Every finding on record at Texan Hospice Provider LLC

Based on record review and interview, the agency failed to provide patient specific written instructions regarding a PEG tube for the hospice aide in 1 (#3) of 4 records reviewed. The failure placed the patient at risk for injury related to inadequate or improper care of the PEG tube. --- Record review of Patient #3s record revealed an interdisciplinary group meeting care plan dated 9/22/2022. The care plan documents that the patient was admitted 9/6/2022 with a diagnosis of cerebrovascular disease (stroke). The care plans dated 9/22/2022, 10/20/2022, and 11/3/2022 showed the aide care plan did not include the PEG tube. The care plan should include instructions to the aide regarding cleaning around the tube or actions to be taken if there is a dressing at the tube site. The aide visit note dated 11/7/2022 also did not include the PEG tube. Per interview 6/29/2023 about 1:58 pm the alternate administrator stated, ";there is no care plan for the aide regarding it [PEG tube]. No aide should be doing anything with it [PEG tube]." Per interview 6/30/2023 about 9:35 am the alternate administrator stated, ";the aide care plan does not tell the aide what to do with the PEG [tube]." The agency had a policy titled ";Coordination of Care" dated 10/01/2021 that was labeled PC.110. The policy read in part: ";Purpose: To ensure coordination of all care provided for patients receiving hospice services and/ or services from other providers. Policy: I. The hospice will provide for and ensure the ongoing sharing of information between disciplines providing care and services in all settings... ...Procedure: ...VII. All communications and coordination of care is documented in the clinical record." The agency had a policy titled ";Plan of Care Process" dated 10/20/2022 that was labeled PC.30. The policy read in part: ";Purpose: To ensure that the care provided is in accordance with the written Plan of Care (POC), appropriately planned, and delivered in a timely manner to meet the patients and familys specific needs. Policy: I. All hospice care and services furnished to patients and their families will follow an individualized written POC established by the Hospice Interdisciplinary Group/ Team (IDG/ IDT) in collaboration with the Attending Physician (if any), the patient or representative, and the primary caregiver... II. The hospice will develop an individualized written POC for each patient... Procedure: ...III. B. The comprehensive assessment will take into consideration the following factors but is not limited to: ...3. Functional capabilities and status... ...8. The need for a Hospice Aide (HA) to assist with the patients activity of daily living (ADLs) and instrumental activity of daily living (IADLs). ...VI. The POC includes, but is not limited to: ...B. A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs, including level of care; ...E. Medical supplies, equipment, and appliances necessary to meet the needs of the patient..."