Every finding on record at A Path of Care Hospice V, LLC

Based on record review and interview, the hospice failed to ensure completion of the initial spiritual assessment no later than 5 calendar days after the election of hospice care for one (Patient #2) of 16 patients. --- Findings:Patient #2A review of the clinical record showed an election of the hospice benefit on 05/20/25 with no completion of the initial spiritual assessment from 05/20/25 to 06/21/25 (32 days after the election of the hospice benefit.)  Documentation showed no patient or caregiver refusal of the initial spiritual assessment.On 07/29/25 at 1:00 pm., Staff A stated the initial spiritual assessment for Patient #2 was not completed within the first five days of the election of the hospice benefit.

Based on record review and interview, the hospice failed to ensure supervisory aide visits were completed every 14 days for two (Patient #1 and 10) of 16 patients. --- Findings:Patient #1A review of the plan of care dated 04/21/25 to 06/19/25 showed a hospice aide frequency of three visits per week for eight weeks and two visits for one week.  A review of the clinical record showed the following:A supervisory aide visit was completed on 05/20/25 for the week of 05/18/25 to 05/24/25.Hospice aide visits were completed on 05/21/25 and 05/23/25 for the week of 05/18/25 to 05/24/25.Hospice aide visits were completed on 05/27/25, 05/28/25 and 05/30/25 for the week of 05/25/25 to 05/31/25.Hospice aide visits were completed on 06/02/25, 06/04/25 and 06/06/25 for the week of 06/01/25 to 06/07/25.Hospice aide visits were completed on 06/09/25, 06/11/25 and 06/13/25 for the week of 06/08/25 to 06/14/25.Hospice aide visits were completed on 06/16/25 and 06/18/25 for the week of 06/15/25 to 06/19/25.No supervisory aide visits were performed from 05/21/25 to 06/19/25 (30 days after the last supervisory aide visit.)Patient #10A review of the plan of care dated 11/15/25 to 01/13/25 showed a hospice frequency of one visit per week for one week, three visits per week for eight weeks and one visits per week for one week.  A review of the clinical record showed the following:A hospice aide visit was completed on 11/15/25 for the week of 11/15/25 to 11/16/25.Hospice aide visits were completed on 11/25/25, 11/27/25 and 11/29/25 for the week of 11/24/25 to 11/30/25.Hospice aide visits were completed on 12/02/25, 12/04/25 and 12/06/25 for the week of 12/01/25 to 12/07/25.Hospice aide visits were completed on 12/09/25, 12/11/25 and 12/13/25 for the week of 12/08/25 to 12/14/25.Hospice aide visits were completed on 12/16/25, 12/17/25 and 12/20/25 for the week of 12/15/25 to 12/21/25.Hospice aide visits were completed on 12/23/25, 12/25/25 and 12/27/25 for the week of 12/22/25 to 12/28/25.Hospice aide visits were completed on 12/30/25, 01/02/25 and 01/03/25 for the week of 12/29/25 to 01/04/25.A supervisory aide visit was completed on 01/08/25 for the week of 01/05/25 to 01/11/25 (53 days with no supervisory aide visits.)On 07/29/25 at 1:29 pm., Staff A stated the supervisory aide visits for Patients #1 and 10 were not completed every 14 days.

Based on record review and interview, the hospice failed to ensure volunteers provided services that equaled 5% of the total patient care hours of all paid hospice employees for 2024. --- Findings:A review of volunteer records and hours showed the hospice volunteers provided services that equaled 0.00% of the total patient care hours of all paid hospice employees for 2024. On 07/28/25 at 3:20 pm, Staff A stated the hospice volunteer services did not provide 5% of the total patient care hours of all paid hospice employees for 2024.

Based on record review and interview, the hospice failed to ensure:1. Completion of the initial bereavement assessment no later than 5 calendar days after the election of hospice care for one (Patient #1) of 11 patients; and2. Completion of the initial psychosocial assessment no later than 5 calendar days after the election of hospice care for one (Patients #2) of 11 patients. --- Patient #1 A review of the clinical record showed an election of the hospice benefit on 08/27/22 with no completion of the initial bereavement assessment from 08/27/22 to 09/07/22 (11 days after election of the hospice benefit) with no documentation of attempts to contact the patient made by the Chaplain and no patient or caregiver refusal of Chaplain visits. Patient #2 A review of the clinical record showed an election of the hospice benefit on 07/07/22 with no completion of the initial psychosocial assessment from 07/07/22 to 10/04/22 (90 days after election of the hospice benefit) with no documentation of attempts to contact the patient made by the Medical Social Worker and no patient or caregiver refusal of Medical Social Worker visits. On 10/19/22 at 12:20 pm, Staff A stated the initial bereavement assessment was not completed within the first five days after the election of the hospice benefit for Patient #1 and the initial psychosocial assessment was not completed within the first five days after the election of the hospice benefit for Patient #2.

