Every finding on record at Talna Hospice Care

Observed in Record Review. In 2 of 4 extended prognosis, During closed record review for live discharges, the Hospice surveyor noted in 2 of 4 records, that there was no documented discussion in the IDG notes that a discharge for extended prognosis was considered prior to the actual discharge. This was validated in a discussion with and observation by the DPCS.

Observed in Emergency Management Session. The surveyor learned that the Emergency Operations Plan did not describe how state and local emergency preparedness officials would be informed of any on-duty staff that they were unable to contact. This was discussed with the Director of Patient Care Services. Observed in Emergency Management Session. The surveyor learned that the Emergency Operations Plan did not describe how state and local emergency preparedness officials would be informed before, during, and after emergencies on patients the organization was unable to contact or in need of evacuation. This was discussed with the Director of Patient Care Services.

Observed in Record Review. In 11 of 11 patient records reviewed, it was noted that the state of California information was provided to patients in their home folders, but the advance directive policy was not. This was discussed with the Director of Patient Care Services.

Observed in Record Review. In 11 of 11 patient records reviewed, the surveyor found that interdisciplinary group meeting notes did not document decline since the previous meeting, nor include clinicians’ plans for upcoming visits during the next two weeks. Many nurses’ notes did document changes since the previous meeting but didn’t include plans. Entries by the social worker and spiritual counselor didn’t document changes or plans. This was discussed with the Director of Patient Care Services.

Observed in Record Review. In 9 of 11 patient records reviewed, it was indicated how many weeks would be required for goals to be accomplished. Dates for completion of the goals were changed frequently, but the number of weeks remained the same, and there was no resolution documented. This was discussed with the Director of Patient Care Services.

Observed in Record Review. In 11 of 11 patient records reviewed, it was noted that patients were provided a form for individualized emergency plans, however one was missing demographic information and all three did not address specific needs such as use of oxygen, home medical equipment, mobility issues, etc. Additionally, there was documentation in their records to indicate that education was provided. This was discussed with the Director of Patient Care Services.