Every finding on record at Tri County Hospice, Inc

Based on record reviews and interview, the Hospice failed to update the patient's Plan Of Care (POC) to reflect the patient's current status for 10 of 13 patient records reviewed. (Patient #1, #3, #4, #5, #6, #7, #8, #9, #11, and #12 ) The findings are: Patient #1 On 2/9/2022 at 12:35 PM, review of Patient #1's chart revealed the patient had an Election Of Care (EOC) dated of 10/26/2021. Certification period from 10/26/2021 to 1/23/2022. The patient's Plan Of care showed the following problems: COVID monitoring, High Risk for Falls, Altered Nutrition, Emotional Support, and Anticipatory Grief. Advanced Directives was added on 10/29/2021. Patient ordered Aide services three times a week, but the patient's plan of care had no problem that addressed the patient's need for "Assistance with Activities of Daily Living." The Interdisciplinary Group (IDG) meeting note dated 12/1/2021 revealed the patient is "currently on oral antibiotics for an upper respiratory infection. The patient is complaining of ear pain and sore throat." The patient's plan of care had no problems addressing the patient's pain or respiratory issues. The findings were verified by the Administrator on 2/11/2022 at 11:59 AM. Patient #3 On 2/9/2022 at 2:55 PM, review of Patient #3's chart revealed the EOC was dated 7/10/2021, and the patient's diagnoses included Hypertensive Heart and Chronic Kidney with Heart Failure. Certification period reviewed began on 1/8/2022. The IDG meeting minutes dated 1/26/2022 revealed the patient was "incontinent of bowel and bladder." Aide visits (with two Aides due to patient size) ordered five times a week for a complete bed bath with etc. Patient is bed bound. The patient's POC had no problem for incontinence or assistance with activities of daily living (Bed Bath). The IDG meeting notes revealed the patient has four plus edema to left lower extremity and three plus edema to the right lower extremity, but was not addressed on the patient's POC. The findings were verified by the Administrator at 12:19 PM on 2/11/2022. Patient #4 On 2/9/2022 at 3:30 PM, review of Patient #4's chart revealed the EOC was 12/27/2021. Certification period reviewed was 12/27/2021 to 3/26/2022. Patient admitted with Chronic Obstructive Pulmonary Disease (COPD). The IDG meeting minutes dated 12/28/2021 revealed patient needs are "shortness of breath, anxiety, decreased mobility, edema, and pain." Review of the patient's POC revealed the POC did not address the patient's anxiety, decreased mobility, or edema. The IDG meeting minutes for 1/25/2022 stated "three plus edema in both legs and feet" and "needs extensive hands on assistance with personal care because of shortness of breath." Aide visits were ordered five times a week. The POC had no problem for a deficit in the patient's ability to perform personal care. IDG meeting minutes dated 2/28/2022 revealed the patient developed "thrush in mouth" and medication ordered, but the patient's POC was not updated with this problem. The findings were verified by the Administrator at 12:04 PM on 2/11/2022. Patient #5 On 2/9/2022 at 4:00 PM, review of Patient #5's chart revealed the patient's EOC was dated 11/19/2021. Certification period reviewed was 11/19/2021 to 2/16/2022. Patient was admitted with Chronic Obstructive Pulmonary Disease(COPD) and encounter for fitting and adjustment of urinary device. The IDG meeting minutes dated 11/23/2021 revealed "has a suprapubic catheter placed, 14 French 10 milliliter balloon." On 1/11/2022, the IDG meeting minutes revealed "high fall risk." Aides were ordered three times a week. The patient's POC did not address COPD issues, the suprapubic catheter, or falls risk. The finding was verified by the Administrator at 12:12 PM on 2/11/2022. Patient #6 On 2/10/2022 at 9:54 AM, review of Patient #6's chart revealed the patient's EOC was dated 11/05/2021. Certification period reviewed was 11/05/2021 to 1/3/2022. Patient #6 was admitted with Chronic Respiratory Failure. IDG meeting minutes dated 12/28/2021 revealed "needs of the patient are weakness, confusion, shortness of breath, and skin breakdown." The patient's POC had no problems that addressed "weakness, confusion, and skin breakdown." Aide ordered five times a week. The patient's POC had no problem that addressed the patient's inability to provide his/her own personal care. The finding was verified by the Administrator at 12:09 PM on 2/11/2022. Patient #7 On 2/10/2022 at 10:46 AM, review of Patient #7's chart revealed the patient's EOC was dated 12/01/2021. Certification period reviewed was 12/01/2021 to 2/28/2022. Patient #7 admitted with Malignant Neoplasm of the Nasal Cavity. The IDG meeting minutes dated 1/26/2022 revealed "nose bleeds out of left nares for some time now, but now it has started in her right nares this week." The IDG meeting minutes dated 2/9/2022 revealed "frank red blood noted in toilet with many clots and in pull-up in trash can." The patient's POC did not address the patient's bleeding needs. Aide ordered twice a week. The patient's POC had no problem for assistance with personal care. The finding was verified by the Administrator at 11:48 AM on 2/11/2022. Patient #8 On 2/10/2022 at 11:19 AM, review of Patient #8's chart revealed the patient's EOC is dated 10/28/2021. Certification period reviewed was 10/28/2021 to 1/25/2022. Patient #8 admitted with Unspecified Severe Protein Calorie Malnutrition. Patient ordered Aide services three times a week. The patient's POC had no problem address the patient's Protein nutritional needs. The finding was verified by the Administrator at 11:11 AM on 2/11/2022. Patient #9 On 2/10/2022 at 12:01 PM, review of Patient #9's chart revealed the patient's EOC was dated 10/28/2021. Certification period reviewed was 12/28/2021 to 1/25/2022. Patient #9 admitted with Alzheimer's Disease. The IDG meeting minutes dated 12/16/2022 revealed the patient "had another fall earlier this week." Aide ordered two times a week. The POC did not address the fall(s). The finding was verified by the Administrator at 12:22 PM on 2/11/2022. Patient #11 On 2/10/2022 at 12:34 PM, review of Patient #11's chart revealed the patient's EOC was dated 12/22/2021. Patient #11 admitted with Acute Myocardial Infarction, Unspecified. Patient ordered Aide services five times a week. The patient's POC did not address the patient needs related to the Myocardial Infarction. The finding was verified by the Administrator at 12:27 PM on 2/11/2022. Patient #12 On 2/10/2022 at 1:03 PM, review of Patient #12's chart revealed the patient's EOC was dated 11/18/2021. Patient #12 admitted with Pulmonary Fibrosis. The IDG meeting minutes dated 12/22/2021 revealed, "Gout flair up, immobilized with sling." The patient's POC was not updated to address the gout. The finding was verified by the Administrator at 12:39 PM on 2/11/2022.