Every finding on record at Orison Hospice, Inc.

Upon patient record review, 2 of 11 (Patient #2, 11) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient #2 and 11, SC and MSW were ordered on the plan of care, with needs identified. The plan of care did not include goals and interventions for SC and MSW.

Upon patient record review, 2 of 11 (Patient #1, 8) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #1, Start of care order included notify MD for SB/P >160 and DB/P >90. SN visit on 11/11/22 B/P 154/98, no documentation of MD notified of elevated B/P. SN visit on 11/25/22 B/P 156/105, no documentation of MD notified of elevated B/P. Patient #8, Start of care order included notify MD for SB/P >160 and DB/P >90. SN visit on 10/23/22 B/P 146/98, no documentation of MD notified of elevated B/P.

Upon observation, there was no evidence the hospice follows acceptable standards of practice to prevent the transmission of infections and communicable diseases, including standard precautions. Patient #1, 2 and 3, LVN went in and out of nursing bag without sanitizing hands between each time entering bag.