Every finding on record at Bnb Healthcare, LLC

Based on staff interview, medical record review, facility policy and procedure review, and review of the Assisted facilitys document ";Facility Delivery Log" the facility failed to provide medications ordered by the hospice physician in a timely manner to control symptoms related to the terminal illness for one (1) of three (3) medical records reviewed; Patient #1 --- Findings Include: During interview with Regional Administrator on 08/08/2024 at 1:00 p.m., it was confirmed the facility failed to provide two (2) medications the hospital physician ordered on 04/20/2024 for control of symptoms and conditions related to the terminal illness for Patient #1 until 04/22/2024. Review of Patient #1s medical record document titled, ";Visit Note Report", dated 04/20/2024, in-home time began 04/20/2024 at 12:25 a.m., revealed an additional visit (PRN) visit was made by Registered Nurse (RN) #2 for a report of hallucinations and a possible Urinary Tract Infection (UTI). RN #2 also documented a report of an unwitnessed fall on 04/20/2024 with no injury. After assessment and report to the hospice physician, RN #2 obtained medication orders from the Hospice Medical Director/Physician for Macrobid 100 milligrams (mg); one (1) tablet by mouth two (2) times a day for seven (7) days on 04/20/2024 at 12:24 a.m. Haloperidol 1.0 mg; one (1) to two (2) tablets by mouth every three (3) hours as needed for agitation was also ordered by the Hospice Medical Director on 04/21/2024 at 10:56 a.m. Continued review of Patient #1s medical record document ";Facility Delivery Log" revealed Nitrofurantoin 100mg Cap and Haloperidol 1mg Tablet was delivered to the Assisted Living Facility by Pharmacy #2 on 04/22/2024 and signed for by Licensed Practical Nurse (LPN) #1. Review of facility policy and procedure, ";Scope of Services", policy #LD.1, Revised Date 03/24/24, revealed, ";...Procedure...XVI. The Following services must be available 24 hours, 7 days a week...C. Medical supplies including drugs and biologicals..." Review of facility policy and procedure, ";Pain and Symptom Management", policy #PC.135, Revised 10/20/2022, revealed, ";...Policy...II. The Hospice will respect the patients right to receive effective pain management and symptom control for conditions related to the terminal illness...Procedure...IX. When mediation changes occur in relation to pain and symptom management, timely follow up by the nurse will be made to determine the effectiveness of those changes..." During the exit conference on 08/08/2024 at 3:30 p.m. with Regional Administrator and Branch Director, survey findings were discussed, and no further documentation was submitted for review.

Based on staff interview, medical record review, and facility policy and procedure, the facility failed to provide nutritional supplements as ordered by the hospice physician on 02/06/2024 and 04/10/2024 to meet the nutritional needs of the patient until 04/20/2024 for one (1) of three (3) medical records reviewed; Patient #1 --- Findings Include: During an interview with the Regional Administrator on 08/08/2024 at10:30 a.m., it was confirmed the facility failed to provide nutritional supplement as ordered on 02/06/2024 and 04/10/2024 until 04/20/2024. Review of Patient #1s medical record revealed an ordered dated 02/06/2024 at 2:13 P.M." for Chocolate Ensure twice (2) a day (BID) and on 04/10/2024 at 12:34 p.m. Ensure/Boost supplement was ordered daily as needed when pt doesnt eat meal due to decrease appetite further review reveals the nutritional supplements were not delivered until 04/20/2024. Review of the facilitys policy and procedure title, ";Scope of Services", policy #LD.1, Revised Date 03/24/24, revealed, ";...Procedure...XV. Medical supplies...related to the palliation and management of the terminal illness and related conditions, as identified in the Hospice Plan of Care, must be provided by the Hospice while the patient is under hospice care..." During the exit conference on 08/08/2024 at 3:30 p.m. with Regional Administrator and Branch Director, survey findings were discussed, and no further documentation was submitted for review.