Every finding on record at Rocky Mountain Home Care II, LLC

An Emergency Preparedness Recertification Survey was completed on 12/07/22. The agency was found to be in compliance with the regulatory requirements and standards of 42 Code of Federal Regulations (CFR) 484.22 Emergency Preparedness (EP) Final Rule Requirement for Condition of Participation for Home Health Agencies.

A recertification survey was completed 12/07/22. Standard level deficiencies were cited.

Last 5 days of every 60 days unless: CFR(s): 484.55(d)(1)(i,ii,iii) The last 5 days of every 60 days beginning with the start-of-care date, unless there is a- (i) Beneficiary elected transfer; (ii) Significant change in condition; or (iii) Discharge and return to the same HHA during the 60-day episode. This ELEMENT is not met as evidenced by: Based on interview and record review, the agency failed to complete a recertification assessment five days prior to the end of the 60 certification period for 1 (#2) of 10 sampled patients. Findings include: During an interview on 12/7/22, staff member A stated a recertification assessment should be completed during the last five days of the certification period. Review of patient #2's Plan of Care, with a certification period of 2/3/22 through 4/3/22, showed a recertification assessment should have been completed no later than 4/2/22, five days before the end of the certification period. Review of patient #2's recertification assessment showed a completion date of 4/5/22. Review of patient #2's physician order, dated 4/4/22, showed the recertification assessment was not done in the last five days of the episode due to clinician illness. Recertification would be completed on 4/5/22.

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 observation, interview, and record review, staff member B failed to follow proper infection control practices while performing wound care, related to changing gloves between clean and dirty tasks for 1 (#7) of 4 sampled patients. This deficient practice had the potential to further increase infection in patient #7’s open wound. Findings include: Review of patient #7’s plan of care, with a start of care on 6/29/22 and a certification period of 10/27/22 to 12/25/22, showed a primary diagnosis of “Infection of Amputation Stump, Left Lower Extremity.” Patient #7 had his left great toe amputated. During an observation on 12/6/22 at 10:02 a.m., staff member B had removed the old dressing from patient #7’s left foot. Staff member doffed her gloves, sanitized her hands, and donned clean gloves. Staff member B dug through two boxes on patient #7’s kitchen table which held wound supplies with the clean gloves on. Staff member B removed several supplies from the boxes, placed them on the barrier, on the table. Staff member B proceeded to cleanse the wound, without a clean barrier under patient #7’s left foot. Staff member B did not doff or don clean gloves after cleansing the wound, but instead sanitized the existing gloves on her hands. Staff member B again dug through the supply boxes on the kitchen table and placed them on the barrier on the table. Staff member B again sanitized her existing, dirty gloves without changing the gloves. Staff member B proceeded with the prescribed treatment applications and gauze wrap, covering patient #7’s wound. Staff member B failed to properly doff dirty gloves and don clean gloves before performing a clean procedure. which had the potential to further increase infection in patient #7’s open wound. During an interview on 12/6/22 at 10:36 a.m., staff member B stated she believed the boxes which held the wound supplies was a clean task and she did not need to change gloves after removing the supplies. Staff member B stated she felt sanitizing her gloves was sufficient and the same practice as doffing the gloves, sanitizing her hands, and donning new, clean gloves. During an interview on 12/6/22 at 11:10 a.m., staff member A stated sanitizing gloves on your hands was not the best infection control practice and did not replace the process of doffing dirty gloves, sanitizing your hands, and donning clean gloves during a wound dressing procedure. Staff member A stated this placed the patient at risk for further infection.