Every finding on record at Stratford VNA

E Tag 000 Unannounced visits were concluded at Stratford VNA on 2/6/25 for the purpose of reviewing the Emergency Preparedness Code of Federal Regulations at §484.102, Condition of Participation for Home Health Agencies (HHA). The agency was in compliance with the requirements at the time of the survey.

An Unannounced visit concluded at Stratford VNA on 2/6/25 for the purpose of review of the Federal Code of Regulations for Home Health Agencies 42 CFR 418.0 for a Federal recertification and state re-licensure. The agency was in substantial compliance at the time of the survey. Standard level deficiencies were identified.

Interdisciplinary assessment of the patient CFR(s): 484.75(b)(1) Ongoing interdisciplinary assessment of the patient; This ELEMENT is not met as evidenced by: Based on clinical record review and interview with agency personnel, for one of four patient’s (Patient #13) requiring blood glucose monitoring for a diagnosis of type II diabetes mellitus, the agency’s nurses failed to provide the necessary assessments. The findings include: Patient #13 had a start of care date of 11/18/24 and diagnoses that included right hemiplegia following a cerebral infarct, type II diabetes mellitus and chronic kidney disease. The physician's orders dated 11/18/24 included nursing services one to three times a week for assessments including blood glucose monitoring and results. Interview and review of the clinical record from 11/18/24 through 12/30/24 with the Supervisor of Clinical Services/SCS on 2/06/25 at 1:30 PM failed to identify evaluation of the patient’s blood glucose on 11/20/24, 11/27/24, 12/03/24, 12/05/24 and 12/09/24 according to the physician’s plan of care.

Unannounced survey was conducted at Stratford VNA Stratford, CT on 11/16/22 for the purpose of Complaint survey # CT 94271 At the time of this survey a standard level deficiency was identified.

Rights of the patient CFR(s): 484.50(c) The patient has the right to- This STANDARD is not met as evidenced by: Based on clinical record review, staff interview, review of agency documentation, and review of agency policies, the home health agency failed to identify the Registered Nurse (RN #1) follow the agency policy for patient rights, and to respect the rights, privilege's and preferences of the patient in providing care. The finding includes: Patient #1 had a start of care date of 8/2/22 to the agency, with admitting diagnoses to include deep incisional surgical wound to the left lower abdomen, colostomy moved to the right abdomen, malignant rectum neoplasm, and depression. The physician certification period for the date 8/2/22 through 9/30/22 indicated that Patient #1 received skilled nursing 1 to 3 times per week to provide wound care and assess wound vacuum suction device. Review of agency documentation with the President and Vice President (VP) of the agency on November 15, 2022, at 1:37pm, identified that on Friday 8/18/22, Patient #1 requested the on-call nurse (RN#1) to visit her residence due to a malfunctioning wound vacuum suction device. Patient #1 indicated when the on-call RN #1 called back, the RN indicated that a visit was not going to be made, "it’s too far away, too much traffic", and RN #1 further stated that he/she needed to wait for his/her spouse to get home for a ride to the visit. RN#1 indicated to Patient #1 that he/she (RN #1) could talk the patient through a" trouble shooting process over the phone" to fix the wound vacuum suction system, but Patient #1 refused the phone education, and stated to RN #1 that he/she was not a nurse, and that he/she wanted an in person nursing visit to fix the problem. Upon RN #1's arrival into the home, RN #1 stated to Patient #1 “let’s go, get into the bedroom", RN #1 further stated to patient, that she was never coming again to Patient #1’s house. Patient further stated that RN #1 was very rude, bossing patient around her bedroom, and indicated that patient did not need a nursing visit that evening and that he/she could have fixed the problem him/herself. Interview with the patient on November 15, 2022, at 9:27am identified, that a call was placed to the agency on-call RN, requesting a nursing visit to assist with a malfunctioning wound vacuum suction device. Patient #1 was told by the on-call RN, that he/she could not come out to the home, "it’s too far away, too much traffic", and RN #1 further stated that he/she needed to wait for his/her spouse to get home for a ride to the visit. RN#1 indicated to Patient #1 that he/she could talk the patient through a" trouble shooting process" to fix the wound vacuum suction system, but Patient #1 refused the phone education, and stated to RN #1 that he/she was not a nurse, and that he/she wanted an in person nursing visit to fix the problem. Upon the on-call nurse's arrival at Patient #1's home later in the evening, and upon entering the home, RN #1 told the patient, " I'm never coming out here again," and I'm going to teach you how to do this, “let’s go, get into the bedroom". Patient #1 further stated that RN #1 was very rude, bossing patient around her bedroom, and repeatedly stated that the patient did not need a nursing visit, that evening, and that he/she could have fixed the problem him/herself. At the conclusion of the visit, RN # 1 pointed her finger at the patient and told her not to call her again, that she, (Patient #1) could have done the wound vacuum suction device repair herself, and that the onsite visit wasn't necessary. Review of agency investigation with the President and Vice President of the agency on 11/15/2022 at 1:40pm, identified an investigation was initiated and completed by the agency, resulting in the termination of the staff member as a result of the substantiation of the complaint allegations, and violation of the agency policy on conduct of internal and external customers. Review of the agency policy regarding patient rights, advises that all personnel will adhere to the agency conduct in the care of internal and external customers