Every finding on record at Reliance Hospice Services, Inc.

Observed in Record Review. Patient record was inaccurate or contained errors. In RRHV#2, the surveyor noted that HA Assignment sheet had bed rails up x 2 even though patient did not have bed rails. This was confirmed by the Administrator.

Observed in Record Review. The LVN did not follow the ordered frequency of visits. In RRHV#3, the surveyor noted that LVN visited patient twice during Week 14, even though the order was for 1 x week. This was confirmed by the Administrator. Observed in Record Review. In 2 of 11 patient records reviewed, care was not provided according to hospice plan of care. In RRHV#1, the surveyor noted that the physical therapist did not follow the ordered frequency of visits, which was 1 x week. During Week 2, patient received 2 visits. Surveyor also noted that the skilled nurse did not follow the ordered frequency of visits, which was 2 x week. During Week 1, patient received 3 visits, then in Week 2 the order changed from SN 2 x week to LVN 2 x week, yet the patient received both 1 RN visit and 2 LVN visits. This was confirmed by the Administrator.

Observed in Patient Home. In 1 of 2 home visits conducted receiving aide services, the home health aide did not provide services as ordered by the physician or allowed practitioner in the plan of care. In HV#2, the home health aide removed the oxygen while bathing even though this was not written in the HA Assignment. The surveyor also noted that the home health aide shampooed patient's hair, put deodorant and lotion on patient even though this was not an assigned task. This was confirmed by the Administrator.

Observed in Patient Home. In 2 of 3 home visits conducted, medication list from the initial home visit was inaccurate. In HV#1, the patient was on Lisinopril 20 mg 1 tab by mouth, which was not listed on the medication list, but according to the caregiver it wasn't a new medication. In HV#3, the surveyor noted that the patient was on Ibuprofen 600 mg take 1 tablet every 8 hours as needed for mild pain and fever; however, the facility has it listed as Ibuprofen 600 mg tab take 1 tab 3 times a day. This was confirmed by the Administrator.

Observed in Patient Home. Organization did not provide the patient with an individualized emergency plan. In RRHV#1, an emergency plan was not found in the home folder, nor in the patient's record. This was confirmed by the Administrator.