Every finding on record at Traditions Hospice of Madisonville, LLC

Observed in Record Review. In 2 of 9 patient records reviewed, for active patients, it was noted by the nurse surveyor that for the Interdisciplinary group meeting notes did not document decline, revisions to plans of care and goals. For example, for HOSHV#1/RR#1, the IDG notes did not reflect the patient’s response to an antibiotic prescribed to treat a UTI. There was no follow up documentation in the IDG notes related to the patient’s UTI. In HOSRR#9 the IDG notes did not reflect the patient’s response to medication changes related to agitation nor did the documentation reflect how the patient’s wound was responding to the ordered treatment. All findings were verified by the Clinical Team Leader.

Observed in Record Review. In 9 of 9 patient records reviewed, for active hospice patients the nurse surveyor noted that the goals were not measurable. For example, “Pain will be managed at a level acceptable to patient in 7 days,” and “Patient/caregiver will feel relief from spiritual concerns” and “Patient/Caregiver will verbalize/demonstrate reductions or relief of cardiopulmonary symptoms by week 3. Additionally, goals were not consistently updated but remained mostly the same from recertification to recertification. Findings were verified by the Clinical Team Leader.

Observed in Patient Home. In 1 of 3 home visits conducted, it was observed by the Nurse Surveyor that the organization did not implement the infection prevention and control activities it had planned per policy “Hand Hygiene – IC15 Policy and Procedure”. For example, during HOSHV#2/RR# the hospice aide washed her hands with soap and water and donned gloves. She then filled up two pans of water for the patient’s bath and placed them at the bedside. She then doffed her gloves and donned cleaned ones without performing hand hygiene per policy. She then began to bathe the patient. At one point during the bath she doffed one glove to put the patient’s dirty gown in the laundry bag and she then donned another glove without hand sanitizing. The Clinical Team Leader was present during the visit and observed the infection control breaches.

Observed in Patient Home. In 1 of 1 home visits conducted, with the hospice aide, it was noted by the nurse surveyor that the hospice aide did not provide care according to the hospice aide plan of care. for HOSHV#2/RR#2, the hospice aide care plan instructed the hospice aide to provide a bed bath Monday, Wednesday, and Friday and a shower Tuesday and Thursday. When asked, the hospice aide said she does not shower the patient, she only provides bed baths. Additionally, the hospice aide care plan instructed the hospice aide to shampoo the patient’s hair every visit, however, the hospice aide stated she only shampoos the patient one time a week. Findings were verified by the Clinical Team Lead who was present during the visit.