Every finding on record at A & R Hospice and Palliative Care, Inc

Upon patient record review, 1 of 14 (Patient #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 medications and treatments. Patient 4:RN documentation 2/21/24 reveals presence of Stage III existing wound from previous amputation. The RN documents wound care performed at each RN visit bi-weekly through most current RN visit date of 4/3/24. Individual components of dressing change are listed on the medication record (betadine, collagen) but there is no evidence found of complete order for dressing change to include frequency or who is to perform dressing changes.

Upon observation, there was no evidence the annual report documents the use of volunteers providing day to day administrative and/or direct patient care services in an amount that, at a minimum, equals 5 percent of the total patient care hours of all paid hospice employees and contract personnel. Annual report reflects volunteer use equals 4.37% of total patient care hours of all paid hospice employees and contract personnel.