Every finding on record at St. Anthony Hospice

Observed in Record Review. In 5 of 10 records reviewed, surveyor noted that the organization failed to provide a written plan of care based on the patient's goals and time frames required to meet those goals. For example, in HV#1 for the problem of altered cardiac function, the goal stated patient's edema will be diminished in a month, in HV#3 for the problem of altered respiratory status, the goal stated patient will be able to tolerate physical assistance and care without shortness of breath with current treatments in 1-2 weeks, in NHV#5, for the problem of anxiety, the goal stated anxiety will be managed effectively by current medication by reduction of anxiety within 1 hour of intervention in 1-2 weeks, in NHV#6 for the problem of anxiety, the goal stated medications for patient's anxiety/panic attacks/restlessness will be effective within 30 minutes of administration in 1-2 weeks, and in NHV#7, for the problem of pain, the goal stated signs and symptoms of non-verbalized pain will be minimized/controlled within 1-2 hours after (administering) medication. This was reviewed with the Administrator and Director of Patient Care Services.

Observed in Record Review. In 1 of 10 records reviewed, surveyor noted that the organization failed to include all services needed for the palliation and management of the terminal illness and related conditions on patient's plan of care. For example, during HV#3, surveyor noted that patient had an over-the-bed table and suction machine, however, upon subsequent record review surveyor noted that the over-the-bed table and the suction machine were not included on the treatment orders/plan of care. This was reviewed with the Administrator and Director of Patient Care Services.

Observed in Patient Home. In 1 of 3 home visits, surveyor noted that the aide did not follow the written plan of care for patient transfers.. For example, in HV#1, the clinician transported the patient in a transport chair from the patient's bedroom to the bathroom without attaching the leg rests to the transport chair, causing the patient's feet to drag on the floor for a few seconds before the patient's caregiver lifted patient's feet to prevent them from dragging on the floor during the transport to the bathroom. The aide did attach the leg rests prior to transporting patient from the bathroom back to the bedroom. This safety concern was not identified and addressed with the clinician and the Director of Patient Care Services.

Observed in Record Review. In 2 of 8 patient records reviewed, Hospice surveyor noted that not all of the goals on the hospice care plan were measurable. For example , for records #3 the goal related to heart disease stated Symptoms of heart disease like Dyspnea/SOB ,elevated BP, syncope, edema will minimize/control /resolve within 24 hours after nursing intervention/medication within 90 days. For home visit #2, the goal was Symptoms will minimize/resolve within 2 to 3 hours after medication. This was validated by the Administrator.