Every finding on record at Arizona Professional Healthcare LLC

Upon observation, there was no evidence the Emergency Plan communication plan must includes a primary and alternate means for communicating with hospice's employees and Federal, state, tribal, regional, and local emergency management agencies. The hospice's 2024 Emergency Communication Plan did not contain evidence of an alternate means of communicating with federal, state, tribal, regional, and local emergency management agencies.

Upon patient record review, 14 of 14 (Patients # 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14) did not have evidence the plan of care must includes all services necessary for the palliation and management of the terminal illness and related conditions, including the following: • A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs • The IDG demonstrates a proactive approach in developing each patient's plan of care by planning ahead for anticipated patient changes and needs. Decisions should reflect the patient/family preferences rather than be solely a response to a crisis. Patients # 1, 3, 7, 10, 13: The plan of care contained PRN visit orders for the Nurse, MSW, NP, and MD. These orders did not contain a scope for the visits. Patients # 2, 4, 6, 11, 12: The plan of care contained PRN visit orders for the Nurse, NP, and MD. These orders did not contain a scope for the visits. Patients # 5, 9: The plan of care contained PRN visit orders for the Nurse, MSW, Chaplain, NP, and MD. These orders did not contain a scope for the visits Patients # 8, 14: The plan of care contained PRN visit orders for the Nurse, Chaplain, NP, and MD. These orders did not contain a scope for the visits.

Upon patient record review, 1 of 14 (Patient # 14) did not have evidence the hospice offers bereavement counseling that includes: • Making bereavement services available to the family and other individuals in the bereavement plan of care up to 1 year following the death of the patient. Bereavement counseling also extends to residents of a SNF/NF or ICF/IID when appropriate and identified in the bereavement plan of care • Ensuring that bereavement services reflect the needs of the bereaved • Development of a bereavement plan of care that notes the kind of bereavement services to be offered and the frequency of service delivery Patient # 14: The patient's medical record did not contain evidence of a bereavement plan of care following the death of the patient.

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: The hospice aide documented a missed visit for 4/16/25. There was no evidence the missed visit was reported/communicated to the RN, and the reason for the missed visit was not documented. The visit was not rescheduled for later in the week and the frequencies where two times per week. The patient received one visit during the week of 4/16/25.

Upon client record review, 5 of 5 (Patient #1, #2, #3, #4, and #5) did not have evidence that the plan of care included IDG's documentation of the patient's or families level of understanding, involvement and agreement with the plan of care.

Upon patient record review, 1 of 5 (Patient #3) did not have evidence in the patient record that a Registered Nurse had written an aide plan of care that specifically indicated the tasks to be done by an aide. Patient #3 The patient had a history of falls and was a high fall risk, no evidence of fall risk on aide care plan. The aide care plan included bath and did not include the type of bath such as bed bath or shower, included nail care but did not check clean or file, included transfer patient as 1 person assist, 2 person assist and standby assist.

Upon personnel record review, 14 of 14 applicable (Personnel #1,#2, #3, #4, #5, #6, #7, #8, #9, #12, #13, #14 and #15) did not have evidence the hospice employees and contract employees had received orientation on the hospice philosophy when they were hired.