Every finding on record at Reliant Home Health, LLC

The Oklahoma State Department of Health conducted an unannounced Emergency Preparedness Program survey at the agency on 05/18/19 to 05/19/26. A deficiency was cited as a result of the Emergency Preparedness Program survey.

Emergency Officials Contact Information CFR(s): 484.102(c)(2) §403.748(c)(2), §416.54(c)(2), §418.113(c)(2), §441.184(c)(2), §460.84(c)(2), §482.15(c)(2), §483.73(c)(2), §483.475(c)(2), §484.102(c)(2), §485.68(c)(2), §485.542(c)(2), §485.625(c)(2), §485.727(c)(2), §485.920(c)(2), §486.360(c)(2), §491.12(c)(2), §494.62(c)(2). [(c) The [facility] must develop and maintain an emergency preparedness communication plan that complies with Federal, State and local laws and must be reviewed and updated at least every 2 years [annually for LTC facilities]. The communication plan must include all of the following: (2) Contact information for the following: (i) Federal, State, tribal, regional, and local emergency preparedness staff. (ii) Other sources of assistance. *[For LTC Facilities at §483.73(c):] (2) Contact information for the following: (i) Federal, State, tribal, regional, and local emergency preparedness staff. (ii) The State Licensing and Certification Agency. (iii) The Office of the State Long-Term Care Ombudsman. (iv) Other sources of assistance. *[For ICF/IIDs at §483.475(c):] (2) Contact information for the following: (i) Federal, State, tribal, regional, and local emergency preparedness staff. (ii) Other sources of assistance. (iii) The State Licensing and Certification Agency. (iv) The State Protection and Advocacy Agency. This STANDARD is not met as evidenced by: Based on record review and interview, the agency failed to ensure the communication plan included contact information for Federal, State, tribal, regional, and local emergency preparedness staff for all current staff and patients. Findings: A request for contact information for Federal, State, tribal, regional, and local emergency preparedness staff yielded no results. On 05/19/26 at 11:30 AM, Staff B stated there was no contact information for the emergency preparedness resources.

The Oklahoma State Department of Health conducted an unannounced Medicare re-certification survey and complaint (#100628 and 10199) survey at the agency on 05/18/26 to 05/19/26. An entrance survey was conducted with Staff A; the survey process was explained. Questions were answered. Staff B was identified as the contact person for administrative issues, and Staff A was identified as the contact person for clinical issues. Findings were discussed with Staff A, B, and C. Standard level deficiencies were cited as a result of the Medicare re-certification survey. No citations were cited related to complaints #100628 and 10199. Glossary: BP - Blood Pressure PIP - Performance Improvement Project Pt - Patient QAPI - Quality Assessment Performance Improvement VS - Vital Sign

Communication with all physicians CFR(s): 484.60(d)(1) Standard: Coordination of Care. The HHA must: (1) Assure communication with all physicians or allowed practitioners involved in the plan of care. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure that VS above ordered parameters were reported to the physician for one (Pt #3) of fifteen patients. Findings: Pt #3 A review of a plan of care dated 12/27/26 to 02/24/26 showed orders to notify the physician of: Pulse greater than 110 and a Systolic BP greater than 160. A nurse's note dated 12/31/25 showed a heart rate of 120 apical and a BP of 168/88 with no physician notification of elevated heart rate or systolic BP. A nurse's note dated 01/29/26 showed a heart rate of 115 apical and a BP of 162/88 with no physician notification of elevated heart rate or systolic BP. On 5/19/26 at 1:27 p.m., Staff A stated there was no physician notification of the vital signs outside of parameters.

Visit schedule CFR(s): 484.60(e)(1) Visit schedule, including frequency of visits by HHA personnel and personnel acting on behalf of the HHA. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure an ordered discipline evaluation was completed for one (Pt #1) of fifteen patients. Findings: Pt #1 A review of a plan of care dated 11/07/25 to 01/05/26 had an order written 11/07/26 for Occupational Therapy to evaluate the week of 11/09/26. Documentation showed no Occupational Therapy evaluation the week of 11/09/22, no patient refusal, no physician's order to discontinue the evaluation, and no missed visit. On 05/19/26 at 1:22 p.m., Staff A stated there is no Occupational Therapy evaluation.

