Every finding on record at Precious Health Corp

An Emergency Preparedness Survey was initiated with the Administrator on 09/24/2024 at 10:00 AM. Census: Licensed and Certified- 98 Personal Assistance Services- 0 An exit conference was conducted with the Administrator on 09/26/2024 at 4:45 PM. The preliminary findings were discussed. The agency was given an opportunity to provide additional information. The agency was found to be in substantial compliance with the Medicare Conditions of Participation for Emergency Preparedness, no deficiencies were cited.

A Recertification and Complaint survey for the Intake #312853 was initiated with the Administrator on 09/24/2024 at 10:00 AM. Census: Licensed and Certified- 98 Personal Assistance Services- 0 An exit conference was conducted with the Administrator on 09/26/2024 at 4:45 PM. The preliminary findings were discussed. The agency was given an opportunity to provide additional information. Written instructions were provided for submitting a plan of correction within 10 days of the receipt of the Statement of Deficiencies. Acronyms: POC- Plan of Care SOC- Start of Care SN- Skilled nurse IV- Intravenous (in the vein) MD- Medical Doctor LVN- Licensed vocational nurse Hha- home health aide RN- Registered nurse DON- Director of Nurses QA- Quality Assurance BON- Board of Nursing

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 agency failed to ensure that a patient received home health services as ordered in the individualized POC for 1 (Patient #1) of 7 active patient records reviewed. The SN failed to measure the patient’s calves each visit as ordered by the physician. This failure potentially placed patients at risk of not receiving interventions when needed to prevent complications, and a decline in the patients’ health status. FINDINGS INCLUDE: Patient #1: Review of the record revealed a POC dated 02/02/2024 to 04/01/2024 with a SOC date 02/02/2024. The POC included the following diagnoses: Cellulitis (a skin infection caused by bacteria); Diabetes Mellitus 2; Heart Failure and Chronic obstructive pulmonary disease. The POC listed physician orders for SN visits once a week for one week, then twice a week for eight weeks. The SN was to measure calves each visit and report to MD greater than 2-5 cm increase in swelling. Record review revealed the following SN visits conducted by the LVN, D with no calf measurements done: 02/07/24; 02/09/24; 02/16/24; 02/20/24; 02/22/24; 03/01/24; 03/06/24; 03/08/24; 03/20/24; 03/22/24 and 03/29/24. In an interview with the Administrator on 09/26/2024 at 3:10 PM, the surveyor reviewed the findings and asked why LVN D did not follow the plan of care and measure the patient’s calves. A phone call was placed to the LVN D and she was asked the question, why Patient #1’s calves were not measured as instructed in the plan of care, for the certification period 02/02/2024 to 04/01/2024. The LVN D stated Patient #1 was not able to get up or do anything and “I don’t know, I didn’t know it was on there (POC).”

Documentation of competency evaluation CFR(s): 484.80(c)(5) The HHA must maintain documentation which demonstrates that the requirements of this standard have been met. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure documentation of the tasks listed at 484.80(b)(3)(i),(iii), (ix), (x) and (xi) were evaluated by observation of the hha performance of the tasks for 3 (hha E, hha F and hha G) of 3 hha personnel records reviewed. No evidence of documentation was found for observed skills competencies completed. This failure potentially placed patients who received hha services at risk for receiving substandard or unsafe care from hha’s when competency could not be verified. FINDINGS INCLUDE: On 09/25/2024, the surveyor was provided an employee roster with dates of hire that included: Hha E: Date of hire 02/05/2024 Hha F: Date of hire 09/22/2023 Hha G: Date of hire 03/24/2023 Hha, E: Review of the personnel record for hha E revealed job description for the position of hha dated 01/15/2024 and signed by hha E. A completed form titled, “Home Health Aide Competency Evaluation- Written Exam” was dated 01/17/2024. No hha observed skills competency verification was found in the record for hha G. Hha, F: Review of the personnel record for hha F revealed a job description for the position of hha dated 08/15/2023 and signed by hha F. A completed form titled, “Home Health Aide Competency Evaluation- Written Exam” was dated 08/22/2023. No hha observed skills competency verification was found in the record for hha f. Hha, G: Review of the personnel record for hha G revealed a job description for the position of hha dated 05/06/2024 and signed by hha G. No hha observed skills competency verification was found in the record for hha G. In an interview with the Administrator on 09/26/2024 at 4:15 PM, the surveyor reviewed the findings and asked if hha’s E, F and G performed skills competencies. The Administrator stated the hha’s had completed all their written and skills competencies. The surveyor asked why there was no documentation to verify completion of skills competencies for hha’s E, F and G. The Administrator stated the agency had moved in the last 2 years and hha competencies documentation could be lost or misplaced.