Every finding on record at Royal Homecare Agency

Substantial Allegation Survey Substantial Allegation 109177 At the time of the substantial allegation survey completed on 09/30/24, no deficiencies were issued in regard to allegations contained in substantial allegation number 109177; however, the facility was found not to be in compliance with all requirements for home health agency's participation and the following deficiency is cited. Royal Homecare Agency is not in compliance with the requirements found at 42 CFR Part 484, Subpart B, C for Home Health Agency.

Only as ordered by a physician CFR(s): 484.60(b)(1) Drugs, services, and treatments are administered only as ordered by a physician or allowed practitioner. This ELEMENT is not met as evidenced by: Based on record review, staff interview, and review of policy, the agency failed to ensure services were provided under a physician’s order. This affected two (Patient #1 and Patient #3) out of three patient records reviewed. The census was 44. 1. Review of the medical record for Patient #3 did not reveal physician’s orders for the home health aide (HHA). Review of the HHA Staff B time sheets for Patient #3 revealed HHA Staff B provided service daily from 04/28/24 through 05/04/24, from 05/06/24 through 05/18/24, 05/20/24 through 05/25/24, 05/27/through 06/01/24, and 06/03/24 through 06/08/24. 2. Review of the medical record for Patient #1 revealed an unsigned physician's plan of care dated 07/20/24 through 09/17/24. Review of the skilled nurse (SN) visit sheets revealed the SN made visits to Patient #1 on 07/22/24, 07/29/24, 08/05/24, 08/15/24, 08/15/24, 08/20/24 and 08/26/24. Review of the undated agency policy titled "Plan of Care – CMS #485 and Physician’s Orders," revealed care and services provided will be provided according to physician’s orders. Interview on 09/30/24 at 2:46 PM, Staff C confirmed these visits were made for Patient #3 and Patient #1 without a physician's order. Review of the agency policy titled Plan of Care – CMS #485 and Physician’s Orders with no effective date revealed care and services provided will be provided according to physician’s orders.