Every finding on record at Silverado Hospice of Houston, Inc.

Observed in Record Review. In 19 of 19 patient records reviewed, The written plan of care is based on the patient’s goals and the time frames, settings, and services required to meet those goals. During review of patient records it was noted that in records 1-19 there was no documentation of time frames with goals in the plan of care. This was confirmed by the QAPI Director.

Observed in Record Review. In 7 of 19 patient records reviewed, The plan of care did not include all services needed for the palliation and management of the terminal illness and related conditions, including the following: to manage pain and symptoms. During review of patient records 4, 5, 6, 11, 12, 13, and 14 it was noted that interventions were not documented based upon the patient assessment. For example in record 8 there was no intervention for dyspnea as identified in the comprehensive assessment. This was confirmed by the QAPI Director.

Observed in Individual Tracer. The organization did not implement the infection prevention and control activities it has planned. During home visit 2 it was observed that the aide did not wash her hands upon entering the patients apartment and before donning gloves. This was confirmed by the Administrator. Observed in Individual Tracer. The organization did not implement the infection prevention and control activities it has planned. During home visit 2 it was noted that the aide did not cleanse her hands before entering the equipment bag on two occasions. This was discussed with the Administrator.

Observed in Record Review. In 5 of 5 patient records reviewed, The hospice did not inform the attending physician of the availability of a discharge summary. The discharge summary was not provided to the practitioner upon the their request and includes the patient's medical and health status at the time of discharge. During review of records 15, 16, 17, 18 and 19 it was noted that the discharge summary was not made available to the physician. This was confirmed by the QAPI Director.