Dynamic Home Health: A Case Study

Initially we had difficulty obtaining his discharge orders as the hospital care manager replied she had forwarded the documentation, but neither I nor Mrs. Bianco had received a copy. Mrs. Bianco made a visit to Mills Creek and met with Mr. Smith at that time she was made aware of an appointment that Mr. Smith attended. Mr. Smith attended a physician appointment on June 28, 2017 with Dr. Leonard, Orthopedic trauma. Mills Creek assisted with the transportation and a mobile x-ray unit was coordinated to obtain x-rays of the femur at the facility as Mr. Smith didn’t bring his slide board to the appointment and couldn’t get onto the radiology table.

Pt is seen in the ER room and states that he is tired and had tremors so he came to the ER to be on the safe side. Daughter also states that he had tremors in the morning and. Patient's CC is that was tired and had tremors in the morning. States that he stays alone, was worried, and has no past history. Assessment of the head shows no sign of deformities or trauma. Neck shows no sign of deformities or trauma. Chest shows no sign of

In the complaint, it is alleged that Dr. Rehman breached the relevant standard of care by discontinuing the pharmaceutical Glucovance, and by ordering insufficient monitoring of Ms. Green’s glucose levels; and that Millennium Health and Rehabilitation “failed to property monitor the deceased, ignor[ed] panic values on her labs, [and] misinterpreted the order discontinuing the Glucovance without order of [Dr.] Rehman.”

S: "I got dizzy and lightheaded." Subject stated he was on hi way home to Kansas City when he took a surge energy drink. Pt attend after that he got lighthead and dizzy so he pulled over. Pt stated at that time he started having anxiety problems and hyperventilating and his hands began to cramp. Pt stated he called his mom who called 911. Pt stated he felt better after he claimed down and got his breathing under control. Pt states he rarly drinks caffeine and avoids coffe or any type of energy drink. Pt states his mom gave it to him for the long drive home. Pt denies any current s/s and states "I feel fine now." Pt states, "I will be fine and don't need to

D-Spoke with the patient as she was being curbside dose. This writer reiterate about TEAM recommendation, at which the patient declines the notion of being placed in a skilled nursing facility due to her medical issues.This writer informed the patient that her level of care is inappropriate for this treatment and a high level of care would be more efficient. According to the patient, she's working with Chrysalis and is willing to sign an ROI for this writer to communicate with her case worker Anthony, aka Tony. Reported stable on her dose.

SC received VM form Tanya, ERS provider via Active Aid Solution. Tanya reported that they received a monthly maintenance service order for ERS but did not get one for the installation and requested that SC put it in ASAP. SC created service order in Oracle and completed service order in SAMS. SC reviewed Pa care plan and everything else looks good. SC placed phone call the Penn Asian Senior Services enhanced day care provider. SC call was transferred to Soon Pack Pa’s social worker at the center. When Soon got on the phone SC introduce self and stated reason for calling (was to visit Pa at the day center) Soon stated that, that would be ok because SC must be there before Pa’s leaves at 1:45 PM. SC asked why Pa leaves so early and Soon reported that, that’s

Client appears to be decompensating. She is losing weight and she was refer to take a urine test to rule out toxicology. CM assessed client needs: client must maintain PA case active, client must meet with CM every Friday and the Client must maintain all off-site medical appointments and medication regiment. CM reviewed Bi-Weekly ILP. Client agreed and

SC received phone from Pa’s dtr starting that she spoke with provider agency Accucare regarding changing Pa’s schedule from a split shift to one shift starting at 5:00 AM and ending at 9:00 AM. SC informed DCW that she is not authorized to make any change to Pa’s care plan or schedule. DCW was furious demanding to know why she is not authorize to make changes to Pa’s care plan since Pa’s she’s Director of Care. SC explained to DCW that she is not Pa’s director of care because Pa’s is directs own care and moreover she cannot be the direct care worker and the Director of Care because both role conflict with each other. DCW stated that she is only being paid for 4 hours but is constantly assisting Pa’s managing her health and navigating services/resources,