Based on record review and interview, the hospice failed to ensure a timely review of medications for two (Patients #4 and 5) of 11 patients --- Patient #4 A review of clinical records showed a skilled nurse assessment dated 07/29/22 which documented the use of oxygen. Documentation showed no addition of oxygen to the medication profile. Patient #5 A review of clinical records showed a skilled nurse assessment dated 07/11/22 which documented the use of oxygen. Documentation showed no addition of oxygen to the medication profile. On 10/19/22 at 11:55 am, Staff A stated oxygen was not added to the medication profile for Patients #4 and 5.

Based on record review and interview, the hospice failed to ensure the plan of care documented the frequency for hospice aide visits for one (Patient #6) of 11 patients. --- Patient #6 A review of the plan of care dated 06/28/22 to 08/26/22 with plan of care updates dated 07/13/22 and 07/27/22 showed no hospice aide frequencies ordered for visits made on 06/29/22, 07/01/22, 07/06/22, 07/08/22, 07/11/22, 07/13/22, 07/15/22, 07/18/22, 07/20/22, 07/22/22, 07/25/22, 07/27/22, 07/29/22, 08/01/22, 08/03/22, 08/05/22, 08/08/22, 08/10/22, 08/15/22, 08/17/22, 08/19/22 and 08/22/22. On 10/19/22 at 12:30 pm, Staff A stated there were no documented hospice aide frequencies from 06/28/22 to 08/26/22.

Based on record review and interview, the hospice failed to ensure the plan of care was revised every 15 days for nine (Patients #1, 2, 3, 4, 5, 7, 8, 9 and 10) of 11 patients. --- Patient #1 A review of the plan of care dated 08/27/22 to 10/25/22 showed no plan of care updates or plan of care reviews from 08/27/22 to 10/19/22 (53 days). Patient #2 A review of the plan of care dated 07/07/22 to 10/04/22 showed no plan of care updates or plan of care reviews from 07/07/22 to 10/04/22 (90 days). Patient #3 A review of the plan of care dated 07/24/22 to 10/21/22 showed no plan of care updates or plan of care reviews from 07/24/22 to 10/19/22 (88 days). Patient #4 A review of the plan of care dated 07/28/22 to 09/25/22 showed no plan of care updates or plan of care reviews from 07/28/22 to 09/25/22 (60 days). Patient #5 A review of the plan of care dated 07/10/22 to 09/07/22 showed no plan of care updates or plan of care reviews from 07/10/22 to 09/07/22 (60 days). Patient #7 A review of the plan of care dated 09/16/22 to 12/24/22 showed no plan of care updates or plan of care reviews from 09/16/22 to 10/19/22 (33 days). Patient #8 A review of the plan of care dated 07/29/22 to 09/26/22 showed no plan of care updates or plan of care reviews from 07/29/22 to 09/26/22 (60 days). Patient #9 A review of the plan of care dated 07/29/22 to 10/26/22 showed no plan of care updates or plan of care reviews from 07/29/22 to 10/26/22 (83 days). Patient #10 A review of the plan of care dated 09/08/22 to 11/06/22 showed no plan of care updates or plan of care reviews from 09/08/22 to 10/19/22 (41 days). On 10/19/22 at 11:36 am, Staff A stated the plan of care for Patients #1, 2, 3, 4, 5, 7, 8, 9 and 10 were not reviewed and updated every 15 days.

Based on record review and interview, the hospice failed to ensure hospice aide frequencies were provided within the scope of practice for three (Patients #1, 3 and 9) of 11 patients. --- Patient #1 A review of the plan of care dated 08/27/22 to10/25/22 with no plan of care updates showed a hospice aide frequency range of two to three visits per week. Documentation showed no instruction on how to determine the number of visits. Patient #3 A review of the plan of care dated 07/24/22 to10/21/22 with no plan of care updates showed a hospice aide frequency range of one to two visits per week. Documentation showed no instruction on how to determine the number of visits. Patient #9 A review of the plan of care dated 07/29/22 to10/26/22 with no plan of care updates showed a hospice aide frequency range of two to three visits per week. Documentation showed no instruction on how to determine the number of visits. On 10/19/22 at 11:50 am, Staff A stated the ranged hospice aide frequencies were inappropriate for the scope of practice of hospice aides.