Every finding on record at Angel Care Hospice LLC

Observed in Record Review. In 1 of 2 live discharge records reviewed where the patient revoked hospice services, the organization did not respect the right to revoke hospice care in accordance with Medicare hospice regulations. For example, in the review for RR1 it was identified that there was no signature of Beneficiary or Legal Representative on the Medicare Hospice Benefit Revocation form. This was reviewed and validated with the CEO and CFO.

Observed in Record Review. In 1 of 2 live discharge records reviewed where the patient revoked hospice services, the organization did not ensure an accurate patient record. Identified during the review of RR2, the Medicare Hospice Benefit Revocation form was signed by the Legal Representative and the Witness (Licensed Vocational Nurse) with an incorrect date that preceded the actual revocation date by approximately one month. This was reviewed and validated with CEO and CFO.

Observed in Record Review. In 3 of 3 active patient records reviewed, the organization did not ensure that all services needed for the palliation and management of the terminal illness and related conditions were included in the plan of care. Reviewed in the records for HV#1, HV#2, and HV#3 there were no goals, interventions, or timelines developed for psychosocial, spiritual, or anticipatory bereavement needs. This was reviewed and validated with the CEO and CFO.

Observed in Record Review. In 1 of 1 home visits conducted where the patient was receiving hospice aide services, the registered nurse (RN) did not conduct a full supervisory visit assessment of the hospice aide. For example, in the review of the record for HV#2 the RN failed to complete the full supervisory assessment in all ongoing comprehensive assessments completed in the last 2 months. The Supervisory Assessment included the following elements and required documentation of a yes or no response: Hospice Aide Present?; Do aide services meet patient's need?; Good communication with Patient & Family; Demonstrates competence with assigned tasks; Complies with infection control policies & procedures. The RN did not document a response to any of the assessment elements. This was reviewed and validated with the CEO and CFO.

Observed in Patient Home. In 1 of 1 home visits conducted where the patient was in a hospital bed with full siderails, there was no evidence that information or education on the safe and effective use of restraint-like medical equipment was provided by the organization. Observed in HV#1, the patient's hospital bed had bilateral full siderails in the raised position. The patient lacked the ability to use the siderails to reposition herself, or to exit the bed, thus the siderails presented as restraints. This was reviewed and validated with the CEO and CFO.