Deficiency Index

Every finding on record at Ava Hospice Corp

Arcadia, California · CCN B31518

2 findings across 1 survey, in the inspector's own words.

The inspector’s own words from form CMS-2567, unedited, including CMS’s own spacing. Names and some dates are redacted by CMS.

Survey of September 27, 2024

2 findings
L0555

Upon patient record review, 3 of 14 (Patient #5,8,9) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #5: POC date 7/24/24 orders RN 1q2weeks RN visited 8/1, 8/27, 9/4, 9/24. Frequency not followed. No missed visits documented Patient #8: 6/19/24 RN note completely empty except for vital signs, did not document care delivered. Patient #9: MSW ordered 1 q cert for entire time on service. Visits documented on 12/10/23 then not again until 9/9/24. Frequency not followed. No missed visit documented nor order to correct frequency.

L0679

Upon patient record review, 2 of 14 (Patient #4,14) 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 #4: Consent form is blank for proposed disciplines as well as financial responsibility Patient #14: Consent form is blank for proposed disciplines, payor source/financial responsibility, Oxygen teaching sheet is signed but not completed on what was taught.

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Federal survey findings only. State licensure findings for hospices are not shown.

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