Every finding on record at Aegis Hospice Care

It is required that if the care of a hospice patient is transferred to a Medicare/Medicaid certified facility, the hospice forwards to the receiving facility a copy of the hospice discharge summary. This standard was not met as evidenced by clinical record review and interview. In 1 of 2 (50%) clinical records reviewed for patient's that either revoked the hospice benefit or were transferred to another hospice revealed the agency did not ensure a copy of the hospice discharge summary was forwarded to the receiving facility. CLINICAL RECORD 6: The patient was transferred to the hospital on 04/12/2025 at which time the family revoked the hospice benefit so the patient could receive aggressive treatment. The record lacked evidence that the discharge summary was forwarded to the receiving facility (hospital). The Administrator/Director of Patient Care Services (DPCS) designee and DPCS stated in an interview on 06/05/2025 that a discharge summary was not forwarded to the receiving facility for this patient.

It is required that if a patient revokes the election of hospice care or is discharged from hospice, the hospice forwards to the patient’s attending physician a copy of the hospice discharge summary. This standard was not met as evidenced by clinical record review and interview. In 1 of 2 (50%) clinical records reviewed for patient's that either revoked the hospice benefit or were transferred to another hospice revealed the agency did not ensure a copy of the hospice discharge summary was forwarded to the patient's attending physician. CLINICAL RECORD 6: The patient was transferred to the hospital on 04/12/2025 at which time the family revoked the hospice benefit so the patient could receive aggressive treatment. The record lacked evidence that the discharge summary was forwarded to the patient's attending physician. The Administrator/Director of Patient Care Services (DPCS) designee and DPCS stated in an interview on 06/05/2025 that the agency did not forward a copy of the hospice discharge summary to the patient's attending physician.

It is required that the hospice designates a registered nurse member of the IDG to provide coordination of care, ensure continuous assessment of each patient’s and family’s needs and ensure the implementation of the interdisciplinary plan of care. Hospice care and services provided to patients and families follow the individualized plan of care established by the hospice IDG in collaboration with the attending physician (if any). This standard was not met as evidenced by a review of clinical records and interviews. 6 of 11 (54%) clinical records reviewed revealed the hospice did not ensure the Licensed Vocational Nurse (LVN) followed the individualized plan of care established by the hospice IDG in collaboration with the attending physician (if any). Record #2 was reviewed and identified the patient elected hospice care on 1/25/2022. The plan of care dated 1/25/2022, documented the LVN visit frequency as one (1) time per week. There were no SN visits documented as completed for the following weeks: 1/24/2022, 2/7/2022, and 2/21/2022. The record did not include evidence of communication with the physician to change the visit frequency or documented missed visits. Record #5 was reviewed and identified the patient elected hospice care on 10/26/2021. The plan of care dated 10/26/2021, documented the LVN visit frequency as one (1) time per week. There were no SN visits documented as completed for the following weeks: 5/29/2022, 6/6/2022, 6/20/2022, and 7/4/2022. The record did not include evidence of communication with the physician to change the visit frequency or documented missed visits. Record #4 was reviewed and identified the patient elected hospice care on12/26/2021. The plan of care dated 12/26/2021; documented the LVN visit frequency as one (1) time per week. There were no SN visit documented as completed for the week of 12/19/2021. The record did not include evidence of communication with the physician to change the visit frequency or a documented missed visit. Record #0 was reviewed and identified the patient elected hospice care on 9/9/2021, The plan of care dated 9/9/2021;documented the LVN visit frequency as two (2) times per week. There was one (1) SN visit documented as completed for the week of 9/20/2021. The record did not include evidence of communication with the physician to change the visit frequency or a documented missed visit. Record #8 was reviewed and identified the patient elected hospice care on 1/19/2022. plan of care order effective 1/19/2022; documented the LVN visit frequency as one (1) time per week. There were no SN visits documented as completed for the following weeks: 5/9/2022, and 5/23/2022. The record did not include evidence of communication with the physician to change the visit frequency or documented missed visits. Record #3 was reviewed and identified the patient elected hospice care on 2/17/2021.documented the LVN visit frequency as one (1) time per week. There were no SN visits documented as completed for the following weeks: 1/31/2022, 2/14/2022, and 2/28/2022. The record did not include evidence of communication with the physician to change the visit frequency or documented missed visits. Clinical records revealed the agency did not ensure the individualized visit frequency orders (LVN) as established by the IDG were followed.

It is required that a hospice aide provides services ordered by the Interdisciplinary Group and included in the plan of care. This standard was not met as evidenced by a review of clinical records and interviews. 3 of 10 (30%) applicable records reviewed in which hospice aide services were accepted revealed the agency did not ensure the hospice aide was compliant with visits ordered by the Interdisciplinary Group and included in the plan of care. Record #4 was reviewed and identified the patient elected hospice care on 12/6/2021. The aide plan of care effective 12/6/2021 documented aide visits to be performed three (3) times per week. The record revealed aide visits dated 12/8/21 and 12/11/21 documented as completed. The actual frequency for the week of 12/6/21 was 2 times a week for one week. The record did not include evidence of a documented missed visit or communication with the physician. Record #0 was reviewed and identified the patient elected hospice care on 9/9/2021. The aide plan of care effective 9/9/2021 documented aide visits to be performed two (2) times per week. There were no aide visit documented as completed the week of 9/9/2021. The record did not include evidence of documented missed visits or communication with the physician. Record #6 was reviewed and identified the patient elected hospice care on 11/6/2021. The aide plan of care effective 11/6/2021 documented aide visits to be performed two (2) times per week. The record revealed aide visits dated 11/8/21, 11/10/21, and 11/12/21 documented as completed. The actual frequency for the week of 11/6/21 was 3 times a week for one week. The record did not include evidence of communication with the physician to change the aide visit frequency. Of applicable records, in which the hospice aide was accepted, revealed the agency did not ensure evidence the hospice aide was compliant with visits as assigned in the hospice plan of care and/or physician’s orders.