Survey Report for 111640

DEPARTMENT OF HEALTH AND HUMAN SERVICES		FORM APPROVED
CENTERS FOR MEDICARE & MEDICAID SERVICES		OMB NO. 0938-0391
STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION	(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER	(X2) MULTIPLE CONSTRUCTION	(X3) DATE SURVEY COMPLETED
STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION	111640	A. BUILDING __________ B. WING ______________	04/01/2022
NAME OF PROVIDER OR SUPPLIER	STREET ADDRESS, CITY, STATE, ZIP
ACCENT CARE HOSPICE & PALLIATIVE CARE OF GEORGIA	11675 GREAT OAKS WAY, SUITE 310, ALPHARETTA, GA, 30022
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See reverse for further instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation
LABORATORY DIRECTOR’S OR PROVIDER/SUPPLIER REPRESENTATIVE’S SIGNATURE		TITLE	(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
(X4) ID PREFIX TAG	SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY SHOULD BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION)
L0653
L0653	38966 Based on clinical record review, staff and family interviews, it was determined that the agency failed to order patients' medication (Morphine). According to regulation, drugs must be made routinely available on 24 hours basis 7 days a week for all patients the hospice agency failed to comply with this regulation for one (1) of three (3) sampled patients (P#1). The finding include: Record review conducted on 3/31/22, at 1:00 p.m., revealed that Registered Nurse (RN) AA, did admission assessment for P#1, on 3/18/22, with a diagnosis of blood disease, myelofibrosis, atrial fibrillation, pulmonary embolism, heart disease, asthma, hypothyroidism, acute pancreatitis, gastrointestinal hemorrhage, and hypertension. The surveyor reviewed P#1's hospice agency's medication profile and plan of care. A discrepancy was found because Morphine was missing in comfort pack. (RN) AA did not order the Morphine upon admission. On 3/31/22, at 2:25 p.m., an interview was conducted with (RN) AA, who stated that the discrepancy was her mistake. (RN) AA also confirmed that she forgot to order Morphine for P#1, upon admission.
L0678
L0678	38966 Based on clinical record review, staff and family interviews, it was determined that the agency failed to obtain physician order to administer Oxycodone rectal, for one (1) of three (3) sampled patients (P#1). The findings include: Review of the initial Skilled Nurse (SN) assessment and Plan of Care (POC) dated 3/18/22, revealed P#1 had physician's order for Oxycodone 5milligrams (MG), give one tablet oral every six hours as needed for pain. On 3/21/22, Registered Nurse (RN) AA, administered Oxycodone 5mg rectal to P#1, without physician's order. Patient #1 was admitted on 3/18/22 with a diagnosis of blood disease, myelofibrosis, atrial fibrillation, pulmonary embolism, heart disease, asthma, hypothyroidism, acute pancreatitis, gastrointestinal hemorrhage, and hypertension. During an interview on 3/31/22, at 2:25 p.m., (RN) AA, confirmed that she did not obtain physician's order to administer Oxycodone 5mg rectally for P#1. (RN) AA, stated she administered the above listed medication, because Morphine was not available when P #1 transitioned.