Atrium Healt at Home Stanly

The agency failed to include all medications on the plan of care for 3 of 5 home visits conducted (9,12, and 15).

Staff interview the RN failed to assess a wound prior to discharge in 2 of 2 patients discharged with a wound (#9, 10).

Caregiver and staff interviews the Plan of Care failed to include and accurate medication list for 2 of 2 patients that had feeding tubes (#13 and 15).

The RN failed to document wound care for 2 of 9 patients with wounds (#1 and 4); and to document interventions and follow up for 1 of 1 patients [ #17] with complaint of pain.

The agency failed to include complete wound orders for 4 of 9 patients with wounds (#2, 4, 10, and 13); to document reason an oxygen saturation level was believed to be inaccurate (#10) for 1 of 5 discharged patients.