Every finding on record at Petersburg Home Care Services LLC

An unannounced Home Health Agency recertification survey was conducted on November 8-10, 2021 by one (1) Medical Facilities Inspector from The Office of Licensure and Certification, Virginia Department of Health. In conjunction with this survey, the agency's emergency preparedness plan was reviewed. The agency was found to be in compliance with 42 CFR 484.102 Conditions of Participation Emergency Preparedness for Home Health Agencies.

An unannounced Home Health Agency recertification survey was conducted on November 8-10, 2021 by one (1) Medical Facilities Inspectors from The Office of Licensure and Certification, Virginia Department of Health. The agency reported an unduplicated census of 429 for the past twelve months. The agency has no branch offices. In conjunction with the survey, ten (10) clinical records, six (6) personnel files, an admission packet, complaint log, emergency preparedness, COVID-19 information, CLIA (Clinical Laboratory Improvement Amendments) and the organization chart were reviewed. Four (4) home visits and staff interviews were conducted. The agency was found not to be in compliance with the federal requirements of 42 CFR 484, Conditions of Participation for Home Health Agencies. Deficiencies were identified and are cited in this report.

Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This STANDARD is not met as evidenced by: Based on observation of clinicians during home visits and staff interview, it was determined the agency failed to follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases for one (1) of four (4) patients observed during home visits (patient #9). The findings were: A home visit was conducted to patient #9 on 11/09/2021 at 1:15 PM accompanied by the administrator (staff #1). The skilled nurse (staff #5) was observed performing wound care to the patient. The nurse set up the clean field with the needed supplies prior to starting wound care. The nurse failed to open the gauze packets prior to putting them on the clean field and the large package of calcium alginate (type of dressing) was not put on the clean field. Staff #5 cleansed the patient's wound per physician orders and changed gloves performing hand hygiene prior to putting on clean gloves. Once the nurse put on clean gloves, the package of calcium alginate was handled to cut the proper size of dressing from the sheet and it was put on the wound. The outer package was not a clean surface and the nurse touched it as well as the clean dressing with the same pair of gloves. The nurse used the same pair of gloves to open the gauze 4x4's to cover the wound. The outer package of gauze was not a clean surface and the nurse touched it as well as the clean 4x4's with the same pair of gloves. This action of moving from dirty to clean surfaces without changing gloves and performing hand hygiene puts the patient at risk for infection and slowed wound healing. The findings were reviewed with the administrator immediately after the home visit. An interview was conducted with the administrator on 11/10/2021 at 8:20 AM. The administrator agreed the nurse contaminated supplies while performing wound care and was nervous during the home visit.

Discharge and transfer summaries CFR(s): 484.110(a)(6)(i-iii) (i) A completed discharge summary that is sent to the primary care practitioner or other health care professional who will be responsible for providing care and services to the patient after discharge from the HHA (if any) within 5 business days of the patient's discharge; or (ii) A completed transfer summary that is sent within 2 business days of a planned transfer, if the patient's care will be immediately continued in a health care facility; or (iii) A completed transfer summary that is sent within 2 business days of becoming aware of an unplanned transfer, if the patient is still receiving care in a health care facility at the time when the HHA becomes aware of the transfer. This ELEMENT is not met as evidenced by: Based on clinical record review and staff interview it was determined the agency staff failed to send the transfer and/or discharge summary to the required entities within the proper time frame for two (2) of three (3) patients in the survey sample requiring a summary. (Clinical records #2 and 3). The findings were: Clinical record #2 was reviewed for the recertification period of 5/19/2021 through 7/17/2021. The patient went to the hospital and was admitted for pneumonia on 7/01/2021. An interview with staff #2 on 11/09/2021 at 9:25 AM revealed the transfer summary was not sent to the hospital until 7/06/2021, more than two (2) business days after the transfer. Clinical record #3 was reviewed for the recertification period of 7/17/2021 through 9/14/2021. The patient was discharged on 9/14/2021. An interview with staff #2 on 11/10/2021 at 8:40 AM revealed the discharge summary was not sent to the physician until 9/22/2021, more than five (5) business days after the discharge.