relevant physician of changes CFR(s): 484.60(c)(1) The HHA must promptly alert the relevant physician(s) or allowed practitioner(s) to any changes in the patient's condition or needs that suggest that outcomes are not being achieved and/or that the plan of care should be altered. This ELEMENT is not met as evidenced by: Based on record review, staff interview, and review of policy, the agency failed to notify the physician when changes were identified in the size of open wounds for one (Patient #3) patient reviewed for wounds. The agency census was 1454 . Review of the medical record for Patient #3 revealed the start of care was 02/16/24. Diagnoses included pressure ulcer of left heel, open wound of right upper arm, peripheral vascular disease, malignant neoplasm of bone and prostate, and chronic kidney disease. The skilled nurse (SN) was to provide service twice a week, assess the wounds at each visit for signs and symptoms of infection, and to report increase in drainage and foul odor. The SN was to instruct the patient/caregiver on the signs and symptoms of wound infection to report to the physician, to include an increase in drainage and fouls odor. Review of the SN visit sheet, dated 06/10/24, revealed the left heel wound measurements were 2 centimeters (cm) length by 3 cm width by 0 cm depth. Review of the (SN) visit sheet dated 06/18/24 revealed Licensed Practical Nurse (LPN) Staff C assessed the left heel to measure 5.5 cm by 5 cm by 0.2 cm. Staff C reviewed with the patient and family the wounds are getting larger with measurements. There was no evidence the physician was notified of the increase in wound size. Review of a Case Conference and 60 Day Summary dated 06/19/24 revealed the registered nurse (RN) Staff D documented the wounds were declining. Review of the SN visit sheet dated 07/02/24 revealed the RN Staff D documented the right heel measured 4.2 cm by 4.0 cm by 0.2 cm. Review of the SN visit sheet dated 07/08/24 revealed LPN Staff C documented the right heel measured 6.2 cm by 4.1 cm by 0.2 cm. The documentation stated the wounds had improved. There was no evidence the physician was notified of the increase in the length of the open area. Interview on 10/23/24 at 12:02 PM the Vice President of Operations Staff A confirmed there was no documented evidence the physician had been notified of the change in the wound measurements. Review of the undated agency policy titled “Physician Notification to Alter the Plan of Care” revealed the home health agency promptly alerts the relevant physicians to any changes in the patient’s condition or needs that suggest that outcomes are not being achieved and that the plan of care should be altered.