OASIS Alert

Preparedness is the name of the game when a surveyor wants an explanation of the emergent care incident that showed up on your last adverse event outcome report.

If one of your patients requires emergent care for an injury caused by a fall or accident at home, wound infection or deteriorating wound status, improper medication administration or medication side effects, or hypo/hyperglycemia, that incident likely will appear as a black mark on your home health agency's next adverse event report.

"If a patient needs emergent care, that's typically a sign that the agency isn't on top of things," says consultant Linda Krulish with Home Therapy Services in Redmond, WA. For example, if a patient suffers a nasty fall because of an unsafe condition in her home and has to go to the emergency room, that could reflect poorly on the agency.

Part of the clinician's duty is to assess the patient's home environment, Krulish explains. "So if the patient falls and needs emergent care, one of the questions is did the agency do a home safety assessment and make recommendations that could have prevented this fall," she tells Eli.

But sometimes a patient randomly will fall and there's nothing the agency can do to prevent the event from occurring, or the patient will have an unfortunate health event that the agency had no control over. After all, accidents do happen, and sometimes people get sicker despite the best possible care.

Unfortunately for HHAs, those kinds of events still will appear on adverse event reports "there's probably no way to avoid that," laments consultant Terri Ayer with Ayer Associates in Annandale, VA.

Agencies aren't completely defenseless in these situations, though. If a surveyor asks about an emergent care incident that has reared its head on an adverse event report, agencies should have to look no farther than the clinical record for an acceptable explanation. "That's one of the situations where you need excellent documentation," Ayer urges.

If your documentation makes the grade, "you have a ready answer and you know exactly why the adverse event happened and can show that it was unavoidable from the organization's standpoint," Ayer explains.

Of course, the only way to ensure that you have this supporting documentation in the event of an unexpected incident that sends a patient to emergent care is to make top-notch documentation a way of life in your agency, she reminds providers.