Every finding on record at Thomaston Hospice, Inc.

Based on review of clinical records, it was determined that the hospice agency failed to ensure that the initial comprehensive assessment was completed within 48 hours after the election of hospice care for one of 12 sampled Patients (P) (P#4). --- The Findings Include: Review of the clinical record for P#4, revealed P#4 was admitted on 8/19/2022 with a diagnosis of Amyotrophic lateral sclerosis (ALS) a progressive nervous system disease that affects nerve cells in the brain and spinal cord, causing loss of muscle control, Atrial Fibrillation (A-fib) a quivering or irregular heartbeat (arrhythmia), and hypertension (HTN) when your blood pressure, the force of blood flowing through your blood vessels is consistently too high. An interview conducted on 1/18/2023 at 3:28 p.m. with the Clinical Administrator revealed that she did not know why the admission nurse (RN) BB completed the admission on 8/25/2022. The Clinical Administrator also confirmed that the surveyor has been provided with all available documentation for the patients record.

Based on observation, clinical record review, and staff interviews, it was determined that the agency failed to ensure that patient plan of care was updated to reflect wound care treatment orders at the time of the comprehensive assessment for one patient (P)(P#2) of twelve (12) sampled patients. --- Based on clinical record reviews, and staff interview, it was determined that the agency failed to ensure that patient plan of care was updated to reflect wound care treatment orders at the time of the comprehensive assessment for one Patient (P)(P#2) of 12 sampled patients. Findings include: During a skilled nursing facility visit conducted on 1/18/2023, at approximately 12:30 p.m., with Registered Nurse (RN) AA, for (P#2), it was revealed that (P#2) was admitted on 11/10/2022, with a diagnosis of cerebral infarction (the pathologic process that results in an area of necrotic tissue in the brain (cerebral infarct), gastroesophageal reflux disease (GERD) occurs when stomach acid repeatedly flows back into the tube connecting your mouth and stomach (esophagus), diabetes (a metabolic disorder in which the body has high sugar levels for prolonged periods of time), coronary artery disease (CAD) the major blood vessels that supply the heart (coronary arteries) struggle to send enough blood, oxygen and nutrients to the heart muscle), hemiplegia (a condition caused by brain damage or spinal cord injury that leads to paralysis on one side of the body), hypertension (HTN) when your blood pressure, the force of blood flowing through your blood vessels is consistently too high, seizure (a sudden, uncontrolled electrical disturbance in the brain), and Alzheimers disease (a progressive neurologic disorder that causes the brain to shrink (atrophy) and brain cells to die). The surveyor compared the current plan of care at the skilled nursing facility for P#2 to the hospice agency's plan of care. Discrepancies were found. The following wound treatment orders were missing from the hospice plan of care for P#2: The order dated on 11/23/2022, revealed to clean open area to right great toe with normal saline, pat dry, apply Medi honey, wrap with gauze, and secure with tape. The order dated 12/29/2022, revealed that skilled nurses should apply betadine to right lateral foot wound. The order dated 12/29/2022, revealed that skilled nurses should apply betadine to front left lower leg wound.