Every finding on record at California Care Hospice Inc.

Observed in Record Review. In 1 of 3 active patient records reviewed the plan of care did not include all services needed for the palliation and management of the terminal illness and related conditions. Identified during the record review of RR HV#3, the patient had no mortuary or burial information identified, and this need was not included in the psychosocial plan of care. This was reviewed and validated with the Administrator and Director of Patient Care Services.

Observed in Record Review. In 1 of 10 patient records reviewed, the organization did not follow the plan of care. Identified during the review of the record for RR HV#2, the Skilled Nurse frequency in the Plan of Care was listed as SN to visit weekly until the end of the certification period with 3 PRN visits related to complications of colostomy site. The Skilled Nurse visit frequency was consistently 2-3 times weekly during the past six months prior to the survey date. This was reviewed and validated with the Administrator and Director of Patient Care Services.

Observed in Patient Home. In 2 of 3 home visit observations conducted, the organization did not use standard precautions to reduce the risk of infection in accordance with policy#9-009.2 - Hand Hygiene. Observed in RRHV#2, the Hospice Aide was gloved as she assisted the patient to the bathroom for a shower. She removed her gloves, and performed hand hygiene, drying her hands on a white cloth towel hanging in the patient's bathroom. Observed in RRHV#3, following the completion of the patient's assessment, the Licensed Vocational Nurse performed hand hygiene, turning off the faucet with his left hand prior to drying his hands with a paper towel. This was reviewed and validated with the Administrator and Director of Patient Care Services. Observed in Patient Home. In 1 of 3 home visits conducted, the organization did not reduce the risk of infections associated with medical equipment, devices, and supplies in accordance with the organizational policy#9-014.2 - Bag Technique. Observed in RRHV#1, the Registered Nurse used a manual blood pressure cuff and infrared thermometer to assess the patient. Following completion of the patient's assessment the infrared thermometer was returned to the clean section of the bag without first being disinfected. This was reviewed and validated with the Administrator and the Director of Patient Care Services.

Observed in Patient Home. In 3 of 3 home visits conducted, the organization had not provided patient education and training based on the patients' condition and assessed needs that included the safe and effective use of medical equipment provided by the organization, or Information on the storage, handling, and access to medical gases and supplies. Identified during the review of the Start of Care Packet, and during home visit observations, there was no evidence of education provided on the potential safety risks associated with the use of siderails (restraint-like equipment) on hospital beds, nor on the safe storage of portable oxygen cylinders. Observed in RRHV#1, the patient was bed bound in a hospital bed with bilateral full siderails in the up position. Observed in RRHV#2, the patient was ambulatory and had a hospital bed with bilateral full siderails, and in RRHV#3, the patient was in a hospital bed with bilateral half siderails, and on supplemental oxygen therapy as needed via concentrator and portable oxygen cylinder. This was reviewed and validated with the Administrator, and the Director of Patient Care Services.