Every finding on record at Stonerise Reliable Healthcare, LLC

An emergency preparedness survey was conducted at Stonerise at Home from 10/12/21 to 10/14/21. The agency is in compliance with the Emergency Preparedness Conditions of Participation.

A recertification survey was conducted at Stonerise at Home from 10/12/21 to 10/14/21. The agency provides skilled nursing, physical therapy and occupational therapy services to Mercer and McDowell counties. The census at the time of the survey was thirty-eight (38). The unduplicated admissions for the past twelve (12) months were two hundred and nineteen (219). Four staff (4) members were interviewed, seven (7) medical records were reviewed and three (3) home visits were made. Two (2) standard level deficiencies were cited at G 514 and G 682.

RN performs assessment CFR(s): 484.55(a)(1) A registered nurse must conduct an initial assessment visit to determine the immediate care and support needs of the patient; and, for Medicare patients, to determine eligibility for the Medicare home health benefit, including homebound status. The initial assessment visit must be held either within 48 hours of referral, or within 48 hours of the patient's return home, or on the physician or allowed practitioner - ordered start of care date. This ELEMENT is not met as evidenced by: Based on record review and staff interview it was determined the facility failed to ensure the initial assessment was completed within forty-eight (48) hours after the referral was received in three (3) of seven (7) medical records reviewed (patients #2, 3 and 7). This failure has the potential to adversely affect all patients. Findings include: 1. A review of the medical record for patient #2 revealed an initial referral for home health services on 1/27/21 and a start of care date of 2/1/21. 2. A review of the medical record for patient #3 revealed an initial referral for home health services on 9/10/21 and a start of care date of 9/14/21. 3. A review of the medical record for patient #7 revealed an initial referral for home health services on 8/25/21 and a start of care date of 8/30/21. 4. An interview was conducted with the Administrator on 10/14/21 at 11:00 a.m. She concurred the initial assessments were not completed within forty-eight (48) hours after the referral was received.

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 and staff interview it was determined the facility failed to follow accepted standards of practice to prevent the transmission of infections and communicable diseases. This deficiency was identified in two (2) of three (3) home visits completed (patients #3 and 4). This deficiency has the potential to adversely affect all patients. Findings include: 1. A home visit was conducted with patient #3 on 10/13/21 at 9:45 a.m. Physical Therapy Assistant (PTA) #1 placed a barrier on the sofa and preceded to lay his/her IPAD and supply bag on the barrier. The PTA proceeded to clean the IPAD and placed it beside the supply bag. After removing the stethoscope and blood pressure cuff from the supply bag, the PTA proceeded to clean the stethoscope and blood pressure cuff and placed them on the barrier where the IPAD was laid prior to cleaning the IPAD. After completing the vital signs, the PTA laid the equipment back into the supply bag. No hand sanitizer was used prior to initiating care to the patient. 2. A home visit was conducted with patient #4 on 10/13/21 at approximately 9:00 a.m. Physical Therapist (PT) #1 placed a barrier on the patient’s table. The PT removed the pulse oximeter (ox) from the supply bag and proceeded to take the patient’s oxygen saturation. Once completed, the PT laid the pulse ox on the barrier after cleaning. The PT then proceeded to take the patient’s temperature; after completion, the PT cleaned the thermometer and laid it on the barrier with the pulse ox. The PT laid the dirty wipe beside the pulse ox machine on the barrier. The dirty wipe was touching the string of the pulse ox. The PT picked up the dirty wipe and laid it beside the supply bag then proceeded to remove the blood pressure cuff and stethoscope from the supply bag. After completing the vital signs, the PT cleaned the stethoscope and laid it on the barrier, where the dirty wipe was previously laid after the pulse ox was cleaned. No hand sanitizer was used prior to initiating care. 3. An interview was conducted with the Administrator on 10/14/21 at approximately 10:30 a.m. When informed of the infection control issues identified at each home visit, the administrator concurred staff did not follow accepted standards of practice.