Every finding on record at Ehs Home Health Care Service Inc.

Observed in Tracer Activities. .During observation of the IDG meeting for patients currently receiving care from the gold team members, the surveyor listened to a review by members of the team preparing the patients for recertification as well as evaluating the patients' progress toward the goals established, the surveyor noted that only clinical areas were reviewed and addressed without input from other staff members representing ancillary services provided eg volunteer services, social work services, chaplain services, etc. This omission was discussed with Hospice management at the time of the survey,

Observed in Patient Home. In 1 of 5 home visits conducted, nurse did not follow organization's cleaning and disinfection policy. In HOSHV#2, the nurse was observed disinfecting equipment without wearing gloves as required by organization's Policy 7918- HHS Cleaning and Disinfection of Non-Critical Equipment and Devices, which states, Gloves are to be worn when cleaning with disinfectants. This was confirmed by the Director of Clinical Services. Observed in Patient Home. In 1 of 5 patient records reviewed, the nurse did not follow the organization's bag technique policy. In HOSHV#2, the nurse was observed placing sphygmomanometer bag on top of the overbed table without placing a barrier as required by organization Policy 7989 HHS Healthcare Bag Technique, which states, Remove required equipment and supplies from bag and place on the impervious barrier. Use additional impervious barriers as needed. This was confirmed by the Director of Clinical Services.

Observed in Record Review. In 1 of 11 patient records reviewed, care was not provided according to the aide care plan. In HOSRR#20, there was no hospice aide care plan documented in the electronic medical record; however, the aide made a scheduled visit. When questioned, the Hospice Clinical Educator explained that the aide care plan had not been completed even though a visit frequency was established. Upon further review, it was determined that the registered nurse verbally gave instructions to the home health aide as to the care that was to be provided. This was confirmed by the Hospice Clinical Educator. Observed in Record Review. In 6 of 11 patient records reviewed receiving aide services, the organization did not plan the patient's care. In HOSHV#3, HOSRR#8, HOSRR#15, HOSRR#19, a patient had wound(s) and the aide care plan did not instruct the hospice aide to notify the nurse if the dressing becomes wet, soiled, or dislodged. In HOSRR#16, the patient had an indwelling urinary catheter and the aide care plan did not instruct the hospice aide on catheter care, emptying the drainage bag, and ensuring the bag and catheter tubing were positioned properly. In HOSRR#20, the patient was on continuous oxygen and the care plan did not address whether the oxygen could be removed for the bath. This was confirmed by the Hospice Clinical Educator.