Every finding on record at Central Hospice, Inc.

Observed in Individual Tracer. In 1 of 1 patient records reviewed, the hospice did not follow its revocation policy/process. DC#3 elected to be sent to the hospital for further 'diagnostics' related to chest pain. A revocation consent was not given or obtained from the patient. This observation was discussed with the director.

Observed in Individual Tracer. In 2 of 7 patient records reviewed, the hospice did not assess the patient at least every 15 days. Based on a review of HV#2, the hospice conducted an IDG in excess of 15 days. RR#5 developed constipation and a laxative was ordered. The comprehensive assessment immediately following the new medication was not updated related to the effectiveness of the laxative. These observations were discussed with the director.

Observed in Individual Tracer. In 2 of 11 patient records reviewed, the hospice did not update the interdisciplinary care plan with pertinent interventions/services. HV#2 had a hospice aide which was discontinued after approximately 1 month. The IDG prior to and immediately following the change in services did not address the discontinuation of the aide services. RR#4 comprehensive care plan did not have the visit frequency for the SN/MSW or Chaplain. These observations were discussed with the director who indicated that she was not sure why the visit frequencies were not on the comprehensive care plan. This organization was utilizing an electronic medical record.

Observed in Individual Tracer. In 2 of 11 patient records reviewed, the hospice did not obtain objective data to support the terminal diagnosis. A review of HV#1 and RR#3 records revealed that there was no history or physical/lab work and or scans obtained from the attending doctor that supported the terminal diagnosis of these patients. These observations were discussed with the director.

Observed in Individual Tracer. In 1 of 1 patient records reviewed, the hospice did not provide a copy of the discharge/transfer summary to the receiving Medicare/Medicaid facility. DC#3 was transferred to the hospital and the discharge/transfer summary was not sent to the hospital. This observation was discussed with the director.

Observed in Tracer Activities. In 1 of 3 contracts reviewed, the hospice did not ensure that the contract(s) had required language. The contract for the durable medical equipment vendor did not stipulate that the supplier would be responsible for the criminal background checks. This observation was discussed with the alternate DON.