Every finding on record at 1st Choice Home Health Care & Hospice Inc.

Upon patient record review, 2 of 14 (Patients #10,11) did not have evidence that the patient chooses a health care provider, including an attending physician. Patient #10: The EOB did not indicate patient chose attending physician in space provided on the form. Patient #11: The EOB did not indicate patient chose attending physician in space provided on the form.

Upon patient record review, 3 of 14 (Patients #4,5,9) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient's family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient's death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. Patient #4; The initial bereavement risk assessment was not completed within 5 days of SOC (10/3/23). This assessment was completed late on 10/9/23. Patient #5; The initial bereavement risk assessment was not completed within 5 days of SOC (11/3/23). This assessment was completed late on 11/30/23. Patient #9; The initial bereavement risk assessment was not completed within 5 days of SOC (5/12/23). This assessment was completed late on 5/19/23.

Upon patient record review, 3 of 14 (Patient #1,3,4) did not have evidence the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions, including equipment and supply needs. Patient #1: This patient had a bed, walker and bedside commode. These were not included on the Plan of Care. Patient #3: This patient had a bed, wheelchair, raised toilet seat, rollator and nebulizer machine. These were not included on the Plan of Care. Patient #4:The record reflected that this patient had a shower chair and cane. These were not included on the Plan of Care.

Upon personnel record review, 1 of 12 (Personnel #9 ) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·Normal range of motion and positioning Personnel #9: The Aide Initial Competency did not include Range of Motion skill as observed/demonstrated as required.

Upon patient record review, 2 of 14 (Patients #10,12) did not have evidence in the patient record that hospice aide assignments and duties are: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient #10: The Aide Visit Frequency did not specify visits per week on POC dated 11/27/23. Instead, there was a range for Aide Services 2-3 x's week identified on POC. patient #12: The Aide Visit Frequency did not specify visits per week on POC dated 8/7/23 or IDG meeting on 8/16/23. Instead, there was a range for Aide Services 2-3 x's week identified on POC and IDG meetings.

Upon patient client record review, 3 of 14 (Patients #7,10,11) did not have evidence that each patient record contains: • Signed election statement in accordance with 418.24 Patient #7: The EOB did not have choice for Notice of Non-Covered Items listed on the form. Patient #10: The EOB did not indicate patient chose attending physician in space provided on the form. Patient #11: The EOB did not indicate patient chose attending physician in space provided on the form.

Upon client record review, 14 of 14 (Patients #1,2,3,4,5,6,7,8,9,10,11,12,13,14) did not have evidence that the written policies and procedures for managing controlled drugs was provided. Patients #1 -14: Controlled Medication Policy was not provided to patients at SOC. This Policy indicated a copy would be provided.