Every finding on record at Marshall Manor Homecare ,LLC

Observed in Record Review. The organization's NOMC discharge of services process was flawed. In RRDC#1, the hospice surveyor noted that the discharge notice provided to patient did not include a section informing patients of their right to appeal and the QIO name and number. Organization was providing patients with a 5 Day Discharge Notice Form and attaching their Patient Discharge Policy PE.4. This was confirmed by the Director of Nursing.

Observed in Record Review. In 1 of 19 patient records reviewed, initial bereavement assessment not completed. In RRHV#1, the surveyor did not find documentation of a bereavement risk assessment in the medical record. This was confirmed by the Director of Nursing.

Observed in Record Review. The need for volunteer services not assessed. This was confirmed by the Director of Nursing.

Observed in Patient Home. In 1 of 4 home visits conducted, staff failed to perform hand hygiene consistent with policy. In RRHV#1, the surveyor observed that the nurse failed to perform hand hygiene in-between glove changes as per the organization's Hand Hygiene Policy IC.15. This was confirmed by the Director of Nursing.

Observed in Record Review. In 1 of 17 patient records reviewed receiving aide services, staff did not provide written patient care instructions for the hospice aide that addressed oxygen and wounds. In RRHV#1, the surveyor noted that the patient was on continuous oxygen and the aide care plan did not address whether the oxygen could be removed for the bath. The surveyor also noted that patient had a coccyx wound and a skin tear to right shin and the aide care plan did not provide directions if dressing becomes soiled or dislodged. This was confirmed by the Director of Nursing.

Observed in Record Review. In 2 of 19 patient records reviewed, the patient's medication profile contained discrepancies. In RRHV#2 record review, the surveyor noted that patient had Cephalexin 500 mg oral tablet; take 1 tab 3 times a day for 7 days. Medication should have discontinued on the medication profile. In RRNHV#3, the surveyor noted that the patient had Cephalexin 250 mg oral capsule; take 1 tab(s) oral 2 times a day for 7 day(s) for infection. Medication was still active and should have been discontinued. This was confirmed by the Director of Nursing.

Observed in Patient Home. In 1 of 3 home visits conducted with patients on oxygen therapy, multiple oxygen tanks were standing upright unsecured. According to caregiver, education had not been provided to reinforce the safety of securing the tanks.  This was confirmed by the Director of Nursing.