Every finding on record at Nhc/Op, L.P.

An Emergency Preparedness recertification and re-licensure survey was conducted on 9/5/2023-9/7/2023. The facility meets all of the requirements for Emergency Preparedness. There were no deficiencies identified.

A recertification survey was conducted on 9/5/2023-9/7/2023. An entrance conference was held on 9/5/2023 at 9:45 AM, with the Administrator. An exit conference was held on 9/7/2023 at 9:50 AM, with the agencies administration.

A review of all current medications CFR(s): 484.55(c)(5) A review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy. This ELEMENT is not met as evidenced by: Based on policy review, medical record review, and interview, the agency failed to update the medication profile for 3 of 7 (Patient #1, #4, and #6) patients reviewed. The findings included: Review of the agencies "Medication Review and Reconciliation," policy dated 5/22, revealed "...To establish processes that maximize patient safety and outcomes related to medications and to comply with related state and federal regulations and clinical best practice...Medication compliance, effects and changes are assessed at every skilled visit. The primary goals are optimal patient care, safety, and outcomes...Medication review and reconciliation is a multi-faceted and on-going process performed via interview and observation techniques. It includes...Eyes-on review of all prescription and non-prescription medications the patient is currently using; Collaboration with the certifying and other relevant providers to reconcile and simplify the medications...The patient's medication profile and plan of care will include all medications that the patient is taking (both prescription and non-prescription)..." Review of the medical record revealed Patient #1 was admitted to the agency on 7/27/2023 with diagnoses of Aortocoronary Bypass Graft, Atherosclerotic Heart Disease, Hypertension, Diabetes Mellitus, Benign Prostatic Hyperplasia, and Hyperlipidemia. Review of the Client Medication Report revealed "...8/1/2023...Colace [stool softener] 100 mg [milligram]...2 capsule...oral...daily...MiraLAX [stool softener] 17 grams...daily...oral...Multivitamin 50 plus...daily...oral...Pantoprazole [treats acid reflux] 40 mg...daily prn [as needed]...oral...Potassium Chloride 10 meq [milliequivalent]...take 2 capsules by mouth once daily as needed when takes dose of Lasix [Diuretic]..." During an interview with Patient #1 on 9/5/2023 at 12:25 PM, he stated "...not needed [Colace, MiraLAX, Multivitamin, and Oxycodone] since July [2023] and surgeon instructed to stop taking Potassium..." During an interview with Director of Services [DOS] on 9/7/2023 at 8:45 AM, confirmed Patient #1's medications needed clarification. Medical record reveal Patient # Patient #4 was admitted to the agency on 7/31/2023 with diagnoses of Joint Replacement Surgery, Presence of Right Artificial Hip, Hypertension, and Osteoarthritis. Home medication review revealed "...Over the Counter (OTC) Omega 3 500 mg by mouth every day...OTC Citracal and D3 by mouth every day...OTC D3 50 mcg (2,000 IU) by mouth everyday...OTC Turmeric Curcumin 500 mg by mouth every day..." During an interview with Patient #4 on 9/6/2023 at 8:30 AM, she stated "...I also take over the counter B12..." During an interview with DOS #2 on 9/7/2023 at 9:05 AM, she confirmed these medications needed to be added to Patient #4's medication profile. Medical record review revealed Patient #6 was admitted to the agency on 6/17/2023 with diagnoses of Mechanical Loosening of Internal Right Prosthetic Knee Joint, Periprosthetic Osteolysis of Internal Prosthetic Knee Joint, Anxiety, Depression, and Attention Deficit Disorder. Review of Patient #6's Home Medications revealed "...Dextroamp-Amphetamin [treats Attention Deficit Disorder] 10 mg every morning...Animal "The Ultimate Training Pack...Allopurinol [treats Gout] 300 mg oral daily..." Review of the Physician Order dated 8/18/2023, revealed "...Stop Allopurinol..." The Administrator confirmed Patient #6's profile needed to include his Training Pack and ADD medication.