Every finding on record at Infinity Hospice Care of Reno, LLC

Observed in Patient Home. In 6 of 13 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, including medications and treatment necessary to meet the patient's needs. In review of the record for HV#3, the patient's plan of care included Lactulose Oral Solution 20 GM/30ML- 30mls by mouth every 8 hours daily x 5 days for constipation. It was confirmed by the RN Case Manager that the patient continued to take Lactulose routinely past the 5 days to reduce ammonia levels. In RR#2, RR#3, RR#5, RR#7, and RR#9, the patient's plan of care included multiple prn pain medications, and in RR#6, the plan of care included two (2) prn laxatives for constipation. There was no clear indications for use (which prn medication to take when). In RR#3, it was documented in the plan of care the patient had a Foley catheter. There was, however, no information/order detailing the type, size, frequency of changes, and care of the indwelling urinary catheter. This was reveiwed and verified with the Executive Director.

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 when cleaning and performing disinfection. In HV#1, the Hospice Aide indicated the fabric woven gait belt used to transfer the patient from the wheelchair to the shower chair was used from patient to patient and laundered weekly. After use, the aide also cleaned the gait belt with a Sani-Cloth prior to placing it back in the field bag. These methods for disinfecting the fabric woven gait belt were not according to manufacturer's recommendations. This was reveiwed and verified with the Executive Director.

Observed in Record Review. In 1 of 10 patient records reveiwed with hospice aide services, the organization did not plan the patient's care by ensuring written patient care instructions for the hospice aide were prepared by the registered nurse. In HV#1, it was noted the patient had a cast to the left forearm/wrist. The hospice aide covered the cast with a plastic bag and secured the bag with plastic tape to the patient's upper arm prior to the shower. In review of the record, it was noted the patient's cast, and tasks related to it, were not included in the care plan/instructions for the hospice aide. The aide also assisted the patient with the transfer from the wheelchair to the facility's roller shower chair. The shower chair was not noted on the aide care plan/instructions. This was reviewed and verified with the Executive Director.