Every finding on record at Affinity Healthcare LLC

Based on record reviews and patient family and staff interview, the agency failed to ensure one out of three sampled patients, and primary care giver(s), received education and training appropriate to their responsibilities for the patients care, specifically training and education for transferring a patient when using a Hoyer lift for one patient (P) (P#3) of three sampled patients (P#3, P#4, P#5). --- Findings include: During a phone interview with caregiver of P#3 on 4/20/23 at 1:00 p.m., revealed caregiver had difficulty transferring P#3 with the Hoyer lift provided by Ajoy hospice. The caregiver revealed while transferring P#3 from bed to chair the Hoyer lift tilted and caregiver nearly dropped P#3. The caregiver additionally revealed of never have used the Hoyer lift again, stating, ";I put it (Hoyer lift) away and called Ajoy to come and get it, but the Hoyer lift is still here in my back room." Surveyor asked if (patients caregiver) had been educated on the use of the Hoyer lift and revealed, ";no, some man dropped it off one day and no one ever told me how to use it." During record review of P#3 it was determined the patients plan of care failed to include documentation of education for the use of a Hoyer lift. During an interview on 4/20/23 1:20 p.m., Administrator confirmed P#3 had requested and received a Hoyer lift but she was not aware that the caregiver did not use the lift for transfers. The Administrator revealed, ";I was not aware the caregiver did not know how to use the lift."

Based on clinical record reviews, staff interview, and review of policy titled ";Coordination of Patient Care," it was determined that the hospice failed to assure that the interdisciplinary group (IDG) reviews, revises and documents the individualized plan of care (POC) no less than every 15 days for three patients (P) (P#3, P#4, P#5) of seven sampled patients (P#1, P#2, P#3, P#4, P#5, P#6, P#7). The findings include: --- 1. Record review on 4/20/2023 at 11:00 a.m. of P#3 revealed admitted to hospice 11/21/2022 with a diagnosis of senile degeneration of the brain (a decrease in cognitive abilities or mental decline). The ";Consolo Comprehensive Assessment 4/7/2023; section ";IDG Comprehensive Assessment Detail" document failed to include signatures and regular interdisciplinary discussion or review of the POC. 2. Record review on 4/20/2023 at 11:00 a.m. of P#4, revealed admitted to hospice on 5/29/2022 with a diagnosis of senile degeneration of the brain (a decrease in cognitive abilities or mental decline). The ";Consolo Comprehensive Assessment 4/7/2023; section ";IDG Comprehensive Assessment Detail" document failed to include signatures and regular interdisciplinary discussion or review of the POC. 3. Record review on 4/20/2023 at 11:00 a.m. of P#5, admitted to hospice on 2/18/2022 with a diagnosis of end stage renal failure (the final, permanent stage of chronic kidney disease, where kidney function has declined to the point that the kidneys can no longer function on their own). The ";Consolo Comprehensive Assessment 4/7/2023; section ";IDG Comprehensive Assessment Detail" document failed to include signatures and regular interdisciplinary discussion or review of the POC. Review of undated policy titled ";Coordination of Patient Care," reveals, ";The IDG (in collaboration with the patients attending physician, if any) reviews, revises and documents the individualized plan as frequently as the patients condition requires, but no less frequently than every 15 calendar days." Interview with the Administrator at 11:45 a.m. on 4/20/2023 reveals confirmation that the Administrator provided all documentation for P#3, P#4, and P#5.

Based on record reviews and interviews it was determined Ajoy Hospice in Alpharetta failed to make bereavement services available to the patient and the patients family on admission, during time patient was on services and one year following the death of the patient for one patient (P) (P#1) of three records reviewed. The findings include: --- Record review on 4/19/2023 at 10:00 a.m., revealed P#1 with a start of care (SOC) dated 11/16/2022 and a death date of 11/17/2022. The agency failed to provide documentation of bereavement services on admission and during the time the patient was on services or one year following death. During an interview on 4/19/23 at 10:30 the Administrator revealed the documentation for bereavement services on P#1 was never completed. Administrator additionally revealed P#1 declined bereavement services, but the Chaplain failed to submit documentation of initial assessment explaining patient had declined bereavement services.

Based on clinical record reviews and staff interview, it was determined that the hospice failed to ensure the hospice aide had on-site supervised visits by a Registered Nurse (RN) no less than every 14 days to assess the quality of care and services provided by the hospice aide for three patients (P) (P #3, P #4, P #5) of seven sampled patients (P #1, P #2, P #3, P #4, P #5, P #6, P #7). The findings include: --- Record reviews completed on 4/20/2023 at 12:00 p.m., for P#3, P#4, and P#5 revealed no documented supervisory visits by a RN. During an interview with the Administrator at 12:00 p.m. on 4/20/2023 revealed the Administrator confirmed there were no supervisory visits charted on the patients every 14 days and that all documentation for P #3, P #4, and P #5 had been provided.

Based on clinical record reviews and staff interview, it was determined that the hospice failed to properly recertify patients terminal illness for one patient (P) (P#3) of seven sampled patients (P #1, P #2, P #3, P #4, P #5, P #6, P #7). The findings include: --- Record review of P #3, admitted to hospice on 11/21/2022 with diagnosis of senile degeneration of the brain (a decrease in cognitive abilities or mental decline). Review of the document titled, ";Face to Face Encounter" dated 11/21/2022 failed to include Nurse Practitioner signature and attestation statement. Review of the document titled ";Face to Face Encounter" with benefit period dates of 1/20/2023 – 3/20/2023 is unsigned and dated 2/13/2023, 24 days after the beginning of the certification. Review of the document titled ";Physician Face-To-Face Encounter/ Recertification of Terminal Illness 60-Day Periods" with a benefit period of 1/20/2023 to 3/20/2023 failed to include a narrative (explanation of the clinical findings) from the certifying physician. Interview with Administrator at 12:00 p.m. on 4/20/2023, revealed all certifications had been provided to this surveyor.