Every finding on record at Oakmont Hospice, LLC

Observed in Record Review. In 5 of 5 patient records reviewed, it was noted by the nurse surveyor that the plan of care did not contain a statement of the scope of discipline visits. For HORRHV#1, HORRHV#2, HORRHV#3, HORRDC#1, and HORRDC#2, the plan of care contained the frequency of the visits but not the scope or duration of the visits over the course of the certification period. Frequencies were also the same for all patients and were determined prior to the comprehensive assessment being completed by all disciplines. Findings were discussed with the Administrator and the Administrator designee.

Observed in Record Review. In 3 of 5 patient records reviewed, it was noted by the nurse surveyor that medication orders were not clear or complete. For HORRHV#1, Order for Docusate Sodium 50mg/5ml, liquid by mouth, 5-10ml 2x a day as needed for constipation. There were no instructions regarding when to give 5ml versus when to increase the dose. Also ordered was Tylenol 500mg by mouth crushed, 1-2 tablets 2xa day, there were no instructions regarding when to give one tablet versus when to give two. For HORRHV#2, Order for Latanoprost 0/005% eye drop, powder into both eyes daily at bedtime. Benzonatate 100mg 1-2 capsules, one half tablet by mouth 2x a day as need for cough - order unclear as to when to take 1 or 2 and if it is a tablet (split) or a capsule that you can't split. For HORRHV#3, order for Acetaminophen 325mg one to two tablets by mouth every 4-6 hours as need for mild to moderate pain, orders are unclear regarding range of one to two tablets for which level of pain. Findings were discussed with the Administrator, the Administrator designee, and the Licensed Practical Nurse.

Observed in Patient Home. In 2 of 3 home visits conducted, it was observed by the Nurse Surveyor that the organization did not implement the infection prevention and control activities it had planned per Hand Hygiene Policy #9-014.1. For example, during RRHV#2 the skilled nurse initially used too much hand sanitizer and shook her hands to dry them. She then went back and forth between taking the patient’s vital signs and writing them down on her note pad, repeatedly touching inanimate objects in the room and then touching the patient without hand sanitizing. She also went in and out of her bag without sanitizing her hands per policy. During RRHV#3, the skilled nurse went in and out of her bag without hand sanitizing. She then went back and forth between taking the patient’s vital signs and writing them down on her note pad, repeatedly touching inanimate objects in the room and then touching the patient without hand sanitizing. Additionally at one point during the visit, her nursing bag fell off of the walker seat she had placed it on and she stopped what she was doing, picked it up off of the floor and went back to performing the patient assessment. Findings were discussed with the Administrator who was present on the home visits and the Administrator Designee.

Observed in Medication Management Tracer. it was noted by the nurse surveyor that the organization’s policy and procedure for the management and disposal of controlled medications in the home was not consistent with state and federal law as it instructed the family/caregiver to flush unused medications. Finding was discussed with the Administrator and the Administrator designee.