SC completed monitoring telephone call with Pa on 1/20/2016. SC called Pa. Pa reported that ding “good”. Pa reported no new health problems, no medications, no falls, and no hospitalizations. Pa reported no outstanding doctor’s visits. Pa reported that’s he saw her PCP on 1/19/2016. SC reviewed Pa's ISP. Pa confirms that she is receiving services in the following type, scope, amount, frequency and duration of services specified in the ISP agency model aide via Total Home Health Care from 10-2PM, Monday through Sunday. Pa's aide provides assists her with the completion of ADLs, IALDs and supervision as needed. Pa has PERS system which gives her access to emergency medical service. Pa also, receives HMD from PCA weekly. She reported being satisfied

Wife reported his multiple providers shared their notes. Mrs. Overman reports 4 year ago when his father died, Mr Overman became depressed and started to abuse opiate and other pain pills. She reports his PCP as recommended him to attend substance abuse treatment. He is not currently attending any outpatient services for substance abuse. Mrs. Overman states out of the 15 year she has known him he has not attempted to harm himself. She reports At the time of the assessment Mr. Overman currently denies suicidal ideation, homicidal ideation, and symptoms of psychosis. He denies any mental health history or attempts to harm himself. He reports attending substance abuse treatment at 2X Bethal Colony. He reports yesterday his friends gave him something to take for his pain. Mr. Overman reports going to Walmart with all his medication and his

Reporting party (RP) stated he arrived at the facility to meet with resident George Dixon (7/11/52) on 3/29/17. Resident was recently placed at the facility after being released from the hospital. Staff did not allow RP to enter the facility so that he could conduct his metal health assessment for the resident. RP presented his business card from his agency but was still denied entry. The resident has been enrolled in RP's program since 02/01/16 and has been visited previously by Social Worker Kathy Kleinman and by staff Denise Ramirez on 3/10/17. Staff told RP that he has to contact the administrator to make an appointment to visit with resident. RP's agency faxed over the consent for treatment to the facility and the DMH contract. Patient's

Cecelia contacted SC via phone Cecelia. Cecelia informed SC that she was concerned about Audrey’s weight. She noted over 30 pounds in the last year and half. SC asked if she address the concern with the provider. She notes yes. She noted the provider took Audrey to her PCP to have blood work done. She noted the blood work show there was no issue with her thyroid. She noted the provider had the PCP to check for Side-effects from medication. PCP noted her medication don’t has weight lost as a side effect. She know she he a lot but just want SC to monitor her weight. SC agree to monitor Audrey weight. Cecelia also notes she see Audrey once a month and take her to dinner. She not the

The documentation submitted includes a recertification for home health care dated August 4, 2014, as billed. However, the plan of care

SC received OLTL ISP approval. SC ordered Pa services in Oracle and generated them in SAMS. SC terminated JEVS Home Care as provider agency and replaces it with BLESSINGS4EVER HOME CARE AGENCY. SC updated both SAMS and Oracle with new provider. SC places order for stir gild assessment and service order instructions sheet. SC placed call to Pa and spoke with Marie/ CG and informed her of the ISP approval asked about her employment status with PAS provider agency and Maries states that she is still in the hiring process SC informed her that at this time she will not be paid for any PAS service she will provider during this time because she is not hired by the agency until she is the service will remain on hold. SC informed Marie that PERS and

This counselor called Jeff to see if he could follow-up with his doctor on the paperwork this counselor sent them as nothing has been received yet. Jeff stated, " I was just getting ready to call you I have some not good news." Jeff proceeded to explain that he went to Dr. Snyder last week because he was sick and they drug tested. Jeff stated he thought it was just routine and had nothing to worry about. Two days later Jeff stated he received a call from the doctor's office informing him that there was an issue with his drug test. Jeff stated that they informed him that his last two months of testing have been negative. Jeff stated he couldn't figure out why that was a bad things, but according to the medical assistant as he is taking narcotics (Tylenol # 4 and Ativan) he should have tested positive. Since he didn't the doctor can only assume that he isn't taking his medications and could possibly be selling them. Because of this the doctor dropped Jeff as a patient. Jeff stated he has tried to speak with the doctor, but the doctor and the receptionist refuse to speak with him. He explained that he is upset that they won't speak with him, especially because he had been working with the doctor to fill out the paperwork this counselor needs for his case and they were almost done.