Every finding on record at Angel Heart Hospice, LLC

Based on record reviews, staff interview, and review of facility policy, it was determined the agency failed to complete an initial comprehensive assessment by the agency Chaplain for eight patients (P) (P#2, P#6, P#7, P#8, P#9, P#10, P#18, P#19) of 19 patient records reviewed. --- Findings include: Review of undated facility policy titled, ";Initial Assessment/ Comprehensive Assessment" reveals the following: Procedure 4. The hospice IDG, in consultation with the patients attending physician (if any), must complete the comprehensive assessment no later than 5 calendar days after the patients election of Hospice care. Record reviews revealed that clinical records for P#2, P#6, P#7, P#8, P#9, P#10, P#18, and P#19 failed to reveal initial Chaplain assessments as part of the initial comprehensive assessment, identifying patient and family needs for establishing the frequency of Chaplain visits throughout the stay or the decline of Chaplain services with the agency. On 3/27/2024 at 10:00 a.m., an interview with the Clinical Manager (CM) confirmed that all clinical records had been provided. The CM stated, ";I believe these patients (P#2, P#6, P#7, P#8, P#9, P#10, P#18, P#19) all declined Chaplain services, but there should be notes in the chart." The CM revealed the Chaplain was having difficulty ";syncing his tablet", causing documentation to be missing from the clinical records.