Every finding on record at Apri Hospice, LLC

Observed in Record Review. In 3 of 5 patient records reviewed, the organization failed to ensure the patient receive effective pain management and symptom control for conditions related to the terminal illness. For example: upon review on HV#1 the initial nursing comprehensive assessment there was a documented pain level of 5 of 10 which was greater than the tolerable level of 3/10, however there was no documentation that there was any action to address the issue of pain documented during the visit. Similar documented pain levels greater than the established tolerable level without any documentation of action to address the complaint of pain was also noted in HV#2, and HV#3. These observations were reviewed with the Administrator, and Administrator Designee.

Observed in Record Review. In 2 of 5 patient records reviewed, the organization failed to ensure the patient and primary care giver receive education and training to their responsibilities for the care and services identified in the plan of care. For example: upon review of RR#5 the patient was documented to be diabetic and receiving insulin and blood glucose monitoring. There was no documentation of education provided to the patient and caregiver related to insulin administration and blood glucose monitoring nor was there documentation of patient/caregiver response and proficiency in safely providing the care as ordered. In RR#4 the patient was also receiving blood glucose monitoring and there was no documentation of education provided to the patient/caregiver nor documentation of response to include proficiency in providing the care. These observations were reviewed with the Administrator.

Observed in Record Review. In 3 of 5 patient records reviewed, the organization failed to ensure the individualized written plan of care for the patient reflect the patient and family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. Upon review of HV#3 the patient was ordered spiritual care one time a month yet there were no spiritual goals and interventions established to guide the patient's care. On review of RR#4, and RR#5 the patients were diabetic with blood glucose monitoring yet the issues were not reflected the patient's care plans with no goals and interventions established to guide care. This observation was reviewed with the Administrator, and Administrator Designee.

Observed in Record Review. In the record where aide services were provided, the organization failed to ensure the care and services were provided in accordance with the plan of care. For example: in review of RR#5 the hospice aide plan of care noted to provide assist with bath/chair yet the aide provided tub/shower each visit. There was oral care assigned however the task was not completed during the visit per documentation. Further, the aide assisted with ambulation on each visit yet this task was not assigned on the plan of care. These observations were reviewed with the Administrator.

Observed in Record Review. In 2 of 5 patient records reviewed, the organization failed to ensure the patient record contains information that reflected the patient's care, treatment, and services. For example: upon review of the record for HV#3 the patient had a documented fast score of 7c however the patient did not have a history of Alzheimers, and was conversational during the home observation and documented in the record as being able to communicate verbally. Discrepancy in Fast score with no history of Alzheimers can also be seen in RR#4. Example 2: In review of RR#4 the SN initial assessment noted the patient was taking lantus SQ however the medication profile noted the diabetic medication was Metformin. These observations were reviewed with the Administrator and the Administrator Designee.