Every finding on record at Reputable Health Care Inc

An unannounced Complaint survey, #2023007882 was attempted but unable to be conducted on 07/05/2023 at Reputable Health Care Inc., Home Health Agency provider. The provider is not in compliance with 42 CFR (Code Of Federal Regulations) Part 484, Subpart A-C, Conditions of Participation for Home Health Agencies.

Available during all operating hours CFR(s): 484.105(b)(3) The administrator or a pre-designated person is available during all operating hours. This ELEMENT is not met as evidenced by: Based on observation and record review the Home Health Agency (HHA) failed to ensure the Administrator or an alternate person designated by the Administrator was available during the HHA's operating hours, Monday to Friday, 9:00 AM to 5:00 PM. The findings include: Observation, on Wednesday, 07/05/23 at 2:35 PM, at the HHA’s location reveals the front door locked with a "sign" taped inside the glass door documenting, “Sorry we are currently out working in the field we will be back soon. Thank you” and lettering on the door that documents, “Monday – Friday 9:00 am – 5:00 pm” and “After Hours” followed by the HHA’s telephone number. Continued observation on 07/05/23 at 2:35 PM through the HHA's glass front door reveals the HHA's lights were off, and no persons could be seen inside. On 07/05/23 at 2:36 PM, the telephone number on the HHA’s door, which is also the same telephone number on the HHA’s 2020 relicensure application, was called and the call went promptly to an automated outgoing message asking the caller to select an option to proceed, and after selecting to reach the Administrator by pressing the stated number, the call went to "hold" for several seconds before disconnecting without hearing any ringing or any sounds of a person answering the call. On 07/05/23 at 2:37 PM, the same telephone number, for the HHA was called and again the call went promptly to an automated outgoing message asking the caller to select an option, and after selecting to reach the Director of Nursing by pressing the stated number, the call went to hold for several seconds before disconnecting the call. On 07/05/23 at 2:38 PM, the same telephone number for the HHA was called and the call went promptly to an automated outgoing message asking the caller to select an option and, after selecting to reach the “Operator” by pressing the stated number “0,” the call went to hold for several seconds before disconnecting the call. Review of the HHA’s 2020 relicensure application reveals the same telephone number observed on the HHA’s front door is listed for each of the HHA's staff with no alternate telephone numbers to reach any staff except for one telephone number, a “1” followed by 6 digits of the main telephone number already provided. On 07/05/23,from 2:35 PM until 3:41 PM, the surveyor remained in direct line of sight to the front door with no persons observed to be seen to enter or leave, and door signage unchanged and further observation that the office lights were off, and no persons were visible in the HHA's office.

During the Recertification survey commenced on 12/28/2020 and concluded on 01/05/2021 at Reputable Health Care Inc., Emergency Preparedness was reviewed. Reputable Health Care Inc. is not in compliance with Emergency Preparedness per Code of Federal Regulations (CFR) 42, Part 484. 102, Condition of Participation for Home Health Agencies.

Develop EP Plan, Review and Update Annually CFR(s): 484.102(a) The [facility] must comply with all applicable Federal, State and local emergency preparedness requirements. The [facility] must develop establish and maintain a comprehensive emergency preparedness program that meets the requirements of this section. The emergency preparedness program must include, but not be limited to, the following elements: (a) Emergency Plan. The [facility] must develop and maintain an emergency preparedness plan that must be [reviewed], and updated at least every 2 years. The plan must do all of the following: * [For hospitals at §482.15 and CAHs at §485.625(a):] Emergency Plan. The [hospital or CAH] must comply with all applicable Federal, State, and local emergency preparedness requirements. The [hospital or CAH] must develop and maintain a comprehensive emergency preparedness program that meets the requirements of this section, utilizing an all-hazards approach. * [For LTC Facilities at §483.73(a):] Emergency Plan. The LTC facility must develop and maintain an emergency preparedness plan that must be reviewed and updated at least annually. * [For ESRD Facilities at §494.62(a):] Emergency Plan. The ESRD facility must develop and maintain an emergency preparedness plan that must be [evaluated], and updated at least every 2 years. This STANDARD is not met as evidenced by: Based on record review and interview, the Home Health Agency failed to ensure their Comprehensive Emergency Management Plan (CEMP) was approved by the State of Florida local County Health Department as required. The findings included, Review of the Home Health Agency's CEMP documentation reveals no evidence of an "Approval" letter from the State of Florida local County Department of Health. During an interview with the Administrator on 01/5/21 at 3:30 PM, she acknowledged the findings.

An unannounced Recertification survey was commenced on 12/28/2020 and concluded on 01/05/2021 at Reputable Health Care Inc., Home Health Agency provider. The provider was not in compliance with 42 CFR Part 484 Subpart A-C, Conditions of Participation for Home Health Agencies.

Home health aide assignments and duties CFR(s): 484.80(g)(1) Standard: Home health aide assignments and duties. Home health aides are assigned to a specific patient by a registered nurse or other appropriate skilled professional, with written patient care instructions for a home health aide prepared by that registered nurse or other appropriate skilled professional (that is, physical therapist, speech-language pathologist, or occupational therapist). This STANDARD is not met as evidenced by: Based on record review and interview, the Home Health Agency failed to ensure their Home Health Aide followed the written instructions prepared by the Registered Nurse for 1 of 9 sampled patients as evidenced by Home Health Aide's failure to follow the written Plan of Care instructions (Patient #1). The findings included: Review of Patient #1's record reveals a "Start of Care date of 6/1/19 and a Home Health Certificate and Plan of Care for the certification period, 10/6/20 to 12/5/20 that documents orders for a Home Health Aide for 61 hours a week for Patient #1. Review of the "Home Health Aide Care Plan," dated 10/23/20 and signed by the Registered Nurse, lacks evidence of documentation regarding "medication assistance" or "medication reminder" for Patient #1. Review of Patient #1's "Home Health Aide Task" forms dated 11/1/20 to 11/7/20 and 11/30/20 to 12/4/20 documents the Home Health Aide provided care and services for 9 hours daily that included "assistance with medications." Review of Patient #1's record lacked evidence of documentation of the Home Health Aide's notification to the Home Health Agency for the need to review and or revise the written instructions for Patient #1. During an interview on 12/28/20 at 2:56 PM, a side-by-side review of Patient #1's record was conducted with the Administrator who acknowledged the findings.