Every finding on record at Approved Hospice Care, Inc

Upon patient record review, 2 of 14 (Patient #8,11) did not have evidence the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions, including equipment and supply needs. Patient #8, No evidence of DME documented on Plan of Care. RN initial assessment documented patient uses walker and cane for ambulation. Patient #11, No evidence of DME documented on Plan of Care. RN initial assessment documented patient uses a cane for ambulation.

Upon client record review, 7 of 14 (Patient #1,2,3,5,9,10,12) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #1, No evidence of order for telephone visits. SC visits on 2/8/24 and 5/3/24 were both telephone visits. Patient #2, No evidence of order for telephone visits. SC visits on 8/11/23, 11/4/23, 2/3/24. 4/2/24, 6/1/24 were all telephone visits. Patient #3, No evidence of order for telephone visits. SC visits on 7/30/23, 10/23/23, 1/20/24, 3/22/24, 5/20/24 were all telephone visits. Patient #5, No evidence of order for telephone visits. SC visits on 12/30/23, 2/24/24, 4/24/24 were all telephone visits. Patient #9, No evidence of order for telephone visits. SC visits on 4/27/24 and 5/25/24 were all telephone visits. MSW visits on 5/20/24 was completed as a telephone visit. Patient #10, No evidence of order for telephone visits. SC visits on 8/2/23, 10/27/23, were completed as telephone visits. Patient #12, No evidence of order for telephone visits. SC visits on 7/20/23 was completed as telephone visit.

Upon patient record review 1 of 14 (Patient #1) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient #1, HHA frequency 2x/week, no evidence of second visit week of 5/26/24.

Upon patient record review 1 of 14 (Patient #3) did not have evidence documentation in the patient record that a Registered Nurse made 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 and to ensure that services ordered by the hospice interdisciplinary group meet the patient's needs. Patient #3, No evidence of supervisory visit of aide every 14 days, missed supervisory visit on 4/4/24.

Upon patient record review, 10 of 14 (Patient #1,5,6,7,8,10,11,12,13,14) did not have evidence that all entries are legible, clear, complete, and appropriately authenticated and dated in accordance with the organizations policies and procedures and currently accepted standards of practice. Electronic signatures are acceptable as long the hospice is following appropriate safeguards to prevent unauthorized access to the patient records. Patient #1, No evidence of signature of MD, RN and SC on 2/13/24 on IDG meeting notes. Patient #5, No evidence of signature of SC on 3/26/24 on IDG meeting notes. Patient #6,7, No evidence of signature of MD on 6/4/24 on IDG meeting notes. Patient #8, No evidence of signature of MD and SC on 4/9/24 on IDG meeting notes. Patient #10, No evidence of signature of MSW on 10/10/23 and 1/20/24 on IDG meeting notes. Patient #11, No evidence of signature of MSW on 9/2/23 and 11/7/23 on IDG meeting notes. Patient #12, No evidence of signature of MSW on 7/24/23 on IDG meeting notes. Patient #13, No evidence of signature of MSW on 8/15/23 on IDG meeting notes. Patient #14, No evidence of signature of MSW on 8/23/23 and 8/29/23 on IDG meeting notes.