Survey Report for 261680

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	261680	A. BUILDING __________ B. WING ______________	02/25/2022
NAME OF PROVIDER OR SUPPLIER	STREET ADDRESS, CITY, STATE, ZIP
TRADITIONS HEALTH	220 NW R.D. MIZE ROAD, SUITE 101, BLUE SPRINGS, MO, 64014
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)
L0520
L0520	29559 Based on clinical record review, policy review, and staff interviews, the hospice provider failed to ensure that registered nurse gathered the critical information necessary on the initial assessment to treat the patient's immediate care needs. The single deficiency example was identified at an condition level due to substantial risk to adversely affect health and safety to hospice patients (L522). The effect of this deficient practice has the potential to affect nursing services for all patients on service with the agency.
L0522
L0522	29559 Based on policy review, record review, and interview, the hospice registered nurse failed to complete an adequate initial assessment in one of three patients sampled (Record/Patient #3). The deficient practice has the potential to affect all patients on service with the hospice provider. Findings included: Review of the undated Traditions Health hospice policy titled, "Patient Assessments PE.1" showed in part, that the initial assessment should include the "patient's physical, psychosocial and emotional status related to the terminal illness and related conditions". RECORD/PATIENT #3: The patient was admitted on 01/28/2022 with the terminal diagnosis of respiratory failure. The patient had dementia and lived in a memory care unit at Autumn Terrace long-term care facility (LTCF). The patient expired on 01/29/2022. Review of LTCF documentation where the patient resided, dated 01/28/2022, showed that the patient had just arrived back to the facility from a hospitalization of COVID-19. The staff documented two sacral pressure ulcers, with no measurements, description, or stage. No orders to treat the pressure ulcers were identified in the LTCF documentation. During the initial hospice assessment visit on 01/28/2022, that lasted from 7:09 PM to 9:50 PM, showed the registered nurse, RN-A, assessed the patient with "no skin breakdown to heels". No additional integumentary or skin assessment was documented. The patient was having dyspnea (labored breathing - a possible sign of pain). During a "as needed " hospice nurse visit on 01/29/2022, from 12:50 AM through 6:20 AM, showed the hospice registered nurse, RN-B, documented the following: - The patient's pain was as assessed at 7 (scale where 10 is most severe); - The patient had an unstaged mid-sacral wound, identified as wound #1. The integumentary section of the assessment failed to include description, or measurements of wound #1; - The narrative section of the assessment showed "This nurse noted when turning patient that two sacral wounds existed that are currently covered with dressing that partially came off, reapplied, area of wound assessed revealed brown and black necrotic eschar very strong foul odor"; - The patient had "IV access to right anterior forearm"; and - The nurse called RN-A and RN-A informed him/her that "I didn't know he/she had an IV or any wounds". During an interview with RN-A on 02/23/2022 at 11:49 AM, the nurse stated that during the initial assessment visit, that "I did not look at the patient's skin, more concerned with the patient's breathing".