Every finding on record at Assisted Home Care, Inc.

Based on observation, interview and record review the hospice agency (HA) failed to maintain an accurate and current medication profile for one of one sampled patient (Patient 1). This failure has the potential for placing the patient at risk for medication errors and adverse drug reactions. --- A review of Patient 1s Patient Information Sheet (Face Sheet) indicated that the patient had a start of care (SOC) date of 10/28/22, with a terminal diagnosis of malignant neoplasm of brain (brain cancer). A home visit was conducted on 11/3/22 at 12 pm, with Registered Nurse 1 (RN 1) at the Patient 1s home. Patient 1s caregiver (Caregiver1) was present. Caregiver 1 showed me a bag of as needed (PRN) medications, as well as medications that the patient was currently taking. The following are Patient 1s PRN medications: Morphine Sulfate oral suspension. 100 milligrams (mg-unit of measurement) per 5 milliliters (ml-unit of measurement). Give 5mg (0.25ml) by mouth/ sublingually (SL-under the tongue) every 1 hour (hr) as needed for moderate to severe pain, shortness of breath (SOB), or respirations >28 per minute). Lorazepam 0.5mg tablet (tab). Give 1 tab by mouth SL every 4 hrs as needed for anxiety/SOB. Hyoscyamine 0.125 mg tab. Give 1 tab by mouth SL. Every 4 hrs as needed for increased secretions/ abdominal cramps. Prochlorperazine- 10mg tab. Take 1 tab by mouth every 6 hrs as needed for nausea and vomiting. Haloperidol 2mg/ml. Give 1 mg/0.5ml by mouth SL. Every 4 hrs as needed for agitation. Bisacodyl 10mg suppository. 1daily as needed for constipation if no bowel movement for 3 days. Levetiracetam suspension 100mg/ml. Take 2 teaspoons (10ml) by mouth 2 times daily for seizure control. The following are the medications Patient 1 was currently taking: Gabapentin (medication to treat seizure and nerve pain) 600 mg tab. 1 tab by mouth in the morning and 2 tabs in the afternoon. Levetiracetam (anti-seizure medication) 1,000mg tab. Take 2 tabs (2,000mg total) by mouth 2 times daily. Lacosamide (anti-seizure medication) 200 mg tab. Take 1 tab by mouth 2 times daily. A review of Patients 1s medication profile dated 11/1/22, indicated the following: Levetiracetam oral solution 100mg/ml. with a start date of 10/28/22. Comfort Pak (Patients as needed medications). During an interview on 11/3/2022 and 12:30 p.m., RN1 stated that he was not aware of the three medications that the patient was currently taking, and the family member did not disclose those medications during the initial assessment. RN 1 stated that he should have followed up again about the medications. A review of Patient 1s Hospice Nursing Assessment and Plan of Care, dated 10/28/22, indicated that the patient was currently taking Gabapentin as a treatment for pain, but that medication was not reflected on the medication profile. A review of the HAs police titled ";Medication Management", dated 3/2019, indicated that all medications a patient is taking will be profiled with a pharmacist via their contracted pharmacy provider to ensure that the patients drug regimen is free from unnecessary drugs.

Based on observation, interview, and record review, the home health agency (HHA) failed to ensure hand sanitizers that were used by office staff and patients were not expired. This failure had the potential that expired hand sanitizers have lost their efficacy and can affect the mitigation process in the spread of infections. --- During an agency tour on 11/2/2022 at 2:30 p.m. with the Director of Patient Care Services (DOPCS) in the hospice agency supply room, the following expired supplies were observed that were stored in the supply cabinet: Mckesson hand sanitizers with expiry date of 06/2022 Mckesson Skin protectant ointment with expiry date of 05/2022 During further observation around the hospice agency, there were multiple Mckesson hand sanitizers with expiration date of 2/2022 that were located all over the office. On 11/2/22 at 2:45 p.m., the supply log that was attached to the wall of the supply/storage room was reviewed. The log indicated that the supplies were last checked on March 2022. During an interview with the Registered Nurse (RN) and DOPCS on 11/4/2022, RN stated that it was his responsibility to continue to check for the supply. RN also stated the use of expired hand sanitizers would not be effective to prevent the spread of infection. A review of the HA's policy and procedure titled, "Infection Control: Surveillance, Prevention and Control of Infection", revised 8/20, indicated all medical supplies shall be inspected prior to use and not used if any of the following are found: any evidence of damage to packaging, expiration date, clarity, discoloration, or any particulate matter in solutions.