Every finding on record at Medical Planet Center

Upon observation, there was no evidence that the patient had the right to be able to identify visiting personnel members through agency generated photo identification. The visiting nurse did not have an agency generated photo id badge when home visits were conducted.

Upon patient record review, 2 of 5 (Patient #2 &3) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications, including herbal remedies that could affect drug therapy. Patient #2 the review of medications was not updated; patient's Ozempic injection was listed twice; 1mg and .5mg injections in a pre filled pen. Basaglar Kwik Pen 90 mg by injection was listed in the medication profile and plan of care as 50 units by injection daily. Patient #3 the medication profile was not updated, Lispro Insulin 5 units by subcutaneous injection was active on survey day 10-18-23, which upon verification with board and care administrator, this medication has been discontinued and patient was not on Insulin as ordered by the physician. There was not an update in the medication profile and or a coordination documented that it was clarified with physician.

Upon patient record review, 1 of 5 (Patient #3) did not have evidence that patient and family received any education and training as appropriate to their responsibilities for the care identified in the plan of care. Patient's plan of care included Insulin injections daily. There was no documentation of teaching, patient/family response to teaching, their level of understanding and the patient's caregivers level of progress towards meeting goals. No written instructions were provided to the patient/family.

Upon patient record review, 3 of 5 (Patient #1,2,3) did not have evidence the plan of care included all services necessary for the palliation and management of the terminal illness and related conditions, including equipment and supply needs. Patient #1 the Plan of Care or any physician's order did not include the patient's walker that was observed and confirmed with patient during home visit. Patient #2 the Plan of Care or any physician's order did not include the patient's walker that was observed and confirmed with patient during home visit. Patient # 3 the Plan of Care or any physician's order did not include the Hospital bed, overbed table that were observed and confirmed with patient during home visit.

Upon patient record review, 1 of 5 (Patient #3) did not have evidence that a revised plan of care includes information from the patient's updated comprehensive assessment and must note the patient's progress towards outcome/goals from the plan of care. Patient 3 had an open wound on the L lateral forearm prior to the home visit on 10-18-23; there was no documented collaboration with the physician or an update in the IDG for the new integumentary problem and how it will be addressed and any wound care goals.

Upon client record review, 1 of 5 (Patient #3) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 3 The nurse was observed to performing the following wound care to the left forearm; wiped the open wound with wet gauze dressing 4 times, patted dry, applied with 2% Mupirocin Ointment and covered with non adherent dressing and secured with tape that had no physician order and was not included in the plan of care/IDG's updates.

Upon personnel record review, 1 of 14 (Personnel #6) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: ·Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff. ·Reading and recording temperature, pulse, and respiration ·Safe transfer techniques and ambulation. ·Normal range of motion and positioning ·Appropriate and safe techniques in personal hygiene and grooming that include-- ·(A) Bed bath ·(B) Sponge, tub, and shower bath ·(C) Shampoo, sink, tub, and bed ·(D) Nail and skin care ·(E) Oral hygiene ·(F) Toileting and elimination The other subject areas in this section may be evaluated through written examination, oral examination or after observation of a Hospice Aide with a patient.

Upon personnel record review, 1 of 14 (Personnel #2) did not have evidence in the alternate administrator's personnel record of a signed job description for this role.

Upon personnel record review, 1 of 14 (Personnel #9) did not have evidence that a skills competency assessment, specific to the discipline had been conducted for the volunteer initially during orientation.

Upon patient record review, 1 of 5 (Patient #3) There was no evidence the plan of care had identified who will check the patient's blood sugar levels which was ordered daily and the administration of the Lispro Insulin 5 units subcutaneous injection TID. The patient was assessed as insulin dependent diabetic, living in a board and care facility and was under the care of non - licensed caregiver, needs maximum assist on all ADLs and unable to safely administer own medications.

Upon personnel record review, 1 of 14 (Personnel #12) did not have evidence that personnel credentialing activity was conducted to verify qualification of the credentialed/licensed personnel in the position held at the time of hire in accordance with specific state practice act requirements.

Upon personnel record review, 1 of 14 (Personnel #12) did not have evidence the hospice obtained a criminal background check on the contracted individual who have direct patient care and access to patient records.