Every finding on record at Aleve Hospice Care of Los Angeles, Inc.

Upon patient record review 1 of 14 (Patient #5) did not have evidence that the IDG ensures that the care and services provided are based on all assessments of the patient and family needs. #5-The nursing notes consistently document the patient is unkempt, dirty, with dirty clothes and dirt caked under her fingernails. There is no evidence that the IDG increased the MSW or CHHA frequencies or services to address these issues.

Upon patient record review, 1 of 14 (Patient #5) did not have evidence that the IDG documents the sharing of information between all disciplines providing care and services in all settings, whether the care and services are provided directly or under arrangement. #5-The nursing and spiritual care comprehensive assessments note the patient's son is cognitively impaired with a history of mental illness. There is no information that this was shared with the MSW/BC as evidenced by its lack of mention in those assessments.

Upon patient record review, 13 of 14 (Patient #1,2,3,4,5,6,7,8,9,10,11,13,14) did not have evidence that there is a physician's brief narrative explanation of the clinical findings that supports a life expectancy of 6 months or less as part of the certification forms, or as an addendum to the certification forms. #1,2,3,4,5,6,7,8,9,10,11,13-The physician narrative is insufficient and are generic, stating "per RN and IDT assessment patient is eligible for comfort and palliative care admission to hospice." There is no patient specific information in any of the physician narratives. #14-There is no evidence of of a written certification in the patient's chart.

Upon client record review, 1 of 11 (Patient #4) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #4- The plan of care included orders for SN 2 x week effective 8/1/22. There was evidence of only 1 SN visit the week of 9/11-9/17/22.

Upon patient record review 4 of 7 applicable (Patient #4, 6, 8, 11) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient #4- The plan of care included orders for aide 2 x week effective 8/1/22. There was evidence of only 1 aide visit the week of 8/1-8/6/22. Patient #6-The plan of care included orders for aide 2 x week effective 8/11/22. There was evidence of only 1 aide visit made the week of 8/11-8/13/22. Patient #8- The plan of care included orders for aide 2 x week effective 8/2/22. There was evidence of only 1 aide visit made the week of 8/2-8/6/22. Patient #11- The plan of care included orders for aide daily. There was 2 aide visits documented on 12/3/21, there was no evidence of an order for the second aide visit.