Every finding on record at Alpine Hospice & Palliative Care LLC

It is required that each patient’s individualized written plan of care identifies planned interventions based on problems identified in the initial and updated comprehensive assessments. This standard was not met as evidenced by clinical record review, document review, and interview. In 2 of 12 (17%) clinical records reviewed revealed the plan of care did not include interventions based on problems identified in the initial and updated comprehensive assessments. Agency Policy 9-17, The Plan of Care (November 2024), stated in part, "The plan of care will be based on the initial, comprehensive and ongoing comprehensive assessment performed by members of the interdisciplinary group" and the written plan of care will contain initial bereavement assessment." Agency Policy 9-23, Bereavement Services, stated in part, "The program will provide bereavement services to the families/caregiver of hospice patient both before and after the patient's death in accordance with the plan of care. The purpose of these services will be to facilitate a normal grieving process." CLINICAL RECORD 4: An initial bereavement assessment conducted by admission nurse (08/28/2025) with the spouse scored a scale rating of 5 or moderate risk. The findings of the assessment were based on "the family is not accepting of impending death of patient and extreme anger, guilt, fear.” The plan of care lacked problem/intervention/goal for anticipatory grief. CLINICAL RECORD 5: Initial bereavement assessment conducted by admission nurse (09/03/2025) with the caregiver/friend scored of 6 or moderate risk. The finding of assessment were based on "estranged or isolated from support system, extreme anger, guilt, fear, extreme dependency" of bereaved friend/caregiver. The plan of care lacked a problem/intervention/goal related to anticipatory grief. An interview with the Clinical Director was conducted on 10/09/2025. The Clinical Director agreed the bereavement assessment findings indicated a problem with anticipatory grief and should have been added to the plan of care. In review of the electronic medical record program, she discovered limitations related to this specific problem statement. She has addressed the issue with the vendor to find a solution.