Every finding on record at Nevada Community Hospice LLC

Observed in Patient Home. In 1 of 3 home visits conducted, several medications in the comfort pack were expired. In HV#1/RR#1, the medication reconciliation process revealed several expired medications, including Lorazepam and Morphine which expired 8 months ago. This was confirmed by the Executive Director.

Observed in Record Review. In 4 of 11 patient records reviewed, the initial bereavement assessment was not completed. In RR#4, RR#5, RR#6, and RR#8, the surveyor noted the bereavement risk assessment was not completed as part of the comprehensive assessment. This was confirmed by the Executive Director.

Observed in Record Review. In 1 of 10 patient records reviewed, The Aide Care Plan did not address the patient wounds. In HV#3/RR#3, the surveyor noted that the patient has 2 wounds, which were not addressed in the aide care plan. This was confirmed by the Executive Director.

Observed in Patient Home. In 2 of 11 patient records reviewed, organization did not provide care according to the patient's individualized plan of care. In HV#3/RR#3, the aide plan of care indicated that patient receive a bed bath on (Mon, Wed, Fri) and clean living area on (Tue, Thu). During survey, living area should have been cleaned. Surveyor also noted upon review of aide visit notes that aide has been documenting that bed bath and clean living area were completed every visit. In HV#7, the aide provided care without an aide care plan being in place. Care plan was created 2 days after initial aide visit. This was confirmed by the Executive Director.

Observed in Patient Home. In 1 of 3 home visits conducted, Hospice aide failed to notify the organization of her concerns regarding the diapers not being changed on a regular basis. Hospice aide reported to the surveyor that she started adding the date to the diaper. Patient has a stage 3 wound to L heel and an unstageable wound to coccyx. This was confirmed by the Executive Director.

Observed in Record Review. In 1 of 10 patient records reviewed, staff were not supervised effectively. In RR#4, the surveyor noted that the Home Health Aide had not been supervised every 14 days as required. A supervisory visit had not been performed in excess of 15 days during an episode. This was confirmed by the Executive Director.

Observed in Record Review. In 1 of 11 patient records reviewed, HCO does not have a policy regarding making changes in the record or protecting the integrity of the patient record. Upon review of Policy 5.004-Communication and Clinical Record Documentation, which states draw one single line through the entry so that the written information. The policy is incomplete. This was confirmed by Executive Director. Observed in Record Review. In 1 of 11 patient records reviewed, The organization failed to maintain the security and integrity of health information. In RR#10, the surveyor noted that the Election of Benefits form was amended the following day. The patient put a line through and initialed, but the date of when the correction was made was not recorded. This was confirmed by the Executive Director.

Observed in Patient Home. In 1 of 3 patient records reviewed, HCO failed to take action to minimize identified safety and security risks. The home health aide and nurse noticed that the bed rail was broken for a patient identified as a fall risk. In HV#3/RR#3, the surveyor noted that the bed rail still had not been fixed. Bed rail was fixed 2 days later. This was confirmed by the Executive Director.