Every finding on record at Allied Hospice, LLC

Based on record review and interview, the hospice failed to ensure completion of the initial bereavement assessment no later than 5 calendar days after the election of hospice care for one (Patient #7) of 14 patients. --- A review of the clinical record showed an election of the hospice benefit on 02/29/24 with no completion of the initial bereavement assessment from 02/29/24 to 04/18/24 (49 days after the election of the hospice benefit) with no documentation of patient or caregiver refusal of the initial bereavement risk assessment. On 04/18/24 at 1:00 pm., Staff C stated the initial bereavement assessment was not completed for Patient #7.

Based on record review and interview, the hospice failed to ensure imminence of death was assessed during the comprehensive assessment for two (Patients #3 and 6) of 14 patients. --- Patient #3 A review of the Initial Assessment dated 01/19/24 showed no assessment of imminence of death. Patient #6 A review of the Initial Assessment dated 01/31/24 showed no assessment of imminence of death. On 04/18/24 at 1:05 pm., Staff C stated imminence of death was not assessed on the comprehensive assessment for Patients #3 and 6.

Based on record review and interview, the hospice failed to ensure a timely review of medications for five (Patient #1, 3, 6, 7 and 11) of 14 patients. --- Patient #1 A review of the plan of care dated 01/22/24 to 03/21/24 included interventions to administer oxygen as ordered (no ordered flow rate was included). Documentation showed no addition of oxygen to the medication profile. Patient #3 A review of the plan of care dated 01/19/24 to 04/17/24 included interventions to administer oxygen as ordered (no ordered flow rate was included). Documentation showed no addition of oxygen to the medication profile. Patient #6 A review of the plan of care dated 01/31/24 to 04/29/24 included interventions to administer oxygen as ordered (no ordered flow rate was included). Documentation showed no addition of oxygen to the medication profile. Patient #7 A review of the plan of care dated 02/29/24 to 05/28/24 showed no addition of any medications to the medication profile. Patient #11 A review of the plan of care dated 03/13/24 to 05/11/24 included interventions to administer oxygen as ordered (no ordered flow rate was included). Documentation showed no addition of oxygen to the medication profile. On 04/18/24 at 1:35 pm, Staff C stated oxygen was not added to the medication profile for Patients #1, 3, 6 and 11 and no medications were added to the medication profile for Patient #7.

Based on record review and interview, the hospice failed to ensure 1. skilled nurse visits were provided in accordance with the plan of care for two (Patients #3) of 14 patients; 2. hospice aide visits were provided in accordance with the plan of care for one (Patient #4) of 14 patients; and 3. social worker visits were provided in accordance with the plan of care for one (Patient #9) of 14 patients. --- 1. Patient #3 A review of the plan of care dated 01/19/24 to 04/17/24 and plan of care updates dated 01/21/24, 02/14/24, 02/23/24 and 03/13/24 showed a skilled nurse frequency of two visits per week for. A review of the clinical record showed the following: A skilled nurse missed visit note date 03/05/24 documented the reason for the missed visit was due the patient being "out with family" for the week of 03/03/24 to 03/09/24 (one of two completed visits for this week). Documentation showed no patient or family refusal of visits, no change in the ordered frequency and no attempts to reschedule the missed visit. 2. Patient #4 A review of the plan of care dated 02/02/24 to 04/01/24 and plan of care updates dated 02/14/24, 02/28/24, 03/13/24 and 03/27/24 showed a hospice aide frequency of two visits per week. A review of the clinical record showed the following: A hospice aide missed visit note dated 03/28/24 documented the reason for the missed visit as being informed by the social worker that the patient would not be "home tomorrow" for the week of 03/17/24 to 03/23/24 (only one of two completed visits for this week). Documentation showed no patient or family refusal of visits, no change in the ordered frequency and no attempts to reschedule the missed visit. Patient #9 A review of the plan of care dated 01/07/24 to 04/05/24 and plan of care updates dated 01/07/24 and 01/17/24 showed a social worker frequency of one to two visits per month. A review of the clinical record showed the following: A social worker visit dated 01/10/24 documented a missed visit (no visits were completed for the month of January). Documentation showed no patient or family refusal of visits, no change in the ordered frequency and no documentation of attempts to reschedule the missed visit.On 04/18/24 at 1:10 pm., Staff B stated: 1. the skilled nurse frequency was not followed as ordered for Patient #3; 2. the hospice aide frequency was no followed as ordered for Patient #4 and 3. the social worker frequency was not followed as ordered for Patient #9.

Based on record review and interview, the hospice failed to ensure an individualized plan of care was fully developed to include all services necessary for the palliation and management of the terminal illness for nineteen (Patients #1, 4 and 5) of 14 patients reviewed. --- Patient #1 A plan of care dated 01/22/24 to 03/21/24 documented a primary diagnosis of senile degeneration of the brain and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #4 A plan of care dated 02/02/24 to 04/01/24 documented a primary diagnosis of cancer of overlapping sites of stomach and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #5 A plan of care dated 02/19/24 to 04/18/24 documented a primary diagnosis of Alzheimer's disease and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. On 04/18/24 at 1:35 pm, Staff C stated the plans of care for Patients #1, 4 and 5 failed to include services necessary for the palliation and management of the terminal illness.