Every finding on record at Clarion Forest VNA Hospice

Based on policies review, clinical record review (CR), observations made during home visits and interview with the chief nursing officer, the facility failed to document that each patient's medication was reviewed for effectiveness of drug therapy, drug side effects, actual or potential drug interactions, duplicate drug therapy and drug therapy currently associated with laboratory monitoring for 1 (one) of 2 (two) observations made. OBS #1., and 1 (one) of 10 (ten) records reviewed. CR #10. Findings include: Review of policy and procedure on April 19, 2022 at approximately 4:00 PM to 5:00 PM "Clarion Forest VNA Hospice Medication Management and Control" stated " The hospice nurse will reconcile mediations during every visit. ..." Review of clinical record #10 (CR#10) revealed the medication profile that was given to state auditor (SA) for review on 4-19-2022 at approximately 1:30 PM had no documentation of the following medication: Morphine 100mg/5ml prn, expiration date 11/2023. Observation #1 (OBS#1) on 4-20-2022 at approximately 9:20 AM SA verbally reviewed current medications with patient's spouse and child. Child stated "We've had this (showing SA the morphine) since he (the patient) signed up with hospice. We just never used it." Interview on 4-21-2022 at approximately 3:00 PM with EMP#1 confirmed the above findings.

Based upon reviews of agency policy, observations, and interview with chief nursing officer ( EMP # 1), employee failed to follow infection control "nursing bag technique" and "Hand Hygiene" policies and practices for two (2) of two (2) observations {OBS}. (OBS # 1 & 2). Findings included: Review of agency policy, on 4-19-2022 at approximately 4:00 PM-5:00 PM, titled "Nursing Bag Technique" stated " 'Using the bag' Enter the home without the bag first. Assess home environment. Return to the car to get the supplies or the bag, depending on the conditions." Review of agency policy, on 4-19-2022 at approximately 4:00 PM-5:00 PM, titled "Hand Hygiene" stated " 'Procedure' Remove hand hygiene supplies from the outer pocket of the nursing bag." Observation # 1 occurred on 4-20-2022 at approximately 9:05 AM; EMP#5 retrieved the "nursing bag" from the trunk of the vehicle that was driven by EMP#5 and made initial entry into the patient's residence. Nursing bag "hung" on back of patient's chair. At approximately 9:15 AM; EMP#5 utilized hand sanitizer that was NOT removed from outer pocket of the nursing bag. Observation # 2, occurred on 4-20-2022 at approximately 10:00AM; EMP#4 retrieved the "nursing bag" from the backset of the vehicle that was driven by EMP#4 and made initial entry into the patient's residence. Nursing bag "hung" on back of the patient's kitchen chair. At approximately 10:14 AM EMP#4 utilized hand sanitizer that was NOT removed from outer pocket of the nursing bag to perform hand hygiene. Interview on 4-21-2022 at approximately 3:15 PM with EMP#1 confirmed the above findings.