Every finding on record at Caresouth Hospice, LLC

Based on chart reviews and interviews, the hospice failed to ensure its Skilled Nurses (SN) managed continuous assessments for wound measurements, lab results and urinary catheter care for 3 of 11 patient charts reviewed for care and services. (Patient #2, #3, and #4) The findings include: Patient #2 On 5/4/2022 at 10:28 AM, review the physician orders dated 2/2/2022 in Patient #2's chart revealed "insert #18 Foley catheter". Review of the SN note dated 2/2/2022 revealed "foley [Foley]catheter inserted with no output". There was no documentation for size of urinary catheter inserted. On 5/5/2022 at 9:14 AM, the Administrator and Hospice Director reported, "Should have documented more information", and verified the finding. Patient #3 On 5/4/2022 at 11:05 AM, review of Patient #3's SN notes revealed the patient had a Stage II pressure ulcer on the right heel. There was no documentation for wound measurements of the pressure ulcer on the patient's right heel during the week of 5/10/2021. Patient #3 expired on 5/22/2021. On 5/5/2022 at 9:33 AM, the Administrator and Hospice Director verified the finding. Patient #4 On 5/4/2022 at 9:01 AM, review of Patient #4's physician orders dated 4/21/2022 revealed orders to obtain a stool specimen for testing C. diff. Nursing note dated 4/21/2022 reports "collected stool specimen for testing for C(Clostridium) diff (Difficile)". There was no follow-up documentation for results of the C Diff test. On 5/5/2022 at 9:27 AM, the Administrator and Hospice Director verified the finding.

Based on observations and interviews, the hospice leadership failed to ensure its staff followed accepted principles of infection control in the provision of patient care by 2 of 2 Skilled Nurses (SN #1 and SN #2) and 1 of 1 Certified Nurse Assistant (CNA #1). The findings include: Patient #4 Observations of Patient #4 in a facility visit on 5/3/2022 between 11:28 AM and 12:08 PM revealed CNA #1 failed to sanitize the electronic charting device and carried the electronic device under his/her arm touching his/her uniform. On 5/3/2022 at 12:06 PM, CNA #1 verified that he/she had not sanitized the electronic equipment. Observations of SN #1 on 5/3/2022 between 11:51 AM and 12:50 PM in the provision of care for Patient #4 revealed the SN touched his/her face mask and glasses 8 times without performing hand hygiene, failed to sanitize the electronic device, and carried the electronic device under his/her arm pressed directly against his/her uniform. On 5/3/2022 at 12:47 PM, SN #1 verified the findings. Patient #5 Observation in Patient #5's home on 5/3/2022 between 1:25 PM and 2:03 PM revealed SN #2 failed to sanitize the electronic device after charting and carried the soiled electronic device under his/her arm pressed directly against his/her uniform. On 5/3/2022 at 1:58 PM, SN #2 verified the findings.

Based on review of the hospice's personnel file and interview, the hospice leadership failed to provide evidence of education or training specific to grief and loss for the bereavement coordinator who is responsible for bereavement services for the hospice patients and families. The finding includes: Review of the hospice's personnel files on 5/5/2022 at 9:25 AM revealed there was no documentation that the hospice's bereavement coordinator received training specific to grief and loss and the job description of the duties for bereavement were not clear. On 5/5/2022 at 11:05 AM, the bereavement counselor when asked about specific grief and loss training revealed "no" and reported the bereavement coordinator job description is combined with the Volunteer Coordinator job description.