Recently I filed a Complaint with the Connecticut Department of Public Health (DPH) based on the failure of a Connecticut home health care agency to provide appropriate and timely in-home medical services to an extraordinarily disabled, medically fragile client. DPH ultimately found that the practices of the home health care agency constituted significant instances of non-compliance with federal and state law and they were ordered to engage in corrective action. The filing of the Complaint followed the failure of the home health care agency to provide home nursing, social work, occupational therapy and physical therapy services to my client. The client had been released from the hospital following an extensive inpatient stay after a traumatic automobile accident. The client's physician had ordered home nursing services immediately upon release from the hospital because the client had extensive spinal cord injury following the accident and now had a diagnosis of quadriplegia. Despite the client's medical needs and the doctor's orders, the home health care agency failed to provide the prescribed services. DPH found that the the home health care agency failed to comply with the following Connecticut regulations 1) Regulation of Connecticut State Agencies Section 19-13-D69 - Nursing Services 2) Regulation of Connecticut State Agencies Section 19-13-D77 - Administrative Organizational Records 3) Regulation of Connecticut State Agencies Section 19-13-D73 - Patient Care Plan (b) DPH conducted an extensive investigation and ordered the homecare agency to develop an extensive plan of correction. Ultimately, the home health care agency instituted new protocols for patient care including 1) identification of all specialty disciplines included in the referral 2) coordination of daily intake to ensure intake staff is assigned to the patient 3) case conferences with the assigned specialty disciplines on the date of admission and 4) weekly monitoring. Also, because the services were not provided with the frequency ordered by the patient's physician, the home health agency instituted new procedures to prevent the practice of unilaterally changing the frequency of specialty services. Finally, to ensure compliance, monitoring and sample auditing were put into place. If you have any questions about this decision please contact me. - Bonnie Bonnie B. Roswig Senior Staff Attorney Medical/Legal Partnership Project Center for Children's Advocacy (860) 545-8581