Every finding on record at Anchor Health LLC

It is required that hospice aides are supervised by a registered nurse who makes an on-site visit to the patient’s home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide, ensure that services ordered by the hospice Interdisciplinary Group (IDG) meet the patient’s need. The hospice aide does not need to be present. This standard was not met as evidenced by clinical record review and interview. In 2 of 16 (12%) clinical records reviewed of patients who received hospice aide services revealed the agency did not ensure that hospice aide supervisory visits were conducted by a Registered Nurse no less frequently than every 14 days to evaluate the services provided by the hospice aide. Clinical Record 4: The patient’s date of election was 12/25/2022. A physician’s order dated 7/30/2023 ordered hospice aide services “2wk7, 1wk1.” A physician’s order dated 8/6/2023 ordered hospice aide services “2wk1, 3wk5, 2wk1.” A physician’s order dated 9/3/2023 ordered “2wk1, 3wk5, 2wk1.” The clinical record contained documentation of Hospice Aide visits as ordered between 8/1/2023-12/7/2023. There was no documented evidence of a hospice aide supervisory visit being conducted between 8/1/2023-12/7/2023. Clinical Record 7: The patient’s date of election was 7/24/2023. A physician’s order dated 10/22/2023 ordered hospice aide services “2wk13.” The clinical record contained documentation of Hospice Aide visits as ordered between 10/22/2023-12/7/2023. There was no documented evidence of a hospice aide supervisory visit being conducted between 10/22/2023-12/7/2023. During a joint record review and interview on 12/8/2023, the Director of Patient Care Services agreed there was no documented evidence that the supervisory visits were completed.

It is required that the hospice medical director or physician-designee provides written and signed recertification of the terminal illness to meet the hospice care benefit requirement. Recertification for the hospice care benefit is informed by the medical director or physician designee’s review of the patient’s clinical information. Recertification is completed no later than two (2) calendar days after the first day of each benefit period, and no more than fifteen (15) days before the next benefit period begins. This standard was not met as evidenced by clinical record review and interview. In 1 of 19 (5%) clinical records reviewed, revealed that the agency did not ensure the physician provided written and signed certification of the terminal illness. Clinical Record 9: The patient’s date of election was 6/19/2023. The CTI on 10/13/2023 did not include a physician's narrative or signature. There was no documented evidence that a recertification was completed for benefit period 5 effective 10/17/2023 to 12/15/2023. During a joint record review and interview on 12/8/2023, the Director of Patient Care Services agreed there was no documented evidence that the recertification was completed.