Eternal Faith Hospice and Palliative Care

“Observed in Record Review. In 9 of 20 patient records reviewed, the organization failed to plan the patient’s care. During record review for RRHV#1, RRHV#2, RRHV#3, RRHV#4, RRNHV#2, RRNHV#5, RRNHV#8, RRNHV#9, RRNHV#10, the Hospice Nurse Surveyor observed all required components of the plan of care were not present. 

For example in RRHV#3, the patient had a goal of pt/ CG verbalizes/ demonstrates understanding of proper safety measures related to fall prevention with no goal date. The patient had a goal of Pt/ CG verbalizes/ demonstrates understanding of medication schedule/ set up and how to dispense with no goal date. And the patient had a goal of facility knowledgeable and involved in hospice plan of care for patient by enter date which was not filled in. 

Also for RRHV#3, the patient’s most recent recertification care included goals to establish SW and SC, which were both established at SOC and not updated or removed at recertification. 

In RRHV#2, the patient had a goal of changes in neurological status will be addressed appropriately which was not measurable. Pt had a goal of pt anxiety/ agitation is minimized/ controlled and caregiver verbalizes understanding of its effects/ origin/ treatment with no date to achieve the goal by. 

In RRHV#4, the patient had a goal of PT/CG will verbalize/ demonstrate understanding of applicable safety measures with no goal date and it had been put in place 1 1/2 years prior to survey. Patient also had a goal of PT stress/ anxiety is reduced to level of comfort which was not measurable. 

In RRNHV#2, the patient had a goal pain is currently managed at a level acceptable to the patient with no criteria as to what the acceptable level is. And the patient recently had an increase in pain per the nursing narrative notes. 

In RRNHV#5, the Social Worker documented at SOC that the pt/ family were working on funeral arrangement and continued to document progressing for the 6 months prior to survey but there was no goals or timeframes in assisting the family with preparations. 

In RRNHV#8, the patient has new onset difficulty swallowing and dysphagia which was mentioned in IDG but there are no interventions, goals or education to the primary caregiver related to these issues as the patient lives at home. 

In RRNHV#9, the patient had a goal of pt/ CG verbalizes understanding of psychological effects of incontinence and measures to improve/ maintain dignity with no goal date and was put intp place at SOC which was 1 1/2 yrs prior to survey. The patient also had a goal of Pt/CG understands the 24 hr/day availability of the on call hospice nurse with no goal date and was put in place 7 months prior to survey. 

In RRNHV#10, the chaplain had a goal of appropriate clergy/ faith groups have been contacted for spiritual support with no timeframe to achieve that goal and it had been in place for 9 months. 

This was discussed and reviewed with the Hospice Director and her leadership team.”

“Observed in Record Review. In 2 of 2 patient records reviewed, with wound care, the organization failed to plan the patient’s care. During record review for RRNHV#3 and RRNHV#4, the Hospice Nurse Surveyor observed

For example in RRNHV#3, the patient had two wound upon admission but once healed the wound care orders were not discontinued. There was also no mention of the wounds being healed on the updated plan of care. 

In RRNHV#4, the patient had two different wounds (skin tear and coccyx wound) with ordered wound care but there was no order to discontinue when the wounds were documented as healed and there was no mention of the healed wounds on the updated plan of care. 

This was discussed with the Hospice Director and the leadership team.”

“Observed in Record Review. In 8 of 20 patient records reviewed, the organization failed to plan the patient’s care. During record review for RRHV#1, RRHV#2, RRHV#3, RRNHV#1, RRNHV#5, RRNHV#7, RRNHV#8, RRNHV#9, the Hospice Nurse Surveyor observed the aide plan of care did not contain all needed elements. 

For example in RRHV#3, the aide care plan did not contain information about oxygen usage and the bath if the patient was using their intermittent oxygen. Also in RRHV#3, the most recent plan of care included aspiration precautions but it was not included on the aide plan of care. 

In RRHV#2, the patient did not have oxygen or bleeding precautions on the aide care plan. 

In RRNHV#1, the patient was on long term aspirin but bleeding precautions were not on the aide plan of care. 

In RRHV#1, NHV#5, and RRNHV#8, the patient did not have oxygen precautions on the aide care plan. 

In RRNHV#7, the patient is on a blood thinner and PRN oxygen but these are not addressed on the aide plan of care. 

In RRNHV#8, the patient has new onset dysphagia and difficulty swallowing but this is not included in precautions on the aide plan of care. 

In RRNHV#9, the patient recently had an addition to their plan of care to add aspiration precautions but it was not added to the aide plan of care. 

This was discussed and reviewed with the Hospice Director and her leadership team.”