Every finding on record at Kaiser Permanente Care at Home, Oahu Hospice

Observed in Record Review. In 1 of 11 patient records reviewed, the organization failed to plan the patient's care. During record review for RRNHV#7, the Hospice Nurse Surveyor observed the nurse documented skin tear right arm, provided wound care- cleansed, placed non-adherent dressing, Wrapped with rolled gauze, secured with tape. Upon review with the organization there were no orders for this wound care. This was discussed and reviewed with the Hospice Team.

Observed in Record Review. In 2 of 6 patient records reviewed, where aide services were ordered, the organization failed to provide care, treatment, or services in accordance with orders, as required by law and regulation. During record review for RRNHV#4 and RRNHV#7, the Hospice Nurse Surveyor observed the aide care plan had not been followed. For example in RRNHV#4, 3 times in the month of February the aide documented declining tasks and one time in March. But there was no communication to the IDG that patient was refusing certain tasks. For RRNHV#7, aide documentation stated the patient declined oral hygiene twice in February, and declined shaving 3x in January and once in February. There was no communication to the IDG. This was discussed and reviewed with the Hospice Team.

Observed in Patient Home. In 1 of 3 home visits conducted, the organization failed to provide a written copy of procedures to follow if care, treatment, or services are disrupted by a natural or man-made emergency. During RRHV#3, the Hospice Nurse Surveyor observed the patient did not have an emergency plan in the home and the one in the SOC booklet was blank. This was discussed and reviewed with the Administrator.