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Based on medical record review and interview, the facility failed to provide tube feedings upon discharge for one patient (#1) of seven patients reviewed.

The findings included:

Patient #1 was admitted to the facility with diagnoses including Acute Respiratory Failure, Acute Myelitis with Cervical and External Fixation Device, End Stage Renal Disease, Pulmonary Embolus, Atrial Fibrillation, Sacral Decubitis Ulcer Stage 4, and Dysphagia. Further review revealed the patient was discharged home with hospice care on January 23, 2015.

Medical record review of a Diet Progress note dated January 13, 2015, at 4:56 p.m., revealed "...Tube feedings continues down PEG [tube inserted in the stomach for nutrition] tube..."

Medical record review of a Diet Progress note dated January 22, 2015, at 4:06 p.m., revealed "...tube feeding currently Novasource at 45 ml/hr [milliliters per hour]..."

Medical record review of a Clinical Communication form dated January 23, 2015, at 8:30 a.m., revealed "...is appropriate for hospice...home with hospice..."

Medical record review of a Case Management note dated January 23, 2015, at 12:00 p.m., revealed "...orders faxed to [named] hospice...they will have everything delivered to [named family member] home by 5:00 p.m., today...will be transported by EMS [emergency medical services]..."

Interview with the Nurse Manager for the 200 unit on February 4, 2015, at 10:15 a.m., in the conference room, revealed "...the patient was discharged home with hospice care..." Further interview revealed "...had a trach [tube in throat to assist with breathing], NGT [nasogastric tube] and a PEG tube was inserted...was on continuous tube feedings..." Continued interview revealed "...[named family member] called the night the patient was discharged...I was working night shift...asked why we did not send tube feedings with the patient when...was discharged..." Further interview revealed "...I asked [named family member] if they had talked to them [hospice]...said they did not have anything..."

Interview with Case Manager #1 on February 4, 2015, at 12:20 p.m., in the conference room, revealed "...on January 23, 2015, we set up hospice care for the patient per the family's request and physician's order..." Continued interview revealed "...the home health agency was notified...EMS was notified of the transport...I faxed the information to the hospice agency and everything was arranged..." Further interview confirmed the patient was receiving continuous tube feedings and the case manager failed to send the patient's tube feedings with the patient upon discharge.

C/O # 35407