Every finding on record at Family Paramount Hospice LLC

It is required that the hospice follows accepted standards of practice to prevent the transmission of infections and communicable disease, including the use of standard precautions, such as hand hygiene. This standard was not met as evidenced by document review, interview and observation. In 1 of 3 (33%) home visit observations it was revealed that the organization did not ensure the staff followed the hand hygiene policy. Document 1: Agency Policy: 5.8 Standard Precautions for All Health Care Workers, dated 2023, stated in part, "Thorough hand washing/hand antisepsis is required of all employees. If antimicrobial hand soap is used, it must be for a period of at least 20 seconds. CDC Hand Hygiene Resource web page. Before and after caring for clients, or when coming in contact with inanimate objects/equipment in the immediate vicinity of the client. Between tasks on the same client and particularly when there is prolonged or intense contact with client, i.e., bathing; after removing gloves, after touching objects that are potentially contaminated... Wet hands with water. Apply enough soap to cover all hand surfaces. Rub hands together palms facing while interlock fingers, then with palms down, one hand on top of the other interlock fingers and rub. Cup one hand and with fingers together on the opposite hand scrub your nails in the palm of the cupped hand. Repeat with the opposite hand. Rinse hands with warm, not hot water. Dry hands completely using a single-use towel or air dry. Use an alcohol-based hand rub that contains 60-95% alcohol if soap and water are not available. Cover all surfaces of your hands and rub them together until they feel dry. " Home Visit 2: During the home visit (Clinical Record 2) on 04/24/2024 with the Registered Nurse (RN) (Staff 5), the RN was observed to wash the hands with soap and water, turn off the water with hand/arm, and use toilet paper to dry the hands. The RN washed the hands with soap and water and dried them with toilet paper two more times during the visit. The RN donned gloves to give a suppository. The RN removed the gloves and picked up the patient's hospice binder to document the visit without washing the hands. The hands were not washed after removing the gloves. Toilet paper was not approved for drying the hands after washing with soap and water. During a document review and interview on 04/24/2024, the Director of Nursing confirmed that the staff did not follow the hand hygiene policy.

It is required that a patient clinical record containing past and current findings is maintained for each hospice patient. The record contains correct clinical information that is available to the patient’s attending physician and hospice staff. The record may be maintained electronically or on paper. Each patient’s record includes, at a minimum signed copies of the notice of patient rights and the hospice election statement. This standard was not met as evidenced by clinical record review. In 3 of 7 (43%) clinical records reviewed it was revealed that the agency did not ensure the clinical record contained a date of the election on the hospice election of benefit statement. Clinical Record 1: The admission date was 11/23/2023. However, the hospice document, "Election, Informed Consent, and Acknowledgment," dated and signed on 11/22/2023, lacked a date of election. A space was available for a date, but it was left blank. Clinical Record 2: The admission date was 12/16/2023. However, the hospice document, "Election, Informed Consent, and Acknowledgment," dated and signed on 12/16/2023, lacked a date of election. A space was available for a date, but it was left blank. Clinical Record 4: The admission date was 12/05/2023. However, the hospice document, "Election, Informed Consent, and Acknowledgment," dated and signed on 12/05/2023, lacked a date of election. A space is available for a date, but it was left blank.