Every finding on record at Pruitthealth Home Health, Inc.

A Recertification survey was conducted at PruittHealth At Home-Gainesville on February 3, 2025, and concluded on February 5, 2025. At the time of the survey, the agency was in compliance with Chapter 42 Part 418.113, Emergency Preparedness.

A Recertification Survey was conducted at Pruitt Health At Home-Gainesville on February 3, 2025, and concluded on February 5, 2025. At the time of the survey, the agency was not in compliance with Chapter 42 CFR Part 418, Rules and Requirements for Home Health and Hospice Agencies. The census was 381. The following deficiencies were cited.

Encoding and transmitting OASIS CFR(s): 484.45(a) Standard: An HHA must encode and electronically transmit each completed OASIS assessment to the CMS system, regarding each beneficiary with respect to which information is required to be transmitted (as determined by the Secretary), within 30 days of completing the assessment of the beneficiary. This STANDARD is not met as evidenced by: Based on the Centers for Medicare & Medicaid Services (CMS) Home Health Agency (HHA) Error Summary by agency report, policy “OASIS Data,” and staff interview, it was determined that the agency failed to electronically transmit monthly Outcome and Assessment Information Set (OASIS) data collected to the CMS system every 30 days. Findings include: Review of the policy titled “OASIS Data” last revised 02/08/2023, revealed the following: Procedure: The HHA will encode and electronically transmit each completed OASIS assessment to the CMS OASIS contractor regarding each beneficiary, with respect to which information is required to be transmitted (as determined by the Secretary), within 30 days of completing the assessment of the beneficiary. Review of CMS report titled “HHA Error Summary by Agency,” with report period of 01/01/2024-12/31/2024 and run date of 1/29/2025, revealed the agency failed to transmit OASIS data to CMS system within 30 days. During an in-office interview on 2/5/2025 at 12:00 pm, the Administrator confirmed awareness of the 30-day OASIS submission timeframe requirements not met during the time frame of 01/01/2024 - 12/31/2024. The Administrator explained the agency OASIS reviewing and submission process was delayed due to complications with the agency’s workflow, specifically with staffing issues. The Administrator confirmed the agency has a Performance Improvement Project (PIP), for OASIS late submission, currently in the agency’s Quality Assurance Performance Improvement (QAPI) program.

At the time of the survey, Pruitthealth At Home in Gainesville, Ga. was in compliance with 42 CFR Part 484.22 Emergency Preparedness for Home Health Agencies as a result of a recertification survey conducted on February 3, 2022. A Focus Infection Control Survey was completed at the time of the survey. No deficiencies were cited.

At the time of the Recertification survey, Pruitthealth At Home in Gainesville, Georgia was in substantial compliance with 42 CFR Part 484, Requirements for Home Health Agencies as a result of the survey conducted on February 3, 2022. A Focus Infection Control Survey was completed at the time of the survey. Current census 262. The follow deficiency was cited.

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 clinical record review, home visit observation and staff interviews, it was determined that the agency staff failed to comply with acceptable professional standards and principles while providing care and maintenance for supra pubic catheter change for 1 of 3 sampled patients (P) requiring catheter changes (#7). Findings are: 1. Review of the plan of care/treatment for patient #7 with a recertification date of 1/25/22 to 3/25/22 and a primary diagnosis of acute gastritis with bleeding required the skilled nurse (SN) to perform insertion/maintenance for foley catheter using 16 french 10cc balloon using aseptic technique monthly. During a home visit observation on 2/7/22 at 2:30 pm, this surveyor observed the SN perform a suprapubic catheter change. During the observation the SN cleansed hands and donned gloves to remove the existing catheter. After the catheter was removed, while still wearing the same gloves the SN donned a second pair of gloves and began to gather supplies to take the patient's vital signs. At this point the SN was wearing 2 pair of gloves. After the vital signs were obtained the SN gathered supplies for the catheter change while still wearing two pair of gloves. The SN then opened the sterile catheter kit and donned a pair of sterile gloves to perform the catheter change. At this time the SN was now wearing 3 pair of gloves. The only time the SN was observed washing/cleansing hands was when the first pair of gloves were donned at the beginning of the visit. According to the agency policy labeled "Suprapublic catheter replacement" with a revision date of 11/22/2016 required the SN to open all sterile packages using sterile technique and put on sterile gloves to remove the existing catheter, remove and discard your gloves, perform hand hygiene, put on new pair of sterile gloves, insert new catheter and discard gloves and cleanse hands. During an interview on 2/2/22 at 2:00 p.m. with the Administrator and Clinical Director, BB both confirmed the SN failed to follow policy and procedure for foley catheter changes to minimize the spread of infection.

