Every finding on record at Bayada Home Health Care, Inc

It is required that the hospice Interdisciplinary Group, in consultation with the individual's attending physician (if any), completes an initial comprehensive assessment no later than five (5) calendar days after the election of hospice care, in accordance with CMS §418.24–the elements of the hospice care election statement. This standard was not met as evidenced by clinical record reviews and interviews. In 3 of 14 (21%) clinical records reviewed, the agency did not ensure the hospice Interdisciplinary Group (IDG) completed an initial comprehensive assessment no later than five (5) calendar days after the patient's election of hospice care. Clinical Record 5: The patient elected hospice care on 2/8/2023. The social worker completed the psychosocial initial comprehensive assessment visit on 2/17/2023, nine (9) days outstanding. The documentation stated, "Evaluation not scheduled at time of admission." A clinical record review revealed no reason documented for the late assessment. During a joint clinical review and interview, the Clinical Director confirmed that the social work initial assessment was completed late. Clinical Record 6: The patient elected hospice care on 7/24/2023. The social worker completed the psychosocial initial comprehensive assessment visit on 8/3/2023, with ten (10) days outstanding. A clinical record review revealed no reason documented for the late assessment. During a joint clinical review and interview, the Clinical Director confirmed that the social work initial assessment was completed late. Clinical Record 10: The patient elected hospice care on 7/14/2023. A clinical record review revealed no evidence that the psychosocial and spiritual initial comprehensive assessments were completed. During a joint clinical review and interview, the Clinical Director confirmed no social work or chaplain visits were made. Upon further investigation, there was no evidence that the patient or family declined the services.

It is required that the comprehensive assessment includes an initial bereavement assessment of the needs of the patient's family and other individuals, focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient's death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and considered in the bereavement plan of care. This standard was not met as evidenced by clinical record review and interview. In 2 of 14 (14%) clinical records reviewed, the agency did not ensure the comprehensive assessment included an initial bereavement assessment. Clinical Record 4: The patient elected hospice care on 1/25/2023. A review of the clinical record revealed no evidence an initial bereavement assessment was completed. During a joint clinical record review and interview, the Clinical Director confirmed that the agency did not complete an initial bereavement assessment. Clinical Record 10: The patient elected hospice care on 7/14/2023. A review of the clinical record revealed no evidence an initial bereavement assessment was completed. During a joint clinical record review and interview, the Clinical Director confirmed that the agency did not complete an initial bereavement assessment.

It is required that a hospice aide provides services: ordered by the Interdisciplinary Group. This standard was not met as evidenced by clinical record review and interview. In 1 of 10 (10%) clinical records reviewed of patients that received hospice aide services, the agency did not ensure that the aide provided services ordered by the interdisciplinary group. Clinical Record 3: The patient elected hospice care on 4/5/2023 with a diagnosis of Unspecified Severe Protein-Calorie malnutrition. The hospice aide plan of care completed by the Registered Nurse (RN) assigned the hospice aide: weight checks once a week. The hospice aide documented the weight checks were completed for the visits dated 7/19/2023, 7/21/2023, 7/25/2023, 7/27/2023, 8/1/2023, 8/3/2023 but did not document the patient's weight. During a joint record review, the Director of Clinical agreed that the hospice aide was not compliant with the aide plan of care.