Every finding on record at Sunset Home Health Services LLC

An unannounced focused infection control and complaint survey for #2021017398 was conducted on 4/11/22 at Sunset Home Health Services, a home health agency in Cape Coral, Florida. Complaint #2021017398 was substantiated at G608. Sunset Home Health Services is in compliance with Code of Federal Regulations (CFR) 42, Part 484, Conditions of Participation for Home Health Services. The following is a description of the Standard level noncompliance.

Coordinate care delivery CFR(s): 484.60(d)(4) Coordinate care delivery to meet the patient's needs, and involve the patient, representative (if any), and caregiver(s), as appropriate, in the coordination of care activities. This ELEMENT is not met as evidenced by: Based on medical record review, and interviews, the home health agency failed to ensure that once the they accepted a patient; the patient is to received the expected services as ordered for 1 (Patient #1) of 3 patients sampled. The home health agency failed to coordinate with the patient, the patient's case manager and the patient's physician to ensure the appropriateness of service delivery. Record review revealed Patient #1 was admitted to the home health agency on 6/28/21 to receive skill nursing services. The patient is a child requiring services for feeding tube, C-pap at night, medication administration, and incontinence care. The patient health history includes asthma. The Start of Care Certified Plan of Care form, physician orders note skill services are to be provided 24 hours a day for 7 days a week. Interview on 4/1/22 at 8:33am, Patient #1's family member said, “She still has the agency as a provider because she cannot find anyone else to take the case. She still has a lot of concerns. The agency is supposed to provide care for her son 24/7, 7 days a week but she has to provide the care Monday through Thursday from 7:00 a.m. to 7:00 p.m. and 24/7 on Saturdays. She said she never knows when anyone will show up and when she talks to the director, she is told by the director that she does not have to tell her the schedule; does not have to tell her anything and spends more time telling the complainant what the agency is not going to do. She said she has had to stop working at her homecare company because she has to stay home and care for her son because the agency does not provide staff to deliver the care.” Interview on 4/11/22 at 10:55 a.m., the Home Health Agency's Administration said, "Yes, I see that some of the evening visits were not done. The visits are 2 twelve-hour shifts. There is no reason as to why they were missed." Missed hours for Patient #1 as follows: Episode 6/28/2021 - 8/26/2021: 7/2/2021 - 12 hours a day 7/3/2021 - 10 hours a night 7/4/2021 - 10 hours a night 7/10/2021 - 12 hours a night 7/17/2021 - 12 hours a day 7/25/2021 - 10 hours a day 7/31/2021 - 11 hours a day 8/1/2021 - 11 hours a day 8/11/2021 - 12 hours a day 8/14/2021 - 11 hours a night 8/19/2021 - 12 hours a night 8/21/2021 - 10.5 hours a day 8/22/2021 - 12 hours a day Episode 8/27/2021 - 10/25/2021: 8/28/2021 - 12hours a night 8/29/2021 - 24 hours 9/3/2021 - 12 hours a day 9/10/2021 - 12 hours a day 9/11/2021 - 12 hours a night 9/12/2021 - 24 hours 9/17/2021 - 12 hours a day 9/19/2021 - 16 hours a night 9/25/2021 - 12 hours a night 9/26/2021 - 12 hours a night 10/2/2021 - 12 hours a night 10/9/2021 - 12 hours a night 10/10/2021 - 12 hours a night 10/16/2021 - 12 hours a night 10/23/2021 - 12 hours a night Episode 10/26/2021 - 12/24/2021: 11/6/2021 - 11 hours a day 11/13/2021 - 8.5 hours a night 11/20/2021 - 8.5 hours a night 11/27/2021 - 8 hours a night 12/1/2021 - 11 hours a day Episode 12/25/2021 - 2/22/2022: 12/25/2021 - 8.4 hours a night 12/31/2021 - 12 hours a night 1/1/2022 - 9 hours a night 1/2/2022 - 19.20 hours a day/night 1/5/2022 - 12 hours a night 1/8/2022 - 9 hours a night 1/14/2022 - 12 hours a day 1/15/2022 - 24 hours a day/night 1/16/2022 - 12 hours a day 1/21/2022 - 12 hours a day 1/22/2022 - 16 hours a night 1/23/2022 - 12 hours a day 1/29/2022 - 9 hours a night 2/5/2022 - 9 hours a night 2/12/2022 - 9 hours a night 2/17/2022 - 12 hours a day 2/19/2022 - 9 hours a night 2/22/2022 - 12 hours a day Episode 2/23/2022 - 4/23/2022: 2/23/2022 - 12 hours a day 2/24/2022 - 12 hours a day 2/26/2022 - 12 hours a night 2/28/2022 - 12 hours a day 3/1/2022 - 12 hours a day 3/5/2022 - 13 hours a day 3/7/2022 - 12 hours a day 3/12/2022 - 24 hours 3/14/2022 - 12 hours a day 3/17/2022 - 12 hours a night 3/19/2022 - 24 hours 3/23/2022 - 12 hours a day 3/24/2022 - 12 hours a day 3/28/2022 - 12 hours a day 3/29/2022 - 12 hours a night 3/30/2022 - 12 hours a day 3/31/2022 - 12 hours a day 4/5/2022 - 12 hours a day 4/6/2022 - 12 hours a day 4/7/2022 - 12 hours a day Interview on 4/11/22 at 3:00 p.m., the Director of Nursing said, "I am not going to lie, yes these hours were missed, all of them were in communication with the mother. The mother had her special nurses, and it was difficult to staff. We were also in communication with the Patient’s Case Worker and had set a date for discharge. The date was 1/21/22 the notification was 12/21/21 to the Case Manager, and we are still caring for him. The Case Manager is having difficulty finding another agency. This family has been through other agencies the mother, grandmother, and grandfather, all know how to care for the patient. No, the child does not go to a Pediatric Extended Care Program. He has always been at home.