Executive responsibilities for QAPI CFR(s): 484.65(e)(1)(2)(3)(4) Standard: Executive responsibilities. The HHA's governing body is responsible for ensuring the following: (1) That an ongoing program for quality improvement and patient safety is defined, implemented, and maintained; (2) That the HHA-wide quality assessment and performance improvement efforts address priorities for improved quality of care and patient safety, and that all improvement actions are evaluated for effectiveness; (3) That clear expectations for patient safety are established, implemented, and maintained; and (4) That any findings of fraud or waste are appropriately addressed. This STANDARD is not met as evidenced by: Based on record review and interview, the agency failed to ensure PIP met requirements for all patients and employees. A review of PIPs QAPI Action Plans showed no: 1. Complete date the PIP was implemented.2. Goal for the PIP.3. Phase of the PIP.4. Interventions for the PIP.5. Data to be tracked to analyze progress toward set goals. On 05/19/26 at 12:20 p.m., Staff B stated the QAPI Action Plan did not contain all necessary information.

The Oklahoma State Department of Health conducted an unannounced Medicare Emergency Preparedness Program survey at the agency on 06/13/23 to 06/14/23. No deficiencies were cited as a result of the Emergency Preparedness Program survey.

The Oklahoma State Department of Health conducted an unannounced Medicare re-certification survey in conjunction with a complaint (98954) survey at the agency on 06/13/23 to 06/14/23. An entrance conference was conducted with Staff A. The survey process was explained. Questions were answered. Staff A and B were identified as the contact persons for clinical and administrative issues. Findings were discussed during an informal exit conference with Staff B. Standard level deficiencies were cited as a result of the Medicare re-certification survey.

Plan of care must include the following CFR(s): 484.60(a)(2)(i-xvi) The individualized plan of care must include the following: (i) All pertinent diagnoses; (ii) The patient's mental, psychosocial, and cognitive status; (iii) The types of services, supplies, and equipment required; (iv) The frequency and duration of visits to be made; (v) Prognosis; (vi) Rehabilitation potential; (vii) Functional limitations; (viii) Activities permitted; (ix) Nutritional requirements; (x) All medications and treatments; (xi) Safety measures to protect against injury; (xii) A description of the patient's risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors. (xiii) Patient and caregiver education and training to facilitate timely discharge; (xiv) Patient-specific interventions and education; measurable outcomes and goals identified by the HHA and the patient; (xv) Information related to any advanced directives; and (xvi) Any additional items the HHA or physician or allowed practitioner may choose to include. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure an individualized plan of care included weight parameters for one (Patient #5) of 13 patients. Patient #5 A review of the plan of care dated 04/20/23 to 06/18/23 showed a primary diagnosis of hypertensive chronic kidney disease. There were no documented weight parameters or orders to obtain or assess significant weight loss or weight gain. Skilled nurse assessments dated 03/28/23, 94/04/23, 04/17/23, 05/04/23, 05/09/23 and 05/17/23 documented no weights. On 06/14/23 at 2:40 pm, Staff B stated weight parameters should have been ordered in relation to the disease process for Patient #5.

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 and interview, the agency failed to ensure the skilled nurse visit frequency was followed as ordered on the plan of care for two (Patient #3 and 4) of thirteen patients. Patient #3 A review of the plan of care dated 03/13/23 to 05/11/23 showed orders for skilled nurse frequency of one visit per week for nine weeks and documented the physician to be notified of weight less than 155 pounds. A skilled nurse assessment dated 04/12/23 documented a weight of 152 pounds with no physician notification. A skilled nurse assessment dated 04/26/23 documented a weight of 148 pounds with no physician notification. A skilled nurse assessment dated 05/03/23 documented a weight of 148 pounds with no physician notification. A skilled nurse assessment dated 05/10/23 documented a weight of 152 pounds with no physician notification. Patient #4 A review of the plan of care dated 03/22/23 to 05/20/23 showed orders for skilled nurse frequency of one visit per week for nine weeks and documented the physician to be notified of weight greater than 148 pounds. A skilled nurse assessment dated 04/20/23 documented a weight of 150.08 pounds with no physician notification. A skilled nurse assessment dated 05/05/23 documented a weight of 148.2 pounds with no physician notification. On 06/14/23 at 2:35 am, Staff A stated the physician should have been notified of the weights outside parameters for Patients #3 and 4.