Every finding on record at A Caring Heart Healthcare Services LLC

Upon home visit observation 1 of 3 visits, there was no evidence the hospice follows acceptable standards of practice to prevent the transmission of infections and communicable diseases, including standard precautions. During patient home visit number 1 with the RN a rolling nursing bag was utilized. The RN parked on the street, removed the rolling bag from the trunk of her car and placed it on the ground outside. The RN rolled the bag from her car to the patients front door into the patients home and into the patients room. Wheels on the rolling bag was small and the bag rubbed on the ground. Surveyor asked RN how often the bag was cleaned and RN reports she cleans rolling bag at end of each day after seeing all patients for the day. Agency has a Bag Technique policy (no. 9-014.1) from The Corridor Group but the bag technique does not include rolling bags.

Observed in Individual Tracer. In 4 of 5 patient records reviewed, Confirmed by the Administrator. The plan of care goals had not been measurable Example: During review of HOSv#3 a goal had documented that the patients pain would be kept at a comfortable level with a target date of two months. During review of HOSv#1 the plan of care had documented that the patient and caregiver would understand medications by the end of the certification period.

Observed in Individual Tracer. In 2 of 5 patient records reviewed, Confirmed by the Administrator. The plan of care had not been based on the patient assessment and treatment to address the patient needs. Example: During review of HOSv# 1 the patient assessment had identified dysphagia requiring diet precautions with either a pureed or mechanical soft diet. The plan of care had not documented a goal or interventions to address the dysphagia or the risks. During review of HOSv#2 the patient assessment had identified the patient to be a high risk for falls, however the plan of care had not reflected a goal or interventions to address the fall risk.

Observed in HR File Review. In 2 of 9 HR files reviewed, Confirmed by the Administrator/DON. Staff initial competence at orientation and probationary period had not been observed as identified in the organization policy. Example: Organization policy had documented that as part of the orientation staff were to be observed for the initial assessment of their skills. During review of the Spiritual Counselor and MSW competence. The competence of their skills had been either completed verbally or written.