Every finding on record at Assisted Home Care, Inc

Based on interview and record review, the facility failed to ensure Patient 3's Psychosocial Assessment, dated 5/4/2022, was filed by Medical Records within 7 days, according to its Clinical Visit Notes, Policy and Procedure. This failure had the potential to not promote continuity of patient care for Patient 3. Findings: A review of the facility's Policy and Procedure (P & P) titled, "Clinical Visit Notes" dated 8/08, indicated, "Notes shall be written on the day of the visit and filed [chronologically] by Medical Records within 7 days." A review of Patient 3's diagnoses included a cerebrovascular disease (when the brain is temporarily or permanently affected by decrease or absence of blood flow). A review of Patient 3's "Psychosocial Assessment," dated 5/4/2022, completed by Social Worker 1 (SW 1), indicated the hospice visit note was transmitted by fax to the facility on 6/14/2022, approximately 41 days after it was written. During a concurrent interview and record review with Branch Manager 2 (BM 2), on 6/15/22 at 4:10 PM, BM 2 stated Patient 3's Psychosocial Assessment Note, dated 5/4/2022, was not submitted to the facility within 7 days, according to policy.

Based on observation, interview, and record review, the facility failed to ensure unvaccinated field staff wore N95 (NIOSH approved respirator with two head straps, designed to achieve a close facial fit with efficient filtration of airborne particles) face mask for home visits. This failure had the potential to spread infectious disease and cause serious illness. Findings: A review of the facility's Policy and Procedure (P & P) titled, "Staff Procedure Emergency Event Type: Novel Coronavirus [COVID-19] Outbreak," revised 3/28/2022, indicated, "...Universal Pandemic Precautions... Field staff: Unvaccinated and not up-to-date vaccinated: [3-28-22]... N-95 face mask required for all visits." 1. On 6/14/2022 at 1 p.m., Patient 5's home visit was conducted with Registered Nurse 1 (RN 1). RN 1 was observed wearing a white face mask covered by a blue surgical (a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer). Patient 5's diagnoses included colorectal carcinoma (cancer that develops in the colon or rectum). During an interview on 6/15/2022 at 1:33 p.m., with RN 1, RN 1 stated that she was wearing a KN95 face mask covered by a surgical face mask. RN 1 also stated that the hospice agency supplied the KN95 face mask. During an interview on 6/16/2022 at 10:04 a.m., with the Director of Nurses (DON), DON stated, "The masks we provide are N95 face masks, not KN95 face masks." The DON stated RN 1 was supposed wear a N95 face mask during Patient 5's home visit. The DON further stated, "Everybody is given N95 face masks." 2. On 6/14/22 at 2 p.m., Patient 9's home visit was conducted with RN 2. RN 2 was observed wearing a blue surgical mask. Patient 9's diagnoses included a nontraumatic intracranial hemorrhage (bleeding into the brain tissue). During an interview on 6/14/2022 at 2:06 p.m., with RN 2, RN 2 stated did not know she was required to wear a N95 face mask. During an interview on 6/14/22 at 3:52 p.m., with Branch Manager (BM 1), BM 1 stated RN 2 should have worn a N95 face mask for Patient 9's home visit. During an interview on 6/15/22 at 9:40 a.m., with Administrator (A 1), A 1 stated RN 2 should have worn a N95 face mask during Patient 9's home visit. A review of the facility's Policy and Procedure (P & P) titled, "Staff Procedure Emergency Event Type: Novel coronavirus [COVID-19] Outbreak," revised 3/28/2022, indicated, "...Universal Pandemic Precautions... Field staff: Unvaccinated and not up-to-date vaccinated: [3-28-22]... N-95 face mask required for all visits."