Every finding on record at Allied Care Hospice, Inc.

Observed in Tracer Activities. During EM tracer review the hospice surveyor noted that the organization failed to develop a mitigation plan from their HVA. This was reviewed and validated with the DCPS.

Observed in Tracer Activities. During EM tracer activity the surveyor noted that the organization failed to complete a continuity of operations plan. This was reviewed and validated with the DPCS.

Observed in Record Review. In 3 of 3 patient records reviewed, the hospice surveyor noted that neither the Admission Consent nor the Election of Benefits included language where the patient could request a copy of non covered items from the organization. The organization failed to notify the patient of their right to a copy of non covered items at admission. This was reviewed and validated with the DCPS.

Observed in Record Review. In 3 of 3 patient records reviewed, the hospice surveyor noted that neither the Admission Consent nor the Election of Benefit included language where the patient could select the Hospice Provider or another provider for their care. The hospice failed to offer the patient a choice of using either the hospice medical director or another provider. This was reviewed and validated with the DCPS.

Observed in Record Review. In 1 of 3 patient records reviewed, the hospice surveyor noted in HOSRRHV #1 that the fall risk assessment had not been completed at admission in the comprehensive assessment. The fall risk assessment was not performed at admission per the organization's policy Initial Assessment Policy Number 2-029.1. This was reviewed and validated with the DPCS. .

Observed in Record Review. In 2 of 3 patient records reviewed, the hospice surveyor observed in HOSRRHV #2 the were 22 days between IDT meetings and in HOSRRHV #3 there was 28 days between hospice IDT meetings. The organization failed to complete an IDT meeting every 15 days per regulation and their policy, Interdisciplinary Group Meeting Policy No. 2-050.1. This was reviewed and validated with the DCPS.

Observed in Record Review. In 1 of 3 patient records reviewed, the hospice surveyor noted that in HOSRRHV #1 where the patient was deemed a fall risk per the home health aide care plan and a bleeding precaution as he was on an anticoagulant the POC for the RN did not include a care plan addressing either of theses precautions. This was reviewed and validated with the DPCS.

Observed in Record Review. In 1 of 3 patient records reviewed, the hospice surveyor noted that the patient had duplicate medications had been ordered and the instructions for use were not clear. The Hospice surveyor noted in HOSRRHV #3 the patient had Bisacodyl 10 mg rectal suppository to be inserted daily and as needed and also Milk of Magnesia 2400 mg/30 ml suspension to take as needed for no bowel movement in 3 days. It is not clear when to begin taking one over the other. This was reviewed and validated with the DPCS. Observed in Record Review. In 1 of 3 patient records reviewed, the organization failed to maintain accurate patient medication information. During HOSRRHV #3 the hospice nurse surveyor observed that the patient has an order for Docusate 5 mg one tab by mouth at bedtime for Congestion. The docusate is for constipation. The indication is inaccurate. In this patient he also had an order for Supplemental Oxygen 3 L via nasal cannula as needed for respiratory comfort. There is no parameter set for respiratory comfort. This was reviewed and validated with the DPCS.

Observed in Record Review. In 1 of 3 patient records reviewed, the organization failed to follow orders in the Plan of Care. In HOSRRHV #3 the patient has an order for monthly (every 30 days) foley catheter changes. The patient had his foley catheter changed on day 44. The patient had one catheter flush done in March, 3 in April, and one in May and there are no orders for catheter flushes. The foley change in April was documented in the EMR the foley change in May and all of the flushes were all documented in the patient's home flow sheet. This was reviewed and validated with the DPCS.

Observed in Patient Home. In 2 of 3 home visits conducted, the hospice surveyor noted during HOSRRHV #1 and HOSRRHV #2 the LVN and CHHA did not follow manufacturer's guidelines for cleaning their pulse oximeters, thermometers, and electronic arm cuffs. The MIFUs for the thermometer and pulse oximeter stated that ETOH must be used. The LVN used a SaniCloth and the CHHA used a Clorox wipe. The electronic arm cuff the Manufacturer's guidelines stated to use a damp soft cloth, the LVN used a SaniCloth wipe and the CHHA used a Clorox wipe.. The staff failed to clean their vital sign equipment per manufacturer's guidelines. This was reviewed and validated with the DCPS.

Observed in Record Review. In 2 of 3 patient records reviewed, where the home health aide was ordered the hospice surveyor noted that in HOSRRHV #1 that the aide care plan failed to include bleeding precautions as the patient is on an anticoagulant. In HOsRRHV #3 the aide care plan failed to include seizure precautions. This was reviewed and validated with the DCPS.

Observed in Record Review. HCO failed to implement policies related to patient rights resulting in a condition level deficiency at 418.52. Discussed and validated with the DCPS.

Observed in HR File Review. In 1 of 10 HR files reviewed, the hospice surveyor noted during HR tracer that the Medical Director did not have an initial competency in his file at hire. This was reviewed and validated with the DCPS.

Observed in Record Review. In 1 of 3 patient records reviewed, treatments performed such as foley catheter changes were not fully described in the record of care. The surveyor noted in HOSRRHV #3 the RN documented foley catheter change performed. No documentation as to the size of the foley catheter used, the amount or type of fluid used to inflate the balloon or if a securement device was used. This was reviewed and validated with the DPCS.

Observed in Record Review. In 1 of 2 patient records reviewed, the hospice surveyor noted In HOSRRDC #1 the patient was transferred to a hospital and the organization failed to send a discharge summary to the receiving organization. The organization failed to follow their policy Transfer Information # 2.070.1. This was reviewed and validated by the DPCS.

Observed in Record Review. In 1 of 2 patient records reviewed, the hospice surveyor noted in HOSRRDC #2 the patient's family revoked from Hospice. The community provider was not sent a discharge summary after a live discharge. The organization did not follow its policy on Revocation of Hospice Benefit Election # 2-068.1. This was reviewed and validated by the DPCS.