Harbor Hospice of Livingston LP

“Observed in Record Review. In 2 of 14 patient records reviewed, it was noted that the organization did not ensure that the plan of care was revised when the patient’s condition changed. For example, during a review of the medical record for RRHV#1, it was noted that the patient experienced a fall with injury during week #4, a fall with injury during week #6, and a fall without injury during week #7, during the 1st benefit period of hospice services. The plan of care was not updated with interventions to maintain patient safety, and strategies to prevent injury. Example #2: During a review of the medical record for RRNHV#6, it was noted that during week 10 of the 1st benefit period, the patient experienced a fall with bruising at chin, and bilateral upper/lower extremities. The plan of care was not updated with interventions to maintain patient safety and strategies to prevent injury. This observation was reviewed with the Administrator.”

“Observed in Competency Session. During the competency session, it was noted that 2 of 2 Human Resource files for Hospice Aides did not document initial competency assessments as required. For example, a review of the competency assessments for Hospice Aide #1, and Hospice Aide #2 revealed the following tasks were documented as being assessed through a verbal examination: 1) Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other staff; 2) Reading and recording temperature, pulse, and respirations; 3) Appropriate and safe techniques in personal hygiene and grooming that include bed, sponge, tub, or shower bath; sink, tub, or bed shampoo; nail and skin care; oral hygiene; toileting and elimination; 4) Safe transfer techniques and ambulation; 5) and Normal range of motion and positioning. This observation was reviewed with the Administrator.”

“Observed in Competency Session. A review of 2 of 2 Human Resource files for Hospice Aides, revealed that competency assessment was not completed as required before the hospice aides provided patient care. For example, Since the initial competency assessment for Hospice Aide #1, and Hospice Aide #2 were completed using a verbal exam. The requirements for the following tasks to be observed with a patient or a pseudo patient were not implemented: 1) Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other staff; 2) Reading and recording temperature, pulse, and respirations; 3) Appropriate and safe techniques in personal hygiene and grooming that include bed, sponge, tub, or shower bath; sink, tub, or bed shampoo; nail and skin care; oral hygiene; toileting and elimination; 4) Safe transfer techniques and ambulation; 5) and Normal range of motion and positioning. This observation was reviewed with the Administrator.”

“Observed in Competency Session. A review of 2 of 2 Human Resource files for Hospice Aides, revealed that the organization’s policy to perform competency assessments annually was not implemented. For example, a review of the annual competency for Hospice Aide #1, and Hospice Aide #2 revealed that the following tasks were assessed through verbal examination. The requirements for the following tasks to be observed with a patient or a pseudo patient were not implemented: 1) Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other staff; 2) Reading and recording temperature, pulse, and respirations; 3) Appropriate and safe techniques in personal hygiene and grooming that include bed, sponge, tub, or shower bath; sink, tub, or bed shampoo; nail and skin care; oral hygiene; toileting and elimination; 4) Safe transfer techniques and ambulation; 5) and Normal range of motion and positioning. This observation was reviewed with the Administrator.”

“Observed in Record Review. In 3 of 3 individual tracers, for patients receiving Hospice Aide services, it was noted that the organization did not ensure Hospice Aide supervision was effective. For example, during the review of the medical record for RRHV#1, and RRHV#2, it was noted that a Hospice Aide supervision visit was not documented by the Registered Nurse every 14 days during the first benefit period. Example #2: During the review of the medical record for RRHV#3, it was noted that a Hospice Aide supervision visit was not documented by the Registered Nurse every 14 days during the 3rd benefit period. This observation was reviewed with the Administrator.”