Every finding on record at Recover Health of Iowa, Inc.

Aveanna Home Health is in compliance with 42 CFR 484.102 Condition of Participation for Home Health Agencies,

Conformance with physician orders CFR(s): 484.60(b) Standard: Conformance with physician or allowed practitioner orders. This STANDARD is not met as evidenced by: Based on record review, policy and procedure review, and staff interview, the agency failed to notify the physician as ordered on the plan of care for 1 of 8 patient records reviewed (Patient- 6). The census was 47. A. Review of the agency policy and procedure titled, Client's Plan of Care (POC), V 12.18.17, revealed drugs, services, and treatments are ordered by the physician that establishes and periodically reviews the plan of care, and are to be administered as ordered. B. Review of Patient-6's clinical record revealed: 1. The Home Health Certification and Plan of Care for the certification period of 7/19/21 through 9/16/21 and 9/17/21 through 11/15/21 included orders to notify the physician for any systolic (the top number, measures the force your heart exerts on the walls of your arteries each time it beats) and/or diastolic (the bottom number, measures the force your heart exerts on the walls of your arteries in between beats) blood pressure less than 90/50 millimeters mercury (mmHg) or greater than 180/110 mmHg. 2. Skilled Visit Notes by the agency nurse revealed the patients blood pressure was 192/106 on 8/26/21, 202/106 on 9/2/21, 192/86 on 9/9/21, 202/106 on 9/21/21, 216/106 on 10/11/21. 3. There was no documentation in the clinical record that the patient's physician was notified of the blood pressure reading on 8/26/21, 9/2/21, 9/9/21 or 10/11/21. C. During an interview on 1/13/22 at 4:30 PM, the Administrator and the Clinical Manager confirmed the patient's nurse did not follow the agency policy for following the physician orders on the plan of care when the nurse failed to notify the patient's physician when the patient's blood pressures were outside the physician established parameters as ordered on the plan of care.

Revised plan of care CFR(s): 484.60(c)(2) A revised plan of care must reflect current information from the patient's updated comprehensive assessment, and contain information concerning the patient's progress toward the measurable outcomes and goals identified by the HHA and patient in the plan of care. This ELEMENT is not met as evidenced by: Based on record review, policy and procedure review, and staff interview, the agency failed to include the progress towards the patient and agency identified measurable outcomes and goals on the plan of care for 3 of 3 patients who had a revised/updated plan of care (Patient 2, 4, and 6). The total sample size was 8, the census was 47. A. Review of the agency policy and procedure titled, Client's Plan of Care (POC) V12.18.17, revealed the revised plan of care was to reflect current information from the patients updated comprehensive assessment, and contain information concerning the patient's progress toward the measurable outcomes and goals identified by the home health agency and the patient. B. Review of clinical records revealed: 1. Patient 2's revised/updated plan of care for the certification periods of 10/23/21 through 12/21/21 and 12/22/21 through 2/19/22 did not include information concerning the patient's progress toward the measurable outcomes and goals identified by the home health agency and the patient. 2. Patient 4's revised/updated plan of care for the certification periods of 9/22/21 through 11/20/21 and 11/21/21 through 1/19/22 did not include information concerning the patient's progress toward the measurable outcomes and goals identified by the home health agency and the patient. 3. Patient 6's revised/updated plan of care for the certification period of 9/17/21 through 11/15/21 did not include information concerning the patient's progress toward the measurable outcomes and goals identified by the home health agency and the patient. C. During an interview on 1/13/22 at 4:30 PM the Administrator and the Clinical Manager confirmed the revised/updated plan of care (as listed in 1, 2, and 3 above) for Patient 2, 4, and 6, did not include information concerning the patient's progress toward the measurable outcomes and goals identified by the home health agency and the patient.