Every finding on record at Recover Health of Iowa, Inc

A complaint investigation for complaint #70810-C was conducted by the Department of Inspections and Appeals from 7/18/22 to 7/20/22. The allegation related to 42 CFR 484.105 Organization and Administration of Services: was Unsubstantiated with no deficiencies. The allegation related to 42 CFR 484.75 Skilled Professional Services: was Unsubstantiated with no deficiencies. The allegation related to 42 CFR 484.60 Care Planning, Coordination, Quality of Care: was Substantiated with deficiencies. The allegation related to 42 CFR 484.50 Patient Rights: was Unsubstantiated with no deficiencies. The survey investigation found the agency to have standard level deficiencies in the above mentioned Condition of Participation, but to be, overall, in substantial compliance with the Conditions of Participation. The agency reported a census of no current patients at the time of the survey.

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 agency policy review, clinical record review and agency staff interviews, the agency failed to follow a Plan of Care established and periodically reviewed by a physician or notify the physician of the need to vary frequency of visits or inability to perform treatments/services as originally ordered on the Plan for Care for 1 of 3 sampled patients (Patients #2). Failure to follow a Plan of Care established by a physician placed patients at risk of not receiving safe, individualized and consistent care designed to meet each patient's health care needs. Findings include: According to the agency policy titled Missed Services, dated 1/19/18, if the agency misses visits or services as required by the plan of care, it must notify the responsible physician of the missed visit. If the agency is consistently unable to provide services ordered, it must be evident and documented that the agency has made attempts to fill the hours and/or to refer the hours to another provider and the physician must be notified. 1. Patient #2 had a start of care date of 8/11/21 and date of discharge of 12/8/21. The patient received skilled nursing and home health aide services and had a diagnosis if diabetes mellitus. Clinical record review and associated agency staff interviews revealed the following: a. The Plans of Care, dated 10/10/21 to 12/8/21, included physician orders for skilled nursing services 1 visit per week and home health aide services 3 visits per week. b. Home Health Aide notes for the week of 11/28/21 through 12/4/21, revealed services provided 1 home health aide visit completed on 12/1/21. c. The Missed Services and Physician Notification Report, dated 11/11/21, lacked notification of the remaining 2 visits when services provided failed to meet the 3 visit per week requirements. d. Home Health Aide notes for the week of 12/5/21 through 12/11/21, revealed services provided no home health aide visits completed and the patient discharged on 12/8/21. c. The Missed Services and Physician Notification Report, dated 11/11/21, lacked notification of the missed 3 visits when services provided failed to meet the 3 visit per week requirements. During an interview on 7/20/22 at 9:25 AM, Staff D, Administrator stated no home health aide visit occurred and no missed visit notification documented. The above stated finding reviewed with Staff D, Administrator. No further information provided prior to the end of the survey.