Every finding on record at The Rosalind & Joseph Gurwin Jewish Geriatric Center of Long Island, Inc.

A post certification visit (PCV) for Gurwin Certified Home Health Agency located at 330 Conklin Street Farmingdale, NY 11735 was conducted on 02/13/2023 – 02/14/2023 as a follow up to the recertification survey that was conducted on 07/07/2023. The PCV survey included a review of 5 clinical records, 2 personnel records, staff education provided, review of record audits as specified in the agency’s Plan of Correction. The Agency has not conducted Quality Assurance activities as specified in the Plan of Correction. Interviews were conducted with the Director of Patient Services (DPS) and Clinical Manager. The Agency's active patients census is 70. The agency is found not be in substantial compliance with the Federal Conditions of Participation requirements. The following Federal deficiency has not been corrected: G0574 - Plan of Care must include the following The following State deficiency has been identified as a result of this survey: J1176 - Governing Authority The following Federal deficiencies have been corrected: G0528 – Health, Psychosocial, Functional, Cognition G0548 – within 48 hours of patient return G0578 - Conformance with Physician Orders G0590 - Promptly alert Physician of changes G0718 - Communication with Physician The following State deficiency has been corrected: J1444 - Personnel

Plan of care must include the following CFR(s): 484.60(a)(2)(i-xvi) The individualized plan of care must include the following: (i) All pertinent diagnoses; (ii) The patient's mental, psychosocial, and cognitive status; (iii) The types of services, supplies, and equipment required; (iv) The frequency and duration of visits to be made; (v) Prognosis; (vi) Rehabilitation potential; (vii) Functional limitations; (viii) Activities permitted; (ix) Nutritional requirements; (x) All medications and treatments; (xi) Safety measures to protect against injury; (xii) A description of the patient's risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors. (xiii) Patient and caregiver education and training to facilitate timely discharge; (xiv) Patient-specific interventions and education; measurable outcomes and goals identified by the HHA and the patient; (xv) Information related to any advanced directives; and (xvi) Any additional items the HHA or physician or allowed practitioner may choose to include. This ELEMENT is not met as evidenced by: Based on clinical record reviews and staff interview, the Agency failed to develop individualized patient Plan of Care. This was evident in one (1) of five (5) clinical records reviewed. (Patient #5). Failure to develop individualized Plans of Care, has the potential for negative patient outcome. Patient #5 has a start of care date of 09/10/2022 with diagnoses including Pressure Ulcer of Sacral -stage 4, Pressure Ulcer of Right Hip - stage 4, Pressure Ulcer Right Heel – unstageable, and Encounter for fitting of Urinary Device as documented on the “Plan of Care” for certification period 01/08/2023 to 03/08/2023. The “Plan of Care” for certification period 01/08/2023 to 03/08/2023 documents an order for SN (Skilled Nurse) 1 -3-week 9 (one visit to three visits a week for nine weeks) to “assess GU (Genito Urinary) status, assess catheter patency”. The “SN Visit” notes dated 01/09/23, 01/11/23, 01/16/23, 01/18/23, 01/20/23, 01/23/23, 01/25/23, 01/30/23, and 02/08/2023, the SN documents that the patient has “Foley catheter – catheter size 14 Fr (French) , Balloon size 10 cc (cubic centimeter). The Plan of Care lacks an order for Urinary Catheter size, Catheter balloon size, catheter care and frequency of catheter change. The Agency failed to develop an individualized Plan of Care. The survey findings were reviewed with the Director of Patient Services (DPS) and Clinical Manager on 02/14/2023 at 2:30 PM. No explanation was provided.