Every finding on record at Bosque Trails Hospice LLC

It is required that counseling services include an organized program for providing bereavement services delivered by or under the supervision of a qualified professional with experience or education in grief or loss counseling. The bereavement services reflect the needs of the bereaved per a bereavement plan of care that includes the types of bereavement services to be offered and the frequency of service delivery. This standard was not met as evidenced by clinical record review and interview. In 2 of 3 (67%) clinical records reviewed with patient discharge due to death, the agency did not ensure development of a bereavement plan of care that included the types of bereavement services to be offered and the frequency of service delivery. CLINICAL RECORD 16: The patient elected the hospice benefit on 02/24/2025 and died on 04/29/2025. Clinical record review revealed no documented evidence of a bereavement plan of care. The clinical record included documentation that bereavement services were offered, however there was no bereavement plan of care that specified the types of bereavement services to be offered and the frequency of service delivery. CLINICAL RECORD 17: The patient elected the hospice benefit on 06/20/2025 and died on 07/06/2025. Clinical record review revealed no documented evidence of a bereavement plan of care. The clinical record included documentation that bereavement services were offered, however there was no bereavement plan of care that specified the types of bereavement services to be offered and the frequency of service delivery. During an interview on 12/18/2025, the Bereavement Coordinator (Personnel Record 8) stated that bereavement services are tracked in an Excel spreadsheet and that when the tasks are completed, the documentation is entered in the clinical record. When asked about the bereavement plan of care, he stated that he is new to the electronic medical record system and will contact the vendor for more education.

It is required that hospice aides are assigned to a specific patient by a registered nurse who is a member of the Interdisciplinary Group. Written patient care instructions for a hospice aide are prepared by a RN who is responsible for the supervision of the hospice aide. This standard was not met as evidenced by clinical record review and interview. In 3 of 19 (16%) clinical records reviewed, the agency did not ensure the registered nurse prepared patient specific written care instructions for the hospice aide. CLINICAL RECORD 1: The patient elected the hospice benefit on 05/29/2025. Clinical record review revealed the aide plan of care dated 11/16/2025 did not include instructions to the aide regarding care of the patient’s wounds and wound dressings to the right heel, left great toe, and buttocks while providing care to the patient. CLINICAL RECORD 3: The patient elected the hospice benefit on 06/13/2024. Clinical record review revealed the aide plan of care dated 12/03/2025 did not include instructions to the aide regarding the patient’s use of Oxygen, and if the Oxygen could be removed during the bath. CLINICAL RECORD 8: The patient elected the hospice benefit on 08/29/2025. Clinical record review revealed the aide plan of care dated 11/18/2025 did not include instructions to the aide regarding the patient’s use of Oxygen, and if the Oxygen could be removed during the bath. During an interview on 12/18/2025, the Director of Clinical Services (Personnel Record 6) stated that they are currently providing education to staff on plans of care and will include education on the aide's plans of care.