Every finding on record at Arcy Hospice LLC

Based on record review and interviews, the agency failed to include in the plan of care a detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs for 8 (#2, #3, #4, #5, #7, #9, #11, & #13) of 14 active patients reviewed. The failure placed patients and family members at risk of not receiving necessary services to meet specific needs. --- Findings: Record review of patient #2s record revealed an informed consent signed 10/11/2022. Physician orders dated 10/12/2022 state to admit the patient to hospice. The initial admission orders do not contain visit scope and frequencies. Record review of patient #3s record revealed an informed consent signed 10/19/2023. Physician orders dated 10/19/2023 state to admit the patient to hospice. The initial admission orders do not contain visit scope and frequencies. Record review of patient #4s record revealed an informed consent signed 2/2/2024. Physician orders dated 2/2/2024 state to admit the patient to hospice. The initial admission orders do not contain visit scope and frequencies. Record review of patient #5s record revealed an informed consents signed 11/29/2023. Physician orders dated 11/29/2023 state to readmit the patient to hospice. The initial admission orders do not contain visit scope and frequencies. Record review of patient #7s record revealed an informed consents signed 12/21/2023. Physician orders dated 12/21/2023 state to admit the patient to hospice. The initial admission orders do not contain visit scope and frequencies. Record review of patient #9s record revealed an informed consents signed 12/28/2023 to begin hospice 1/5/2024. Physician orders dated 1/5/2024 state to admit the patient to hospice. The initial admission orders do not contain visit scope and frequencies. Record review of patient #11s record revealed physician orders dated 2/4/2024 to readmit the patient to hospice. The initial admission orders do not contain visit scope and frequencies. Record review of patient #13s record revealed physician orders dated 4/5/2024 to admit the patient to hospice. The initial admission orders do not contain visit scope and frequencies. An interview 4/18/2024 at 3:19 p.m. with the Administrator, AADM, and the Alternate Supervising Nurse was started to review record findings. The AADM stated, ";the way the system [EMR] is set up everything is put in under different windows and I think everyone considers it part of the initial order (POC), but its not seen on the order (POC)." In an interview 4/19/2024 at 12:50 p.m. with the AADM and ASN the AADM stated, ";we use the doctor order for the IPOC. [EMR] has popup windows that address the different aspects like frequencies. However, the different screens dont populate on the actual order, but it would if we printed the POC. So, no at this time, not all actual visual physician initial orders contain all needed elements." The agency had a policy (PC.30) titled, ";Plan of Care Process" dated 1/26/2024. The policy read in parts; ";...Purpose: To ensure that the care provided is in accordance with the written Plan of Care (POC), appropriately planned, and delivered in a timely manner to meet the patients and familys specific needs. Policy: ...II. The Hospice will develop an individualized written POC for each patient. ...The POC will include all services necessary for the palliation and management of the terminal illness and related conditions. Procedure: I. Information will be gathered from the initial assessment and be used by the Hospice to develop the Initial Plan of Care (IPOC)/ Physicians Orders and to provide care and services to treat a patients and patients familys immediate care and support needs. ...II. The IPOC will be developed and established by the Hospice RN, the Hospice Physician or the Hospice Medical Director, the patient, the patients caregiver, and the patients chosen attending physician (if any) after the initial assessment and prior to delivering care. ...VI. The POC includes, but is not limited to: ...B. A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs, including level of care..."