Every finding on record at A New Day Hospice Care

Observed in Record Review. the Surveyor noted an RN assessment visit had not been conducted every 15 days. For example, in RRNHV6, the patient had been missing an RN visit between the 2nd week of November and the first visit in December, equaling 21 days. This was validated with the DOPCS.

Observed in Record Review. In 3 of 14 patient records reviewed, the Hospice Surveyor noted patient care orders that had been incomplete. For example, in RRNHV3, the patient had an order for wound care: Cleanse w/ NS, pat dry, apply medihoney to area and cover w/ dry dressing. Change 2x/ wk or PRN if soiled or dislodged. The order had been missing who was to complete the care. In RRNHV4, the patient had the medications: Albuterol sulfate HFA 90 mcg/actuation aerosol inhaler and DuoNeb solution both ordered PRN Every 4 Hours for SOB/wheezing. The patient also had lactulose 10 gram/15 mL oral solution and docusate sodium 100 mg capsule, both ordered PRN 3 Times daily for constipation. In RRNHV5, the patient had wound care orders that indicated: Stage 2 PU to sacral area- Cleanse w/ NS, pat dry, apply medihoney to open area, and cover w/ 4x4 foam dressing. Change 3x/wk or PRN if soiled or dislodged. without indicating who was to complete the care. This was validated with the DOPCS

Observed in Record Review. In 1 of 14 patient records reviewed, the Hospice Surveyor noted that care had not been provided as ordered on the hospice aide plan of care (POC). For example, in RRNHV3, the Hospice Aide (HA) had orders to document patients last bowel movement (LBM) and report if no BM in 3 days; however, in 8 visits, there had been no documentation of the LBM. This was validated with the DOPCS.

Observed in Record Review. In 2 of 14 patient records reviewed, the Surveyor noted documentation had not been entered into the patient record within the 48 hours as required by HCO policy. For example, in RRHV1, there had been nursing notes missing for a visit completed 6 days prior. In RRNHV6, there is an incomplete LVN note from 14 days prior to survey. This was validated with the DOPCS.

Observed in Emergency Management Session. The organization did not have a process for cooperation and collaboration with the local, state, tribal, regional, and federal emergency preparedness officials’ efforts to maintain an integrated response during a disaster or emergency situation. During the emergency management systems tracer, it was reported that the emergency plan did not include the process for collaborating with emergency preparedness officials. This was confirmed by the CEO.

Observed in Individual Tracer. The organization did not reduce the risk of infections associated with medical equipment, devices, and supplies. During home visit 1 it was observed that the RN disinfected equipment after use with Micro Kill and did not allow the 10 minute dry time as required by the manufacturer's guidelines. This was confirmed by the Director of Patient Care Services.