Every finding on record at Uconn Health Community Network Home Health, Inc

Unannounced visits were concluded at VNA Health at Home on 11/04/2021 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.

Unannounced visits were concluded at Visiting Nurses Association Health At Home on 11/04/2021 for the purpose of recertification and re-licensure 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 review of clinical records and interview with agency personnel for one of one patient (Patient #6) with an implanted port for chemotherapy, the agency nurses failed to complete necessary assessments. The findings include: Patient #6 had a start of care date of 9/01/21 and diagnoses that included malignant neoplasm of the right upper lobe of the lung, malignant neoplasm of the brain and chronic respiratory failure. The physician's orders dated 9/01/21 included nursing services once a week for nine weeks for assessments. The initial nursing assessment dated 9/01/21 identified the presence of a right chest wall implanted port-a-catheter for chemotherapy. Interview and review of the nurse's notes from 9/08/21 to 10/13/21 (6 nursing visits) with the Supervisor of Clinical Services/SCS at 11:30 am failed to identify the assessment of the right chest wall port at every visit.

Onsite supervisory visit every 14 days CFR(s): 484.80(h)(1)(i) If home health aide services are provided to a patient who is receiving skilled nursing, physical or occupational therapy, or speech-language pathology services, a registered nurse or other appropriate skilled professional who is familiar with the patient, the patient's plan of care, and the written patient care instructions described in §484.80(g), must make an onsite visit to the patient's home no less frequently than every 14 days. The home health aide does not have to be present during this visit. This ELEMENT is not met as evidenced by: Based on review of the clinical record, interview with agency personnel and agency policies, for two of two patients (Patient’s #3 and #5) who received skilled nursing services along with home health aide services, the agency Registered Nurse (RN) failed to provide onsite supervisory visits no less frequently than every 14 days. The findings include: 2. Patient #5 had a start of care date of 11/03/20 and diagnoses that included complications of a stump amputation and chronic kidney disease. The physician's orders for the certification periods from 8/30/21 to 12/27/21 included skilled nursing services and home health aide services one time a week. Interview and review of the nurse's notes from 8/30/21 to 11/03/21 with the Supervisor of Clinical Services/SCS and the Home Health Aide Supervisor on 11/04/21 at 10 AM failed to identify onsite supervisory visits to Patient # 5 by a registered nurse/RN from 9/30/21 to 11/02/21 (a period of thirty-three days). The agency policy on Home Health Aide Supervision directed the RN to provide onsite supervisory visits to the patient's home no less frequently than every fourteen days when the patient received skilled services. 1.Patient #3 had a start of care date of 9/9/2020 and diagnoses that included congestive heart failure, Parkinson's disease and chronic obstructive pulmonary disease (COPD). The physician's orders for the certification period of 9/4/2021 to 11/02/2021 included nursing services one time every other week for nine weeks for medication pre-pour, assessments and patient teaching, and home health aide services one time a week for nine weeks for assistance with activities of daily living and showers. Interview and review of the nurse's notes from 9/1/21 to 10/13/21 with the Supervisor of Clinical Services (SCS) on 11/04/21 at 12:15 pm identified that Registered Nurse/RN#1 documented aide supervisory visits on 9/1/21 and 10/31/21, further review of the clinical record identified nursing visits completed on 9/15/21 and 9/29/21 but failed to identify aide supervisory visits from 9/1/21 to 10/13/21 ( a period of forty-one days).