Every finding on record at State Health Care, Ltd

EMERGENCY PREPAREDNESS SURVEY At the time of the emergency preparedness survey completed on 04/06/22, State Health Care, LTD is in compliance with the provisions at 42 CFR Part 484.102, Conditions of Participation for Home Health Agencies.

Partial Extended Recertification Survey The following deficiency is based on the partial extended recertification survey completed on 04/06/22. State Health Care, LTD 368404, is not in compliance with the requirements found at 42 CFR Part 484, Subpart B, C for Home Health Agencies.

Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician or allowed practitioner refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician or allowed practitioner is consulted to approve additions or modifications to the original plan. This STANDARD is not met as evidenced by: Based on record review, interview and policy review, the agency failed to ensure each patient received home health agency services as written in the plan of care for one of seven medical records reviewed (Patient #5). The total census was 51. Findings include: Review of the policy and procedure titled, POC-CMS-#485 and Physician Orders, revised 2009, revealed skilled nursing and other home health aide services will be in accordance with the plan of care based on patient diagnosis and assessment of immediate and long range needs and resources. The plan of care includes frequency of visits and duration and is established in consultation with the physician, agency staff, the patient and members of the patient's family. The agency staff will promptly alert the physician to any changes that suggest a need to alter the plan of care. Review of the medical record for Patient #5 revealed the patient was admitted to the agency on 11/30/19 with a primary diagnosis of chronic obstructive pulmonary disease (COPD). Review of the certification period dated 01/18/22 to 03/18/22 and 03/19/22 through 05/17/22 revealed orders for home health aide (HHA) services 21 hours a week. Review of the home health aide time sheets from 01/02/22 to 03/12/22 revealed Patient #5 was receiving HHA services for 25 hours a week. Review of a waiver authorization confirmation start date of 01/01/22 to 03/31/22 revealed personal care hours for 25 hours a week. Interview with Staff A on 04/06/22 at 3:18 PM revealed Patient #5 was still receiving 25 hours of HHA services for the certification period of 03/19/22 to 05/18/22.