Interventions and patient response CFR(s): 484.110(a)(2) All interventions, including medication administration, treatments, and services, and responses to those interventions; This ELEMENT is not met as evidenced by: Based on clinical record reviews and staff interviews, it was determined the agency staff failed to ensure that clinical records contained clear, complete and accurate documentation for 8 of 17 (#2, #5, #7,#10, #12, #13. #14 and #17) sampled patients (P). Findings were: 1.Review of the plan of care/treatment for patient #2 with a certification period of 1/18/22 to 3/18/22 and a diagnosis of displaced intertrochanteric fracture of left femur required the skilled nurse (SN) to obtain labs on 1/29/22 via venipuncture using aseptic technique for CBC with Auto Diff. The SN visited the patient on 1/29/21 and documented blood sample was obtained via venipuncture to right antecubital area. However, the SN failed to document the needle size used, which labs were obtained or the patient’s tolerance to the procedure. The SN failed to document the complete lab draw procedure. During an interview on 2/3/22 at approximately 10:00 a.m., the Administrator and Clinical Manager, BB confirmed the SN failed to document the complete lab draw procedure. 2. Review of the plan of care/treatment for patient #5 with a certification period of 12/23/21 to 2/20/22 and a diagnosis of fracture of unspecified part of the neck of left femur required the SN to provide wound care to the lower right buttock as follows: cleanse with dermal wound cleanser, pat dry with gauze, apply barrier cream, apply ABD pad, secure with paper tape. The SN visited the patient on 1/6, 1/19 and 1/26/22 and documented the wound care was performed and patient tolerated well. However, the SN failed to document the specific steps used to be perform wound care as required. During an interview on 2/3/22 at approximately 10:00 a.m., the Administrator and Clinical Manager, BB confirmed the SN failed to document the specific steps used to be perform wound care as required. 3. Review of the plan of care/treatment for patient #7 with a recertification period of 1/26/22 to 3/25/22 and a diagnosis of acute gastritis with bleeding required the SN to provide care and maintenance to the suprapubic catheter using a 16 french/10cc balloon with 10cc sterile water instilled in balloon. The SN visited the patient on 12/20/21 and documented the catheter was changed using a new 16 french foley however, the SN failed to document the balloon size used and amount of fluid instilled into the balloon. The SN failed to document the complete catheter change. During an interview on 2/3/22 at approximately 10:00 a.m., the Administrator and Clinical Manager, BB confirmed the SN failed to document the complete catheter change. 4. Review of the plan of care/treatment for patient #10 with a recertification period of 1/1/22 to 3/1/22 with a diagnosis of Chronic Obstructive Pulmonary Disease revealed the patient was on oxygen therapy continuous at 3-4 liters per minute however, the order does not specify the route of administration. The SN failed to obtain a complete oxygen order. Additionally, a verbal order dated 1/13/22 required the SN to provide wound care to the right lower quadrant as follows: cleanse area with wound cleanser and gauze, pat dry with gauze, apply siver AG foam or adhesive dressing for excess drainage two times a week for one week. The SN visited the patient on 1/13/22 and documented wound care was done per physician’s order. However, the SN failed to document the specific steps used to be perform wound care as required. During an interview on 2/3/22 at approximately 10:00 a.m., the Administrator and Clinical Manager, BB confirmed the SN failed to document the specific steps used to be perform wound care as required and failed to obtain a route for the use of oxygen therapy. 5. Review of the plan of care/treatment for patient #12 with a recertification period of 12/29/21 to 2/26/22 with a diagnosis of Encounter for change and removal of nonsurgical wound dressing revealed a verbal order dated 1/1/22 which required the SN to perform wound care to the left lateral nose as follows: cleanse wound with wound spray and gauze, pat dry with clean gauze, apply antibiotic ointment and cover with bordered gauze every other day. The SN visited the patient on 1/12/22 and documented wound care was done per orders. However, the SN failed to document the specific steps used to be perform wound care as required. During an interview on 2/3/22 at approximately 10:00 a.m., the Administrator and Clinical Manager, BB confirmed the SN failed to document the specific steps used to be perform wound care as required. 6. Review of the plan of care/treatment for patient #13 with a recertification period of 8/6/21 to 10/4/21 (closed record) with a diagnosis of Encounter for change and removal of nonsurgical wound dressing required the SN to provide wound care to the right knee as follows: using clean aseptic technique remove dressing and cleanse with wound cleanser, pat dry with gauze, apply skin prep to periwound, dress with iodosorb, cover with foam border dressing 3 times per week. SN to provide wound care to stage two pressure ulcer of perineum as follows: using clean/aseptic technique , remove dressing and cleanse with wound cleanser, pat dry with gauze, apply skin prep to periwound , pack with ½ inch packing strip moistened full strength dakins, cover with ABD pad two times weekly. May use comparable products. The SN visited the patient on 9/2, 9/5, 9/9, 9/13 and 9/17/21 and performed wound care however, the SN failed to document the specific steps used to perform wound care as required at each visit. During an interview on 2/3/22 at approximately 10:00 a.m., the Administrator and Clinical Manager, BB confirmed the SN failed to document the specific steps used to be perform wound care as required. 7. Review of the plan of care/treatment for patient #14 with a recertification period of 1/21/21 to 3/21/21 (closed record) with a diagnosis of Encounter for change and removal of nonsurgical wound dressing required the SN to perform wound care to the left heel as follows: using clean technique, clean with wound cleanser and 4X4, protect periwound skin with skin prep, apply hydrocel and cover with foam bordered dressing. Change three times weekly. The SN visited the patient on 2/1, 2/3, 2/5, 2/10 and 2/12/21 and performed wound care however, the SN failed to document the specific steps used to perform wound care as required at each visit. During an interview on 2/3/22 at approximately 10:00 a.m., the Administrator and Clinical Manager, BB confirmed the SN failed to document the specific steps used to be perform wound care as required. 8. Review of the plan or care/treatment for patient #17 with a recertification period of 5/5/21 to 7/3/21 (closed record) with a diagnosis of hemiplegia following cerebral vascular accident revealed the speech therapist (ST) visited the patient one time a week for 8 weeks. The ST visited the patient on 6/21/21 and discharged the patient however, the clinical record lacked a documentation of a discharge summary completed by the ST. The ST failed to complete the discharge summary to close out the episode of care. During an interview on 2/3/22 at approximately 10:00 a.m., the Administrator and Clinical Manager, BB confirmed the ST failed to complete the discharge summary to close out the episode of care.