Every finding on record at Bristol Hospice - Chicago, L.L.C.

It is required that a hospice aide provides services ordered by the Interdisciplinary Group, included in the plan of care, permitted to be performed under state law and regulation, [and] consistent with the hospice aide training. This standard was not met as evidenced by clinical record review and interview. In 3 of 10 (30%) clinical records reviewed, the hospice did not ensure that the hospice aide provided patient care as ordered by the interdisciplinary group on the aide plan of care. Clinical Record 3: The patient was admitted to hospice services on 6/23/2023. The aide plan of care assigned the aide the task: bath Tuesday and Fridays of every week. The aide visit note dated Wednesday, 6/28/2023, documented a bath was completed. There was no evidence of changes to the aide plan of care documented by the interdisciplinary group. Clinical Record 8: The patient was admitted to hospice services on 6/16/2023. The aide plan of care assigned the aide the tasks: shower every Tuesday, change linen, and trim nails every Monday. The aide visit note dated Friday, 6/23/2023, documented the tasks as completed: shower, change linen, and trim nails. There was no evidence of changes to the aide plan of care documented by the interdisciplinary group. Clinical Record 9: The patient was admitted to hospice services on 5/21/2023. The aide plan of care assigned the aide the task: shave and shampoo hair every Friday. The aide visit note dated Monday, 5/22/2023, documented the tasks as completed: shave and shampoo hair. There was no evidence of changes to the aide plan of care documented by the interdisciplinary group. The Regional Director of Quality and Executive Director confirmed the findings during the interview and joint record reviews.

It is required that a patient clinical record containing past and current findings is maintained for each hospice patient. The record contains correct clinical information that is available to the patient’s attending physician and hospice staff. The record may be maintained electronically or on paper. Each patient’s record includes, at a minimum, responses to medications, symptom management, treatments, and services. This standard was not met as evidenced by clinical record review and interview. In 3 of 8 (30%) clinical records reviewed of patients that received hospice aide services, the hospice did not ensure that the patient's record included accurate and timely responses to hospice aide services. Clinical Record 2: The patient was admitted to hospice services on 6/21/2023. The plan of care ordered hospice aide visits "5xwk/13wk." The Registered Nurse (RN) documented an aide supervisory visit as completed on 6/22/2023, however, the initial hospice aide visit was not made until 6/26/2023. Clinical Record 6: The patient was admitted to hospice service on 6/16/2023. The plan of care ordered hospice aide visits "5xwk/13wks." The RN documented an aide supervisory visit as completed on 6/17/2023, however, the initial hospice aide visit was not made until 6/20/2023. Clinical Record 8: The patient was admitted to hospice services on 6/16/2023. The plan of care ordered hospice aide visits "5xwk/13wks." The RN documented an aide supervisory visit as completed on 6/17/2023, however, the initial hospice aide visit was not made until 6/19/2023. During an interview and a joint review of the records, the Executive Director confirmed that all three clinical records documented that the feedback from the patient was positive, the plan of care was being followed and the aide was performing all tasks. However, there was no aide visit made prior to the initial supervisory visit for the patient or family to report on. In an interview with the Executive Director, it was found that the RN was documenting aide supervisory visit before the aide visit was actually made. On all three clinical records it was documented that the feedback from the patient was positive, the plan of care was being followed and the aide was performing all tasks. However, there was no aide visit made prior to initial supervisory visit for the patient or family to report on.