The Villa At West Branch

up, CNA Q replied, Yeah, a bit. (Resident #701) was like moaning a flinching.

When queried if they had taken care of Resident #701 recently prior to their passing, CNA Q verbalized they had but was unable to recall a specific date. CNA Q stated, (Resident #701) was a lot better than that.

They were eating and was (getting) up.

When (Resident #701) started not wanting to feed themselves, we knew they were declining.

CNA Q was asked if they recalled anything else and stated, I remember when the hospice nurse came in, (Resident #701) was running a fever and when we rolled (the Resident), they were just screaming in pain.

When queried if Resident #701's skin felt hot when they touched them, CNA Q replied, Yes, very hot. CNA Q was asked if they informed the nurse and replied, Yeah. CNA Q then stated, It was the hospice nurse who said to take (Resident #701's) vitals.Review of facility policy/procedure entitled, Change in a Resident's Condition or Status (Revised: February 2021) revealed, Our facility promptly notifies the resident, his or her attending physician, and the resident representative of changes in the resident's medical/mental condition and/or status. 1.

The nurse will notify the resident's attending physician or physician on call when there has been a(an). d. significant change in the resident's physical/emotional/mental condition; e.

Need to alter the resident's medical treatment significantly; f. refusal of treatment or medications two (2) or more consecutive times) . 2. A significant change of condition is a major decline or improvement in the resident's status that: a. will not normally resolve itself without intervention by staff or by implementing standard disease-related clinical interventions (is not self-limiting); b. impacts more than one area of the resident's health status; c. requires interdisciplinary review and/or revision to the care plan. 8.

The nurse will record in the resident's medical record information relative to changes in the resident's medical/mental condition or status.Review of facility provided policy/procedure entitled, Hospice Program (Revised July 2017) revealed, Hospice services are available to residents at the end of life. 9. In general, it is the responsibility of the hospice to manage the resident's care as it relates to the terminal illness and related conditions, including the following: a.

Determining the appropriate hospice plan of care. c.

Providing medical direction, nursing and clinical management of the terminal illness. e.

Providing medical supplies, durable medical equipment, and medications necessary for the palliation of pain and symptoms. 10. In general, it is the responsibility of the facility to meet the resident's personal care and nursing needs in coordination with the hospice representative, and ensure that the level of care provided is appropriately based on the individual resident's needs.

These responsibilities include the following: a.

Twenty-four-hour room and board care; b.

Administering prescribed therapies, including those therapies determined appropriate by the hospice and delineated in the hospice plan of care; c.

Notifying the hospice about the following: (1) A significant change in the resident's physical, mental, social, or emotional status. (2) Clinical complications that suggest a need to alter the plan of care. (4) The resident's death. d.

Communicating with the hospice provider (and documenting such communication) to ensure that the needs of the resident are addressed and met 24 hours per day.

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