Every finding on record at Visiting Nurse Association of Central PA Inc

Based upon the findings of an unannounced on site Medicare recertification and state re-licensure survey conducted on 4/1/2021-4/2/2021, 4/5/2021 & 4/7/2021, VNA of Central Pennsylvania, was found to be in compliance with the requirements of 42 CFR, Part 484.22, Subpart B, Conditions of Participation: Home Health Agencies.

Based upon the findings of an unannounced on site Medicare recertification and state re-licensure survey conducted on 4/1/2021-4/2/2021, 4/5/2021 & 4/7/2021, VNA of Central Pennsylvania, was found to be not in compliance with the requirements of 42 CFR, Part 484, Subparts B and C, Conditions of Participation: Home Health Agencies.

Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician is consulted to approve additions or modifications to the original plan. This STANDARD is not met as evidenced by: Based upon review of agency policy, medical records (MR), and interview with supervising nurse ( EMP # 1), agency failed to conform to physician orders with discipline visit frequency for three (3) of ten (10) files reviewed. ( MR # 1, MR # 8, MR # 10). Findings included: Review of agency policy on 4/7/2021 between approximately 1:00 PM- 2:00 PM titled " Plan of Care" stated (5). "The written plan of care reflects each of the patient's needs, problems, interventions, treatment modalities, goals, and outcomes. This plan also correlates to the physician's orders. " The therapist will develop a plan of care based on relevant data identified on initial visit". Review of MR on 4/2/2021 between approximately 10:30 AM-12:30 PM & 2:00 PM-3:00 PM & 4/5/2021 between approximately 9:15 AM-11:00 AM revealed: MR # 1, Start of Care (SOC) 3/4/2021; certification period: 3/4/2021-5/2/2021; Verbal physician order dated 3/5/2021 "OT 1-2 x/week for 5 weeks". No documentation of OT visit during week of 3/28/2021-4/3/2021. MR # 8, SOC 3/20/2021; certification period: 3/20/2021-5/18/2021. Verbal physician order dated 3/24/2021, "OT 1-2 x/week for 4 weeks". No documentation of OT visit during week of 3/28/2021-4/3/2021. MR # 10, SOC 3/2/2021; certification period: 3/2/2021-4/30/2021; Verbal physician order dated 3/5/2021, " PT 2x/week x 4 weeks" . One (1) documented PT visit during week of 3/2/2021-3/6/2021. Interview with EMP # 1 on 4/7/2021 between approximately 2:00 PM-3:00 PM confirmed above findings.