Every finding on record at Trinity Hospice, Inc.

Observed in Record Review. In 1 of 1 patient records reviewed, it was noted that the organization did not ensure that the Hospice Election and Consent Form(s) were completed as required. For example, a review of the Hospice Election and Consent Form for RRHV#1 revealed that: 1) The attending physician that would provide care to the individual was not identified. 2) The patient or the patient’s representative did not acknowledge that they were informed of the right to choose an attending physician. 3) The patient or the patient’s representative was not informed of their right to request patient notification of hospice noncovered items, services, and drugs. 4) The patient or the patient’s representative was not provided information on the Beneficiary and Family Centered Quality Improvement Organization (BFCC-QIO), including the right to immediate advocacy and BFCC-QIO contact information. This observation was reviewed with the Director of Patient Care Services Designee.

Observed in Record Review. In 2 of 2 Individual Tracers, it was noted that the organization did not ensure a Registered Nurse comprehensive assessment for the interdisciplinary team was completed every 15 days. For example, a review of the medical record for RRHV#1, revealed no documented evidence that a Registered Nurse comprehensive assessment was completed every 15 days during benefit period #1, #2, #3, and #4. Example #2: A review of the medical record for RRHV#2, revealed no documented evidence that a Registered Nurse comprehensive assessment was completed every 15 days during benefit period #1.

Observed in Individual Tracer. In 1 of 2 Individual Tracers, it was noted that the organization did not ensure its policy titled Nursing Bag Techniques was implemented. For example, during home visit activity for RRHV#2, it was noted that after equipment cleaning was completed the clinician placed clean equipment (stethoscope) around her neck instead of the nursing bag. This observation was reviewed with the Director of Patient Care Services Designee. Observed in Individual Tracer. In 1 of 2 Individual Tracers, the organization did not ensure that standard precautions were implemented during patient care activities. For example, during home visit activity for RRHV#1, it was noted that the clinician removed gloves after performing patient care activity and did not perform hand hygiene prior to applying new gloves. This observation was reviewed with the Director of Patient Care Services Designee.